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Sample records for bloqueio neuromuscular produzido

  1. Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia

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    Angélica de Fátima de Assunção Braga

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos farmacodinâmicos dos bloqueadores neuromusculares (BNM podem ser influenciados por diferentes drogas, entre elas os hipnóticos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram incluídos 60 pacientes, ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: GI (propofol e GII (etomidato. As pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, a indução foi com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de fentanil (250 µg e seguido de cisatracúrio (0,1 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% até a obtenção de redução de 95% ou mais na amplitude da resposta do adutor do polegar, quando foi feita a laringoscopia e a intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Avaliaram-se o início de ação do cisatracúrio, as condições de intubação traqueal e as repercussões hemodinâmicas. RESULTADOS: Os tempos médios e os desvios padrão para o início de ação do cisatracúrio foram: GI (86,6 ± 14,3" e GII (116,9 ± 11,6", com diferença significativa (p < 0,0001. As condições de intubação traqueal foram aceitáveis em 100% dos pacientes do GI e em 53,3% no GII (p < 0,0001. CONCLUSÕES: A instalação do bloqueio neuromuscular com o cisatracúrio foi mais rápida e as condições de intubação traqueal foram melhores nos pacientes que receberam propofol em relação ao grupo que recebeu etomidato, sem repercussões hemodinâmicas.

  2. Phenobarbital influence on neuromuscular block produced by rocuronium in rats Influência do fenobarbital no bloqueio neuromuscular produzido pelo rocurônio em ratos

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    Angélica de Fátima de Assunção Braga

    2008-08-01

    Full Text Available PURPOSE: To evaluate in vitro and in vivo neuromuscular blockade produced by rocuronium in rats treated with Phenobarbital and to determine cytochrome P450 and cytochrome b5 concentrations in hepatic microsomes. METHODS: Thirty rats were included in the study and distributed into 6 groups of 5 animals each. Rats were treated for seven days with phenobarbital (20 mg/kg and the following parameters were evaluated: 1 the amplitude of muscle response in the preparation of rats exposed to phenobarbital; 2 rocuronium effect on rat preparation exposed or not to phenobarbital; 3 concentrations of cytochrome P450 and cytochrome b5 in hepatic microsomes isolated from rats exposed or not to phenobarbital. The concentration and dose of rocuronium used in vitro and in vivo experiments were 4 µg/mL and 0,6 mg/kg, respectively. RESULTS: Phenobarbital in vitro and in vivo did not alter the amplitude of muscle response. The neuromuscular blockade in vitro produced by rocuronium was significantly different (p=0.019 between exposed (20% and not exposed (60% rats; the blockade in vivo was significantly greater (p=0.0081 in treated rats (93.4%. The enzymatic concentrations were significantly greater in rats exposed to phenobarbital. CONCLUSIONS: Phenobarbital alone did not compromise neuromuscular transmission. It produced enzymatic induction, and neuromuscular blockade in vivo produced by rocuronium was potentiated by phenobarbital.OBJETIVO: Avaliar in vitro e in vivo o bloqueio neuromuscular produzido pelo rocurônio em ratos tratados com fenobarbital e determinar as concentrações de citocromo P450 e b5 em microssomos hepáticos. MÉTODOS: Trinta ratos foram incluídos no estudo e distribuídos em seis grupos de cinco animais cada. Ratos foram tratados por sete dias com fenobarbital (20 mg/kg e avaliou-se: 1 amplitude das respostas musculares em preparação de ratos expostos ao fenobarbital; 2 o efeito do rocurônio em preparações de ratos expostos ou n

  3. Influência do propofol e do etomidato no bloqueio neuromuscular produzido pelo rocurônio: avaliação pela aceleromiografia

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    Munhoz Derli Conceição

    2002-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Alguns hipnóticos podem interagir com os bloqueadores neuromusculares (BNM potencializando seus efeitos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo rocurônio. MÉTODO: Foram incluídos no estudo 60 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: Grupo I (propofol e Grupo II (etomidato. Todos os pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, 30 minutos antes da cirurgia. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de alfentanil (50 µg.kg-1 e seguido de rocurônio (0,6 mg.kg-1. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de ação do rocurônio (T1 <= 25%; tempo para instalação do bloqueio neuromuscular total; grau de bloqueio neuromuscular no momento da intubação traqueal; condições de intubação traqueal e repercussões hemodinâmicas. RESULTADOS: Os tempos de início de ação e instalação de bloqueio neuromuscular total (segundos produzido pelo rocurônio foram: Grupo I (48,20 ± 10,85 s e 58,87 ± 10,73 s e Grupo II (51,20 ± 13,80 s e 64,27 ± 18,55 s. O grau de bloqueio neuromuscular no momento da intubação traqueal foi: Grupo I (77,50% e Grupo II (76,96%. As condições de intubação traqueal foram satisfatórias em 100% dos pacientes do Grupo I e em 83,33% no Grupo II. Nos dois grupos, após a injeção do hipnótico, observou-se diminuição significativa da pressão arterial média seguida de eleva

  4. Phenobarbital influence on neuromuscular block produced by rocuronium in rats Influência do fenobarbital no bloqueio neuromuscular produzido pelo rocurônio em ratos

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    Angélica de Fátima de Assunção Braga; Caroline Coutinho de Barcelos; Franklin Sarmento da Silva Braga; Samanta Cristina Antoniassi Fernandes; Yoko Oshima Franco; Mario Mantovani; Léa Rodrigues Simioni

    2008-01-01

    PURPOSE: To evaluate in vitro and in vivo neuromuscular blockade produced by rocuronium in rats treated with Phenobarbital and to determine cytochrome P450 and cytochrome b5 concentrations in hepatic microsomes. METHODS: Thirty rats were included in the study and distributed into 6 groups of 5 animals each. Rats were treated for seven days with phenobarbital (20 mg/kg) and the following parameters were evaluated: 1) the amplitude of muscle response in the preparation of rats exposed to phenob...

  5. Influência do sevoflurano e do isoflurano na recuperação do bloqueio neuromuscular produzido pelo cisatracúrio Influencia del sevoflurano y del isoflurano en la recuperación del bloqueo neuromuscular producido por el cisatracúrio The influence of sevoflurane and isoflurane on the recovery from cisatracurium-induced neuromuscular block

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    Angélica de Fátima de Assunção Braga

    2002-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos dos agentes bloqueadores neuromusculares sobre a junção neuromuscular são aumentados pelos anestésicos voláteis. O objetivo deste estudo foi avaliar a influência do sevoflurano e do isoflurano na recuperação do bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram estudados 90 pacientes, estado físico ASA I e II, submetidos à cirurgias eletivas sob anestesia geral, distribuídos em três grupos: Grupo I (sevoflurano, Grupo II (isoflurano e Grupo III (propofol. Todos os pacientes receberam como medicação pré-anestésica, midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da cirurgia. A indução anestésica foi obtida com alfentanil (50 µg.kg-1, propofol (2,5 mg.kg-1 e cisatracúrio (0,15 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% sob máscara até o desaparecimento das quatro respostas a SQE, quando foram realizadas as manobras de laringoscopia e intubação traqueal. Os agente voláteis para a manutenção da anestesia foram introduzidos logo após a intubação traqueal e empregados nas concentrações de 2% e 1%, respectivamente para o sevoflurano e isoflurano, e o propofol em infusão contínua (7 a 10 mg.kg-1.h-1. Em todos os pacientes empregou-se a mistura de oxigênio e óxido nitroso a 50%. A função neuromuscular foi monitorizada por aceleromiografia do músculo adutor do polegar, empregando-se a SQE a cada 15 segundos. Foram avaliados: a duração clínica do bloqueio neuromuscular (T1(25% e o índice de recuperação (IR= T1(25-75%. RESULTADOS: Os tempos médios e desvios padrão para a duração clínica (T1(25% e índice de recuperação (IR = T1(25-75% foram respectivamente: Grupo I (66,2 ± 13,42 min e 23,6 ± 5,02 min, Grupo II (54,4 ± 6,58 min e 14,9 ± 3,82 min e Grupo III (47,2 ± 7,43 min e 16,2 ± 2,93 min. Em relação à duração clínica houve diferença significante entre os grupos I e II, I e III, e II e III. Para o índice de

  6. The influence of lidocaine and racemic bupivacaine on neuromuscular blockade produced by rocuronium: a study in rat phrenic nerve-diaphragm preparation Influência da lidocaína e da bupivacaína racêmica no bloqueio neuromuscular produzido pelo rocurônio: estudo em preparação nervo frênico-diafragma de rato

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    Vanessa Henriques Carvalho

    2009-06-01

    Full Text Available PURPOSE: To evaluate in vitro lidocaine and racemic bupivacaine effects in neuromuscular transmission and in neuromuscular blockade produced by rocuronium. METHODS: Rats were distributed in 5 groups (n = 5 in agreement with the studied drugs: lidocaine, racemic bupivacaine, rocuronium, separately (Groups I, II, III; rocuronium in preparations exposed to local anesthetics (Groups IV, V. The concentrations used were: 20 µg/mL, 5 µg/mL and 4 µg/mL, for lidocaine, bupivacaine and rocuronium, respectively. It was evaluated: 1 amplitude of diaphragm muscle response to indirect stimulation, before and 60 minutes after separately addition of lidocaine, racemic bupivacaine and rocuronium and the association of local anesthetics - rocuronium; 2 membrane potentials (MP and miniature end-plate potentials (MEPP. RESULTS: Lidocaine and bupivacaine separately didn't alter the amplitude of muscle response and MP. In preparations previously exposed to lidocaine and racemic bupivacaine, the rocuronium blockade was significantly larger (90.10 ± 9.15% and 100%, respectively, in relation to the produced by rocuronium separately (73.12 ± 9.89%. Lidocaine caused an increase in the frequency of MEPP, being followed by blockade; racemic bupivacaine produced decrease being followed by blockade. CONCLUSIONS: Local anesthetics potentiated the blockade caused by rocuronium. The alterations of MEPP identify presynaptic action.OBJETIVO: Avaliar in vitro os efeitos da lidocaína e bupivacaína racêmica na transmissão neuromuscular e no bloqueio neuromuscular produzido pelo rocurônio. MÉTODOS: Ratos foram distribuídos em 5 grupos (n = 5 de acordo com a droga estudada: lidocaina, bupivacaína racêmica, rocurônio, isoladamente (Grupos I, II, III; rocurõnio em preparações expostas aos anestésicos locais (Grupos IV, V. As concentrações utilizadas foram: 20 µg/mL, 5 µg/mL e 4 µg/mL, para lidocaína, bupivacaína e rocurônio, respectivamente. Avaliou-se: 1

  7. Influência dos Hipnóticos no bloqueio neuromuscular produzido pelo cisatracúrio: emprego da aceleromiografia Influencia de los hipnóticos en el bloqueo neuromuscular producido por el cisatracurio: uso de la aceleromiografía Influence of hypnotics on cisatracurium-induced neuromuscular block: use of acceleromyograhpy

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    Angélica de Fátima de Assunção Braga

    2013-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos farmacodinâmicos dos bloqueadores neuromusculares (BNM podem ser influenciados por diferentes drogas, entre elas os hipnóticos. O objetivo deste estudo foi avaliar a influência do propofol e do etomidato sobre o bloqueio neuromuscular produzido pelo cisatracúrio. MÉTODO: Foram incluídos 60 pacientes, ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos de acordo com o hipnótico empregado: GI (propofol e GII (etomidato. As pacientes receberam midazolam (0,1 mg.kg-1 por via muscular como medicação pré-anestésica, a indução foi com propofol (2,5 mg.kg-1 ou etomidato (0,3 mg.kg-1 precedido de fentanil (250 µg e seguido de cisatracúrio (0,1 mg.kg-1. Os pacientes foram ventilados com oxigênio a 100% até a obtenção de redução de 95% ou mais na amplitude da resposta do adutor do polegar, quando foi feita a laringoscopia e a intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Avaliaram-se o início de ação do cisatracúrio, as condições de intubação traqueal e as repercussões hemodinâmicas. RESULTADOS: Os tempos médios e os desvios padrão para o início de ação do cisatracúrio foram: GI (86,6 ± 14,3" e GII (116,9 ± 11,6", com diferença significativa (p JUSTIFICATIVA Y OBJETIVOS: Los efectos farmacodinámicos de los bloqueantes neuromusculares (BNM pueden estar influenciados por diferentes fármacos, entre ellos los hipnóticos. El objetivo de este estudio, fue evaluar la influencia del propofol y del etomidato sobre el bloqueo neuromuscular producido por el cisatracurio. MÉTODO: Se incluyeron en el estudio 60 pacientes, con ASA I y II, sometidos a cirugías electivas bajo anestesia general, distribuidos aleatoriamente en dos grupos de acuerdo con el hipnótico usado: GI (propofol y GII (etomidato. Las pacientes recibieron midazolam (0,1 mg.kg-1 por vía muscular como medicación preanest

  8. Influência da lidocaína no bloqueio neuromuscular produzido pelo rocurônio: estudo em preparação nervo frênico-diafragma de rato Influencia de la lidocaína en el bloqueo neuromuscular producido por el rocuronio: estudio en preparación nervio frénico-diafragma de ratón Influence of lidocaine on the neuromuscular block produced by rocuronium: study in rat phrenic-diaphragmatic nerve preparation

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    Yolanda Christina S. Loyola

    2006-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O mecanismo de ação dos anestésicos locais (AL na junção neuromuscular motivou a realização de vários estudos. Em baixas doses eles não interferem na transmissão neuromuscular, mas em altas doses podem comprometer a transmissão neuromuscular e potencializar os efeitos de bloqueadores neuromusculares. O objetivo do estudo foi avaliar, em diafragma de rato, a interação da lidocaína com o rocurônio através da influência no grau de bloqueio neuromuscular. MÉTODO: Foram utilizados ratos, com peso entre 250 e 300 g. A preparação foi feita de acordo com a técnica descrita por Bulbring. Formaram-se grupos (n = 5 de acordo com a droga em estudo: lidocaína - 20 µg.mL-1 (Grupo I; rocurônio - 4 µg.mL-1 (Grupo II e rocurônio - 4 µg.mL-1 com lidocaína - 20 µg.mL-1 (Grupo III. Foram avaliadas: 1 a amplitude das respostas do músculo diafragma à estimulação indireta, antes e 60 minutos após a adição da lidocaína e do bloqueador neuromuscular; 2 os potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM; 3 a eficácia da neostigmina e 4-aminopiridina na reversão do bloqueio neuromuscular. RESULTADOS: A lidocaína isoladamente não alterou a amplitude das respostas musculares. Com o uso prévio de lidocaína o bloqueio neuromuscular do rocurônio foi de 82,8% ± 1,91%, com diferença significativa (p = 0,0079 em relação ao grupo com rocurônio isolado (57,8% ± 1,9%. O bloqueio foi parcial e totalmente revertido pela neostigmina e 4-aminopiridina, respectivamente. A lidocaína não alterou o potencial de membrana e ocasionou aumento inicial na freqüência dos PPTM, seguido de bloqueio. CONCLUSÕES: A lidocaína potencializou o bloqueio neuromuscular produzido pelo rocurônio. As alterações do PPTM identificam ação pré-sináptica. O antagonismo completo da 4-aminopiridina sugere componente pré-sináptico, idéia que é suportada pelo antagonismo parcial pela neostigmina

  9. Influência da procainamida sobre o bloqueio neuromuscular produzido pelo rocurônio e investigação sobre o mecanismo de ação da procainamida na junção neuromuscular Influencia de la procainamida sobre el bloqueo neuromuscular producido por el rocuronio e investigación sobre el mecanismo de acción de la procainamida en la junción neuromuscular Influence of procainamide on the neuromuscular blockade caused by rocuronium and investigation on the mechanism of action of procainamide on the neuromuscular junction

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    Thalita Duque Martins

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A potencialização da procainamida sobre o bloqueio neuromuscular produzido pela d-tubocurarina já está comprovada, porém o mecanismo é controverso. O objetivo do estudo foi avaliar a influência da procainamida no bloqueio neuromuscular produzido pelo rocurônio e investigar os mecanismos desta interação. MÉTODO: Foram utilizados 15 ratos (250 a 300 g em preparação descrita por Bülbring. Formaram-se os seguintes grupos (n = 5 cada: procainamida - 20 µg.mL-1 (Grupo I; rocurônio - 4 µg.mL-1 (Grupo II e rocurônio - 4 µg.mL-1 e procainamida - 20 µg.mL-1 (Grupo III. Avaliaram-se: 1 a amplitude das contrações musculares sob estimulação indireta em cada grupo, antes e após a adição dos fármacos; 2 os potenciais de placa terminal em miniatura (PPTM; 3 a eficácia da 4-aminopiridina na reversão do bloqueio neuromuscular. O mecanismo da interação foi estudado em Biventer cervicis (n = 5 e diafragma de rato desnervado (n = 5, observando-se a influência da procainamida na resposta à acetilcolina antes e após a adição da procainamida. RESULTADOS: A procainamida isoladamente não alterou as respostas neuromusculares. O bloqueio produzido com o Grupo III foi de 68,6% ± 7,1%, com diferença significativa (p = 0,0067 em relação ao Grupo II (10,4% ± 4,5%, revertido pela 4-aminopiridina. A procainamida ocasionou aumento na freqüência dos PPTM, seguido de bloqueio revertido pela 4-aminopiridina. Em Biventer cervicis a procainamida aumentou a resposta à ação de contração da acetilcolina, resultado não observado com o diafragma desnervado. CONCLUSÕES: A procainamida potencializou o bloqueio produzido pelo rocurônio. As alterações observadas com PPTM e Biventer cervicis identificaram ação pré-sináptica. O antagonismo da 4-aminopiridina sobre o bloqueio dos PPTM sugeriu dessensibilização dos receptores pela procainamida.JUSTIFICATIVA Y OBJETIVOS: La potenciación de la procainamida sobre

  10. Influência do lítio no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia del litio en el bloqueo neuromuscular producido por el atracurio y por el cisatracurio: estudio en preparo nervio frénico-diafragma del ratón Influence of lithium on the neuromuscular blockade produced by atracurium and cisatracurium: study on rat phrenic nerve-diaphragm preparations

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    Samanta Cristina Antoniassi Fernandes

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O lítio, fármaco amplamente utilizado nos distúrbios bipolares, pode interagir com os bloqueadores neuromusculares. Os mecanismos para explicar os seus efeitos na transmissão neuromuscular e a interação com bloqueadores neuromusculares são controversos. O objetivo deste trabalho foi avaliar, em diafragma de rato, os efeitos do lítio sobre a resposta muscular à estimulação indireta e a possível interação com os bloqueadores neuromusculares. MÉTODO: Utilizaram-se ratos com peso entre 250g e 300g, sacrificados sob anestesia com uretana. A preparação nervo frênico-diafragma foi montada de acordo com a técnica descrita por Bulbring. O diafragma foi mantido sob tensão, ligado a um transdutor isométrico e submetido à estimulação indireta de 0,1 Hz de freqüência. As contrações do diafragma foram registradas em fisiógrafo. Da análise da amplitude das respostas musculares avaliaram-se: os efeitos dos fármacos: lítio (1,5 mg.mL-1; atracúrio (20 µg.mL-1 e cisatracúrio (3 µg.mL-1 empregados isoladamente; da associação lítio-bloqueadores neuromusculares; e do lítio no bloqueio neuromuscular produzido pelo atracúrio (35 µg.mL-1 e cisatracúrio (5 µg.mL-1. Os efeitos foram avaliados antes e 45 minutos após a adição dos fármacos. Também foram estudados os efeitos do lítio nos potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM. RESULTADOS: O lítio isoladamente não alterou a amplitude das respostas musculares, mas diminuiu significativamente o bloqueio neuromuscular produzido pelo atracúrio e cisatracúrio. Não alterou o PM e ocasionou aumento inicial da freqüência dos PPTM. CONCLUSÕES: O lítio empregado isoladamente não comprometeu a transmissão neuromuscular e aumentou a resistência ao efeito do atracúrio e cisatracúrio. Não mostrou ação sobre a fibra muscular, sendo que as alterações nos potenciais de placa terminal em miniatura evidenciaram a

  11. Influência da nifedipina no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato Influencia de la nifedipina en el bloqueo neuromuscular producido por atracurio y cisatracurio: estudio en preparación nervio frénico diafragma de ratón Influence of nifedipine on the neuromuscular block produced by atracurium and cistracurium: study in rat phrenic-diaphragmatic nerve preparation

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    Silmara Rodrigues de Sousa

    2006-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os bloqueadores de canais de cálcio podem interagir com bloqueadores neuromusculares potencializando seus efeitos. Os estudos sobre essa interação mostram resultados controversos. Em alguns estudos essas drogas produziram bloqueio neuromuscular, ou contratura, ou nenhum efeito sobre as respostas musculares esqueléticas foi evidenciado. O estudo avaliou, em diafragma de rato, os efeitos da nifedipina sobre a resposta muscular e sua possível interação com os bloqueadores neuromusculares. MÉTODO: Foram utilizados 25 ratos, com peso entre 250 e 300 g sacrificados sob anestesia com pentobarbital (40 mg.kg -1 por via intraperitonial. A preparação foi montada de acordo com a técnica descrita por Bulbring. O diafragma foi mantido sob tensão, ligado a um transdutor isométrico e submetido à estimulação indireta de 0,1 Hz de freqüência. As contrações do diafragma foram registradas em fisiógrafo. Para avaliação dos efeitos das drogas na transmissão neuromuscular, estas foram adicionadas isoladamente ou associadas à preparação, nas seguintes concentrações: nifedipina (4 µg.mL-1; atracúrio (20 µg.mL-1; cisatracúrio (3 µg.mL-1. Nas preparações nervo frênico-diafragma avaliaram-se: 1 a amplitude das respostas do músculo diafragma à estimulação indireta, antes e 45 minutos após a adição da nifedipina e dos bloqueadores neuromusculares isoladamente e após a associação das drogas; 2 os efeitos da nifedipina nos potenciais de membrana (PM e potenciais de placa terminal em miniatura (PPTM. RESULTADOS: A nifedipina empregada isoladamente não alterou a amplitude das respostas musculares, mas aumentou significativamente a atividade bloqueadora neuromuscular do atracúrio e do cisatracúrio. Não alterou o potencial de membrana e ocasionou aumento inicial na freqüência dos PPTM, seguido de bloqueio. CONCLUSÕES: A nifedipina na concentração empregada potencializou o bloqueio neuromuscular

  12. Influência da freqüência de estímulos na instalação do bloqueio neuromuscular produzido pelo rocurônio e pancurônio: avaliação pelo método acelerográfico Influencia de la frecuencia de estímulos en la instalación del bloqueo neuromuscular producido por el rocuronio y pancuronio: evaluación por el método acelerográfico Influence of stimulation frequency on rocuronium and pancuronium-induced neuromuscular block onset: acceleromyography evaluation

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    Derli da Conceição Munhóz

    2004-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Fatores relacionados ao paciente e ao bloqueador neuromuscular (BNM, assim como outros inerentes à monitorização da função neuromuscular podem influenciar na instalação do bloqueio neuromuscular. O objetivo deste estudo foi avaliar a influência de duas diferentes freqüências de estímulos sobre o tempo de instalação do bloqueio produzido pelo pancurônio e pelo rocurônio. MÉTODO: Foram incluídos no estudo 120 pacientes, estado físico ASA I e II, submetidos a cirurgias eletivas sob anestesia geral, distribuídos aleatoriamente em dois grupos, de acordo com a freqüência de estímulo empregada, para a monitorização do bloqueio neuromuscular: Grupo I - 0,1 Hz (n = 60 e Grupo II - 1 Hz (n = 60. Em cada grupo formaram-se dois subgrupos (n = 30 de acordo com o bloqueador neuromuscular empregado: Subgrupo P (pancurônio e Subgrupo R (rocurônio. A medicação pré-anestésica consistiu de midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da cirurgia. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 precedido de alfentanil (50 µg.kg-1 e seguido de pancurônio ou rocurônio. Os pacientes foram ventilados sob máscara com oxigênio a 100% até a obtenção de redução de 75% ou mais na amplitude da resposta do músculo adutor do polegar, quando foram realizadas as manobras de laringoscopia e intubação traqueal. A função neuromuscular foi monitorizada com aceleromiografia. Foram avaliados: tempo de início de ação do pancurônio e do rocurônio; tempo para instalação do bloqueio total e condições de intubação traqueal. RESULTADOS: Os tempos médios (segundos para o início de ação e instalação de bloqueio neuromuscular total produzido pelo pancurônio foram: Grupo I (159,33 ± 35,22 e 222 ± 46,56 e Grupo II (77,83 ± 9,52 e 105,96 ± 15,58; para o rocurônio: Grupo I (83 ± 17,25 e 125,33 ± 20,12 e Grupo II (48,96 ± 10,16 e 59,83 ± 10,36 com diferença significativa

  13. Influência de anestésicos locais sobre o bloqueio neuromuscular produzido pelo rocurônio: ação da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína na junção neuromuscular Influencia de anestésicos locales sobre el bloqueo neuromuscular producido por el rocuronio: acción de la lidocaína y de la mezcla enantiomérica en exceso de 50% de bupivacaína en la junción neuromuscular Influence of local anesthetics on the neuromuscular blockade produced by rocuronium: effects of lidocaine and 50% enantiomeric excess bupivacaine on the neuromuscular junction

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    Angélica de Fátima de Assunção Braga

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os efeitos dos anestésicos locais (AL na transmissão neuromuscular e sua influência no bloqueio neuromuscular produzido por bloqueadores neuromusculares competitivos são ainda alvo de pouca investigação. O objetivo do estudo foi avaliar in vitro os efeitos da lidocaína e da mistura enantiomérica em excesso de 50% de bupivacaína (S75-R25 no bloqueio neuromuscular produzido pelo rocurônio. MÉTODOS: Ratos foram distribuídos em cinco grupos (n = 5 de acordo com o fármaco estudado: lidocaína, bupivacaína (S75-R25, rocurônio, isoladamente (grupos I, II e III; rocurônio em preparações previamente expostas aos AL (grupos IV e V. As concentrações utilizadas foram: 20 µg.mL-1, 5 µg.mL-1 e 4 µg.mL¹ para lidocaína, bupivacaína (S75-R25 e rocurônio, respectivamente. Avaliaram-se: 1 a força de contração muscular do diafragma à estimulação elétrica indireta, antes e 60 minutos após a adição dos AL e do rocurônio isoladamente, e a associação AL-rocurônio; 2 os efeitos dos AL sobre o potencial de membrana (PM e potenciais de placa terminal em miniatura (PPTM. Em preparação biventer cérvicis de pintainho, foi avaliado o efeito do AL na resposta contraturante à acetilcolina. RESULTADOS: A lidocaína e a bupivacaína (S75-R25 isoladamente não alteraram as respostas musculares e os valores do PM. Nas preparações expostas aos AL, o bloqueio pelo rocurônio foi significativamente maior em relação ao produzido pelo rocurônio isoladamente. Em preparação biventer cervicis de pintainho, a lidocaína e a bupivacaína (S75-R25 diminuíram a resposta de contração à acetilcolina. A lidocaína aumentou a frequência dos PPTM, seguido de bloqueio; a bupivacaína (S75-R25 produziu diminuição seguida de bloqueio. CONCLUSÕES: Os anestésicos locais potencializaram o bloqueio neuromuscular causado pelo rocurônio. Os resultados mostraram ação pré-sináptica e póssináptica.JUSTIFICATIVA Y

  14. Metoclopramida e ondansetrona alteram o bloqueio neuromuscular induzido por mivacúrio? - um estudo randomizado

    OpenAIRE

    Mehmet Tercan; Esra Mercanoglu Efe; Gurkan Turker; Fatma Nur Kaya; Belgin Yavascaoglu; Yesim Ozarda; Elif Basagan Mogol

    2014-01-01

    Experiência: Objetivamos investigar os efeitos de metoclopramida e ondansetrona no bloqueio neuromuscular por mivacúrio. Métodos: Foram incluídos no estudo 75 pacientes ASA I-II, com idades entre 18 e 65 anos e agendados para cirurgia eletiva necessitando de intubação traqueal. Os pacientes receberam metoclopramida 10 mg, ondansetrona 4 mg ou salina normal 5 mL; grupo M, grupo O e grupo SN (n = 25) respectivamente. Antes da anestesia, os medicamentos em estudo fo...

  15. Anestesia peribulbar com ropivacaína como alternativa ao bloqueio neuromuscular para facectomia em cães Peribulbar anesthesia with ropivacaine as an alternative to neuromuscular blocking agents for cataract surgery in dogs

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    V.N.L.S. Oliva

    2010-06-01

    Full Text Available Desenvolveu-se uma técnica de bloqueio peribulbar comparando-a à técnica de anestesia oftálmica com bloqueio neuromuscular parcial em cães submetidos à facectomia extracapsular. Doze cães, de diferentes raças, foram alocados em dois grupos (G1 e G2 e anestesiados com acepromazina (0,05mg/kg, IV e propofol (5mg/kg, IV e mantidos com isofluorano sob ventilação espontânea. Os cães do G1 receberam o bloqueio peribulbar com ropivacaína 0,75%, e os do G2 o bloqueio neuromuscular parcial com brometo de pancurônio (0,01mg/kg, IV. Utilizaram-se, como parâmetros comparativos, escores de posicionamento do globo ocular, controle do reflexo oculocardíaco e pressão intraocular (mmHg. Foi possível propor uma técnica eficaz para cães baseando-se na técnica de bloqueio peribulbar posterior realizada no homem. Em ambos os grupos, o globo ocular permaneceu centralizado. Não ocorreram alterações eletrocardiográficas atribuídas ao reflexo oculocardíaco. Houve redução significativa da pressão intraocular em G1 após o bloqueio (10,7±0,6 e 14,7±0,6. Conclui-se que o bloqueio peribulbar proporcionou condições cirúrgicas apropriadas para a realização da facectomia, com a vantagem de promover bloqueio sensitivo do olho.A peribulbar block technique was developed and its clinical efficacy was compared with neuromuscular blockade in dogs undergoing cataract surgery. Twelve dogs of different breeds were randomly and equally allocated in two groups. After given acepromazine (0.05mg/kg, IV, anesthesia was induced with propofol (5mg/kg, IV and maintained with isoflurane in oxygen during spontaneous breathing. A peribulbar block with 0.75% ropivacaine was performed in G1 dogs while partial neuromuscular blockade with pancuronium (0.01mg/kg IV was provided in G2 dogs. Globe position scores, oculocardiac reflex, and intra-ocular pressure (mmHg were evaluated at pre-defined intervals during surgery. Peribulbar blocks were successful performed

  16. Síndrome de Tako-Tsubo em decorrência de bloqueio neuromuscular residual: relato de caso Síndrome de Tako-Tsubo como consecuencia de bloqueo neuromuscular residual: relato de caso Tako-Tsubo syndrome secondary to residual neuromuscular blockade: case report

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    Marcos Guilherme Cunha Cruvinel

    2008-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A síndrome de Tako-Tsubo é uma complicação pós-operatória rara, com mortalidade em torno de 5%. O objetivo deste relato é apresentar o bloqueio neuromuscular residual como fator desencadeante da referida síndrome, discutir sobre a mesma e alertar sobre o bloqueio neuromuscular residual. RELATO DO CASO: Paciente do sexo feminino, 61 anos, estado físico ASA I, submetida à anestesia geral associada a bloqueio paravertebral cervical para reparo artroscópico de lesão de manguito rotator. Após extubação foi evidenciado bloqueio neuromuscular residual por meio do exame clínico. Na sala de recuperação pós-anestésica evoluiu com sonolência, taquicardia, hipertensão arterial e acidose respiratória grave. Após a reintubação, evoluiu com parada cardíaca em atividade elétrica sem pulso, revertida com adrenalina e massagem cardíaca externa. Apresentou no pós-operatório elevação de segmento ST, aumento de troponina e acinesia de segmento médio-apical de ventrículo esquerdo com fração de ejeção estimada em 30%. A cineangiocoronariografia mostrou coronárias isentas de ateromatose significativa e grave comprometimento da função sistólica com acinesia inferior e ântero-septo-apical com hipercontratilidade compensatória de suas porções basais. Com o tratamento instituído houve recuperação funcional completa. CONCLUSÕES: O bloqueio neuromuscular residual associado à paralisia diafragmática e possível atelectasia pulmonar levando a insuficiência respiratória, hipercapnia e descarga adrenérgica foram os fatores desencadeantes da síndrome de Tako-Tsubo com sua grave repercussão clínica.JUSTIFICATIVA Y OBJETIVOS: El Síndrome de Tako-Tsubo es una complicación postoperatoria rara con una mortalidad en torno de un 5%. El objetivo de este relato es presentar el bloqueo neuromuscular residual como factor desencadenante del referido síndrome, discutir sobre él y alertar sobre el bloqueo

  17. The effects of local anesthetics on the neuromuscular transmission and on the blockade produced by rocuronium : experimental study

    OpenAIRE

    Vanessa Henriques Carvalho

    2009-01-01

    Resumo: Os anestésicos locais podem interagir com os bloqueadores neuromusculares e modificar as suas propriedades farmacocinéticas e farmacodinâmicas, no entanto o mecanismo dessa interação é controverso. Este estudo experimental, realizado em preparação nervo frênico - diafragma de ratos e musculo biventer cervicis de pintainhos, teve por objetivo avaliar o efeito de diferentes anestésicos locais na transmissão neuromuscular e sua influência no bloqueio produzido pelo rocurônio. Foram avali...

  18. Avaliação do bloqueio neuromuscular residual e da recurarização tardia na sala de recuperação pós-anestésica Evaluación del bloqueo neuromuscular residual y de la recurarización tardia en la sala de recuperación pós-anestésica Evaluation of residual neuromuscular block and late recurarization in the post-anesthetic care unit

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    Maria Cristina Simões de Almeida

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio neuromuscular residual altera a patência das vias aéreas aumentando o risco de graves complicações no pós-operatório. Nos pacientes que recebem o anticolinesterásico, a transmissão neuromuscular é incrementada pelo acúmulo de acetilcolina na placa motora, mas que, findo o efeito da neostigmina, teoricamente é possível uma "recurarização", visto que o agente antagonista não desloca o bloqueador neuromuscular do seu local de ação. Foi objetivo deste trabalho quantificar o grau de paralisia residual em Sala de Recuperação Pós-Anestésica (SRPA e averiguar se os pacientes que receberam neostigmina apresentam fenômeno de "recurarização" tardia. MÉTODO: Foram estudados na SRPA 119 pacientes adultos que receberam bloqueadores neuromusculares para diferentes tipos de procedimentos. Ao chegarem na SRPA, a transmissão neuromuscular foi quantificada através de um monitor por método acelerográfico. Os eletrodos estimuladores foram instalados no trajeto do nervo ulnar no punho, e empregou-se a seqüência de 4 estímulos, com correntes de 30 mA, na periodicidade de 15 até 120 minutos. Nesta pesquisa considerou-se como resíduo de bloqueio neuromuscular uma relação T4/T1 abaixo de 0,9. No tempo de permanência da SRPA foram igualmente registrados os sintomas clínicos sugestivos de bloqueio neuromuscular residual e aferidos os sinais vitais. Para análise estatística foram empregadas medidas descritivas tais como média e freqüência absoluta. RESULTADOS: Os pacientes que receberam pancurônio apresentaram maior incidência de resíduo de bloqueio neuromuscular, principalmente os idosos. Nos pacientes que receberam neostigmina houve expressivo percentual de bloqueio neuromuscular residual. Em nenhum grupo observou-se o fenômeno de "recurarização" tardia. CONCLUSÕES: Constatou-se expressivo número de pacientes com resíduo de bloqueio neuromuscular, quando utilizado o pancurônio. A

  19. Efeito da administração do atracúrio sobre a recuperação do bloqueio neuromuscular induzido pelo pancurônio Efecto de la administración del atracúrio sobre la recuperación del bloqueo neuromuscular inducido por el pancuronio Effect of atracurium on pancuronium-induced neuromuscular block recovery

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    Luís Fernando Rodrigues Maria

    2004-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Freqüentemente em cirurgias abdominais, na fase de fechamento da parede, há necessidade de doses adicionais de bloqueador neuromuscular. O objetivo deste estudo foi analisar, na vigência de recuperação parcial do bloqueio neuromuscular induzido pelo pancurônio, o efeito da administração de dose complementar de atracúrio sobre a recuperação espontânea do bloqueio neuromuscular. MÉTODO: Foram estudados 30 pacientes, divididos em dois grupos, 14 pacientes formaram o grupo pancurônio e 16 pacientes, o grupo atracúrio. A função neuromuscular foi monitorizada de forma contínua por acelerometria do músculo adutor do polegar, utilizando a seqüência de quatro estímulos (SQE, através da estimulação supramáxima do nervo ulnar. A indução da anestesia foi feita com propofol, fentanil, pancurônio 0,08 mg.kg-1 e a manutenção com N2O 60% em oxigênio e isoflurano na concentração expirada de 0,5%. Quando a primeira contração da seqüência de quatro estímulos (T1 recuperou 25%, o grupo pancurônio recebeu pancurônio 0,025 mg.kg-1 e o grupo atracúrio, 0,20 mg.kg-1 de atracúrio. Após a dose complementar foram anotados os tempos para recuperação espontânea de T1 igual a 10%, 25%, 75%, do índice de recuperação (IR25-75% e da relação T4/T1 igual a 0,8. RESULTADOS: Os tempos de recuperação espontânea após dose complementar de pancurônio ou atracúrio não diferiram quando avaliados pela recuperação de T1 em 10% (45,00 ± 15,50 vs 49,69 ± 9,41, 25% (61,64 ± 18,58 vs 64,25 ± 12,51 e 75% (94,00 ± 28,52 vs 84,69 ± 16,50. O IR25-75% (32,36 ± 13,76 vs 20,44 ± 9,24 e o tempo de recuperação da relação T4/T1 = 0,8 (176,86 ± 29,57 vs 141,50 ± 29,57 foram menores no grupo do atracúrio. CONCLUSÕES: Nas condições deste estudo, a complementação com atracúrio não promoveu alteração na recuperação espontânea inicial do bloqueio neuromuscular induzido pelo pancurônio e promoveu

  20. Complete atrioventricular block on isolated guinea pig heart induced by an aqueous fraction obtained from Psidium guajava L. leaf Bloqueio atrioventricular completo em coração isolado de cobaia produzido por uma fração aquosa obtida das folhas de Psidium guajava L

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    Antonio N.S. Gondim

    2006-09-01

    Full Text Available This paper aimed to study the electrocardiographic effect produced by the aqueous fraction (AqF obtained from the acetic extract of Psidium guajava L. leaf on the isolated guinea pig heart. Electrocardiographic records (ECG were obtained on isolated hearts beating spontaneously or under regular electrical stimulation. The hearts were mounted in a constant flow Langendorff perfusion system. Until 20 mg/mL, AqF did not change the spontaneous cardiac rate (control: 180 ± 9 bpm, test: 182 ± 10 bpm; N = 3; p > 0.05. Concentrations equal or greater then 20 mg/mL induced complete atrioventricular block (AVB. However, this effect promptly disappeared when AqF was removed from the perfusion fluid (N = 3 hearts. The AVB induced by AqF involves heart muscarinic receptors because atropine sulfate (1.5 mM could prevent the appearance of such disturbance.O presente trabalho visou estudar o efeito eletrocardiográfico produzido pela fração aquosa (AqF obtida do extrato acético das folhas de Psidium guajava L. em coração isolado de cobaia. Os traçados eletrocardiográficos foram obtidos em corações batendo espontaneamente ou então sob estimulação elétrica. Os corações foram montados em uma sistema de perfusão do tipo Langendoff de fluxo constante. A AqF, usada em concentrações menores que 20 mg/mL, não alterou a freqüência espontânea do coração (controle: 180 ± 9 bpm, teste: 182 ± 10 bpm; N = 3; p > 0,05. Todavia, concentrações iguais ou maiores que 20 mg/mL produziram bloqueio atrioventricular completo (BAV. Este efeito, contudo, desapareceu prontamente quando se removeu a AqF do fluido de perfusão coronariana (N = 3 corações. O BAV promovido pela AqF se faz mediado pelos receptores muscarínicos porque o sulfato de atropina (1,5 mM impediu o aparecimento deste efeito.

  1. Efeitos neuromusculares in vitro e in vivo do atracúrio e do rocurônio em ratos submetidos a tratamento de sete dias com carbamazepina Efectos neuromusculares in vitro e in vivo del atracurio y del rocuronio en ratones sometidos a tratamiento de siete días con carbamazepina In vitro and in vivo neuromuscular effects of atracurium and rocuronium in rats treated with carbamazepine for seven days

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    Caroline Coutinho de Barcelos

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Trata-se de um estudo experimental que investigou in vitro e in vivo o bloqueio neuromuscular produzido pelo rocurônio e atracúrio em ratos tratados com carbamazepina e determinou as concentrações de citocromo P450 e b5 redutase em microssomos hepáticos. MÉTODO: Ratos foram tratados por sete dias com carbamazepina (CBZ - 40 mg.kg-1 pelo método de gavagem e sacrificados no oitavo dia sob anestesia com uretana. As preparações in vitro e in vivo foram montadas de acordo com as técnicas de Bulbring e de Leeuwin e Wolters, respectivamente. As concentrações e doses utilizadas dos bloqueadores nas preparações in vitro e in vivo foram, respectivamente, 20 µg.mL-1 e 0,5 mg.kg-1 para atracúrio (ATC; 4 µg.mL-1 e 0,6 mg.kg-1 para rocurônio (ROC. Cada protocolo teve um n = 5 e as respostas foram observadas por 60 minutos. Os efeitos do ATC e ROC foram avaliados nas preparações de ratos tratados (Cbz t e comparados com os observados nas de ratos não-tratados (CBZst. As concentrações de citocromo P450 e b5 redutase foram determinadas em microssomos isolados de fígados de ratos tratados (CBZt e comparadas com as obtidas em ratos não tratados (CBZst. RESULTADOS: A carbamazepina não alterou a amplitude das respostas musculares; in vitro e in vivo, não houve diferença entre o bloqueio neuromuscular produzido pelo atracúrio nas preparações CBZt versus CBZst; o bloqueio neuromuscular produzido pelo rocurônio nas preparações CBZt foi potencializado in vitro. A carbamazepina não alterou as concentrações de citocromo P450 e b5. CONCLUSÕES: O tratamento por sete dias com carbamazepina não influenciou no bloqueio produzido pelo atracúrio, e alterou in vitro os efeitos do rocurônio. O tempo de tratamento não foi suficiente para causar indução enzimática e diminuir a sensibilidade ao rocurônio.JUSTIFICATIVA Y OBJETIVOS: Se trata de un estudio experimental que investigó in vitro e in vivo el bloqueo

  2. The tof-guard neuromuscular transmission monitor and its use in horses O monitor da transmissão neuromuscular "tof-guard" e seu uso em eqüinos

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    Juliana Noda Bechara

    1999-03-01

    Full Text Available It has been emphasized in the human medical literature, that when using a neuromuscular blocking agent, it is of vital importance the monitoring of the neuromuscular block and that these agents should never be used without it. The purpose of this study was to evaluate the use of the neuromuscular transmission monitor TOF-Guard in horses. Twelve horses were randomly assigned whether to receive pancuronium or atracurium as the neuromuscular blocking agent. All horses were pre-medicated with romifidine, anaesthesia induced with diazepam and ketamine and maintenance with halothane. Abolition of spontaneous ventilation was accomplished by the administration of atracurium or pancuronium. The time from injection of the muscle relaxant agent to the onset of maximum block (T1=0, recovery of T1 to 25% and the recovery of TOF ratio to 0.7 were recorded, as was the time for recovery of T1 from 25 to 75%. It was concluded that it is very important the neuromuscular transmission monitoring during the use of a nondepolarizing neuromuscular blocking agent, since it provides a safer anaesthetic and surgical procedure with the use of adequate dosages and due to the impossibility of a superficialization of the neuromuscular blockade during a surgical procedure. The TOF-Guard showed to be a good option for neuromuscular monitoring in horses.Quando da utilização de bloqueadores neuromusculares, já foi enfatizado na literatura médica humana, que é de vital imporância a monitoração do bloqueio neuromuscular e que estes agentes nunca devem ser utilizados sem a mesma. O objetivo deste estudo foi o de avaliar o uso do monitor da transmissão neuromuscular TOF-Guard em eqüinos. Para tanto, doze eqüinos foram separados aleatoriamente para receberem como bloqueadores neuromusculares o pancurônio ou o atracúrio. Todos os eqüinos foram pré-medicados com romifidina, induzidos com diazepam e quetamina e mantidos com halotano. Foi administrado o atracúrio ou o

  3. Doenças neuromusculares Neuromuscular disorders

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  4. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico

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    Patrícia Falcão Pitombo

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Cirurgias artroscópicas do ombro cursam com intensa dor pós-operatória. Diversas técnicas analgésicas têm sido preconizadas. O objetivo deste estudo foi comparar o bloqueio dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro com a abordagem interescalênica do plexo braquial. MÉTODO: Sessenta e oito pacientes foram alocados em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI e grupo seletivo (GS, sendo ambas as abordagens realizadas com neuroestimulador. No GI, após resposta motora adequada foram injetados 30 mL de levopubivacaína em excesso enantiomérico de 50% a 0,33% com adrenalina 1:200.000. No GS, após resposta motora do nervo supraescapular e axilar, foram injetados 15 mL da mesma substância em cada nervo. Em seguida, realizada anestesia geral. Variáveis avaliadas: tempo para realização dos bloqueios, analgesia, consumo de opioide, bloqueio motor, estabilidade cardiocirculatória, satisfação e aceitabilidade pelo paciente. RESULTADOS: Tempo para execução do bloqueio interescalênico foi significativamente menor que para realização do bloqueio seletivo. Analgesia foi significativamente maior no pós-operatório imediato no GI e no pós-operatório tardio no GS. Consumo de morfina foi significativamente maior na primeira hora no GS. Bloqueio motor foi significativamente menor no GS. Estabilidade cardiocirculatória, satisfação e aceitabilidade da técnica pelo paciente não diferiram entre os grupos. Ocorreu uma falha no GI e duas no GS. CONCLUSÕES: Ambas as técnicas são seguras, eficazes com mesmo grau de satisfação e aceitabilidade. O bloqueio seletivo de ambos os nervos apresentou analgesia satisfatória, com a vantagem de proporcionar bloqueio motor restrito ao ombro.

  5. O uso de bloqueadores neuromusculares no Brasil El uso de bloqueadores neuromusculares en Brasil Neuromuscular blockers in Brazil

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    Maria Cristina Simões de Almeida

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Dados estatísticos referentes ao uso de bloqueadores neuromusculares no Brasil são desconhecidos. Este trabalho se propõe a análise estatística desse tópico. MÉTODO: Foram compiladas 831 respostas de um questionário preenchido em parte por anestesiologistas presentes ao 48º Congresso Brasileiro de Anestesiologia em Recife, 2001 e em parte via Internet, por anestesiologistas cujos endereços eletrônicos constam na página da Sociedade Brasileira de Anestesiologia (www.sba.com.br. Foram analisados os seguintes dados: tempo de contato com a especialidade, região onde atuam os anestesiologistas, uso de bloqueadores neuromusculares (BNM em ordem de preferência, indicações do uso de succinilcolina, uso do monitor da transmissão neuromuscular, critérios para se considerar o paciente descurarizado, uso de neostigmina, forma de administração dos BNM e descrição de complicações observadas. RESULTADOS: A maioria dos anestesiologistas em questão exerce a profissão há mais de 11 anos e o maior número de respostas foi proveniente da região sudeste do Brasil. O BNM mais empregado é o atracúrio, seguido de pancurônio e succinilcolina. A succinilcolina é mais empregada na indução rápida e em crianças (80% e 25% respectivamente. Monitores da transmissão neuromuscular, 53% dos anestesiologistas nunca usam, e como critério de recuperação, 92% consideram o paciente descurarizado mediante sinais clínicos. Em 45% das vezes os profissionais empregam a neostigmina de forma rotineira, e 94% administra os BNM sob forma de bolus. Cerca de 30% registra ter havido complicação decorrente do uso de BNM. As complicações mais apontadas foram o bloqueio prolongado, o broncoespasmo grave e a curarização residual. CONCLUSÕES: O atracúrio é o bloqueador neuromuscular mais empregado no Brasil, há percentual alto de uso da succinilcolina em situações não emergenciais, o uso de monitores da transmiss

  6. Neuromuscular disorders in pregnancy.

    Science.gov (United States)

    Guidon, Amanda C; Massey, E Wayne

    2012-08-01

    Preexisting and coincident neuromuscular disorders in pregnancy are challenging for clinicians because of the heterogeneity of disease and the limited data in the literature. Many questions arise regarding the effect of disease on the pregnancy, delivery, and newborn in addition to the effect of pregnancy on the course of disease. Each disorder has particular considerations and possible complications. An interdisciplinary team of physicians is essential. This article discusses the most recent literature on neuromuscular disorders in pregnancy including acquired root, plexus, and peripheral nerve lesions; acquired and inherited neuropathies and myopathies; disorders of the neuromuscular junction; and motor neuron diseases.

  7. Doenças neuromusculares Neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Umbertina C. Reed

    2002-08-01

    Full Text Available Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo. Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de hipotonia muscular secundária ao comprometimento do sistema nervoso central ou a doenças sistêmicas não-neurológicas, são enfatizados, com base na experiência clínica vinda do atendimento a crianças com doenças neuromusculares durante os últimos 12 anos, no ambulatório de doenças neuromusculares do Hospital das Clínicas da Faculdade de Medicina, da Universidade de São Paulo. A revisão bibliográfica foi efetuada através do Medline e do periódico Neuromuscular Disorders, publicação oficial da World Muscle Society. Síntese dos dados: nas crianças, a maior parte destas afecções é geneticamente determinada, sendo as mais comuns a distrofia muscular progressiva ligada ao sexo, de Duchenne, a amiotrofia espinal infantil, a distrofia muscular congênita, a distrofia miotônica de Steinert, e as miopatias congênitas, estruturais e não estruturais. Polineuropatias hereditárias, síndrome miastênica congênita e miopatias metabólicas são menos comuns, porém mostram correlação geno-fenotípica cada vez mais precisa. Conclusões: na década passada, inúmeros avanços da genética molecular facilitaram imensamente o diagnóstico e o aconselhamento genético das doenças neuromusculares mais comuns das crianças, inclusive possibilitando diagnóstico fetal e, adicionalmente, vieram permitir melhor caracterização fenotípica e classificação mais objetiva.Objective: to discuss the most important aspects for performing a

  8. Steroidal neuromuscular blocking agents

    NARCIS (Netherlands)

    Wierda, JMKH; Mori, K; Ohmura, A; Toyooka, H; Hatano, Y; Shingu, K; Fukuda, K

    1998-01-01

    Since 1964 approximately 20 steroidal neuromuscular blocking agents have been evaluated clinically. Pancuronium, a bisquaternary compound designed on the drawingboard, was the first steroidal relaxant introduced into clinical practice worldwide in the 1970's. Although a major improvement, pancuroniu

  9. Hereditary neuromuscular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Oezsarlak, O. E-mail: ozkan.ozsarlak@uza.be; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J

    2001-12-01

    This article presents the actual classification of neuromuscular diseases based on present expansion of our knowledge and understanding due to genetic developments. It summarizes the genetic and clinical presentations of each disorder together with CT findings, which we studied in a large group of patients with neuromuscular diseases. The muscular dystrophies as the largest and most common group of hereditary muscle diseases will be highlighted by giving detailed information about the role of CT and MRI in the differential diagnosis. The radiological features of neuromuscular diseases are atrophy, hypertrophy, pseudohypertrophy and fatty infiltration of muscles on a selective basis. Although the patterns and distribution of involvement are characteristic in some of the diseases, the definition of the type of disease based on CT scan only is not always possible.

  10. Electrodiagnosis in neuromuscular disease.

    Science.gov (United States)

    Lipa, Bethany M; Han, Jay J

    2012-08-01

    Electromyography (EMG) is an important diagnostic tool for the assessment of individuals with various neuromuscular diseases. It should be an extension of a thorough history and physical examination. Some prototypical characteristics and findings of EMG and nerve conduction studies are discussed; however, a more thorough discussion can be found in the textbooks and resources sited in the article. With an increase in molecular genetic diagnostics, EMG continues to play an important role in the diagnosis and management of patients with neuromuscular diseases and also provides a cost-effective diagnostic workup before ordering a battery of costly genetic tests.

  11. Raquianestesia total após bloqueio do plexo lombar: relato de caso

    Directory of Open Access Journals (Sweden)

    Zafer Dogan

    2014-04-01

    Full Text Available O bloqueio do plexo lombar (BPL é um método adequado para uso em pacientes idosos e cirurgias na extremidade inferior. Muitas complicações podem ser observadas durante o BPL, mas não tanto quanto no bloqueio central. Neste relato de caso, nosso objetivo foi relatar uma raquianestesia total, uma complicação incomum. BPL com bloqueio ciático foi planejado para um paciente do sexo masculino, 76 anos, programado para artroplastia total do joelho por causa de gonartrose. O paciente ficou inconsciente após o bloqueio do compartimento do psoas com a técnica de Chayen para BPL. A operação terminou em 145 minutos. O paciente foi internado em unidade de terapia intensiva até o segundo dia pós-operatório e recebeu alta hospitalar no quinto dia pós-cirúrgico. A principal preocupação da monitoração do paciente deve ser a presença do anestesiologista. Dessa forma, conclui-se que o contato com o paciente deve ser garantido durante esses procedimentos.

  12. Bloqueio do plexo braquial por via infraclavicular: abordagem ântero-posterior

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2001-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial é a técnica preferida pelos anestesiologistas para cirurgias nos membros superiores. Embora o acesso infraclavicular seja menos utilizado, ele pode oferecer algumas vantagens. O objetivo deste estudo prospectivo é mostrar os resultados observados em 50 pacientes submetidos a bloqueio do plexo braquial pela via infraclavicular, usando estimulador de nervo periférico e abordagem ântero-posterior. MÉTODO: Cinqüenta pacientes, com idades entre 17 e 87 anos, estado físico ASA I e II, escalados para cirurgias ortopédicas da extremidade superior foram anestesiados com bloqueio do plexo braquial pela via infraclavicular. Todos os bloqueios foram realizados com estimulador de nervo periférico, a partir de 1 mA. Quando se obtinha uma adequada contração muscular na mão, no antebraço ou músculos do braço, a amperagem era diminuída até desaparecimento da resposta. Se a resposta desaparecesse com estímulo superior a 0,6 mA, a agulha poderia ser movimentada a procura de melhor resposta. Se a resposta não desaparecesse com estímulo menor que 0,5 mA, injetavam-se 50 ml de lidocaína a 1,6% com epinefrina 1:200.000. Foram avaliados o tempo de latência, duração da cirurgia, tolerância ao uso do torniquete, duração dos bloqueios sensitivo e motor, complicações e efeitos adversos. RESULTADOS: O bloqueio foi efetivo em 94% dos pacientes, o tempo médio da latência foi de 8,78 min, a duração média da cirurgia foi de 65,52 min e a tolerância ao torniquete foi observada em todos os pacientes. A média de duração do bloqueio sensitivo foi de 195,56 min e do bloqueio motor de 198,86 min. Ocorreu uma punção vascular. Não foram observados sinais e sintomas clínicos de toxicidade do anestésico local ou do vasoconstritor. Nenhum paciente apresentou efeitos adversos do bloqueio. CONCLUSÕES: O bloqueio infraclavicular do plexo braquial proporciona uma anestesia efetiva para

  13. [Characteristics of neuromuscular scoliosis].

    Science.gov (United States)

    Putzier, M; Groß, C; Zahn, R K; Pumberger, M; Strube, P

    2016-06-01

    Usually, neuromuscular scolioses become clinically symptomatic relatively early and are rapidly progressive even after the end of growth. Without sufficient treatment they lead to a severe reduction of quality of life, to a loss of the ability of walking, standing or sitting as well as to an impairment of the cardiopulmonary system resulting in an increased mortality. Therefore, an intensive interdisciplinary treatment by physio- and ergotherapists, internists, pediatricians, orthotists, and orthopedists is indispensable. In contrast to idiopathic scoliosis the treatment of patients with neuromuscular scoliosis with orthosis is controversially discussed, whereas physiotherapy is established and essential to prevent contractures and to maintain the residual sensorimotor function.Frequently, the surgical treatment of the scoliosis is indicated. It should be noted that only long-segment posterior correction and fusion of the whole deformity leads to a significant improvement of the quality of life as well as to a prevention of a progression of the scoliosis and the development of junctional problems. The surgical intervention is usually performed before the end of growth. A prolonged delay of surgical intervention does not result in an increased height but only in a deformity progression and is therefore not justifiable. In early onset neuromuscular scolioses guided-growth implants are used to guarantee the adequat development. Because of the high complication rates, further optimization of these implant systems with regard to efficiency and safety have to be addressed in future research.

  14. Eficácia do saque, ataque e bloqueio no voleibol masculino brasileiro

    Directory of Open Access Journals (Sweden)

    Fábio Angioluci Diniz Campos

    2015-10-01

    Full Text Available Objetivo: analisar a eficácia de três diferentes indicadores de desempenho (saque, ataque e bloqueio no voleibol das equipes que participaram da Superliga Nacional Masculina, temporada 2012-2013. Método: a amostra foi composta de 132 jogos da superliga nacional masculina (temporada 2012/2013, totalizando 525 sets disputados na primeira fase da competição. Foram observados os indicadores de desempenho que perfazem o resultado do jogo: ataque, bloqueio e saque. Para a análise dos dados, utilizou-se de procedimentos de estatistica descritiva (média e desvio padrão. Resultados: durante os jogos as ações de ataque possuem alta eficácia, apresentando valores de 48±5%; as ações de bloqueio possuem moderada eficácia com 20±4% e as ações de saque com baixa eficácia, com valores de 4±2%. Os indicadores de desempenho do ataque e do bloqueio são as ações com maiores níveis de eficácia em campeonatos brasileiros de voleibol de alto nível. Considerações finais: assim, estes resultados podem ser utilizados por treinadores e comissão técnica para o aprimoramento das estratégias de treinamento, com enfoque nos indicadores de desempenho para uma maior eficácia, durante jogos de voleibol.

  15. Bloqueio do nervo supraescapular: procedimento importante na prática clínica

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A dor no ombro é uma queixa frequente que ocasiona grande incapacidade funcional no membro acometido, assim como redução na qualidade de vida dos pacientes. O bloqueio do nervo supraescapular é um método terapêutico eficaz e vem sendo cada vez mais utilizado pelos anestesiologistas tanto para anestesia regional quanto para analgesia pós-operatória de cirurgias realizadas nesta articulação, o que justifica a presente revisão, cujo objetivo principal é descrever a técnica aplicada e as indicações clínicas. CONTEÚDO: Apresenta-se a anatomia do nervo supraescapular, desde a sua origem do plexo braquial até os seus ramos terminais, assim como as características gerais e a técnica empregada na execução do bloqueio deste nervo, as principais drogas utilizadas e o volume e as situações em que se faz jus a sua aplicação. CONCLUSÕES: O bloqueio do nervo supraescapular é um procedimento seguro e extremamente eficaz na terapia da dor no ombro. Também de fácil reprodutibilidade, está sendo muito utilizado por profissionais de várias especialidades médicas. Quando bem indicado, este método deve ser considerado

  16. Neuromuscular complications of acromegaly.

    Science.gov (United States)

    Pickett, J B; Layzer, R B; Levin, S R; Scheider, V; Campbell, M J; Sumner, A J

    1975-07-01

    Seventeen consecutive acromegalic patients were evaluated for evidence of neuromuscular dysfunction and followed for 1 year after hypophysectomy. Before treatment, four patients had both a myopathy and the carpal tunnel syndrome, five had myopathy alone, four had carpal tunnel syndrome alone, and four had neither. The myopathy was caracterized by mild, strictly promixal weakness and flabbiness of muscles; electromyography revealed typical myopathic abnormalities, but serum enzymes and muscle biopsy usually were normal. The presence of myopathy or the carpal tunnel syndrrome could not be correlated with the magnitude of growth hormone elevation or any secondary endocrine derangement, but myopathy was associated with a longer duration of acromegaly. Carpal tunnel symptoms usually improved in the first 6 weeks after hypophysectomy, while myopathy improved more slowly and sometimes was detectable 1 year later.

  17. Bloqueio contínuo do plexo lombar via posterior bilateral com bomba de infusão descartável: relato de caso

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2011-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O número de artroplastia total de quadril (ATQ bilateral tem aumentado a cada ano. Analgesia pós-operatória pela infusão contínua perineural com anestésico local tem se mostrado favorável quando comparada com analgesia sistêmica. O uso de bombas elastoméricas tem aumentado a satisfação do paciente quando em comparação com os modelos eletrônicos. O objetivo deste relato foi descrever um caso de analgesia contínua bilateral do plexo lombar via posterior, com infusão contínua através de bomba elastomérica, em paciente submetido à uma artroplastia bilateral de quadril. RELATO DO CASO: Paciente feminina, 46 anos, 65 kg, 162 cm, com artrite reumatoide e hipertensão arterial, estado físico ASA II, escalada para ser submetida a ATQ bilateral em um único estágio. Uso de corticosteroide por 13 anos. Hemoglobina = 10,1 g.dL-1, hematócrito = 32,7%. Monitoração de rotina. Raquianestesia com 15 mg de bupivacaína 0,5% isobárica. Anestesia geral com propofol (PFS e remifentanil e intubação sem bloqueadores neuromusculares. ATQ direita e no final, bloqueio plexo lombar com estimulador e conjunto agulha 150 mm e injeção de 20 mL bupivacaína 0,2% e passagem de cateter. ATQ esquerda e, no final, mesmo procedimento. Estudado dispersão do anestésico e contraste. Instalado bomba elastomérica com bupivacaína 0,1% (400 mL em velocidade de 14 mL.h-1. Transferida para Unidade de Cuidados Intensivos (UCI. Vinte e quatro horas após, nova bomba com a mesma solução. Nenhum bolus durante 50 horas. Após remoção de cateter, dor controlada por via oral com cetoprofeno e dipirona. CONCLUSÕES: O bloqueio bilateral contínuo periférico com infusão de bupivacaína a 0,1% com bombas elastoméricas é um procedimento seguro e efetivo em adultos.

  18. Neuromuscular disease classification system

    Science.gov (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen

    2013-06-01

    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  19. Microbiologia de queijo tipo Minas Frescal produzido artesanalmente

    Directory of Open Access Journals (Sweden)

    Loguercio Andrea Pinto

    2001-01-01

    Full Text Available Com o objetivo de avaliar as condições higiênico-sanitárias do queijo Minas Frescal produzido artesanalmente em Cuiabá - MT, foi realizada análise microbiológica de trinta amostras obtidas em dois pontos de comercialização. A análise microbiológica consistiu da contagem em placas de Staphylococcus aureus e da contagem estimativa de coliformes totais, fecais e Escherichia coli pela técnica do NMP-3 tubos. Na determinação de coliformes fecais, 28 amostras (93,33% apresentaram número mais provável (NMP > 10² NMP/g e somente duas amostras (6,67% estavam dentro dos padrões legais exigidos. Na contagem de S. aureus, em 29 amostras (96,67% obteve-se valores superiores a 10³ufc/g, estando apenas 1 amostra (3,33% em conformidade com o padrão legal. Conclui-se que uma maior atenção deve ser dada pelas autoridades sanitárias em relação à permissão de fabricar e comercializar esse produto, uma vez que ele representa risco à saúde dos consumidores.

  20. Doenças neuromusculares

    OpenAIRE

    Umbertina C. Reed

    2002-01-01

    Objetivo: apresentar os dados essenciais para o diagnóstico diferencial entre as principais doenças neuromusculares, denominação genérica sob a qual agrupam-se diferentes afecções, decorrentes do acometimento primário da unidade motora (motoneurônio medular, raiz nervosa, nervo periférico, junção mioneural e músculo). Fontes dos dados: os aspectos clínicos fundamentais para estabelecer o diagnóstico diferencial entre as diferentes doenças neuromusculares, bem como entre estas e as causas de h...

  1. Neuromuscular ultrasound of cranial nerves.

    Science.gov (United States)

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-04-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed.

  2. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F; Wevers, CWJ; Wintzen, AR; Busch, HFM; Howeler, CJ; deJager, AEJ; Padberg, GW; deVisser, M; Wokke, JHJ

    1997-01-01

    The present study analyses the actual occupational situation, vocational handicaps and past labour career of a group of about 1000 Dutch patients suffering from a neuromuscular disorder (NMD). On the basis of the likelihood of a substantial employment history and sufficient numbers of patients, four

  3. Muscle ultrasound in neuromuscular disorders.

    NARCIS (Netherlands)

    Pillen, S.; Arts, I.M.P.; Zwarts, M.J.

    2008-01-01

    Muscle ultrasound is a useful tool in the diagnosis of neuromuscular disorders, as these disorders result in muscle atrophy and intramuscular fibrosis and fatty infiltration, which can be visualized with ultrasound. Several prospective studies have reported high sensitivities and specificities in th

  4. Bloqueio simpático esquerdo por videotoracoscopia no tratamento da cardiomiopatia dilatada

    Directory of Open Access Journals (Sweden)

    Paulo M. Pêgo-Fernandes

    2010-12-01

    Full Text Available FUNDAMENTO: O nível da atividade nervosa simpática é um dos mais importantes determinantes prognósticos em pacientes com insuficiência cardíaca. OBJETIVO: O propósito dessa investigação foi realizar um estudo de viabilidade do emprego do bloqueio simpático esquerdo por toracoscopia em pacientes com insuficiência cardíaca (IC para avaliar a segurança e os efeitos imediatos. MÉTODOS: Quinze pacientes com cardiomiopatia dilatada e fração de ejeção do ventrículo esquerdo (FEVE 65 bpm, a despeito do uso adequado de beta-bloqueadores ou intolerantes a eles, forma selecionados. Dez pacientes foram submetidos à clipagem do espaço inter-espinhal em nível de T3-T4 e da porção inferior dos gânglios estrelados esquerdos através de videotoracocopia, enquanto outros cinco pacientes foram randomizados para um grupo controle. RESULTADOS: Nenhum dos pacientes operados apresentou qualquer evento cardiovascular adverso relacionado ao procedimento cirúrgico no período perioperatório. Dois pacientes do grupo cirúrgico morreram devido a tromboembolismo pulmonar ou infarto do miocárdio nos 6 meses de seguimento inicial, enquanto três pacientes do grupo controle apresentaram progressão da IC e morreram ou desenvolveram choque cardiogênico no mesmo período. Nos pacientes tratados, houve melhora na qualidade de vida, nível de atividade física e FEVE (de 25 ± 9% para 32 ± 8%, p=0,024 aos 6 meses de seguimento, enquanto esses parâmetros não se alteraram nos pacientes do grupo controle. CONCLUSÃO: O bloqueio simpático esquerdo via toracoscopia é factível e parece ser seguro em pacientes com IC grave. Esse estudo inicial sugere que esse procedimento pode ser uma abordagem alternativa eficaz para o bloqueio simpático no tratamento de cardiomiopatias dilatadas.

  5. Patologia do bloqueio atrioventricular na cardiomiopatia por depósito de desmina

    Directory of Open Access Journals (Sweden)

    Luiz Alberto Benvenuti

    2012-01-01

    Full Text Available Geralmente, a cardiomiopatia restritiva por deposição de desmina é caracterizada pela restrição ao enchimento diastólico ventricular e por diferentes graus de bloqueio atrioventricular (BAV. Neste relato, são descritas as alterações anatomopatológicas do sistema de condução cardíaco relacionadas ao BAV. O nó sinusal, o nó compacto e o feixe penetrante (feixe de His não apresentavam anormalidades, entretanto, havia extensa fibrose das porções terminais do feixe ramificante e do início dos feixes esquerdo e direito, no topo do septo ventricular. A patogenia dessa substituição fibrosa é provavelmente a mesma que origina a extensa fibrose do miocárdio ventricular contrátil, e permanece por ser elucidada.

  6. The undesirable effects of neuromuscular blocking drugs

    DEFF Research Database (Denmark)

    Claudius, C; Garvey, L H; Viby-Mogensen, J

    2009-01-01

    Neuromuscular blocking drugs are designed to bind to the nicotinic receptor at the neuromuscular junction. However, they also interact with other acetylcholine receptors in the body. Binding to these receptors causes adverse effects that vary with the specificity for the cholinergic receptor...... in question. Moreover, all neuromuscular blocking drugs may cause hypersensitivity reactions. Often the symptoms are mild and self-limiting but massive histamine release can cause systematic reactions with circulatory and respiratory symptoms and signs. At the end of anaesthesia, no residual effect...... of a neuromuscular blocking drug should be present. However, the huge variability in response to neuromuscular blocking drugs makes it impossible to predict which patient will suffer postoperative residual curarization. This article discusses the undesirable effects of the currently available neuromuscular blocking...

  7. Efeito perioperatório do índice de massa corporal elevado no bloqueio do nervo periférico: uma análise de 528 bloqueios interescalênicos guiados por ultrassom

    Directory of Open Access Journals (Sweden)

    Kristopher Schroeder

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os pacientes obesos podem representar um desafio anestésico perioperatório único, tornando as técnicas anestésicas regionais um meio desafiador de oferecer analgesia para esta população. A orientação por ultrassom foi recentemente elogiada como sendo benéfica para esta população na qual os limites anatômicos de superfície podem ser obscurecidos. Neste estudo, é investigado o efeito do Índice de Massa Corporal (IMC elevado no bloqueio interescalênico do nervo periférico guiado por ultrassom. MATERIAL E MÉTODOS: Este estudo é uma análise retrospectiva de 528 pacientes consecutivos que receberam bloqueios nervosos interescalênicos pré-operatórios guiados por ultrassom no Hospital e Clínica da University of Wisconsin. Examinamos a associação entre IMC e os parâmetros: tempo exigido para localização do bloqueio; presença de náuseas e vômitos pós-operatórios (NVPO; pontuações de dor pós-operatória na sala de recuperação pós-anestésica (SRPA; volume de anestésico local injetado; complicações agudas; e administração de opioides antes, durante e depois da cirurgia. Foram utilizadas regressões univariada e multivariada com estimativa dos mínimos quadrados e logística. RESULTADOS: Um IMC elevado foi associado a maiores: tempo exigido para localização do bloqueio (p = 0,025, administração de fentanil durante a cirurgia (p < 0,001, pico de pontuações de dor em SRPA (p < 0,001, administração de opioide na SRPA (p < 0,001, administração oral de opioide na SRPA (p < 0,001, administração total de opioide na SRPA (p < 0,001 e incidência de náusea em SRPA (p = 0,025. CONCLUSÕES: Os bloqueios nervosos interescalênicos guiados por ultrassom para analgesia perioperatória podem ser executados de forma segura e efetiva em pacientes obesos, mas o procedimento pode ser mais difícil e a analgesia talvez não seja completa

  8. Neuromuscular Control and Coordination during Cycling

    Science.gov (United States)

    Li, Li

    2004-01-01

    The neuromuscular control aspect of cycling has been investigated through the effects of modifying posture and cadence. These studies show that changing posture has a more profound influence on neuromuscular coordination than does changing slope. Most of the changes with standing posture occur late in the downstroke: increased ankle and knee joint…

  9. Mitochondrial dysfunction in neuromuscular disorders.

    Science.gov (United States)

    Katsetos, Christos D; Koutzaki, Sirma; Melvin, Joseph J

    2013-09-01

    This review deciphers aspects of mitochondrial (mt) dysfunction among nosologically, pathologically, and genetically diverse diseases of the skeletal muscle, lower motor neuron, and peripheral nerve, which fall outside the traditional realm of mt cytopathies. Special emphasis is given to well-characterized mt abnormalities in collagen VI myopathies (Ullrich congenital muscular dystrophy and Bethlem myopathy), megaconial congenital muscular dystrophy, limb-girdle muscular dystrophy type 2 (calpainopathy), centronuclear myopathies, core myopathies, inflammatory myopathies, spinal muscular atrophy, Charcot-Marie-Tooth neuropathy type 2, and drug-induced peripheral neuropathies. Among inflammatory myopathies, mt abnormalities are more prominent in inclusion body myositis and a subset of polymyositis with mt pathology, both of which are refractory to corticosteroid treatment. Awareness is raised about instances of phenotypic mimicry between cases harboring primary mtDNA depletion, in the context of mtDNA depletion syndrome, and established neuromuscular disorders such as spinal muscular atrophy. A substantial body of experimental work, derived from animal models, attests to a major role of mitochondria (mt) in the early process of muscle degeneration. Common mechanisms of mt-related cell injury include dysregulation of the mt permeability transition pore opening and defective autophagy. The therapeutic use of mt permeability transition pore modifiers holds promise in various neuromuscular disorders, including muscular dystrophies.

  10. Bloqueio cardíaco completo em espondilite anquilosante Complete heart block in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Juan Pablo Restrepo

    2012-10-01

    Full Text Available A espondilite anquilosante é uma doença reumática crônica de homens jovens que afeta principalmente o esqueleto axial e está associada ao HLA-B27 em 90% dos casos. A incidência de envolvimento cardiovascular em casos de espondilite anquilosante varia entre 10%-30%; foram descritos distúrbios de condução em 1%-9% dos pacientes com a doença. A maior parte do grupo acometido demonstra uma relação com doença de longa data. Este é o primeiro relato de bloqueio cardíaco completo em espondilite anquilosante precoce de nosso conhecimento.Ankylosing spondylitis (AS is a chronic rheumatic disease of young men that affects mainly the axial skeleton and is associated with HLA-B27 in 90% of the cases. Incidence of cardiovascular involvement in AS ranges between 10%-30%; conduction disturbances have been described in 1%-9% of the patients with AS. The majority of the series show a relationship with longstanding disease. To our knowledge, this is the first report of complete heart block in early AS.

  11. Estudo comparativo entre dois protocolos anestésicos envolvendo bloqueio do nervo alveolar inferior convencional e de Vazirani-Akinosi para exodontia de terceiro molar inferior

    Directory of Open Access Journals (Sweden)

    Danilo de Paula Ribeiro Borges

    Full Text Available INTRODUÇÃO: O bloqueio do nervo alveolar inferior (BNAI apresenta alta porcentagem de falha na Odontologia. A fim de melhorar esse índice, vêm-se estudando diferentes alternativas, como diferentes técnicas e soluções anestésicas. OBJETIVO: Avaliar duas diferentes técnicas - técnica convencional e de Vazirani-Akinosi - para o bloqueio do nervo alveolar inferior, bem como compará-las quanto à sua efetividade e quantificar o percentual de aspirações positivas nas duas diferentes técnicas. MATERIAL E MÉTODO: Foram avaliados 160 pacientes de ambos os sexos, sendo 80 submetidos ao bloqueio do nervo alveolar inferior de Vazirani-Akinosi e bloqueio do nervo bucal (G1, e 80 submetidos ao bloqueio do nervo alveolar inferior convencional e ao bloqueio do nervo bucal (G2. Em ambos os grupos, utilizou-se a combinação de articaína 4% com epinefrina 1:100.000 para bloqueio do nervo bucal, e lidocaína 2% com epinefrina 1:100.000 para bloqueio do nervo alveolar inferior. Foram avaliados: a quantidade de aspirações positivas, a eficácia da anestesia e o momento em que ocorreu a falha anestésica durante o procedimento cirúrgico. RESULTADO: Não houve diferenças estatisticamente significantes (p = 0,2453 entre os grupos G1 e G2 observando-se a eficácia e o índice de aspirações positivas, e o momento em que ocorreu a falha anestésica, observando-se uma maior eficácia de ambas as técnicas, quando comparadas com a literatura (90% CONCLUSÃO: Não houve diferença significativa entre o BNAI pela técnica convencional e o BNAI pela técnica de Vazirani-Akinosi quanto a quantidade de aspirações positivas e eficácia, sendo que o uso da articaína 4% com epinefrina 1:100.000 no bloqueio do nervo bucal possivelmente aumentou a eficácia anestésica de ambas as técnicas.

  12. The effects of roxatidine on neuromuscular transmission.

    Science.gov (United States)

    Bossa, R; Chiericozzi, M; Galatulas, I; Salvatore, G; Teli, M; Baggio, G; Castelli, M

    1995-01-01

    We have investigated the effects of the H2 receptor antagonist roxatidine on the neuromuscular transmission by using the sciatic nerve-gastrocnemius muscle preparation of the rat in vivo. Roxatidine, administered by i.v. injection, potentiates the neuromuscular blockade induced by d-tubocurarine, pancuronium and aminoglycoside antibiotic, kanamycin. Moreover, the drug alone is capable of producing a blockade on the preparation stimulated at high frequency. The neuromuscular blockade induced by roxatidine is partially reversed by 4-aminopyridine but not by dimaprit.

  13. Acute neuromuscular weakness associated with dengue infection

    OpenAIRE

    Harmanjit Singh Hira; Amandeep Kaur; Anuj Shukla

    2012-01-01

    Background: Dengue infections may present with neurological complications. Whether these are due to neuromuscular disease or electrolyte imbalance is unclear. Materials and Methods: Eighty-eight patients of dengue fever required hospitalization during epidemic in year 2010. Twelve of them presented with acute neuromuscular weakness. We enrolled them for study. Diagnosis of dengue infection based on clinical profile of patients, positive serum IgM ELISA, NS1 antigen, and sero-typing. Complete ...

  14. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    OpenAIRE

    2013-01-01

    Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  15. Bloqueio do plano transverso abdominal contínuo bilateral em doente com cirurgia abdominal prévia

    Directory of Open Access Journals (Sweden)

    Isabel Flor de Lima

    2013-10-01

    Full Text Available Os autores apresentam um caso clínico em que foi realizado um bloqueio do plano do músculo transverso abdominal, com colocação de cateter bilateral, para analgesia pós-operatória de laparotomia exploradora, em doente com cirurgia abdominal prévia, insuficiência cardíaca, renal e hepática, em opção à analgesia epidural e aos opioides endovenosos em perfusão.

  16. Bases anatômicas para o bloqueio anestésico do plexo braquial por via infraclavicular

    OpenAIRE

    Gusmão,Luiz Carlos Buarque de; Lima, Jacqueline Silva Brito; Prates, José Carlos [UNIFESP

    2002-01-01

    JUSTIFICATIVA E OBJETIVOS: Procuramos demonstrar neste estudo a presença constante da fossa infraclavicular, com a finalidade de sua utilização como via de acesso para o bloqueio anestésico do plexo braquial por via infraclavicular. Visando solucionar o ponto onde os fascículos do plexo braquial podem ser localizados no interior da fossa, propusemos medidas a partir da face anterior da clavícula e do ângulo formado pelo encontro do músculo deltóide com a clavícula (ângulo deltoclavicular). A ...

  17. Neuromuscular Adaptations to Reduced Use

    Science.gov (United States)

    Ploutz-Snyder, Lori

    2009-01-01

    This viewgraph presentation reviews the studies done to reduce neuromuscular strength loss during unilateral lower limb suspension (ULLS). Since there are animals that undergo fairly long periods of muscular disuse without any or minimal muscular atrophy, there is an answer to that might be applicable to human in situations that require no muscular use to diminish the effects of muscular atrophy. Three sets of ULLS studies were reviewed indicated that muscle strength decreased more than the muscle mass. The study reviewed exercise countermeasures to combat the atrophy, including: ischemia maintained during Compound muscle action potential (CMAP), ischemia and low load exercise, Japanese kaatsu, and the potential for rehabilitation or situations where heavy loading is undesirable. Two forms of countermeasures to unloading have been successful, (1) high-load resistance training has maintained muscle mass and strength, and low load resistance training with blood flow restriction (LL(sub BFR)). The LL(sub BFR) has been shown to increase muscle mass and strength. There has been significant interest in Tourniquet training. An increase in Growth Hormone(GH) has been noted for LL(sub BFR) exercise. An experimental study with 16 subjects 8 of whom performed ULLS, and 8 of whom performed ULLS and LL(sub BFR) exercise three times per week during the ULLS. Charts show the results of the two groups, showing that performing LL(sub BFR) exercise during 30 days of ULLS can maintain muscle size and strength and even improve muscular endurance.

  18. Protein defects in neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Vainzof M.

    2003-01-01

    Full Text Available Muscular dystrophies are a heterogeneous group of genetically determined progressive disorders of the muscle with a primary or predominant involvement of the pelvic or shoulder girdle musculature. The clinical course is highly variable, ranging from severe congenital forms with rapid progression to milder forms with later onset and a slower course. In recent years, several proteins from the sarcolemmal muscle membrane (dystrophin, sarcoglycans, dysferlin, caveolin-3, from the extracellular matrix (alpha2-laminin, collagen VI, from the sarcomere (telethonin, myotilin, titin, nebulin, from the muscle cytosol (calpain 3, TRIM32, from the nucleus (emerin, lamin A/C, survival motor neuron protein, and from the glycosylation pathway (fukutin, fukutin-related protein have been identified. Mutations in their respective genes are responsible for different forms of neuromuscular diseases. Protein analysis using Western blotting or immunohistochemistry with specific antibodies is of the utmost importance for the differential diagnosis and elucidation of the physiopathology of each genetic disorder involved. Recent molecular studies have shown clinical inter- and intra-familial variability in several genetic disorders highlighting the importance of other factors in determining phenotypic expression and the role of possible modifying genes and protein interactions. Developmental studies can help elucidate the mechanism of normal muscle formation and thus muscle regeneration. In the last fifteen years, our research has focused on muscle protein expression, localization and possible interactions in patients affected by different forms of muscular dystrophies. The main objective of this review is to summarize the most recent findings in the field and our own contribution.

  19. Técnicas modernas em espectrometria de massas aplicadas no isolamento de bioherbicidas produzidos por microrganismos

    OpenAIRE

    Tânia Petta

    2008-01-01

    Neste trabalho foi empregada uma metodologia rápida e eficiente para a identificação de metabólitos fitotóxicos produzidos por microrganismos. O isolamento do composto bioativo foi guiado através de bioensaio com Lemna minor. A espectrometria de massas, em especial o LC-MS, foi utilizada para acelerar o processo de identificação do composto ativo. As bactérias estudadas eram simbióticas do fungo fitopatogênico Sclerotium rolfsii. Seus respectivos extratos orgânicos obtidos de culturas em meio...

  20. Scoliosis and the impact in neuromuscular disease.

    Science.gov (United States)

    Mayer, Oscar Henry

    2015-01-01

    Scoliosis can alter respiratory mechanics by changing the orientation of the muscles and joints of the respiratory system and in severe forms can put a patient at risk of severe respiratory morbidity or respiratory failure. However, perhaps the most important factor in determining the pulmonary morbidity in scoliosis is the balance between the "load" or altered respiratory mechanics and the "pump" or the respiratory muscle strength. Therefore, scoliosis in patients with neuromuscular disease will both lead to increased "load" and a weakened "pump", an exceptionally unfortunate combination. While progressive neuromuscular disease by its nature does not respond favorably to attempts to improve respiratory muscle strength, the natural approach of early proactive management of the "load" and in the case of scoliosis a variety of different strategies have been tried with variable short term and long term results. Figuring this out requires both an understanding of the underlying pathophysiology of a particular neuromuscular condition and the available options for and timing of surgical intervention.

  1. Bloqueios nervosos guiados por ultra-som Bloqueos nerviosos guiados por ultrasonido Ultrasound-guided nerve blocks

    Directory of Open Access Journals (Sweden)

    Pablo Escovedo Helayel

    2007-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As técnicas de bloqueios nervosos guiados por ultra-som são baseadas na visualização direta das estruturas nervosas, da agulha de bloqueio e das estruturas anatômicas adjacentes. Desta maneira, é possível depositar a solução de anestésico local precisamente em torno dos nervos e acompanhar a sua dispersão em tempo real, obtendo-se, assim, um bloqueio mais eficaz, de menor latência, menor dependência de referências anatômicas, menor volume de solução anestésica e maior segurança. CONTEÚDO: O artigo revisa os aspectos relativos aos mecanismos físicos para formação de imagens, a anatomia ultra-sonográfica do neuroeixo e dos plexos braquial e lombossacral, os equipamentos e materiais empregados nos bloqueios, os ajustes do aparelho de ultra-som para melhorar as imagens, os planos de visualização das agulhas de bloqueio e as técnicas e o treinamento em bloqueios guiados por ultra-som. CONCLUSÕES: Os passos para se obter sucesso em anestesia regional incluem a identificação exata da posição dos nervos, a localização precisa da agulha, sem lesões nas estruturas adjacentes e, finalmente, a injeção cuidadosa de anestésico local junto aos nervos. Embora a neuroestimulação forneça grande auxílio na identificação dos nervos, esta não consegue, isoladamente, preencher todas essas exigências. Por isso, acredita-se que os bloqueios guiados por ultra-som serão a técnica de eleição para anestesia regional num futuro não muito distante.JUSTIFICATIVA Y OBJETIVOS: Las técnicas de bloqueos nerviosos guiados por ultrasonido se basan en la visualización directa de las estructuras nerviosas, de la aguja de bloqueo y de las estructuras anatómicas adyacentes. De esa manera, se puede depositar la solución de anestésico local precisamente en torno de los nervios y acompañar su dispersión en tiempo real, obteniéndose así, un bloqueo más eficaz, de menor latencia, menor dependencia de

  2. Research highlights of partial neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Cheng ZHANG

    2014-05-01

    Full Text Available In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type Ⅱ (GSD Ⅱ, Duchenne muscular dystrophy (DMD, amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. The important references will be useful for clinicians. doi: 10.3969/j.issn.1672-6731.2014.05.004

  3. Neuromuscular action of crotalid venom: preliminar data

    OpenAIRE

    Maria Dorvalina Silva; Luiz Antônio L. Resende; Anete Kimuni Ueda; Benedito Barraviera; Mendes, R P; Montenegro, Mário Rubens G. [UNESP

    1996-01-01

    Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores ad...

  4. 21 CFR 882.5860 - Implanted neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implanted neuromuscular stimulator. 882.5860... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5860 Implanted neuromuscular stimulator. (a) Identification. An implanted neuromuscular stimulator is a device that...

  5. Prevalence of complications in neuromuscular scoliosis surgery

    DEFF Research Database (Denmark)

    Sharma, Shallu; Wu, Chunsen; Andersen, Thomas;

    2013-01-01

    PURPOSE: Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. METHODS: PubMed and Em...

  6. Neuromuscular Effects of Acute Organophosphate Poisoning

    Directory of Open Access Journals (Sweden)

    Taylan Pekoz

    2014-08-01

    Conclusion: There is no evoked potential studies performed in organophosphate poisoning althoung electroneurography repetitive and P300 studies exist in literature. More further studies are needed to evaluate the cardiac and neuromuscular effects of organophosphate poisoning. [Cukurova Med J 2014; 39(4.000: 795-800

  7. CLINICAL PHARMACOKINETICS OF NEUROMUSCULAR BLOCKING-DRUGS

    NARCIS (Netherlands)

    AGOSTON, S; VANDENBROM, RHG; WIERDA, JMKH

    1992-01-01

    Neuromuscular blocking agents provide muscle relaxation for a great variety of surgical procedures with light planes of general anaesthesia. Besides having a significant impact in the development of anaesthesia and surgery, these agents continue to play an important role as pharmacological tools in

  8. Electrodiagnosis of disorders of neuromuscular transmission.

    Science.gov (United States)

    Howard, James F

    2013-02-01

    This article reviews the use of electrodiagnostic testing in disorders of neuromuscular transmission and discusses the differences between various presynaptic and postsynaptic disorders. Attention is paid to quality control issues that influence the sensitivity of repetitive nerve stimulation and single fiber electromyography. Electrodiagnostic testing, when used as an extension of the clinician's history and physical examination, will provide appropriate direction in establishing the diagnosis.

  9. Benzo(apireno em óleos de milho produzidos e comercializados no Brasil

    Directory of Open Access Journals (Sweden)

    TOLEDO M. Cecilia de F.

    1998-01-01

    Full Text Available Óleos de milho de diferentes marcas, produzidos e comercializados no Brasil, foram analisados quanto à presença de benzo(apireno (B(aP. A metodologia utilizada envolveu extração com ciclohexano, purificação em coluna de silica gel e determinação por cromatografia líquida de alta eficiência com detector de fluorescência. Todas amostras analisadas mostraram-se contaminadas por B(aP e os níveis determinados variaram entre as diferentes marcas analisadas e entre diferentes lotes de mesma marca, dentro da faixa de 0,85 a 25,17 µg/kg. Entre 49 amostras analisadas no período de dois anos, apenas uma apresentou nível de contaminação por B(aP abaixo do limite referencial de 1 µg/kg.

  10. Neuromuscular blockade in children Bloqueadores neuromusculares em crianças

    Directory of Open Access Journals (Sweden)

    João Fernando Lourenço de Almeida

    2000-06-01

    Full Text Available Neuromuscular blocking agents (NMBAs have been widely used to control patients who need to be immobilized for some kind of medical intervention, such as an invasive procedure or synchronism with mechanical ventilation. The purpose of this monograph is to review the pharmacology of the NMBAs, to compare the main differences between the neuromuscular junction in neonates, infants, toddlers and adults, and moreover to discuss their indications in critically ill pediatric patients. Continuous improvement of knowledge about NMBAs pharmacology, adverse effects, and the many other remaining unanswered questions about neuromuscular junction and neuromuscular blockade in children is essential for the correct use of these drugs. Therefore, the indication of these agents in pediatrics is determined with extreme judiciousness. Computorized (Medline 1990-2000 and active search of articles were the mechanisms used in this review.Os bloqueadores neuromusculares têm sido amplamente utilizados para controlar pacientes que necessitem imobilidade para algum tipo de intervenção médica, desde a realização de procedimentos invasivos até a obtenção de sincronismo com a ventilação mecânica. O objetivo básico desta monografia é revisar a farmacologia dos principais bloqueadores neuromusculares, analisar as diferenças existentes na junção neuromuscular de neonatos, lactentes, pré-escolares e adultos, além de discutir suas indicações em pacientes criticamente enfermos internados em unidade de terapia intensiva pediátrica. Revisão computadorizada da literatura (Medline 1990-2000 associado a busca ativa de artigos compuseram o mecanismo de busca dos dados desta revisão.

  11. Riscos cardiovasculares do bloqueio androgênico Riesgos cardiovasculares del bloqueo androgénico Cardiovascular risks of androgen deprivation therapy

    OpenAIRE

    Adriano Freitas Ribeiro; César Camara; Carlos Alexandre Segre; Miguel Srougi; Serrano Jr., Carlos V.

    2010-01-01

    O adenocarcinoma de próstata é o câncer mais comum no sexo masculino após o câncer de pele. Entre as várias formas de tratamento do câncer de próstata, a terapia de bloqueio androgênico é uma modalidade consagrada nos pacientes com doença metastática ou localmente avançada, que provavelmente resulta em aumento de sobrevida. No entanto, o bloqueio androgênico é causador de uma série de consequências adversas. Complicações como osteoporose, disfunção sexual, ginecomastia, anemia e alterações na...

  12. Neuromuscular blockade during laparoscopic ventral herniotomy

    DEFF Research Database (Denmark)

    Medici, Roar; Madsen, Matias V; Asadzadeh, Sami;

    2015-01-01

    INTRODUCTION: Laparoscopic herniotomy is the preferred technique for some ventral hernias. Several factors may influence the surgical conditions, one being the depth of neuromuscular blockade (NMB) applied. We hypothesised that deep neuromuscular blockade defined as a post-tetanic count below eight...... would provide a better surgical workspace. METHODS: This was an investigator-initiated, assessor- and patient-blinded randomised cross-over study. A total of 34 patients with planned laparoscopic umbilical, incisional and linea alba herniotomy were studied. Patients would be randomised to receive deep......'s rating of surgical conditions during suturing, duration of surgery and duration of the suturing of the hernia. CONCLUSION: This randomised cross-over study investigated a potential effect on the surgical workspace in laparoscopic ventral herniotomy using deep NMB compared with no NMB. The study may...

  13. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V;

    2015-01-01

    PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS......: An assessor-blinded, randomised controlled trial including people aged 30-50 years with no to mild pain following medial arthroscopic partial meniscectomy was conducted. Participants were randomly allocated to either a 12-week neuromuscular exercise program that targeted neutral lower limb alignment...... or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary...

  14. Neuromuscular monitoring: old issues, new controversies.

    Science.gov (United States)

    Kopman, Aaron F

    2009-03-01

    "Expert" editorial opinion suggests that objective or quantitative neuromuscular monitors should be used whenever nondepolarizing blocking agents are administered. It is clear that this advice has by and large fallen on deaf ears. A sizeable number of clinicians here (North America) and abroad (Europe) fail to use even conventional peripheral nerve stimulators routinely. This chapter will explore potential reasons for and consequences of this disconnect between academia and "the real world." Along the way, we will examine such questions as how do we define and measure adequate recovery from nondepolarizing block. What are the limitations of clinical tests of recovery such as the "head-lift test?" What is the incidence of undetected postoperative residual curarization (PORC)? Does neuromuscular monitoring reduce the frequency of PORC? How will the availability of sugammadex alter the above discussion?

  15. Neuromuscular adaptation to actual and simulated weightlessness

    Science.gov (United States)

    Edgerton, V. R.; Roy, R. R.

    1994-01-01

    The chronic "unloading" of the neuromuscular system during spaceflight has detrimental functional and morphological effects. Changes in the metabolic and mechanical properties of the musculature can be attributed largely to the loss of muscle protein and the alteration in the relative proportion of the proteins in skeletal muscle, particularly in the muscles that have an antigravity function under normal loading conditions. These adaptations could result in decrements in the performance of routine or specialized motor tasks, both of which may be critical for survival in an altered gravitational field, i.e., during spaceflight and during return to 1 G. For example, the loss in extensor muscle mass requires a higher percentage of recruitment of the motor pools for any specific motor task. Thus, a faster rate of fatigue will occur in the activated muscles. These consequences emphasize the importance of developing techniques for minimizing muscle loss during spaceflight, at least in preparation for the return to 1 G after spaceflight. New insights into the complexity and the interactive elements that contribute to the neuromuscular adaptations to space have been gained from studies of the role of exercise and/or growth factors as countermeasures of atrophy. The present chapter illustrates the inevitable interactive effects of neural and muscular systems in adapting to space. It also describes the considerable progress that has been made toward the goal of minimizing the functional impact of the stimuli that induce the neuromuscular adaptations to space.

  16. Influence of intense neuromuscular blockade on surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Donatsky, Anders Meller; Jensen, Bente Rona

    2015-01-01

    neuromuscular block on surgical conditions with a subjective rating scale, force needed to close the fascia, incidences of abdominal contractions while suctioning the lungs, width of the wound diastase and operating time as outcome parameters. RESULTS: In all six pigs no abdominal contractions occurred while......, operating time and subjective ratings using a four-point rating scale when comparing no neuromuscular block with intense neuromuscular block. However, these outcomes were related to the order of the suturing round. CONCLUSION: Intense neuromuscular block prevented abdominal muscle contractions but did...

  17. Bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno intravenoso melhora a analgesia após histerectomia abdominal

    Directory of Open Access Journals (Sweden)

    Evren Yucel

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da aplicação intravenosa(IV de dexcetoprofeno trometamol em bloqueio dos nervos ilioinguinal e ílio-hipogástrico na qualidade analgésica e no consumo de morfina após histerectomia abdominal total. MÉTODO: Estudo clínico controlado e randomizado conduzido com 61 pacientes. O estudo foi feito em sala de operação, sala de recuperação pós-anestésica e ambulatório. Os 61 pacientes foram randomicamente alocados em três grupos: grupo controle (Grupo C, grupo bloqueio (Grupo B e grupo bloqueio com dexcetoprofeno (Grupo BD. Antes da incisão cirúrgica feita após a indução da anestesia, fizemos o bloqueio dos nervos ilioinguinal e ilio-hipogástrico (Grupo C recebeu solução salina e grupos B e BD receberam levobupivacaína. Em contraste com os grupos C e B, o Grupo BD recebeu dexcetoprofeno. Administramos morfina a todos os pacientes para analgesia, com o uso do método de analgesia controlada pelo paciente (ACP durante o pós-operatório de 24 horas. Registramos os escores para dor pela escala visual analógica (EVA, os índices de satisfação, o consumo de morfina e os efeitos colaterais durante o pós-operatório de 24 horas. RESULTADOS: Os escores EVA do Grupo BD foram menores do que os dos grupos C e B no pós-operatório (p < 0,05 nos intervalos de 1, 2, 6 e 12 horas. Os escores EVA do Grupo C foram maiores do que os do Grupo B nas primeiras 2 horas de pós-operatório. O tempo até a primeira demanda de ACP foi mais longo, os valores de consumo de morfina mais baixos e os índices de satisfação maiores no Grupo BD do que nos outros dois grupos (p < 0,05. CONCLUSÃO: O bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno IV aumenta a satisfação do paciente e diminui o consumo de opioides e sugere que dexcetoprofeno trometamol é um analgésico anti-inflamatório não esteroide eficaz em analgesia pós-operatória.

  18. Níveis de organoclorados em queijos produzidos no Estado do Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Santos Joice Sifuentes dos

    2006-01-01

    Full Text Available Os compostos organoclorados são pesticidas que foram usados na agricultura, no controle de vetores biológicos e de ectoparasitas do gado. Atualmente seu uso está proibido no Brasil, exceto para o controle de vetores biológicos em casos de epidemia. No entanto, resíduos desses compostos ainda são encontrados no meio ambiente e nos alimentos. Por esse motivo, avaliou-se a presença de organoclorados em queijos produzidos no Estado do Rio Grande do Sul (Brasil, bem como os níveis desses compostos em queijos dos tipos "colonial" e industrializado. A gordura das amostras foi extraída pela adição de sulfato de sódio seguida por uma lavagem com éter de petróleo. Os pesticidas foram purificados a partir da gordura em uma coluna contendo florisil e eluída com hexano. O extrato obtido foi utilizado para as análises cromatográficas (cromatografia gasosa com captura de elétrons. Os compostos alfa-HCH, HCB, lindano, aldrin, o,p-DDD e p,p-DDD foram identificados em 100% das amostras; o,p-DDE em 88,9% e o,p-DDT em 94,4%. p,p-DDD foi o pesticida detectado na maior concentração (11,5ng g-1 de gordura, seguido pelo aldrin (8,7ng g-1 de gordura. Os níveis de alfa-HCH, aldrin e DDT total foram maiores que o limite máximo de resíduos em 2, 8 e 1 amostra de queijo, respectivamente. Não foram encontradas diferenças significativas nos níveis de organoclorados entre as amostras de queijo "colonial" e industrializado, ou entre amostras de queijos produzidos em três regiões do Estado.

  19. Neuromuscular Manifestations of West Nile Virus Infection

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    A. Arturo eLeis

    2012-03-01

    Full Text Available The most common neuromuscular manifestation of West Nile virus (WNV infection is a poliomyelitis syndrome with asymmetric paralysis variably involving one (monoparesis to four limbs (quadriparesis, with or without brainstem involvement and respiratory failure. This syndrome of acute flaccid paralysis may occur without overt fever or meningoencephalitis. Although involvement of anterior horn cells in the spinal cord and motor neurons in the brainstem are the major sites of pathology responsible for neuromuscular signs, inflammation also may involve skeletal or cardiac muscle (myositis, myocarditis, motor axons (polyradiculitis, peripheral nerve (Guillain-Barré syndrome, brachial plexopathy. In addition, involvement of spinal sympathetic neurons and ganglia provides a plausible explanation for autonomic instability seen in some patients. Many patients also experience prolonged subjective generalized weakness and disabling fatigue. Despite recent evidence that WNV may persist long term in the central nervous system or periphery in animals, the evidence in humans is controversial. WNV persistence would be of great concern in immunosuppressed patients or in those with prolonged or recurrent symptoms. Support for the contention that WNV can lead to autoimmune disease arises from reports of patients presenting with various neuromuscular diseases that presumably involve autoimmune mechanisms (GBS, other demyelinating neu¬ropathies, myasthenia gravis, brachial plexopathies, stiff-person syndrome, and delayed or recurrent symptoms. Although there is no specific treatment or vaccine currently approved in humans, and the standard remains supportive care, drugs that can alter the cascade of immunobiochemical events leading to neuronal death may be potentially useful (high-dose corticosteroids, interferon preparations, and intravenous immune globulin containing WNV-specific antibodies. Human experience with these agents seems promising based on anecdotal

  20. Acute neuromuscular weakness associated with dengue infection

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    Harmanjit Singh Hira

    2012-01-01

    Full Text Available Background: Dengue infections may present with neurological complications. Whether these are due to neuromuscular disease or electrolyte imbalance is unclear. Materials and Methods: Eighty-eight patients of dengue fever required hospitalization during epidemic in year 2010. Twelve of them presented with acute neuromuscular weakness. We enrolled them for study. Diagnosis of dengue infection based on clinical profile of patients, positive serum IgM ELISA, NS1 antigen, and sero-typing. Complete hemogram, kidney and liver functions, serum electrolytes, and creatine phosphokinase (CPK were tested. In addition, two patients underwent nerve conduction velocity (NCV test and electromyography. Results: Twelve patients were included in the present study. Their age was between 18 and 34 years. Fever, myalgia, and motor weakness of limbs were most common presenting symptoms. Motor weakness developed on 2 nd to 4 th day of illness in 11 of 12 patients. In one patient, it developed on 10 th day of illness. Ten of 12 showed hypokalemia. One was of Guillain-Barré syndrome and other suffered from myositis; they underwent NCV and electromyography. Serum CPK and SGOT raised in 8 out of 12 patients. CPK of patient of myositis was 5098 IU. All of 12 patients had thrombocytopenia. WBC was in normal range. Dengue virus was isolated in three patients, and it was of serotype 1. CSF was normal in all. Within 24 hours, those with hypokalemia recovered by potassium correction. Conclusions: It was concluded that the dengue virus infection led to acute neuromuscular weakness because of hypokalemia, myositis, and Guillain-Barré syndrome. It was suggested to look for presence of hypokalemia in such patients.

  1. [Transition experience of patients with neuromuscular disease].

    Science.gov (United States)

    Greif, Valeria; Ugo, Florencia; de Castro Pérez, M Fernanda; Mozzoni, Julieta; Aguerre, Verónica; Saldías, Milagros; Monges, M Soledad

    2017-02-01

    Neuromuscular diseases are mostly genetic disorders, with chronic and progressive course. Affected people are at high risk of developing physical and emotional disabilities. In the last decades, the advance in technology and science has increased chronic pediatric patients survival rate, thus requiring an ongoing assistance in adult hospitals, making the transition a necessity and a challenge. This article reports the clinical practice designed between Hospital Garrahan and Hospital Ramos Mejía for the transition of 27 adolescents during 2015, setting achievements, findings and challenges resulting from this experience.

  2. Desarrollo neuromuscular en la atrofia muscular espinal

    OpenAIRE

    Martínez Hernàndez, Rebeca

    2012-01-01

    INTRODUCCIÓN: La atrofia muscular espinal (AME) es una enfermedad neuromuscular infantil caracterizada por la muerte de las neuronas motoras del asta anterior de la médula espinal. Como consecuencia de ello hay una degeneración y atrofia muscular, por lo que los pacientes mueren a menudo de insuficiencias respiratorias graves. La AME se clasifica en tres tipos principales según el grado de gravedad, la edad de aparición y las pautas motoras. Se trata de una enfermedad con patrón de herencia a...

  3. Bloqueio combinado raquiperidural versus bloqueio peridural contínuo para analgesia de parto em primigestas: resultados maternos e perinatais Combined spinal-epidural block versus continuous epidural block in labor analgesia for primiparous women: newborns and women outcomes

    Directory of Open Access Journals (Sweden)

    Márcio Antonio de Souza

    2009-10-01

    Full Text Available OBJETIVOS: comparar a evolução materna e perinatal após a utilização da analgesia peridural contínua versus analgesia combinada raqui-peridural em parturientes primigestas. MÉTODOS: foi realizado ensaio clínico aleatorizado com 128 gestantes primigestas em trabalho de parto, divididas em dois grupos: analgesia peridural (APC com 65 mulheres e grupo analgesia combinada raqui-peridural (ACRP com 63, admitidas no pré-parto de duas maternidades na cidade de Jundiaí - SP. Foram estudadas as variáveis: tempo de latência de instalação da analgesia, intensidade da dor e tempo total decorrido até a dilatação completa, índice de Apgar no primeiro e quinto minutos, tempo de resolução do parto, grau de bloqueio motor, efeitos adversos como náuseas, vômitos, prurido, hipotensão arterial, e grau de satisfação materna. Foram critérios de inclusão: primigestas, estado físico ASA 1 e 2, feto único, apresentação cefálica, de termo, dilatação cervical de 3 a 6 cm e solicitação de analgesia pelo obstetra. Foram excluídas mulheres com morbidades, ruptura de membranas, anormalidades fetais e uso de opioides até quatro horas antes. Para a análise estatística utilizou-se o teste de Mann-Whitney para as variáveis contínuas não paramétricas e os testes exato de Fisher e χ2 de Pearson, para variáveis categóricas. RESULTADOS: não houve diferença entre os grupos para velocidade de dilatação cervical, tempo para resolução do parto, parâmetros hemodinâmicos maternos, vitalidade do recém-nascido, complementações analgésicas durante o trabalho de parto e modo de parto. Houve maior rapidez de instalação da analgesia no grupo da ACRP e menor bloqueio motor no grupo de APC. Não foram observadas diferenças em relação aos efeitos adversos como náuseas, vômitos, prurido e hipotensão, sendo hipotensão mais frequente no grupo APC (16,9 versus 6,3% e náusea no grupo ACRP (6,3 versus 3,1%. CONCLUSÕES: as duas t

  4. Neuromuscular disruption with ultrashort electrical pulses

    Science.gov (United States)

    Pakhomov, Andrei; Kolb, Juergen F.; Joshi, Ravindra P.; Schoenbach, Karl H.; Dayton, Thomas; Comeaux, James; Ashmore, John; Beason, Charles

    2006-05-01

    Experimental studies on single cells have shown that application of pulsed voltages, with submicrosecond pulse duration and an electric field on the order of 10 kV/cm, causes sudden alterations in the intracellular free calcium concentration, followed by immobilization of the cell. In order to examine electrical stimulation and incapacitation with such ultrashort pulses, experiments on anesthetized rats have been performed. The effect of single, 450 nanosecond monopolar pulses have been compared with that of single pulses with multi-microsecond duration (TASER pulses). Two conditions were explored: 1. the ability to elicit a muscle twitch, and, 2. the ability to suppress voluntary movement by using nanosecond pulses. The second condition is relevant for neuromuscular incapacitation. The preliminary results indicate that for stimulation microsecond pulses are advantageous over nanosecond pulses, whereas for incapacitation, the opposite seems to apply. The stimulation effects seem to scale with electrical charge, whereas the disruption effects don't follow a simple scaling law. The increase in intensity (time of incapacitation) for a given pulse duration, is increasing with electrical energy, but is more efficient for nanosecond than for microsecond pulses. This indicates different cellular mechanisms for incapacitation, most likely subcellular processes, which have been shown to become increasingly important when the pulse duration is shortened into the nanosecond range. If further studies can confirm these initial results, consequences of reduced pulse duration are a reduction in weight and volume of the pulse delivery system, and likely, because of the lower required energy for neuromuscular incapacitation, reduced safety risks.

  5. Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

    Science.gov (United States)

    Çankayalı, İlkin; Boyacılar, Özden; Demirağ, Kubilay; Uyar, Mehmet; Moral, Ali Reşat

    2016-01-01

    Background: Electrophysiological studies show that critical illness polyneuromyopathy appears in the early stage of sepsis before the manifestation of clinical findings. The metabolic response observed during sepsis causes glutamine to become a relative essential amino acid. Aims: We aimed to assess the changes in neuromuscular transmission in the early stage of sepsis after glutamine supplementation. Study Design: Animal experimentation. Methods: Twenty male Sprague-Dawley rats were randomized into two groups. Rats in both groups were given normal feeding for one week. In the study group, 1 g/kg/day glutamine was added to normal feeding by feeding tube for one week. Cecal ligation and perforation (CLP) surgery was performed at the end of one week. Before and 24 hours after CLP, compound muscle action potentials were recorded from the gastrocnemius muscle. Results: Latency measurements before and 24 hours after CLP were 0.68±0.05 ms and 0.80±0.09 ms in the control group and 0.69±0.07 ms and 0.73±0.07 ms in the study group (p<0.05). Conclusion: Since enteral glutamine prevented compound muscle action potentials (CMAP) latency prolongation in the early phase of sepsis, it was concluded that enteral glutamine replacement might be promising in the prevention of neuromuscular dysfunction in sepsis; however, further studies are required. PMID:27308070

  6. Electrophysiological study in neuromuscular junction disorders

    Directory of Open Access Journals (Sweden)

    Ajith Cherian

    2013-01-01

    Full Text Available This review is on ultrastructure and subcellular physiology at normal and abnormal neuromuscular junctions. The clinical and electrophysiological findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome (LEMS, congenital myasthenic syndromes, and botulinum intoxication are discussed. Single fiber electromyography (SFEMG helps to explain the basis of testing neuromuscular junction function by repetitive nerve stimulation (RNS. SFEMG requires skill and patience and its availability is limited to a few centers. For RNS supramaximal stimulation is essential and so is display of the whole waveform of each muscle response at maximum amplitude. The amplitudes of the negative phase of the first and fourth responses are measured from baseline to negative peak, and the percent change of the fourth response compared with the first represents the decrement or increment. A decrement greater than 10% is accepted as abnormal and smooth progression of response amplitude train and reproducibility form the crux. In suspected LEMS the effect of fast rates of stimulation should be determined after RNS response to slow rates of stimulation. Caution is required to avoid misinterpretation of potentiation and pseudofacilitation.

  7. Neuromuscular imaging in inherited muscle diseases

    Energy Technology Data Exchange (ETDEWEB)

    Wattjes, Mike P. [VU University Medical Center, Department of Radiology, De Boelelaan 1117, HV, Amsterdam (Netherlands); Kley, Rudolf A. [Klinken Bergmannsheil, Ruhr-University, Department of Neurology, Neuromuscular Centre Ruhrgebiet, Bochum (Germany); Fischer, Dirk [University Hospital of Basel, Department of Neurology, Basel (Switzerland); University Children' s Hospital Basel, Department of Neuropaediatrics, Basel (Switzerland)

    2010-10-15

    Driven by increasing numbers of newly identified genetic defects and new insights into the field of inherited muscle diseases, neuromuscular imaging in general and magnetic resonance imaging (MRI) in particular are increasingly being used to characterise the severity and pattern of muscle involvement. Although muscle biopsy is still the gold standard for the establishment of the definitive diagnosis, muscular imaging is an important diagnostic tool for the detection and quantification of dystrophic changes during the clinical workup of patients with hereditary muscle diseases. MRI is frequently used to describe muscle involvement patterns, which aids in narrowing of the differential diagnosis and distinguishing between dystrophic and non-dystrophic diseases. Recent work has demonstrated the usefulness of muscle imaging for the detection of specific congenital myopathies, mainly for the identification of the underlying genetic defect in core and centronuclear myopathies. Muscle imaging demonstrates characteristic patterns, which can be helpful for the differentiation of individual limb girdle muscular dystrophies. The aim of this review is to give a comprehensive overview of current methods and applications as well as future perspectives in the field of neuromuscular imaging in inherited muscle diseases. We also provide diagnostic algorithms that might guide us through the differential diagnosis in hereditary myopathies. (orig.)

  8. NEUROMUSCULAR AND CARDIOVASCULAR EFFECTS OF NEOSTIGMINE AND METHYL-ATROPINE ADMINISTERED AT DIFFERENT DEGREES OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK

    NARCIS (Netherlands)

    VANDENBROEK, L; PROOST, JH; WIERDA, JMKH; NJOO, MD; HENNIS, PJ

    1994-01-01

    The neuromuscular and cardiovascular effects of neostigmine, 40 mug kg-1, and methyl-atropine, 7 mug kg-1, administered at different degrees of rocuronium-induced (600 mug kg-1) neuromuscular block were evaluated. In one group of patients spontaneous recovery was awaited (Group A; n = 20). Neostigmi

  9. Nova técnica de bloqueio do plexo braquial em cães New technique of brachial plexus block in dogs

    Directory of Open Access Journals (Sweden)

    Fábio Futema

    1999-03-01

    Full Text Available O objetivo do presente estudo foi analisar a viabilidade e a eficácia de uma nova técnica para o bloqueio do plexo braquial em cães. Para tanto, foram utilizados 11 cães, machos e fêmeas, idade e peso variáveis e mestiços. Os animais foram pré-tratados com acepromazina e a indução da anestesia foi realizada com propofol. Posteriormente, os animais foram submetidos ao bloqueio do plexo braquial que constou da associação da técnica de múltiplas injeções com o emprego do estimulador de nervos e a técnica da palpação arterial como ponto de referência para a localização dos nervos. Utilizou-se como anestésico local, a bupivacaína com vasoconstritor administrado na dose total de 4mg/kg a 0,375% . O volume total foi dividido em 4 partes iguais, administradas na velocidade de 30 segundos cada, com o objetivo de se atingir a maior quantidade de nervos. O tempo necessário para realização da técnica foi de 11,30 ± 4,54 minutos; o período de latência para o bloqueio motor foi de 9,70 ± 5,52 minutos e para o bloqueio sensitivo foi de 26,20 ± 8,86 min. , sendo a duração da analgesia de 11:00 ± 0:45 horas. Em 90% dos animais, o bloqueio foi efetivo, constatado através da anestesia de todo membro torácico distal à articulação escápulo-umeral. A única complicação observada foi a hipotensão arterial desenvolvida em um animal. Mediante os resultados obtidos, pode-se pressupor que as cirurgias envolvendo o membro torácico distal à articulação escápulo-umeral poderão ser utilizadas com auxílio desta nova técnica do bloqueio do plexo braquial, bem como na analgesia pós-operatória de longa duração.The aim of this study was to evaluate the viability and efficacy of a new technique of brachial plexus block in dogs. Eleven mongrel dogs of different ages and weight, both male and female were used. Animals were pre-medicated with acepromazine and induction of anesthesia was performed with propofol. The brachial

  10. New considerations on pupillary block mechanim Novas considerações sobre o mecanismo do bloqueio pupilar

    Directory of Open Access Journals (Sweden)

    Sebastião Cronemberger

    2010-02-01

    Full Text Available PURPOSE: To study the mechanisms of pupillary block in eyes with occludable angle by ultrasound biomicroscopy. METHODS: Initially, a pilot study of 13 eyes with acute primary angle-closure without medication was executed. Ultrasound biomicroscopy measurements of the angle, posterior chamber depth and iris thickness were performed in the temporal quadrant under light and dark conditions. Afterwards, ultrasound biomicroscopy measurements of iris-lens contact distance and iris-lens angle in the temporal quadrant and central anterior chamber depht were made in 32 eyes with acute primary angle-closure or intermittent primary angle-closure without medication, under light and dark conditions before and after laser peripheral iridectomy. RESULTS: In the pilot study, a significant decrease in the angle as well as a significant increase in the iris thickness occurred when comparing light to dark conditions. Before and after laser peripheral iridectomy (second study, significant differences were found in iris-lens contact distance (POBJETIVO: Investigar o mecanismo do bloqueio pupilar em olhos com fechamento angular primário agudo ou intermitente por meio da biomicroscopia ultrassônica. MÉTODOS: Inicialmente, fez-se estudo piloto de 13 olhos com fechamento angular primário agudo sem medicação. Medimos pela biomicroscopia ultrassônica, no claro e no escuro, a amplitude do seio camerular, a profundidade da câmara posterior e a espessura da íris no quadrante temporal. Posteriormente, avaliamos pela biomicroscopia ultrassônica 32 olhos com fechamento angular primário agudo ou fechamento angular intermitente sem medicação, no claro e no escuro e antes e após iridectomia periférica. Medimos a distância de contato irido-cristaliniano e o ângulo irido-cristaliniano no quadrante temporal e a profundidade central da câmara anterior. RESULTADOS: No estudo piloto, demonstrou-se com significância estatística redução da amplitude do seio camerular

  11. A dissincronia mecânica é semelhante em diferentes padrões do bloqueio de ramo esquerdo

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    Rodrigo Bellio de Mattos Barretto

    2013-11-01

    Full Text Available FUNDAMENTOS: O bloqueio do ramo esquerdo (BRE e a presença de disfunção sistólica são as principais indicações de terapia de ressincronização cardíaca (TRC. A dissincronia ventricular mecânica pela ecocardiografia pode ajudar a identificar pacientes responsivos à TRC. O BRE pode mostrar diferentes padrões em sua morfologia. OBJETIVO: Comparar a prevalência de dissincronia mecânica em diferentes padrões de BRE em pacientes com disfunção sistólica esquerda. MÉTODOS: Analisaram-se 48 pacientes com fração de ejeção (FE 150 ms. RESULTADOS: Eram 24 homens, com idade 60 ± 11 anos e FEVE de 29 ± 7%. Trinta e dois apresentavam QRS > 150 ms, e 22, ECG eixo entre -30º e +90º. A dissincronia interventricular foi identificada em 73% dos pacientes e a intraventricular em valores entre 37-98%. Portadores de QRS > 150 ms apresentaram maiores dimensões do átrio e ventrículo esquerdos, e menor FE (p < 0,05, e o desvio esquerdo do eixo associou-se a pior função diastólica e maior diâmetro atrial. A presença de dissincronia mecânica interventricular e intraventricular (10 métodos foi semelhante entre os diferentes padrões de BRE (p = ns. CONCLUSÃO: Nos dois diferentes padrões eletrocardiográficos de BRE analisados, não foram observadas diferenças em relação à presença de dissincronia mecânica.

  12. Avaliação da adição do tramadol sobre o tempo de regressão do bloqueio motor induzido pela lidocaína: estudo experimental em ratos

    OpenAIRE

    Sousa,Angela Maria; Cutait,Martim M; ASHMAWI, Hazem Adel

    2013-01-01

    JUSTIFICATIVA E OBJETIVOS: O tramadol bloqueia potenciais somatossensitivos in vitro e pode ser associado a anestésicos locais com o intuito de melhorar a qualidade da analgesia. O objetivo deste estudo foi avaliar se o tramadol altera o tempo de regressão do bloqueio motor da lidocaína em duas diferentes concentrações. MÉTODO: Ratos machos da linhagem Wistar, pesando de 250 a 300 g, foram submetidos a bloqueio de nervo ciático guiado por neuroestimulação percutânea. Os animais foram distribu...

  13. Neuromuscular blockade in cardiac surgery: An update for clinicians

    Directory of Open Access Journals (Sweden)

    Hemmerling Thomas

    2008-01-01

    Full Text Available There have been great advancements in cardiac surgery over the last two decades; the widespread use of off-pump aortocoronary bypass surgery, minimally invasive cardiac surgery, and robotic surgery have also changed the face of cardiac anaesthesia. The concept of "Fast-track anaesthesia" demands the use of nondepolarising neuromuscular blocking drugs with short duration of action, combining the ability to provide (if necessary sufficiently profound neuromuscular blockade during surgery and immediate re-establishment of normal neuromuscular transmission at the end of surgery. Postoperative residual muscle paralysis is one of the major hurdles for immediate or early extubation after cardiac surgery. Nondepolarising neuromuscular blocking drugs for cardiac surgery should therefore be easy to titrate, of rapid onset and short duration of action with a pathway of elimination independent from hepatic or renal dysfunction, and should equally not affect haemodynamic stability. The difference between repetitive bolus application and continuous infusion is outlined in this review, with the pharmacodynamic and pharmacokinetic characteristics of vecuronium, pancuronium, rocuronium, and cisatracurium. Kinemyography and acceleromyography are the most important currently used neuromuscular monitoring methods. Whereas monitoring at the adductor pollicis muscle is appropriate at the end of surgery, monitoring of the corrugator supercilii muscle better reflects neuromuscular blockade at more central, profound muscles, such as the diaphragm, larynx, or thoraco-abdominal muscles. In conclusion, cisatracurium or rocuronium is recommended for neuromuscular blockade in modern cardiac surgery.

  14. Bloqueio seletivo dos nervos supraescapular e axilar promove analgesia satisfatória e menor grau de bloqueio motor: comparação com o bloqueio interescalênico El bloqueo selectivo de los nervios supraescapular y axilar promueve una analgesia satisfactoria y un menor grado de bloqueo motor: comparación con el bloqueo interescalénico Selective suprascapular and axillary nerve block provides adequate analgesia and minimal motor block: comparison with interscalene block

    Directory of Open Access Journals (Sweden)

    Patrícia Falcão Pitombo

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: Cirurgias artroscópicas do ombro cursam com intensa dor pós-operatória. Diversas técnicas analgésicas têm sido preconizadas. O objetivo deste estudo foi comparar o bloqueio dos nervos supraescapular e axilar nas cirurgias artroscópicas de ombro com a abordagem interescalênica do plexo braquial. MÉTODO: Sessenta e oito pacientes foram alocados em dois grupos de 34, de acordo com a técnica utilizada: grupo interescalênico (GI e grupo seletivo (GS, sendo ambas as abordagens realizadas com neuroestimulador. No GI, após resposta motora adequada foram injetados 30 mL de levopubivacaína em excesso enantiomérico de 50% a 0,33% com adrenalina 1:200.000. No GS, após resposta motora do nervo supraescapular e axilar, foram injetados 15 mL da mesma substância em cada nervo. Em seguida, realizada anestesia geral. Variáveis avaliadas: tempo para realização dos bloqueios, analgesia, consumo de opioide, bloqueio motor, estabilidade cardiocirculatória, satisfação e aceitabilidade pelo paciente. RESULTADOS: Tempo para execução do bloqueio interescalênico foi significativamente menor que para realização do bloqueio seletivo. Analgesia foi significativamente maior no pós-operatório imediato no GI e no pós-operatório tardio no GS. Consumo de morfina foi significativamente maior na primeira hora no GS. Bloqueio motor foi significativamente menor no GS. Estabilidade cardiocirculatória, satisfação e aceitabilidade da técnica pelo paciente não diferiram entre os grupos. Ocorreu uma falha no GI e duas no GS. CONCLUSÕES: Ambas as técnicas são seguras, eficazes com mesmo grau de satisfação e aceitabilidade. O bloqueio seletivo de ambos os nervos apresentou analgesia satisfatória, com a vantagem de proporcionar bloqueio motor restrito ao ombro.JUSTIFICATIVA Y OBJETIVOS: Las cirugías artroscópicas del hombro cursan con un intenso dolor postoperatorio. Diversas técnicas analgésicas han sido preconizadas

  15. Effects of sugammadex on incidence of postoperative residual neuromuscular blockade

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P;

    2015-01-01

    by randomized allocation to sugammadex (2 or 4 mg kg(-1)) or usual care (neostigmine/glycopyrrolate, dosing per usual care practice) for reversal of neuromuscular blockade. Timing of reversal agent administration was based on the providers' clinical judgement. Primary endpoint was the presence of residual......BACKGROUND: This study aimed to investigate whether reversal of rocuronium-induced neuromuscular blockade with sugammadex reduced the incidence of residual blockade and facilitated operating room discharge readiness. METHODS: Adult patients undergoing abdominal surgery received rocuronium, followed...... neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio

  16. Neuromuscular ultrasound findings in polyneuropathy secondary to disulfiram.

    Science.gov (United States)

    Stone, Sarah L; Cartwright, Michael S; Panea, Oana R; Vann, Ryan C; Magruder, John L; Walker, Francis O

    2014-12-01

    Disulfiram toxicity can cause multiple neurologic problems, including a reversible distal sensorimotor axonal polyneuropathy. Although electrodiagnosis and biopsy results have been described in the diagnosis and management of patients with disulfiram associated polyneuropathy, neuromuscular ultrasound findings have not been reported. The authors present a case of electrodiagnostically confirmed axonal polyneuropathy with relative sural sparing secondary to disulfiram and describe the neuromuscular ultrasound findings in this individual. Ultrasound demonstrated distal enlargement with slight side-to-side asymmetry and normal proximal cross-sectional area in the lower extremity nerves. Neuromuscular ultrasound is another diagnostic modality that may be used to assist in the diagnosis of patients with polyneuropathy secondary to disulfiram.

  17. Neuromuscular impairment following backpack load carriage.

    Science.gov (United States)

    Blacker, Sam D; Fallowfield, Joanne L; Bilzon, James L J; Willems, Mark E T

    2013-01-01

    Load Carriage using backpacks is an occupational task and can be a recreational pursuit. The aim of this study was to investigate the mechanisms responsible for changes in neuromuscular function of the m. quadriceps femoris following load carriage. The physiological responses of 10 male participants to voluntary and electrically stimulated isometric contractions were measured before and immediately after two hours of treadmill walking at 6.5 km•h(-1) during level walking with no load [LW], and level walking with load carriage (25 kg backpack) [LC]. Maximal voluntary contraction force decreased by 15 ± 11 % following LC (p=0.006), with no change following LW (p=0.292). Voluntary activation decreased after LW and LC (p=0.033) with no difference between conditions (p=0.405). Doublet contraction time decreased after both LW and LC (p=0.002), with no difference between conditions (p=0.232). There were no other changes in electrically invoked doublet parameters in either condition. The 20:50 Hz ratio did not change following LW (p=0.864) but decreased from 0.88 ± 0.04 to 0.84 ± 0.04 after LC (p=0.011) indicating reduced Ca2+ release from the sarcoplasmic reticulum during excitation contraction coupling. In conclusion, two hours of load carriage carrying a 25 kg back pack caused neuromuscular impairment through a decrease in voluntary activation (i.e. central drive) and fatigue or damage to the peripheral muscle, including impairment of the excitation contraction coupling process. This may reduce physical performance and increase the risk of musculoskeletal injury.

  18. Visual and tactile assessment of neuromuscular fade.

    Science.gov (United States)

    Brull, S J; Silverman, D G

    1993-08-01

    The accuracy of visual and tactile assessment of the neuromuscular fade in response to train-of-four (TOF) and double-burst stimulation (DBS) were compared to assess their relative utility in the clinical setting. For each of 74 data sets with a mechanographic TOF ratio less than 0.70, an observer (blinded to the presence or degree of fade) performed visual and tactile assessments of fade in response to TOF, DBS3,3, and DBS3,2 stimuli at low current (20 and 30 mA) and high current (50 and 60 mA). For the range of mechanographic TOF ratios between 0.41 and 0.70, visual assessment failed to identify TOF, DBS3,3, and DBS3,2 fade in 46%, 18%, and 14% of cases at high current and in 23%, 5%, and 0% of cases at low current, respectively. Tactile assessments failed to identify fade in 55%, 23%, and 14% of cases at high current and in 23%, 14%, and 14% of cases at low current. Overall, the ability to detect fade was comparable for visual and tactile assessments regardless of the method of neurostimulation (P = NS with paired t-test). However, the degree of overestimation of the fade ratio (i.e., quantitative assessment) tended to be less when using tactile means; the difference achieved significance for TOF at low current and DBS3,3 at both low and high currents. We conclude that the differences between the visual and tactile means of assessment are relatively small compared to the differences among the TOF and DBS patterns of neurostimulation. Both subjective techniques are often inadequate in settings in which assurance of full recovery of neuromuscular function is critical.

  19. Modelagem da retração por secagem de concretos produzidos com agregados reciclados

    Directory of Open Access Journals (Sweden)

    A. E. B. Cabral

    Full Text Available A preocupação com a conservação dos recursos não renováveis tem levado o meio acadêmico a pesquisar sobre a utilização dos agregados reciclados na produção de concretos. A retração por secagem do concreto é um fenômeno que está intimamente ligado à perda de água da massa do concreto, a qual é quase inevitável, desde que o concreto esteja exposto a um ambiente de umidade abaixo da condição de saturação. Este artigo apresenta um estudo experimental, onde foram produzidos concretos variando-se a relação água/cimento (de 0,4 a 0,8 e o tipo e a proporção dos três principais constituintes do resíduo de construção e demolição (concreto, argamassa e cerâmica vermelha usados como agregados graúdos e miúdos reciclados, produzindo-se modelos matemáticos que correlacionam tais variáveis com a retração por secagem dos concretos aos 56 e 224 dias de idade. Os resultados apontam que, para a idade de 56 dias, o modelo apresentou uma excessiva variabilidade, manifestando somente 4 das 7 variáveis como termos significativos. Para a idade de 224 dias, o modelo proposto ainda apresentou uma elevada variabilidade, entretanto todas as variáveis foram tidas como significativas. Os resultados apontam que a substituição do agregado natural pelo reciclado propicia um acréscimo na retração por secagem, sendo este efeito mais sentido para a substituição do agregado miúdo. O efeito mais pronunciado está associado ao emprego do agregado miúdo reciclado de concreto e o menor, ao do agregado graúdo reciclado de concreto.

  20. Ventriculo-auriculostomia nos bloqueios ao trânsito do líquido cefalorraqueano na cisticercose encefálica

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    Gilberto M. Almeida

    1966-09-01

    Full Text Available São apresentados 16 casos de cisticercose encefálica com bloqueio ao trânsito do líquido cefalorraqueano, nos quais foi feita ventrículo-auriculostomia com válvula de Holter. Dos 16 pacientes, 5 faleceram, 10 estão vivos e sem sinais de hipertensão intracraniana e um não foi seguido. Considerando-se o prognóstico reservado da doença, principalmente quando existe hipertensão intracraniana, os resultados podem ser considerados bons. A derivação ventriculovenosa constitui, portanto, valioso método no tratamento da neurocisticercose com dilatação ventricular, causada por bloqueio ao trânsito do LCR. Algumas vêzes a má evolução do caso está relacionada à progressão da própria doença e não à falha no contrôle da hipertensão intracraniana.

  1. Agenesia de cava superior associada a bloqueio atrioventricular de 3º grau Agenesis of the right superior vena cava associated with total heart block

    Directory of Open Access Journals (Sweden)

    Gustavo J. Ventura Couto

    2008-03-01

    Full Text Available A persistência de veia cava superior esquerda com ausência da veia cava superior é uma anomalia rara, principalmente quando associada a bloqueio atrioventricular de 3º grau. Relatamos o caso de uma paciente, na qual durante implante de marca-passo definitivo, para a correção de bloqueio atrioventricular total, foi detectada presença de veia cava superior esquerda com suspeição de ausência de veia cava superior, o que levou ao emprego de técnica diferenciada para fixação do eletrodo ventricular. Para confirmação da provável agenesia, foram realizados diversos exames complementares de imagem, demonstrando-se a dificuldade no diagnóstico da síndrome aqui descrita.The superior left vena cava with the absent superior vena cava is a rare abnormality, especially when associated with total heart block. We report a case of a patient in which the presence of superior left vena cava and the absence of the superior vena cava was detected during the implantation of a pacemaker for the correction of a total heart block, which led us to use a different technique for the fixation of the ventricular electrode. To confirm the supposed absence, several image exams were made showing the difficulty on the diagnosis of the described syndrome.

  2. A MODALIZAÇÃO EM E-MAILS PRODUZIDOS EM AMBIENTE ORGANIZACIONAL: UMA ABORDAGEM SITUADA NO INTERACIONISMO SOCIODISCURSIVO

    OpenAIRE

    Garcia Klautau, Eneida; Pessoa, Fátima

    2012-01-01

    O objetivo geral deste artigo é abordar, com base no modelo descendente de produção e análise textual do interacionismo sociodiscursivo, a relação entre os parâmetros de um contexto organizacional de interlocução e as operações de gestão do texto realizadas pelo enunciador frente às suas representações acerca desses parâmetros. Especificamente, busca-se explicar a presença/ausência da modalização em e-mails produzidos em um ambiente organizacional regido por um sistema de ge...

  3. Effect of nimodipine and flunarizine on neuromuscular function in mice

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    Swapnil B. Kaikade

    2016-08-01

    Conclusions: Nimodipine has significant dose dependent depressant action on neuromuscular function while flunarizine has no effect on the above mentioned parameter. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1524-1527

  4. Exploring employment in consultation reports of patients with neuromuscular diseases

    NARCIS (Netherlands)

    Heerkens, Yvonne; Kuyk-Minis, Marie Antoinette van; Cup, Edith; Engels, Josephine; Engelen, Baziel van; Oostendorp, Rob

    2012-01-01

    To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were emplo

  5. The role of proprioception and neuromuscular stability in carpal instabilities.

    Science.gov (United States)

    Hagert, E; Lluch, A; Rein, S

    2016-01-01

    Carpal stability has traditionally been defined as dependent on the articular congruity of joint surfaces, the static stability maintained by intact ligaments, and the dynamic stability caused by muscle contractions resulting in a compression of joint surfaces. In the past decade, a fourth factor in carpal stability has been proposed, involving the neuromuscular and proprioceptive control of joints. The proprioception of the wrist originates from afferent signals elicited by sensory end organs (mechanoreceptors) in ligaments and joint capsules that elicit spinal reflexes for immediate joint stability, as well as higher order neuromuscular influx to the cerebellum and sensorimotor cortices for planning and executing joint control. The aim of this review is to provide an understanding of the role of proprioception and neuromuscular control in carpal instabilities by delineating the sensory innervation and the neuromuscular control of the carpus, as well as descriptions of clinical applications of proprioception in carpal instabilities.

  6. Genetics of Pediatric-Onset Motor Neuron and Neuromuscular Diseases

    Science.gov (United States)

    2015-08-24

    Spinal Muscular Atrophy; Charcot-Marie-Tooth Disease; Muscular Dystrophy; Spinal Muscular Atrophy With Respiratory Distress 1; Amyotrophic Lateral Sclerosis; Motor Neuron Disease; Neuromuscular Disease; Peroneal Muscular Atrophy; Fragile X Syndrome

  7. The potential of disease management for neuromuscular hereditary disorders.

    Science.gov (United States)

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean

    2009-01-01

    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  8. Bloqueio completo do ramo esquerdo esforço-induzido: prevalência e prognóstico

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    Ricardo Stein

    2011-07-01

    Full Text Available FUNDAMENTO: O bloqueio completo do ramo esquerdo esforço-induzido (BCRE E-I é um achado infrequente ao teste de exercício e sua prevalência e significado prognóstico não são claros. OBJETIVO: Avaliar de forma longitudinal a prevalência e o significado prognóstico do BCRE E-I em homens americanos veteranos de guerra. MÉTODOS: Avaliamos 9.623 pacientes que realizaram ergometria em esteira (TE entre 1987 e 2007. Os desfechos foram comparados entre aqueles com TE NL, os com BCRE E-I e os que apresentaram Dep ST anormal. A mortalidade e a causa das mortes foram identificadas de forma cega para os resultados do TE. RESULTADOS: Nesta coorte prospectiva, 6922 indivíduos apresentaram TE NL (57,2 ± 11,4 anos, 1.739 apresentaram Dep ST anormal (62,7 ± 9,8 anos e 38 casos de BCRE E-I foram identificados (65,2 ± 11,9 anos. A prevalência do BCRE E-I foi 0,38%. Após 8,8 anos, ocorreram 1.699 mortes por todas as causas e 610 mortes cardiovasculares (CV. Doença arterial coronária e insuficiência cardíaca foram mais prevalentes nos pacientes com BCRE E-I. Pacientes com BCRE E-I tiveram razão de azar de 2,37 (p = 0,002 para mortalidade por todas as causas, mas a mesma não foi significativa quando ajustada para idade ou quando a mortalidade cardiovascular foi o desfecho avaliado. CONCLUSÃO: BCRE E-I é um achado raro. Indivíduos com BCRE E-I apresentam maior mortalidade por todas as causas quando comparados aqueles com TE NL. No entanto, tal fato é explicado por esses pacientes serem significativamente mais velhos e por apresentarem mais enfermidades cardiovasculares associadas.

  9. The sagital balance in idiopatic and neuromuscular scoliosis

    OpenAIRE

    Borges,Paulo Alvim; Ocampos, Guilherme Pereira; Mancuso Filho,José Antonio; Letaif,Olavo Biraghi; Marcon, Raphael Martus; Cristante, Alexandre Fogaça

    2014-01-01

    OBJECTIVES: To describe and compare the distribution of spinopelvic parameters (SPP) in a Brazilian population with idiopathic scoliosis (IS) and neuromuscular scoliosis (NMS), and evaluate the association between pelvic incidence (PI) and lumbar lordosis (LL). METHOD: Medical records investigation was performed. Sagital balance angles were measured in patients with neuromuscular and idiopathic scoliosis. RESULTS: IS sample means (in degrees): PI 55.55; Sacral Slope (SS) 45.35; Pelvic Tilt (P...

  10. Bloqueio peridural caudal: técnica anestésica de uso exclusivo em crianças? É possível sua realização em adultos? Qual o papel do ultrassom nesse contexto?

    Directory of Open Access Journals (Sweden)

    Ilana Esquenazi Najman

    2011-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio peridural caudal é a mais popular entre todas as técnicas de anestesia regional em crianças. Com o avanço da idade, apenas a relativa dificuldade em localizar o hiato sacral limita seu uso. Entretanto, em adultos a técnica vem sendo largamente utilizada para controle de dor crônica com o auxílio da fluoroscopia. Assim, a habilidade em localizar o hiato e definir as variações anatômicas é o principal fator determinante do sucesso e segurança na execução do bloqueio peridural pela via caudal. Nesse contexto, o ultrassom vem ganhando espaço como guia para a realização do bloqueio caudal. O objetivo desta revisão foi elucidar o papel do ultrassom na anestesia caudal, além de demonstrar que o bloqueio caudal, muito utilizado em crianças, também é útil e pode ser usado em adultos. CONTEÚDO: Uma revisão literária sobre a anatomia da região sacral e da técnica anestésica necessária para a realização adequada do bloqueio caudal foi promovida. Além disso, artigos recentes sobre estudos realizados com bloqueios peridurais caudais guiados por ultrassom tanto em crianças quanto em adultos também foram incluídos. CONCLUSÕES: O ultrassom, apesar de suas limitações, pode ser útil como ferramenta adjuvante no posicionamento da agulha no espaço caudal. Permite a fácil identificação da anatomia sacral, além de visualização da injeção, em tempo real. Sua natureza portátil, não invasiva e livre de exposição à radiação faz dele uma tecnologia atrativa na sala operatória, principalmente na emergência de casos difíceis. Entretanto, como seu uso em bloqueios centrais do neuroeixo ainda é muito primitivo, é necessário que mais pesquisas sejam feitas para se consagre como técnica de rotina na prática anestésica.

  11. Determinação do volume mínimo efetivo de bupivacaína 0,5% para bloqueio do plexo braquial por via axilar guiado por ultrassom

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    Leonardo Henrique Cunha Ferraro

    2014-01-01

    Full Text Available Justificativa e objetivo: o uso do ultrassom para acompanhar o correto posicionamento da agulha e a dispersão do anestésico local permitiu a redução do volume de anestésico local necessário para o bloqueio de nervos periféricos. Existem poucos trabalhos sobre o volume mínimo efetivo de anestésico local para o bloqueio do plexo braquial via axilar (BPVA. Este estudo foi conduzido com o objetivo de determinar o volume mínimo efetivo (VE90 de bupivacaína 0,5% comadrenalina (1:200.000 para o BPVA guiado por ultrassom. Método: o método up-and-down proposto por Massey e Dixon foi usado para o cálculo do volume mínimo efetivo. A dose inicial foi de 5 ml por nervo (radial, mediano, ulnar e musculocutâneo. No caso de falha do bloqueio, o volume era aumentado em 0,5 mL por nervo. O sucesso do bloqueio resultava na diminuição do volume em 0,5 mL por nervo para o paciente subsequente. O sucesso do bloqueio foi definido como bloqueio da função motora ≤ 2 segundo a escala de Bromage modificada, ausência de sensibilidade térmica e de resposta ao pinprick. Foi definido como critério para término do estudo a obtenção de cinco casos de falha seguidos de casos de sucesso. Resultados: foram incluídos 19 pacientes no estudo. O volume mínimo efetivo (VE90 de bupi-vacaína 0,5% com 1:200.000 de adrenalina foi de 1,56 ml (IC 95% 0,99-3,5 por nervo. Conclusão: este trabalho corrobora alguns estudos que mostram que é possível obter anestesia cirúrgica com baixos volumes de anestésico local para bloqueios de nervo periférico guiados por ultrassom.

  12. Bloqueio dos nervos femoral e isquiático guiados por ultrassom em paciente anticoagulado: case reports Bloqueo de los nervios femoral e isquiático guiados por ultrasonido en paciente anticoagulado Ultrasound-guided femoral and sciatic nerve blocks in an anticoagulated patient: relato de casos

    OpenAIRE

    Leonardo Henrique Cunha Ferraro; Maria Angela Tardelli; Américo Masafuni Yamashita; José Daniel Braz Cardone; Juliana Midori Kishi

    2010-01-01

    JUSTIFICATIVA E OBJETIVOS: O uso de ultrassom para guiar a punção em bloqueios de nervos periféricos tem-se tornado cada vez mais frequente. Com a menor probabilidade de promover lesões vasculares, o ultrassom torna-se uma ferramenta interessante na realização de bloqueios periféricos, especialmente nos pacientes em uso de anticoagulantes ou com distúrbios da coagulação. O objetivo foi relatar dois casos em que se realizaram os bloqueios isquiático e femoral guiados por ultrassom em pacientes...

  13. Neuromuscular Fatigue During 200 M Breaststroke

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    Ana Conceição

    2014-03-01

    Full Text Available The aims of this study were: i to analyze activation patterns of four upper limb muscles (duration of the active and non-active phase in each lap of 200m breaststroke, ii quantify neuromuscular fatigue, with kinematics and physiologic assessment. Surface electromyogram was collected for the biceps brachii, deltoid anterior, pectoralis major and triceps brachii of nine male swimmers performing a maximal 200m breaststroke trial. Swimming speed, SL, SR, SI decreased from the 1st to the 3rd lap. SR increased on the 4th lap (35.91 ± 2.99 stroke·min-1. Peak blood lactate was 13.02 ± 1.72 mmol·l-1 three minutes after the maximal trial. The EMG average rectified value (ARV increased at the end of the race for all selected muscles, but the deltoid anterior and pectoralis major in the 1st lap and for biceps brachii, deltoid anterior and triceps brachii in the 4th lap. The mean frequency of the power spectral density (MNF decreased at the 4th lap for all muscles. These findings suggest the occurrence of fatigue at the beginning of the 2nd lap in the 200m breaststroke trial, characterized by changes in kinematic parameters and selective changes in upper limb muscle action. There was a trend towards a non-linear fatigue state.

  14. Neuromuscular dentistry: Occlusal diseases and posture.

    Science.gov (United States)

    Khan, Mohd Toseef; Verma, Sanjeev Kumar; Maheshwari, Sandhya; Zahid, Syed Naved; Chaudhary, Prabhat K

    2013-01-01

    Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.

  15. Diagnostic Certified Assay: Neuromuscular and Cardiac Assessments

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    Rea Valaperta

    2013-01-01

    Full Text Available The expansion of the specific trinucleotide sequence, [CTG], is the molecular pathological mechanism responsible for the clinical manifestations of DM1. Many studies have described different molecular genetic techniques to detect DM1, but as yet there is no data on the analytical performances of techniques used so far in this disease. We therefore developed and validated a molecular method, “Myotonic Dystrophy SB kit,” to better characterize our DM1 population. 113 patients were examined: 20 DM1-positive, 11 DM1/DM2-negative, and13 DM1-negative/DM2-positive, who had a previous molecular diagnosis, while 69 were new cases. This assay correctly identified 113/113 patients, and all were confirmed by different homemade assays. Comparative analysis revealed that the sensitivity and the specificity of the new kit were very high (>99%. Same results were obtained using several extraction procedures and different concentrations of DNA. The distribution of pathologic alleles showed a prevalence of the “classical” form, while of the 96 nonexpanded alleles 19 different allelic types were observed. Cardiac and neuromuscular parameters were used to clinically characterize our patients and support the new genetic analysis. Our findings suggest that this assay appears to be a very robust and reliable molecular test, showing high reproducibility and giving an unambiguous interpretation of results.

  16. Assessment of Motor Units in Neuromuscular Disease.

    Science.gov (United States)

    Henderson, Robert D; McCombe, Pamela A

    2017-01-01

    The motor unit comprises the anterior horn cell, its axon, and the muscle fibers that it innervates. Although the true number of motor units is unknown, the number of motor units appears to vary greatly between different muscles and between different individuals. Assessment of the number and function of motor units is needed in diseases of the anterior horn cell and other motor nerve disorders. Amyotrophic lateral sclerosis is the most important disease of anterior horn cells. The need for an effective biomarker for assessing disease progression and for use in clinical trials in amyotrophic lateral sclerosis has stimulated the study of methods to measure the number of motor units. Since 1970 a number of different methods, including the incremental, F-wave, multipoint, and statistical methods, have been developed but none has achieved widespread applicability. Two methods (MUNIX and the multipoint incremental method) are in current use across multiple centres and are discussed in detail in this review, together with other recently published methods. Imaging with magnetic resonance and ultrasound is increasingly being applied to this area. Motor unit number estimates have also been applied to other neuromuscular diseases such as spinal muscular atrophy, compression neuropathies, and prior poliomyelitis. The need for an objective measure for the assessment of motor units remains tantalizingly close but unfulfilled in 2016.

  17. Electrophysiology of autonomic neuromuscular transmission involving ATP.

    Science.gov (United States)

    Sneddon, P

    2000-07-01

    Electrophysiological investigations of autonomic neuromuscular transmission have provided great insights into the role of ATP as a neurotransmitter. Burnstock and Holman made the first recordings of excitatory junction potentials (e.j.p.s) produced by sympathetic nerves innervating the smooth muscle of the guinea-pig vas deferens. This led to the identification of ATP as the mediator of e.j.p.s in this tissue, where ATP acts as a cotransmitter with noradrenaline. The e.j.p.s are mediated solely by ATP acting on P2X(1) receptors leading to action potentials and a rapid phasic contraction, whilst noradrenaline mediates a slower, tonic contraction which is not dependent on membrane depolarisation. Subsequent electrophysiological studies of the autonomic innervation of smooth muscles of the urogenital, gastrointestinal and cardiovascular systems have revealed a similar pattern of response, where ATP mediates a fast electrical and mechanical response, whilst another transmitter such as noradrenaline, acetylcholine, nitric oxide or a peptide mediates a slower response. The modulation of junction potentials by a variety of pre-junctional receptors and the mechanism of inactivation of ATP as a neurotransmitter will also be described.

  18. Neuromuscular disorders in chronic alcohol intoxication

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    A. Yu. Emelyanova

    2015-01-01

    Full Text Available The paper reviews the present-day Russian and foreign literature on neuromuscular disorders in chronic alcohol intoxication. The most common manifestations of alcohol disease include alcoholic polyneuropathy (PNP and alcohol-induced skeletal muscle injury. The clinical polymorphism of alcoholic PNP is discussed. The paper considers a chronic sensory automatic form due to the direct toxic effects of ethanol and its metabolites during long-term alcohol intoxication, as well as acute/subacute sensorimotor neuropathy, the basis for the pathogenesis of which is B group vitamins, predominantly thiamine, deficiency that develops in the presence of drinking bouts concurrent with malnutrition and/or alcohol-related gastrointestinal tract diseases. In addition to nonuse of alcohol and a properly balanced diet, antioxidant therapy with alphalipoic acid and neurotropic B group vitamins is considered to be pathogenetic therapy for neuropathy. The most common and least studied clinicalform of alcohol-induced musculoskeletal injury is chronic alcoholic myopathy (AM, the diagnostic standard for which is morphometricand immunohistochemical examination of a muscle biopsy specimen. The morphological base for this form of myopathy is predominantly type 2 muscle fiber atrophy caused by impaired protein synthesis and a decreased regenerative potential of muscle fiber. The efficacy of antioxidants and leucine-containing amino acid mixtures in the treatment of chronic AM is discussed.

  19. Anticoagulantes e bloqueios espinhais

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    Itagyba Martins Miranda Chaves

    2001-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Com o uso de anticoagulantes para tromboprofilaxia, a incidência de hematomas em anestesias espinhais aumentou. O objetivo desta revisão é verificar a ocorrência de casos de hematomas espinhais e sua correlação com o uso de drogas utilizadas na tromboprofilaxia. CONTEÚDO: São feitas algumas considerações clínicas e farmacológicas sobre as drogas utilizadas em tromboprofilaxia (cumarínicos, aspirina e heparina. São ressaltados os fatores de risco, particularmente aos relatos de casos de pacientes que desenvolveram hematoma peridural decorrente do uso simultâneo de heparina de baixo peso molecular e anestesia peridural. CONCLUSÕES: Existe importante associação entre hematoma peridural e distúrbios hemorrágicos, principalmente em pacientes em tratamento com anticoagulantes. O reconhecimento do aumento do risco da associação da anestesia peridural, da anestesia subaracnóidea, a continuada vigilância e a educação são fundamentais para evitar futuros casos.

  20. Hematoma neuroaxial após bloqueio peridural. É possível prevenir ou detectar? Relato de dois casos

    Directory of Open Access Journals (Sweden)

    Rodrigo de Lima e Souza

    2011-04-01

    ós-operatória nos pacientes submetidos aos bloqueios de neuroeixo, podem contribuir para a prevenção de sequelas neurológicas graves.

  1. Neuromuscular monitoring and postoperative residual curarisation: a meta-analysis.

    Science.gov (United States)

    Naguib, M; Kopman, A F; Ensor, J E

    2007-03-01

    We conducted a meta-analysis to examine the effect of intraoperative monitoring of neuromuscular function on the incidence of postoperative residual curarisation (PORC). PORC has been considered present when a patient has a train-of-four (TOF) ratio of < 0.7 or < 0.9. We analysed data from 24 trials (3375 patients) that were published between 1979 and 2005. We excluded data on mivacurium from this meta-analysis because only three studies had examined the incidence of PORC associated with its use. Long- and intermediate-acting neuromuscular blocking drugs had been given to 662 and 2713 patients, respectively. Neuromuscular function was monitored in 823 patients (24.4%). A simple peripheral nerve stimulator was used in 543 patients, and an objective monitor was used in 280. The incidence of PORC was found to be significantly lower after the use of intermediate neuromuscular blocking drugs. We could not demonstrate that the use of an intraoperative neuromuscular function monitor decreased the incidence of PORC.

  2. Current Status of Neuromuscular Reversal and Monitoring: Challenges and Opportunities.

    Science.gov (United States)

    Brull, Sorin J; Kopman, Aaron F

    2017-01-01

    Postoperative residual neuromuscular block has been recognized as a potential problem for decades, and it remains so today. Traditional pharmacologic antagonists (anticholinesterases) are ineffective in reversing profound and deep levels of neuromuscular block; at the opposite end of the recovery curve close to full recovery, anticholinesterases may induce paradoxical muscle weakness. The new selective relaxant-binding agent sugammadex can reverse any depth of block from aminosteroid (but not benzylisoquinolinium) relaxants; however, the effective dose to be administered should be chosen based on objective monitoring of the depth of neuromuscular block.To guide appropriate perioperative management, neuromuscular function assessment with a peripheral nerve stimulator is mandatory. Although in many settings, subjective (visual and tactile) evaluation of muscle responses is used, such evaluation has had limited success in preventing the occurrence of residual paralysis. Clinical evaluations of return of muscle strength (head lift and grip strength) or respiratory parameters (tidal volume and vital capacity) are equally insensitive at detecting neuromuscular weakness. Objective measurement (a train-of-four ratio greater than 0.90) is the only method to determine appropriate timing of tracheal extubation and ensure normal muscle function and patient safety.

  3. Atividade fitorreguladora de jasmonatos produzidos por Botryosphaeria rhodina Phytoregulatory activity of jasmonates produced by Botryosphaeria rhodina

    Directory of Open Access Journals (Sweden)

    Any MP Linares

    2010-12-01

    Full Text Available O ácido jasmônico e seus derivados jasmonatos são reguladores vegetais endógenos produzidos por várias espécies vegetais, que atuam no mecanismo de defesa das plantas e agem como sinalizadores de estresse. O objetivo deste trabalho foi comparar o potencial fitorregulador de um fermentado, obtido pela fermentação do fungo filamentoso Botryosphaeria rhodina, contendo jasmonatos, comparado à ação do ácido jasmônico (AJ usado como padrão. Sementes selecionadas de Capsicum frutescens (pimenta malagueta e Physalis angulata (camapú foram plantadas em terra contendo fertilizantes orgânicos e minerais. Plantas após 37 dias de germinação foram tratadas via pulverização foliar com duas diferentes concentrações de AJ (25,0 e 50,0 mg L-1 e com fermentado contendo jasmonatos (correspondendo a 50 mg L-1 de AJ e como controle foi utilizado água. Os experimentos foram realizados em casa de vegetação, em blocos casualizados, com três repetições de cinco plantas por tratamentos, com os tratamentos dispostos em fatorial de 4x1 (1 controle; 2 doses de AJ e 1 dose do filtrado. A avaliação das plantas foi realizada 80 dias após a aplicação de AJ e o fermentado. Plantas controle de Capsicum produziram 6,4 frutos/planta enquanto que plantas tratadas com 25,0 e 50,0 mg L-1 de AJ produziram 7,2 frutos/planta e 9,2 frutos/planta, respectivamente e plantas tratadas com o fermentado produziram 11,7 frutos/planta. Adicionalmente, plantas controle de Physalis produziram 10,5 botões/planta e quando tratadas com 25,0 e 50,0 mg L-1 de AJ produziram 15,5 e 16,0 botões/planta, respectivamente. Plantas tratadas com o fermentado dobraram a produção de botões/planta (23,0 quando comparados ao controle. Resultados obtidos validam o potencial fitorregulador do AJ e do fermentado contendo jasmonatos, comprovado pelo aumento na produção de frutos e botões florais pelas espécies vegetais testadas, evidenciando assim o potencial de uso deste

  4. Exercise Therapy in Spinobulbar Muscular Atrophy and Other Neuromuscular Disorders

    DEFF Research Database (Denmark)

    Dahlqvist, Julia Rebecka; Vissing, John

    2016-01-01

    There is no curative treatment for most neuromuscular disorders. Exercise, as a treatment for these diseases, has therefore received growing attention. When executed properly, exercise can maintain and improve health and reduce the risk of cardiovascular disease, obesity, and diabetes. In persons...... in patients with neuromuscular diseases associated with weakness and wasting. We review studies that have investigated different types of exercise in both myopathies and motor neuron diseases, with particular emphasis on training of persons affected by spinobulbar muscular atrophy (SBMA). Finally, we provide...... with muscle wasting due to neuromuscular conditions, however, a common belief has been that physical activity could accelerate degeneration of the diseased muscle and a careful approach to training has therefore been suggested. In this review, we describe the current knowledge about physical training...

  5. Perceived pain and temporomandibular disorders in neuromuscular diseases.

    Science.gov (United States)

    Fischer, Michael J; Riedlinger, Kathrin; Schoser, Benedikt; Bernateck, Michael

    2009-10-01

    Little is known about pain associated with temporomandibular disorders (TMD) in neuromuscular diseases. Inpatients (N = 134) with neuromuscular disorder diagnoses were given questionnaires to estimate pain localization and intensity. Research Diagnostic Criteria for Temporomandibular Disorders and the Temporomandibular Index (TMI) were utilized to assess TMD. Pain was reported by 116 patients (86%). Legs (52%) and arms (33%) were the most common locations for pain localization, but the highest Pearson correlations (TMI vs. perceived pain) appeared for pain located in the trunk and arms (0.861, P < 0.01). No correlation between TMI and diagnosis group existed except for "acquired myopathy" and "miscellaneous neuromuscular diseases." These results suggest that the degree of TMD does not correlate with pain according to disease, although common mechanisms might be responsible for pain development in specific body regions connected with TMD. Most important, higher levels of TMD are associated with higher levels of perceived pain.

  6. Bloqueio do nervo isquiático via médio lateral da coxa como opção anestésica no trauma: relato de caso

    Directory of Open Access Journals (Sweden)

    Geier Karl Otto

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Nos pacientes com trauma de membros inferiores e com estômago cheio, tantos os bloqueios de plexos nervosos como os bloqueios de nervos periféricos isolados são procedimentos incomuns, prevalecendo os bloqueios peridural e subaracnóideo como primeira indicação. Este relato de caso registrou a escolha do bloqueio do nervo isquiático, como melhor indicação para anestesia em paciente de estômago cheio e traumatismo grave de pé. RELATO DO CASO: Paciente do sexo masculino, 50 anos, estado físico ASA II, obeso moderado (IMC = 29,8, hipertenso, motorista de ônibus por 29 anos, com laminectomia lombar descompressiva (L4-L5 e L5-S1, prévia há 10 anos, em uso de antidepressivos, vítima de acidente de motocicleta, após ter-se alimentado. O teste de Mallampati mostrou-se classe III. Após terem sido excluídas várias alternativas de técnicas para a execução da anestesia, a escolha recaiu no bloqueio isquiático como a melhor opção. A mistura anestésica administrada consistiu de 10 mL de lidocaína a 2% e 15 mL de bupivacaína a 0,5%, ambas com adrenalina a 1:200.000, resultando em mais de 15 horas de analgesia. CONCLUSÕES: A escolha do bloqueio do nervo isquiático por via médio lateral da coxa, como opção anestésica de trauma no pé, baseou-se em critérios previamente estabelecidos como a preferência de anestesia regional em pacientes com estômago cheio e candidatos a cirurgias de urgência nos membros; a limitação postural dos pacientes para realizar certas técnicas, como as espinhais; o conhecimento anatômico da inervação somática dos membros e o domínio de técnicas regionais alternativas.

  7. Train-of-four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-04-01

    Fade in the train-of-four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 micrograms/kg), vecuronium (40 or 80 micrograms/kg), pancuronium (60 or 120 micrograms/kg) and tubocurarine (450 micrograms/kg). TOF ratios were measured at approximate heights of T1 (first response in the TOF) of 75, 50 and 25%. Fade in TOF increased as the height of T1 decreased, with maximum fade being observed at T1 of 25%. The greatest difference between relaxants was observed at T1 of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or pancuronium.

  8. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    Directory of Open Access Journals (Sweden)

    T. Ayuso

    2008-01-01

    Full Text Available La debilidad muscular aguda (DMA es el síntoma predominante de las urgencias neuromusculares, especialmente si afecta a la musculatura respiratoria u orofaríngea. La DMA es un síndrome plurietiológico y con distintos niveles lesionales en la unidad motora. Dentro del amplio grupo de enfermedades neuromusculares, las que con mayor frecuencia provocan DMA e insuficiencia respiratoria son el síndrome de Guillain-Barré (SGB y la miastenia gravis (MG. El SGB constituye la causa más frecuente de parálisis flácida aguda; puede ocasionar fallo respiratorio en un tercio de los casos precisando ventilación mecánica. El diagnóstico preciso de este síndrome permitirá iniciar tratamiento inmunomodulador, que ha demostrado que modifica el curso de la enfermedad. Además, la valoración clínica de los pacientes y el conocimiento de sencillos tests neurofisiológicos y de función respiratoria guiarán la decisión de ventilación mecánica evitando la intubación de urgencia. La urgencia más frecuente que ocasiona la MG es la crisis miasténica, definida por el deterioro en la función bulbar con insuficiencia respiratoria aguda y riesgo de parada respiratoria. Ocurre en un 15-20% de pacientes miasténicos y puede desencadenarse por múltiples factores. Además del diagnóstico preciso de la crisis es importante la supresión de los factores desencadenantes y medidas de soporte ventilatorio. Entre las medidas farmacológicas son la plasmaféresis y las inmunoglobulinas intravenosas los instrumentos más útiles en la actualidad; estos tratamientos no sustituyen la vigilancia intensiva y el reconocimiento de los signos inminentes de fallo respiratorio que implican soporte ventilatorio invasivo o no invasivo.Acute muscle weakness (AMW is the predominant symptom of neuromuscular emergencies, especially if it affects the respiratory or oropharyngeal musculature . AMW is a multi-etiological syndrome, with different lesion levels in the motor unit

  9. Neuromuscular activity and knee kinematics in adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens L.;

    2013-01-01

    This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS).......This study aimed to investigate the neuromuscular control of the knee during stair descent among female adolescents with patellofemoral pain (PFP) and to report its association with self-reported clinical status assessed by the Knee Injury and Osteoarthritis Outcome Score (KOOS)....

  10. New techniques in the tissue diagnosis of gastrointestinal neuromuscular diseases

    Institute of Scientific and Technical Information of China (English)

    Charles H Knowles; Joanne E Martin

    2009-01-01

    Gastrointestinal neuromuscular diseases are a clinically heterogeneous group of disorders of children and adults in which symptoms are presumed or proven to arise as a result of neuromuscular (including interstitial cell of Cajal) dysfunction. Common to most of these diseases are symptoms of impaired motor activity which manifest as slowed or obstructed transit with or without evidence of transient or persistent radiological visceral dilatation. A variety of histopathological techniques and allied investigations are being increasingly applied to tissue biopsies from such patients. This review outlines some of the more recent advances in this field, particularly in the most contentious area of small bowel disease manifesting as intestinal pseudo-obstruction.

  11. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional...... instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise....

  12. Prevention and management of limb contractures in neuromuscular diseases.

    Science.gov (United States)

    Skalsky, Andrew J; McDonald, Craig M

    2012-08-01

    Limb contractures are a common impairment in neuromuscular diseases. They contribute to increased disability from decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living, and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures compared with neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve range of motion in neuromuscular diseases in a sustained manner is lacking, there are generally accepted principles with regard to splinting, bracing, stretching, and surgery that help minimize the impact or disability from contractures.

  13. [Organization of therapeutic aid to patients with hereditary neuromuscular diseases].

    Science.gov (United States)

    Kalinin, V A; Temin, P A; Arkhipov, B A; Zavadenko, N N

    1989-01-01

    The paper summarizes experience gained for many years by the All-Union Research Methodological Center for Study of Hereditary Neuromuscular Diseases. The specialists of the Center render counselling and therapeutic assistance to patients afflicted with neuromuscular diseases. The counselling and diagnostic services are characterized by the fact that it is based on the activity of a large hospital intended for the treatment of various diseases. The problems which are being solved by the out- and inpatient services of the Center are considered in detail. The advantages of the setting up of the common in- and outpatient complex on the basis of the hospital intended for the treatment of various diseases are described.

  14. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

    OpenAIRE

    A.M. Labrador-Cerrato; P. Ortega Sánchez-Diezma; G. Lanzas Melendo; Gutiérrez-Ortega, C.

    2015-01-01

    Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplas...

  15. Neuromuscular hip biomechanics and pathology in the athlete.

    Science.gov (United States)

    Torry, Michael R; Schenker, Mara L; Martin, Hal D; Hogoboom, Doug; Philippon, Marc J

    2006-04-01

    Although hip arthroscopic techniques have been developed and evolved over the last 5 to 10 years to help active athletes, the mechanisms of athletic hip injuries across various sports are not well understood. The purpose of this article is to review the literature related to the osseous and ligamentous support as well as the neuromuscular control strategies associated with hip joint mechanics. The neuromuscular contributions to hip stability and mobility with respect to gait will be provided because this data represents the largest body of knowledge regarding hip function. Further, this article will present and describe probable mechanisms of injury in sporting activities most often associated with hip injury in the young athlete.

  16. Anormalidades neuromuscular no desuso, senilidade e caquexia

    Directory of Open Access Journals (Sweden)

    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.

  17. Optimising abdominal space with deep neuromuscular blockade in gynaecologic laparoscopy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Gätke, M R; Springborg, H H

    2015-01-01

    neuromuscular blockade (NMB) would enlarge surgical space, measured as the distance from the sacral promontory to the trocar in patients undergoing gynaecologic laparoscopy. METHODS: Fourteen patients were randomised in an assessor-blinded crossover design. The distance from the sacral promontory to the trocar...

  18. Is deep neuromuscular blockade beneficial in laparoscopic surgery?

    DEFF Research Database (Denmark)

    Madsen, M V; Staehr-Rye, A K; Claudius, C;

    2016-01-01

    BACKGROUND: Deep neuromuscular blockade during laparoscopic surgery may provide some clinical benefit. We present the 'Pro-' argument in this paired position paper. METHODS: We reviewed recent evidence from a basic database of references which we agreed on with the 'Con-' side, and present this i...

  19. Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia.

    Science.gov (United States)

    Knutson, Jayme S; Fu, Michael J; Sheffler, Lynne R; Chae, John

    2015-11-01

    This article reviews the most common therapeutic and neuroprosthetic applications of neuromuscular electrical stimulation (NMES) for upper and lower extremity stroke rehabilitation. Fundamental NMES principles and purposes in stroke rehabilitation are explained. NMES modalities used for upper and lower limb rehabilitation are described, and efficacy studies are summarized. The evidence for peripheral and central mechanisms of action is also summarized.

  20. Drug Development and Challenges for Neuromuscular Clinical Trials.

    Science.gov (United States)

    El Mouelhi, Mohamed

    2016-03-01

    Drug development process faces many challenges, including those encountered in clinical trials for neuromuscular diseases. Drug development is a lengthy and highly costly process. Out of 10 compounds entering first study in man (phase 1), only one compound reaches the market after an average of 14 years with a cost of $2.7 billion. Nevertheless, according to the Centers for Medicare and Medicaid services, prescription drugs constituted only 9 % of each health care dollar spent in USA in 2013. Examples of challenges encountered in neuromuscular clinical trials include lack of validated patient-reported outcome tools, blinding issues, and the use of placebo in addition to lack of health authority guidance for orphan diseases. Patient enrollment challenge is the leading cause of missed clinical trial deadlines observed in about 80 % of clinical trials, resulting in delayed availability of potentially life-saving therapies. Another specific challenge introduced by recent technology is the use of social media and risk of bias. Sharing personal experiences while in the study could easily introduce bias among patients that would interfere with accurate interpretation of collected data. To minimize this risk, recent neuromuscular studies incorporate as an inclusion criterion the patient's agreement not to share any of study experiences through social media with other patients during the study conduct. Consideration of these challenges will allow timely response to the high unmet medical needs for many neuromuscular diseases.

  1. Facial rehabilitation: a neuromuscular reeducation, patient-centered approach.

    Science.gov (United States)

    Vanswearingen, Jessie

    2008-05-01

    Individuals with facial paralysis and distorted facial expressions and movements secondary to a facial neuromotor disorder experience substantial physical, psychological, and social disability. Previously, facial rehabilitation has not been widely available or considered to be of much benefit. An emerging rehabilitation science of neuromuscular reeducation and evidence for the efficacy of facial neuromuscular reeducation, a process of facilitating the return of intended facial movement patterns and eliminating unwanted patterns of facial movement and expression, may provide patients with disorders of facial paralysis or facial movement control opportunity for the recovery of facial movement and function. We provide a brief overview of the scientific rationale for facial neuromuscular reeducation in the structure and function of the facial neuromotor system, the neuropsychology of facial expression, and relations among expressions, movement, and emotion. The primary purpose is to describe principles of neuromuscular reeducation, assessment and outcome measures, approach to treatment, the process, including surface-electromyographic biofeedback as an adjunct to reeducation, and the goal of enhancing the recovery of facial expression and function in a patient-centered approach to facial rehabilitation.

  2. Neuromuscular Bandage: Neurophysiological Effects and the Role of Fascias

    Directory of Open Access Journals (Sweden)

    Ximena María Villota Chicaíza

    2014-05-01

    Full Text Available During the last years, neuromuscular bandage, a therapeutic application created in 1979 by doctor Kenzo Kase has been introduced in the management of many disorders of the musculo-skeletal system and even more so in the treatment of neurological disorders; This therapeutic tool which consists of a self adhesive elastic bandage allows recovery of the injured party without diminishing its bodily function. According to the existing literature on the physiological effects of this therapeutic application in the body, you could say that there is consensus. However in this article the author wants to highlight the significant although little highlighted role played by the fas¬cias on the therapeutic effects of neuromuscular bandage, analyzing from a reflective perspective the analgesic, neuromechanical and circulatory effects, as fundamental effects of neuromuscular bandage and fascias in the same function, trying to bring a global understanding on the way they relate to all connective tissues, aspects that are of great importance for the proper evaluation of alterations and prescription of neuromuscular bandage

  3. Muscle ultrasound quantifies segmental neuromuscular outcome in pediatric myelomeningocele

    NARCIS (Netherlands)

    Verbeek, Renate J; Hoving, Eelco; Maurits, Natalia M; Brouwer, Oebele F; van der Hoeven, Johannes H; Sival, Deborah A

    2014-01-01

    In pediatric spina bifida aperta (SBA), non-invasive assessment of neuromuscular integrity by muscle ultrasound density (MUD) could provide important information about the clinical condition. We therefore aimed to determine the association between pediatric SBA MUD and segmental neurologic function.

  4. Tortuosity and anomalous diffusion in the neuromuscular junction

    Science.gov (United States)

    Lacks, Daniel J.

    2008-04-01

    The signal transfer from nerve to muscle occurs by diffusion across the neuromuscular junction. The continuum level analysis of diffusion processes is based on the diffusion equation, which in one dimension is ∂c/∂t=D(∂2c/∂x2) , where c is the molecular concentration and D is the diffusivity. However, in confined systems such as the neuromuscular junction, the diffusion equation may not be valid, and even if valid the value of D may be altered by the confinement. In this paper, Monte Carlo simulations are used to probe diffusion at the molecular level in a realistic model of a neuromuscular junction. The results show that diffusion is anomalous (i.e., not described by the diffusion equation) for time scales less than ˜0.01s , which is the time scale relevant for signaling processes in the synapse. At longer time scales, the diffusion is normal (i.e., described by the diffusion equation), but with a value of D that is reduced by a factor of ˜5 times compared to the value for diffusion in open space. As the width of the synaptic cleft decreases, these effects become even more pronounced. The physical basis of these results is described in terms of the structure of the neuromuscular junction.

  5. Antagonism of non-depolarising neuromuscular block: current practice.

    Science.gov (United States)

    Kopman, A F; Eikermann, M

    2009-03-01

    There is now mounting evidence that even small degrees of postoperative residual neuromuscular block increases the incidence of adverse respiratory events in the Post Anaesthesia Care Unit and may increase longer-term morbidity as well. In the absence of quantitative neuromuscular monitoring, residual block is easily missed. A very strong case can be made for the routine administration of a non-depolarising antagonist unless it can be objectively demonstrated that complete recovery has occurred spontaneously. However, the use of acetylcholinesterase inhibitors is associated with the potential for cardiovascular and respiratory side-effects, so there are cogent reasons for using low doses when the level of neuromuscular block is not intense. As little as 0.015-0.025 mg.kg(-1) of neostigmine is required at a train-of-four count of four with minimal fade, whereas 0.04-0.05 mg.kg(-1) is needed at a train-of-four count of two or three. If only a single twitch or none at all can be evoked, neostigmine should not be expected to promptly reverse neuromuscular block, and antagonism is best delayed till a train-of-four-count of two is achieved.

  6. Volume of the effect compartment in simulations of neuromuscular block

    NARCIS (Netherlands)

    Nigrovic, Vladimir; Proost, Johannes H.; Amann, Anton; Bhatt, Shashi B.

    2005-01-01

    Background: The study examines the role of the volume of the effect compartment in simulations of neuromuscular block (NMB) produced by nondepolarizing muscle relaxants. Methods: The molar amount of the postsynaptic receptors at the motor end plates in muscle was assumed constant; the apparent recep

  7. Neuromuscular and mitochondrial disorders: what is relevant to the anaesthesiologist?

    NARCIS (Netherlands)

    Driessen, J.J.

    2008-01-01

    PURPOSE OF REVIEW: The review provides an up-to-date information to the anaesthesiologist about the more frequent and important neuromuscular disorders for which new basic insights or clinical implications have been reported. RECENT FINDINGS: The findings include the mechanisms of the hyperkalemia a

  8. Neuromuscular Activity of Micrurus laticollaris (Squamata: Elapidae Venom in Vitro

    Directory of Open Access Journals (Sweden)

    Alejandro Carbajal-Saucedo

    2014-01-01

    Full Text Available In this work, we have examined the neuromuscular activity of Micrurus laticollaris (Mexican coral snake venom (MLV in vertebrate isolated nerve-muscle preparations. In chick biventer cervicis preparations, the MLV induced an irreversible concentration- and time-dependent (1–30 µg/mL neuromuscular blockade, with 50% blockade occurring between 8 and 30 min. Muscle contractures evoked by exogenous acetylcholine were completely abolished by MLV, whereas those of KCl were also significantly altered (86% ± 11%, 53% ± 11%, 89% ± 5% and 89% ± 7% for one, three, 10 and 30 µg of venom/mL, respectively; n = 4; p < 0.05. In mouse phrenic nerve-diaphragm preparations, MLV (1–10 µg/mL promoted a slight increase in the amplitude of twitch-tension (3 µg/mL, followed by neuromuscular blockade (n = 4; the highest concentration caused complete inhibition of the twitches (time for 50% blockade = 26 ± 3 min, without exhibiting a previous neuromuscular facilitation. The venom (3 µg/mL induced a biphasic modulation in the frequency of miniature end-plate potentials (MEPPs/min, causing a significant increase after 15 min, followed by a decrease after 60 min (from 17 ± 1.4 (basal to 28 ± 2.5 (t15 and 12 ± 2 (t60. The membrane resting potential of mouse diaphragm preparations pre-exposed or not to d-tubocurarine (5 µg/mL was also significantly less negative with MLV (10 µg/mL. Together, these results indicate that M. laticollaris venom induces neuromuscular blockade by a combination of pre- and post-synaptic activities.

  9. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II Suprascapular nerve block: important procedure in clinical practice. Part II

    Directory of Open Access Journals (Sweden)

    Marcos Rassi Fernandes

    2012-08-01

    Full Text Available O bloqueio do nervo supraescapular é um método de tratamento reprodutível, confiável e extremamente efetivo no controle da dor no ombro. Esse método tem sido amplamente utilizado por profissionais na prática clínica, como reumatologistas, ortopedistas, neurologistas e especialistas em dor, na terapêutica de enfermidades crônicas, como lesão irreparável do manguito rotador, artrite reumatoide, sequelas de AVC e capsulite adesiva, o que justifica a presente revisão (Parte II. O objetivo deste estudo foi descrever as técnicas do procedimento e suas complicações descritas na literatura, já que a primeira parte reportou as indicações clínicas, drogas e volumes utilizados em aplicação única ou múltipla. Apresentamse, detalhadamente, os acessos para a realização do procedimento tanto direto como indireto, anterior e posterior, lateral e medial, e superior e inferior. Diversas são as opções para se realizar o bloqueio do nervo supraescapular. Apesar de raras, as complicações podem ocorrer. Quando bem indicado, este método deve ser considerado.The suprascapular nerve block is a reproducible, reliable, and extremely effective treatment method in shoulder pain control. This method has been widely used by professionals in clinical practice such as rheumatologists, orthopedists, neurologists, and pain specialists in the treatment of chronic diseases such as irreparable rotator cuff injury, rheumatoid arthritis, stroke sequelae, and adhesive capsulitis, which justifies the present review (Part II. The objective of this study was to describe the techniques and complications of the procedure described in the literature, as the first part reported the clinical indications, drugs, and volumes used in single or multiple procedures. We present in details the accesses used in the procedure: direct and indirect, anterior and posterior, lateral and medial, upper and lower. There are several options to perform suprascapular nerve block

  10. Corticosteroids and neuromuscular blockers in development of critical illness neuromuscular abnormalities: A historical review.

    Science.gov (United States)

    Wilcox, Susan R

    2017-02-01

    Weakness is common in critically ill patients, associated with prolonged mechanical ventilation and increased mortality. Corticosteroids and neuromuscular blockade (NMB) administration have been implicated as etiologies of acquired weakness in the intensive care unit. Medical literature since the 1970s is replete with case reports and small case series of patients with weakness after receiving high-dose corticosteroids, prolonged NMB, or both. Several risk factors for weakness appear in the early literature, including large doses of steroids, the dose and duration of NMB, hyperglycemia, and the duration of mechanical ventilation. With improved quality of data, however, the association between weakness and steroids or NMB wanes. This may reflect changes in clinical practice, such as a reduction in steroid dosing, use of cisatracurium besylate instead of aminosteroid NMBs, improved glycemic control, or trends in minimizing mechanical ventilatory support. Thus, based on the most recent and high-quality literature, neither corticosteroids in commonly used doses nor NMB is associated with increased duration of mechanical ventilation, the greatest morbidity of weakness. Minimizing ventilator support as soon as the patient's condition allows may be associated with a reduction in weakness-related morbidity.

  11. Estudo comparativo entre bupivacaína (S75-R25 e ropivacaína para avaliar a segurança cardiovascular em bloqueio do plexo braquial

    Directory of Open Access Journals (Sweden)

    Adilson Hamaji

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Bupivacaína é o fármaco de escolha para anestesia regional por causa da eficácia, longa duração e do bloqueio motor menos intenso. Bupivacaína (S75-R25 é uma mistura de isômeros ópticos que contém 75% de levobupivacaína (S- e 25% de dextrobupivacaína (R+ e foi criada por uma companhia farmacêutica brasileira. Este estudo comparou a eficácia e segurança de bupivacaína S75-R25 com vasoconstritor e ropivacaína para o sistema cardiovascular em bloqueio do plexo braquial. MÉTODOS: Pacientes foram randomizados para receber bloqueio do plexo braquial com bupivacaína S75-R25 (Grupo B com epinefrina 1:200.000 ou ropivacaína (Grupo R, ambos os fármacos a 0,50%, em 30 mL ECG contínuo (Holter foi registrado durante todo o procedimento, bem como a escala de força de Lovett, além de monitoramento (frequência cardíaca, oximetria de pulso e pressão arterial não invasiva. A incidência de eventos adversos foi comparada com os testes do qui-quadrado ou exato de Fisher. RESULTADOS: Quarenta e quatro pacientes foram estudados. Não houve diferença significativa em relação à idade, peso, altura, gênero e tempo cirúrgico. Não houve diferença entre arritmias supraventriculares antes ou depois do bloqueio do plexo braquial, independentemente do anestésico local escolhido. A perda de sensibilidade foi mais rápida no Grupo B (23,1 ± 11,7 min em comparação com o Grupo R (26,8 ± 11,5 min, embora não significativa (p = 0,205, teste t de Student. Houve uma redução da frequência cardíaca, observada durante a monitoração contínua de 24 horas (Holter. CONCLUSÃO: Este estudo demonstrou eficácia semelhante entre bupivacaína S75-R25 e ropivacaína para bloqueio do plexo braquial, com incidências semelhantes de arritmias supraventriculares.

  12. Bloqueio do nervo isquiático por abordagem posterior simplificada no ponto médio do sulco glúteo-femoral: estudo com diferentes volumes de lidocaína a 1%

    Directory of Open Access Journals (Sweden)

    Fonseca Neuber Martins

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do nervo isquiático por via subglútea foi descrito com sucesso em estudo anterior, sendo mais uma opção entre as várias abordagens possíveis. O nervo isquiático torna-se superficial na borda inferior do músculo glúteo máximo, permitindo seu acesso com fácil localização, pouco desconforto e baixo risco de punção acidental de grandes vasos. O objetivo deste estudo foi avaliar o bloqueio do nervo isquiático por esta abordagem simplificada com diferentes volumes de lidocaína a 1%. MÉTODO: Foram estudados 40 pacientes com intervenções cirúrgicas na perna ou no pé distribuídos em dois grupos. Após monitorização, eles foram posicionados em decúbito ventral e realizado bloqueio no ponto médio do sulco glúteo-femoral, com auxílio de neuroestimulador e agulha de 5 cm eletricamente isolada, utilizando 300 mg (G1 ou 200 mg (G2 de lidocaína a 1% sem adrenalina. RESULTADOS: Obteve-se anestesia adequada em todos os casos com o volume e a concentração usados. O tempo de execução do bloqueio foi de 8,6 ? 5,7 min (G1 e 5,6 ? 5,7 min (G2. A latência foi de 5,98 ? 1,4 min (G1 e 6,7 ? 2,9 min (G2. A duração sensitiva e motora do bloqueio foi de 243 ? 37 min e 152 ? 30 min (G1 e 235 ? 39 min e 149 ? 59 min (G2, respectivamente. Não foram observadas diferenças estatísticas significativas entre os grupos estudados. CONCLUSÕES: Essa abordagem é eficaz e de fácil execução, podendo a dose total de anestésico ser reduzida sem comprometimento da qualidade.

  13. Análise retrospectiva de fatores de risco e preditores de complicações intraoperatórias dos bloqueios do neuroeixo realizados na Faculdade de Medicina de Botucatu-UNESP

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    Ivan Dias Fernandes Pereira

    2011-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: As alterações cardiovasculares associadas aos bloqueios do neuroeixo apresentam interesse pela frequência com que ocorrem e porque algumas delas podem ser consideradas efeitos fisiológicos desencadeados pelo bloqueio do sistema nervoso simpático. O objetivo desta pesquisa foi avaliar as complicações cardiovasculares intraoperatórias e os fatores preditores associados aos bloqueios do neuroeixo em pacientes com idades > 18 anos submetidos a procedimentos não obstétricos, em um período de 18 anos, em hospital universitário de atendimento terciário-HCFMB-UNESP. MÉTODO: Foi realizada análise retrospectiva das seguintes complicações: hipertensão arterial, hipotensão arterial, bradicardia sinusal e taquicardia sinusal. Tais complicações foram correlacionadas com técnica anestésica, estado físico (ASA, idade, sexo e comorbidades pré-operatórias. Para a análise estatística, foram utilizadas o teste de Tukey para comparações entre proporções e regressão logística. RESULTADOS: Foram avaliados 32.554 pacientes submetidos a bloqueios do neuroeixo e houve 4.109 citações de hipotensão arterial, 1.107 de bradicardia sinusal, 601 de taquicardia sinusal e 466 de hipertensão arterial no período intraoperatório. Hipotensão foi mais frequente nos pacientes submetidos à anestesia subaracnoidea contínua (29,4%, OR = 2,39, com idades > 61 anos e do sexo feminino (OR = 1,27. CONCLUSÕES: Hipotensão e bradicardia intraoperatórias foram complicações mais frequentes, sendo que a hipotensão arterial esteve relacionada à técnica anestésica (ASC, faixa etária elevada e sexo feminino. Taquicardia e hipertensão arterial podem não ter sido diretamente relacionadas aos bloqueios do neuroeixo.

  14. Histochemical and immunohistological approach to comparative neuromuscular diseases.

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    Serenella Papparella

    2009-12-01

    Full Text Available The broad category of neuromuscular diseases covers conditions that involve the weakness or wasting of the body muscles. These problems may occur in the spinal cord, the peripheral nerves or the muscle fibers. Some may be hereditary, while others are acquired. Commonly recognized conditions fall into the categories of myopathies, which are diseases of the muscle like muscular dystrophy, disorders of the junction where the nerve impulses are transmitted to the muscle like myasthenia gravis, and neuropathies, which are diseases of the peripheral nervous system. The diagnosis of most neuromuscular diseases rest on careful clinical evaluation of the patient, electromyography, the muscle biopsy, and in some instances, molecular genetic studies. Muscle biopsy, associated to histochemical and immunohistological techniques, plays a key role in diagnosis of many neuromuscular disorders. A number of morphological abnormalities of muscle can be recognized on histological stains such as haematoxylin and eosin and Engel trichrome. Histochemical techniques are essential for the study of muscle biopsies for four main reasons. First, they demonstrate the non-uniform nature of the muscle highlighting the different biochemical properties of specific fibre type and their selective involvement in certain disease processes. Second, they may show an absences of a particular enzyme. Third, an excess of a particular substrate can be demonstrated. Fourth, they may show structural changes in the muscle which would not be apparent with routine histological stains, such as the enzyme-deficient cores in central core disease "mouth-eaten" fibers, and abnormalities in the distribution of mitochondria. In some neuromuscular disorders there could be only non-specific myopathological features. However, a number of proteins, including sarcolemmal, sarcomeric, and nuclear proteins as well as enzymes with defects responsible for neuromuscular disorders, have been identified during

  15. Efectos del vendaje neuromuscular sobre la flexibilidad del raquis lumbar

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    A.M. Labrador-Cerrato

    2015-03-01

    Full Text Available Introducción: El vendaje neuromuscular es una técnica que produce una estimulación muy selectiva sobre la piel a través de la aplicación de unas vendas elásticas especiales con el fin de lograr cambios propioceptivos, aumento o inhibición del tono muscular y mitigación de algias, entre otros. Objetivos: Comprobar si la aplicación del vendaje neuromuscular permite aumentar la flexión del raquis lumbar comparándola con otras técnicas de vendaje placebo (esparadrapo rígido convencional; Omniplaste®-E; observar la concordancia entre la prueba sit-and-reach y el test de Schober en la valoración de la ganancia de flexión lumbar. Material y métodos: Estudio piloto experimental a triple ciego. Se distribuyeron aleatoriamente 45 sujetos sanos de 20-55 años en tres grupos: 1 esparadrapo convencional; 2 Omniplaste®-E; 3 vendaje neuromuscular. En todos los participantes se evaluó la flexión del raquis lumbar mediante la prueba sit-and-reach y el test de Schober antes y después de la intervención siguiendo el mismo protocolo. Resultados: Considerado un intervalo de confianza del 95% y grado de significación estadística p<0,05 en todos los casos, se obtuvo un incremento estadísticamente significativo de la flexión lumbar en todos los grupos según la prueba sit-and-reach, que fue mayor en el grupo del vendaje neuromuscular (1,5 cm de mediana; p=0,011. Según el test de Schober, solamente el vendaje neuromuscular se mostró eficiente (p<0,001, incrementándose el valor basal en un 6,25% (1 cm de mediana. Conclusiones: La aplicación del vendaje neuromuscular sobre la columna lumbar mejora la flexión lumbar respecto a técnicas placebo a partir de los resultados obtenidos mediante el test de Schober, así como una mayor flexión global del tronco que estas técnicas según la prueba sit-and-reach. El test de Schober parece ser más fiable y preciso que la prueba sit-and-reach para estudios de este tipo.

  16. Trabalho e subjetividade no contexto hospitalar: análise institucional do discurso produzido em grupo com profissionais de enfermagem da pediatria

    OpenAIRE

    2013-01-01

    A presente pesquisa tem como objetivo realizar uma analise institucional do discurso produzido em grupo por profissionais da equipe de enfermagem da Clinica Pediatrica de um hospital escola da rede publica de saude da cidade de Sao Paulo. Nossa analise foca a relacao que este profissional estabelece com o trabalho a partir do referencial metodologico conceitual da Analise Institucional do Discurso desenvolvido por Guirado (2010). Como produto desse estudo demonstramos que a relacao construida...

  17. The role of patient advocacy organisations in neuromuscular disease R&D - The case of the Dutch neuromuscular disease association VSN

    NARCIS (Netherlands)

    Boon, W.P.C.; Broekgaarden, R.

    2010-01-01

    This article investigates to what extent patient advocacy organisations play a role in influencing R&D and policymaking for rare neuromuscular diseases. The Dutch neuromuscular disease organisation VSN is studied in depth. A brief history of the VSN is sketched along with the international embedding

  18. Anormalidades neuromuscular no desuso, senilidade e caquexia Neuromuscular abnormalities in disuse, cachexia and ageing

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    João Aris Kouyoumdjian

    1993-09-01

    Full Text Available É feita revisão de literatura sobre as principais alterações do sistema neuromuscular no desuso, senilidade e caquexia no ser humano e em modelos animais. A diminuição do diâmetro das fibras musculares após período de inatividade/imobilidade (desuso deve-se à perda de miofibrilas periféricas não ocorrendo formação de core-targetóides ou diminuição da atividade da miofosforilase, próprias da desnervação; mantêm-se a liberação espontânea de acetilcolina e fatores tróficos na junção mio-neural; em geral são afetadas preferencialmente fibras II, que podem assumir forma angular. Existe um processo contínuo intrínseco de envelhecimento de nervos e músculos, com desnervação e reinervação lenta e progressiva; o número de unidades motoras se reduz após 60 anos, sem ocorrência de atividade elétrica desnervatória; a quantidade de acetilcolina liberada nos neurônios terminais e a capacidade máxima de utilização de oxigênio estão diminuídas; a redução da capacidade oxidativa mitocondrial pode explicar o aumento de fibras I, mantendo-se o equilíbrio energético. Após poucas semanas de caquexia as fibras musculares podem ter o diâmetro reduzido em 30%, essa redução ocorre em ordem decrescente nos músculos dos membros inferiores, superiores e tronco; existe atrofia II preferencial com fibras angulares ocasionais, redução de RNA/síntese proteica, mantendo-se DNA normal.Cachexia, ageing and disuse and their effects on the human and animals neuromuscular system are reviewed. Disuse induces reduction of muscle fibers (mainly II diameter with peripheral myofibrils lost; there is no core-targetoid or even reduction on myophosphorilase activity, both typical of denervation; the acetylcholine spontaneous release and trophic factors on myoneural junction are maintained; muscle fibers could change to angular shape. Ageing affects nerve and muscle by a continuous and progressive process of denervation and reinner

  19. Supervised neuromuscular exercise prior to hip and knee replacement

    DEFF Research Database (Denmark)

    Fernandes, Linda; Roos, Ewa M; Overgaard, Søren

    2017-01-01

    BACKGROUND: There are indications of beneficial short-term effect of pre-operative exercise in reducing pain and improving activity of daily living after total hip replacement (THR) and total knee replacement (TKR) surgery. Though, information from studies conducting longer follow-ups and economic...... evaluations of exercise prior to THR and TKR is needed. The aim of the study was to analyse 12-month clinical effect and cost-utility of supervised neuromuscular exercise prior to THR and TKR surgery. METHODS: The study was conducted alongside a randomised controlled trial including 165 patients scheduled...... for standard THR or TKR at a hospital located in a rural area of Denmark. The patients were randomised to replacement surgery with or without an 8-week preoperative supervised neuromuscular exercise program (Clinical Trials registration no.: NCT01003756). Clinical effect was measured with Hip disability...

  20. An overview of neurological and neuromuscular signs in mitochondrial diseases.

    Science.gov (United States)

    Chaussenot, A; Paquis-Flucklinger, V

    2014-05-01

    Mitochondrial disorders have a broad clinical spectrum and are genetically heterogeneous, involving two genomes. These disorders may be develop at any age, with isolated or multiple system involvement, and any pattern of inheritance. Neurological involvement is the most frequent, and concerns muscular, peripheral and central nervous system. Among these diverse signs, some are suggestive of mitochondrial disease, such as progressive external ophthalmoplegia, exercise intolerance, psychomotor regression, stroke-like episodes, refractory epilepsy and Epilepsia Partialis Continua. Others are less specific and mitochondrial hypothesis may be evocated because of either association of different neuromuscular signs or a multisystemic involvement. This review describes the wealth of this neurological and neuromuscular symptomatology through different syndromes reported in the literature, according to preponderant signs and to modes of inheritance, as key elements to guide genetics testing.

  1. Early appearance and possible roles of non-neuromuscular cholinesterases.

    Directory of Open Access Journals (Sweden)

    Carla eFalugi

    2012-04-01

    Full Text Available The biological function of the cholinesterase (ChE enzymes is well known and has been studied since the beginning of the XXth century; in particular, acetylcholinesterase (AChE, E.C. 3.1.1.7 is an enzyme playing a key role in the modulation of neuromuscular impulse transmission. However, in the past decades, there has been increasing interest concerning its role in regulating non-neuromuscular cell-to-cell interactions mediated by intracellular ion concentration changes, like the ones occurring during gamete interaction and embryonic development. An understanding of the mechanisms of the cholinergic regulation of these events can help us foresee the possible impact on environmental and human health, including gamete efficiency and possible teratogenic effects on different models, and help elucidate the extent to which exposure to ChE inhibitors may affect human health.

  2. Computed tomography of skeletal muscles in neuromuscular disease

    Energy Technology Data Exchange (ETDEWEB)

    Rodiek, S.O.; Kuether, G.

    1985-06-01

    CT-documentation of skeletal muscular lesions caused by neuromuscular diseases implies an essential contribution to conventional techniques in the macroscopic field. Size, distribution and degree of lesions as well as compensatory mechanisms are proved thereby. We report about the different effects on muscle appearance referring to 106 patients of our own experience in amyotrophic lateral sclerosis, spinal muscular atrophy, poliomyelitis, polyradiculitis, polyneuropathy as well as peripheral traumatic nerve lesions.

  3. Report on Adaptive Force, a specific neuromuscular function

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    Marko Hoff

    2015-08-01

    Full Text Available In real life motions, as well as in sports, the adaptation of the neuromuscular systems to externally applied forces plays an important role. The term Adaptive Force (AF shall characterize the ability of the nerve-muscle-system to adapt to impacting external forces during isometric and eccentric muscle action. The focus in this paper is on the concept of this neuromuscular action, which is not yet described in this way. A measuring system was constructed and evaluated for this specific neuromuscular function, but only the main information of the evaluation of the measuring system and the preliminary reference values are mentioned here, while an article with detailed description will be published separately. This paper concentrates on the three following points: 1 What is the peculiarity of this neuromuscular function, introduced as AF? 2 Is the measuring system able to capture its specific characteristics and which phases of measurement occur? 3 It seems reasonable to discuss if AF can be distinguished and classified among the known force concepts. The article describes the measuring system and how it is able to capture special features of real life motions like submaximal intensities and the subjects’ option to react adequately on external varying forces. Furthermore, within one measurement the system records three different force qualities: the isometric submaximal Adaptive Force (AFiso, the maximal isometric Adaptive Force (AFisomax and the maximal eccentric Adaptive Force (AFeccmax. Each of these phases provide different and unique information on the nerve-muscle-system that are discussed in detail. Important, in terms of the Adaptive Force, seems to be the combination of conditional and coordinative abilities.

  4. Aggravated neuromuscular symptoms of mercury exposure from dental amalgam fillings.

    Science.gov (United States)

    Akbal, Ayla; Yılmaz, Hınç; Tutkun, Engin; Köş, Durdu Mehmet

    2014-01-01

    Dental amalgam fillings are widely used all over the world. However, their mercury content can lead to various side effects and clinical problems. Acute or chronic mercury exposure can cause several side effects on the central nerve system, renal and hepatic functions, immune system, fetal development and it can play a role on exacerbation of neuromuscular diseases. In this case, we will present a patient with vacuolar myopathy whose symptoms were started and aggravated with her dental amalgam fillings.

  5. Neuromuscular responses to simulated brazilian jiu-jitsu fights.

    Science.gov (United States)

    da Silva, Bruno Victor Corrêa; Ide, Bernardo Neme; de Moura Simim, Mário Antônio; Marocolo, Moacir; da Mota, Gustavo Ribeiro

    2014-12-01

    The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ) fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m) undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest). Neuromuscular performance was measured by the bench press throw (BPT) and vertical counter movement jump (VCMJ) tests, assessed before the 1st fight (Pre) and after the last one (Post). Blood lactate (LA) was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power) was observed.

  6. Defective membrane remodeling in neuromuscular diseases: insights from animal models.

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    Belinda S Cowling

    Full Text Available Proteins involved in membrane remodeling play an essential role in a plethora of cell functions including endocytosis and intracellular transport. Defects in several of them lead to human diseases. Myotubularins, amphiphysins, and dynamins are all proteins implicated in membrane trafficking and/or remodeling. Mutations in myotubularin, amphiphysin 2 (BIN1, and dynamin 2 lead to different forms of centronuclear myopathy, while mutations in myotubularin-related proteins cause Charcot-Marie-Tooth neuropathies. In addition to centronuclear myopathy, dynamin 2 is also mutated in a dominant form of Charcot-Marie-Tooth neuropathy. While several proteins from these different families are implicated in similar diseases, mutations in close homologues or in the same protein in the case of dynamin 2 lead to diseases affecting different tissues. This suggests (1 a common molecular pathway underlying these different neuromuscular diseases, and (2 tissue-specific regulation of these proteins. This review discusses the pathophysiology of the related neuromuscular diseases on the basis of animal models developed for proteins of the myotubularin, amphiphysin, and dynamin families. A better understanding of the common mechanisms between these neuromuscular disorders will lead to more specific health care and therapeutic approaches.

  7. Altered neuromuscular control mechanisms of the trapezius muscle in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Karlsson Stefan J

    2010-03-01

    Full Text Available Abstract Background fibromyalgia is a relatively common condition with widespread pain and pressure allodynia, but unknown aetiology. For decades, the association between motor control strategies and chronic pain has been a topic for debate. One long held functional neuromuscular control mechanism is differential activation between regions within a single muscle. The aim of this study was to investigate differences in neuromuscular control, i.e. differential activation, between myalgic trapezius in fibromyalgia patients and healthy controls. Methods 27 fibromyalgia patients and 30 healthy controls performed 3 minutes bilateral shoulder elevations with different loads (0-4 Kg with a high-density surface electromyographical (EMG grid placed above the upper trapezius. Differential activation was quantified by the power spectral median frequency of the difference in EMG amplitude between the cranial and caudal parts of the upper trapezius. The average duration of the differential activation was described by the inverse of the median frequency of the differential activations. Results the median frequency of the differential activations was significantly lower, and the average duration of the differential activations significantly longer in fibromyalgia compared with controls at the two lowest load levels (0-1 Kg (p Conclusion these findings illustrate a different neuromuscular control between fibromyalgia patients and healthy controls during a low load functional task, either sustaining or resulting from the chronic painful condition. The findings may have clinical relevance for rehabilitation strategies for fibromyalgia.

  8. Fatty replacement of lower paraspinal muscles: normal and neuromuscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hader, H.; Gadoth, N.; Heifetz, H.

    1983-11-01

    The physiologic replacement of the lower paraspinal muscles by fat was evaluated in 157 patients undergoing computed tomography for reasons unrelated to abnormalities of the locomotor system. Five patients with neuromuscular disorders were similarly evaluated. The changes were graded according to severity at three spinal levels: lower thoracic-upper lumbar, midlumbar, and lumbosacral. The results were analyzed in relation to age and gender. It was found that fatty replacement of paraspinal muscles is a normal age-progressive phenomenon most prominent in females. It progresses down the spine, being most advanced in the lumbosacral region. The severest changes in the five patients with neuromuscular disorders (three with poliomyelitis and two with progressive muscular dystrophy) consisted of complete muscle group replacement by fat. In postpoliomyelitis atrophy, the distribution was typically asymmetric and sometimes lacked clinical correlation. In muscular dystrophy, fatty replacement was symmetric, showing relative sparing of the psoas and multifidus muscles. In patients with neuromuscular diseases, computed tomography of muscles may be helpful in planning a better rehabilitation regimen.

  9. Fatigue in neuromuscular disorders: focus on Guillain–Barré syndrome and Pompe disease

    OpenAIRE

    2009-01-01

    textabstractFatigue accounts for an important part of the burden experienced by patients with neuromuscular disorders. Substantial high prevalence rates of fatigue are reported in a wide range of neuromuscular disorders, such as Guillain-Barré syndrome and Pompe disease. Fatigue can be subdivided into experienced fatigue and physiological fatigue. Physiological fatigue in turn can be of central or peripheral origin. Peripheral fatigue is an important contributor to fatigue in neuromuscular di...

  10. PICU EXTUBATION FAILURE: THE ROLE OF NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    N. Billan MD,

    2007-02-01

    Full Text Available ObjectiveNeuromuscular disorders (diseases of the motor unit, can cause respiratory problems such as impaired cough reflex, chest deformity, recurrent pneumonia and acute respiratory failure; these are the worst most common complications of these diseases and the leading cause of death in such patients (1, 2. Their management hence, very often, entails admission to the Pediatric Intensive Care Unit (PICU (3,4 and during this phase, endotracheal intubation is almost always necessary, to maintain the patency of airways and to apply Positive Pressure Ventilation (PPV. However, endotracheal intubation is always temporary, and its success or failure depends on the timely decision of its termination to restore the normal respiration or to avoid the risk of recurring respiratory failure (5, 6. We designed this study to evaluate the role of neuromuscular disorders in causing extubation failure as compared to that of other risk factors.Materials & MethodsIn an analytical cross-sectional study, the risk factors of reintubation and duration of mechanical ventilation in two groups of 30 patients each, was compared, the first successful extubation and the second with extubation failure.ResultsNeuromuscular disorders (including Spinal Muscular Atrophy, Guillain- Barre' Syndrome, Congenital Myopathies and Muscular Dystrophies were the main underlying diseases in extubation-failure group (P= 0.0002. Hypercapnia (PaCO2>50mmHg was shown to be the most common cause of both the first intubation (P=0.001 and reintubation (P=0.004 in the group of patients who failed extubation. The mean duration of intubation and mechanical ventilation was longer in patients with neuromuscular disorders who had extubation failure (P= 0.01.ConclusionThis study showed that, as underlying problems, neuromuscular disorders are the most common causes of prolonged intubation which defeat weaning from the ventilator and result in reintubation by inducing hypercapnia. Therefore the weaning

  11. Avaliação da atividade antimicrobiana de pigmentos extracelulares produzidos por fungos endofíticos

    Directory of Open Access Journals (Sweden)

    Deyze Alencar Soares

    2015-12-01

    Full Text Available Os pigmentos fúngicos apresentam um grande potencial biotecnológico e algumas propriedades são atribuídas, tais como atividade antimicrobiana e antioxidante. Fungos endofíticos estão em íntima associação com os vegetais e são uma fonte alternativa de corantes naturais utilizados na medicina. Este estudo teve como objetivo investigar a atividade antimicrobiana de pigmentos produzidos por fungos endofíticos pertencentes à Coleção de Microorganismos do Laboratório de Microbiologia Geral e Aplicada da Universidade Federal do Tocantins contra patógenos. Sessenta isolados foram selecionados quanto à produção de pigmento, colocados em erlenmeyer contendo 100 mL de caldo batata e incubados a 30ºC por 14 dias. Após este período, os pigmentos extracelulares foram extraídos com etanol 95% e filtrados. O teste de antagonismo in vitro utilizado foi de difusão em discos, inoculados com 10 µL de filtrado dos pigmentos e incubados a 37°C por 24 horas contra patógenos humanos Escherichia coli, Staphylococcus aureus e Candida albicans. Avaliou-se a atividade antimicrobiana pela formação de halos de inibição. Os filtrados não apresentaram potencial antimicrobiano para os patógenos testes. Dessa forma, é de fundamental importância o estudo sobre os fungos endofíticos no combate a bactérias e fungos patogênicos visando identificar substâncias antimicrobianas.

  12. Arraste via fecal de nutrientes da ingestão produzido por bagaço de mandioca hidrolisado

    Directory of Open Access Journals (Sweden)

    Raupp Dorivaldo da Silva

    2002-01-01

    Full Text Available A ingestão de fibras alimentares pode resultar em arraste de outros nutrientes para as fezes. Bagaço de mandioca produzido por polvilheira foi submetido à hidrólise enzimática para obtenção de um produto mais concentrado em fibra alimentar insolúvel denominado de bagaço de mandioca hidrolisado (BMH. O BMH foi avaliado em ensaios biológicos com ratos Wistar quanto a sua habilidade de arrastar os nutrientes da ingestão para as fezes, tendo como padrão de fibra o farelo de trigo (FT. Acréscimo à dieta base, substituindo igual quantidade de amido, de dose de 5%, 15% ou 25% de BMH promoveu arraste significativo de minerais (globalidade ou proteína; dose de 15% ou 25% promoveu arraste significativo de lipídeo; e, dose de 25% promoveu arraste significativo de carboidrato digestível. Dose de 25% de FT produziu arraste significativo de minerais (globalidade, proteína ou carboidrato digestível, mas, o lipídeo não foi arrastado. BMH produziu efeito mais pronunciado que FT em arrastar minerais (globalidade ou proteína para a dose de 5% ou 15%; no entanto, para a dose alta, de 25%, as fontes produziram efeitos semelhantes em arrastar a proteína, mas o FT promoveu maior arraste de minerais (globalidade. Não houve diferença entre fontes, BMH e FT, em arrastar lipídeo ou carboidrato digestível para as fezes. Na dose alta (25% o BMH promoveu efeitos, no máximo, semelhantes ao FT, em arrastar para as fezes os nutrientes da ingestão; assim, é recomendado como fonte alternativa de fibra alimentar insolúvel para a formulação de alimentos funcionais-digestivos.

  13. Bloqueio do plexo lombar no compartimento do psoas para analgesia pós-operatória em cirurgias ortopédicas Lumbar plexus blockage on psoas compartment for postoperative analgesia after orthopaedic surgeries

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    Luiz Eduardo Imbelloni

    2008-01-01

    Full Text Available OBJETIVOS: O plexo lombar foi localizado entre os músculos quadrado lombar e psoas maior. O objetivo deste estudo foi avaliar a eficácia da injeção única de bupivacaína 0,25% através do bloqueio do compartimento do psoas na analgesia pós-operatória em pacientes de cirurgias ortopédicas. MÉTODO: Quarenta pacientes receberam bloqueio do plexo lombar no compartimento do psoas através da localização com estimulador de nervos e injeção de bupivacaína a 0,25%. Avaliou-se a analgesia e a intensidade da dor às 4, 8, 12, 16, 20 e 24 horas após o término da cirurgia, assim como opióides de resgate. RESULTADOS: Os nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foram bloqueados em 90% dos pacientes. O bloqueio reduziu o regaste de opióides administrados, sendo que 52,5% dos pacientes não necessitaram de complementação analgésica, com duração de 24 horas. Não foram observados sinais e sintomas clínicos da toxicidade da bupivacaína, nem seqüelas associadas com o bloqueio dos nervos. CONCLUSÕES: Este estudo mostra que a injeção no espaço do compartimento do psoas é fácil de realizar com efetivo bloqueio dos cinco nervos. O bloqueio do plexo lombar no compartimento do psoas pode ser recomendado para o uso na analgesia pós-operatória após cirurgias ortopédicas.OBJECTIVES: The lumbar plexus is located between the quadratus lumborum and the psoas major muscles. The aim of this study was to evaluate the efficacy of a single 0.25% bupivacaine injection through the psoas compartment blockage in postoperative analgesia of patients undergoing orthopedic surgery. METHODS: 40 patients received lumbar plexus blockage at the psoas compartment through nerve stimulator and a 0.25% bupivacaine 40-ml injection. Analgesia and pain severity were evaluated at 4, 8, 12, 16, 20 and 24 hours after surgery, similarly to rescue opioids. RESULTS: The ilioinguinal, genitofemoral, lateral cutaneous of the

  14. Implante de marcapasso ventricular esquerdo no tratamento da miocardiopatia dilatada e bloqueio de ramo esquerdo associado a discinesia de contração septal

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    MOREIRA NETO Francisco Fernandes

    1998-01-01

    Full Text Available O Bloqueio de Ramo (BRE pode apresentar-se como entidade isolada, inclusive em corações normais, nos quais aparentemente não causa importante prejuízo à função ventricular esquerda. Estudos realizados com a indução de BRE pelo implante de marcapasso ventricular direito (1 mostraram, no entanto, efeitos deletérios tanto na função sistólica como diastólica do ventrículo esquerdo, inclusive com aparecimento e/ou acentuação de insuficiência mitral. O BRE pode também vir acompanhado de contração discinética do septo interventricular, que causa um prejuízo adicional à função ventricular esquerda e está, em geral, associada a um quadro de miocardiopatia e insuficiência cardíaca de mau prognóstico (2. Estimulados pelo trabalho de CAZEAU et al. (3, em 1994, estudaram pacientes miocardiopatas e demonstraram que a utilização de marcapasso nas quatro câmaras cardíacas causava agudamente redução da pressão capilar pulmonar e aumento do débito cardíaco, provavelmente pela sincronização de contração ventricular estimulando os dois átrios e ventrículos sincronicamente. Nós investigamos a possibilidade da utilização apenas de estimulação ventricular esquerda através de um marcapasso bicameral, para a tentativa de sicronização de contração do ventrículo esquerdo e septo interventricular em pacientes portadores de miocardiopatia, bloqueio de ramo esquerdo e discinesia septal. O procedimento foi realizado em 3 pacientes que foram submetidos no pós-operatório, com o MP ligado e desligado, a estudo ecocardiográfico e cintilográfico para a análise da função ventricular esquerda através do cálculo da fração de ejeção. Os resultados mostraram importante melhora deste parâmetro: no primeiro caso indo de 17% para 25%; no segundo de 13% para 30% e no terceiro de 13% para 27%. A discinesia praticamente desapareceu em 2 dos casos e foi quantificada como +/4 no primeiro caso. A classe funcional e a insufici

  15. Bloqueio anestésico do nervo occipital maior na profilaxia da migrânea Anesthetic blockade of the greater occipital nerve in migraine prophylaxis

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    Elcio Juliato Piovesan

    2001-09-01

    Full Text Available Na fisiopatologia da enxaqueca muitas estruturas estão envolvidas, sendo que o nervo trigêmeo pode ser considerado a estrutura principal. Com o objetivo de determinar a influência do nervo occipital maior (NOM sobre o comportamento da enxaqueca, estudamos 37 pacientes que apresentavam crises de enxaqueca. Utilizando-se de um estudo duplo cego "cruzado" os pacientes foram submetidos a infiltração do NOM com bupivacaína 0,5% (BP e soro fisiológicos 0,9% (SF, os efeitos clínicos após os bloqueios anestésicos foram avaliados: subjetivamente através da escala visual analítica para dor e objetivamente determinou-se os limiares de percepção dolorosa. A comparação entre os dois grupos (BP-SF e (SF-BP mostrou que: o número e a duração das crises em todos os momentos do estudo não mudaram; a intensidade das crises no grupo (BP-SF foi menor somente depois da segunda infiltração (P=0,020, em todos os outros momentos não se observaram alterações significativas. Concluímos que o bloqueio anestésico com BP sobre o NOM não altera o número e a duração das crises de migrânea, porém promove uma redução média na intensidade das crises 60 dias após a sua infiltração. Os resultados mostrados sugerem que o NOM participa ativamente sobre a modulação nociceptiva durante as crises de enxaqueca sem aura.Migraine comprises a great many encephalic structures in its pathophysiology with the trigeminal nerve (TN type being one of the main ones. For the purpose of determining a possible influence of the greater occipital nerve (GON on migraine behavior, 37 patients who showed this pathology were studied. Using a double blind "cross over" group and submitting those patients to a GON infiltration with bupivacaina 0.5% (BP and physiological serum 0.9% (PS, the clinical effects were evaluated: subjectively, through a pain analytical visual scale; objectively, by determining the threshold of pain perception (algometry. The comparison between

  16. Riscos cardiovasculares do bloqueio androgênico Riesgos cardiovasculares del bloqueo androgénico Cardiovascular risks of androgen deprivation therapy

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    Adriano Freitas Ribeiro

    2010-09-01

    Full Text Available O adenocarcinoma de próstata é o câncer mais comum no sexo masculino após o câncer de pele. Entre as várias formas de tratamento do câncer de próstata, a terapia de bloqueio androgênico é uma modalidade consagrada nos pacientes com doença metastática ou localmente avançada, que provavelmente resulta em aumento de sobrevida. No entanto, o bloqueio androgênico é causador de uma série de consequências adversas. Complicações como osteoporose, disfunção sexual, ginecomastia, anemia e alterações na composição corporal são bem conhecidas. Recentemente, uma série de complicações metabólicas foi descrita como aumento da circunferência abdominal, resistência à insulina, hiperglicemia, diabete, dislipidemia e síndrome metabólica com consequente aumento do risco de eventos coronarianos e mortalidade cardiovascular nessa população específica. Este artigo de atualização apresenta uma revisão bibliográfica realizada no MEDLINE de toda literatura publicada em inglês no período de 1966 até junho de 2009, com as seguintes palavras-chave: androgen deprivation therapy, androgen supression therapy, hormone treatment, prostate cancer, metabolic syndrome e cardiovascular disease, no intuito de analisar quais seriam os reais riscos cardiovasculares da terapia de deprivação androgênica, também chamada bloqueio androgênico, nos pacientes com câncer de próstata.El adenocarcinoma de próstata es el cáncer más común en el sexo masculino después del cáncer de piel. Entre las varias formas de tratamiento del cáncer de próstata, la terapia de bloqueo androgénico es una modalidad consagrada en los pacientes con enfermedad metastásica o localmente avanzada, que probablemente resulta en aumento de sobrevida. Mientras tanto, el bloqueo androgénico es causante de una serie de consecuencias adversas. Complicaciones como osteoporosis, disfunción sexual, ginecomastia, anemia y alteraciones en la composición corporal son

  17. Eficácia analgésica pós-operatória de diferentes volumes e massas de ropivacaína no bloqueio de plexo braquial pela via posterior

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    Bruno Salome de Morais

    2012-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial pela via posterior tem sua eficácia para cirurgias de ombro demonstrada por diferentes autores. Entretanto, não há um consenso sobre a massa e o volume ideal de anestésico local a ser empregado. O objetivo deste estudo é com parar diferentes volumes e massas de ropivacaína no bloqueio do plexo braquial pela via posterior em cirurgias artroscópicas de ombro. MÉTODO: Sessenta pacientes com idade > 18 anos, estado físico ASA I e II, escalados para cirurgias artroscópicas de ombro unilateral foram alocados aleatoriamente em três grupos: A (10 mL a 0,5%, B (20 mL a 0,5%, C (5 mL a 1%. O bloqueio foi realizado com agulha 22G de 100 mm conectada ao neuroestimulador, em um ponto 3 cm lateral ao ponto médio do interespaço de C6 e C7, sendo injetada a solução correspondente a cada grupo. A dor pós-operatória foi avaliada na SRPA e nas primeiras 24 horas do pós-operatório. Os grupos foram comparados quanto ao tempo para primeira queixa de dor, à pontuação na ENV e ao consumo de morfina nas primeiras 24 horas. RESULTADOS: Não houve diferença estatisticamente significativa entre os três grupos em relação a idade, peso e altura. Não houve diferença no tempo até a primeira queixa de dor, ENV superior a três e consumo de morfina no pós-operatório entre os grupos. CONCLUSÕES: O presente estudo concluiu que 5 mL de ropivacaína 1% promoveu eficácia analgésica similar a 10 mL ou 20 mL de ropivacaína 0,5% no bloqueio do plexo braquial pela via posterior com o uso do neuroestimulador

  18. Quality of life after surgery for neuromuscular scoliosis

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    Peter Obid

    2013-02-01

    Full Text Available Surgery in patients with neuromuscular scoliosis is associated with a higher rate of complications. It is still controversially discussed whether the patients truly benefit from deformity correction. The purpose of this study is to investigate if the quality of life has been improved and if the patients and their caregivers are satisfied with the results of surgery. This is a retrospective clinical outcome study of 46 patients with neuromuscular scoliosis which were treated with primary stable posterior pedicle screw instrumentation and correction. To achieve fusion only autologous bone was used. Follow up was minimum 2 years and maximum 5 years with an average of 36 months. The patients and/or their caregivers received a questionnaire based on the PEDI (pediatric disability inventory and the GMFS (gross motor function score. The patients (and their caregivers were also asked if the quality of life has improved after surgery. Only 32 of 46 patients answered the questionnaire. The answers showed a high approval-rate regarding the patients satisfaction with the surgery and the improvement of quality of life. The questionnaire could be answered from 1 (I do not agree to 4 (I completely agree. The average agreement to the following statements was: i the quality of life has improved: 3.35; ii I am satisfied with surgery: 3.95; iii the operation has fulfilled my expectations: 3.76. The average age at surgery was 12.7 years. The mean pre-operative cobb-angle of the main curve was 83.1° with a correction post-operatively to a mean of 36.9° and 42.6° at final follow-up. That is an average correction of 56.9%. Although spinal fusion in neuromuscular scoliosis is associated with a higher rate of complications our results show that the patients and their caregivers are satisfied with the operation and the quality of life has improved after surgery.

  19. Neuromuscular Responses to Simulated Brazilian Jiu-Jitsu Fights

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    Corrêa da Silva Bruno Victor

    2014-12-01

    Full Text Available The aim of this study was to investigate the neuromuscular performance responses following successive Brazilian Jiu-Jitsu (BJJ fights. Twenty-three BJJ athletes (age: 26.3 ± 6.3 years; body mass: 79.4 ± 9.7 kg; body height: 1.80 ± 0.1 m undertook 3 simulated BJJ fights (10 min duration each separated by 15 min of rest. Neuromuscular performance was measured by the bench press throw (BPT and vertical counter movement jump (VCMJ tests, assessed before the 1st fight (Pre and after the last one (Post. Blood lactate (LA was measured at Pre, 1 min Post, and 15 min Post fights. Paired t-tests were employed in order to compare the BPT and VCMJ results. One-way ANOVA with Bonferroni post hoc tests were utilized to compare LA responses. The results revealed a significant (p < 0.05 increase in VCMJ performance (40.8 ± 5.5 cm Pre vs. 42.0 ± 5.8 cm Post, but no significant changes in the BPT (814 ± 167 W Pre vs. 835 ± 213 W Post were observed. LA concentration increased significantly (p < 0.05 at Post, both in the 1st min and the 15th min of recovery. We concluded that successive simulated BJJ fights demanded considerable anaerobic contribution of ATP supply, reinforcing the high-intensity intermittent nature of the sport. Nevertheless, no negative impact on acute neuromuscular performance (power was observed.

  20. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study - Efficacy, safety, and pharmacokinetics

    NARCIS (Netherlands)

    Sparr, Harald J.; Vermeyen, Karel M.; Beaufort, Anton M.; Rietbergen, Henk; Proost, Johannes H.; Saldien, Vera; Velik-Salchner, Corinna; Wierda, J. Mark K. H.

    2007-01-01

    Background: Sugammadex reverses the neuromuscular blocking effects of rocuronium by chemical encapsulation. The efficacy, safety, and pharmacokinetics of sugammadex for reversal of profound rocuronium-induced neuromuscular blockade were evaluated. Methods: Ninety-eight male adult patients were rando

  1. Comparison of mechanomyography and acceleromyography for the assessment of rocuronium induced neuromuscular block in myotonic dystrophy type 1.

    NARCIS (Netherlands)

    Vanlinthout, L.E.H.; Booij, L.H.D.J.; Egmond, J. van; Robertson, E.N.

    2010-01-01

    We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies

  2. Pellets de trigo e soja produzidos por extrusão Wheat and soybean pellets produced by extrusion-cooking

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    Sin Huei Wang

    2008-09-01

    Full Text Available A mistura de trigo e soja representa uma importante fonte calórico-protéica com proteínas de boa qualidade. Apesar disso, a utilização da soja como ingrediente tem sido limitada pelo seu sabor de feijão cru (beany flavor, o qual é melhorado pelo processo de extrusão. Foram estudados os efeitos de umidade da mistura, Temperatura de Barril (TB e Velocidade de Rotação de Parafuso (VRP, Nº 5 do extrusor no Índice de Expansão (IE, no Índice de Solubilidade em Água (ISA e nas características sensoriais de pellets produzidos com mistura de trigo e soja (90:10, objetivando a otimização deste processo para a obtenção de pellets fritos com melhores qualidades sensoriais. A farinha mista crua foi extrusada em 2 umidades (32 e 35%, 4 TB (60 a 90 °C e 4 VRP (60 a 150 rpm, totalizando 32 tratamentos. O pellet frito, preparado com a farinha mista com 32% de umidade e extrusada em 60 rpm a 80 °C, apresentou o maior IE e as melhores qualidades sensoriais (aparência, sabor e textura, sendo preferido pela equipe de provadores não treinados, tanto com sabor de bacon como com sabor de queijo.The mixture of wheat with soybean represents an important calorie-protein source with good protein quality. In spite of this, the use of soybeans as an ingredient has been limited by their beany flavor, which is improved by the extrusion process. Effects of mixture moisture, Barrel Temperature (BT and Screw-Speed (SS, Nº 5 on Expansion Index (EI, Water Solubility Index (WSI and sensory characteristics of pellets produced with a wheat-soybean (90:10 mixture were studied, in order to optimize this process for obtaining fried pellets with better sensory qualities. Raw mixed flour was extruded at two moisture contents (32 and 35%, four BT (60 to 90 °C and four SS (60 to 150 rpm, totalizing 32 treatments. The fried pellets, prepared with the mixed flour with 32% moisture and extruded at 60 rpm and 80 °C, presented the greatest EI and the best sensory

  3. Efeito do estradiol e da progesterona no desenvolvimento e na qualidade de embriões bovinos produzidos in vitro

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    A.N Reis

    2010-12-01

    Full Text Available Avaliaram-se o desenvolvimento e a qualidade de embriões bovinos, cocultivados com células epiteliais do oviduto bovino (CEOBs expostas ou não ao estradiol e à progesterona. Os ovócitos foram maturados in vitro por 24h e, então, fertilizados utilizando-se sêmen congelado, em estufa de CO2 a 5% e 38,5ºC. As CEOBs foram cultivadas em TCM-199 com ou sem estradiol (E2 (24 horas, nas mesmas condições da maturação e fertilização in vitro (MIV e FIV, e, em seguida, adicionadas aos diferentes grupos em CR2 com ou sem progesterona (P4 (G1=P4+E2; (G2=E2; (G3=P4 e (G4=controle. Após 18h da FIV, as células foram cultivadas nos diferentes sistemas. Nenhuma diferença (P>0,05 foi observada nas taxas de clivagem entre G1, G2 e G4 (53,5%; 56,3%; 51,7% e nos padrões de blastocistos (BLs (29,3%; 31,2%, 28,7%. Índices menores (P<0,05 foram obtidos no G3 para ambas as variáveis (34,5%; 16,4%. G1 e G2 apresentaram taxas de eclosão maiores (P<0,05 que os outros grupos (23,3%; 23,2%, sendo G4 (19,3% diferente de G3 (16,1%. Em G1, G2 e G3, o número de células nos BLs aumentou 125,9; 128,4 e 123,6, respectivamente (P<0,05, em relação ao G4 (112,5. Conclui-se que o tratamento das CEOBs com o E2, nas primeiras 24 horas de cultivo, pode ser usado isoladamente ou em combinação com a progesterona, a fim de melhorar a qualidade de embriões bovinos produzidos in vitro

  4. MODELAGEM MATEMÁTICA DOS IMPACTOS EXTRAMUROS DO RUÍDO PRODUZIDO POR UMA UNIVERSIDADE EM MOSSORÓ-RN

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    Carlos Enrique Jeronimo

    2015-04-01

    Full Text Available Neste trabalho, desenvolveu-se um estudo para quantificação do ruído produzido por uma universidade em Mossoró-RN, bem como, estimando-se os níveis de atenuação deste ruído com distanciamento, por meio da modelagem matemática. As medições do ruído ambiental foram realizadas por meio de um analisador de Ruído no período noturno no campus da instituição, variando de 0 a 100 m de distância em cada vértice. Aplicaram-se os modelos matemáticos para encontrar relações entre o nível de ruído e a distância de leitura dos dados. Após análise dos resultados, encontrou-se uma relação entre a atenuação pela distância em apenas dois vértices e que os níveis de ruídos estão acima do permitido. Foi possível a determinação do parâmetro K, para a atenuação dos níveis de ruído em dois vértices do prédio, obtendo-se valores de 5,94 e 8.44 dB(A.m-1 nos vértices 3 e 4, respectivamente. Por fim, espera-se que os resultados obtidos neste mapeamento acústico e modelagem de parâmetros matemáticos possam auxiliar no planejamento da implantação de empreendimentos e edificações futuras ao redor do campus da universidade, especialmente, pois é possível fazer a previsibilidade de certas zonas e orientar na indicação dos locais mais silenciosos e os locais mais ruidosos no seu entorno.

  5. Active zone stability: insights from fly neuromuscular junction

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    Xiaolin Tian

    2015-01-01

    Full Text Available The presynaptic active zone is a dynamic structure that orchestrates regulated release of neurotransmitters. Developmental and aging processes, and changes in neuronal network activity can all modulate the number, size and composition of active zone and thereby synaptic efficacy. However, very little is known about the mechanism that controls the structural stability of active zone. By studying a model synapse, the Drosophila neuromuscular junction, our recent work shed light on how two scaffolding proteins at the active zone regulate active zone stability by promoting a localized dephosphorylation event at the nerve terminal. Here we discuss the major insights from our findings and their implications for future research.

  6. Tissue engineering for neuromuscular disorders of the gastrointestinal tract

    Institute of Scientific and Technical Information of China (English)

    Kenneth L Koch; Khalil N Bitar; John E Fortunato

    2012-01-01

    The digestive tract is designed for the optimal processing of food that nourishes all organ systems.The esophagus,stomach,small bowel,and colon are sophisticated neuromuscular tubes with specialized sphincters that transport ingested food-stuffs from one region to another.Peristaltic contractions move ingested solids and liquids from the esophagus into the stomach; the stomach mixes the ingested nutrients into chyme and empties chyme from the stomach into the duodenum.The to-and-fro movement of the small bowel maximizes absorption of fat,protein,and carbohydrates.Peristaltic contractions are necessary for colon function and defecation.

  7. Assessing neuromuscular mechanisms in human-exoskeleton interaction.

    Science.gov (United States)

    Sylla, N; Bonnet, V; Venture, G; Armande, N; Fraisse, P

    2014-01-01

    In this study, we propose to evaluate a 7 DOF exoskeleton in terms of motion control. Using criteria from the human motor control literature, inverse optimization was performed to assess an industrial screwing movement. The results of our study show that the hybrid composition of the free arm movement was accurately determined. At contrary, when wearing the exoskeleton, which produces an arbitrary determined torque compensation, the motion is different from the naturally adopted one. This study is part of the evaluation and comprehension of the complex neuromuscular mechanism resulting in wearing an exoskeleton several hours per day for industrial tasks assistance.

  8. El vendaje neuromuscular en podología

    OpenAIRE

    Vázquez Amela, F. Xavier (Francesc Xavier); Verdaguer Sanmartí, Josefina; Lluch Fruns, Joan; Genís Barniol, Silvia

    2008-01-01

    Desde hace unos cinco años la introducción en España de los vendajes neuromusculares ha ido cobrando mayor relevancia, llegando el momento más álgido las imágenes de las olimpiadas de Beijing, donde se pudo observar el uso de este tipo de vendajes en muchas de las disciplinas deportivas. En este artículo pretendemos hacer una introducción general a este tipo de vendajes y la aplicación en patologías podales de gran incidencia en nuestras consultas.

  9. Calcium channels, neuromuscular synaptic transmission and neurological diseases.

    Science.gov (United States)

    Urbano, Francisco J; Pagani, Mario R; Uchitel, Osvaldo D

    2008-09-15

    Voltage-dependent calcium channels are essential in neuronal signaling and synaptic transmission, and their functional alterations underlie numerous human disorders whether monogenic (e.g., ataxia, migraine, etc.) or autoimmune. We review recent work on Ca(V)2.1 or P/Q channelopathies, mostly using neuromuscular junction preparations, and focus specially on the functional hierarchy among the calcium channels recruited to mediate neurotransmitter release when Ca(V)2.1 channels are mutated or depleted. In either case, synaptic transmission is greatly compromised; evidently, none of the reported functional replacements with other calcium channels compensates fully.

  10. MRI in neuromuscular disorders; MRT bei neuromuskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Fischmann, Arne [Klinik St. Anna, Luzern (Switzerland). Inst. fuer Radiologie und Nuklearmedizin; Fischer, Dirk [Kantonsspital Bruderholz (Switzerland)

    2014-03-15

    Neuromuscular disorders are caused by damage of the skeletal muscles or supplying nerves, in many cases due to a genetic defect, resulting in progressive disability, loss of ambulation and often a reduced life expectancy. Previously only supportive care and steroids were available as treatments, but several novel therapies are under development or in clinical trial phase. Muscle imaging can detect specific patterns of involvement and facilitate diagnosis and guide genetic testing. Quantitative MRT can be used to monitor disease progression either to monitor treatment or as a surrogate parameter for clinical trails. Novel imaging sequences can provide insights into disease pathology and muscle metabolism. (orig.)

  11. Cardiac involvement in children with neuro-muscular disorders

    Directory of Open Access Journals (Sweden)

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  12. Correction of organophosphate-induced neuromuscular blockade by diphenhydramine.

    Science.gov (United States)

    Clemmons, R M; Meyer, D J; Sundlof, S F; Rappaport, J J; Fossler, M E; Hubbell, J; Dorsey-Lee, M R

    1984-10-01

    Dogs exposed to topical organophosphate (fenthion) developed decreased plasma and muscle cholinesterase activities. After 2 doses were applied (1 week between doses), plasma concentrations declined 80% and muscle cholinesterase activity was reduced by 56%. Decremental responses to repetitive nerve stimulation developed after fenthion administration. Diphenhydramine, but not placebo, corrected the electrical abnormalities caused by organophosphate application, but without altering plasma or muscle cholinesterase activity. Control dogs housed in the same kennel demonstrated a slight decrease (18%) of plasma cholinesterase, which indicates that there may be potential cross contamination. Diphenydramine may be effective in treating organophosphate-induced neuromuscular weakness which is refractory to other forms of therapy.

  13. Análise das alternativas tecnológicas de desaguamento de lodos produzidos em estações de tratamento de esgoto

    OpenAIRE

    Vanzetto, Aliny Stradiotti

    2013-01-01

    O objetivo desta pesquisa foi desenvolver uma metodologia para realizar a análise tecnológica das alternativas de desaguamento de lodos produzidos em Estações de Tratamento de Esgotos – ETEs, tendo como base uma abordagem multiobjetivo e multicritério. Um dos principais motivos para a utilização dessa abordagem neste trabalho advém da complexidade da problemática envolvida no tema, a qual deve incluir diversos atores e objetivos, muitas vezes ...

  14. Número racional na representação fracionária: entendimentos produzidos por alunos da educação básica

    OpenAIRE

    Campos, Claudia Fatima de Matos

    2013-01-01

    O presente artigo constitui-se a partir de pesquisa qualitativa com abordagens quantitativas, tem como objetivo investigar os entendimentos que os alunos da Educação Básica apresentam acerca dos números racionais na representação fracionária, envolvendo os cinco significados. Os dados empíricos foram produzidos por meio de questões desenvolvidas com uma turma de alunos do 1° ano do ensino médio, em uma escola da rede Estadual de Ensino no Município de Panambi/RS. Os dados foram...

  15. Psicoterapia como estratégia de tratamento dos transtornos alimentares: análise crítica do conhecimento produzido

    OpenAIRE

    SCORSOLINI-COMIN, Fabio; Santos,Manoel Antônio dos

    2012-01-01

    O objetivo deste estudo foi empreender uma análise crítica acerca do conhecimento científico produzido sobre a utilização das psicoterapias como estratégia de tratamento dos transtornos alimentares. A partir de buscas nas bases PsycINFO, PePSIC e SciELO, no período entre 1999 e 2011, foram recuperados 35 artigos, categorizados em: psicoterapias breves, grupais, psicodinâmicas, complementares, bem como psicoterapias aliadas a outros tratamentos, como o psicofarmacológico. As abordagens mais fr...

  16. Neuromuscular blockade for optimising surgical conditions during abdominal and gynaecological surgery

    DEFF Research Database (Denmark)

    Madsen, M V; Staehr-Rye, A K; Gätke, M R

    2015-01-01

    BACKGROUND: The level of neuromuscular blockade (NMB) that provides optimal surgical conditions during abdominal surgery has not been well established. The aim of this systematic review was to evaluate current evidence on the use of neuromuscular blocking agents in order to optimise surgical cond...

  17. Critical illness polyneuropathy and myopathy; a neuromuscular disorder encountered in the intensive care unit

    NARCIS (Netherlands)

    M-A.C.J. de Letter

    2001-01-01

    textabstractPatients with neuromuscular disorders encountered on the ICU can be divided into two main categories. One category has been admitted to the intensive care unit (ICU) due to an underlying neuromuscular disorder, mainly the Guillam Barre Syndrome ( GBS) and myasthenia gravis. The other cat

  18. The prejunctional inhibitory effect of suramin on neuromuscular transmission in vitro

    NARCIS (Netherlands)

    Henning, RH; Rowan, EG; Braga, MFM; Nelemans, A; Harvey, AL

    1996-01-01

    The P-2 purinoceptor antagonist suramin reverses skeletal muscle paralysis evoked by non-depolarizing neuromuscular blocking agents in vitro and in vivo. To further study the action of suramin on neuromuscular transmission, (miniature) endplate potentials ((m.)e.p.ps), motor nerve terminal currents

  19. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes

    NARCIS (Netherlands)

    Zech, Astrid; Klahn, Philipp; Hoeft, Jon; Eulenburg, Christine Zu; Steib, Simon

    2014-01-01

    Purpose Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular traini

  20. Pharmacokinetic studies of neuromuscular blocking agents : Good Clinical Research Practice (GCRP)

    NARCIS (Netherlands)

    Viby-Mogensen, J; Ostergaard, D; Donati, F; Fisher, D; Hunter, J; Kampmann, JP; Kopman, A; Proost, JH; Rasmussen, SN; Skovgaard, LT; Varin, F; Wright, PMC

    2000-01-01

    In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines fur good clinical research practice (GCRT) in pharmacokinetic studies of neuromuscular blocking agents

  1. Plantar flexor neuromuscular adjustments following match-play football in hot and cool conditions

    DEFF Research Database (Denmark)

    Girard, O; Nybo, Lars; Mohr, Magni;

    2015-01-01

    We assessed neuromuscular fatigue and recovery of the plantar flexors after playing football with or without severe heat stress. Neuromuscular characteristics of the plantar flexors were assessed in 17 male players at baseline and ∼30 min, 24, and 48 h after two 90-min football matches in tempera...

  2. Sarcocystis fayeri in skeletal muscle of horses with neuromuscular disease.

    Science.gov (United States)

    Aleman, Monica; Shapiro, Karen; Sisó, Silvia; Williams, Diane C; Rejmanek, Daniel; Aguilar, Beatriz; Conrad, Patricia A

    2016-01-01

    Recent reports of Sarcocystis fayeri-induced toxicity in people consuming horse meat warrant investigation on the prevalence and molecular characterization of Sarcocystis spp. infection in horses. Sarcocysts in skeletal muscle of horses have been commonly regarded as an incidental finding. In this study, we investigated the prevalence of sarcocysts in skeletal muscle of horses with neuromuscular disease. Our findings indicated that S. fayeri infection was common in young mature horses with neuromuscular disease and could be associated with myopathic and neurogenic processes. The number of infected muscles and number of sarcocysts per muscle were significantly higher in diseased than in control horses. S. fayeri was predominantly found in low oxidative highly glycolytic myofibers. This pathogen had a high glycolytic metabolism. Common clinical signs of disease included muscle atrophy, weakness with or without apparent muscle pain, gait deficits, and dysphagia in horses with involvement of the tongue and esophagus. Horses with myositis were lethargic, apparently painful, stiff, and reluctant to move. Similar to humans, sarcocystosis and cardiomyopathy can occur in horses. This study did not establish causality but supported a possible association (8.9% of cases) with disease. The assumption of Sarcocysts spp. being an incidental finding in every case might be inaccurate.

  3. Stathmin is required for stability of the Drosophila neuromuscular junction.

    Science.gov (United States)

    Graf, Ethan R; Heerssen, Heather M; Wright, Christina M; Davis, Graeme W; DiAntonio, Aaron

    2011-10-19

    Synaptic connections can be stably maintained for prolonged periods, yet can be rapidly disassembled during the developmental refinement of neural circuitry and following cytological insults that lead to neurodegeneration. To date, the molecular mechanisms that determine whether a synapse will persist versus being remodeled or eliminated remain poorly understood. Mutations in Drosophila stathmin were isolated in two independent genetic screens that sought mutations leading to impaired synapse stability at the Drosophila neuromuscular junction (NMJ). Here we demonstrate that Stathmin, a protein that associates with microtubules and can function as a point of signaling integration, is necessary to maintain the stability of the Drosophila NMJ. We show that Stathmin protein is widely distributed within motoneurons and that loss of Stathmin causes impaired NMJ growth and stability. In addition, we show that stathmin mutants display evidence of defective axonal transport, a common feature associated with neuronal degeneration and altered synapse stability. The disassembly of the NMJ in stathmin includes a predictable sequence of cytological events, suggesting that a common program of synapse disassembly is induced following the loss of Stathmin protein. These data define a required function for Stathmin during synapse maintenance in a model system in which there is only a single stathmin gene, enabling future genetic investigation of Stathmin function with potential relevance to the cause and progression of neuromuscular degenerative disease.

  4. Effects on mother and fetus of epidural and combined spinal-epidural techniques for labor analgesia Efeitos maternos e fetais da analgesia de parto pelas técnicas peridural e duplo bloqueio

    Directory of Open Access Journals (Sweden)

    Giane Nakamura

    2009-01-01

    Full Text Available OBJECTIVE: Epidural (EA and combined spinal-epidural (CSE techniques have both been utilized for labor analgesia. This study compared the effects on the mother and newborn of these techniques in labor analgesia and anesthesia. METHODS: Forty pregnant women received epidural analgesia with 15 mL of 0.125% ropivacaine (EA group and 5 µg of sufentanil plus 2.5mg bupivacaine in the subarachnoid space (CSE group. Pain intensity, sensory blockade level, latency time, motor block intensity, labor analgesia duration, epidural analgesia duration, maternal hypotension, and pruritus were evaluated. The newborns were evaluated by Apgar and the neurological and adaptive capacity score (NACS developed by Amiel-Tison. RESULTS: There were no significant statistical differences between groups for pain scores, latency time, sensory blockade level, and Apgar score. Motor block, labor analgesia duration, and epidural analgesia duration were greater in the CSE group, whose seven mothers had mild pruritus. The NACS were greater in the EA group after half, two, and 24 hours. Ninety five percent of EA group newborns and 60% of CSE group newborns were found to be neurologically healthy at the 24 hour examination. CONCLUSION: EA and CSE analgesia relieved maternal pain during obstetric analgesia, but CSE mothers had pruritus and a longer labor. Newborns of mothers who received epidural analgesia showed the best NACS.OBJETIVO: A peridural (AP e a técnica de duplo bloqueio (DB são utilizadas em analgesia para o trabalho de parto. Este estudo comparou os efeitos na mãe e no feto de ambas as técnicas em analgesia e anestesia para o parto. MÉTODOS: Quarenta parturientes ASA I e II receberam por via peridural 15 ml de ropivacaína a 0,125% (grupo AP e 5 µg de sufentanil com 2,5 mg bupivacaína por via subaracnóidea (grupo DB. Foram avaliados: intensidade de dor, altura do bloqueio sensitivo, tempo de latência, bloqueio motor, duração da analgesia de parto, tempo

  5. Controle da dor pós-operatória da artroplastia total do joelho: é necessário associar o bloqueio do nervo isquiático ao bloqueio do nervo femoral? Control del dolor postoperatorio de la artroplastia total de la rodilla: ¿es necesario asociar el bloqueo del nervio isquiático al bloqueo del nervio femoral? Control of postoperative pain following total knee arthroplasty: is it necessary to associate sciatic nerve block to femoral nerve block?

    Directory of Open Access Journals (Sweden)

    Affonso H. Zugliani

    2007-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A artroplastia total do joelho (ATJ promove grande trauma tecidual, produzindo intensa dor no pós-operatório. A analgesia pós-operatória de boa qualidade é fundamental, devendo-se considerar que a mobilização articular precoce é um importante aspecto para obtenção de bons resultados. Há controvérsias na literatura sobre a eficácia do bloqueio isolado do nervo femoral. O objetivo deste estudo foi avaliar a analgesia pós-operatória com a associação do bloqueio dos nervos isquiático e femoral. MÉTODO: Foram estudados 17 pacientes submetidos à ATJ sob raquianestesia, divididos em dois grupos: A e B. No Grupo A (n = 9 foi realizado bloqueio do nervo femoral e no Grupo B (n = 8, bloqueio dos nervos femoral e isquiático. Os bloqueios foram realizados no pós-operatório imediato utilizando-se 20 mL de ropivacaína a 0,5% em cada um. A dor foi aferida nas primeiras 24 horas pela Escala Analógica Visual e escala verbal. Foi observado o tempo decorrido entre os bloqueios e a primeira queixa de dor (M1. RESULTADOS: A mediana do tempo de analgesia (M1 no Grupo A foi de 110 min. e no Grupo B de 1.285 min. (p = 0,0001. Não foram observadas complicações atribuíveis às técnicas utilizadas. CONCLUSÃO: O bloqueio do nervo isquiático, quando associado ao bloqueio do nervo femoral, nas condições deste estudo, melhorou de maneira significativa a qualidade da analgesia pós-operatória da ATJ.JUSTIFICATIVA Y OBJETIVOS: La artroplastia total de la rodilla (ATR promueve gran trauma del tejido produciendo un intenso dolor en el postoperatorio. La analgesia de postoperatorio de buena calidad es fundamental, debiendo considerar que la movilización articular precoz es un importante aspecto para la obtención de buenos resultados. Existen controversias en la literatura sobre la eficacia del bloqueo aislado del nervio femoral. El objetivo de este estudio fue evaluar la analgesia en postoperatorio con la asociaci

  6. Bloqueio "3 em 1" por via anterior: bloqueio parcial, completo ou superdimensionado? Correlação entre anatomia, clínica e radio imagens Bloqueo "3 en 1" por vía anterior: bloqueo parcial, completo o superdimensionado? Correlación entre anatomía, clínica y radio imágenes Anterior "3-in-1" blockade: partial, total or overdimensioned block? Correlation between anatomy, clinic and radio images

    Directory of Open Access Journals (Sweden)

    Karl Otto Geier

    2004-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O clássico bloqueio "3 em 1" por via anterior tem suscitado divergências quanto ao envolvimento anestésico de seus três nervos participantes, o femoral, o cutâneo lateral da coxa e o obturador. O objetivo deste estudo é verificar o desfecho do bloqueio "3 em 1" por via anterior, através das técnicas: injeção única (G1, cateteres curtos (G2 e cateteres longos (G3. Os bloqueios "3 em 1", clinicamente identificados como completos ou superdimensionados foram, adicionalmente, investigados por meio de rádio imagem. MÉTODO: A identificação do espaço subfascial ilíaco nos bloqueios "3 em 1" com injeção única ou com cateteres foi feita pela perda de resistência ao ar. Em vários eventos dolorosos, o volume anestésico administrado variou entre 30 e 40 ml e a introdução cranial dos cateteres foi até 18 cm no espaço subfascial ilíaco. Quando a pesquisa clínica apontava envolvimento do nervo obturador ou de outro nervo adicional ao bloqueio "3 em 1", complementava-se a investigação com estudo radiográfico e tomodensiométrico com o propósito de estabelecer correspondência com a anatomia pélvica. RESULTADOS: O envolvimento dos nervos fêmoro cutâneo lateral e obturador não foram constantes, ao contrário do nervo femoral. No estudo, nenhum bloqueio "3 em 1" completo com injeção única (G1 se manifestou, e sim um bloqueio "2 em 1", com a participação eventual do ramo femoral do nervo genitofemoral (bloqueio "2,5 em 1". Contudo, quando foram utilizados cateteres curtos (G2, obteve-se bloqueio "3 em 1" em apenas um paciente, ao passo que com cateteres longos (G3 introduzidos no sentido cefálico até 18 cm no espaço subfascial ilíaco, três bloqueios "3 em 1" superdimensionados foram registrados, pelo envolvimento adicional dos nervos fibular comum em dois pacientes e o nervo tibial em um paciente. CONCLUSÕES: Apesar da pequena amostra, com injeção única (G1, sempre se obteve um bloqueio "2

  7. Caracterização microbiológica e físico-química do leite cru de cabra produzido no estado do Paraná

    OpenAIRE

    2014-01-01

    O presente estudo teve por objetivo caracterizar a composição físico-química e microbiológica do leite cru de cabra produzido no estado do Paraná. Foram obtidas 32 amostras, logo após a ordenha, provenientes de oito propriedades, que juntas produzem cerca de 24% do leite de cabra produzido no Paraná. Para caracterização microbiológica foram quantificados micro-organismos aeróbios mesófilos, psicrotróficos, coliformes totais, Escherichia coli, Staphylococcus coagulase positiva, proteolíticos, ...

  8. Neuromuscular Adaptations to Unilateral vs. Bilateral Strength Training in Women.

    Science.gov (United States)

    Botton, Cíntia E; Radaelli, Regis; Wilhelm, Eurico N; Rech, Anderson; Brown, Lee E; Pinto, Ronei S

    2016-07-01

    Botton, CE, Radaelli, R, Wilhelm, EN, Rech, A, Brown, LE, and Pinto, RS. Neuromuscular adaptations to unilateral vs. bilateral strength training in women. J Strength Cond Res 30(7): 1924-1932, 2016-Considering the bilateral deficit, the sum of forces produced by each limb in a unilateral condition is generally greater than that produced by them in a bilateral condition. Therefore, it can be speculated that performing unilateral strength exercises may allow greater training workloads and subsequently greater neuromuscular adaptations when compared with bilateral training. Hence, the purpose of this study was to compare neuromuscular adaptations with unilateral vs. bilateral training in the knee extensor muscles. Forty-three recreationally active young women were allocated to a control, unilateral (UG) or bilateral (BG) training group, which performed 2 times strength training sessions a week for 12 weeks. Knee extension one repetition maximum (1RM), maximal isometric strength, muscle electrical activity, and muscle thickness were obtained before and after the study period. Muscle strength was measured in unilateral (right + left) and bilateral tests. Both UG and BG increased similarly their unilateral 1RM (33.3 ± 14.3% vs. 24.6 ± 11.9%, respectively), bilateral 1RM (20.3 ± 6.8% vs. 28.5 ± 12.3%, respectively), and isometric strength (14.7 ± 11.3% vs. 13.1 ± 12.5%, respectively). The UG demonstrated greater unilateral isometric strength increase than the BG (21.4 ± 10.5% vs. 10.3 ± 11.1%, respectively) and only the UG increased muscle electrical activity. Muscle thickness increased similarly for both training groups. Neither group exhibited pretesting 1RM bilateral deficit values, but at post-testing, UG showed a significant bilateral deficit (-6.5 ± 7.8%) whereas BG showed a significant bilateral facilitation (5.9 ± 9.0%). Thus, performing unilateral or bilateral exercises was not a decisive factor for improving morphological adaptations and bilateral

  9. INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCKADE AT TRACHEAL EXTUBATION: COMPARISON OF ATRACURIUM WITH VECURONIUM

    Directory of Open Access Journals (Sweden)

    Shwetha S

    2015-11-01

    Full Text Available BACKGROUND: Occurrence of undetected residual neuromuscular blockade is a common event in the post anaesthesia care unit. AIM: To compare the incidence and degree of residual neuromuscular blockade with the use of intermediate acting neuromuscular blocking agents Atracurium and Vecuronium. METHODS: 360 patients satisfying the inclusion and exclusion criteria were enrolled in the study and randomly allocated into one of the two study groups of 180 each to receive either Atracurium or Vecuronium intraoperatively. The anaesthesiologist blinded from the study extubated the patient based on the standard clinical criteria and the corresponding Train of Four(TOF ratios were noted by a blinded research assistant using a TOF watch (TOF- Watch® SX Organon, Ireland Ltd., Dublin, Ireland. Residual neuromuscular blockade was defined as a TOF ratio of 0.9 thirty minutes after tracheal extubation. CONCLUSION: We conclude from our study that significant post-operative residual curarization (TOF < 0.9 exists in majority of patients at the time of tracheal extubation (54.4% incidence despite the use of intermediate acting neuromuscular blocking drugs. The incidence and degree of post-operative residual curarization is significantly greater with Vecuronium compared to Atracurium. Thus we suggest that quantitative neuromuscular monitoring is required to assure complete neuromuscular recovery.

  10. Active zone stability:insights from fly neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Xiaolin Tian; Chunlai Wu

    2015-01-01

    The presynaptic active zone is a dynamic structure that orchestrates regulated release of neurotrans-mitters. Developmental and aging processes, and changes in neuronal network activity can all modulate the number, size and composition of active zone and thereby synaptic efifcacy. However, very little is known about the mechanism that controls the structural stability of active zone. By study-ing a model synapse, theDrosophila neuromuscular junction, our recent work shed light on how two scaffolding proteins at the active zone regulate active zone stability by promoting a localized dephos-phorylation event at the nerve terminal. Here we discuss the major insights from our ifndings and their implications for future research.

  11. Resúmenes de los trabajos sobre las Enfermedades Neuromusculares

    Directory of Open Access Journals (Sweden)

    Congreso Nacional de Neurología

    2010-03-01

    Full Text Available Las enfermedades neuromusculares constituyen un conjunto de afectaciones que afectan las neuronas motoras periférica, las vías motoras eferentes o los efectores (músculos esqueléticos. Sus manifestaciones clínicas son muy variadas y dependen de la causa y de los niveles de afectación. En este acápite se pueden encontrar los resúmenes de trabajos relacionados con el síndrome de Guillain Barre, polineuropatía diabética, Atrofia Muscular Espinal, Distrofia miotónica y otros todos presentados en el salón que abordó estas enfermedades.

  12. Regional neuromuscular regulation within human rectus femoris muscle during gait.

    Science.gov (United States)

    Watanabe, Kohei; Kouzaki, Motoki; Moritani, Toshio

    2014-11-01

    The spatial distribution pattern of neuromuscular activation within the human rectus femoris (RF) muscle was investigated during gait by multi-channel surface electromyography (surface EMG). Eleven healthy men walked on a treadmill with three gait speeds (4, 5, and 6 km/h) and gradients (0°, 12.5°, and 25°). The spatial distribution of surface EMG was tested by central locus activation (CLA), which is calculated from 2-D multi-channel surface EMG with 46 surface electrodes. For all conditions, CLA was around the middle regions during the swing-to-stance transition and moved in a proximal direction during the stance phase and stance-to-swing transition (pphase significantly moved to proximal site with increasing gait speed (pphases, with increasing grade, CLA significantly moved distally (pgait cycle and is non-uniformly regulated longitudinally.

  13. Isozyme patterns and protein profiles in neuromuscular disorders.

    Science.gov (United States)

    Edwards, Y H; Tipler, T D; Morgan-Hughes, J A; Neerunjun, J S; Hopkinson, D A

    1982-06-01

    The isozyme patterns of six different enzymes and the polypeptide profiles of soluble proteins have been examined in muscle biopsy specimens from 74 patients with a wide variety of neuromuscular disorders. About half of the samples showed unusual features in at least one, and often several, of the enzymes and proteins tested. The extent of the biochemical abnormalities was roughly proportional to the severity of the disorders. In all cases the unusual isozymes and polypeptide profiles seemed to reflect a reversion to the fetal pattern of gene expression. However, this change appeared to occur in extant muscle and was not dependent on the appearance of new muscle fibres. Among the enzymes, phosphoglycerate mutase followed by creatine kinase appeared to be the most sensitive index of muscle disorder. The extent of the change in the muscle creatine kinase isozyme pattern was not correlated with the levels of serum creatine kinase activity.

  14. Fuzzy Control Method with Application for Functional Neuromuscular Stimulation System

    Institute of Scientific and Technical Information of China (English)

    吴怀宇; 周兆英; 熊沈蜀

    2001-01-01

    A fuzzy control technique is applied to a functional neuromuscular stimulation (FNS) physicalmultiarticular muscle control system. The FNS multiarticular muscle control system based on the fuzzy controllerwas developed with the fuzzy control rule base. Simulation experiments were then conducted for the joint angletrajectories of both the elbow flexion and the wrist flexion using the proposed fuzzy control algorithm and aconventional PID control algorithm with the FNS physical multiarticular muscle control system. The simulationresults demonstrated that the proposed fuzzy control method is more suitable for the physiologicalcharacteristics than conventional PID control. In particular, both the trajectory-following and the stability of theFNS multiarticular muscle control system were greatly improved. Furthermore, the stimulating pulse trainsgenerated by the fuzzy controller were stable and smooth.``

  15. Abdominal compartment syndrome successfully treated with neuromuscular blockade

    Directory of Open Access Journals (Sweden)

    Kris T Chiles

    2011-01-01

    Full Text Available A 48 year old male admitted to the intensive care unit after a cardiac arrest complicated by a stroke intra-operatively during automatic implantable cardioverter defibrillator placement. He post-operatively developed a rigid abdomen, elevated peak and plateau pressures, hypoxia and renal insufficiency. He was diagnosed with abdominal compartment syndrome with an intra-abdominal compartment pressure of 40mmHg. The patient was administered 10 mg of intravenous cisatracuriumbesylate in preparation for bedside surgical abdominal decompression. Cisatracurium eliminated the patients need for surgical intervention by reducing his abdominal compartment pressures to normal and improving his hypoxia and renal function. This case illustrates that neuromuscular blockade should be attempted in patients with abdominal compartment syndrome prior to surgical intervention.

  16. Alterations in neuromuscular function in girls with generalized joint hypermobility

    DEFF Research Database (Denmark)

    Jensen, Bente Rona; Melcher, Jesper Sandfeld; Melcher, Pia Grethe Sandfeld;

    2016-01-01

    BACKGROUND: Generalized Joint Hypermobility (GJH) is associated with increased risk of musculoskeletal joint pain. We investigated neuromuscular performance and muscle activation strategy. METHODS: Girls with GJH and non-GJH (NGJH) performed isometric knee flexions (90°,110°,130°), and extensions...... (90°) at 20 % Maximum Voluntary Contraction, and explosive isometric knee flexions while sitting. EMG was recorded from knee flexor and extensor muscles. RESULTS: Early rate of torque development was 53 % faster for GJH. Reduced hamstring muscle activation in girls with GJH was found while knee...... adaptation to compensate for hypermobility. Higher medial muscle activation indicated higher levels of medial knee joint compression in girls with GJH. Increased flexion-extension co-activation ratios in GJH were explained by decreased agonist drive to the hamstrings....

  17. The use of neuromuscular blocking agents in the ICU: where are we now?

    Science.gov (United States)

    Greenberg, Steven B; Vender, Jeffery

    2013-05-01

    Intensivists use neuromuscular blocking agents for a variety of clinical conditions, including for emergency intubation, acute respiratory distress syndrome, status asthmaticus, elevated intracranial pressure, elevated intra-abdominal pressure, and therapeutic hypothermia after ventricular fibrillation-associated cardiac arrest. The continued creation and use of evidence-based guidelines and protocols could ensure that neuromuscular blocking agents are used and monitored appropriately. A collaborative multidisciplinary approach coupled with constant review of the pharmacology, dosing, drug interactions, and monitoring techniques may reduce the adverse events associated with the use of neuromuscular blocking agents.

  18. Neuromuscular medicine competency in physical medicine and rehabilitation residents: a method of development and assessment.

    Science.gov (United States)

    Lin, Lei; Cuccurullo, Sara J; Innerfield, Caitlin E; Strax, Thomas E; Petagna, Anne

    2013-03-01

    This project endeavored to create an educational module including methodology to instruct physical medicine and rehabilitation residents in the evaluation and appropriate treatment of patients with neuromuscular disorders. It further sought to verify acquired competencies in neuromuscular rehabilitation through objective evaluation methodology. An American Association of Neuromuscular and Electrodiagnostic Medicine board-certified physician with 10 yrs of clinical experience in neuromuscular and general rehabilitation trained 19 residents using a standardized competency-based module. The residents were trained through clinical training, lectures, and review of self-assessment examination concepts from the American Academy of Physical Medicine & Rehabilitation syllabus provided in the Archives of Physical Medicine and Rehabilitation. After delivery of the educational module, knowledge acquisition and skill proficiency were measured in (1) completion of neuromuscular history and physical examination satisfactorily, (2) diagnosis and ability to design a patient care management plan via chart stimulated recall examinations, (3) physician-patient interaction via patient surveys, (4) physician-staff interaction via 360-degree global ratings, and (5) ability to write a comprehensive patient care report and to document a patient care management plan in accordance with Medicare guidelines via written patient reports. Assessment tools developed for this program address the basic competencies outlined by the Accreditation Council for Graduate Medical Education. To test the success of the standardized educational module, data were collected on an ongoing basis. The objective measures compared resident self-assessment examination scores in neuromuscular rehabilitation before and after the institution of the comprehensive neuromuscular competency module in the residency program. Nineteen (100%) of 19 residents successfully demonstrated proficiency in every segment of the

  19. Combined application of neuromuscular electrical stimulation and voluntary muscular contractions.

    Science.gov (United States)

    Paillard, Thierry

    2008-01-01

    Electromyostimulation (EMS) and voluntary muscle contraction (VC) constitute different modes of muscle activation and induce different acute physiological effects on the neuromuscular system. Long-term application of each mode of muscle activation can produce different muscle adaptations. It seems theoretically possible to completely or partially cumulate the muscle adaptations induced by each mode of muscle activation applied separately. This work consisted of examining the literature concerning the muscle adaptations induced by long-term application of the combined technique (CT) [i.e. EMS is combined with VC - non-simultaneously] compared with VC and/or EMS alone in healthy subjects and/or athletes and in post-operative knee-injured subjects. In general, CT induced greater muscular adaptations than VC whether in sports training or rehabilitation. This efficiency would be due to the fact that CT can facilitate cumulative effects of training completely or partially induced by VC and EMS practiced alone. CT also provides a greater improvement of the performance of complex dynamic movements than VC. However, EMS cannot improve coordination between different agonistic and antagonistic muscles and thus does not facilitate learning the specific coordination of complex movements. Hence, EMS should be combined with specific sport training to generate neuromuscular adaptations, but also allow the adjustment of motor control during a voluntary movement. Likewise, in a therapeutic context, CT was particularly efficient to accelerate recovery of muscle contractility during a rehabilitation programme. Strength loss and atrophy inherent in a traumatism and/or a surgical operation would be more efficiently compensated with CT than with VC. Furthermore, CT also restored more functional abilities than VC. Finally, in a rehabilitation context, EMS is complementary to voluntary exercise because in the early phase of rehabilitation it elicits a strength increase, which is necessary

  20. Neuromuscular anatomy and evolution of the cetacean forelimb.

    Science.gov (United States)

    Cooper, Lisa Noelle; Dawson, Susan D; Reidenberg, Joy S; Berta, Annalisa

    2007-09-01

    The forelimb of cetaceans (whales, dolphins, and porpoises) has been radically modified during the limb-to-flipper transition. Extant cetaceans have a soft tissue flipper encasing the manus and acting as a hydrofoil to generate lift. The neuromuscular anatomy that controls flipper movement, however, is poorly understood. This study documents flipper neuromuscular anatomy and tests the hypothesis that antebrachial muscle robustness is related to body size. Data were gathered during dissections of 22 flippers, representing 15 species (7 odontocetes, 15 mysticetes). Results were compared with published descriptions of both artiodactyls and secondarily aquatic vertebrates. Results indicate muscle robustness is best predicted by taxonomic distribution and is not a function of body size. All cetaceans have atrophied triceps muscles, an immobile cubital joint, and lack most connective tissue structures and manus muscles. Forelimbs retain only three muscle groups: triceps (only the scapular head is functional as the humeral heads are vestigal), and antebrachial extensors and flexors. Well-developed flexor and extensor muscles were found in mysticetes and basal odontocetes (i.e., physeterids, kogiids, and ziphiids), whereas later diverging odontocetes (i.e., monodontids, phocoenids, and delphinids) lack or reduce these muscles. Balaenopterid mysticetes (e.g., fin and minke whales) may actively change flipper curvature, while basal odontocetes (e.g., sperm and beaked whales) probably stiffen the flipper through isometric contraction. Later diverging odontocetes lack musculature supporting digital movements and are unable to manipulate flipper curvature. Cetacean forelimbs are unique in that they have lost agility and several soft tissue structures, but retain sensory innervations.

  1. The origins of neuromuscular fatigue post-stroke.

    Science.gov (United States)

    Knorr, S; Ivanova, T D; Doherty, T J; Campbell, J A; Garland, S J

    2011-10-01

    Fatigue post-stroke is a disabling and persistent symptom affecting many stroke survivors. Despite its high prevalence, the pathophysiology underlying this phenomenon remains obscure. The aim of the present study was to investigate the origins of neuromuscular fatigue post-stroke. Ten chronic stroke survivors and 10 controls sustained an isometric contraction at 30% of maximal voluntary contraction (MVC) with the ankle dorsiflexors. Motor evoked potential (MEP), cortical silent period (SP), voluntary activation, M wave and contractile properties were evaluated before, during and after fatigue among the paretic, non-paretic and control limbs. The pattern of response to fatigue in the non-paretic and control limbs was comparable; therefore, results are presented between the paretic and non-paretic limbs. Before fatigue, reduced MVC peak torque and MEP amplitude were observed on the paretic side in comparison with the non-paretic side. During fatigue, the cortical SP duration increased significantly in both limbs, whereas the MEP amplitude significantly increased only in the non-paretic limb. After fatigue, MVC peak torque decreased significantly in both limbs. Significant reductions in M wave and twitch peak torque were observed in both limbs, pointing to the development of peripheral fatigue. However, central fatigue, evident by a significant reduction in voluntary activation, was greater in the paretic than in the non-paretic limb. After stroke, an inability to increase central excitability in response to an increased cortical inhibition associated with the fatiguing contraction may contribute to central fatigue observed in the paretic limb, which may also be linked to increased self-reported fatigue during activities of daily living. These findings advance our understanding of the neuromuscular basis of fatigue post-stroke.

  2. Electrical stimulation for testing neuromuscular function: from sport to pathology.

    Science.gov (United States)

    Millet, Guillaume Y; Martin, Vincent; Martin, Alain; Vergès, Samuel

    2011-10-01

    The use of electrical stimulation (ES) can contribute to our knowledge of how our neuromuscular system can adapt to physical stress or unloading. Although it has been recently challenged, the standard technique used to explore central modifications is the twitch interpolated method which consists in superimposing single twitches or high-frequency doublets on a maximal voluntary contraction (MVC) and to compare the superimposed response to the potentiated response obtained from the relaxed muscle. Alternative methods consist in (1) superimposing a train of stimuli (central activation ratio), (2) comparing the MVC response to the force evoked by a high-frequency tetanus or (3) examining the change in maximal EMG response during voluntary contractions, if this variable is normalized to the maximal M wave, i.e. EMG response to a single stimulus. ES is less used to examine supraspinal factors but it is useful for investigating changes at the spinal level, either by using H reflexes, F waves or cervicomedullary motor-evoked potentials. Peripheral changes can be examined with ES, usually by stimulating the muscle in the relaxed state. Neuromuscular propagation of action potentials on the sarcolemma (M wave, high-frequency fatigue), excitation-contraction coupling (e.g. low-frequency fatigue) and intrinsic force (high-frequency stimulation at supramaximal intensity) can all be used to non-invasively explore muscular function with ES. As for all indirect methods, there are limitations and these are discussed in this review. Finally, (1) ES as a method to measure respiratory muscle function and (2) the comparison between electrical and magnetic stimulation will also be considered.

  3. Nitrato e nitrito em leite produzido em sistemas convencional e orgânico Nitrate and nitrite in milk produced by conventional and organic systems

    Directory of Open Access Journals (Sweden)

    Joice S. dos Santos

    2005-06-01

    Full Text Available Nitratos e nitritos podem estar presentes naturalmente em diversos alimentos, entre eles o leite. Devido a sua toxicidade, são estabelecidos limites para a presença destes compostos nos alimentos. Assim, investigou-se os níveis de nitratos e nitritos em amostras de leite in natura, produzido por vacas submetidas aos sistemas de manejo convencional e orgânico. As amostras foram coletadas em propriedades da Região da Depressão Central do Rio Grande do Sul, Brasil. Os teores médios de nitrato e nitrito encontrados nas amostras (n=45 foram de 6,65±0,84mg/L e 1,76±0,17mg/L, respectivamente. O leite produzido no sistema orgânico apresentou 7,08mg/L de nitrato e 1,61mg/L de nitrito, enquanto o produzido no sistema convencional apresentou 6,36 e 1,87mg/L, respectivamente. Não foi observada diferença significativa entre os teores de nitrato e nitrito encontrados nas amostras de leite em função do sistema de produção avaliado, época de coleta, turno de ordenha ou local de origem, isto é, propriedade produtora.Nitrates and nitrites can be naturally found in many foods, including milk. Due to their toxicity there is a maximum level allowed for these compounds in foods. In the present study, nitrate and nitrite levels were evaluated in raw milk samples produced in conventional and organic systems. Samples were collected from farms of the Depressão Central of Rio Grande do Sul, Brazil. The average levels of nitrate and nitrite in samples (n=45 were 6.65±0.84mg/L and 1.76±0.17mg/L, respectively. Milk produced in the organic system exhibited 7.08mg/L nitrate and 1.61mg/L nitrite, while milk produced in the conventional system exhibited 6.36 and 1.87mg/L, respectively. Nitrate and nitrite levels in raw milk were not affected by the production system, the period of collection, milking shift or the site of production (farm.

  4. ANÁLISE SENSORIAL E MICROBIOLÓGICA DE KEFIR ARTESANAL PRODUZIDO A PARTIR DE LEITE DE CABRA E DE LEITE DE VACA

    Directory of Open Access Journals (Sweden)

    Felipe Alves de Almeida

    2011-02-01

    Full Text Available O kefir vem sendo considerado como um alimento funcional, produzido através da fermentação lática e alcoólica do leite por bactérias e leveduras, possuindo consistência semelhante à de um iogurte, mas de valor nutricional e terapêutico muito maior. É originário das montanhas dos Cáucaso e da Ásia Central tendo sido consumido por milhares de anos pela população das montanhas que relacionam seu uso diário com a longevidade e saúde. O objetivo deste trabalho foi elaborar um kefir a base de leite de vaca e outro a base de leite de cabra e avaliar suas características microbiológicas e a aceitabilidade de cada um dos produtos.

  5. Monitoramento de um sistema piloto no tratamento da água residuária do café produzido por via úmida

    OpenAIRE

    Silva,Júlia Ferreira da

    2014-01-01

    Objetivou-se, nesta pesquisa, monitorar uma lagoa de estabilização, a partida e o funcionamento de reatores UASB em escala piloto no tratamento da água residuária do café (ARC) produzido por via úmida. O sistema utilizado, localizado no Núcleo de Estudos em Cafeicultura (NECAF/UFLA), foi composto de duas grades de retenção de sólidos grosseiros, caixa de areia, lagoa de estabilização, dois reatores UASB concêntricos trabalhando em série, um equalizador de pressão, três filtros de remoção de g...

  6. Neuromuscular electrical stimulation for preventing skeletal-muscle weakness and wasting in critically ill patients

    DEFF Research Database (Denmark)

    Maffiuletti, Nicola A.; Roig, Marc; Karatzanos, Eleftherios;

    2013-01-01

    Background: Neuromuscular electrical stimulation (NMES) therapy may be useful in early musculoskeletal rehabilitation during acute critical illness. The objective of this systematic review was to evaluate the effectiveness of NMES for preventing skeletal-muscle weakness and wasting in critically...

  7. Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review.

    NARCIS (Netherlands)

    Cup, E.H.C.; Pieterse, A.J.; Broek-Pastoor, J.M. Ten; Munneke, M.; Engelen, B.G.M. van; Hendricks, H.T.; Wilt, G.J. van der; Oostendorp, R.A.B.

    2007-01-01

    OBJECTIVE: To summarize and critically appraise the available evidence on exercise therapy and other types of physical therapies for patients with neuromuscular diseases (NMD). DATA SOURCES: Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, Medline, CINAHL,

  8. Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching on Muscle Strength and Power Output

    OpenAIRE

    Marek, Sarah M; Cramer, Joel T; Fincher, A. Louise; Massey, Laurie L; Dangelmaier, Suzanne M; Purkayastha, Sushmita; Fitz, Kristi A; Culbertson, Julie Y

    2005-01-01

    Context: Stretching is commonly used as a technique for injury prevention in the clinical setting. Our findings may improve the understanding of the neuromuscular responses to stretching and help clinicians make decisions for rehabilitation progression and return to play.

  9. Propriedades físicas de painéis aglomerados de madeira produzidos com adição de película de polipropileno biorientado

    Directory of Open Access Journals (Sweden)

    Laurenn B. de Macedo

    2015-07-01

    Full Text Available No Brasil, as últimas décadas foram marcadas pela crescente produção de paineis de madeira seguida pelo aumento do consumo nacional; isto descreve o quão promissora é a área devido à sua grande potencialidade quanto ao desenvolvimento de novos produtos e tecnologias; como exemplo disto existe a possibilidade de mistura entre materiais lignocelulósicos e os diversos resíduos produzidos pela sociedade. Entre tais resíduos o plástico é o que apresenta maior abundância nos descartes domésticos. Neste contexto, o presente trabalho objetivou determinar propriedades físicas de paineis aglomerados homogêneos confeccionados com partículas de madeira de Eucalyptus sp e Pinus sp e de embalagens de película de polipropileno biorientado tendo, como adesivo, a resina poliuretana à base de óleo de mamona. Foram avaliadas as propriedades: inchamento em espessura e absorção de água, com corpo de prova com e sem impermeabilização, e massa específica. Concluiu-se que, dos fatores investigados, apenas o uso do impermeabilizante foi significativo. De acordo com a ANSI A208.1 (ANS, 1999 os paineis produzidos são classificados como de alta massa específica (H. Relativamente ao inchamento em espessura por 2 h, os paineis atenderam ao exigido pela NBR 14810 (ABNT, 2013 para espessura de 8 a 13 mm.

  10. Can hyperbaric oxygen be used to prevent deep infections in neuro-muscular scoliosis surgery?

    OpenAIRE

    Inanmaz, Mustafa Erkan; Kose, Kamil Cagri; Isik, Cengiz; Atmaca, Halil; Basar, Hakan

    2014-01-01

    Background The prevalence of postoperative wound infection in patients with neuromuscular scoliosis surgery is significantly higher than that in patients with other spinal surgery. Hyperbaric oxygen has been used as a supplement to treat postsurgical infections. Our aim was to determine beneficiary effects of hyperbaric oxygen treatment in terms of prevention of postoperative deep infection in this specific group of patients in a retrospective study. Methods Forty two neuromuscular scoliosis ...

  11. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function

    OpenAIRE

    Hindle, Kayla B.; Whitcomb, Tyler J.; Briggs, Wyatt O.; Hong, Junggi

    2012-01-01

    Proprioceptive neuromuscular facilitation (PNF) is common practice for increasing range of motion, though little research has been done to evaluate theories behind it. The purpose of this study was to review possible mechanisms, proposed theories, and physiological changes that occur due to proprioceptive neuromuscular facilitation techniques. Four theoretical mechanisms were identified: autogenic inhibition, reciprocal inhibition, stress relaxation, and the gate control theory. The studies s...

  12. O bloqueio da síntese do óxido nítrico promove aumento da hipertrofia e da fibrose cardíaca em ratos submetidos a treinamento aeróbio

    OpenAIRE

    Souza, Hugo Celso Dutra de; Penteado,Daniel Martins Dias; Martin-Pinge,Marli Cardoso; Barbosa Neto,Octávio; Teixeira,Vicente de Paula Antunes; Blanco,João Henrique Dutra; Silva, Valdo José Dias da

    2007-01-01

    OBJETIVO: O presente estudo avaliou as adaptações teciduais cardíacas em ratos submetidos a treinamento aeróbio, após o bloqueio da síntese de óxido nítrico (NO). MÉTODOS: Os animais (n = 48) foram divididos em quatro grupos: sedentários (grupo CONTROLE), hipertensos após administração de Ng-nitro-L-arginina metil éster durante sete dias (grupo L-NAME), treinados por meio de natação durante oito semanas (grupo TREINADO) e treinados e tratados com L-NAME na última semana (grupo TREINADO L-NAME...

  13. Avaliação psicológica de meninas com puberdade precoce central idiopática antes e durante o bloqueio puberal com análogos de GnRH

    OpenAIRE

    Tais Alencar Santos Menk

    2015-01-01

    Introdução: A puberdade é considerada precoce quando ocorre antes dos 8 anos nas meninas. É classificada como puberdade precoce central (PPC) quando decorre da ativação prematura do eixo gonadotrófico e é considerada idiopática quando não há alteração no sistema nervoso central. O bloqueio puberal com análogos de GnRH é o tratamento de escolha da PPC e visa a regressão ou estabilização dos caracteres sexuais secundários, desaceleração da velocidade de crescimento e da maturação óssea com melh...

  14. Evaluation of neuromuscular activity in patients with obstructive sleep apnea using chin surface electromyography of polysomnography

    Institute of Scientific and Technical Information of China (English)

    YIN Guo-ping; YE Jing-ying; HAN De-min; WANG Xiao-yi; ZHANG Yu-huan; LI Yan-ru

    2013-01-01

    Background It is believed that defects in upper airway neuromuscular control play a role in sleep apnea pathogenesis.Currently,there is no simple and non-invasive method for evaluating neuromuscular activity for the purpose of screening in patients with obstructive sleep apnea.This study was designed to assess the validity of chin surface electromyography of routine polysomnography in evaluating the neuromuscular activity of obstructive sleep apnea subjects and probe the neuromuscular contribution in the pathogenesis of the condition.Methods The chin surface electromyography of routine polysomnography during normal breathing and obstructive apnea were quantified in 36 male patients with obstructive sleep apnea.The change of chin surface electromyography from normal breathing to obstructive apnea was expressed as the percent compensated electromyography value,where the percent compensated electromyography value =(normal breath surface electromyography-apnea surface electromyography)/normal breath surface electromyography,and the percent compensated electromyography values among subjects were compared.The relationship between sleep apnea related parameters and the percent compensated electromyography value was examined.Results The percent compensated electromyography value of the subjects varied from 1% to 90% and had a significant positive correlation with apnea hypopnea index (R2=0.382,P <0.001).Conclusions Recording and analyzing chin surface electromyography by routine polysomnography is a valid way of screening the neuromuscular activity in patients with obstructive sleep apnea.The neuromuscular contribution is different among subjects with obstructive sleep apnea.

  15. Analgesia, sedação e relaxamento neuromuscular no doente ventilado em cuidados intensivos cardíacos: parte III: relaxantes neuromusculares

    OpenAIRE

    Vilela, H; D. Ferreira

    2006-01-01

    Neste artigo são revistos aspectos clínicos relevantes relacionados com a sedação, analgesia e relaxamento neuromuscular em cuidados intensivos cardíacos, incluindo métodos de monitorização e opções terapêuticas disponíveis. São ainda abordadas as implicações fisiopatológicas da dor, agitação, ansiedade e delírio no doente ventilado. Apesar de terem sido publicadas recentemente normas de orientação para sedação, analgesia e relaxamento neuromuscular em Cuidados I...

  16. "THE EFFECTS OF ANODAL IONTOPHORESIS OF EPINEPHRINE ON NEUROMUSCULAR RESPONSES IN HEALTHY MEN AND PATIENTS WITH MYASTHENIA GRAVIS "

    OpenAIRE

    Talebian, S.; Abolfazli, R.; G. R. Olyaei S. Hajizadeh

    2005-01-01

    Iontophoresis of epinephrine for assessment of neuromuscular junction response is a new technique that can improve diagnose of neuromuscular dysfunction. The purpose of this study was to investigate the effects of iontophoresis of epinephrine on neuromuscular junction response. Iontophoresis of epinephrine solution (1mg/ml), sodium chloride, calcium gluconate, epinephrine with sodium chloride and distilled water was applied in five groups of healthy men and 7 patients with myasthenia gravis (...

  17. Neuromuscular adjustments of the quadriceps muscle after repeated cycling sprints.

    Directory of Open Access Journals (Sweden)

    Olivier Girard

    Full Text Available PURPOSE: This study investigated the supraspinal processes of fatigue of the quadriceps muscle in response to repeated cycling sprints. METHODS: Twelve active individuals performed 10 × 6-s "all-out" sprints on a cycle ergometer (recovery = 30 s, followed 6 min later by 5 × 6-s sprints (recovery = 30 s. Transcranial magnetic and electrical femoral nerve stimulations during brief (5-s and sustained (30-s isometric contractions of the knee extensors were performed before and 3 min post-exercise. RESULTS: Maximal strength of the knee extensors decreased during brief and sustained contractions (~11% and 9%, respectively; P0.05. While cortical voluntary activation declined (P 40% reduced (P<0.001 following exercise. CONCLUSION: The capacity of the motor cortex to optimally drive the knee extensors following a repeated-sprint test was shown in sustained, but not brief, maximal isometric contractions. Additionally, peripheral factors were largely involved in the exercise-induced impairment in neuromuscular function, while corticospinal excitability was well-preserved.

  18. Applications of Shape Memory Alloys for Neurology and Neuromuscular Rehabilitation

    Directory of Open Access Journals (Sweden)

    Simone Pittaccio

    2015-05-01

    Full Text Available Shape memory alloys (SMAs are a very promising class of metallic materials that display interesting nonlinear properties, such as pseudoelasticity (PE, shape memory effect (SME and damping capacity, due to high mechanical hysteresis and internal friction. Our group has applied SMA in the field of neuromuscular rehabilitation, designing some new devices based on the mentioned SMA properties: in particular, a new type of orthosis for spastic limb repositioning, which allows residual voluntary movement of the impaired limb and has no predetermined final target position, but follows and supports muscular elongation in a dynamic and compliant way. Considering patients in the sub-acute phase after a neurological lesion, and possibly bedridden, the paper presents a mobiliser for the ankle joint, which is designed exploiting the SME to provide passive exercise to the paretic lower limb. Two different SMA-based applications in the field of neuroscience are then presented, a guide and a limb mobiliser specially designed to be compatible with diagnostic instrumentations that impose rigid constraints in terms of electromagnetic compatibility and noise distortion. Finally, the paper discusses possible uses of these materials in the treatment of movement disorders, such as dystonia or hyperkinesia, where their dynamic characteristics can be advantageous.

  19. Drosophila RSK negatively regulates bouton number at the neuromuscular junction.

    Science.gov (United States)

    Fischer, Matthias; Raabe, Thomas; Heisenberg, Martin; Sendtner, Michael

    2009-03-01

    Ribosomal S6 kinases (RSKs) are growth factor-regulated serine-threonine kinases participating in the RAS-ERK signaling pathway. RSKs have been implicated in memory formation in mammals and flies. To characterize the function of RSK at the synapse level, we investigated the effect of mutations in the rsk gene on the neuromuscular junction (NMJ) in Drosophila larvae. Immunostaining revealed transgenic expressed RSK in presynaptic regions. In mutants with a full deletion or an N-terminal partial deletion of rsk, an increased bouton number was found. Restoring the wild-type rsk function in the null mutant with a genomic rescue construct reverted the synaptic phenotype, and overexpression of the rsk-cDNA in motoneurons reduced bouton numbers. Based on previous observations that RSK interacts with the Drosophila ERK homologue Rolled, genetic epistasis experiments were performed with loss- and gain-of-function mutations in Rolled. These experiments provided evidence that RSK mediates its negative effect on bouton formation at the Drosophila NMJ by inhibition of ERK signaling.

  20. The neuromuscular features of acromegaly: a clinical and pathological study.

    Science.gov (United States)

    Khaleeli, A A; Levy, R D; Edwards, R H; McPhail, G; Mills, K R; Round, J M; Betteridge, D J

    1984-09-01

    A study of the neuromuscular features of acromegaly was performed in six patients. Clinical assessment was supplemented by quadriceps force measurements, plasma creatine kinase (CK) activities, electromyography (EMG) and nerve conduction studies. Muscle mass was measured by urinary creatinine/height indices (CHI) and cross sectional area (CSA) of thighs and calves on computed tomography. Quadriceps force/unit cross sectional area was derived. Needle biopsies of vastus lateralis were studied by histochemical and ultrastructural methods. Mean fibre area (MFA) and fibre type proportions were measured. Most of the subjects studied had muscle pain and proximal muscle weakness confirmed by quadriceps force measurements. This occurred in the absence of muscle wasting, as shown by cross sectional area measurements and normal or raised creatinine/height indices. "Myopathic" features were demonstrated by needle biopsy in half the patients and occasionally by electromyography and raised plasma creatine kinase activity. Abnormalities on needle biopsy included variation in fibre size, type 2 fibre atrophy and large type 1 MFA relative to type 2 MFA. Electronmicroscopy showed the non-specific findings of increased glycogen accumulation, excess lipofuscin pigment and myofilament loss.

  1. Tetanic fade following administration of nondepolarizing neuromuscular blocking drugs.

    Science.gov (United States)

    Gibson, F M; Mirakhur, R K

    1989-06-01

    Fade in response to tetanic stimulation was studied following administration of atracurium 120 or 225 micrograms/kg, vecuronium 23 or 40 micrograms/kg, pancuronium 30 or 60 micrograms/kg, or d-tubocurarine 185 or 450 micrograms/kg. Ten patients received each dose and tetanic fade was measured at maximum block in the patients, who received the lower doses of the relaxants or at 10% recovery in those who received the higher doses. Fade during tetanic stimulation was generally similar in all the groups with the exception of the higher dose of pancuronium which showed a significantly greater fade in comparison with the higher doses of atracurium and d-tubocurarine. If fade in response to tetanic stimulation represents a prejunctional effect, the results from the present study suggest that neuromuscular blocking drugs cannot be differentiated with respect to their relative prejunctional effects by measurement of tetanic fade during established block after administration of clinically useful doses as used in the present study.

  2. Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

    Science.gov (United States)

    Pallarés, J G; López-Samanes, Á; Fernández-Elías, V E; Aguado-Jiménez, R; Ortega, J F; Gómez, C; Ventura, R; Segura, J; Mora-Rodríguez, R

    2015-12-01

    This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold [World Anti-Doping Agency (WADA)]. Nine resistance-trained males carried out bench press and full squat exercises against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum [1RM]), in a randomized, double-blind, cross-over design. Participants ingested either 180 mg of PSE (supra-therapeutic dose) or placebo in the morning (7:00 h; AM(PLAC) and AM(PSE)) and in the afternoon (17:00 h; PM(PLAC) and PM(PSE)). PSE enhanced muscle contraction velocity against 25% and 50% 1RM loads, only when it was ingested in the mornings, and only in the full squat exercise (4.4-8.7%; P < 0.05). PSE ingestion raised urine and plasma PSE concentrations (P < 0.05) regardless of time of day; however, cathine only increased in the urine samples. PSE ingestion resulted in positive tests occurring in 11% of samples, and it rose some adverse side effects such us tachycardia and heart palpitations. Ingestion of a single dose of 180 mg of PSE results in enhanced lower body muscle contraction velocity against low and moderate loads only in the mornings. These mild performance improvements are accompanied by undesirable side effects and an 11% risk of surpassing the doping threshold.

  3. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.

  4. Neuromuscular Fatigue after Submaximal Intermittent Contractions in Motorcycle Riders.

    Science.gov (United States)

    Torrado, P; Cabib, C; Morales, M; Valls-Sole, J; Marina, M

    2015-11-01

    Highly repetitive submaximal intermittent contractions of the forearm muscles during periods of 30-50 min partially explain why motorcycle races are so demanding for the neuromuscular system. This study investigated the contribution of central and peripheral mechanisms of fatigue on the exerted and contralateral extensor digitorum communis following an intermittent fatigue protocol (IFP) designed for motorcycle riders. 12 riders performed an IFP, which simulates the braking and throttle handle gesture. We examined the time course of recovery of maximal voluntary contraction (MVC), M-wave, motor evoked potential (MEP) to transcranial magnetic stimuli in relaxed and facilitated condition, and the cortical silent period (CSP) at time windows of 1, 3, 5, 10 and 20 min after the IFP. Whereas MVC, M-wave and MEP decreased, CSP lengthened significantly in the fatigued limb after completion of the IFP. Nevertheless, no differences were observed in the contralateral limb. All neurophysiological parameters reverted to baseline values in less than 20 min, while MVC remained lower in the exercised limb. No cross-over effects were observed in the contralateral non-exercised limb. Our results suggest that local factors are those mainly responsible for the incomplete MVC recovery after an intermittent muscle contraction protocol.

  5. Neuromuscular characteristics and fatigue during 10 km running.

    Science.gov (United States)

    Paavolainen, L; Nummela, A; Rusko, H; Häkkinen, K

    1999-11-01

    This study investigated neuromuscular characteristics and fatigue during 10 km running (10 K) performance in well-trained endurance athletes with different distance running capability. Nine high (HC) and ten low (LC) caliber endurance athletes performed the 10 K on a 200 m indoor track, constant velocity lap (CVL, 4.5 m x s(-1)) 5 times during the course of the 10 K and maximal 20 m speed test before (20 m(b)) and after (20 m(a)) the 10 K. Running velocity (V), ground contact times (CT), ground reaction forces (F) and electromyographic activity (EMG) of the leg muscles (vastus lateralis; VL, biceps femoris; BF, gastrocnemius; GA) were measured during 20 m(b), 20 m(a), and CVLs. The 10 K times differed (pactivity of GA in relation to the IEMG of the total contact phase during the CVLs was higher (prun did not differentiate endurance athletes with different V10K. However, a capability to produce force rapidly throughout the 10 K accompanied with optimal preactivation and contact phase activation seem to be important for 10 km running performance in well trained endurance athletes.

  6. Neuromuscular disorders: genes, genetic counseling and therapeutic trials

    Directory of Open Access Journals (Sweden)

    Mayana Zatz

    Full Text Available Abstract Neuromuscular disorders (NMD are a heterogeneous group of genetic conditions, with autosomal dominant, recessive, or X-linked inheritance. They are characterized by progressive muscle degeneration and weakness. Here, we are presenting our major contributions to the field during the past 30 years. We have mapped and identified several novel genes responsible for NMD. Genotype-phenotype correlations studies enhanced our comprehension on the effect of gene mutations on related proteins and their impact on clinical findings. The search for modifier factors allowed the identification of a novel "protective"; variant which may have important implication on therapeutic developments. Molecular diagnosis was introduced in the 1980s and new technologies have been incorporated since then. Next generation sequencing greatly improved our capacity to identify disease-causing mutations with important benefits for research and prevention through genetic counseling of patients' families. Stem cells researches, from and for patients, have been used as tools to study human genetic diseases mechanisms and for therapies development. The clinical effect of preclinical trials in mice and canine models for muscular dystrophies are under investigation. Finally, the integration of our researches and genetic services with our post-graduation program resulted in a significant output of new geneticists, spreading out this expertise to our large country.

  7. Neuromuscular fatigue after maximal exercise in patients with cystic fibrosis.

    Science.gov (United States)

    Vallier, J M; Gruet, M; Mely, L; Pensini, M; Brisswalter, J

    2011-04-01

    The aim of this study was to determine whether patients with cystic fibrosis (CF), despite their ventilatory limitation, would develop neuromuscular fatigue of quadriceps muscles following a maximal cycling exercise. Eleven adults with CF (age=26.8±6.9years; forced expiratory volume in 1s=54.1±12.8% predicted) and 11 age-matched healthy subjects performed a maximal incremental cycle test with respiratory gas exchange measurements. Maximal voluntary contraction (MVC) and electromyographic (EMG) activity of the vastus medialis muscle were recorded before and after exercise. Neural and contractile properties of the quadriceps were also investigated using femoral nerve electrical stimulation. Patients had lower exercise capacity, peak oxygen uptake and MVC than controls. MVC fell significantly postexercise in both groups (CF: -20±10%, controls: -19±6%; ppattern (-38.4±14.4%, -42.1±14.7% and -15±20.4%) but the statistical significance was not reached for the maximal rate of twitch torque relaxation. In conclusion, CF patients demonstrated lower limb fatigue following symptom-limited cycle exercise, which was comparable to that exhibited by healthy controls. This fatigue may be due to contractile impairments and not to transmission failure. Further studies should be conducted in a larger sample to confirm these preliminary results.

  8. Verifax: Biometric instruments measuring neuromuscular disorders/performance impairments

    Science.gov (United States)

    Morgenthaler, George W.; Shrairman, Ruth; Landau, Alexander

    1998-01-01

    VeriFax, founded in 1990 by Dr. Ruth Shrairman and Mr. Alex Landau, began operations with the aim of developing a biometric tool for the verification of signatures from a distance. In the course of developing this VeriFax Autograph technology, two other related applications for the technologies under development at VeriFax became apparent. The first application was in the use of biometric measurements as clinical monitoring tools for physicians investigating neuromuscular diseases (embodied in VeriFax's Neuroskill technology). The second application was to evaluate persons with critical skills (e.g., airline pilots, bus drivers) for physical and mental performance impairments caused by stress, physiological disorders, alcohol, drug abuse, etc. (represented by VeriFax's Impairoscope prototype instrument). This last application raised the possibility of using a space-qualified Impairoscope variant to evaluate astronaut performance with respect to the impacts of stress, fatigue, excessive workload, build-up of toxic chemicals within the space habitat, etc. The three applications of VeriFax's patented technology are accomplished by application-specific modifications of the customized VeriFax software. Strong commercial market potentials exist for all three VeriFax technology applications, and market progress will be presented in more detail below.

  9. [Critical study of radiculomedullary and neuromuscular complications of ankylosing spondylitis].

    Science.gov (United States)

    Serratrice, G; Acquaviva, P; Pouget, J; Guerra, L

    1987-03-01

    Medullo-radicular and neuro-muscular involvements of ankylosing spondylarthritis, often reported in an analytic fashion in the literature, deserve to be the subject of a critical study. Various neurological manifestations secondary to exceptional atlo-occipital and sometimes axis-atlas subluxations and medullary lesions as well as syndromes of the cauda equina. The medullary lesions have an epidural origin (3 cases in the literature, 2 cases from the authors) or are secondary to a spondylodiscitis (4 cases in the literature) or secondary to both (1 case reported by the authors). As for syndromes of the cauda equina the authors report 3 cases to be added to the 55 published previously. It concerns always old spondylarthritis. The lesions combine posterior diverticula and lesions of the lamina. The treatment is usually ineffective. A special case is represented by forms with trophic disorders. More debatable are the radicular lesions, which, except for intercostal pain, should be linked to local pain. Electromyographic abnormalities are of no significance. Alterations of the paravertebral muscles viewed on the scanner X have, for now, an uncertain significance. Finally, various associations, without significance such as multiple sclerosis, diffuse muscular lesions and the classic spondylotic pseudo-tabes, should be rejected.

  10. Safe neuromuscular electrical stimulator designed for the elderly.

    Science.gov (United States)

    Krenn, Matthias; Haller, Michael; Bijak, Manfred; Unger, Ewald; Hofer, Christian; Kern, Helmut; Mayr, Winfried

    2011-03-01

    A stimulator for neuromuscular electrical stimulation (NMES) was designed, especially suiting the requirements of elderly people with reduced cognitive abilities and diminished fine motor skills. The aging of skeletal muscle is characterized by a progressive decline in muscle mass, force, and condition. Muscle training with NMES reduces the degradation process. The discussed system is intended for evoked muscle training of the anterior and posterior thigh. The core of the stimulator is based on a microcontroller with two modular output stages. The system has two charge-balanced biphasic voltage-controlled stimulation channels. Additionally, the evoked myoelectric signal (M-wave) and the myokinematic signal (surface acceleration) are measured. A central controller unit allows using the stimulator as a stand-alone device. To set up the training sequences and to evaluate the compliance data, a personal computer is connected to the stimulator via a universal serial bus. To help elderly people handle the stimulator by themselves, the user interface is kept very simple. For safety reasons, the electrode impedance is monitored during stimulation. A comprehensive compliance management with included measurements of muscle activity and stimulation intensity enables a scientific use of the stimulator in clinical trials.

  11. Some aspects of the neuromuscular system of Ascaris.

    Science.gov (United States)

    del Castillo, J; Rivera, A; Solórzano, S; Serrato, J

    1989-12-01

    1. The structure and physiological properties of the somatic neuromuscular system of the nematode Ascaris lumbricoides var. suum are discussed taking into account early work from this laboratory, the results of other workers, and experiments in progress. 2. Anatomically, the central feature of the somatic musculature is the presence of a specialized muscular, but not contractile, structure: the syncytium or sarcopile, formed by the terminal processes of the muscle cell arms that contact the nerve cord. In this region, they are electrically coupled to one another and form chemical synapses with the nerve fibres. 3. The syncytium serves, primarily, as a nerve-muscle manifold, or device which allows the neural control of the muscle fields with great economy in the amount of nervous tissue, numbers of chemical junctions and quantities of synaptic transmitters. 4. The structure of the syncytium is being studied with the scanning electron microscope. The results reveal the convergence of the arms on discrete sites as they approach the cords, as well as a longitudinal arrangement of the terminal processes as they course over the cords, at least in the posterior region of the animal. 5. The characteristics of the electrical coupling between the muscle cells are being investigated. A pattern has been observed that is dependent on the position of the cell pairs with respect to the longitudinal axis of the animal. 6. A study of signal propagation in the arms has revealed that the morphology of the muscle cells contributes to the extent and preferential direction of propagation.

  12. Jornalismo em segunda tela. Webjornal produzido com dispositivos móveis em redação virtual

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    Zanei Ramos Barcellos

    2014-12-01

    Full Text Available Este artigo inicialmente aborda o uso de dispositivos móveis pessoais, portáteis, interativos e multimídias nas várias etapas da produção, distribuição e consumo de produtos e conteúdos jornalísticos. Discute a possibilidade de o trabalho jornalístico ser feito totalmente no ciberespaço de forma remota. Também propõe o uso dos termos “redação virtual” e “jornalismo em segunda tela” amparado pela narrativa transmidiática. Num segundo momento, o trabalho relata a experiência de produção, formatação e distribuição de conteúdos jornalísticos multimídia em segunda tela, usando dispositivos móveis e em redação virtual. O objetivo é produzir matérias direcionada a mídias que sejam mais adequadas à cada notícia, tendo um telejornal de grande audiência como primeira tela. A transmissão paralela ao Jornal Nacional, da Rede Globo de Televisão, levantou antecipadamente suas pautas e produziu matérias sobre os mesmos temas, mas com foco local. Esse jornal, o #Tela2, foi produzido por alunos do curso de Jornalismo da Pontifícia Universidade Católica do Paraná (PUCPR. O artigo expõe também o processo de criação e de planejamento, e detalha todas as etapas da produção realizada pelos alunos, acompanhadas de avaliações críticas. As turmas mesclaram-se e dividiram-se em equipes para desempenhar diferentes tarefas: conselho editorial, rádio-escuta, redes sociais, reportagem de televisão, reportagem de rádio, reportagem de jornal (texto e foto, reportagem com texto coletivo em tempo real. Também foram designadas equipes para a realização de três entradas ao vivo: câmera fixa para televisão, matéria de televisão ao vivo (câmara viva e entrevista de rádio. Os resultados apontam que a experimentação foi satisfatória ao demonstrar ser possível realizar jornalismo integralmente em redações virtuais, usando apenas dispositivos móveis comuns na atualidade em todas as etapas do fazer jornal

  13. Analgesia para a sutura artroscópica do manguito rotador: estudo comparativo entre o bloqueio interescalênico do plexo braquial e o bloqueio da bursa subacromial contínuo Management of pain after the rotator cuff arthroscopic suture: comparative study among the interescalenic blockade and the continuous intrabursal infusion

    Directory of Open Access Journals (Sweden)

    Alexandre Almeida

    2007-10-01

    Full Text Available OBJETIVO: Comparar o nível de dor pós-operatória de pacientes submetidos à sutura artroscópica da lesão do manguito rotador (MR que receberam protocolos diferentes de analgesia pós-operatória. Demonstrar a relação entre dor e o sexo do paciente, a dimensão da lesão suturada e a utilização da capsulotomia interna. Verificar a prevalência dos efeitos colaterais. MÉTODO: Foram analisados três grupos de pacientes operados entre 1º de junho de 2004 e 31 de maio de 2007. O grupo I foi composto pelos pacientes que receberam bloqueio interescalênico com ropivacaína a 0,75%. No grupo II, o mesmo bloqueio foi acrescido de 150µg de clonidina. No grupo III foi administrado um bolus de 30ml de ropivacaína a 0,75% para infiltração dos portais artroscópicos e diretamente no espaço subacromial, seguido de infusão contínua de ropivacaína a 0,2% em bomba de infusão. Os pacientes foram submetidos à medição da escala analógica visual (EAV com 24 horas após o procedimento. As variáveis estudadas foram: EAV, sexo, tamanho da lesão, necessidade de capsulotomia interna e prevalência dos efeitos colaterais. O estudo avaliou 196 pacientes, dos quais foram excluídos 51, totalizando n = 145 pacientes. O total de pacientes no grupo I foi de 65; no grupo II, de 19; e no grupo III, de 61. RESULTADOS: O índice da EAV médio encontrado no grupo I foi de 3,88 ± 1,737 (3; no grupo II, de 3,8 ± 1,6 (3; e no grupo III, de 1,95 ± 1,6 (2. Houve diferença significativa ao comparar os grupos I e III (p OBJECTIVE: To compare the level of postoperative pain in patients submitted to arthroscopic suture of a rotator cuff lesion who had different analgesia protocols. To demonstrate the relationship between pain and the gender of the patient, the dimension of the lesion sutured, and the use of internal capsulotomy. To check the prevalence of side effects. METHODS: Three groups of patients operated on between June 01, 2004 and May 31, 2007 were

  14. Caracterização físico-química e perfil lipídico de queijos produzidos com leite ovino

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    Luiz Gustavo de Pellegrini

    2013-10-01

    Full Text Available Este trabalho teve por objetivo caracterizar os queijos Pecorino Toscano, Feta e Labneh produzidos com leite ovino quanto aos aspectos físico-químicos e perfil lipídico. Foram adquiridos e analisados queijos tipo Pecorino Toscano Fresco, com 90, 180 e 270 dias de maturação, Feta e Labneh elaborados com leite de ovelha, comercializados no estado do Rio Grande do Sul, Brasil. As análises realizadas foram: pH, acidez titulável, proteína, gordura, umidade, cinzas e perfil de ácidos graxos. O maior pH ocorreu nos queijos tipo Pecorino Toscano com 180 dias de maturação e Feta. Em relação à acidez titulável estes apresentaram comportamento contrário ao do pH. Os valores de proteína oscilaram entre 15,98 e 28,29% m/m, sendo os maiores valores para os queijos com maior tempo de maturação. A gordura apresentou variação idêntica à proteína, onde os queijos tipo Pecorino Toscano com 180 e 270 dias de maturação apresentaram maior valor. Os valores de umidade apresentaram-se inversos ao tempo de maturação, sendo que os queijos com 270, 180 e 90 dias de maturação apresentaram valores de 25,14, 25,95 e 30,26% m/m respectivamente. As cinzas também se demonstraram maiores para os queijos maturados. Em relação ao perfil lipídico, foram identificados 23 ácidos graxos, ocorrendo diferença significativa na maioria dos resultados, inclusive no somatório dos ácidos graxos saturados, monoinsaturados, poliinsaturados e na relação entre insaturados e saturados. Portanto, devido à escassez de informações sobre a composição de queijos produzidos com leite ovino, outras pesquisas devem ser realizadas para caracterizar de forma consistente estes produtos.

  15. Neuromuscular scoliosis and pelvic fixation in 2015: Where do we stand?

    Science.gov (United States)

    Anari, Jason B; Spiegel, David A; Baldwin, Keith D

    2015-09-18

    Neuromuscular scoliosis is a challenging problem to treat in a heterogeneous patient population. When the decision is made for surgery the surgeon must select a technique employed to correct the curve and achieve the goals of surgery, namely a straight spine over a level pelvis. Pre-operatively the surgeon must ask if pelvic fixation is worth the extra complications and infection risk it introduces to an already compromised host. Since the advent of posterior spinal fusion the technology used for instrumentation has changed drastically. However, many of the common problems seen with the unit rod decades ago we are still dealing with today with pedicle screw technology. Screw cut out, pseudoarthrosis, non-union, prominent hardware, wound complications, and infection are all possible complications when extending a spinal fusion construct to the pelvis in a neuromuscular scoliosis patient. Additionally, placing pelvic fixation in a neuromuscular patient results in extra blood loss, greater surgical time, more extensive dissection with creation of a deep dead space, and an incision that extends close to the rectum in patients who are commonly incontinent. Balancing the risk of placing pelvic fixation when the benefit, some may argue, is limited in non-ambulating patients is difficult when the literature is so mottled. Despite frequent advancements in technology issues with neuromuscular scoliosis remain the same and in the next 10 years we must do what we can to make safe neuromuscular spine surgery a reality.

  16. A Dutch guideline for the treatment of scoliosis in neuromuscular disorders

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    Titarsolej PJ

    2008-09-01

    Full Text Available Abstract Background Children with neuromuscular disorders with a progressive muscle weakness such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy frequently develop a progressive scoliosis. A severe scoliosis compromises respiratory function and makes sitting more difficult. Spinal surgery is considered the primary treatment option for correcting severe scoliosis in neuromuscular disorders. Surgery in this population requires a multidisciplinary approach, careful planning, dedicated surgical procedures, and specialized after care. Methods The guideline is based on scientific evidence and expert opinions. A multidisciplinary working group representing experts from all relevant specialties performed the research. A literature search was conducted to collect scientific evidence in answer to specific questions posed by the working group. Literature was classified according to the level of evidence. Results For most aspects of the treatment scientific evidence is scarce and only low level cohort studies were found. Nevertheless, a high degree of consensus was reached about the management of patients with scoliosis in neuromuscular disorders. This was translated into a set of recommendations, which are now officially accepted as a general guideline in the Netherlands. Conclusion In order to optimize the treatment for scoliosis in neuromuscular disorders a Dutch guideline has been composed. This evidence-based, multidisciplinary guideline addresses conservative treatment, the preoperative, perioperative, and postoperative care of scoliosis in neuromuscular disorders.

  17. Effects of neuromuscular electrostimulation in patients with heart failure admitted to ward

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    de Araújo Carlos José Soares

    2012-11-01

    Full Text Available Abstract Background Neuromuscular electrostimulation has become a promising issue in cardiovascular rehabilitation. However there are few articles published in the literature regarding neuromuscular electrostimulation in patients with heart failure during hospital stay. Methods This is a randomized controlled pilot trial that aimed to investigate the effect of neuromuscular electrostimulation in the walked distance by the six-minute walking test in 30 patients admitted to ward for heart failure treatment in a tertiary cardiology hospital. Patients in the intervention group performed a conventional rehabilitation and neuromuscular electrostimulation. Patients underwent 60 minutes of electrostimulation (wave frequency was 20 Hz, pulse duration of 20 us two times a day for consecutive days until hospital discharge. Results The walked distance in the six-minute walking test improved 75% in the electrostimulation group (from 379.7 ± 43.5 to 372.9 ± 46.9 meters to controls and from 372.9 ± 62.4 to 500 ± 68 meters to electrostimulation, p Conclusion The neuromuscular electrostimulation group showed greater improvement in the walked distance in the six-minute walking test in patients admitted to ward for compensation of heart failure.

  18. RANDOMIZED CLINICAL TRIAL TO COMPARE THE INCIDENCE OF RESIDUAL NEUROMUSCULAR BLOCK FOLLOWING PANCURONIUM AND ATRACURIUM USING TRAIN OF FOUR RATIO

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    Nagesha

    2014-04-01

    Full Text Available BACKGROUND: Several clinical studies have reported that significant number of patients receiving non depolarizing muscle relaxants during general anesthesia show postoperative residual neuromuscular block when assessed by neuromuscular monitor in the recovery room. The degree of residual neuromuscular block produced by non-depolarizing muscle relaxants can be evaluated by clinical tests as well as by neuromuscular monitoring y neuromuscular monitor in the recovery room. A randomized double blind clinical trial to determine and compare the incidence of postoperative residual neuromuscular block in patients receiving pancuronium and atracurium applying Train of Four ratio using Train of Four- Guard neuromuscular monitor. AIMS AND OBJECTIVES: To compare the incidence of postoperative residual neuromuscular block following pancuronium and atracurium using Train of Four Ratio in the recovery room. MATERIALS AND METHODS: Comparative randomized study done using 100 patients of age between 15-60 years belonging to either sex, ASA grade 1 and 2 with GROUP ‘P’ – Pancuronium was employed as the muscle relaxant, GROUP ‘A’ – Atracurium was employed as the muscle relaxant. Statistical analysis done using student “t” test. RESULTS: The mean duration required to attain Train of Four Ratio of 0.80 in patients with initial Train of four ratio <0.80 in group ‘P’ was 9.65±5.4413 min and in group ‘A’ was 2.8± 1.4832 min. CONCLUSION: 1. Our study concludes that the incidence of residual neuromuscular block in patients receiving pancuronium and atracurium were 40% and 10% respectively. Thus residual neuromuscular block can be a significant problem in recovery room, during the postoperative period. 2. The use of intermediate acting non depolarizing muscle relaxant like atracurium lowers the incidence of residual neuromuscular block but does not eliminate it.

  19. Neuromuscular fatigue following isometric contractions with similar torque time integral.

    Science.gov (United States)

    Rozand, V; Cattagni, T; Theurel, J; Martin, A; Lepers, R

    2015-01-01

    Torque time integral (TTI) is the combination of intensity and duration of a contraction. The aim of this study was to compare neuromuscular alterations following different isometric sub-maximal contractions of the knee extensor muscles but with similar TTI. Sixteen participants performed 3 sustained contractions at different intensities (25%, 50%, and 75% of Maximal Voluntary Contraction (MVC) torque) with different durations (68.5±33.4 s, 35.1±16.8 s and 24.8±12.9 s, respectively) but similar TTI value. MVC torque, maximal voluntary activation level (VAL), M-wave characteristics and potentiated doublet amplitude were assessed before and immediately after the sustained contractions. EMG activity of the vastus lateralis (VL) and -rectus femoris (RF) muscles was recorded during the sustained contractions. MVC torque reduction was similar in the 3 conditions after the exercise (-23.4±2.7%). VAL decreased significantly in a similar extent (-3.1±1.3%) after the 3 sustained contractions. Potentiated doublet amplitude was similarly reduced in the 3 conditions (-19.7±1.5%), but VL and RF M-wave amplitudes remained unchanged. EMG activity of VL and RF muscles increased in the same extent during the 3 contractions (VL: 54.5±40.4%; RF: 53.1±48.7%). These results suggest that central and peripheral alterations accounting for muscle fatigue are similar following isometric contractions with similar TTI. TTI should be considered in the exploration of muscle fatigue during sustained isometric contractions.

  20. Neuromuscular consequences of an extreme mountain ultra-marathon.

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    Guillaume Y Millet

    Full Text Available We investigated the physiological consequences of one of the most extreme exercises realized by humans in race conditions: a 166-km mountain ultra-marathon (MUM with 9500 m of positive and negative elevation change. For this purpose, (i the fatigue induced by the MUM and (ii the recovery processes over two weeks were assessed. Evaluation of neuromuscular function (NMF and blood markers of muscle damage and inflammation were performed before and immediately following (n = 22, and 2, 5, 9 and 16 days after the MUM (n = 11 in experienced ultra-marathon runners. Large maximal voluntary contraction decreases occurred after MUM (-35% [95% CI: -28 to -42%] and -39% [95% CI: -32 to -46%] for KE and PF, respectively, with alteration of maximal voluntary activation, mainly for KE (-19% [95% CI: -7 to -32%]. Significant modifications in markers of muscle damage and inflammation were observed after the MUM as suggested by the large changes in creatine kinase (from 144 ± 94 to 13,633 ± 12,626 UI L(-1, myoglobin (from 32 ± 22 to 1,432 ± 1,209 µg L(-1, and C-Reactive Protein (from <2.0 to 37.7 ± 26.5 mg L(-1. Moderate to large reductions in maximal compound muscle action potential amplitude, high-frequency doublet force, and low frequency fatigue (index of excitation-contraction coupling alteration were also observed for both muscle groups. Sixteen days after MUM, NMF had returned to initial values, with most of the recovery process occurring within 9 days of the race. These findings suggest that the large alterations in NMF after an ultra-marathon race are multi-factorial, including failure of excitation-contraction coupling, which has never been described after prolonged running. It is also concluded that as early as two weeks after such an extreme running exercise, maximal force capacities have returned to baseline.

  1. Effects of hindlimb unloading on neuromuscular development of neonatal rats

    Science.gov (United States)

    Huckstorf, B. L.; Slocum, G. R.; Bain, J. L.; Reiser, P. M.; Sedlak, F. R.; Wong-Riley, M. T.; Riley, D. A.

    2000-01-01

    We hypothesized that hindlimb suspension unloading of 8-day-old neonatal rats would disrupt the normal development of muscle fiber types and the motor innervation of the antigravity (weightbearing) soleus muscles but not extensor digitorum longus (EDL) muscles. Five rats were suspended 4.5 h and returned 1.5 h to the dam for nursing on a 24 h cycle for 9 days. To control for isolation from the dam, the remaining five littermates were removed on the same schedule but not suspended. Another litter of 10 rats housed in the same room provided a vivarium control. Fibers were typed by myofibrillar ATPase histochemistry and immunostaining for embryonic, slow, fast IIA and fast IIB isomyosins. The percentage of multiple innervation and the complexity of singly-innervated motor terminal endings were assessed in silver/cholinesterase stained sections. Unique to the soleus, unloading accelerated production of fast IIA myosin, delayed expression of slow myosin and retarded increases in standardized muscle weight and fiber size. Loss of multiple innervation was not delayed. However, fewer than normal motor nerve endings achieved complexity. Suspended rats continued unloaded hindlimb movements. These findings suggest that motor neurons resolve multiple innervation through nerve impulse activity, whereas the postsynaptic element (muscle fiber) controls endplate size, which regulates motor terminal arborization. Unexpectedly, in the EDL of unloaded rats, transition from embryonic to fast myosin expression was retarded. Suspension-related foot drop, which stretches and chronically loads EDL, may have prevented fast fiber differentiation. These results demonstrate that neuromuscular development of both weightbearing and non-weightbearing muscles in rats is dependent upon and modulated by hindlimb loading.

  2. A murine model of muscle training by neuromuscular electrical stimulation.

    Science.gov (United States)

    Ambrosio, Fabrisia; Fitzgerald, G Kelley; Ferrari, Ricardo; Distefano, Giovanna; Carvell, George

    2012-05-09

    Neuromuscular electrical stimulation (NMES) is a common clinical modality that is widely used to restore (1), maintain (2) or enhance (3-5) muscle functional capacity. Transcutaneous surface stimulation of skeletal muscle involves a current flow between a cathode and an anode, thereby inducing excitement of the motor unit and the surrounding muscle fibers. NMES is an attractive modality to evaluate skeletal muscle adaptive responses for several reasons. First, it provides a reproducible experimental model in which physiological adaptations, such as myofiber hypertophy and muscle strengthening (6), angiogenesis (7-9), growth factor secretion (9-11), and muscle precursor cell activation (12) are well documented. Such physiological responses may be carefully titrated using different parameters of stimulation (for Cochrane review, see (13)). In addition, NMES recruits motor units non-selectively, and in a spatially fixed and temporally synchronous manner (14), offering the advantage of exerting a treatment effect on all fibers, regardless of fiber type. Although there are specified contraindications to NMES in clinical populations, including peripheral venous disorders or malignancy, for example, NMES is safe and feasible, even for those who are ill and/or bedridden and for populations in which rigorous exercise may be challenging. Here, we demonstrate the protocol for adapting commercially available electrodes and performing a NMES protocol using a murine model. This animal model has the advantage of utilizing a clinically available device and providing instant feedback regarding positioning of the electrode to elicit the desired muscle contractile effect. For the purpose of this manuscript, we will describe the protocol for muscle stimulation of the anterior compartment muscles of a mouse hindlimb.

  3. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study

    DEFF Research Database (Denmark)

    Sorgenfrei, Iben F; Norrild, Kathrine; Larsen, Per Bo;

    2006-01-01

    Sugammadex (Org 25969) forms a complex with steroidal neuromuscular blocking agents, thereby reversing neuromuscular block. This study investigated the dose-response relation, safety, and pharmacokinetics of sugammadex to reverse rocuronium-induced block....

  4. Neuromuscular factors related to success in Olympic wrestling FACTORES NEUROMUSCULARES RELACIONADOS CON EL RENDIMIENTO EN LUCHA OLÍMPICA

    Directory of Open Access Journals (Sweden)

    Francisco Borrego

    2011-03-01

    Full Text Available AbstractThis study was undertaken to determine the relationship between maximum dynamic and isometric strength and success in male and female Olympic wrestling. Thirty-five female and thirty-seven male wrestlers were assigned into 4 groups according to their gender and competitive level: men elite (♂ ET, n = 18 and amateur (AT ♂, n = 19 and female elite (♀ ET n = 13 and amateur (AT ♀, n = 22. All subjects underwent assessments of body composition, countermovement jump, maximum dynamic strength test in full squat and bench press exercises and maximum isometric strength test of grip and hip extension. All the neuromuscular markers studied showed significantly higher values in the two elite groups compared to their respective amateur groups results, except the jump height between ♀ET y ♀AT, where no significant differences were detected. The present results suggest that the higher maximum isometric and dynamic strength values, explained in part by the differences in lean mass, will give elite wrestlers a clear advantage during the most frequently used techniques in Olympic wrestling. Key  Words: bench press; squat; maximum dynamic strength; maximum isometric strength; combat.ResumenEste estudio se llevó a cabo para determinar la relación entre la fuerza dinámica e isométrica máxima con el éxito en Lucha Olímpica masculina y femenina. Treinta cinco mujeres y treinta y siete varones luchadores fueron divididos en 4 grupos de acuerdo a su género y nivel competitivo: hombres élite (♂ET, n = 18 y amateur (♂AT, n = 19 y mujeres élite (♀ET, n = 13 y amateur (♀AT, n = 22. Todos los sujetos fueron sometidos a valoraciones de la composición corporal, salto con contramovimiento, test de fuerza dinámica máxima en los ejercicios de sentadilla completa y press banca así como test de fuerza isométrica máxima de agarre y de extensión de cadera. Todas las variables neuromusculares estudiadas presentaron valores

  5. Tratamento das fraturas femorais subtrocantéricas com placas de bloqueio lateral da parte proximal do fêmur The treatment of femoral subtrochanteric fractures with the proximal lateral femur locking plates

    Directory of Open Access Journals (Sweden)

    Sun-Jun Hu

    2012-12-01

    Full Text Available OBJETIVO: Estudar o desfecho de fraturas subtrocantéricas de quadril tratadas com placa de bloqueio lateral da parte proximal do fêmur. MÉTODO: Revisamos retrospectivamente os resultados clínicos de 48 casos de fraturas subtrocantéricas tratadas com placas de bloqueio lateral da parte proximal do fêmur de janeiro de 2008 a maio de 2010. Registrou-se o progresso da consolidação da fratura, assim como a ocorrência de complicações. A função da articulação do quadril foi avaliada pelo índice social de Harris e o escore de mobilidade de Parker-Palmer, um ano após a cirurgia. RESULTADO: Quarenta e cinco pacientes foram acompanhados até a união da fratura ou a revisão da cirurgia. Entre os 45 pacientes, 43 atingiram a união da fratura sem outra intervenção. Trinta e oito fraturas consolidaram sem perda da posição no acompanhamento de um ano. Não houve casos de perfuração da cabeça do fêmur pelo parafuso. O escore médio do índice social de Harris foi 86,5 ± 9,8 (73 ~95. A média do escore de mobilidade de Parker e Palmer foi 7,4 ± 2,1 (3~ 9. CONCLUSÃO: A placa de bloqueio lateral da parte proximal do fêmur é o tipo de fixação interna estável e efetiva para tratar as fraturas subtrocantéricas de quadril e tem a vantagem de fixação estável, em especial em fratura da parede lateral do fêmur. Nível de evidência IV, Série de Casos.OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated by using a proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from Jan 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by Harris social index and the Parker and Palmer mobility score at 1 year after the operation. RESULT: 45 patients were followed up until fracture

  6. Bloqueio por clipagem de gânglios simpáticos torácicos no tratamento da hiper-hidrose Thoracic sympathetic block by clamping for treatment of hyperhidrosis

    Directory of Open Access Journals (Sweden)

    Wilson de Souza Stori Jr.

    2006-10-01

    Full Text Available FUNDAMENTOS: Bloqueio simpático videotoracoscópico no tratamento da hiper-hidrose é realizado por clipagem do tronco simpático, com possibilidade de reversão em casos de sudorese compensatória intensa. OBJETIVO: Avaliar sucesso terapêutico, satisfação e sudorese compensatória nos pacientes submetidos a essa técnica. MÉTODO: Estudo prospectivo em que 45 pacientes foram divididos em dois grupos. Grupo I: um paciente com hiper-hidrose palmar e 20 com hiper-hidrose palmar e plantar submetidos a bloqueio de T3; Grupo II: quatro pacientes com hiper-hidrose axilar , dois com hiper-hidrose axilar e palmar, dois com hiper-hidrose axilar e plantar e 16 com hiperidrose axilar, palmar e plantar submetidos a bloqueio de T3 e T4. RESULTADOS: No grupo I 95,2% dos pacientes tinham hiper-hidrose palmar e plantar, e no grupo II 66,7% tinham hiperidrose axilar, palmar e plantar. Na região palmar, resultados excelentes ou bons ocorreram em 95,3% do grupo I e em 94,4% do grupo II; na região plantar 40% do grupo I e 44,5% do grupo II apresentaram bons resultados; e na região axilar, 95,8% relataram resultados excelentes ou bons. Em seis meses, havia sudorese compensatória em 76,2% do grupo I e 91,7% do grupo II, mas a sudorese compensatória intensa ocorreu em apenas três pacientes do grupo II. CONCLUSÕES: Esse tratamento foi eficiente para o tratamento da hiper-hidrose. Ao final de seis meses, todos os pacientes do grupo I e 95,9% dos pacientes do grupo II estavam satisfeitos com os resultados.BACKGROUND: Videothoracoscopic for the treatment of hyperhidrosis is carried out by clamping of the sympathetic trunk, with a possibility for reversal in cases of intense compensatory sweating. OBJECTIVE: To evaluate therapeutic success, satisfaction, and compensatory sweating in patients submitted to this technique. METHOD: Prospective study in which 45 patients were divided into two groups. Group I: one patient with palmar hyperhidrosis and 20 patients with

  7. Neuromuscular scoliosis as a sequelae of Guillain-Barré syndrome.

    Science.gov (United States)

    Edwards, Max R; Panteliadis, Pavlos; Lucas, Jonathan D

    2010-01-01

    The neuromuscular sequaelae of Guillain-Barré syndrome are well documented in the literature. Persistent distal muscular weakness and loss of peripheral limb reflexes are common in those affected. We report a case of a 14-year-old boy who developed the Miller-Fisher variant of Guillain-Barré syndrome at the age of 8 years. Six years after the acute episode, he had persistent lower limb areflexia and mild weakness. He had also developed a neuromuscular scoliosis. The scoliosis was successfully treated with posterior instrumentation and fusion surgery. Neuromuscular scoliosis is rare following Guillain-Barré syndrome, with no previous reports associated with the Miller-Fisher variant that we are aware of. When evaluating patients post Guillain-Barré syndrome, structural spinal examination is essential to identify rare deformity that may need surgical correction.

  8. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    neuromuscular exercise prior to total joint arthroplasty (TJA) of the hip or knee did not confer additional benefits 3 months postoperatively compared with TJA alone. However, the intervention group experienced a statistically significant short-term benefit in ADL and pain, suggesting an earlier onset......OBJECTIVE: To investigate the postoperative efficacy of a supervised programme of neuromuscular exercise prior to hip or knee arthroplasty. METHODS: In this assessor-blinded randomised controlled trial, we included 165 patients scheduled for hip or knee arthroplasty due to severe osteoarthritis (OA......). An 8-week preoperative neuromuscular supervised exercise programme was delivered twice a week for 1 h as adjunct treatment to the standard arthroplasty procedure and compared with the standard arthroplasty procedure alone. The primary outcome was self-reported physical function measured...

  9. Local identifiability and sensitivity analysis of neuromuscular blockade and depth of hypnosis models.

    Science.gov (United States)

    Silva, M M; Lemos, J M; Coito, A; Costa, B A; Wigren, T; Mendonça, T

    2014-01-01

    This paper addresses the local identifiability and sensitivity properties of two classes of Wiener models for the neuromuscular blockade and depth of hypnosis, when drug dose profiles like the ones commonly administered in the clinical practice are used as model inputs. The local parameter identifiability was assessed based on the singular value decomposition of the normalized sensitivity matrix. For the given input signal excitation, the results show an over-parameterization of the standard pharmacokinetic/pharmacodynamic models. The same identifiability assessment was performed on recently proposed minimally parameterized parsimonious models for both the neuromuscular blockade and the depth of hypnosis. The results show that the majority of the model parameters are identifiable from the available input-output data. This indicates that any identification strategy based on the minimally parameterized parsimonious Wiener models for the neuromuscular blockade and for the depth of hypnosis is likely to be more successful than if standard models are used.

  10. Naturally occurring plant polyphenols as potential therapies for inherited neuromuscular diseases.

    Science.gov (United States)

    Fuller, Heidi R; Humphrey, Emma L; Morris, Glenn E

    2013-11-01

    There are several lines of laboratory-based evidence emerging to suggest that purified polyphenol compounds such as resveratrol, found naturally in red grapes, epigallocatechin galate from green tea and curcumin from turmeric, might be useful for the treatment of various inherited neuromuscular diseases, including spinal muscular atrophy, Duchenne muscular dystrophy and Charcot-Marie-Tooth disease. Here, we critically examine the scientific evidence related to the known molecular effects that these polyphenols have on different models of inherited neuromuscular disease, with particular attention to problems with the validity of in vitro evidence. We also present proteomic evidence that polyphenols have in vitro effects on cells related to metal ion chelation in cell-culture media. Although their precise mechanisms of action remain somewhat elusive, polyphenols could be an attractive approach to therapy for inherited neuromuscular disease, especially since they may be safer to use on young children, compared with some of the other drug candidates.

  11. Assessment of bone density in patients with scoliosis neuromuscular secondary to cerebral palsy

    Directory of Open Access Journals (Sweden)

    Charbel Jacob Júnior

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate bone mineral density in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy. METHODS: A prospective descriptive study in which, in addition to bone densitometry, the anthropometric data of the patients were assessed. As inclusion criterion we adopted patients with spastic quadriplegic cerebral palsy, wheelchair users, aged between 10 and 20 years and with neuromuscular scoliosis. RESULTS: We evaluated 31 patients, 20 female, whose average age was 14.2 years. The mean bone density was -3.2 standard deviation (Z-score, with mean biceps circumference of 19.4 cm, calf circumference 18.6 cm and BMI of 13.6 kg/m². CONCLUSION: There is a high incidence of osteoporosis in patients with neuromuscular scoliosis secondary to spastic quadriplegic cerebral palsy.

  12. Update on the approach of respiratory therapy in patients with neuromuscular diseases

    Directory of Open Access Journals (Sweden)

    Priscilla Barreto Paula

    2010-03-01

    Full Text Available Objective: To assess the role of physiotherapy in approaching neuromuscular disease (NMD, with emphasis on preventive and therapeutic aspects of respiratory therapy. Methods: A nonsystematic literature review covering the past twenty years, using the databases MEDLINE and LILACS through the following descriptors: neuromuscular diseases, physical therapy, vital capacity and respiratory failure. Results: The studies reviewed show the need to establish a routine periodic evaluation of respiratory function in order to introduce physical therapy measures relevant to each stage of the disease. The monitoring should include pulmonary function tests and specific techniques of chest physiotherapy, in order to avoid complications such as respiratory failure. Conclusion: The introduction of regular monitoring and preventive physiotherapy measures have helped to increase survival and improve quality of life of patients with neuromuscular diseases.

  13. Interpretation of electroneuromyographic studies in diseases of neuromuscular junction and myopathies

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    Mansukhani Khushnuma

    2008-01-01

    Full Text Available Electroneuromyography (ENMG also called electrodiagnosis or at times simply (and erroneously electromyography (EMG, has been used for the diagnosis of neuromuscular and muscle diseases. It consists of tests done serially and assessed collectively, to arrive at a diagnosis of neuromuscular weakness. The test should be treated as an extension of the clinical examination and not a replacement. When done adequately ENMG is the only test which gives information about the function of the peripheral nervous system and hence co-relates well with the clinical signs. This article reviews the role of ENMG in the evaluation of neuromuscular and muscle disease. We hope this will meet the requirements of both practicing neurologists and dedicated electromyographers.

  14. The effects of neuromuscular training on knee joint motor control during sidecutting in female elite soccer and handball players

    DEFF Research Database (Denmark)

    Zebis, Mette K; Bencke, Jesper; Andersen, Lars

    2008-01-01

    and knee, and ground reaction forces were recorded during a sidecutting maneuver. Neuromuscular activity in the prelanding phase was obtained 10 and 50 ms before foot strike on a force plate and at 10 and 50 ms after foot strike on a force plate. RESULTS: Neuromuscular training markedly increased before...

  15. Ovos produzidos por rainhas e operárias de Scaptotrigona depilis (Hymenoptera, Apidae, Meliponina: morfometria e aspectos relacionados Eggs produced by queens and workers of Scaptotrigona depilis (Hymenoptera, Apidae, Meliponina: morphometry and related aspects

    Directory of Open Access Journals (Sweden)

    Lenira M. Lacerda

    2006-03-01

    Full Text Available A caracterização morfométrica de 785 ovos produzidos por rainhas e 193 (161 funcionais e 32 tróficos produzidos por operárias de Scaptotrigona depilis (Moure, 1942, mostrou que eles são similares, em tamanho e formato, aos de outras espécies de abelhas Meliponina. Numa mesma colônia, ovos de rainha sempre apresentaram menor comprimento que os de operárias (funcionais ou tróficos. Entre ovos produzidos por operárias, ovos funcionais foram, normalmente, mais curtos e estreitos que os tróficos. O estudo dos ovos produzidos por rainhas não mostrou, como esperado, a presença de dois grupos de ovos distinguíveis pelo comprimento, como observado em S. postica (Latreille, 1807.The morphometric characterization of 785 eggs laid by queens and 193 (161 functional and 32 trophic eggs laid by workers of Scaptotrigona depilis (Moure, 1942 has shown that they are similar in size and shape to the ones from other species of Meliponina. In the same colony, the queen's eggs always presented significant smaller size than the ones of the workers (functional or trophic. Among the workers' eggs, the functional eggs were, usually, shorter and narrower than the trophic eggs. The study of eggs laid by the queen has not shown, as expected, the presence of two groups of eggs with distinctive length, as observed in S. postica (Latreille, 1807.

  16. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    LENUS (Irish Health Repository)

    O'Driscoll, Jeremiah

    2011-06-09

    Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI) are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed\\/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT) scores, 2 Star Excursion Balance Test (SEBT) reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs) during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  17. Effect of a 6-week dynamic neuromuscular training programme on ankle joint function: A Case report

    Directory of Open Access Journals (Sweden)

    O'Driscoll Jeremiah

    2011-06-01

    Full Text Available Abstract Background Ankle joint sprain and the subsequent development of chronic ankle instability (CAI are commonly encountered by clinicians involved in the treatment and rehabilitation of musculoskeletal injuries. It has recently been advocated that ankle joint post-sprain rehabilitation protocols should incorporate dynamic neuromuscular training to enhance ankle joint sensorimotor capabilities. To date no studies have reported on the effects of dynamic neuromuscular training on ankle joint positioning during landing from a jump, which has been reported as one of the primary injury mechanisms for ankle joint sprain. This case report details the effects of a 6-week dynamic neuromuscular training programme on ankle joint function in an athlete with CAI. Methods The athlete took part in a progressive 6-week dynamic neuromuscular training programme which incorporated postural stability, strengthening, plyometric, and speed/agility drills. The outcome measures chosen to assess for interventional efficacy were: 1 Cumberland Ankle Instability Tool (CAIT scores, 2 Star Excursion Balance Test (SEBT reach distances, 3 ankle joint plantar flexion during drop landing and drop vertical jumping, and 4 ground reaction forces (GRFs during walking. Results CAIT and SEBT scores improved following participation in the programme. The angle of ankle joint plantar flexion decreased at the point of initial contact during the drop landing and drop vertical jumping tasks, indicating that the ankle joint was in a less vulnerable position upon landing following participation in the programme. Furthermore, GRFs were reduced whilst walking post-intervention. Conclusions The 6-week dynamic neuromuscular training programme improved parameters of ankle joint sensorimotor control in an athlete with CAI. Further research is now required in a larger cohort of subjects to determine the effects of neuromuscular training on ankle joint injury risk factors.

  18. The role of neuromuscular changes in aging and knee osteoarthritis on dynamic postural control.

    Science.gov (United States)

    Takacs, Judit; Carpenter, Mark G; Garland, S Jayne; Hunt, Michael A

    2013-04-01

    Knee osteoarthritis (OA) is a chronic joint condition, with 30% of those over the age of 75 exhibiting severe radiographic disease. Nearly 50% of those with knee OA have experienced a fall in the past year. Falls are a considerable public health concern, with a high risk of serious injury and a significant socioeconomic impact. The ability to defend against a fall relies on adequate dynamic postural control, and alterations in dynamic postural control are seen with normal aging. Neuromuscular changes associated with aging may be responsible for some of these alterations in dynamic postural control. Even greater neuromuscular deficits, which may impact dynamic postural control and the ability to defend against a fall, are seen in people with knee OA. There is little evidence to date on how knee OA affects the ability to respond to and defend against falls and the neuromuscular changes that contribute to balance deficits. As a result, this review will: summarize the key characteristics of postural responses to an external perturbation, highlight the changes in dynamic postural control seen with normal aging, review the neuromuscular changes associated with aging that have known and possible effects on dynamic postural control, and summarize the neuromuscular changes and balance problems in knee OA. Future research to better understand the role of neuromuscular changes in knee OA and their effect on dynamic postural control will be suggested. Such an understanding is critical to the successful creation and implementation of fall prevention and treatment programs, in order to reduce the excessive risk of falling in knee OA.

  19. Bloqueio do nervo femoral: avaliação da analgesia pós-operatória na operação de reconstrução artroscópica do ligamento cruzado anterior

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    Úrsula Bueno do Prado Guirro

    2013-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A operação de reconstrução do ligamento cruzado anterior do joelho (RLCA pode ter pós-operatório doloroso. O objetivo principal deste estudo foi avaliar se o emprego do bloqueio do nervo femoral (BNF associado à raquianestesia melhoraria o tratamento da dor pós-operatória na RLCA; os objetivos secundários foram avaliar solicitação do tramadol e eventos adversos. MÉTODO: 53 pacientes foram divididos aleatoriamente nos grupos A e B. No Grupo A, 26 receberam raquianestesia e no Grupo B, 27 receberam raquianestesia e BNF. Todos receberam analgesia multimodal e poderiam solicitar analgésico de resgate a qualquer momento. As avaliações ocorreram em 6, 12 e 24 horas. RESULTADOS: Os grupos não apresentaram diferenças quanto às variáveis demográficas e clínico-cirúrgicas. A intensidade da dor não mostrou diferença entre os grupos. Escores médios de dor foram mais elevados 12 horas no Grupo A e não houve variação no Grupo B; 55,6% relataram dor moderada no Grupo A e 53,8% dor leve no Grupo B. Não houve diferença na solicitação de tramadol. Os eventos adversos não foram graves: 80,8% dos pacientes do Grupo B apresentaram bloqueio motor da coxa e dois caíram. CONCLUSÕES: A analgesia foi mais efetiva com a associação de raquianestesia e BNF, que permitiu melhor controle da dor pós-operatória na avaliação em 12 horas após a anestesia. Não houve diferença na solicitação do tramadol. Os eventos adversos apresentados pelos pacientes neste estudo não foram graves, porém deve-se estar atento à paralisia motora e à possibilidade de queda dos pacientes quando o BNF for feito.

  20. Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized-controlled trial

    DEFF Research Database (Denmark)

    Claudius, C; Viby-Mogensen, J; Skovgaard, Lene Theil

    2009-01-01

    and opioid. Neuromuscular blockade was induced with rocuronium 100, 150, 200 or 250 microg/kg. Neuromuscular monitoring was performed with AMG (TOF-Watch SX) with pre-load (Hand Adapter) at one arm and MMG (modified TOF-Watch SX) on the other, using 0.1 Hz single twitch stimulation. Dose......) for this purpose. The aim of this study was to compare AMG and MMG for establishing dose-response relationship and potency, using rocuronium as an example. METHODS: We included 40 adult patients in this randomized-controlled single-dose response study. Anaesthesia was induced and maintained with propofol...

  1. Valoració i entrenament del control neuromuscular per a la millora del rendiment esportiu

    OpenAIRE

    Fort Vanmeerhaeghe, Azahara

    2010-01-01

    El control neuromuscular ha estat descrit com un important factor per a l'èxit en el rendiment esportiu. De la mateixa manera, també s'ha identificat com a clau en la prevenció i readaptació de les lesions esportives. El principal objectiu d'aquesta tesi doctoral és avaluar l'eficàcia de diferents tipus d'entrenament neuromuscular en esportistes.S'ha utilitzat una mostra de 81 esportistes sans entre els diferents estudis que s'hi presenten. Les diferents avaluacions realitzades han registrat ...

  2. Propiocepción y control neuromuscular en el fútblo infantil

    OpenAIRE

    Zarza, Cristían

    2014-01-01

    En el fútbol profesional la escasa utilización de la pierna no hábil hace que muchas situaciones de juego no se resuelvan eficazmente, además de predisponer a la aparición de lesiones. El presente estudio se concentró en determinar la influencia del entrenamiento propioceptivo y del control neuromuscular en las cualidades físicas y técnicas del miembro no hábil. Objetivo: Indagar el nivel propioceptivo y de control neuromuscular del miembro inferior no hábil en chicos que re...

  3. Clinical applications of immunoglobulin in neuromuscular diseases: focus on inflammatory myopathies

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    Paulo Victor Sgobbi de Souza

    2014-12-01

    Full Text Available During recent years, an increasing number of neuromuscular diseases have been recognized either to be caused primarily by autoimmune mechanisms, or to have important autoimmune components. The involved pathophysiological mechanisms and clinical manifestations have been better recognized and many of these disorders are potentially treatable by immunosuppression or by immunomodulation with intravenous immunoglobulin (IVIg. IVIg has been tried in a variety of immune-mediated neurological diseases, being target of widespread use in central and peripheral nervous systems diseases. Objective To give an overview of the main topics regarding the mechanism of action and different therapeutic uses of IVIg in neurological practice, mainly in neuromuscular diseases.

  4. Efectividad del vendaje neuromuscular en pacientes con retropié pronado

    OpenAIRE

    Bersano, Federico

    2012-01-01

    Por medio de una evaluación funcional del retropié, recolectaremos datos sobre su estado desde el punto de vista de la semiología clínica, de la osteocinemática, la artrocinemática y la miocinematica. A partir de aquí se procederá a realizar la aplicación de un Vendaje Neuromuscular para analizar el beneficio de la técnica de corrección articular. Objetivos: Determinar los efectos de la aplicación del vendaje neuromuscular en pacientes con retropié pronado. Sujetos de estudio: Pacientes...

  5. Pharmacokinetic studies of neuromuscular blocking agents: good clinical research practice (GCRP).

    Science.gov (United States)

    Viby-Mogensen, J; Ostergaard, D; Donati, F; Fisher, D; Hunter, J; Kampmann, J P; Kopman, A; Proost, J H; Rasmussen, S N; Skovgaard, L T; Varin, F; Wright, P M

    2000-11-01

    In September 1997, an international consensus conference on standardization of studies of neuromuscular blocking agents was held in Copenhagen, Denmark. Based on the conference, a set of guidelines for good clinical research practice (GCRP) in pharmacokinetic studies of neuromuscular blocking agents is presented. Guidelines include: design of the study; relevant patient groups to investigate; test drug administration, sampling and analysis; pharmacokinetic analysis; pharmacokinetic/pharmacodynamic modeling; population pharmacokinetics; statistics; and presentation of pharmacokinetic data. The guidelines are intended to aid those working in this research area; it is hoped that they will assist researchers, editors of scientific papers, and pharmaceutical companies in improving the quality of pharmacokinetic studies.

  6. Ação neuro-muscular do veneno crotálico: dados preliminares

    OpenAIRE

    Silva,Maria Dorvalina; Luiz Antônio L. Resende; Ueda,Anete Kimuni; Barraviera, Benedito [UNESP; Mendes, R P; Montenegro, Mário Rubens G. [UNESP

    1996-01-01

    Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores ad...

  7. Neuromuscular abnormality and autonomic dysfunction in patients with cerebrotendinous xanthomatosis

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    Huang Chi-Ren

    2011-05-01

    Full Text Available Abstract Background Cerebrotendinous xanthomatosis (CTX is a rare lipid-storage disease. Neuromuscular abnormality and autonomic system (ANS dysfuction in CTX are rarely examined in large-scale studies in the literature. We studied the peripheral nervous system, myopathology, and autonomic system of four CTX patients and performed a literature review of the reported CTX patients with peripheral neuropathy. Methods Four biochemically and genetically confirmed CTX patients, belonging to two families, were included for study and all received nerve conduction study (NCS, muscle biopsy for histopathologic and ultrastructural study, skin biopsy for intraepidermal nerve fiber (INEF density measurement, autonomic testings including sympathetic skin response, R-R interval variation and head-up tilt test using an automated tilt table to record the changes of blood pressure and heart rate in different postures. The Q-Sweat test was also applied for the detection of sweat amount and onset time of response. The clinical characteristics, study methods and results of 13 studies of peripheral neuropathy in CTX patients in the literature were also recorded for analysis. Results The results of NCS study showed axonal sensory-motor polyneuropathy in three CTX cases and mixed axonal and demyelinating sensor-motor polyneuropathy in one. The myopathological and histopathologic studies revealed mild denervation characteristics, but the ultrastructural study revealed changes of mitochondria and the membranous system, and increased amounts of glycogen, lipofuscin and lipid deposition. The ANS study revealed different degrees of abnormalities in the applied tests and the INEF density measurement showed small fiber neuropathy in three of the four CTX patients. The literature review of peripheral neuropathy in CTX revealed different types of peripheral neuropathy, of which axonal peripheral neuropathy was the most common. Conclusions Peripheral neuropathy, especially the

  8. Neuromuscular electrical stimulation for mobility support of elderly

    Directory of Open Access Journals (Sweden)

    Winfried Mayr

    2015-10-01

    Full Text Available The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in “compliance data storage” as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC and maximum stimulation induced contraction (MSC were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period

  9. Genetic and evolutionary analysis of the Drosophila larval neuromuscular junction

    Science.gov (United States)

    Campbell, Megan

    Although evolution of brains and behaviors is of fundamental biological importance, we lack comprehensive understanding of the general principles governing these processes or the specific mechanisms and molecules through which the evolutionary changes are effected. Because synapses are the basic structural and functional units of nervous systems, one way to address these problems is to dissect the genetic and molecular pathways responsible for morphological evolution of a defined synapse. I have undertaken such an analysis by examining morphology of the larval neuromuscular junction (NMJ) in wild caught D. melanogaster as well as in over 20 other species of Drosophila. Whereas variation in NMJ morphology within a species is limited, I discovered a surprisingly extensive variation among different species. Compared with evolution of other morphological traits, NMJ morphology appears to be evolving very rapidly. Moreover, my data indicate that natural selection rather than genetic drift is primarily responsible for evolution of NMJ morphology. To dissect underlying molecular mechanisms that may govern NMJ growth and evolutionary divergence, I focused on a naturally occurring variant in D. melanogaster that causes NMJ overgrowth. I discovered that the variant mapped to Mob2, a gene encoding a kinase adapter protein originally described in yeast as a member of the Mitotic Exit Network (MEN). I have subsequently examined mutations in the Drosophila orthologs of all the core components of the yeast MEN and found that all of them function as part of a common pathway that acts presynaptically to negatively regulate NMJ growth. As in the regulation of yeast cytokinesis, these components of the MEN appear to act ultimately by regulating actin dynamics during the process of bouton growth and division. These studies have thus led to the discovery of an entirely new role for the MEN---regulation of synaptic growth---that is separate from its function in cell division. This work

  10. Bloqueio do nervo frênico após realização de bloqueio do plexo braquial pela via interescalênica: relato de caso A bloqueo del nervio frénico después de la realización de bloqueo del plexo braquial por la vía interescalénica: relato de caso Phrenic nerve block after interscalene brachial plexus block: case report

    Directory of Open Access Journals (Sweden)

    Luis Henrique Cangiani

    2008-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Bloqueio do nervo frênico é um evento adverso do bloqueio do plexo braquial; entretanto, na sua maioria, sem repercussões clínicas importantes. O objetivo deste relato foi apresentar um caso em que ocorreu bloqueio do nervo frênico, com comprometimento ventilatório, em paciente com insuficiência renal crônica submetido a instalação de fístula arteriovenosa extensa, sob bloqueio do plexo braquial pela via perivascular interescalênica. RELATO DO CASO: Paciente do sexo masculino, 50 anos, tabagista, portador de insuficiência renal crônica em regime de hemodiálise, hipertensão arterial, hepatite C, diabetes mellitus, doença pulmonar obstrutiva crônica, a ser submetido à instalação de fístula arteriovenosa extensa no membro superior direito sob bloqueio de plexo braquial pela via interescalênica. O plexo braquial foi localizado com utilização do estimulador de nervo periférico. Foram injetados 35 mL de uma solução de anestésico local, constituída de uma mistura de lidocaína a 2% com epinefrina a 1:200.000 e ropivacaína a 0,75% em partes iguais. Ao final da injeção o paciente apresentava-se lúcido, porém com dispnéia e predomínio de incursão respiratória intercostal ipsilateral ao bloqueio. Não havia murmúrio vesicular na base do hemitórax direito. A SpO2 manteve-se em 95%, com cateter nasal de oxigênio. Não foi necessária instalação de métodos de auxílio ventilatório invasivo. Radiografia do tórax revelou que o hemidiafragma direito ocupava o 5° espaço intercostal. O quadro clínico foi revertido em três horas. CONCLUSÕES: O caso mostrou que houve paralisia total do nervo frênico com sintomas respiratórios. Apesar de não ter sido necessária terapêutica invasiva para o tratamento, fica o alerta para a restrição da indicação da técnica nesses casos.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del nervio frénico es un evento adverso del bloqueo del plexo braquial, sin

  11. Ação neuro-muscular do veneno crotálico: dados preliminares Neuromuscular action of crotalid venom: preliminar data

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    Maria Dorvalina Silva

    1996-03-01

    Full Text Available Estudamos 6 pacientes, 2 cães e um coelho com intoxicação crotálica. Avaliamos a condução nervosa periférica sensitiva e motora, a transmissão neuromuscular e eletromiografias. As biópsias de músculo foram processadas por histoquímica. Os 6 pacientes apresentaram mononeuropatia sensitiva no nervo periférico adjacente ao local da inoculação do veneno e encontramos evidências histoquímicas de miopatia mitocondrial. Os defeitos da transmissão neuromuscular foram mínimos. A maioria dos autores admite que veneno crotálico determina síndrome miastênica. Nossos achados indicam que ptose palpebral, facies miastênico e fraqueza muscular observados após acidente crotálico, correspondem provavelmente a miopatia mitocondrial, muitas vezes transitória e reversível.We studied 6 patients and 2 dogs that have been bitten by South American rattlesnake Crotalus durissus terrificus and one rabbit inoculated with crotalid venom. We analized sensory and motor peripheral nerve conduction, repetitive stimulation for studying neuromuscular transmission and electromyographies. Muscle biopsies were processed by histochemistry. All patients had peripheral mononeuropathy of the closest sensitive nerve to the area of snakebite. The neuromuscular transmission alterations were minimal. Muscle histochemistry of 4 patients, 2 dogs and 1 rabbit showed findings of mitochondrial myopathy. The majority of authors admit that crotalid venom causes myastenic syndrome. Our findings suggest that palpebral ptosis, myastenic facies and muscular weakness observed after crotalid poisoning are, probably, due to transient and reversible mitochondrial myopathy. As far as we know, this is the first report on the ability of the venom of this rattlesnake to cause local sensitive mononeuropathy and the first muscle histochemistry showing mitochondrial myopathy in humans poisoned by crotalid venom.

  12. [Translation and validation of the Individualised Neuromuscular Quality of Life scale for the Spanish population: quality of life assessment for persons with neuromuscular diseases].

    Science.gov (United States)

    Fagoaga, J; Girabent-Farres, M; Bagur-Calafat, C

    2017-03-01

    Introduccion. La escala Individualized Neuromuscular Quality of Life (INQoL) es un cuestionario que valora la calidad de vida relacionada con la salud de personas adultas con enfermedades neuromusculares. Objetivo. Validar y analizar la fiabilidad de la version española de la INQoL, como instrumento de medicion de la calidad de vida relacionada con la salud en individuos con enfermedades neuromusculares. Pacientes y metodos. Se realiza una traduccion-retrotraduccion de la INQoL en la poblacion española y, posteriormente, para el analisis de fiabilidad se llevan a cabo dos mediciones, test-retest, a 50 pacientes de 19 a 67 años. De este modo se evalua la concordancia intraobservador y se evalua la consistencia interna de la escala. Resultados. El estudio de la fiabilidad del indice de concordancia intraobservador tiene un valor de excelente en siete de las diez subdimensiones y en la puntuacion total de la calidad de vida; de buena, en dos; y de moderada, en una. El analisis del alfa de Cronbach para las subdimensiones de la INQoL tiene un valor de excelente (> 0,818) en siete de ellas, asi como en la puntuacion total de la calidad de vida relacionada con la salud (0,928), un valor de buena consistencia interna en tres de las subdimensiones y de moderada en una. Conclusiones. La version española de la INQoL es un instrumento valido y fiable como herramienta de medicion de la calidad de vida en individuos adultos con enfermedades neuromusculares.

  13. Neuromuscular adaptations to training, injury and passive interventions: implications for running economy.

    Science.gov (United States)

    Bonacci, Jason; Chapman, Andrew; Blanch, Peter; Vicenzino, Bill

    2009-01-01

    Performance in endurance sports such as running, cycling and triathlon has long been investigated from a physiological perspective. A strong relationship between running economy and distance running performance is well established in the literature. From this established base, improvements in running economy have traditionally been achieved through endurance training. More recently, research has demonstrated short-term resistance and plyometric training has resulted in enhanced running economy. This improvement in running economy has been hypothesized to be a result of enhanced neuromuscular characteristics such as improved muscle power development and more efficient use of stored elastic energy during running. Changes in indirect measures of neuromuscular control (i.e. stance phase contact times, maximal forward jumps) have been used to support this hypothesis. These results suggest that neuromuscular adaptations in response to training (i.e. neuromuscular learning effects) are an important contributor to enhancements in running economy. However, there is no direct evidence to suggest that these adaptations translate into more efficient muscle recruitment patterns during running. Optimization of training and run performance may be facilitated through direct investigation of muscle recruitment patterns before and after training interventions. There is emerging evidence that demonstrates neuromuscular adaptations during running and cycling vary with training status. Highly trained runners and cyclists display more refined patterns of muscle recruitment than their novice counterparts. In contrast, interference with motor learning and neuromuscular adaptation may occur as a result of ongoing multidiscipline training (e.g. triathlon). In the sport of triathlon, impairments in running economy are frequently observed after cycling. This impairment is related mainly to physiological stress, but an alteration in lower limb muscle coordination during running after cycling

  14. Comparação da qualidade do bloqueio oftálmico periconal com ropivacaína a 1% e 0,75% com punção os pontos infraorbitário lateral e medial da órbita

    Directory of Open Access Journals (Sweden)

    Vásquez Carlos Escobar

    2002-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: São diversos os fármacos empregados e diversas as vias de abordagem da região peribulbar. Nosso objetivo foi investigar a qualidade do bloqueio oftálmico periconal, através de dois pontos de punção, utilizando ropivacaína em diferentes concentrações, sem adição de hialuronidase. MÉTODO: Foram estudados 50 pacientes submetidos à cirurgia oftalmológica, distribuídos aleatoriamente em dois grupos: R1 (Ropivacaína a 1% e R0,75 (Ropivacaína a 0,75%. O volume de anestésico local injetado foi ajustado conforme a tolerância e distensibilidade do espaço periconal no ponto infraorbitário e, se necessário, um volume adicional de até 3 ml no compartimento periconal medial da órbita. Escores de motilidade foram atribuídos a cada músculo reto. Foi avaliado também o grau de bloqueio motor dos músculos elevador da pálpebra superior e orbicular ocular. Os dados foram avaliados nos seguintes momentos: M0 = imediatamente antes de realizar o bloqueio; M5 = 5 minutos após o bloqueio; M10 = 10 minutos após o bloqueio; e M15 = 15 minutos após o bloqueio. RESULTADOS: Dois pacientes do grupo R1 e oito pacientes no grupo R0,75 necessitaram complementação, sendo esta diferença significativa. Em 72% dos casos, em ambos os grupos, foram realizadas somente as duas punções iniciais. O volume total de anestésico e o volume empregado na primeira punção foram respectivamente, no grupo R1: 9,72 ± 2,38 ml e 6,96 ± 0,97 ml e no grupo R0,75: 12,64 ± 5,10 ml e 7,36 ± 1,07 ml, apresentando também diferença significativa. Houve diferença significativa dos escores de motricidade nos momentos M10(R1 = 1,6; R0,75 = 3,8 e M15(R1 = 1,04; R0,75 = 2,8. CONCLUSÕES: Concluímos que a ropivacaína a 1% mostrou-se mais eficiente do que a ropivacaína a 0,75% quando utilizadas sem hialuronidase para realização de bloqueios oftálmicos periconais pelas técnicas apresentadas. Houve uma tendência a um menor número de pun

  15. Estudo qualiquantitativo do biogás produzido por substratos em biodigestores tipo batelada Qualiquantitatve study of biogas produced by substrates in batch biodigestors

    Directory of Open Access Journals (Sweden)

    João A. Galbiatti

    2010-04-01

    Full Text Available A presente pesquisa foi desenvolvida no Departamento de Engenharia Rural da FCAV/UNESP, SP, Brasil, com o objetivo de se estudar, qualiquantitativamente, o biogás produzido por 5 substratos que, após utilizados na digestão anaeróbia, foram caracterizados como: 1 - Esterco de aves de corte com cama de capim napier (EACN; 2 - Esterco de aves de corte com cama de capim napier triturado (EACNT; 3 - Esterco suíno (ES; 4 - Esterco bovino (EB e 5 - Esterco de bovino misturado com 50% de bagaço de cana-de-açúcar (EB50C. Dos dados levantados concluiu-se que: o substrato EACN e o ES produziram volumes maiores e menores de biogás, respectivamente, comparados com os demais; a mistura de bagaço de cana-de-açúcar no substrato EB prejudica a produção acumulada de biogás e sua qualidade; a partir dos 57 dias após o enchimento dos biodigestores todos os substratos já produziam biogás com teor de metano superior a 48%, com exceção do substrato ES; o substrato triturado (EACNT não apresentou características muito distintas do substrato não triturado (EACN; a qualidade do biogás na fase de produção máxima é semelhante para todos os substratos estudados; o biogás que mostrou maior valor de metano na sua composição foi o produzido com EB, superior em até 17,7% à produção do EACNT.Aiming to study the biogas produced by 5 substrates from both quality and quantity point of view, this research was conducted at the Rural Engineering Department of FCAV/UNESP - Brazil, State of São Paulo. The substractes that were used in the anaerobic digestion were characterized as: 1 - Slaughter fowls' manure with napier grass bed (MFNG; 2 - Slaughter fowls' manure with triturate napier grass bed (MFNGT; 3 - Suine manure (SM; 4 - Bovine manure (BM and 5 - Bovine manure mixed with 50% of sugarcane bagasse (BM50S. From the data colIected it was concluded that: the substract (MFNG and the substract containing SM produced higher and lower volumes of biogas

  16. Mirror Visual Feedback Induces Lower Neuromuscular Activity in Children with Spastic Hemiparetic Cerebral Palsy

    Science.gov (United States)

    Feltham, Max G.; Ledebt, Annick; Deconinck, Frederik J. A.; Savelsbergh, Geert J. P.

    2010-01-01

    The study examined the effects of mirror feedback information on neuromuscular activation during bimanual coordination in eight children with spastic hemiparetic cerebral palsy (SHCP) and a matched control group. The "mirror box" creates a visual illusion, which gives rise to a visual perception of a zero lag, symmetric movement between the two…

  17. The assisted 6-minute cycling test to assess endurance in children with a neuromuscular disorder

    NARCIS (Netherlands)

    Jansen, M.; Jong, M. de; Coes, H.M.; Eggermont, F.; Alfen, N. van; Groot, I.J. de

    2012-01-01

    Introduction: For late- or non-ambulant children with a neuromuscular disorder no suitable endurance tests are currently available. We developed the assisted 6-minute cycling test (A6MCT) for the legs and arms and investigated its psychometric properties in healthy boys and boys with Duchenne muscul

  18. Vladimir Karlovich Roth (1848-1916): the founder of neuromuscular diseases studies in Russia.

    Science.gov (United States)

    Kazakov, Valery M; Rudenko, Dmitry I; Stuchevskaya, Tima R

    2014-05-01

    This article shortly examines the biography, scientific activity and scientific work on neuromuscular diseases of the famous Russian neurologist Vladimir Roth who was the founder of neuromuscular disorders study in Russia. In 1876 he was the first in Russia who performed an autopsy and a detailed histological study of a case of progressive muscular atrophy, in which he did not find changes in the nervous system. He called this disease "muscular tabes" i.e. myopathy. In 1884 Vladimir Roth expressed his opinion about the nosological place of the peripheral type of muscular tabes to be considered as a distal myopathy. Dr. Roth became well-known for his monograph of the neuromuscular diseases, published in Moscow in 1895 under the name "Muscular Tabes" in which he described the history of neuromuscular diseases in a very detailed way, analyzing 1014 cases published in the world literature from 1830 to 1893 and 125 personal observations in the period 1874-1894. He performed a thorough analysis of the pattern of muscle involvement using both electrodiagnostic and histological study of muscles and central/peripheral nervous system. We report a short review of this monograph and two cases of peripheral (distal) myopathy.

  19. ROCURONIUM-INDUCED AND MIVACURIUM-INDUCED NEUROMUSCULAR BLOCK AND INTUBATING CONDITIONS - A COMPARISON WITH VECURONIUM

    NARCIS (Netherlands)

    VANDENBROEK, L; HOMMES, FDM; NAP, HJA; WIERDA, JMKH

    1995-01-01

    The time-course of action after an initial 2 x ED(90) dose and after maintenance doses of 0.5 x ED(90), and intubating conditions at 90 s after a 2 x ED(90) dose following rocuronium, vecuronium and mivacurium were evaluated in anaesthetized adult patients. Neuromuscular measurements were performed

  20. Non-invasive neuromuscular electrical stimulation in patients with central nervous system lesions: an educational review.

    Science.gov (United States)

    Schuhfried, Othmar; Crevenna, Richard; Fialka-Moser, Veronika; Paternostro-Sluga, Tatjana

    2012-02-01

    The aim of this educational review is to provide an overview of the clinical application of transcutaneous electrical stimulation of the extremities in patients with upper motor neurone lesions. In general two methods of electrical stimulation can be distinguished: (i) therapeutic electrical stimulation, and (ii) functional electrical stimulation. Therapeutic electrical stimulation improves neuromuscular functional condition by strengthening muscles, increasing motor control, reducing spasticity, decreasing pain and increasing range of motion. Transcutaneous electrical stimulation may be used for neuromuscular electrical stimulation inducing repetitive muscle contraction, electromyography-triggered neuromuscular electrical stimulation, position-triggered electrical stimulation and subsensory or sensory transcutaneous electric stimulation. Functional electrical stimulation provokes muscle contraction and thereby produces a functionally useful movement during stimulation. In patients with spinal cord injuries or stroke, electrical upper limb neuroprostheses are applied to enhance upper limb and hand function, and electrical lower limb neuroprostheses are applied for restoration of standing and walking. For example, a dropped foot stimulator is used to trigger ankle dorsiflexion to restore gait function. A review of the literature and clinical experience of the use of therapeutic electrical stimulation as well as of functional electrical stimulation in combination with botulinum toxin, exercise therapy and/or splinting are presented. Although the evidence is limited we conclude that neuromuscular electrical stimulation in patients with central nervous system lesions can be an effective modality to improve function, and that combination with other treatments has an additive therapeutic effect.

  1. Effect of exercise therapy on neuromuscular activity and knee strength in female adolescents with patellofemoral pain

    DEFF Research Database (Denmark)

    Rathleff, Michael S.; Samani, Afshin; Olesen, Jens L.;

    2016-01-01

    . A random subsample of 57 female adolescents was included and tested at baseline and after 3months. Neuromuscular control of the knee was quantified as the complexity of surface electromyography of the vastus lateralis and vastus medialis during stair descent. Secondary outcomes were complexity of knee...

  2. Electromyographic and Neuromuscular Force Patterns Associated with Unexpectedly Loaded Rapid Limb Movements.

    Science.gov (United States)

    Richardson, Charles; Simmons, Roger W.

    Bi-articular, unidirectional arm movements were studied to evaluate the electromyographic (EMG) and neuromuscular force patterns that occur when a limb is unexpectedly perturbed. A series of training trials were continued with a control load spring attached to the apparatus until a pre-specified criterion for learning was attained. The limb was…

  3. Effect of intravenous anesthetic propofol on synaptic vesicle exocytosis at the frog neuromuscular junction

    Institute of Scientific and Technical Information of China (English)

    Luciana Ferreira LEITE; Renato Santiago GOMEZ; Matheus de Castro FONSECA; Marcus Vinicius GOMEZ; Cristina GUATIMOSIM

    2011-01-01

    Aim: To investigate the presynaptic effects of propofol, a short-acting intravenous anesthetic, in the frog neuromuscular junction. Methods: Frog cutaneous pectoris nerve muscle preparations were prepared. A fluorescent tool (FM1-43) was used to visualize the effect of propofol on synaptic vesicle exocytosos in the frog neuromuscular junction. Results: Low concentrations of propofol, ranging from 10 to 25 μmol/L, enhanced spontaneous vesicle exocytosis monitored by FM1-43 in a Ca2+-dependent and Na+-independent fashion. Higher concentrations of propofol (50, 100, and 200 μmol/L) had no effect on spontaneous exocytosis. By contrast, higher concentrations of propofol inhibited the Na+-dependent exocytosis evoked by 4-aminopyri-dine but did not affect the Na+-independent exocytosis evoked by KCI. This action was similar and non-additive with that observed by tetrodotoxin, a Na+ channel blocker.Conclusion: Our data suggest that propofol has a dose-dependent presynaptic effect at the neuromuscular transmission which mayhelp to understand some of the clinical effects of this agent on neuromuscular function.

  4. Synaptic defects in the spinal and neuromuscular circuitry in a mouse model of spinal muscular atrophy.

    Directory of Open Access Journals (Sweden)

    Karen K Y Ling

    Full Text Available Spinal muscular atrophy (SMA is a major genetic cause of death in childhood characterized by marked muscle weakness. To investigate mechanisms underlying motor impairment in SMA, we examined the spinal and neuromuscular circuitry governing hindlimb ambulatory behavior in SMA model mice (SMNΔ7. In the neuromuscular circuitry, we found that nearly all neuromuscular junctions (NMJs in hindlimb muscles of SMNΔ7 mice remained fully innervated at the disease end stage and were capable of eliciting muscle contraction, despite a modest reduction in quantal content. In the spinal circuitry, we observed a ∼28% loss of synapses onto spinal motoneurons in the lateral column of lumbar segments 3-5, and a significant reduction in proprioceptive sensory neurons, which may contribute to the 50% reduction in vesicular glutamate transporter 1(VGLUT1-positive synapses onto SMNΔ7 motoneurons. In addition, there was an increase in the association of activated microglia with SMNΔ7 motoneurons. Together, our results present a novel concept that synaptic defects occur at multiple levels of the spinal and neuromuscular circuitry in SMNΔ7 mice, and that proprioceptive spinal synapses could be a potential target for SMA therapy.

  5. Whole-body vibration does not influence knee joint neuromuscular function or proprioception.

    Science.gov (United States)

    Hannah, R; Minshull, C; Folland, J P

    2013-02-01

    This study examined the acute effects of whole-body vibration (WBV) on knee joint position sense and indices of neuromuscular function, specifically strength, electromechanical delay and the rate of force development. Electromyography and electrically evoked contractions were used to investigate neural and contractile responses to WBV. Fourteen healthy males completed two treatment conditions on separate occasions: (1) 5 × 1 min of unilateral isometric squat exercise on a synchronous vibrating platform [30 Hz, 4 mm peak-to-peak amplitude] (WBV) and (2) a control condition (CON) of the same exercise without WBV. Knee joint position sense (joint angle replication task) and quadriceps neuromuscular function were assessed pre-, immediately-post and 1 h post-exercise. During maximum voluntary knee extensions, the peak force (PF(V)), electromechanical delay (EMD(V)), rate of force development (RFD(V)) and EMG of the quadriceps were measured. Twitch contractions of the knee extensors were electrically evoked to assess EMD(E) and RFD(E). The results showed no influence of WBV on knee joint position, EMD(V), PF(V) and RFD(V) during the initial 50, 100 or 150 ms of contraction. Similarly, electrically evoked neuromuscular function and neural activation remained unchanged following the vibration exercise. A single session of unilateral WBV did not influence any indices of thigh muscle neuromuscular performance or knee joint proprioception.

  6. Family Stress with Chronic Childhood Illness: Cystic Fibrosis, Neuromuscular Disease, and Renal Disease.

    Science.gov (United States)

    Holroyd, Jean; Guthrie, Donald

    1986-01-01

    Parents of children with neuromuscular disease, cystic fibrosis, and renal disease were compared with parents of control subjects matched by age to the clinical cases. The three clinical groups exhibited different patterns of stressful response, consistent with the nature of their illnesses and the requirements for care imposed on the families.…

  7. Neuromuscular Adaptations to Eccentric Strength Training in Children and Adolescents with Cerebral Palsy

    Science.gov (United States)

    Reid, Siobhan; Hamer, Peter; Alderson, Jacqueline; Lloyd, David

    2010-01-01

    Aim: To determine the neuromuscular outcomes of an eccentric strength-training programme for children and adolescents with cerebral palsy (CP). Method: In this randomised, parallel-group trial with waiting control, 14 participants with CP (six males, eight females; mean age 11y, SD 2y range 9-15y), diagnosed with upper-limb spasticity were…

  8. A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

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    Abdelazeem Eldawlatly

    2013-01-01

    Full Text Available Background: This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB in 2012. Methods: We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine "first choice" use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT, type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium. Results: A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively. From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB. Conclusions: We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20% and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

  9. Stability and migration across femoral varus derotation osteotomies in children with neuromuscular disorders

    DEFF Research Database (Denmark)

    Buxbom, Peter; Sonne-Holm, Stig; Ellitsgaard, Niels;

    2016-01-01

    ), and acetabuloplasty. Relapse is observed in one-fifth of cases during adolescence. In this prospective cohort study, we performed a descriptive evaluation of translation and rotation across VDROs in children with neuromuscular disorders and syndromes by radiostereometric analysis (RSA). We assessed "RSA stability...

  10. Dysarthria and dysphagia are highly prevalent among various types of neuromuscular diseases

    NARCIS (Netherlands)

    Knuijt, S.; Kalf, J.G.; Swart, B.J. de; Drost, G.; Hendricks, H.T.; Geurts, A.C.; Engelen, B.G. van

    2014-01-01

    PURPOSE: Patients with a neuromuscular disease (NMD) can present with dysarthria and/or dysphagia. Literature regarding prevalence rates of dysarthria and dysphagia is scarce. The purpose of this study was to determine prevalence rates, severity and co-presence of dysarthria and dysphagia in adult p

  11. Dysarthria and dysphagia are highly prevalent among various types of neuromuscular diseases

    NARCIS (Netherlands)

    Knuijt, Simone; Kalf, Johanna G.; de Swart, Bert J. M.; Drost, Gea; Hendricks, Henk T.; Geurts, Alexander C. H.; van Engelen, Baziel G. M.

    2014-01-01

    Purpose: Patients with a neuromuscular disease (NMD) can present with dysarthria and/or dysphagia. Literature regarding prevalence rates of dysarthria and dysphagia is scarce. The purpose of this study was to determine prevalence rates, severity and co-presence of dysarthria and dysphagia in adult p

  12. Man-machine interface system for neuromuscular training and evaluation based on EMG and MMG signals.

    Science.gov (United States)

    de la Rosa, Ramon; Alonso, Alonso; Carrera, Albano; Durán, Ramon; Fernández, Patricia

    2010-01-01

    This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System), a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES) and, as a novelty, the myomechanic signals (MMS). In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  13. Man-Machine Interface System for Neuromuscular Training and Evaluation Based on EMG and MMG Signals

    Directory of Open Access Journals (Sweden)

    Patricia Fernández

    2010-12-01

    Full Text Available This paper presents the UVa-NTS (University of Valladolid Neuromuscular Training System, a multifunction and portable Neuromuscular Training System. The UVa-NTS is designed to analyze the voluntary control of severe neuromotor handicapped patients, their interactive response, and their adaptation to neuromuscular interface systems, such as neural prostheses or domotic applications. Thus, it is an excellent tool to evaluate the residual muscle capabilities in the handicapped. The UVa-NTS is composed of a custom signal conditioning front-end and a computer. The front-end electronics is described thoroughly as well as the overall features of the custom software implementation. The software system is composed of a set of graphical training tools and a processing core. The UVa-NTS works with two classes of neuromuscular signals: the classic myoelectric signals (MES and, as a novelty, the myomechanic signals (MMS. In order to evaluate the performance of the processing core, a complete analysis has been done to classify its efficiency and to check that it fulfils with the real-time constraints. Tests were performed both with healthy and selected impaired subjects. The adaptation was achieved rapidly, applying a predefined protocol for the UVa-NTS set of training tools. Fine voluntary control was demonstrated to be reached with the myoelectric signals. And the UVa-NTS demonstrated to provide a satisfactory voluntary control when applying the myomechanic signals.

  14. Use of neuromuscular electrostimulation in the treatment of dysphagia in patients with multiple sclerosis

    NARCIS (Netherlands)

    H. Bogaardt; D. van Dam; N.M. Wever; C.E. Bruggeman; J. Koops; W.J. Fokkens

    2009-01-01

    OBJECTIVES: We explored the possible effects of neuromuscular electrostimulation on the swallowing function of patients with multiple sclerosis and swallowing problems. METHODS: Twenty-five patients (average age, 53.1 years; SD, 9.8 years) with multiple sclerosis and swallowing problems were treated

  15. The effect of neuromuscular blockade on canine laparoscopic ovariectomy: A double-blinded, prospective clinical trial

    NARCIS (Netherlands)

    van Goethem, B.; van Nimwegen, S.A.; Akkerdaas, L.C.; Murrell, J.C.; Kirpensteijn, J.

    2012-01-01

    The Effect of Neuromuscular Blockade on Canine Laparoscopic Ovariectomy: A Double-Blinded, Prospective Clinical Trial Bart Van Goethem, Diplomate ECVS, Sebastiaan Alexander van Nimwegen, PhD, Ies Akkerdaas, DVM, Joanna Claire Murrell, BVSc., PhD, Diplomate ECVAA, and Jolle Kirpensteijn, PhD, Diploma

  16. Neuromuscular adaptations to 4 weeks of intensive drop jump training in well-trained athletes

    DEFF Research Database (Denmark)

    Alkjær, Tine; Meyland, Jacob; Raffalt, Peter C

    2013-01-01

    This study examined the effects of 4 weeks of intensive drop jump training in well-trained athletes on jumping performance and underlying changes in biomechanics and neuromuscular adaptations. Nine well-trained athletes at high national competition level within sprinting and jumping disciplines...

  17. Effects of intensive physical rehabilitation on neuromuscular adaptations in adults with poststroke hemiparesis

    DEFF Research Database (Denmark)

    Andersen, Lars L; Zeeman, Peter; Jørgensen, Jørgen R

    2011-01-01

    the effect of intensive physical rehabilitation on neuromuscular and functional adaptations in outpatients suffering from hemiparesis after stroke. A within-subject repeated-measures design with the paretic leg as the experimental leg and the nonparetic leg as the control leg was used. Eleven outpatients...

  18. Proprioceptive Neuromuscular Facilitation Flexibility Techniques: Acute Effects on Arterial Blood Pressure.

    Science.gov (United States)

    Cornelius, William L.; Craft-Hamm, Kelley

    1988-01-01

    The effects of stretching techniques on arterial blood pressure (ABP) were studied in three groups of 20 men each. Each group performed one of three proprioceptive neuromuscular facilitation (PNF) techniques. Results are presented. The study indicates that the benefits of stretching may outweigh the risk of elevated ABP. (JL)

  19. How Persons with a Neuromuscular Disease Perceive Employment Participation : A Qualitative Study

    NARCIS (Netherlands)

    Minis, Marie-Antoinette; Satink, Ton; Kinébanian, Astrid; Engels, Josephine; Heerkens, Yvonne; Engelen, Baziel van

    2014-01-01

    Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant c

  20. Neuromuscular disorders in zebrafish: state of the art and future perspectives.

    Science.gov (United States)

    Pappalardo, Andrea; Pitto, Letizia; Fiorillo, Chiara; Alice Donati, M; Bruno, Claudio; Santorelli, Filippo M

    2013-06-01

    Neuromuscular disorders are a broad group of inherited conditions affecting the structure and function of the motor system with polymorphic clinical presentation and disease severity. Although individually rare, collectively neuromuscular diseases have an incidence of 1 in 3,000 and represent a significant cause of disability of the motor system. The past decade has witnessed the identification of a large number of human genes causing muscular disorders, yet the underlying pathogenetic mechanisms remain largely unclear, limiting the developing of targeted therapeutic strategies. To overcome this barrier, model systems that replicate the different steps of human disorders are increasingly being developed. Among these, the zebrafish (Danio rerio) has emerged as an excellent organism for studying genetic disorders of the central and peripheral motor systems. In this review, we will encounter most of the available zebrafish models for childhood neuromuscular disorders, providing a brief overview of results and the techniques, mainly transgenesis and chemical biology, used for genetic manipulation. The amount of data collected in the past few years will lead zebrafish to became a common functional tool for assessing rapidly drug efficacy and off-target effects in neuromuscular diseases and, furthermore, to shed light on new etiologies emerging from large-scale massive sequencing studies.

  1. Choice of Intravenous Agents and Intubation Neuromuscular Blockers by Anesthesia Providers

    Science.gov (United States)

    1996-09-01

    nondepolarizing muscle blockers (Omoigui, 1995). 8 Neuromuscular Blockers Atracurium is a nondepolarizing skeletal muscle relaxant and its...vecuronium. Feldman (1994) and Wicks (1994) report that rocuronium has the most rapid onset of any other nondepolarizing muscle relaxant with...prolonged muscle relaxant block at usual intubation doses. Mirakhur (1994) and Robertson, Hull, Verbeek, 8L Bonjii (1994) report minimal changes in

  2. Surgical Space Conditions During Low-Pressure Laparoscopic Cholecystectomy with Deep Versus Moderate Neuromuscular Blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S.; Rosenberg, Jacob;

    2014-01-01

    described, but deep neuromuscular blockade may be beneficial. We investigated if deep muscle relaxation would be associated with a higher proportion of procedures with "optimal" surgical space conditions compared with moderate relaxation during low-pressure (8 mm Hg) laparoscopic cholecystectomy. METHODS...... with surgical space conditions that were marginally better than with moderate muscle relaxation during low-pressure laparoscopic cholecystectomy....

  3. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review

    Directory of Open Access Journals (Sweden)

    Schaller SJ

    2013-09-01

    Full Text Available Stefan Josef Schaller,1,2 Heidrun Fink11Klinik für Anaesthesiologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 2Department of Anesthesia, Massachusetts General Hospital, Boston, MA, USAAbstract: Sugammadex is the first clinical representative of a new class of drugs called selective relaxant binding agents. It has revolutionized the way anesthesiologists think about drug reversal. Sugammadex selectively binds rocuronium or vecuronium, thereby reversing their neuromuscular blocking action. Due to its 1:1 binding of rocuronium or vecuronium, it is able to reverse any depth of neuromuscular block. So far, it has been approved for use in adult patients and for pediatric patients over 2 years. Since its approval in Europe, Japan, and Australia, further insight on its use in special patient populations and specific diseases have become available. Due to its pharmacodynamic profile, sugammadex, in combination with rocuronium, may have the potential to displace succinylcholine as the "gold standard" muscle relaxant for rapid sequence induction. The use of rocuronium or vecuronium, with the potential of reverse of their action with sugammadex, seems to be safe in patients with impaired neuromuscular transmission, ie, neuromuscular diseases, including myasthenia gravis. Data from long-term use of sugammadex is not yet available. Evidence suggesting an economic advantage of using sugammadex and justifying its relatively high cost for an anesthesia-related drug, is missing. Keywords: reversal agent, cyclodextrin, PORC, SRBAs

  4. INTUBATING CONDITIONS AND ONSET OF NEUROMUSCULAR BLOCK OF ROCURONIUM (ORG-9426) - A COMPARISON WITH SUXAMETHONIUM

    NARCIS (Netherlands)

    HUIZINGA, ACT; VANDENBROM, RHG; WIERDA, JMKH; HOMMES, FDM; HENNIS, PJ

    1992-01-01

    The intubating conditions and neuromuscular blocking profile following 600-mu-g.kg-1 rocuronium (Org 9426) have been investigated in patients under various experimental conditions. They were compared with conditions following 1.5 mg.kg-1 suxamethonium, preceded by a precurarising dose (10 mg) of gal

  5. Optimized surgical space during low-pressure laparoscopy with deep neuromuscular blockade

    DEFF Research Database (Denmark)

    Staehr-Rye, Anne K; Rasmussen, Lars S; Rosenberg, Jacob;

    2013-01-01

    Laparoscopic cholecystectomy (LC) can be performed using low intra-abdominal pressure (space conditions using either deep, continuous muscle relaxation or moderate blockade during low-pressure (8 mm......Hg) LC. We hypothesized that a deep neuromuscular block would be associated with a higher proportion of optimal surgical space conditions....

  6. Optimizing referral of patients with neuromuscular disorders to allied health care.

    NARCIS (Netherlands)

    Pieterse, A.J.; Cup, E.H.C.; Akkermans, R.P.; Hendricks, H.T.; Engelen, B.G.M. van; Wilt, G.J. van der; Oostendorp, R.A.B.

    2009-01-01

    BACKGROUND AND PURPOSE: To report the predictive validity of the perceived limitations in activities and need questionnaire (PLAN-Q), a screening instrument to support neurologists to select patients with neuromuscular disorders (NMD) for referral for a one-off consultation by occupational therapist

  7. A synaptic nidogen: Developmental regulation and role of nidogen-2 at the neuromuscular junction

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    Smyth Neil

    2008-09-01

    Full Text Available Abstract Background The skeletal neuromuscular junction is a useful model for elucidating mechanisms that regulate synaptogenesis. Developmentally important intercellular interactions at the neuromuscular junction are mediated by the synaptic portion of a basal lamina that completely ensheaths each muscle fiber. Basal laminas in general are composed of four main types of glycosylated proteins: laminins, collagens IV, heparan sulfate proteoglycans and nidogens (entactins. The portion of the muscle fiber basal lamina that passes between the motor nerve terminal and postsynaptic membrane has been shown to bear distinct isoforms of the first three of these. For laminins and collagens IV, the proteins are deposited by the muscle; a synaptic proteoglycan, z-agrin, is deposited by the nerve. In each case, the synaptic isoform plays key roles in organizing the neuromuscular junction. Here, we analyze the fourth family, composed of nidogen-1 and -2. Results In adult muscle, nidogen-1 is present throughout muscle fiber basal lamina, while nidogen-2 is concentrated at synapses. Nidogen-2 is initially present throughout muscle basal lamina, but is lost from extrasynaptic regions during the first three postnatal weeks. Neuromuscular junctions in mutant mice lacking nidogen-2 appear normal at birth, but become topologically abnormal as they mature. Synaptic laminins, collagens IV and heparan sulfate proteoglycans persist in the absence of nidogen-2, suggesting the phenotype is not secondary to a general defect in the integrity of synaptic basal lamina. Further genetic studies suggest that synaptic localization of each of the four families of synaptic basal lamina components is independent of the other three. Conclusion All four core components of the basal lamina have synaptically enriched isoforms. Together, they form a highly specialized synaptic cleft material. Individually, they play distinct roles in the formation, maturation and maintenance of the

  8. Neuromuscular determinants of maximum walking speed in well-functioning older adults.

    Science.gov (United States)

    Clark, David J; Manini, Todd M; Fielding, Roger A; Patten, Carolynn

    2013-03-01

    Maximum walking speed may offer an advantage over usual walking speed for clinical assessment of age-related declines in mobility function that are due to neuromuscular impairment. The objective of this study was to determine the extent to which maximum walking speed is affected by neuromuscular function of the lower extremities in older adults. We recruited two groups of healthy, well functioning older adults who differed primarily on maximum walking speed. We hypothesized that individuals with slower maximum walking speed would exhibit reduced lower extremity muscle size and impaired plantarflexion force production and neuromuscular activation during a rapid contraction of the triceps surae muscle group (soleus (SO) and gastrocnemius (MG)). All participants were required to have usual 10-meter walking speed of >1.0m/s. If the difference between usual and maximum 10m walking speed was 0.6m/s, the individual was assigned to the "Faster" group (n=12). Peak rate of force development (RFD) and rate of neuromuscular activation (rate of EMG rise) of the triceps surae muscle group were assessed during a rapid plantarflexion movement. Muscle cross sectional area of the right triceps surae, quadriceps and hamstrings muscle groups was determined by magnetic resonance imaging. Across participants, the difference between usual and maximal walking speed was predominantly dictated by maximum walking speed (r=.85). We therefore report maximum walking speed (1.76 and 2.17m/s in Slower and Faster, ptriceps surae (p=.44), quadriceps (p=.76) and hamstrings (p=.98). MG rate of EMG rise was positively associated with RFD and maximum 10m walking speed, but not the usual 10m walking speed. These findings support the conclusion that maximum walking speed is limited by impaired neuromuscular force and activation of the triceps surae muscle group. Future research should further evaluate the utility of maximum walking speed for use in clinical assessment to detect and monitor age

  9. Fatiguing exercise intensity influences the relationship between parameters reflecting neuromuscular function and postural control variables.

    Directory of Open Access Journals (Sweden)

    Sébastien Boyas

    Full Text Available The purpose of this study was to investigate the influence of fatiguing exercise intensity on the nature and extent of fatigue-induced changes in neuromuscular function and postural stability in quiet standing. We also explored the contribution of selected neuromuscular mechanisms involved in force production to postural stability impairment observed following fatigue using an approach based on multivariate regressions. Eighteen young subjects performed 30-s postural trials on one leg with their eyes closed. Postural trials were performed before and after fatiguing exercises of different intensities: 25, 50 and 75% of maximal isometric plantarflexor torque. Fatiguing exercises consisted of sustaining a plantarflexor isometric contraction at the target intensity until task failure. Maximal isometric plantarflexor torque, electromyographic activity of plantarflexor and dorsiflexor muscles, activation level (twitch interpolation technique and twitch contractile properties of plantarflexors were used to characterize neuromuscular function. The 25% exercise was associated with greater central fatigue whereas the 50 and 75% exercises involved mostly peripheral fatigue. However, all fatiguing exercises induced similar alterations in postural stability, which was unexpected considering previous literature. Stepwise multiple regression analyses showed that fatigue-related changes in selected parameters related to neuromuscular function could explain more than half (0.51≤R(2≤0.82 of the changes in postural variables for the 25% exercise. On the other hand, regression models were less predictive (0.17≤R(2≤0.73 for the 50 and 75% exercises. This study suggests that fatiguing exercise intensity does not influence the extent of postural stability impairment, but does influence the type of fatigue induced and the neuromuscular function predictors explaining changes in postural variables.

  10. Intermediate acting non-depolarizing neuromuscular blocking agents and risk of postoperative respiratory complications: prospective propensity score matched cohort study

    Science.gov (United States)

    Grosse-Sundrup, Martina; Henneman, Justin P; Sandberg, Warren S; Bateman, Brian T; Uribe, Jose Villa; Nguyen, Nicole Thuy; Ehrenfeld, Jesse M; Martinez, Elizabeth A; Kurth, Tobias

    2012-01-01

    Objective To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. Design Prospective, propensity score matched cohort study. Setting General teaching hospital in Boston, Massachusetts, United States, 2006-10. Participants 18 579 surgical patients who received intermediate acting neuromuscular blocking agents during surgery were matched by propensity score to 18 579 reference patients who did not receive such agents. Main outcome measures The main outcome measures were oxygen desaturation after extubation (hemoglobin oxygen saturation 3%) and reintubations requiring unplanned admission to an intensive care unit within seven days of surgery. We also evaluated effects on these outcome variables of qualitative monitoring of neuromuscular transmission (train-of-four ratio) and reversal of neuromuscular blockade with neostigmine to prevent residual postoperative neuromuscular blockade. Results The use of intermediate acting neuromuscular blocking agents was associated with an increased risk of postoperative desaturation less than 90% after extubation (odds ratio 1.36, 95% confidence interval 1.23 to 1.51) and reintubation requiring unplanned admission to an intensive care unit (1.40, 1.09 to 1.80). Qualitative monitoring of neuromuscular transmission did not decrease this risk and neostigmine reversal increased the risk of postoperative desaturation to values less than 90% (1.32, 1.20 to 1.46) and reintubation (1.76, 1.38 to 2.26). Conclusion The use of intermediate acting neuromuscular blocking agents during anesthesia was associated with an increased risk of clinically meaningful respiratory complications. Our data suggest that the strategies used in our trial to prevent residual postoperative neuromuscular blockade should be revisited. PMID:23077290

  11. Overstimulation of the inhibitory nervous system plays a role in the pathogenesis of neuromuscular and neurological diseases: a novel hypothesis.

    Science.gov (United States)

    Tuk, Bert

    2016-01-01

    Based upon a thorough review of published clinical observations regarding the inhibitory system, I hypothesize that this system may play a key role in the pathogenesis of a variety of neuromuscular and neurological diseases. Specifically, excitatory overstimulation, which is commonly reported in neuromuscular and neurological diseases, may be a homeostatic response to inhibitory overstimulation. Involvement of the inhibitory system in disease pathogenesis is highly relevant, given that most approaches currently being developed for treating neuromuscular and neurological diseases focus on reducing excitatory activity rather than reducing inhibitory activity.

  12. Invasive home mechanical ventilation, mainly focused on neuromuscular disorders

    Directory of Open Access Journals (Sweden)

    Börger, Sandra

    2010-01-01

    Full Text Available Introduction and background: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborate and technology-dependent ventilation is carried out via an artificial airway (tracheal cannula to the trachea. Exact numbers about the incidence of home mechanical ventilation are not available. Patients with neuromuscular diseases represent a large portion of it. Research questions: Specific research questions are formulated and answered concerning the dimensions of medicine/nursing, economics, social, ethical and legal aspects. Beyond the technical aspect of the invasive home, mechanical ventilation, medical questions also deal with the patient’s symptoms and clinical signs as well as the frequency of complications. Economic questions pertain to the composition of costs and the differences to other ways of homecare concerning costs and quality of care. Questions regarding social aspects consider the health-related quality of life of patients and caregivers. Additionally, the ethical aspects connected to the decision of home mechanical ventilation are viewed. Finally, legal aspects of financing invasive home mechanical ventilation are discussed. Methods: Based on a systematic literature search in 2008 in a total of 31 relevant databases current literature is viewed and selected by means of fixed criteria. Randomized controlled studies, systematic reviews and HTA reports (health technology assessment, clinical studies with patient numbers above ten, health-economic evaluations, primary studies with particular cost analyses and quality-of-life studies related to the research questions are included in the analysis. Results and discussion: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia are rare

  13. Analgesia pós-operatória para procedimentos cirúrgicos ortopédicos de quadril e fêmur: comparação entre bloqueio do compartimento do psoas e bloqueio perivascular inguinal Analgesia postoperatoria para procedimientos quirúrgicos ortopédicos de cadera y fémur: comparación entre bloqueo del compartimiento del psoas y bloqueo perivascular inguinal Postoperative analgesia for orthopedic surgeries of the hip and femur: a comparison between psoas compartment and inguinal paravascular blocks

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2006-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Este estudo avaliou a eficácia da injeção única de bupivacaína a 0,25% no compartimento do psoas ou perivascular inguinal por meio do estimulador de nervos periféricos para analgesia pós-operatória em pacientes submetidos a intervenções cirúrgicas ortopédicas. MÉTODO: Cem pacientes receberam bloqueio do plexo lombar através do compartimento do psoas e foram comparados com 100 pacientes que receberam bloqueio do plexo lombar via perivascular inguinal, identificados pelo estimulador de nervos periféricos com a injeção de 40 mL bupivacaína a 0,25% sem epinefrina. A analgesia nos nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foi avaliada 4, 8, 12, 16, 20 e 24 horas após o final da intervenção cirúrgica. A intensidade da dor foi também avaliada no mesmo período. A quantidade de opióides administrada no pós-operatório foi anotada. Em cinco pacientes de cada grupo, estudo radiográfico com contraste não-iônico foi realizado para avaliar a dispersão da solução anestésica. RESULTADOS: Os nervos ilioinguinal, genitofemoral, cutâneo femoral lateral, femoral e obturatório foram bloqueados em 92% dos pacientes no compartimento do psoas versus 62% no bloqueio perivascular inguinal. O bloqueio do plexo lombar reduziu a necessidade de opióides e 42% dos pacientes submetidos ao bloqueio do compartimento do psoas e 36% dos pacientes no bloqueio inguinal não necessitaram de analgésico adicional no pós-operatório. A duração da analgesia foi em torno de 21 horas com bloqueio do compartimento do psoas e 15 horas com bloqueio perivascular inguinal. CONCLUSÕES: O bloqueio do compartimento do psoas e perivascular inguinal é uma excelente técnica para analgesia pós-operatória em intervenções cirúrgicas ortopédicas reduzindo a necessidade de opióides. Este estudo mostrou que a injeção no compartimento do psoas foi mais fácil e mais efetiva no bloqueio

  14. Bloqueio extraconal para facectomia com implante de lente intra-ocular: influência do fentanil associado ao anestésico local na qualidade do bloqueio e na analgesia pós-operatória Bloqueo extraconal para facectomia con implantación de lente intra-ocular: influencia del fentanil asociado al anestésico local en la calidad del bloqueo y en la analgesia pos-operatoria Extraconal block for cataract extraction surgery with implantation of intraocular lens: contribution of fentanyl associated to local anesthetics for quality of block and postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Daniel Espada Lahoz

    2003-09-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anestesia locorregional para cirurgias oftalmológicas oferece vantagens, como: mínimas alterações fisiológicas, anestesia completa, bloqueio dos reflexos oculares, pequena incidência de náuseas e vômitos, menor tempo de recuperação e analgesia pós-operatória. A preocupação constante com a qualidade do bloqueio, assim como da abordagem da analgesia pós-operatória deve ficar sob a responsabilidade do anestesiologista. O objetivo deste estudo foi avaliar se o fentanil contribui na qualidade do bloqueio extraconal e na analgesia pós-operatória de facectomias com implante de lente intra-ocular. MÉTODO: Estudou-se a associação do fentanil e bupivacaína a 0,75% na qualidade do bloqueio ocular e na analgesia pós-operatória em 164 pacientes submetidos a facectomia com implante de lente intra-ocular (técnica extracapsular, de ambos os sexos com homogeneidade de parâmetros antropométricos, olho operado, classificação do estado físico (ASA e índice de risco cardíaco de Goldman. Os pacientes foram distribuídos em dois grupos (82 pacientes em cada grupo por sorteio de forma aleatória, com e sem fentanil. Avaliou-se a qualidade do bloqueio por: aparecimento da dor no per-operatório, manutenção de movimentação das pálpebras ou do globo ocular, persistência do reflexo de Bell, número de bloqueios realizados para a obtenção de condições cirúrgicas e avaliação do bloqueio pelo cirurgião. A analgesia pós-operatória foi avaliada pela necessidade de complementação analgésica pelo paciente. RESULTADOS: Fentanil associado à solução anestésica no bloqueio extraconal aumentou significativamente o bloqueio do músculo reto medial (com fentanil - 17,1%, sem fentanil - 32,9% e diminuiu o consumo de analgésicos no período pós-operatório (uso de analgésicos com fentanil - 20,7%, não uso de analgésicos com fentanil - 41,5%. CONCLUSÕES: Nas condições deste estudo o fentanil

  15. Architectural properties of the neuromuscular compartments in selected forearm skeletal muscles.

    Science.gov (United States)

    Liu, An-Tang; Liu, Ben-Li; Lu, Li-Xuan; Chen, Gang; Yu, Da-Zhi; Zhu, Lie; Guo, Rong; Dang, Rui-Shan; Jiang, Hua

    2014-07-01

    The purposes f this study were to (i) explore the possibility of splitting the selected forearm muscles into separate compartments in human subjects; (ii) quantify the architectural properties of each neuromuscular compartment; and (iii) discuss the implication of these properties in split tendon transfer procedures. Twenty upper limbs from 10 fresh human cadavers were used in this study. Ten limbs of five cadavers were used for intramuscular nerve study by modified Sihler's staining technique, which confirmed the neuromuscular compartments. The other 10 limbs were included for architectural analysis of neuromuscular compartments. The architectural features of the compartments including muscle weight, muscle length, fiber length, pennation angle, and sarcomere length were determined. Physiological cross-sectional area and fiber length/muscle length ratio were calculated. Five of the selected forearm muscles were ideal candidates for splitting, including flexor carpi ulnaris, flexor carpi radials, extensor carpi radialis brevis, extensor carpi ulnaris and pronator teres. The humeral head of pronator teres contained the longest fiber length (6.23 ± 0.31 cm), and the radial compartment of extensor carpi ulnaris contained the shortest (2.90 ± 0.28 cm). The ulnar compartment of flexor carpi ulnaris had the largest physiological cross-sectional area (5.17 ± 0.59 cm(2)), and the ulnar head of pronator teres had the smallest (0.67 ± 0.06 cm(2)). Fiber length/muscle length ratios of the neuromuscular compartments were relatively low (average 0.27 ± 0.09, range 0.18-0.39) except for the ulnar head of pronator teres, which had the highest one (0.72 ± 0.05). Using modified Sihler's technique, this research demonstrated that each compartment of these selected forearm muscles has its own neurovascular supply after being split along its central tendon. Data of the architectural properties of each neuromuscular compartment provide insight into the 'design' of their

  16. Tratamiento farmacológico de las alteraciones neuromusculares en el paciente crítico Pharmacological treatment neuromuscular impairments in critically ill patients

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    C. Ortiz Leyba

    2006-05-01

    Full Text Available El empleo de fármacos para tratamiento de las alteraciones neuromusculares que se presentan en el enfermo ingresado en una Unidad de Cuidados Intensivos es prácticamente inexistente. El empleo de inmunoglobulinas por vía venosa para el tratamiento de la polineuropatía del paciente crítico (PPC no aporta ninguna evidencia para su uso. Más importancia tiene el tratamiento profiláctico, como es el caso de la administración de una perfusión de insulina para prevenir la hiperglucemias que seasocian a un mayor desarrollo de la PPC. Nuevos datos inducen a pensar que el mecanismo protector de esta perfusión, normalizando los niveles de glucosa se hacen modulando una disfunción endotelial y a unos menores niveles de dimetilarginina asimétrica (ADMA. Con respecto a la miopatía del paciente crítico o a los cuadros de bloqueo neuromuscular prolongado, el tratamiento consiste en evitar el empleo de diversos fármacos que se sabe se asocian al desarrollo de estas entidades como son los corticoides, los relajantes musculares y los aminoglucósidos. Por lo que respecta a la parálisis aguda flácida -infección por el virus del oeste del nilo se han comunicado casos anecdóticos de mejoría con el empleo de corticoides o de interferón, pero su tratamiento rutinario queda aún por establecer.The use of drugs for treating neuromuscular impairments that present in the patient admitted to the Intensive Care Unit is virtually inexistent. The use of intravenous immunoglobulins for managing polyneuropathy of the critically ill patient (PCIP is supported by no evidence. More important is prophylactic therapy, as is the administration of insulin perfusion to prevent hyperglycemia that is associated to increased development of PCIP. New data suggest that the protective mechanism of this perfusion, which normalizes glucose levels, is achieved through the modulation of endothelial dysfunction and lowering levels of asymmetrical di-methyl arginine (ADMA. As

  17. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes.

  18. Estimativas das propriedades de compostos LVL produzidos com paricá (Schizolobium amazonicum Huber ex Ducke por meio de stress wave

    Directory of Open Access Journals (Sweden)

    Rafael Rodolfo Melo

    2014-12-01

    Full Text Available Foram avaliadas as propriedades físicas e mecânicas de compósitos LVL produzidos com a madeira de paricá (Schizolobium amazonicum Huber ex. Ducke, por meio de Stress Wave Timer. Os compósitos foram confeccionados em laboratório, dos quais foram retiradas amostras, que foram inicialmente destinadas à realização dos ensaios não destrutivos. Todas as amostras, com dimensões de 2,2 × 2,2 × 40 cm, foram ensaiadas, não destrutivamente, com a propagação de ondas nos sentidos flatwise e edgewise. Em sequência, as mesmas amostras foram destinadas à confecção de subamostras, para realização dos ensaios destrutivos, físicos (absorção de água, inchamento em espessura e inchamento residual e mecânicos (resistência e rigidez à flexão estática flatwise; resistência e rigidez à flexão estática edgewise; resistência à compressão paralela e resistência ao cisalhamento paralelo e perpendicular. A velocidade de propagação das ondas (V0 e o módulo de elasticidade dinâmico (Emd, obtidos com o auxílio do Stress Wave, foram utilizados para elaboração de modelos de predição das propriedades avaliadas. Os resultados indicaram que o Stress Wave Timer apresenta resultados satisfatórios para predição das propriedades mecânicas de compósitos LVL. Com relação às propriedades físicas, embora tenham sido verificados modelos com ajustes significativos, constatou-se limitação dessa ferramenta para predição desses parâmetros. Contudo, considerando ambas as propriedades, físicas e mecânicas, os melhores ajustes foram observados em amostras ensaiadas com a propagação de ondas no sentido edgewise e com o uso da variável independente Emd.

  19. Bloqueio do nervo alveolar mandibular com ropivacaína a 0,5 % em gatos Bockage of the jaw’s alveolar nerve with 0.5% ropivacaine in cats

    Directory of Open Access Journals (Sweden)

    Vanessa Martins Fayad Milken

    2006-04-01

    Full Text Available Objetivou-se, com este experimento, avaliar a ação da ropivacaína a 0,5% no bloqueio do nervo alveolar mandibular de gatos. Vinte gatos adultos, sem raça definida, machos ou fêmeas, receberam clorpromazina (1,0mg kg-1, VO e propofol (3,0mg kg-1, IV. Ropivacaína a 0,5% foi administrada com uma agulha 13x3,8 em forma de "L", inserida no ângulo da mandíbula direita, aproximadamente 1,0cm rostral ao processo angular e 0,5cm dorsal à superfície medial do ramo da mandíbula, a fim de depositá-la próximo ao nervo alveolar mandibular, no forame mandibular. As freqüências cardíaca e respiratória foram mensuradas antes da administração da clorpromazina, 20 minutos após administração desta (T0, 20 minutos após o bloqueio do nervo alveolar mandibular com ropivacaína (T20 e, em intervalos de 20 minutos, até a volta da sensibilidade na região anestesiada. Observou-se o período de latência e a duração da anestesia por meio do pinçamento da pele e gengiva da região lateral direita da mandíbula. Encontrou-se início da anestesia após 22 minutos, com duração de 164,25 minutos. Os parâmetros de freqüência cardíaca e freqüência respiratória tiveram alterações, porém sem significado clínico para a espécie. A ropivacaína a 0,5% anestesia a região dos dentes pré-molares, molares, caninos, incisivos, pele e mucosa oral e lábio inferior, sem causar efeitos colaterais.This study intended to evaluate the 0.5% ropivacaine action on the alveolar mandibular nerve block in cats. Twenty adult cats, non-defined breed, male or female, received chlorpromazine (1.0 mg kg-1 VO and propofol (3,0 mg/kg IV. Ropivacaine at 0.5% was administrated with an "L" 13x3,8 needle, inserted in the angle of the right mandible, close to 1.0cm rostral to the angular process and 0.5cm dorsal to the medial surface of the mandible branch, intending to deposit close to the alveolar mandibular nerve, at the mandibular forame. The heart and respiratory

  20. The effect of timing electrical stimulation to robotic-assisted stepping on neuromuscular activity and associated kinematics

    OpenAIRE

    Sina Askari, MS; TeKang Chao; Ray D. de Leon, PhD; Deborah S. Won, PhD

    2013-01-01

    Results of previous studies raise the question of how timing neuromuscular functional electrical stimulation (FES) to limb movements during stepping might alter neuromuscular control differently than patterned stimulation alone. We have developed a prototype FES system for a rodent model of spinal cord injury (SCI) that times FES to robotic treadmill training (RTT). In this study, one group of rats (n = 6) was trained with our FES+RTT system and received stimulation of the ankle flexor (tibia...

  1. Horner's syndrome and brachial paresis as a complication of lumbar sympathetic block: a case report Síndrome de Horner e paresia braquial como complicação de bloqueio simpático lombar: relato de caso

    Directory of Open Access Journals (Sweden)

    Pa. Maranhão-Filho

    1995-12-01

    Full Text Available An unusual case of Homer's syndrome secondary to a sympathetic block in a patient with chronic adhesive arachnoiditis (CAA is described. The patient, a 40-year-old white woman, presented with spastic paraplegia, hyperreflexia, bilateral Babinski sigh, superficial and deep sensitive hypoaesthesia at the T4 level, in addition to bladder and rectal dysfunction since she was 32. At age of 38 she complained of excessive daily sweating below the T4 level, mostly at night. A 4mL 0.5% bupivacaine lumbar sympathetic block was performed. Within 15 min aright brachial paresis and an ipsilateral Horner's syndrome were noted. Speculatively, an abnormal cephalic spread of the anaesthesic due to a putative erratic space secondary to the CAA may justify the clinical picture even using a relatively small amount of anaesthesic (4 mL.Os autores descrevem o caso de uma mulher branca de 40 anos de idade, com paraplegia espástica, hiperreflexia, sinal de Babinski bilateral, hipoestesia superficial e profunda em T4, além de incontinência fecal e urinária, desde os 32 anos decorrente de aracnoidite crônica adesiva (CAA. Aos 38 anos passou apresentar sudorese excessiva com limite superior em T4, diária, com intensificação noturna. Um bloqueio simpático lombar foi efetuado com 4mL de bupivacaina 0.5%. Quinze minutos depois a paciente apresentou monoparesia braquial direita e síndrome de Horner ipsolateral. Devido provavelmente a um espaço peridural estreito e errático, secundário à CAA, pode-se justificar o quadro clínico como secundário à ascenção cranial do anestésico, mesmo utilizado em reduzida quantidade (4mL.

  2. Comparison of mechanomyography and acceleromyography for the assessment of rocuronium induced neuromuscular block in myotonic dystrophy type 1.

    Science.gov (United States)

    Vanlinthout, L E H; Booij, L H D J; van Egmond, J; Robertson, E N

    2010-06-01

    We measured acceleromyography and mechanomyography simultaneously with monitoring of rocuronium-induced neuromuscular block in four patients with myotonic dystrophy type 1. Furthermore, we compared neuromuscular block measures from these patients with those from normal controls from previous studies. In myotonic dystrophy type 1 patients, the dose-response curve obtained with acceleromyography was steeper and right-shifted compared with that obtained using mechanomyography. However, the effective doses to produce 95% neuromuscular block determined with both acceleromyography and mechanomyography were similar to each other and to values found in normal patients. In the three myotonic dystrophy type 1 patients with mild to moderate disease, times to recovery from block were similar to those observed in normal controls. In both patients and normal controls, neuromuscular block recovered faster with acceleromyography. However, in one patient with severe muscle wasting, recovery of neuromuscular block was prolonged. We conclude that mechanomyography and acceleromyography cannot be used interchangeably to monitor neuromuscular block in myotonic dystrophy type 1 patients.

  3. Donepezil: A cause of inadequate muscle relaxation and delayed neuromuscular recovery

    Directory of Open Access Journals (Sweden)

    Alka Bhardwaj

    2011-01-01

    Full Text Available A 74-year-old female with diabetes mellitus type II and Alzheimer′s disease, taking donepezil for 4 months was operated for right modified radical mastectomy under general anesthesia. During the procedure a higher dose of non-depolarizing muscle relaxant was required than those recommended for her age yet the muscle relaxation was inadequate intra-operatively. Residual neuromuscular blockade persisted postoperatively, due to the cumulative effect of large doses of non-depolarizing muscle relaxant, needing post-operative ventilatory assistance. After ruling out other causes of resistance to non-depolarizing muscle relaxants, we concluded that acetylcholinesterase inhibitor donepezil was primarily responsible for inadequate muscle relaxation and delayed post-operative neuromuscular recovery.

  4. Two- and 6-minute walk tests assess walking capability equally in neuromuscular diseases

    DEFF Research Database (Denmark)

    Andersen, Linda Kahr; Knak, Kirsten Lykke; Witting, Nanna;

    2016-01-01

    to participate on 2 test days, each consisting of 1 2MWT and 1 6MWT separated by a minimum 30-minute period of rest. The order of the walk tests was randomly assigned via sealed envelopes. A group of 38 healthy controls completed 1 6MWT. RESULTS: The mean walking distance for the 2MWT was 142.8 meters......OBJECTIVE: This methodologic study investigates if the 2-minute walk test (2MWT) can be a valid alternative to the 6-minute walk test (6MWT) to describe walking capability in patients with neuromuscular diseases. METHODS: Patients (n = 115) with different neuromuscular diseases were invited...... and for the 6MWT 405.3 meters. The distance walked in the 2MWT was highly correlated to the distance walked in the 6MWT (r = 0.99, p minute in the 6MWT, both among patients and healthy controls, which was not evident in the 2MWT...

  5. The influence of gender on neuromuscular pre-activity during side-cutting

    DEFF Research Database (Denmark)

    Bencke, Jesper; Zebis, Mette K

    2011-01-01

    investigated. This cross-sectional study aimed to examine gender differences in neuromuscular pre-activity during a maneuver that mimics a movement associated with the incidence of ACL injuries. Twenty-four team handball players (12 male and 12 female) with no history of ACL injury were tested for EMG pre......It is well established that female athletes are at increased risk for sustaining ACL injuries in sports, where sudden changes of direction are a frequent movement pattern. The underlying neuromuscular mechanisms related to the elevated ACL injury rate in female athletes has yet to be fully......-activity of vastus lateralis, vastus medialis, semitendinosus, and biceps femoris during a side-cutting maneuver. Mean EMG amplitude 50ms prior to toe down was normalized to maximal EMG obtained during maximal isometric contraction. The results showed that females had significantly lower hamstring EMG pre...

  6. Effects of mescaline and some of its analogs on cholinergic neuromuscular transmission.

    Science.gov (United States)

    Ghansah, E; Kopsombut, P; Malleque, M A; Brossi, A

    1993-02-01

    Mescaline (3,4,5-trimethoxyphenylethylamine; MES) and its analogs, anhalinine (ANH) and methylenemescaline trimer (MMT) were investigated, using sciatic-sartorius preparations of the frog and cortical tissue from the rat. The effects of MES and its analogs were examined with respect to muscle twitch, resting membrane potential and nicotinic receptor binding. Mescaline and its analogs (10-100 microM) blocked both directly and neurally evoked twitches but their effects on neurally evoked twitches were greater than those on directly evoked twitches. Mescaline, ANH and MMT decreased amplitude of the miniature endplate and endplate potentials, decreased acetylcholine (ACh) quantal content, hyperpolarized the resting membrane potential and prolonged duration of the action potential. They did not significantly displace the binding of [125I]-alpha-bungarotoxin (alpha-BTX) to nicotinic receptors, at concentrations which blocked neuromuscular transmission. These results suggest that MES and its analogs inhibit cholinergic neuromuscular transmission by blocking release of ACh; they also affect K+ conductance.

  7. Neuromuscular Junctions as Key Contributors and Therapeutic Targets in Spinal Muscular Atrophy

    Science.gov (United States)

    Boido, Marina; Vercelli, Alessandro

    2016-01-01

    Spinal muscular atrophy (SMA) is a recessive autosomal neuromuscular disease, representing the most common fatal pediatric pathology. Even though, classically and in a simplistic way, it is categorized as a motor neuron (MN) disease, there is an increasing general consensus that its pathogenesis is more complex than expected. In particular, neuromuscular junctions (NMJs) are affected by dramatic alterations, including immaturity, denervation and neurofilament accumulation, associated to impaired synaptic functions: these abnormalities may in turn have a detrimental effect on MN survival. Here, we provide a description of NMJ development/maintenance/maturation in physiological conditions and in SMA, focusing on pivotal molecules and on the time-course of pathological events. Moreover, since NMJs could represent an important target to be exploited for counteracting the pathology progression, we also describe several therapeutic strategies that, directly or indirectly, aim at NMJs. PMID:26869891

  8. Neuromuscular control of scapula muscles during a voluntary task in subjects with Subacromial Impingement Syndrome

    DEFF Research Database (Denmark)

    Larsen, C M; Søgaard, Karen; Chreiteh, S S;

    2013-01-01

    Imbalance of neuromuscular activity in the scapula stabilizers in subjects with Subacromial Impingement Syndrome (SIS) is described in restricted tasks and specific populations. Our aim was to compare the scapular muscle activity during a voluntary movement task in a general population...... with and without SIS (n=16, No-SIS=15). Surface electromyography was measured from Serratus anterior (SA) and Trapezius during bilateral arm elevation (no-load, 1kg, 3kg). Mean relative muscle activity was calculated for SA and the upper (UT) and lower part of trapezius (LWT), in addition to activation ratio...... and time to activity onset. In spite of a tendency to higher activity among SIS 0.10-0.30 between-group differences were not significant neither in ratio of muscle activation 0.80-0.98 nor time to activity onset 0.53-0.98. The hypothesized between-group differences in neuromuscular activity of Trapezius...

  9. Split-dose atropine versus glycopyrrolate with neostigmine for reversal of gallamine-induced neuromuscular blockade

    DEFF Research Database (Denmark)

    Wetterslev, J; Jarnvig, I; Jørgensen, L N

    1991-01-01

    The effects of a split-dose of atropine sulphate versus a single dose of glycopyrrolate given with neostigmine for the reversal of gallamine-induced neuromuscular blockade were studied in 55 patients undergoing gynaecological surgery. The patients were randomized to receive either a single dose...... of glycopyrrolate (7 micrograms.kg-1) or two doses of atropine (8 micrograms.kg-1 each), given with an interval of 1 min. There were no differences between the two methods with respect to percentage heart rate changes, salivation or arousal time. Four patients demonstrated cardiac arhythmias in the atropine group......, whereas none occurred in the glycopyrrolate group (P less than 0.05). It is concluded that a split-dose of atropine has similar chronotropic effects to a single dose of glycopyrrolate for the reversal of gallamine-induced neuromuscular blockade. However, the finding of a higher incidence of cardiac...

  10. Enhancement of Neuromuscular Activity by Natural Specimens and Cultured Mycelia of Cordyceps sinensis in Mice

    Science.gov (United States)

    Singh, K. P.; Meena, H. S.; Negi, P. S.

    2014-01-01

    The present study was aimed to evaluate the effect of natural specimen and laboratory cultured mycelia of Cordyceps sinensis on neuromuscular activity in mice. The powder of natural specimen and laboratory cultured Cordyceps sinensis was orally administered at the dose rate of 100, 300 and 500 mg/kg for 30 days. Natural specimen and in vitro propagated Cordyceps sinensis showed significant (P<0.05) enhancement in neuromuscular endurance and antidepressant activity at 300 and 500 mg/kg as compared to the control group. However, the fungus did not proved to be as effective as fluoxetine in exhibiting antidepressant action. Muscular endurance was determined on a Rota rod apparatus while antidepressant (mood elevating) activity was measured on a photoactometer in Swiss albino mice. The effects produced by both natural specimens and laboratory cultured Cordyceps sinensis were comparable and showed almost equal potency. PMID:25425763

  11. EFFECT OF NEUROMUSCULAR REEDUCATION IN BILATERAL FACIAL PALSY ON PATIENT WITH GBS

    Directory of Open Access Journals (Sweden)

    Sanjiv Kumar, MPT, PhD

    2014-04-01

    Full Text Available Background: Bilateral facial palsy is a rare entity and remains to be a challenging case to diagnose and manage which has the major impact on the physical and social aspect of the affected individual. Objective: The aim of the report is to determine the role of neuromuscular reeducation in restoration of function in person with Guillain Barre Syndrome present with facial diplegia. Case report: We report the case of 23 year male presenting with history of deviation of mouth to the right side, followed by bilateral facial involvement and latter distal symmetrical involvement of bilateral upper and lower limb. The facial diplegia was managed by PNF and Electrical stimulation. Conclusions: Neuromuscular reeducation is an effective intervention for restoration of function after facial diplegia.

  12. The use of "stabilization exercises" to affect neuromuscular control in the lumbopelvic region: a narrative review.

    Science.gov (United States)

    Bruno, Paul

    2014-06-01

    It is well-established that the coordination of muscular activity in the lumbopelvic region is vital to the generation of mechanical spinal stability. Several models illustrating mechanisms by which dysfunctional neuromuscular control strategies may serve as a cause and/or effect of low back pain have been described in the literature. The term "core stability" is variously used by clinicians and researchers, and this variety has led to several rehabilitative approaches suggested to affect the neuromuscular control strategies of the lumbopelvic region (e.g. "stabilization exercise", "motor control exercise"). This narrative review will highlight: 1) the ongoing debate in the clinical and research communities regarding the terms "core stability" and "stabilization exercise", 2) the importance of sub-grouping in identifying those patients most likely to benefit from such therapeutic interventions, and 3) two protocols that can assist clinicians in this process.

  13. Effects of intensive physical rehabilitation on neuromuscular adaptations in adults with poststroke hemiparesis

    DEFF Research Database (Denmark)

    Andersen, Lars L; Zeeman, Peter; Jørgensen, Jørgen R;

    2011-01-01

    with hemiparesis after stroke participated in 12 weeks of intensive physical rehabilitation comprising unilateral high-intensity strength training with near-maximal loads (4-12 repetition maximum) and body weight supported treadmill training. At baseline and 12-week follow-up, the patients went through testing...... the effect of intensive physical rehabilitation on neuromuscular and functional adaptations in outpatients suffering from hemiparesis after stroke. A within-subject repeated-measures design with the paretic leg as the experimental leg and the nonparetic leg as the control leg was used. Eleven outpatients...... observed in the nonparetic control leg. Gait performance increased 52-68%. In conclusion, intensive physical rehabilitation after stroke leads to clinically relevant neuromuscular improvements, leading to increased voluntary strength during a wide range of contraction modes and velocities, and improved...

  14. Maximum likelihood q-estimator reveals nonextensivity regulated by extracellular potassium in the mammalian neuromuscular junction

    CERN Document Server

    da Silva, A J; Santos, D O C; Lima, R F

    2013-01-01

    Recently, we demonstrated the existence of nonextensivity in neuromuscular transmission [Phys. Rev. E 84, 041925 (2011)]. In the present letter, we propose a general criterion based on the q-calculus foundations and nonextensive statistics to estimate the values for both scale factor and q-index using the maximum likelihood q-estimation method (MLqE). We next applied our theoretical findings to electrophysiological recordings from neuromuscular junction (NMJ) where spontaneous miniature end plate potentials (MEPP) were analyzed. These calculations were performed in both normal and high extracellular potassium concentration, [K+]o. This protocol was assumed to test the validity of the q-index in electrophysiological conditions closely resembling physiological stimuli. Surprisingly, the analysis showed a significant difference between the q-index in high and normal [K+]o, where the magnitude of nonextensivity was increased. Our letter provides a general way to obtain the best q-index from the q-Gaussian distrib...

  15. Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study.

    Science.gov (United States)

    Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N; Aslan, Sevda C; Pitts, Teresa; Folz, Rodney J

    2016-07-15

    The objective of this study was to examine the feasibility of a full-scale investigation of the neurophysiological mechanisms of COPD-induced respiratory neuromuscular control deficits. Characterization of respiratory single- and multi-muscle activation patterns using surface electromyography (sEMG) were assessed along with functional measures at baseline and following 21±2 (mean±SD) sessions of respiratory motor training (RMT) performed during a one-month period in four patients with GOLD stage II or III COPD. Pre-training, the individuals with COPD showed significantly increased (prespiratory muscle activity and disorganized multi-muscle activation patterns in association with lowered spirometrical measures and decreased fast- and slow-twitch fiber activity as compared to healthy controls (N=4). Following RMT, functional and respiratory sEMG activation outcomes during quite breathing and forced expiratory efforts were improved suggesting that functional improvements, induced by task-specific RMT, are evidence respiratory neuromuscular networks re-organization.

  16. Reactive Neuromuscular Training: A Multi-level Approach to Rehabilitation of the Unstable Shoulder.

    Science.gov (United States)

    Guido, John A; Stemm, John

    2007-05-01

    In this clinical commentary, the use of reactive neuromuscular training (RNT) will be discussed as part of an overall functional rehabilitation program in the treatment of the unstable glenohumeral joint. The RNT program is designed to restore the synchrony and synergy of muscle firing patterns about the shoulder, which are required for dynamic joint stability and fine motor control. Reactive neuromuscular training allows the clinician to bridge the gap between the achievement of clinical based goals and a return to athletic competition. The possible effects of RNT on central nervous system (CNS) programming to establish appropriate reflex responses and functional stability at the glenohumeral joint will be explored. The issues reviewed in this article will highlight the need for future research in this area.

  17. Neuromuscular exercise improves functional performance in patients with severe hip osteoarthritis

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Larsen, Anders Holsgaard

    . Randomized controlled trial (Clinicaltrials.gov identifier: NCT01003756). 84 patients, 51% female, mean age 68.6±7.8 years, BMI 28.7±4.7 scheduled for total hip replacement at Svendborg Community Hospital, Odense University Hospital, Denmark were included. Intervention. Participants were randomized...... to an eight-week neuromuscular exercise (NEMEX-TJR) intervention or care-as-usual (verbal and written preoperative information). Intervention was supervised and offered twice a week with each session lasting one hour. The program is considered feasible and safe in this patient group and previously described......±4 sessions (Table 1). In favor of the intervention group, the between-group difference was significant for 20-m walk (2.2 seconds, p=.009), chair stands (1.7 seconds, p=.022) and leg extension for the non operated leg (.17 W/kg, p=.049) (Table 2). Conclusion. Eight weeks neuromuscular exercise according...

  18. Alterações da junção neuromuscular em miopatias experimentais no camundongo

    OpenAIRE

    Luiz Fernando Bleggi Torres

    1989-01-01

    As alterações morfológicas observadas em junção neuromuscular de dois modelos de miopatia em camundongos são estudadas por métodos histoquímicos para demonstrar atividade da enzima acetilcolinesterase e por microscopia eletrônica. Em ambas as situações os resultados obtidos são similares, indicando que a junção neuromuscular permanece intacta mesmo quando a fibra que inerva está sofrendo necrose. Em fibras musculares regeneradas há acentuada simplificação das pregas pós-sinápticas, com reduçã...

  19. Design of low-cost general purpose microcontroller based neuromuscular stimulator.

    Science.gov (United States)

    Koçer, S; Rahmi Canal, M; Güler, I

    2000-04-01

    In this study, a general purpose, low-cost, programmable, portable and high performance stimulator is designed and implemented. For this purpose, a microcontroller is used in the design of the stimulator. The duty cycle and amplitude of the designed system can be controlled using a keyboard. The performance test of the system has shown that the results are reliable. The overall system can be used as the neuromuscular stimulator under safe conditions.

  20. Effects of some depressant drugs on synaptic responses to glutamate at the crayfish neuromuscular junction.

    OpenAIRE

    1984-01-01

    Excitatory junction currents produced by glutamate were recorded with an extracellular electrode at the neuromuscular junction of the crayfish. Pentobarbitone, phenobarbitone, diazepam, chlordiazepoxide and procaine had only minimal effects on current decay at concentrations which are highly effective in other preparations. The glutamate synapse in the crayfish appears relatively resistant to these drugs. In contrast, ether and halothane increased the rate of decay of the currents at concentr...

  1. Laminins promote postsynaptic maturation by an autocrine mechanism at the neuromuscular junction

    OpenAIRE

    Nishimune, Hiroshi; Jarad, George; Moulson, Casey L.; Müller, Ulrich; Miner, Jeffrey H.; Valdez, Gregorio; Sanes, Joshua R

    2008-01-01

    A prominent feature of synaptic maturation at the neuromuscular junction (NMJ) is the topological transformation of the acetylcholine receptor (AChR)-rich postsynaptic membrane from an ovoid plaque into a complex array of branches. We show here that laminins play an autocrine role in promoting this transformation. Laminins containing the α4, α5, and β2 subunits are synthesized by muscle fibers and concentrated in the small portion of the basal lamina that passes through the synaptic cleft at ...

  2. Long Term Follow-up of Ventilated Patients with Thoracic Restriction and Neuromuscular Disease

    Directory of Open Access Journals (Sweden)

    Dina Brooks

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the long term effects of home mechanical ventilation (HMV on pulmonary function, nighttime gas exchange, daytime arterial blood gases, sleep architecture and functional exercise capacity (6 min walk. Patients with respiratory failure attributable to thoracic restrictive disease (TRD (kyphoscoliosis or neuromuscular disease (NMD were assessed, ventilated, trained and followed in a dedicated unit for the care of patients requiring long term ventilation.

  3. Surface neuromuscular electrical stimulation for quadriceps strengthening pre and post total knee replacement.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2010-01-01

    Total knee replacement has been demonstrated to be one of the most successful procedures in the treatment of osteoarthritis. However quadriceps weakness and reductions in function are commonly reported following surgery. Recently Neuromuscular Electrical Stimulation (NMES) has been used as an adjunct to traditional strengthening programmes. This review considers the effectiveness of NMES as a means of increasing quadriceps strength in patients before and after total knee replacement.

  4. The effects of pentoxifylline on skeletal muscle contractility and neuromuscular transmission during hypoxia

    Directory of Open Access Journals (Sweden)

    Simsek-Duran Fatma

    2009-01-01

    Full Text Available Objectives : The objective of this study was to investigate the effects of pentoxifylline (PTX, a drug that is mainly used for indications related to tissue hypoxia, on hypoxia-induced inhibition of skeletal muscle contractility and neuromuscular transmission in mice. We hypothesized that chronic PTX treatment alters skeletal muscle contractility and hypoxia-induced dysfunction. Materials and Methods : Mice were treated with 50 mg/kg PTX or saline intraperitoneally for a week. Following ether anesthesia, diaphragm muscles were removed; isometric muscle contractions and action potentials were recorded. Time to reach neuromuscular blockade and the rate of recovery of muscle contractility were assessed during hypoxia and re-oxygenation. Results : The PTX group displayed 90% greater twitch amplitudes (P < 0.01. Hypoxia depressed twitch contractions and caused neuromuscular blockade in both groups. However, neuromuscular blockade occurred earlier in PTX-treated animals (P < 0.05. Muscle contractures developed during hypoxia were more pronounced in the PTX group (P < 0.05. Re-oxygenation reduced contracture and indirect muscle contractions resumed. The rate of recovery of contractions was faster (P < 0.05 and the amplitude of contractions was greater (P < 0.01 in the PTX group. PTX treatment increased amplitude (P < 0.05 and shortened action potential (P < 0.05 without altering resting membrane potential, excitation threshold, and neurotransmitter release. Conclusion : Chronic PTX treatment increases diaphragm contractility, but amplifies hypoxia-induced contractile dysfunction in mice. These results may implicate important clinical consequences for clinical usage of PTX in hypoxia-related conditions.

  5. Abnormalities of neuromuscular transmission in patients with Miller-Fisher syndrome.

    Science.gov (United States)

    Menon, Parvathi; Mahant, Neil; Vucic, Steve

    2012-11-01

    The mechanism of motor weakness in patients with Miller-Fisher syndrome (MFS) remains to be fully elucidated. We performed stimulated single fibre electromyography (sSFEMG) in a clinically weak frontalis muscle in a patient with MFS. Stimulate single fiber EMG revealed increased jitter in over 50% of the apparent single fibre action potentials from the frontalis muscle in addition to increased mean jitter. The findings in the present study suggest dysfunction of neuromuscular transmission in patients with MFS.

  6. Preferences of Mexican anesthesiologists for vecuronium, rocuronium, or other neuromuscular blocking agents: a survey

    Directory of Open Access Journals (Sweden)

    Garduño-Espinosa J

    2002-05-01

    Full Text Available Abstract Background Several neuromuscular blocking (NMB agents are available for clinical use in anesthesia. The present study was performed in order to identify preferences and behaviors of anesthesiologists for using vecuronium, rocuronium or other NMB agents in their clinical practice. Material and methods The cross-sectional survey was applied at the Updated Course of the Colegio Mexicano de Anestesiología performed last year. Of 989, 282 (28.5% surveys were returned. Results Most anesthesiologists were working at both public and private hospitals, performed anesthetic procedures for hospitalized and ambulatory patients, and anesthetized children as well as adults. Respondents did not consider mechanomyography as the gold standard method for neuromuscular monitoring. The T25 was not recognized as a pharmacodynamic parameter that represents the clinical duration of the neuromuscular block. Most answered that vecuronium induces less histamine release than rocuronium, had never used any neuromuscular monitor, did not know the cost of vecuronium and rocuronium, and preferred rocuronium in multiple-sampling vials and vecuronium in either a vial for single or multiple sampling. Rocuronium was preferred for emergency surgery in patients with full stomach only. Almost all of anesthesiologists that conserve the unused drug did it without refrigeration and more than 30% conserve the unused drug in one syringe for further use. Conclusion Vecuronium was preferred for most clinical situations, and the decision for this choice was not based on costs. Storage of unused drugs without refrigeration in a single syringe for purpose of future use in several patients represented a dangerous common practice.

  7. Neuromuscular scoliosis and pelvic fixation in 2015: Where do we stand?

    OpenAIRE

    Anari, Jason B; Spiegel, David A.; Baldwin, Keith D

    2015-01-01

    Neuromuscular scoliosis is a challenging problem to treat in a heterogeneous patient population. When the decision is made for surgery the surgeon must select a technique employed to correct the curve and achieve the goals of surgery, namely a straight spine over a level pelvis. Pre-operatively the surgeon must ask if pelvic fixation is worth the extra complications and infection risk it introduces to an already compromised host. Since the advent of posterior spinal fusion the technology used...

  8. Rigidity and flexibility in protein-protein interaction networks: a case study on neuromuscular disorders

    OpenAIRE

    2014-01-01

    Mutations in proteins can have deleterious effects on a protein's stability and function, which ultimately causes particular diseases. Genetically inherited muscular dystrophies (MDs) include several genetic diseases, which cause increasing weakness in muscles and disability to perform muscular functions progressively. Different types of mutations in the gene coding translates into defunct proteins cause different neuro-muscular diseases. Defunct protein interactions in human proteome may cau...

  9. Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique.

    Science.gov (United States)

    Modi, Hitesh N; Suh, Seung Woo; Fernandez, Harry; Yang, Jae Hyuk; Song, Hae-Ryong

    2008-12-01

    It is a retrospective analytic study of 1,009 transpedicular screws (689 thoracic and 320 lumbosacral), inserted with free-hand technique in neuromuscular scoliosis using postoperative CT scan. The aim of paper was to determine the accuracy and safety of transpedicular screw placement with free-hand technique in neuromuscular scoliosis and to compare the accuracy at different levels in such population. All studies regarding accuracy and safety of pedicle screw in scoliosis represent idiopathic scoliosis using various techniques such as free-hand, navigation, image intensifier, etc., for screw insertion. Anatomies of vertebrae and pedicle are distorted in scoliosis, hence accurate and safe placement of pedicle screw is prerequisite for surgery. Between 2004 and 2006, 37 consecutive patients, average age 20 years (9-44 years), of neuromuscular scoliosis were operated with posterior pedicle screw fixation using free-hand technique. Accuracy of pedicle screws was studied on postoperative CT scan. Placement up to 2 mm medial side and 4 mm lateral side was considered within-safe zone. Of the 1,009 screws, 273 screws were displaced medially, laterally or on the anterior side showing that 73% screws (68% in thoracic and 82.5% in lumbar spine) were accurately placed within pedicle. Considering the safe zone, 93.3% (942/1009, 92.4% in thoracic and 95.3% in lumbar spine) of the screws were within the safe zone. Comparing accuracy according to severity of curve, accuracy was 75% in group 1 (curve 90 degrees) with a safety of 94.8 and 91.2%, respectively (P = 0.35). Comparing the accuracy at different thoracic levels, it showed 67, 64 and 72% accuracy in upper, middle and lower thoracic levels with safety of 96.6, 89.2 and 93.1%, respectively, exhibiting no statistical significant difference (P = 0.17). Pedicle screw placement in neuromuscular scoliosis with free-hand technique is accurate and safe as other conditions.

  10. CLINICAL PICTURE AND TREATMENT TACTICS OF PATIENTS WITH TEMPOROMANDIBULAR JOINT NEUROMUSCULAR DYSFUNCTIONAL SYNDROME

    OpenAIRE

    2009-01-01

    We have analyzed the results of diagnostics and treatment of 36 patients with neuromuscular dysfunctional syndrome of TMJ. We have found that the cause of pathology is acute damage, stress, parafunction of masseteric muscules, durable influence on the joint. NDS is characterized by the impairment of masseteric muscularfunction, that results in motional restriction in all directions. Treatment must include elimination of etiological factors, symptoms of the disease, normalization of masseteric...

  11. Effectiveness of neuromuscular electrical stimulation in the functional knee rehabilitation in soldiers

    OpenAIRE

    R. Castillo-Lozano

    2015-01-01

    Background: The versatility of military physical therapist practice enables them not only to diagnose knee injuries but also to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. The aim this study was to evaluate the effectiveness of interventions by Neuromuscular Electrical Stimulation (NMES) in the functional knee rehabilitation in soldiers and describe the main predictors and determinants in each intervention. Methods: A systematic search ...

  12. Comparative investigation of the pharmacology of fish and mammalian neuromuscular systems

    Energy Technology Data Exchange (ETDEWEB)

    Gant, D.B.

    1985-01-01

    Neuromuscular pharmacology has been extensively studied in mammals but there have been few investigations examining the neuromuscular systems of fish. In situ experiments have shown that the basic cholinergic characteristics of fish neuromuscular junctions are different from those of mammals. In order to further understand the nature of these differences, the nicotinic acetylcholine receptors (AChR) of rat and buffalo sculpin (Enophrys bison) neuromuscular junctions and the AChR of electric ray (Torpedo california) electroplax, were investigated using receptor binding analysis. A rapid filtration assay was utilized to measure (/sup 125/I)..cap alpha..-BGT binding to tissue membranes. Scatchard analysis of (/sup 175/I)..cap alpha..-BGT binding was performed on sculpin pectoral muscle rat gastrocnemius, rat denervated gastrocnemius, and Torpedo electroplax. The affinity constant was similar for all tissues studied. In competition studies, d-tubocurarine had the highest affinity for the (/sup 125/I)-..cap alpha..-BGT binding site in all tissues, illustrating the nicotinic nature of the binding sites. Acetylcholine had high affinity for the rat gastrocnemius binding site and low affinity for the sculpin pectoral muscle and Torpedo electroplax binding site. Atropine had high affinity for the sculpin pectoral muscle binding site when compared to the rate gastrocnemius and Torpedo electroplax binding site, indicating that the sculpin pectoral site may have some mixed muscarinic-nicitinic characteristics. These results indicate that there are definite qualitative as well as quantitative differences between the fish skeletal muscle nicotinic receptor and the nicotinic receptor of fish electroplax and rat skeletal muscle.

  13. Postnatal downregulation of inhibitory neuromuscular transmission to the longitudinal muscle of the guinea pig ileum.

    Science.gov (United States)

    Bian, X; Burda, J E; Carrasquillo, M; Galligan, J J

    2009-09-01

    Neuromuscular transmission is crucial for normal gut motility but little is known about its postnatal maturation. This study investigated excitatory/inhibitory neuromuscular transmission in vitro using ileal nerve-muscle preparations made from neonatal (nicotine (0.3-30 micromol L(-1)) contracted longitudinal muscle preparations in a tetrodotoxin (TTX) (0.3 micromol L(-1))-sensitive manner. The muscarinic receptor antagonist, scopolamine (1 micromol L(-1)), reduced substantially nicotine-induced contractions in neonatal tissues but not adult tissues. In the presence of N(omega)-nitro-l-arginine (NLA, 100 micromol L(-1)) to block nitric oxide (NO) mediated inhibitory neuromuscular transmission, scopolamine-resistant nicotine-induced contractions were revealed in neonatal tissues. NLA enhanced the nicotine-induced contractions in neonatal but not in adult tissues. Electrical field stimulation (20 V; 0.3 ms; 5-25 Hz, scopolamine 1 micromol L(-1) present) caused NLA and TTX-sensitive longitudinal muscle relaxations. Frequency-response curves in neonatal tissues were left-shifted compared with those obtained in adult tissues. Immunohistochemical studies revealed that NO synthase (NOS)-immunoreactivity (ir) was present in nerve fibres supplying the longitudinal muscle in neonatal and adult tissues. However, quantitative studies demonstrated that fluorescence intensity of NOS-ir nerve fibres was higher in neonatal than adult tissues. Nerve fibres containing substance P were abundant in longitudinal muscle in adult but not in neonatal tissues. Inhibitory neuromuscular transmission is relatively more effective in the neonatal guinea pig small intestine. Delayed maturation of excitatory motor pathways might contribute to paediatric motility disturbances.

  14. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2010-07-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  15. Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

    LENUS (Irish Health Repository)

    Weekes, G

    2012-02-01

    A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg\\/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg\\/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.

  16. Neuromuscular factors associated with decline in long-distance running performance in master athletes.

    Science.gov (United States)

    Brisswalter, Jeanick; Nosaka, Kazunori

    2013-01-01

    This review focuses on neuromuscular factors that may affect endurance performance in master athletes. During the last decade, due to the rapid increase in the number of master or veteran participants in endurance sporting competitions, many studies attempted to identify metabolic factors associated with the decrease in endurance, especially long-distance running performance with ageing, focusing on decreases in maximal oxygen consumption. However, neuromuscular factors have been less studied despite the well-known phenomena of strength loss with ageing. For master athletes to perform better in long-distance running events, it is important to reduce muscle fatigue and/or muscle damage, to improve locomotion efficiency and to facilitate recovery. To date, no consensus exists that regular endurance training is beneficial for improving locomotion efficiency, reducing muscle fatigue and muscle damage, and enhancing recovery capacity in master athletes. Some recent studies seem to indicate that master athletes have similar muscle damage to young athletes, but they require a longer recovery time after a long-distance running event. Further analyses of these parameters in master athletes require more experimental and practical interest from researchers and coaches. In particular, more attention should be directed towards the capacity to maintain muscle function with training and the role of neuromuscular factors in long-distance performance decline with ageing using a more cellular and molecular approach.

  17. Comparison of electromyography and kinemyography during recovery from non-depolarising neuromuscular blockade.

    Science.gov (United States)

    Stewart, P A; Freelander, N; Liang, S; Heller, G; Phillips, S

    2014-05-01

    In this study, two commercially available quantitative neuromuscular function monitoring techniques, electromyography (EMG) and kinemyography (KMG), were compared with respect to repeatability and accuracy during late recovery from neuromuscular blockade. Train-of-four (TOF) ratios were recorded in 30 patients using KMG and EMG at the adductor pollicis muscle. Measurements were taken on the same hand using the Datex-Ohmeda NeuroMuscular Transmission monitor (GE Healthcare, Helsinki, Finland). Instrumental precision was evaluated using the coefficient of repeatability, while accuracy was assessed using the bias and limits of agreement. The coefficients of repeatability were similar for both techniques (0.035 for KMG and 0.043 for EMG), indicating a similar level of precision. KMG overestimated the TOF ratios measured with EMG with a bias of 0.11 (95% limits of agreement: -0.13 to 0.35). At a TOF ratio of 0.90 the bias was 0.08 (95% limits of agreement: -0.08 to 0.25). This means that at a TOF ratio of 0.90 measured with KMG will be approximately equivalent to a TOF ratio of 0.80 measured with EMG at the adductor pollicis muscle, but it may indeed be as low as 0.65 or as high as 1.00. Therefore, TOF ratios measured by KMG and EMG cannot be used interchangeably.

  18. Exercise-induced dehydration does not alter time trial or neuromuscular performance.

    Science.gov (United States)

    Stewart, C J; Whyte, D G; Cannon, J; Wickham, J; Marino, F E

    2014-08-01

    This study examined the effect of exercise-induced dehydration by ~4% body mass loss on 5-km cycling time trial (TT) performance and neuromuscular drive, independent of hyperthermia. 7 active males were dehydrated on 2 occasions, separated by 7 d. Participants remained dehydrated (DEH, -3.8±0.5%) or were rehydrated (REH, 0.2±0.6%) over 2 h before completing the TT at 18-25 °C, 20-30% relative humidity. Neuromuscular function was determined before dehydration and immediately prior the TT. The TT started at the same core temperature (DEH, 37.3±0.3°C; REH, 37.0±0.2 °C (P>0.05). Neither TT performance (DEH, 7.31±1.5 min; REH, 7.10±1.3 min (P>0.05)) or % voluntary activation were affected by dehydration (DEH, 88.7±6.4%; REH, 90.6±6.1% (P>0.05)). Quadriceps peak torque was significantly elevated in both trials prior to the TT (Pperformance and neuromuscular function are not reduced by dehydration, independent of hyperthermia.

  19. Laminin-database v.2.0: an update on laminins in health and neuromuscular disorders.

    Science.gov (United States)

    Golbert, Daiane C F; Santana-van-Vliet, Eliane; Mundstein, Alex S; Calfo, Vicente; Savino, Wilson; de Vasconcelos, Ana Tereza R

    2014-01-01

    The laminin (LM)-database, hosted at http://www.lm.lncc.br, was published in the NAR database 2011 edition. It was the first database that provided comprehensive information concerning a non-collagenous family of extracellular matrix proteins, the LMs. In its first version, this database contained a large amount of information concerning LMs related to health and disease, with particular emphasis on the haemopoietic system. Users can easily access several tabs for LMs and LM-related molecules, as well as LM nomenclatures and direct links to PubMed. The LM-database version 2.0 integrates data from several publications to achieve a more comprehensive knowledge of LMs in health and disease. The novel features include the addition of two new tabs, 'Neuromuscular Disorders' and 'miRNA--LM Relationship'. More specifically, in this updated version, an expanding set of data has been displayed concerning the role of LMs in neuromuscular and neurodegenerative diseases, as well as the putative involvement of microRNAs. Given the importance of LMs in several biological processes, such as cell adhesion, proliferation, differentiation, migration and cell death, this upgraded version expands for users a panoply of information, regarding complex molecular circuitries that involve LMs in health and disease, including neuromuscular and neurodegenerative disorders.

  20. The role of laminins in the organization and function of neuromuscular junctions.

    Science.gov (United States)

    Rogers, Robert S; Nishimune, Hiroshi

    2017-01-01

    The synapse between motor neurons and skeletal muscle is known as the neuromuscular junction (NMJ). Proper alignment of presynaptic and post-synaptic structures of motor neurons and muscle fibers, respectively, is essential for efficient motor control of skeletal muscles. The synaptic cleft between these two cells is filled with basal lamina. Laminins are heterotrimer extracellular matrix molecules that are key members of the basal lamina. Laminin α4, α5, and β2 chains specifically localize to NMJs, and these laminin isoforms play a critical role in maintenance of NMJs and organization of synaptic vesicle release sites known as active zones. These individual laminin chains exert their role in organizing NMJs by binding to their receptors including integrins, dystroglycan, and voltage-gated calcium channels (VGCCs). Disruption of these laminins or the laminin-receptor interaction occurs in neuromuscular diseases including Pierson syndrome and Lambert-Eaton myasthenic syndrome (LEMS). Interventions to maintain proper level of laminins and their receptor interactions may be insightful in treating neuromuscular diseases and aging related degeneration of NMJs.

  1. Role of calcium and vesicle-docking proteins in remobilising dormant neuromuscular junctions in desert frogs.

    Science.gov (United States)

    Lavidis, Nickolas A; Hudson, Nicholas J; Choy, Peng T; Lehnert, Sigrid A; Franklin, Craig E

    2008-01-01

    Despite prolonged immobility the desert frog, Cyclorana alboguttata, suffers little impairment in muscle function. To determine compensatory mechanisms at neuromuscular junctions, transmitter release was examined along primary terminals in C. alboguttata iliofibularis muscle. Using extracellular recording we found the amplitudes of evoked endplate currents were significantly smaller in dormant frogs. In active frogs we identified two negatively sloping proximal-distal gradients of transmitter frequency and quantal content; a shallow proximal-distal gradient with low probability of transmitter release (0.6). During aestivation, only a shallow gradient was identified. The high probability release sites in control frogs were inhibited during aestivation by a mechanism that could be reversed by (1) increasing the extracellular calcium concentration, and (2) increasing the frequency of stimulation. This suggests that transmitter vesicles are available during aestivation but not released. We quantified expression of messenger RNA transcripts coding for the transmitter vesicle-docking proteins synaptotagmin 1, syntaxin 1B and UNC-13. All three were rare transcripts maintained at control values during aestivation. Neuromuscular remobilisation after dormancy in C. alboguttata is more likely a product of rapidly reversible physiologic mechanisms than reorganisations of the neuromuscular transcriptome.

  2. Treatment of neuromuscular scoliosis with posterior-only pedicle screw fixation

    Directory of Open Access Journals (Sweden)

    Fernandez Harry M

    2008-06-01

    Full Text Available Abstract Background To determine whether posterior-only approach using pedicle screws in neuromuscular scoliosis population adequately addresses the correction of scoliosis and maintains the correction over time. Methods Between 2003 and 2006, 26 consecutive patients (7 cerebral palsy, 10 Duchenne muscular dystrophy, 5 spinal muscular atrophy and 4 others with neuromuscular scoliosis underwent posterior pedicle screw fixation for the deformity. Preoperative, immediate postoperative and final follow-up Cobb's angle and pelvic obliquity were analyzed on radiographs. The average age of the patients was 17.5 years (range, 8–44 years and the average follow-up was 25 months (18–52 months. Results Average Cobb's angle was 78.53° before surgery, 30.70° after surgery (60.9% correction, and 33.06° at final follow-up (57.9% correction showing significant correction (p Conclusion Results indicate that in patients with neuromuscular scoliosis, acceptable amounts of curve correction can be achieved and maintained with posterior-only pedicle screw instrumentation without anterior release procedure.

  3. The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG)

    Science.gov (United States)

    Hornik, Alejandro; Guerch, Meziane; Veripuram, Anantha; Yerram, Sushma; Ardelt, Agnieszka

    2017-01-01

    Introduction. Myoclonus status epilepticus is independently associated with poor outcome in coma patients after cardiac arrest. Determining if myoclonus is of cortical origin on continuous electroencephalography (CEEG) can be difficult secondary to the muscle artifact obscuring the underlying CEEG. The use of a neuromuscular blocker can be useful in these cases. Methods. Retrospective review of CEEG in patients with postanoxic myoclonus who received cisatracurium while being monitored. Results. Twelve patients (mean age: 53.3 years; 58.3% male) met inclusion criteria of clinical postanoxic myoclonus. The initial CEEG patterns immediately prior to neuromuscular blockade showed myoclonic artifact with continuous slowing (50%), burst suppression with myoclonic artifact (41.7%), and continuous myogenic artifact obscuring CEEG (8.3%). After intravenous administration of cisatracurium (0.1 mg–2 mg), reduction in artifact improved quality of CEEG recordings in 9/12 (75%), revealing previously unrecognized patterns: continuous EEG seizures (33.3%), lateralizing slowing (16.7%), burst suppression (16.7%), generalized periodic discharges (8.3%), and, in the patient who had an initially uninterpretable CEEG from myogenic artifact, continuous slowing. Conclusion. Short-acting neuromuscular blockade is useful in determining background cerebral activity on CEEG otherwise partially or completely obscured by muscle artifact in patients with postanoxic myoclonus. Fully understanding background cerebral activity is important in prognostication and treatment, particularly when there are underlying EEG seizures. PMID:28265468

  4. The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG

    Directory of Open Access Journals (Sweden)

    Christopher R. Newey

    2017-01-01

    Full Text Available Introduction. Myoclonus status epilepticus is independently associated with poor outcome in coma patients after cardiac arrest. Determining if myoclonus is of cortical origin on continuous electroencephalography (CEEG can be difficult secondary to the muscle artifact obscuring the underlying CEEG. The use of a neuromuscular blocker can be useful in these cases. Methods. Retrospective review of CEEG in patients with postanoxic myoclonus who received cisatracurium while being monitored. Results. Twelve patients (mean age: 53.3 years; 58.3% male met inclusion criteria of clinical postanoxic myoclonus. The initial CEEG patterns immediately prior to neuromuscular blockade showed myoclonic artifact with continuous slowing (50%, burst suppression with myoclonic artifact (41.7%, and continuous myogenic artifact obscuring CEEG (8.3%. After intravenous administration of cisatracurium (0.1 mg–2 mg, reduction in artifact improved quality of CEEG recordings in 9/12 (75%, revealing previously unrecognized patterns: continuous EEG seizures (33.3%, lateralizing slowing (16.7%, burst suppression (16.7%, generalized periodic discharges (8.3%, and, in the patient who had an initially uninterpretable CEEG from myogenic artifact, continuous slowing. Conclusion. Short-acting neuromuscular blockade is useful in determining background cerebral activity on CEEG otherwise partially or completely obscured by muscle artifact in patients with postanoxic myoclonus. Fully understanding background cerebral activity is important in prognostication and treatment, particularly when there are underlying EEG seizures.

  5. Neuromuscular junctions are pathological but not denervated in two mouse models of spinal bulbar muscular atrophy.

    Science.gov (United States)

    Poort, Jessica E; Rheuben, Mary B; Breedlove, S Marc; Jordan, Cynthia L

    2016-09-01

    Spinal bulbar muscular atrophy (SBMA) is a progressive, late onset neuromuscular disease causing motor dysfunction in men. While the morphology of the neuromuscular junction (NMJ) is typically affected by neuromuscular disease, whether NMJs in SBMA are similarly affected by disease is not known. Such information will shed light on whether defective NMJs might contribute to the loss of motor function and represent a potential therapeutic target for treating symptoms of SBMA. To address this gap in information, the morphology of NMJs was examined in two mouse models of SBMA, a myogenic model that overexpresses wildtype androgen receptor (AR) exclusively in muscle fibres and a knockin (KI) model expressing a humanized mutant AR gene. The tripartite motor synapse consisting of motor nerve terminal, terminal Schwann cells (tSCs) and postsynaptic specialization were visualized and analysed using confocal microscopy. Counter to expectation, we found no evidence of denervation in either model, but junctions in both models show pathological fragmentation and an abnormal synaptophysin distribution consistent with functionally weak synapses. Neurofilament accumulations were observed only in the myogenic model, even though axonal transport dysfunction is characteristic of both models. The ultrastructure of NMJs revealed additional pathology, including deficits in docked vesicles presynaptically, wider synaptic clefts, and simpler secondary folds postsynaptically. The observed pathology of NMJs in diseased SBMA mice is likely the morphological correlates of defects in synaptic function which may underlie motor impairments associated with SBMA.

  6. Possible applications of Neuromuscular Taping in pain reduction in Multiple Sclerosis subject: a preliminary report

    Directory of Open Access Journals (Sweden)

    Carmine Berlingieri

    2016-12-01

    Full Text Available Pain is a common disabling symptom in patients with Multiple Sclerosis (MS. It has been indicated that pain prevalence in MS patients is between 29–86 %. It is evident that most MS patients requiring treatment will be also searching pain related treatments to assist in day to day activities. Neuropathic pain is a difficult symptom and is generally inadequately relieved even though different rehabilitative approaches may be used. Neuromuscular Taping inducing micro-movements by stimulating receptors in the skin has been described in literature as a possible intervention in neurological and orthopedic rehabilitation improving mobility and in pain reduction. The aim of this preliminary report was to analyze the effect and to evaluate the possible applications of Neuromuscular Taping (NMT in patients with MS in order to reduce pain in comparison to the Transcutaneous Electrical Nerve Stimulation (TENS and to physical rehabilitation treatment alone. We observed that NMT together with standard physical rehabilitation was able to reduce neuropathic pain to greater lengths, with statistically significant differences between pre and post treatment, compared to the other treatments evaluated. This study showed increased efficacy in pain reduction when NMT was applied to standard physical treatment in long standing pain conditions. Neuromuscular Taping may constitute a low cost treatment strategy for neuropathic pain conditions in MS.

  7. Acute and subchronic neuromuscular blocking characteristics of streptomycin: a comparison with neomycin.

    Science.gov (United States)

    Lee, C; deSilva, A J

    1979-05-01

    The characteristics of the neuromuscular block produced by streptomycin in vivo were studied on the sciatic-tibialis anterior nerve-muscle preparation of eight anaesthetized cats. The lungs of the animals were ventilated mechanically and normocarbia was maintained. During acute exposure to streptomycin (within 2 h), ED50 for blockade of the twitch was 56 (SEM +/- 5) mg kg-1 of the base. The characteristics of block were similar to those of neomycin-induced block in some aspects. There was absence of train-of-four fade and tetanic fade, partial sparing of the responses elicited at 10 Hz and 20 Hz, and total sparing of the 50 Hz tetanus, as well as the post-tetanic twitch. In contrast to neomycin-induced neuromuscular block, however, post-tetanic exhaustion was not observed and prolonged exposure to streptomycin (22-28 h) did not change the characteristics of the block. We conclude that, despite their chemical similarities, streptomycin and neomycin block neuromuscular transmission differently.

  8. Comparison of the Capacity of Different Jump and Sprint Field Tests to Detect Neuromuscular Fatigue.

    Science.gov (United States)

    Gathercole, Rob J; Sporer, Ben C; Stellingwerff, Trent; Sleivert, Gord G

    2015-09-01

    Different jump and sprint tests have been used to assess neuromuscular fatigue, but the test with optimal validity remains to be established. The current investigation examined the suitability of vertical jump (countermovement jump [CMJ], squat jump [SJ], drop jump [DJ]) and 20-m sprint (SPRINT) testing for neuromuscular fatigue detection. On 6 separate occasions, 11 male team-sport athletes performed 6 CMJ, SJ, DJ, and 3 SPRINT trials. Repeatability was determined on the first 3 visits, with subsequent 3 visits (0-, 24-, and 72-hour postexercise) following a fatiguing Yo-Yo running protocol. SPRINT performance was most repeatable (mean coefficient of variation ≤2%), whereas DJ testing (4.8%) was significantly less repeatable than CMJ (3.0%) and SJ (3.5%). Each test displayed large decreases at 0-hour (33 of 49 total variables; mean effect size = 1.82), with fewer and smaller decreases at 24-hour postexercise (13 variables; 0.75), and 72-hour postexercise (19 variables; 0.78). SPRINT displayed the largest decreases at 0-hour (3.65) but was subsequently unchanged, whereas SJ performance recovered by 72-hour postexercise. In contrast, CMJ and DJ performance displayed moderate (12 variables; 1.18) and small (6 variables; 0.53) reductions at 72-hour postexercise, respectively. Consequently, the high repeatability and immediate and prolonged fatigue-induced changes indicated CMJ testing as most suitable for neuromuscular fatigue monitoring.

  9. Neuromuscular onset succession of high level gymnasts during dynamic leg acceleration phases on high bar.

    Science.gov (United States)

    von Laßberg, Christoph; Rapp, Walter; Mohler, Betty; Krug, Jürgen

    2013-10-01

    In several athletic disciplines there is evidence that for generating the most effective acceleration of a specific body part the transfer of momentum should run in a "whip-like" consecutive succession of body parts towards the segment which shall be accelerated most effectively (e.g. the arm in throwing disciplines). This study investigated the question how this relates to the succession of neuromuscular activation to induce such "whip like" leg acceleration in sports like gymnastics with changed conditions concerning the body position and momentary rotational axis of movements (e.g. performing giant swings on high bar). The study demonstrates that during different long hang elements, performed by 12 high level gymnasts, the succession of the neuromuscular activation runs primarily from the bar (punctum fixum) towards the legs (punctum mobile). This demonstrates that the frequently used teaching instruction, first to accelerate the legs for a successful realization of such movements, according to a high level kinematic output, is contradictory to the neuromuscular input patterns, being used in high level athletes, realizing these skills with high efficiency. Based on these findings new approaches could be developed for more direct and more adequate teaching methods regarding to an earlier optimization and facilitation of fundamental movement requirements.

  10. Conservative treatment of neuromuscular scoliosis in adult tetraplegia: a case report.

    Science.gov (United States)

    Hastings, Jennifer D; Dickson, Julie; Tracy, Linsey; Baniewich, Christine; Levine, Cedar

    2014-12-01

    We report successful correction of new onset neuromuscular scoliosis without spinal surgery in a man who is 30-years post-American Spinal Injury Association Impairment Scale grade A C6 injury with new onset of left neuromuscular scoliosis (Cobb angle 45°) after a motor vehicle collision. Interventions included nightly low-load prolonged stretching (LLPS) (4h left side lying over bolster), a series of 6 botulinum toxin injections (BTIs) at 3-month intervals, and progressive seating adjustments to counteract the spinal curvature. Monthly seating adjustments included rear quadrant wedging, lateral supports, and hip blocking to promote erect and symmetrical posture. A normative Cobb angle (5°) was achieved after 8 months of treatment. Improvements in alignment were demonstrated in physical examination outcome measures at the final session and follow-up. LLPS, seating adjustments, and paraspinal BTI are nonsurgical options for treating neuromuscular scoliosis in adults with tetraplegia. Further studies are necessary to determine optimum protocols and examine generalizability of these treatment methods.

  11. Nonmuscle Myosin II helps regulate synaptic vesicle mobility at the Drosophila neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Qiu Xinping

    2010-03-01

    Full Text Available Abstract Background Although the mechanistic details of the vesicle transport process from the cell body to the nerve terminal are well described, the mechanisms underlying vesicle traffic within nerve terminal boutons is relatively unknown. The actin cytoskeleton has been implicated but exactly how actin or actin-binding proteins participate in vesicle movement is not clear. Results In the present study we have identified Nonmuscle Myosin II as a candidate molecule important for synaptic vesicle traffic within Drosophila larval neuromuscular boutons. Nonmuscle Myosin II was found to be localized at the Drosophila larval neuromuscular junction; genetics and pharmacology combined with the time-lapse imaging technique FRAP were used to reveal a contribution of Nonmuscle Myosin II to synaptic vesicle movement. FRAP analysis showed that vesicle dynamics were highly dependent on the expression level of Nonmuscle Myosin II. Conclusion Our results provide evidence that Nonmuscle Myosin II is present presynaptically, is important for synaptic vesicle mobility and suggests a role for Nonmuscle Myosin II in shuttling vesicles at the Drosophila neuromuscular junction. This work begins to reveal the process by which synaptic vesicles traverse within the bouton.

  12. Sex alters impact of repeated bouts of sprint exercise on neuromuscular activity in trained athletes.

    Science.gov (United States)

    Billaut, François; Smith, Kurt

    2009-08-01

    This study characterized the effect of sex on neuromuscular activity during repeated bouts of sprint exercise. Thirty-three healthy male and female athletes performed twenty 5-s cycle sprints separated by 25 s of rest. Mechanical work and integrated electromyograhs (iEMG) of 4 muscles of the dominant lower limb were calculated in every sprint. The iEMG signals from individual muscles were summed to represent overall electrical activity of these muscles (sum-iEMG). Neuromuscular efficiency (NME) was calculated as the ratio of mechanical work and sum-iEMG for every sprint. Arterial oxygen saturation was estimated (SpO2) with pulse oximetry throughout the protocol. The sprint-induced work decrement (18.9% vs. 29.6%; p women than for the men. However, the sprints decreased NME (10.1%; p men, R2 = 0.87; women, R2 = 0.91; all p sprint exercise is not likely to be explained by a difference in muscle contractility impairment in men and women, but may be due to a sex difference in muscle recruitment strategy. We speculate that women would be less sensitive to arterial O2 desaturation than men, which may trigger lower neuromuscular adjustments to exhaustive exercise.

  13. Studies on neuromuscular blockade by boldine in the mouse phrenic nerve-diaphragm.

    Science.gov (United States)

    Kang, J J; Cheng, Y W; Fu, W M

    1998-02-01

    The effects of boldine [(S)-2,9-dihydroxyl-1,10-dimethoxy-aporphine], a major alkaloid in the leaves and bark of Boldo (Peumus boldus Mol.), on neuromuscular transmission were studied using a muscle phrenic-nerve diaphragm preparation. Boldine at concentrations lower than 200 microM preferentially inhibited, after an initial period of twitch augmentation, the nerve-evoked twitches of the mouse diaphragm and left the muscle-evoked twitches unaffected. The twitch inhibition could be restored by neostigmine or washout with Krebs solution. The twitches evoked indirectly and directly were both augmented initially, suggesting that the twitch augmentation induced by boldine was myogenic. Boldine inhibited the acetylcholine-induced contraction of denervated diaphragm dose-dependently with an IC50 value of 13.5 microM. At 50 microM, boldine specifically inhibited the amplitude of the miniature end plate potential. In addition, boldine was similar to d-tubocurarine in its action to reverse the neuromuscular blocking action of alpha-bungarotoxin. These results showed that the neuromuscular blockade by boldine on isolated mouse phrenic-nerve diaphragm might be due to its direct interaction with the postsynaptic nicotinic acetylcholine receptor.

  14. Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis

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    Vishal Sarwahi

    2015-01-01

    Full Text Available Minimally invasive surgery (MIS has been described in the treatment of adolescent idiopathic scoliosis (AIS and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.

  15. Neuromuscular Junction Impairment in Amyotrophic Lateral Sclerosis: Reassessing the Role of Acetylcholinesterase

    Science.gov (United States)

    Campanari, Maria-Letizia; García-Ayllón, María-Salud; Ciura, Sorana; Sáez-Valero, Javier; Kabashi, Edor

    2016-01-01

    Amyotrophic Lateral Sclerosis (ALS) is a highly debilitating disease caused by progressive degeneration of motorneurons (MNs). Due to the wide variety of genes and mutations identified in ALS, a highly varied etiology could ultimately converge to produce similar clinical symptoms. A major hypothesis in ALS research is the “distal axonopathy” with pathological changes occurring at the neuromuscular junction (NMJ), at very early stages of the disease, prior to MNs degeneration and onset of clinical symptoms. The NMJ is a highly specialized cholinergic synapse, allowing signaling between muscle and nerve necessary for skeletal muscle function. This nerve-muscle contact is characterized by the clustering of the collagen-tailed form of acetylcholinesterase (ColQ-AChE), together with other components of the extracellular matrix (ECM) and specific key molecules in the NMJ formation. Interestingly, in addition to their cholinergic role AChE is thought to play several “non-classical” roles that do not require catalytic function, most prominent among these is the facilitation of neurite growth, NMJ formation and survival. In all this context, abnormalities of AChE content have been found in plasma of ALS patients, in which AChE changes may reflect the neuromuscular disruption. We review these findings and particularly the evidences of changes of AChE at neuromuscular synapse in the pre-symptomatic stages of ALS. PMID:28082868

  16. Alterações da junção neuromuscular em miopatias experimentais no camundongo

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    Luiz Fernando Bleggi Torres

    1989-06-01

    Full Text Available As alterações morfológicas observadas em junção neuromuscular de dois modelos de miopatia em camundongos são estudadas por métodos histoquímicos para demonstrar atividade da enzima acetilcolinesterase e por microscopia eletrônica. Em ambas as situações os resultados obtidos são similares, indicando que a junção neuromuscular permanece intacta mesmo quando a fibra que inerva está sofrendo necrose. Em fibras musculares regeneradas há acentuada simplificação das pregas pós-sinápticas, com redução de até 50% dos valores normais, comprovado por estudos morfométricos. A ausência de repercussões fisiológicas ou clínicas detectáveis nesses modelos, apesar da significativa hipotrofia da membrana pós-sináptica, sugere que a exuberante quantidade de pregas pós-sinápticas normalmente encontradas nas junções mioneürais pode representar mecanismo anatômico de segurança na transmissão química neuromuscular.

  17. Analgesia pós-operatória em correção cirúrgica de pé torto congênito: comparação entre bloqueio nervoso periférico e bloqueio peridural caudal Analgesia postoperatoria en corrección quirúrgica de pie jorobado congénito: comparación entre bloqueo nervioso periférico y bloqueo epidural caudal Postoperative analgesia for the surgical correction of congenital clubfoot: comparison between peripheral nerve block and caudal epidural block

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    Monica Rossi Rodrigues

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O procedimento de correção de pé torto congênito (PTC cursa com dor pós-operatória intensa. A técnica mais utilizada em crianças é a peridural caudal associada à anestesia geral. Tem como limitação a curta duração da analgesia pós-operatória. Os bloqueios de nervos periféricos têm sido apontados como procedimentos com baixa incidência de complicações e tempo prolongado de analgesia. O objetivo do estudo foi comparar o tempo de analgesia dos bloqueios nervosos periféricos e bloqueio caudal e o consumo de morfina nas primeiras 24 horas após a correção de PTC em crianças. MÉTODO: Estudo randômico, encoberto, em crianças submetidas à intervenção cirúrgica para liberação póstero-medial de PTC, alocadas em 4 grupos conforme a técnica anestésica: Caudal (ACa; Bloqueios isquiático e femoral (IF; Bloqueios isquiático e safeno (IS; Bloqueio isquiático e anestesia local (IL, associados à anestesia geral. Nas primeiras 24 horas os pacientes receberam dipirona e paracetamol via oral e foram avaliados por anestesiologista que desconhecia a técnica empregada. Conforme escores da escala CHIPPS (Children's and infants postoperative pain scale era administrada morfina via oral (0,19 mg.kg-1 por dia. RESULTADOS: Foram estudadas 118 crianças distribuídas nos grupos ACa (30, IF (32, IS (28 IL (28. O tempo médio entre o bloqueio e a primeira dose de morfina foi 6,16 horas no grupo ACa, 7,05 horas no IF, 7,58 horas no IS e 8,18 horas no IL. O consumo de morfina foi 0,3 mg.kg-1 por dia nos quatro grupos. Não houve diferença significativa entre os grupos. CONCLUSÕES: Os bloqueios nervosos periféricos não promoveram maior tempo de analgesia, tampouco redução no consumo de morfina nas primeiras 24 horas em crianças submetidas à correção de PTC quando comparados ao bloqueio peridural caudal.JUSTIFICATIVA Y OBJETIVOS: El procedimiento de corrección de pie jorobado congénito (PJC, debuta

  18. Resistência de painéis aglomerados produzidos com diferentes proporções de madeira e casca de arroz a fungos e cupins xilófagos

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    Rafael Rodolfo de Melo

    2010-09-01

    Full Text Available Foi avaliada a resistência a fungos apodrecedores e a cupins subterrâneos de painéis aglomerados produzidos com diferentes proporções de madeira e casca de arroz. As chapas foram produzidas utilizando a madeira de Eucalyptus grandis com a inclusão de casca de arroz nas proporções de 0, 20, 40, 60, 80 e 100%, utilizando como aglutinante as resinas uréia-formaldeído e tanino-formaldeído. Os resultados obtidos indicaram que, painéis produzidos com casca de arroz geralmente apresentam maior resistência ao ataque de fungos apodrecedores e aos cupins subterrâneos. Painéis colados com tanino-formaldeído foram mais resistentes ao ataque dos térmitas, enquanto que, para os fungos, foi detectada diferença significativa entre o efeito dos adesivos apenas quando submetidas ao ataque de Gloeophyllum trabeum, sendo as chapas produzidas com uréia-formaldeído as mais resistentes. Dentre os fungos, Trametes versicolor proporcionou uma maior perda de massa aos painéis.

  19. Biobank of Cells, Tissues and DNA from Patients with Neuromuscular Diseases: An Indispensable link between Clinical Centers and the Scientific Community

    OpenAIRE

    Mora, Marina; Bragato, Cinzia; Gibertini, Sara; Zanotti, Simona; Curcio, Maurizio; Canioni, Eleonora; Salerno, Franco; Blasevich, Flavia; Saredi, Simona; Ruggieri, Alessandra; Pasanisi, Maria Barbara; Bernasconi, Pia; Maggi, Lorenzo; Mantegazza, Renato; Andreetta, Francesca

    2017-01-01

    The Biobank was established in 1986 as part of the routine diagnostic activity of the Division of Neuromuscular Diseases and Neuroimmunology, of the Carlo Besta Neurological Institute. It stores muscle tissue, cells and DNA from patients with neuromuscular diseases.The biobank provides samples as a service to the scientific community conducting research on neuromuscular disorders. Samples are from patients affected by different forms of muscular dystrophy, including the severe congenital and ...

  20. Caffeine ingestion reverses the circadian rhythm effects on neuromuscular performance in highly resistance-trained men.

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    Ricardo Mora-Rodríguez

    Full Text Available PURPOSE: To investigate whether caffeine ingestion counteracts the morning reduction in neuromuscular performance associated with the circadian rhythm pattern. METHODS: Twelve highly resistance-trained men underwent a battery of neuromuscular tests under three different conditions; i morning (10:00 a.m. with caffeine ingestion (i.e., 3 mg kg(-1; AM(CAFF trial; ii morning (10:00 a.m. with placebo ingestion (AM(PLAC trial; and iii afternoon (18:00 p.m. with placebo ingestion (PM(PLAC trial. A randomized, double-blind, crossover, placebo controlled experimental design was used, with all subjects serving as their own controls. The neuromuscular test battery consisted in the measurement of bar displacement velocity during free-weight full-squat (SQ and bench press (BP exercises against loads that elicit maximum strength (75% 1RM load and muscle power adaptations (1 m s(-1 load. Isometric maximum voluntary contraction (MVC(LEG and isometric electrically evoked strength of the right knee (EVOK(LEG were measured to identify caffeine's action mechanisms. Steroid hormone levels (serum testosterone, cortisol and growth hormone were evaluated at the beginning of each trial (PRE. In addition, plasma norepinephrine (NE and epinephrine were measured PRE and at the end of each trial following a standardized intense (85% 1RM 6 repetitions bout of SQ (POST. RESULTS: In the PM(PLAC trial, dynamic muscle strength and power output were significantly enhanced compared with AM(PLAC treatment (3.0%-7.5%; p≤0.05. During AM(CAFF trial, muscle strength and power output increased above AM(PLAC levels (4.6%-5.7%; p≤0.05 except for BP velocity with 1 m s(-1 load (p = 0.06. During AM(CAFF, EVOK(LEG and NE (a surrogate of maximal muscle sympathetic nerve activation were increased above AM(PLAC trial (14.6% and 96.8% respectively; p≤0.05. CONCLUSIONS: These results indicate that caffeine ingestion reverses the morning neuromuscular declines in highly resistance

  1. Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses Efectos neuromusculares y cardiovasculares del pipecuronio: estudio comparativo entre diferentes dosis Neuromuscular and cardiovascular effects of pipecuronium: a comparative study between different dose

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    Angélica de Fátima de Assunção Braga

    2008-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O pipecurônio é um bloqueador neuromuscular não-despolarizante, com propriedades similares as do pancurônio, mas desprovido de efeitos cardiovasculares. Foram avaliados os efeitos neuromusculares, as condições de intubação traqueal e as repercussões hemodinâmicas de duas diferentes doses de pipecurônio. MÉTODO: Pacientes foram distribuídos em dois grupos de acordo com a dose de pipecurônio: Grupo I (0,04 mg.kg-1 e Grupo II (0,05 mg.kg-1. A medicação pré-anestésica consistiu em midazolam (0,1 mg.kg-1 por via muscular, 30 minutos antes da operação. A indução anestésica foi obtida com propofol (2,5 mg.kg-1 precedido de fentanil (5 µg.kg-1 e pipecurônio nas doses de 0,04 e 0,05 mg.kg-1 para os Grupos I e II, respectivamente. Os pacientes foram ventilados com O2 a 100% sob máscara até a redução de 75% da amplitude da resposta a estímulo isolado (1 Hz, quando foram realizadas a laringoscopia e intubação traqueal. O isoflurano (0,5 a 1% em mistura de O2 e N(20 a 50% para a manutenção da anestesia, foi introduzido logo após a intubação traqueal. Os pacientes foram ventilados mecanicamente para manter P ET CO2 entre 32 e 36 mmHg. A farmacodinâmica do pipecurônio foi avaliada por aceleromiografia. RESULTADOS: Os tempos médios e desvios-padrão para o início de ação, duração clínica (T1(25% e índice de recuperação (T1(25-75% foram: Grupo I (122,10 ± 4,18 s, 49,63 ± 9,54 min e 48,21 ± 6,72 min e Grupo II (95,78 ± 8,91 s, 64,84 ± 13,13 min e 48,52 ± 4,95 min. O início de ação, a duração clínica e as condições de intubação traqueal foram significativamente diferentes entre os grupos. CONCLUSÕES: O pipecurônio na dose 0,05 mg.kg-1 pode ser usado em procedimentos de longa duração, nos quais é desejável evitar alterações cardiocirculatórias.JUSTIFICATIVA Y OBJETIVOS: El pipecuronio es un bloqueador neuromuscular no despolarizador, con propiedades similares a las

  2. Neuromuscular adaptations predict functional disability independently of clinical pain and psychological factors in patients with chronic non-specific low back pain.

    Science.gov (United States)

    Dubois, Jean-Daniel; Abboud, Jacques; St-Pierre, Charles; Piché, Mathieu; Descarreaux, Martin

    2014-08-01

    Patients with chronic low back pain exhibit characteristics such as clinical pain, psychological symptoms and neuromuscular adaptations. The purpose of this study was to determine the independent contribution of clinical pain, psychological factors and neuromuscular adaptations to disability in patients with chronic low back pain. Clinical pain intensity, pain catastrophizing, fear-avoidance beliefs, anxiety, neuromuscular adaptations to chronic pain and neuromuscular responses to experimental pain were assessed in 52 patients with chronic low back pain. Lumbar muscle electromyographic activity was assessed during a flexion-extension task (flexion relaxation phenomenon) to assess both chronic neuromuscular adaptations and neuromuscular responses to experimental pain during the task. Multiple regressions showed that independent predictors of disability included neuromuscular adaptations to chronic pain (β=0.25, p=0.006, sr(2)=0.06), neuromuscular responses to experimental pain (β=-0.24, p=0.011, sr(2)=0.05), clinical pain intensity (β=0.28, p=0.002, sr(2)=0.08) and psychological factors (β=0.58, ppain intensity and psychological factors, and contribute to inter-individual differences in patients' disability. This suggests that disability, in chronic low back pain patients, is determined by a combination of factors, including clinical pain, psychological factors and neuromuscular adaptations.

  3. Viabilidade do inoculante turfoso produzido com bactérias associativas e molibdênio Viability of peat inoculum produced with associative bacteria and molybdenum

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    Salomão Lima Guimarães

    2013-03-01

    Full Text Available Dentre os veículos de inoculação de bactérias diazotróficas, o turfoso é considerado o mais utilizado no Brasil. A turfa possibilita a viabilidade de um grande número de células, protegendo-as também das adversidades do solo. O objetivo deste trabalho foi avaliar a viabilidade do inoculante turfoso desenvolvido com bactérias diazotróficas associativas e molibdênio. As bactérias BR11417 (Herbaspirillum seropedicae e BR11340 (Burkholderia sp., foram multiplicadas por um período de 24 horas e uma alíquota de 10 mL com 10(8 cel. mL-1 foi transferida para sacos de polipropileno contendo 35 g de turfa. Foram adicionadas duas doses e duas fontes de molibdênio: 1,12 e 2,25 g de molibdato de sódio e de amônio, respectivamente. Como controle, foi utilizado o inoculante sem molibdênio. A legislação brasileira, por meio da lei n° 86955, especifica que os inoculantes comerciais à base de micro-organismos fixadores de nitrogênio apresentem concentrações mínimas de 10(8 células viáveis por grama do produto no momento do uso e que a viabilidade das células seja mantida por um período mínimo de seis meses. Este estudo mostrou que sem a adição do molibdênio ao inoculante, as bactérias sobreviveram com um número de células viáveis em torno de 10(8 células g-1 de inoculante, por um período de até 110 dias. Com a adição do molibdênio, o inoculante manteve-se viável por um período de 180 dias. A aplicação do molibdênio contribui para o aumento da viabilidade do inoculante turfoso produzido com as estirpes BR11417 e BR11340.Among the vehicles in use for diazotroph inoculation, peat is considered the most-widely used in Brazil. Peat makes possible the viability of a large number of cells, at the same time protecting them from adversities found in the soil. The objective of this study was to evaluate the viability of peat inoculum developed with diazotroph bacteria and molybdenum. The bacteria BR11417 (Herbaspirillum

  4. Bloqueio do nervo maxilar para redução de fraturas do osso zigomático e assoalho da órbita Bloqueo del nervio maxilar para reducción de fracturas del hueso zigomático y suelo de la órbita Maxillary nerve block for zygoma and orbital floor fractures reduction

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    Karl Otto Geier

    2003-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Poucos relatos existem sobre redução de fraturas da órbita zigomática e do arco zigomático sob anestesia regional. O objetivo deste estudo é verificar a qualidade do bloqueio do nervo maxilar por via extraoral, para redução de fraturas do osso zigomático e do assoalho da órbita. MÉTODO: Quinze pacientes foram submetidos à bloqueio do nervo maxilar pela técnica de Moore (abordagem infrazigomática para redução de fraturas isoladas do arco zigomático (oito pacientes e associadas ao assoalho da órbita (sete pacientes. Nenhum paciente recebeu medicação pré-anestésica. Após sedação e anestesia local com 2 ml de lidocaína a 1,5% com adrenalina a 1:300.000, o nervo maxilar foi abordado com 8 ml da mesma solução anestésica através de uma agulha 22G, 10 cm de comprimento de ponta romba. Foram avaliados: o tempo de bloqueio, a latência, o tempo de analgesia, a incidência de falhas, a necessidade de anestesia geral e as complicações. RESULTADOS: Os primeiros três bloqueios foram difíceis, resultando em dois bloqueios parciais e uma falha. Os restantes foram efetivos e os pacientes não referiram nenhum desconforto ou dor durante o bloqueio e a cirurgia. O tempo para a realização do bloqueio variou de 5 a 20 minutos, enquanto a latência anestésica ficou entre 3 e 10 minutos. Foram registradas 7 ocorrências de punção vascular, porém sem relatos de formação de hematomas. CONCLUSÕES: Redução de fraturas zigomáticas são factíveis sob bloqueio do nervo maxilar, quando realizadas na fossa ptérigo palatina, permitindo anestesia de seus dois ramos distais, nervo zigomático-temporal e nervo zigomático-frontal.JUSTIFICATIVA Y OBJETIVOS: Pocos relatos existen sobre reducción de fracturas de la órbita zigomática y del arco zigomático bajo anestesia regional. El objetivo de este estudio es confirmar la calidad del bloqueo del nervio maxilar por vía extraoral, para reducción de

  5. Bupivacaine 0,25% versus ropivacaine 0,25% in brachial plexus block in dogs of beagle breedBupivacaína 0,25% versus ropivacaína 0,25% no bloqueio do plexo braquial em cães da raça beagle

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    Thiago Ignácio Wakoff

    2013-06-01

    Full Text Available The brachial plexus block (BPB is a regional anesthesia technique which enables the attainment of surgical procedures distal scapulohumeral articulation. This study aimed to compare the efficacy of ropivacaine and bupivacaine 0.25% without vasoconstrictor in BPB guided by electrical stimulation in dogs. Thirteen male and female beagle dogs underwent a BPB using bupivacaine and ropivacaine 0.25% (4mg/kg, both alone and in different times. The anesthesic block was performed in the right forelimb and as control group the block proceeded in the left forelimb using a solution of sodium chloride 0.9% in volume corresponding to the drug in the contralateral limb. The block was performed after the localization of the radial nerve with the aid of eletrical stimulation, which was infiltrated half the volume of anesthetic calculated and subsequently the remaining solution was administered on the median nerve. We evaluated sensitive and motor latencies and sensitive and motor block total time by clamping technique. In the present study, a technique for electrical stimulation was effective in 100% of animals. Bupivacaine had lower motor latency period, however, the sensitive latency between the two groups showed no statistically significant differences. In the block total time, bupivacaine obtained time significantly higher. Clinical signs characteristic of Horner’s syndrome were present in 15% of animals treated with bupivacaine. Furthermore, two animals presented signs of cardiotoxicity in bupivacaine group. The use of bupivacaine (4mg/kg without vasoconstrictor in dogs brachial plexus block provided longer analgesia and motor blockade, however, ropivacaine at the same dose and concentration was found to be free of deleterious effects associated of cardiovascular instability, hemodynamic and respiratory. O bloqueio do plexo braquial (BPB é uma técnica de anestesia regional que possibilita a realização de procedimentos cirúrgicos distais a articula

  6. Evaluation of two regional anesthetic methods on the front limb of dogs using hyperbaric bupivacaine Avaliação de dois métodos de bloqueios anestésicos regionais no membro anterior em cães usando bupivacaína hiperbárica

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    Gustavo Guerino Macedo

    2010-06-01

    Full Text Available PURPOSE: To evaluate the effects of bupivacaine 0.5 and 0.25% in intravenous regional anesthesia (IVRA and brachial plexus block (BPB, respectively, on anesthesia, motor block and cardiovascular parameters in dogs. METHODS: Fourteen healthy adult dogs averaging 10 kilograms (kg of body weight. Animals were randomly assigned to receive one of the two treatments IVRA (n=7 or BPB (n=7. All the animals were sedated with acepromazine (0.1 mg/kg intramuscular. To execute the BPB was used an electrical nerve stimulation. Anesthesia, motor block, sedation, cardiovascular and respiratory effects were measured as effect of the treatment. RESULTS: BPA showed superior efficiency and duration of anesthesia (BPB - 456 ± 94 minutes vs IVRA - 138 ± 44 as well as motor block. There only physiologic parameter which change were the systolic pressure in BPB and respiratory rate for both treatments. CONCLUSION: In dogs the 0.25 % hyperbaric bupivacaine in BPB produces a front limb anesthesia about three times more than the 0.5 % in IVRA, with ptosis of the limb blocked and little interference in the cardiovascular system but with decrease in respiratory rate.OBJETIVO: Avaliar os efeitos da bupivacaína 0,5 e 0,25 % na anestesia regional endovenosa (IVRA e no bloqueio do plexo braquial (BPB respectivamente, na anestesia, bloqueio motor e parâmetros cardiovasculares em cães. MÉTODOS: Foram utilizados 14 cães sadios adultos pesando em média 10 kilos. Animais foram aleatoriamente designados a um de dois tratamentos IVRA (n = 7 ou BPB (n = 7. Todos os animais foram sedados com acepromazina (0,1 mg/kg intramuscular. Para realizar o BPB foi usado um estimulador elétrico nervoso. Anestesia, bloqueio motor, sedação, efeitos cardiovascular e respiratório foram mensurados como efeitos dos respectivos bloqueios. RESULTADOS: O bloqueio BPB demonstrou eficiência superior e maior duração da anestesia (BPB - 456 ± 94 minutos vs IVRA - 138 ± 44 minutos bem como maior

  7. Manejo de longo prazo em crianças com transtornos neuromusculares Long-term management of children with neuromuscular disorders

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    Eugen-Matthias Strehle

    2009-10-01

    Full Text Available OBJETIVO: A distrofia muscular de Duchenne é o tipo mais comum de miopatia genética. Contudo, existe um grande número de doenças neuromusculares hereditárias que são individualmente muito raras e sobre as quais não há muita informação clínica disponível. Este artigo de revisão baseia-se na experiência do autor em uma clínica pediátrica para tratamento de doenças musculares e apresenta orientação prática e planos terapêuticos para os problemas frequentemente encontrados. FONTES DE DADOS: O banco de dados da MEDLINE foi pesquisado com o objetivo de localizar artigos recentes e relevantes para o manejo de crianças com miopatias e neuropatias hereditárias. Uma coorte de 200 pacientes foi avaliada através de análise estatística descritiva. SÍNTESE DOS DADOS: A distrofia muscular de Duchenne representou quase metade dos diagnósticos, seguida da atrofia muscular espinhal (12%, da distrofia muscular de Becker e da distrofia miotônica (7% cada. Dezesseis pacientes (9% apresentaram miopatia de origem desconhecida. CONCLUSÕES: Assim como ocorre com outras doenças crônicas, esses pacientes devem passar por acompanhamento periódico realizado por profissionais de saúde desde cedo para aumentar sua expectativa de vida e melhorar sua qualidade de vida. É útil para os médicos adotarem uma abordagem estruturada ao atender crianças com transtornos neuromusculares e monitorar todos os sistemas de órgãos afetados.OBJECTIVE: Duchenne muscular dystrophy is the commonest genetic myopathy but there exist a large number of inherited neuromuscular diseases which individually are very rare and where clinical information is not widely available. This review is based on the author's experience in a pediatric muscle clinic and provides practical guidance and treatment plans for frequently encountered problems. SOURCES: A MEDLINE search was conducted to retrieve recent articles relevant to the management of children with

  8. Comparação da anestesia geral e bloqueio do plexo cervical superficial em tireoidectomias parciais Comparison between general anesthesia and superficial cervical plexus block in partial thyroidectomies

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    Rui Celso Martins Mamede

    2008-02-01

    Full Text Available Tireoidectomia sob efeito de bloqueio do plexo cervical superficial (BPCS tem sofrido resistência. OBJETIVO: Comparar variáveis cirúrgicas e anestésicas, custos do tratamento e grau de satisfação de pacientes submetidos à hemitireoidectomia sob efeito de anestesia geral e BPCS. CASUÍSTICA E MÉTODOS: Foram 21 pacientes submetidos à anestesia geral (AG e outro tanto ao BPCS. Após sedação, no grupo com BPCS, usou-se marcaína com vasoconstritor, e quando necessário, lidocaína a 2% com vasoconstritor. Sedação intra-operatória com diazepam endovenoso e metoprolol para controle da PA e FC eram administradas quando necessário. Usou-se anestesia geral (AG segundo padronização do serviço. RESULTADOS: Foram significantes (pThyroidectomy under the effect of superficial cervical plexus block (SCPB has met resistance. AIM: to compare variables in patients submitted to hemithyroidectomy under the effect of general anesthesia (GA and SCPB. CASE REPORT AND METHODS: GA was used in 21 patients, and SCPB was used in another 21 patients. Following sedation, marcaine 0.5% with vasoconstrictor was used in the SCPB group. Intraoperative sedation with diazepam and metoprolol to control arterial pressure and cardiac frequency was given as needed. GA followed the standard method in the unit. RESULTS: We found significant results (p<0.05, Student’s t-test for surgery time (GA - 111.4 min; SCPB - 125.5 min, anesthesia time (GA - 154.1 min; SCPB - 488.6 min, time in the surgery room (GA - 15 min; SCPB - 1 min, treatment costs (GA - R$203.2; SCPB - R$87.4, presence of bradycardia (GA - 0; SCPB - 23.8% and laryngotracheal injury (GA - 51; SCPB - 0 %. We also found the following non-significant results: hospitalization time (GA - 17.3; SCPB - 15.1 hours; bleeding volume (GA - 41,9 g; SCPB - 47.6 g, size of the operative specimen (GA - 52.1 cm3; SCPB - 93.69 cm3 and patient satisfaction level (GA - 3.8; SCPB - 3.9. CONCLUSION: Although the incidence of

  9. Bloqueio do plexo braquial por via supraclavicular: estudo clínico comparativo entre bupivacaína e levobupivacaína Bloqueo del plexo braquial por vía supraclavicular: estudio clínico comparativo entre bupivacaína y levobupivacaína Supraclavicular brachial plexus block: a comparative clinical study between bupivacaine and levobupivacaine

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    José Ricardo Pinotti Pedro

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio de plexo braquial é técnica anestésica utilizada para procedimentos em membros superiores. O plexo braquial é território potencial para absorção de anestésicos locais. Estudos dos estereoisômeros da bupivacaína vêm demonstrando menor potencial de toxicidade da fração levógira (levobupivacaína sobre o sistema cardiovascular. Porém, é discutida a eficácia anestésica (bloqueio sensitivo e motor da levobupivacaína em anestesia do neuroeixo. Este estudo visa demonstrar a eficácia anestésica da levobupivacaína, comparandoa com a bupivacaína racêmica em bloqueio de plexo braquial, via perivascular subclávia. MÉTODO: Cinquenta pacientes adultos de ambos os sexos, ASA I e II, foram submetidos à anestesia de plexo braquial via perivascular subclávia para procedimentos ortopédicos de membros superiores, com auxílio de neuroestimulador. Foram divididos de modo aleatório em dois grupos: G BUPI - bupivacaína racêmica e G LEVO - levobupivacaína, num volume de 30 mL a 0,5%. O bloqueio sensitivo foi avaliado pelo método de "picada de agulha" nos metâmeros de C5 a C8; e o bloqueio motor, nos intervalos em minutos 1, 2, 5, 10, 15, 20, 25, 30 ou até instalação do bloqueio em movimentos dos dedos, mão, antebraço e braço. RESULTADOS: Não houve diferença estatística entre os dois grupos quanto à latência, incidência de falhas e grau do bloqueio motor, bem como incidência de falhas do bloqueio sensitivo, mas verificou-se diferença estatística da latência do bloqueio sensitivo em todos os metâmeros analisados. Não houve efeitos adversos inerentes à aplicação do anestésico local. CONCLUSÕES: A levobupivacaína demonstrou eficácia anestésica em bloqueio de plexo braquial, equiparável à solução racêmica usualmente empregada.JUSTIFICATIVA Y OBJETIVOS: El bloqueo de plexo braquial es la técnica anestésica utilizada para procedimientos en miembros superiores. El plexo

  10. The response of cortical alpha activity to pain and neuromuscular changes caused by exercise-induced muscle damage.

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    Plattner, K; Lambert, M I; Tam, N; Baumeister, J

    2014-02-01

    Exercise-induced muscle damage (EIMD) is characterized by pain, swelling, and shortening of the muscle; increased serum creatine kinase; decreased force output; and altered neuromuscular function. The aim of this study was to investigate the effects of EIMD to determine the relationship between the peripheral symptoms, neuromuscular changes, and delayed pain sensation during a submaximal movement of the biceps brachii on cortical alpha (α) activity. In contrast to the control (n = 12) group, the experimental (n = 16) group participated in an EIMD protocol, and both groups were monitored for 132 h post-EIMD protocol. At 12 h, neuromuscular functioning was already disturbed while the sensation of pain was perceived, but not fully developed. Muscle pain scores in the experimental group peaked after 36 h with the lowest torque reported at 12 h. α-1 activity increased significantly in the motor and somatosensory area 12 h post-EIMD while α-2 activity increased in the contralateral fronto-central area. At 36 h, pain had further increased and neuromuscular function improved while α-1 and α-2 activities had decreased. We hypothesize that α-1 activity over the motor and somatosensory cortex of the experimental group displays a compensatory increase in response to the changes in neuromuscular function during movement, while an increase in α-2 activity is related to the suppression of pain experienced within the first 12 h.

  11. Biomechanical and neuromuscular characteristics of male athletes: implications for the development of anterior cruciate ligament injury prevention programs.

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    Sugimoto, Dai; Alentorn-Geli, Eduard; Mendiguchía, Jurdan; Samuelsson, Kristian; Karlsson, Jon; Myer, Gregory D

    2015-06-01

    Prevention of anterior cruciate ligament (ACL) injury is likely the most effective strategy to reduce undesired health consequences including reconstruction surgery, long-term rehabilitation, and pre-mature osteoarthritis occurrence. A thorough understanding of mechanisms and risk factors of ACL injury is crucial to develop effective prevention programs, especially for biomechanical and neuromuscular modifiable risk factors. Historically, the available evidence regarding ACL risk factors has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes. Therefore, the principal purpose of this article was to review existing evidence regarding the investigation of biomechanical and neuromuscular characteristics that may imply aberrant knee kinematics and kinetics that would place the male athlete at risk of ACL injury. Biomechanical evidence related to knee kinematics and kinetics was reviewed by different planes (sagittal and frontal/coronal), tasks (single-leg landing and cutting), situation (anticipated and unanticipated), foot positioning, playing surface, and fatigued status. Neuromuscular evidence potentially related to ACL injury was reviewed. Recommendations for prevention programs for ACL injuries in male athletes were developed based on the synthesis of the biomechanical and neuromuscular characteristics. The recommendations suggest performing exercises with multi-plane biomechanical components including single-leg maneuvers in dynamic movements, reaction to and decision making in unexpected situations, appropriate foot positioning, and consideration of playing surface condition, as well as enhancing neuromuscular aspects such as fatigue, proprioception, muscle activation, and inter-joint coordination.

  12. Análise físico-química dos méis das abelhas Apis mellifera e Melipona scutellaris produzidos em regiões distintas no Estado da Paraíba

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    Evangelista-Rodrigues Adriana

    2005-01-01

    Full Text Available O mel de abelhas é um produto muito apreciado, no entanto, de fácil adulteração com açúcares ou xaropes. Desta forma, é necessário que haja algumas análises para a determinação da sua qualidade para que seja comercializado. Este trabalho teve como objetivo fazer a análise físico-química dos méis de abelha Apis mellifera. e Melipona scutellaris para a comparação entre as espécies e entre as localidades do Brejo e do Cariri (regiões do Estado da Paraíba. Observou-se que o mel de abelha nativa apresenta um maior teor de água (umidade de 25,25% quando comparado com o mel de abelha africanizada (18,76%, dificultando o seu armazenamento, pois o alto teor de água do produto diminui a sua vida útil de prateleira. Para as análises de hidroximetilfurfural, o valor mais alto foi para o mel produzido na região do Cariri, quando comparado com o mel produzido na região do Brejo, o que pode ser explicado pela diferença de temperatura, sendo mais alta no Cariri. Para os valores de pH, obteve-se diferença significativa entre os méis, com o mel do Cariri apresentando valor mais baixo (3,8. Para Acidez Total, o mel de abelha africanizada do Brejo Paraibano apresentou 41,6 meq/kg de mel, enquanto o mel de abelha nativa apresentou 28,3 meq/kg de mel. Para os demais parâmetros estudados, não houve diferença significativa entre os tratamentos. Conclui-se que os méis produzidos pelas abelhas africanizadas (A. mellifera e pela abelha nativa Melipona scutellaris na Estação Experimental do Cariri e da Chã-de-Jardim pertencentes ao CCA/UFPB apresentam valores diferentes dos padrões da Regulamento Técnico de Identidade e Qualidade do Mel (Ministério da Agricultura e do Abastecimento para alguns parâmetros, o que pode dificultar o seu armazenamento por um longo período.

  13. Pathophysiological actions of neuropathy-related anti-ganglioside antibodies at the neuromuscular junction.

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    Plomp, Jaap J; Willison, Hugh J

    2009-08-15

    The outer leaflet of neuronal membranes is highly enriched in gangliosides. Therefore, specific neuronal roles have been attributed to this family of sialylated glycosphingolipids, e.g. in modulation of ion channels and transporters, neuronal interaction and recognition, temperature adaptation, Ca(2+) homeostasis, axonal growth, (para)node of Ranvier stability and synaptic transmission. Recent developmental, ageing and injury studies on transgenic mice lacking subsets of gangliosides indicate that gangliosides are involved in maintenance rather than development of the nervous system and that ganglioside family members are able to act in a mutually compensatory manner. Besides having physiological functions, gangliosides are the likely antigenic targets of autoantibodies present in Guillain-Barré syndrome (GBS), a group of neuropathies with clinical symptoms of motor- and/or sensory peripheral nerve dysfunction. Antibody binding to peripheral nerves is thought to either interfere with ganglioside function or activate complement, causing axonal damage and thereby disturbed action potential conduction. The presynaptic motor nerve terminal at the neuromuscular junction (NMJ) may be a prominent target because it is highly enriched in gangliosides and lies outside the blood-nerve barrier, allowing antibody access. The ensuing neuromuscular synaptopathy might contribute to the muscle weakness in GBS patients. Several groups, including our own, have studied the effects of anti-ganglioside antibodies in ex vivo and in vivo experimental settings at mouse NMJs. Here, after providing a background overview on ganglioside synthesis, localization and physiology, we will review those studies, which clearly show that anti-ganglioside antibodies are capable of binding to NMJs and thereby can exert a variety of pathophysiological effects. Furthermore, we will discuss the human clinical electrophysiological and histological evidence produced so far of the existence of a neuromuscular

  14. Effect of jumping interval training on neuromuscular and physiological parameters: a randomized controlled study.

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    Ache-Dias, Jonathan; Dellagrana, Rodolfo A; Teixeira, Anderson S; Dal Pupo, Juliano; Moro, Antônio R P

    2016-01-01

    This study analyzed the effect of 4 weeks of jumping interval training (JIT), included in endurance training, on neuromuscular and physiological parameters. Eighteen recreational runners, randomized in control and experimental groups, performed 40 min of running at 70% of velocity at peak oxygen uptake, for 3 times per week. Additionally, the experimental group performed the JIT twice per week, which consisted of 4 to 6 bouts of continuous vertical jumps (30 s) with 5-min intervals. Three days before and after the training period, the countermovement (CMJ) and continuous jump (CJ30), isokinetic and isometric evaluation of knee extensors/flexors, progressive maximal exercise, and submaximal constant-load exercise were performed. The JIT provoked improvement in neuromuscular performance, indicated by (i) increased jump height (4.7%; effect size (ES) = 0.99) and power output (≈ 3.7%; ES ≈ 0.82) of CMJ and rate of torque development of knee extensors in isometric contraction (29.5%; ES = 1.02); (ii) anaerobic power and capacity, represented by the mean of jump height (7.4%; ES = 0.8), and peak power output (PPO) (5.6%; ES = 0.73) of the first jumps of CJ30 and the mean of jump height (10.2%, ES = 1.04) and PPO (9.5%, ES = 1.1), considering all jumps of CJ30; and (iii) aerobic power and capacity, represented by peak oxygen uptake (9.1%, ES = 1.28), velocity at peak oxygen uptake (2.7%, ES = 1.11), and velocity corresponding to the onset of blood lactate accumulation (9.7%, ES = 1.23). These results suggest that the JIT included in traditional endurance training induces moderate to large effects on neuromuscular and physiological parameters.

  15. Assessment of ventilatory neuromuscular drive in patients with obstructive sleep apnea

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    L.R.A. Bittencourt

    1998-04-01

    Full Text Available The presence of abnormalities of the respiratory center in obstructive sleep apnea (OSA patients and their correlation with polysomnographic data are still a matter of controversy. Moderately obese, sleep-deprived OSA patients presenting daytime hypersomnolence, with normocapnia and no clinical or spirometric evidence of pulmonary disease, were selected. We assessed the ventilatory control and correlated it with polysomnographic data. Ventilatory neuromuscular drive was evaluated in these patients by measuring the ventilatory response (VE, the inspiratory occlusion pressure (P.1 and the ventilatory pattern (VT/TI, TI/TTOT at rest and during submaximal exercise, breathing room air. These analyses were also performed after inhalation of a hypercapnic mixture of CO2 (DP.1/DPETCO2, DVE/DPETCO2. Average rest and exercise ventilatory response (VE: 12.2 and 32.6 l/min, respectively, inspiratory occlusion pressure (P.1: 1.5 and 4.7 cmH2O, respectively, and ventilatory pattern (VT/TI: 0.42 and 1.09 l/s; TI/TTOT: 0.47 and 0.46 l/s, respectively were within the normal range. In response to hypercapnia, the values of ventilatory response (DVE/DPETCO2: 1.51 l min-1 mmHg-1 and inspiratory occlusion pressure (DP.1/DPETCO2: 0.22 cmH2O were normal or slightly reduced in the normocapnic OSA patients. No association or correlation between ventilatory neuromuscular drive and ventilatory pattern, hypersomnolence score and polysomnographic data was found; however a significant positive correlation was observed between P.1 and weight. Our results indicate the existence of a group of normocapnic OSA patients who have a normal awake neuromuscular ventilatory drive at rest or during exercise that is partially influenced by obesity

  16. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training

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    Martin eBehrens

    2015-05-01

    Full Text Available Previously published studies on the effect of short-term endurance training on the neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after eight weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms and isometric maximum voluntary contraction of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave, peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that the endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue

  17. The punctum fixum-punctum mobile model: a neuromuscular principle for efficient movement generation?

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    Christoph von Laßberg

    Full Text Available According to the "punctum fixum-punctum mobile model" that was introduced in prior studies, for generation of the most effective intentional acceleration of a body part the intersegmental neuromuscular onset succession has to spread successively from the rotation axis (punctum fixum toward the body part that shall be accelerated (punctum mobile. The aim of the present study was to investigate whether this principle is, indeed, fundamental for any kind of efficient rotational accelerations in general, independent of the kind of movements, type of rotational axis, the current body position, or movement direction. Neuromuscular onset succession was captured by surface electromyography of relevant muscles of the anterior and posterior muscle chain in 16 high-level gymnasts during intentional accelerating movement phases while performing 18 different gymnastics elements (in various body positions to forward and backward, performed on high bar, parallel bars, rings and trampoline, as well as during non-sport specific pivot movements around the longitudinal axis. The succession patterns to generate the acceleration phases during these movements were described and statistically evaluated based on the onset time difference between the muscles of the corresponding muscle chain. In all the analyzed movement phases, the results clearly support the hypothesized succession pattern from punctum fixum to punctum mobile. This principle was further underlined by the finding that the succession patterns do change their direction running through the body when the rotational axis (punctum fixum has been changed (e.g., high bar or rings [hands] vs. floor or trampoline [feet]. The findings improve our understanding of intersegmental neuromuscular coordination patterns to generate intentional movements most efficiently. This could help to develop more specific methods to facilitate such patterns in particular contexts, thus allowing for shorter motor learning

  18. Neuromuscular function and fatigue resistance of the plantar flexors following short-term cycling endurance training.

    Science.gov (United States)

    Behrens, Martin; Weippert, Matthias; Wassermann, Franziska; Bader, Rainer; Bruhn, Sven; Mau-Moeller, Anett

    2015-01-01

    Previously published studies on the effect of short-term endurance training on neuromuscular function of the plantar flexors have shown that the H-reflex elicited at rest and during weak voluntary contractions was increased following the training regime. However, these studies did not test H-reflex modulation during isometric maximum voluntary contraction (iMVC) and did not incorporate a control group in their study design to compare the results of the endurance training group to individuals without the endurance training stimulus. Therefore, this randomized controlled study was directed to investigate the neuromuscular function of the plantar flexors at rest and during iMVC before and after 8 weeks of cycling endurance training. Twenty-two young adults were randomly assigned to an intervention group and a control group. During neuromuscular testing, rate of torque development, isometric maximum voluntary torque and muscle activation were measured. Triceps surae muscle activation and tibialis anterior muscle co-activation were assessed by normalized root mean square of the EMG signal during the initial phase of contraction (0-100, 100-200 ms) and iMVC of the plantar flexors. Furthermore, evoked spinal reflex responses of the soleus muscle (H-reflex evoked at rest and during iMVC, V-wave), peak twitch torques induced by electrical stimulation of the posterior tibial nerve at rest and fatigue resistance were evaluated. The results indicate that cycling endurance training did not lead to a significant change in any variable of interest. Data of the present study conflict with the outcome of previously published studies that have found an increase in H-reflex excitability after endurance training. However, these studies had not included a control group in their study design as was the case here. It is concluded that short-term cycling endurance training does not necessarily enhance H-reflex responses and fatigue resistance.

  19. Direct and indirect measurement of neuromuscular fatigue in Canadian football players.

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    Clarke, Nick; Farthing, Jonathan P; Lanovaz, Joel L; Krentz, Joel R

    2015-05-01

    This study assessed the effects of a fatiguing game simulation (G-Sim) on the balance of collegiate Canadian football players. The purpose of the study was to evaluate postural control as a potential tool for monitoring neuromuscular fatigue (NMF) in collision-based team sports. Fifteen male Canadian football players were recruited (mean±SD: age 21.8±1.6 years, weight 97.6±14.7 kg). Indirect NMF measures (postural sway and countermovement jump (CMJ)) were performed 24 h before (TBase), immediately before (TPre) and after (TPost), and 24 h (T24) and 48 h after (T48) a Canadian football G-Sim. Peak isometric knee extensor torque of a maximal voluntary contraction (MVC) and electrically evoked tetani at 20 Hz (P20) and 80 Hz (P80) were also recorded as direct NMF measures at TBase, TPre, TPost, and T48. At TPost, we observed significant declines in MVC, P20, and the MVC/P80 ratio (-15.3%, -15.7%, and -12.1%, respectively; n=12) along with reductions in CMJ takeoff velocity and peak power (-6.9% and -6.5%, respectively; n=12) and larger area of the center of pressure trajectory (95.2%; n=10) during a 60-s postural sway task. All variables were no longer different than baseline by T48. Acute neuromuscular impairment in this cohort is likely attributable to alterations in excitation-contraction coupling due to structural damage and central activation failure. Congruency between the direct and indirect measures of NMF suggests monitoring postural sway has the potential to identify both neuromuscular and somatosensory alterations induced by acute game-induced fatigue in collision-based team sports players.

  20. Neuromuscular and Blood Lactate Response After a Motocross Training Session in Amateur Riders

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    Simões

    2016-03-01

    Full Text Available Background Motocross is one of the most popular motorized off-road sports, characterized by riding on irregular natural terrain of hard earth and/or sand with various obstacles throughout the course. Objectives This study evaluated the influence of a motocross training session on neuromuscular response and blood lactate in amateur riders. Patients and Methods Nine motocross riders (22.7 ± 2.8 years participating in amateur competitions at the state level conducted a training session of 20 minutes duration at a motocross track (1.6 km with a 250-cc four-stroke motorcycle. Metabolic demand was measured with blood lactate concentrations before and immediately, 3, 5, 8, and 10 minutes after the training session. To measure neuromuscular response, riders completed handgrip strength and horizontal jump tests before and 10 minutes after the training session. Student’s t-test and analysis of variance one-way repeated measures were used to compare the changes before and after the motocross training session. Results Significant decreases in handgrip strength were observed for both hands (left: P = 0.010 and right: P = 0.004. However, no significant difference (P = 0.241 in horizontal jump ability was observed. Significant blood lactate values were observed immediately (P = 0.001, 3 (P = 0.001, 5 (P = 0.001, and 8 (P = 0.01 minutes after training when compared to the value before training. The peak blood lactate value was 6.5 ± 2.7 mM at 8 minutes after the training session. Conclusions Amateur motocross riders had significant anaerobic metabolism demands and had reduced handgrip strength following a training session. These data suggest an importance of physical training aimed at improving anaerobic and neuromuscular performance of the upper limbs in amateur motocross riders.

  1. An alternate method for estimating the dose-response relationships of neuromuscular blocking drugs.

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    Kopman, A F; Klewicka, M M; Neuman, G G

    2000-05-01

    Slopes of the dose-response relationships for all available neuromuscular blocking drugs appear to be essentially parallel and to approximate a log-dose/logit value of 4.75. We tested the possibility of estimating both 50% effective dose (ED(50)) and 95% effective dose (ED(95)) values from a single dose-response data point when that slope is postulated. We compared the ED(50) and ED(95) values of rocuronium and succinylcholine calculated by using traditional log-dose/logit regression analysis with the same values obtained by averaging individual estimates of potency as determined by using the Hill equation. After the induction of anesthesia (propofol/alfentanil), tracheal intubation was accomplished without the administration of neuromuscular blocking drugs. Anesthesia was maintained with nitrous oxide and propofol. The evoked electromyographic response to 0.10-Hz single stimuli was continuously recorded. After baseline stabilization, a single IV bolus of succinylcholine (0.08-0.26 mg/kg, n = 50) or rocuronium (0. 13-0.30 mg/kg, n = 40) was administered and the peak effect noted. By using log-dose/logit regression analysis, we calculated ED(50) and ED(95) values for rocuronium of 0.17 and 0.33 mg/kg and 0.14 and 0.27 mg/kg for succinylcholine. When potency was calculated from the Hill equation, the resultant ED(50) and ED(95) values did not differ by more than +/-4% from those obtained by using regression analysis. Averaging of single-dose estimates of neuromuscular potency provides a useful adjunct and reasonable alternative to conventional regression analysis.

  2. Clinical diagnosis of neuromuscular diseases using fat/water suppression magnetic resonance imaging

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    Tsubahara, Akio [Kawasaki Medical School, Kurashiki, Okayama (Japan); Okajima, Yasutomo

    1996-01-01

    Pixel values in fat/water suppression MRI, and the T1 and T2 relaxation times of skeletal muscles were measured to establish criteria for the clinical MRI diagnosis of neuromuscular diseases. The subjects were 15 patients with a diagnosis of neuromuscular disease based on clinical symptoms and findings made by electrophysiological methods, and 3 patients with hysterical conversion reactions. Normal values were obtained from 33 healthy volunteers. Transaxial MR images of the bilateral thigh muscles were recorded with T1/T2 relaxation time calculation imaging and fat/water suppression imaging (Dixon`s method). The patients with muscular dystrophy showed remarkably decreased pixel values in their water images (PV 1) and tremendously increased pixel values in their fat images (PV 2). The finding that T1 became much shorter and T2 slightly longer seemed to be related to the fact that the extent of the increase in PV 2 was relatively greater than that of the decrease in PV 1. The patients with polymyositis showed a PV 1 value that was higher than normal. This finding was quite different from that for muscular dystrophy. As this disease grew worse, the PV 2 increased. The length of T1 seemed to depend on the relationship between PV 1 and PV 2. Prolongation of T2 appeared to be due to increase in PV 2. Both PV 1 and PV 2 in myotonic dystrophy and neurogenic diseases were slightly higher than normal. The patients with polyradiculoneuropathy showed both T1 and T2 relaxation times that were longer than normal. However, the T1 relaxation time in motor neuron diseases had a tendency to become shorter. The parameters in the patients with hysterical conversion reactions remained approximately within normal range. We concluded that measurements of the objective parameters in MRI are useful for the clinical diagnosis of neuromuscular diseases. (author)

  3. Cause of exercise associated muscle cramps (EAMC)--altered neuromuscular control, dehydration or electrolyte depletion?

    Science.gov (United States)

    Schwellnus, M P

    2009-06-01

    Exercise Associated Muscle Cramps (EAMC) is one of the most common conditions that require medical attention during or immediately after sports events. Despite the high prevalence of this condition the aetiology of EAMC in athletes is still not well understood. The purpose of this review is to examine current scientific evidence in support of (1) the "electrolyte depletion" and "dehydration" hypotheses and (2) the "altered neuromuscular control" hypothesis in the aetiology of EAMC. In this review, scientific evidence will, as far as possible, be presented using evidence-based medicine criteria. This is particularly relevant in this field, as the quality of experimental methodology varies considerably among studies that are commonly cited in support of hypotheses to explain the aetiology of EAMC. Scientific evidence in support of the "electrolyte depletion" and "dehydration" hypotheses for the aetiology of EAMC comes mainly from anecdotal clinical observations, case series totalling 18 cases, and one small (n = 10) case-control study. Results from four prospective cohort studies do not support these hypotheses. In addition, the "electrolyte depletion" and "dehydration" hypotheses do not offer plausible pathophysiological mechanisms with supporting scientific evidence that could adequately explain the clinical presentation and management of EAMC. Scientific evidence for the "altered neuromuscular control" hypothesis is based on evidence from research studies in human models of muscle cramping, epidemiological studies in cramping athletes, and animal experimental data. Whilst it is clear that further evidence to support the "altered neuromuscular control" hypothesis is also required, research data are accumulating that support this as the principal pathophysiological mechanism for the aetiology of EAMC.

  4. Same-day physical therapy consults in an outpatient neuromuscular disease physician clinic

    Directory of Open Access Journals (Sweden)

    Pucillo EM

    2016-10-01

    Full Text Available Evan M Pucillo,1 Nancy Christensen-Mayer,2 Shelly D Poole,2 Denise M Whitten,2 Danielle Freeman,3 Blake R Bohe,4 Brandon R Swensen,3 A Gordon Smith,1 Nicholas E Johnson1 1Department of Neurology, School of Medicine, 2Department of Physical Medicine & Rehabilitation, 3Outpatient Neurology, University of Utah Hospitals and Clinics, 4Business Support, University of Utah Information Technology, Salt Lake City, UT, USA Background: Team-based care has been shown to offer more comprehensive benefits to patients when compared to standard physician-based care alone in clinics for chronic conditions. However, apart from grant-funded multidisciplinary clinics, there are no reports on the usage of same-day physical therapy (PT consults within a daily outpatient neuromuscular disease (NMD physician clinic.Objective: To determine the impact of same-day PT consults at the University of Utah’s outpatient Clinical Neurosciences Center.Design: A qualitative assessment and survey of patient satisfaction.Methods: An eight question Health Insurance Portability and Accountability Act-compliant patient satisfaction survey using a 5-point Likert scale was administered. Demographic data and Press-Ganey Provider Satisfaction surveys were retrospectively collected from electronic medical records for patients receiving same-day PT encounters in the neuromuscular division over 1 year.Results: Mean (standard deviation age was 54.22 (19.81 years for 134 patient encounters, median age was 60 years, with 76 male (57% and 58 female (43% patients. Mean Likert score for 61 self-reported patient satisfaction surveys for same-day PT consults was 4.87 (97.4%. Press-Ganey Provider Satisfaction scores improved from 89.9% (N=287 for the year prior to 90.8% (N=320 for the corresponding year (P=0.427. A total of 46 (75.4% patients have either never before received PT care or never before received PT care for their NMD, 67.4% of whom were male.Conclusion: Same-day PT consults in an

  5. Artrosis trapeciometacarpiana.efecto diferencial del método facilitación neuromuscular propioceptiva.

    OpenAIRE

    Campos Villegas, Cristina

    2016-01-01

    Hipótesis: el presente estudio sostiene que un programa de tratamiento basado en la Facilitación Neuromuscular Propioceptiva (F.N.P) en pacientes de sexo femenino afectadas de artrosis TMC de grado ≤ 3 en la clasificación Eaton-Litter Burton, disminuye el dolor, mejora la capacidad funcional del miembro superior, aumenta la fuerza de empuñadura y fuerza de pinza tetradigital, terminal y de llave. Métodos: Se realizó un muestreo de casos consecutivos de pacientes afectadas de rizartrosis, q...

  6. Elaboracion de un objeto virtual de aprendizaje (ova) sobre “tecnicas de facilitacion neuromuscular propioceptiva”

    OpenAIRE

    Gomez Diaz, Isabel Cristina

    2010-01-01

    El presente resumen corresponde a un ejercicio de innovación en el aula que se constituye en un aporte en el marco de los “productos electrónicos” los cuales se refieren a libros o contenidos en formato digital diseñados para la educación facilitada con objetos virtuales de aprendizaje. El propósito de elaborar un OVA sobre “Técnicas de Facilitación Neuromuscular Propioceptiva - TFNP” fue proporcionar al fisioterapeuta (profesional o en formación) una herramienta que le facilite el apr...

  7. Valoración de la fatiga neuromuscular en el antebrazo del motorista de velocidad

    OpenAIRE

    Torrado Pineda, Priscila

    2015-01-01

    Actualmente, es frecuente ver cómo muchas escuderías tienen sus motos paradas en boxes por patologías neuromusculares de sus pilotos oficiales, debiendo recurrir a pilotos substitutos. Durante una carrera de motos la fatiga es alta porque los pilotos tienen que soportar niveles de tensión muscular elevados, particularmente en los brazos y antebrazos y además mantenidos durante un largo periodo de tiempo. Un estudio previo realizado durante una carrera de resistencia de 24 h (Marina,...

  8. Upper limb functions regained in quadriplegia: a hybrid computerized neuromuscular stimulation system.

    Science.gov (United States)

    Nathan, R H; Ohry, A

    1990-05-01

    A new, computerized neuromuscular stimulation system was applied to the upper limbs of two patients with complete quadriplegia below the C4 level. The stimulation-generated movements were integrated and augmented by residual, voluntary shoulder girdle movements and mechanical splinting. Up to 12 muscles were stimulated individually with high-resolution surface electrodes; coordination and control of the stimulation was effected by microcomputer. Simple vocal commands to the computer triggered preprogrammed hand prehensions, arm motion, and other functions, giving the patient complete control over the system. In pilot clinical trials of six weeks, writing, eating, and drinking, including picking up and replacing the pen or cup, were achieved.

  9. A novel skeletal-myosin blocking drug for the study of neuromuscular physiology

    Directory of Open Access Journals (Sweden)

    Dante J Heredia

    2016-12-01

    Full Text Available The failure to transmit neural action potentials (APs into muscle APs is referred to as neuromuscular transmission failure (NTF. Although synaptic dysfunction occurs in a variety of neuromuscular diseases and impaired neurotransmission contributes to muscle fatigue, direct evaluation of neurotransmission by measurement of successfully transduced muscle APs is difficult due to the subsequent movements produced by muscle. Moreover, the voltage-gated sodium channel inhibitor used to study neurotransmitter release at the adult neuromuscular junction is ineffective in embryonic tissue, making it nearly impossible to precisely measure any aspect of neurotransmission in embryonic lethal mouse mutants. In this study we utilized 3-(N-butylethanimidoyl-4-hydroxy-2H-chromen-2-one (BHC, previously identified in a small-molecule screen of skeletal muscle myosin inhibitors, to suppress movements without affecting membrane currents. In contrast to previously characterized drugs from this screen such as BTS, which inhibit skeletal muscle myosin ATPase activity but also block neurotransmission, BHC selectively blocked nerve-evoked muscle contraction without affecting neurotransmitter release. This feature allowed a detailed characterization of neurotransmission in both embryonic and adult mice. In the presence of BHC, neural APs produced by tonic stimulation of the phrenic nerve at rates up to 20 Hz were successfully transmitted into muscle APs. At higher rates of phrenic nerve stimulation, NTF was observed. NTF was intermittent and characterized by successful muscle APs following failed ones, with the percentage of successfully transmitted muscle APs diminishing over time. Nerve stimulation rates that failed to produce NTF in the presence of BHC similarly failed to produce a loss of peak muscle fiber shortening, which was examined using a novel optical method of muscle fatigue, or a loss of peak cytosolic calcium transient intensity, examined in whole

  10. Age- and sex-related differences in the anthropometry and neuromuscular fitness of competitive taekwondo athletes

    Science.gov (United States)

    Nikolaidis, Pantelis Theodoros; Buśko, Krzysztof; Clemente, Filipe Manuel; Tasiopoulos, Ioannis; Knechtle, Beat

    2016-01-01

    Anthropometry and neuromuscular fitness have been shown to relate with taekwondo (TKD) performance; however, little information is available on the variation of these fitness components by sex and age in athletes practicing this sport. The aim of the present study was to examine the anthropometry and neuromuscular fitness of TKD athletes by sex and age. A total of 393 athletes (7–48 years old), separated into six age groups (7–9, 10–11, 12–13, 14–17, 18–32, and 33+), were examined for anthropometry and performed a series of neuromuscular fitness tests (flexibility, agility, muscle power, and isometric strength). An age × sex interaction on body mass, body height, and body fat percentage (BF, p≤0.003, η2≥0.045), but not on body mass index (p=0.172, η2=0.020), was shown, where a larger increase in body mass and body height from 12–13 to 14–17 groups was observed in males than in females, and the sex difference in BF increased from 12–13 to 14–17 age group. An age × sex interaction on sit-and-reach (SAR) test, mean power output in the Bosco test, and Abalakov jump (p≤0.038, η2≥0.031) was observed with larger differences between 12–13 and 18–32 groups in males than in females. In SAR, it was remarkable that the male athletes achieved similar scores as female athletes in the 18–32 group. An age × sex group interaction on measures of isometric muscle strength (right and left handgrip, trunk, and legs) was also shown (p≤0.002, η2≥0.068), where larger differences in male than female athletes were observed between the 12–13 and 14–17 groups. From a practical perspective, coaches can use these findings as reference for the evaluation of their athletes. Because the anthropometric characteristics and neuromuscular fitness varied by sex (i.e., highest scores in males, except flexibility) and age (i.e., highest scores in the 18–32 age group) with unique sport-specific patterns in TKD athletes, these findings would be important

  11. A Novel Striated Muscle-Specific Myosin-Blocking Drug for the Study of Neuromuscular Physiology

    Science.gov (United States)

    Heredia, Dante J.; Schubert, Douglas; Maligireddy, Siddhardha; Hennig, Grant W.; Gould, Thomas W.

    2016-01-01

    The failure to transmit neural action potentials (APs) into muscle APs is referred to as neuromuscular transmission failure (NTF). Although synaptic dysfunction occurs in a variety of neuromuscular diseases and impaired neurotransmission contributes to muscle fatigue, direct evaluation of neurotransmission by measurement of successfully transduced muscle APs is difficult due to the subsequent movements produced by muscle. Moreover, the voltage-gated sodium channel inhibitor used to study neurotransmitter release at the adult neuromuscular junction is ineffective in embryonic tissue, making it nearly impossible to precisely measure any aspect of neurotransmission in embryonic lethal mouse mutants. In this study we utilized 3-(N-butylethanimidoyl)-4-hydroxy-2H-chromen-2-one (BHC), previously identified in a small-molecule screen of skeletal muscle myosin inhibitors, to suppress movements without affecting membrane currents. In contrast to previously characterized drugs from this screen such as N-benzyl-p-toluene sulphonamide (BTS), which inhibit skeletal muscle myosin ATPase activity but also block neurotransmission, BHC selectively blocked nerve-evoked muscle contraction without affecting neurotransmitter release. This feature allowed a detailed characterization of neurotransmission in both embryonic and adult mice. In the presence of BHC, neural APs produced by tonic stimulation of the phrenic nerve at rates up to 20 Hz were successfully transmitted into muscle APs. At higher rates of phrenic nerve stimulation, NTF was observed. NTF was intermittent and characterized by successful muscle APs following failed ones, with the percentage of successfully transmitted muscle APs diminishing over time. Nerve stimulation rates that failed to produce NTF in the presence of BHC similarly failed to produce a loss of peak muscle fiber shortening, which was examined using a novel optical method of muscle fatigue, or a loss of peak cytosolic calcium transient intensity, examined

  12. Neuromuscular versus quadriceps strengthening exercise in patients with medial knee osteoarthritis and varus malalignment

    DEFF Research Database (Denmark)

    Bennell, Kim L; Kyriakides, Mary; Metcalf, Ben

    2014-01-01

    OBJECTIVE: To compare the effects of neuromuscular exercise (NEXA) and quadriceps strengthening (QS) on the knee adduction moment (an indicator of mediolateral distribution of knee load), pain, and physical function in patients with medial knee joint osteoarthritis (OA) and varus malalignment...... component. Primary outcomes were peak external knee adduction moment (3-dimensional gait analysis), pain (visual analog scale), and self-reported physical function (Western Ontario and McMaster Universities Osteoarthritis Index). RESULTS: Eighty-two patients (38 [76%] of 50 in the NEXA group and 44 [88...

  13. Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    OBJECTIVE: Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA. METHODS: This was a randomized controlled assessor-blinded trial...... and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb...

  14. EFEITO DO TREINO NEUROMUSCULAR NA ROTAÇÃO DO JOELHO DURANTE A ATERRISSAGEM EM MULHERES

    Directory of Open Access Journals (Sweden)

    Narayana Vianna Spanó

    2016-04-01

    Full Text Available Introdução: O grande índice de lesões do ligamento cruzado anterior sem envolver contato em mulheres é motivo de curiosidade entre os cientistas, pois avaliações de aterrissagem podem sugerir a predisposição ao risco dessa lesão. Neste sentido, vários protocolos de treinamento foram utilizados como intervenção e obtiveram resultados diversificados na alteração desse fator de risco. Objetivo: O objetivo deste projeto foi avaliar as possíveis alterações de rotação do joelho na aterrissagem unipodal após a intervenção de um programa de treinamento neuromuscular. Métodos: Participaram do estudo 18 mulheres com idade entre 18 e 51 anos, que foram distribuídas em dois grupos: grupo de treinamento neuromuscular de oito semanas (GTN (n = 11 e grupo controle (GC (n = 7. Além disso, não apresentavam lesão musculoesquelética ou dores nos membros inferiores. Cada participante realizou cinco aterrissagens unipodais válidas de uma plataforma de 40 cm de altura. O processo de captura de movimento foi realizado com 12 câmeras infravermelho do sistema OptiTrack(tm para obter as coordenadas tridimensionais de marcadores fixados nos pontos anatômicos de interesse. Os sistemas de coordenadas locais da coxa e da perna foram definidos por meio dos respectivos marcadores fixados nos pontos anatômicos. Dessa forma, foram calculados os ângulos de rotação do joelho nos planos sagital, frontal e transverso através das sequências dos ângulos de Euler e as velocidades angulares através das formulações dos quatérnions. Resultados: Os resultados mostraram que houve um aumento na velocidade de rotação do joelho após o treinamento neuromuscular. Conclusão: Conclui-se que o treinamento neuromuscular resultou em maior velocidade de rotação no joelho nos 40 milissegundos que sucedem a aterrissagem unipodal.

  15. Vendaje neuromuscular: Efectos neurofisiológicos y el papel de las fascias

    OpenAIRE

    Villota Chicaíza, Ximena María

    2014-01-01

    Durante los últimos años, el vendaje neuromuscular, un aplicativo terapéutico creado en 1979 por el doctor Kenzo Kase, ha venido introduciéndose en el manejo de muchas alteraciones del sistema musculo-esquelético y más aún en el tratamiento de trastornos neurológicos; esta herramienta terapéutica que consiste en un vendaje elástico autoadhesivo permite la recuperación de la parte lesionada sin disminuir su función corporal. De acuerdo con la literatura existente sobre los efectos fisiológicos...

  16. Dolor en niños y adolescentes con enfermedades neuromusculares

    OpenAIRE

    2013-01-01

    El objetivo de este trabajo es revisar la información disponible sobre la experiencia de dolor en niños y adolescentes con una enfermedad neuromuscular (ENM). Para ello, se examinaron las bases de datos SCOPUS y MEDLINE y se localizaron los artículos publicados sobre el tema hasta marzo de 2012. Tras un análisis exhaustivo, se identificaron 33 artículos que cumplían con los criterios de inclusión. Del análisis efectuado se desprende que el dolor es una experiencia muy habitual en estos jóvene...

  17. Vendaje Neuromuscular y su aplicación en la mejora del rendimiento muscular

    OpenAIRE

    Rodrigo Rodríguez, Jorge

    2016-01-01

    El Vendaje Neuro-Muscular (VNM) es una técnica que utiliza vendajes blandos muy elásticos, por sus efectos, entre otros, sobre la fisiología de los músculos vendados. En el mundo del deporte esta técnica es usada con finalidad preventiva, terapéutica en fase aguda, y favorecedora de la recuperación en la fase post-lesión. Diversos autores han encontrado resultados contradictorios en cuanto a su posible utilidad en el aumento del rendimiento deportivo (Tieh-Cheng et al.2008; Li-Chun Yu et al. ...

  18. The mathematical basis of population rhythms in nervous and neuromuscular systems.

    Science.gov (United States)

    Christakos, C N

    1986-03-01

    The mechanism underlying rhythmical aggregate activity of a population of neural or neuromuscular elements is examined in this report. By making use of the spectral properties of stochastic processes (Papoulis, 1965), it is shown that such population rhythms are the inevitable effect of the rhythmical activities of the individual elements, irrespective of the phase relations of the latter. This result applies to both "discrete" signals, such as spike trains, and "continuous" ones, such as membrane potential fluctuations. It has implications regarding the generation of common physiological rhythms and the preservation of rhythms when converging activity of one of the above two types is transformed into activity of the other type.

  19. Preventing Ischial Pressure Ulcers: III. Clinical Pilot Study of Chronic Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: BIONs™ (BIOnic Neurons are injectable, wireless microstimulators that make chronic BION Active Seating (BAS possible for pressure ulcer prevention (PUP. Neuromuscular electrical stimulation (NMES produces skeletal motion and activates trophic factors, counteracting three major etiological mechanisms leading to pressure ulcers (PUs: immobility, soft-tissue atrophy, and ischemia. Companion papers I and II reviewed prior experience with NMES for PUP, and analyzed the biomechanical considerations, respectively. This paper presents a treatment strategy derived from this analysis, and the clinical results of the first three cases.

  20. Contribución del soporte nutricional al tratamiento de las alteraciones neuro-musculares del paciente crítico Contribution of nutritional support to treatment neuromuscular impairments of critically ill patients

    OpenAIRE

    J. C. Montejo González

    2006-01-01

    Las alteraciones neuromusculares que tienen lugar en el paciente crítico han sido atribuidas a factores como la situación séptica, la liberación de mediadores inflamatorioso el empleo de fármacos que afectan desfavorablemente a la función neuro-muscular. El papel de factores metabólicos y nutricionales en el desarrollo de esta patología ha recibido poca atención. En la actualidad, el empleo de protocolos de control intensivo de la glucemia podría tener gran interés en la prevención de las alt...

  1. 神经肌肉阻滞剂在ICU的应用%Neuromuscular blocking agents in ICU

    Institute of Scientific and Technical Information of China (English)

    刘春峰; 杨雨航

    2014-01-01

    神经肌肉阻滞剂在ICU用于很多疾病的辅助治疗,如急性呼吸窘迫综合征、哮喘持续状态、颅内高压等,重症医学科的医生在使用神经肌肉阻滞剂时要根据循证医学证据及指南合理使用,以减少相关并发症的发生.%Neuromuscular blocking agents have been used for a variety of clinical conditions such as emergency intubation,acute respiratory distress syndrome,status asthmaticus,elevated intracranial pressure,etc.Neuromuscular blocking agents should be used and monitored appropriately according to evidence-based guidelines to reduce the adverse events associated with the use of neuromuscular blocking agents.

  2. Effects of regular Tai Chi practice and jogging on neuromuscular reaction during lateral postural control in older people.

    Science.gov (United States)

    Wang, Shao-Jun; Xu, Dong-Qing; Li, Jing-Xian

    2017-01-01

    This study examined the effects of regular Tai Chi practice and jogging on the neuromuscular activity of the trunk, hip, and ankle joint muscles of older people during lateral postural perturbation. A total of 42 older people participated in the study and formed the Tai Chi, jogging, and sedentary control groups. Electromyography signals were collected from the peroneus longus, anterior tibialis, gluteus medius, and erector spinae during unpredictable mediolateral perturbation. The Tai Chi group exhibited significantly faster latencies of the tibialis anterior and erector spinae than the control group. The jogging group showed a significantly shorter neuromuscular reaction time of the erector spinae than the control group. No significant difference was observed between the Tai Chi and jogging groups. Long-term regular Tai Chi practice enhanced the neuromuscular reaction of the erector spinae and tibialis anterior to lateral perturbation and will help timely posture correction when lateral postural distributions occur.

  3. Qualidade dos frutos de tipos de melão,produzidos em ambiente protegido Quality of melon fruit type produced under protected system

    Directory of Open Access Journals (Sweden)

    Micheline Tavares Paduan

    2007-01-01

    Full Text Available O interesse pela cultura do melão no Brasil tem aumentado muito nos últimos anos, pelas crescentes exportações e pelo incremento no consumo do mercado interno. O objetivo deste trabalho foi avaliar as características físicas e químicas, assim como a atividade da pectinametilesterase dos frutos de tipos de melão (Cucumis melo L., produzidos em ambiente protegido, no município de Centenário do Sul-PR. Os tipos estudados foram: Valenciano ('Amarelo-Ouro', Caipira ('Gaúcho Caipira', Net Melon ('Net Galia', Orange ('Orange Melon' e Pele-de-Sapo ('Filipo', com cinco repetições, utilizando seis frutos por repetição em delineamento inteiramente casualizado. Os frutos do Valenciano e Pele-de-Sapo destacaram-se quanto à massa, com valores 2,02 e 2,07 kg, respectivamente, e formatos alongados, enquanto os demais tipos apresentaram formatos arredondados e massa em torno de 1,4 kg. Os melões Pele-de-Sapo apresentaram espessura da polpa de 43,36 mm, estatisticamente superior à dos frutos Valenciano, com 38,98 mm. A menor espessura de polpa, 24,78 cm, e a maior espessura de casca, 9,74 mm, foram encontradas nos frutos do tipo Caipira que diferiu estatisticamente dos outros tipos. Os valores de pH não se apresentaram estatisticamente diferentes e variaram de 6,24 a 6,48. O Net Melon apresentou polpa com 12,3ºBrix e diferiu estatisticamente do Orange, Valenciano e Pele-de-Sapo, com 11;12; 10,34 e 9,94 ºBrix, respectivamente. O Caipira atingiu 5,06ºBrix, e também o menor conteúdo de acidez, 0,10 g de ac. cítrico.100-1 g de suco, o que inviabiliza sua comercialização. A atividade da pectinametilesterase na polpa dos frutos foi muito baixa, inferior a 0,005 PEu x 10(4 mL-1, nos cinco tipos avaliados. Na região norte do Paraná (Vale do Paranapanema, sob condições de cultivo protegido, os melões Pele-de-Sapo, Net Melon, Orange e Valenciano apresentaram boas características físicas e químicas dos frutos, destacando-se o Net Melon

  4. Quality of raw milk produced in agreste region of Pernambuco, Brazil / Qualidade do leite cru produzido na região do agreste de Pernambuco, Brasil

    Directory of Open Access Journals (Sweden)

    Márcia de Aguiar Ferreira Barros

    2010-04-01

    negativamente na produção e rendimento de derivados. No Estado de Pernambuco, não é diferente. Sendo o segundo maior produtor do Nordeste, Pernambuco tem sua maior produção de leite localizada na Região Agreste do estado, que fica entre a Zona da Mata e o Sertão. A produção de leite no Agreste, cresceu 23% nos últimos dois anos, chegando a 980 mil litros/dia. Com o objetivo de avaliar a qualidade microbiológica e físico-química do leite cru produzido nesta região, foram coletadas amostras em 53 propriedades rurais, nos municípios de Saloa, Águas Belas, São Bento do Una e Bom Conselho. Enumeraram-se aeróbios mesófilos, coliformes totais, Escherichia coli e estafilococos em placas de Petrifilm™ especificas (3M do Brasil Ltda.. A detecção de Listeria monocytogenes e Salmonella ssp foi realizada utilizando o sistema VIDAS (BioMeriex®. Organofosforados e carbamatos foram pesquisados pela técnica de Cromatografia em Camada Delgada. O teor de gordura, sólidos totais, sólidos não gordurosos, densidade, proteína e lactose foram obtidos por espectroscopia de em analisador ultra-sônico (US. Realizou-se ainda crioscopia, California Mastite Teste (CMT, peroxidase, acidez Dornic e Ring-test para monitoramento da presença de Brucelose nas propriedades. Nas análises microbiológicas, as amostras apresentaram altas contagens de microrganismos aeróbios mesófilos, coliformes totais, Escherichia coli, psicrotróficos e estafilococos coagulase positiva. A média de aeróbios mesófilos foi de 1,68% X 107, sendo 83% acima de 106. Listeria monocytogenes e Salmonella sp não foram detectadas, 47% das amostras foram positivas para carbamatos, organofosforados ou ambos. No CMT 67,9% das amostras foram positivas, e no Ring test 26,4% das propriedades foram positivas. Assim, apenas 2 (3,77% das amostras estariam dentro dos padrões estabelecidos pela IN 51.

  5. Efeitos dentoesqueléticos produzidos pelo aparelho de Herbst na dentadura mista Dentoskeletal treatment effects produced by the Herbst appliance in the mixed dentition

    Directory of Open Access Journals (Sweden)

    Marcio Rodrigues de Almeida

    2006-10-01

    Full Text Available OBJETIVO: o objetivo desta pesquisa clínica prospectiva foi avaliar as alterações cefalométricas dentárias e esqueléticas produzidas pelo aparelho de Herbst em jovens com má oclusão de Classe II, 1ª divisão durante a dentadura mista. METODOLOGIA: trinta jovens (15 do gênero masculino e 15 do feminino com idade média inicial de 9 anos e 10 meses foram tratados com o aparelho de Herbst por um período de 12 meses. Para a comparação dos grupos utilizou-se uma amostra controle de 30 jovens (15 do gênero masculino e 15 do feminino Classe II, 1ª divisão, com idade média inicial de 9 anos e 8 meses, que foram mantidos sem tratamento durante 12 meses. Para cada jovem foram utilizadas duas telerradiografias em norma lateral, obtidas ao início e no final do período de acompanhamento. Utilizou-se um método convencional de avaliação cefalométrica e o método proposto por Pancherz. RESULTADOS E CONCLUSÕES: os resultados deste estudo demonstraram que os efeitos do aparelho de Herbst produzidos na dentadura mista foram primariamente de natureza dentoalveolar. Os incisivos inferiores foram inclinados para vestibular e os superiores foram retruídos; também houve uma extrusão significante dos molares inferiores, enquanto os superiores sofreram restrição de desenvolvimento no sentido vertical. Não houve diferença significante de restrição do crescimento anterior da maxila entre os dois grupos. No sentido vertical da face, a altura facial ântero-inferior se comportou de forma similar, não demonstrando alteração significante entre os grupos. O tratamento com o aparelho de Herbst produziu um aumento modesto, porém, significante no comprimento da mandíbula comparado ao grupo controle. Este aumento, entretanto, foi de menor magnitude que aquele observado em pacientes adolescentes utilizando o mesmo protocolo de tratamento. A correção do overjet (Herbst ocorreu devido a 22% de alterações esqueléticas e 78% de altera

  6. Increased pain sensitivity but normal function of exercise induced analgesia in hip and knee osteoarthritis - treatment effects of neuromuscular exercise and total joint replacement

    DEFF Research Database (Denmark)

    Kosek, E; Roos, Ewa M.; Ageberg, E;

    2013-01-01

    To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters.......To assess exercise induced analgesia (EIA) and pain sensitivity in hip and knee osteoarthritis (OA) and to study the effects of neuromuscular exercise and surgery on these parameters....

  7. A randomized, dose-response study of sugammadex given for the reversal of deep rocuronium- or vecuronium-induced neuromuscular blockade under sevoflurane anesthesia

    DEFF Research Database (Denmark)

    Duvaldestin, Philippe; Kuizenga, Karel; Saldien, Vera;

    2010-01-01

    Sugammadex is the first of a new class of selective muscle relaxant binding drugs developed for the rapid and complete reversal of neuromuscular blockade induced by rocuronium and vecuronium. Many studies have demonstrated a dose-response relationship with sugammadex for reversal of neuromuscular...

  8. A Markov computer simulation model of the economics of neuromuscular blockade in patients with acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    Chow John L

    2006-03-01

    Full Text Available Abstract Background Management of acute respiratory distress syndrome (ARDS in the intensive care unit (ICU is clinically challenging and costly. Neuromuscular blocking agents may facilitate mechanical ventilation and improve oxygenation, but may result in prolonged recovery of neuromuscular function and acute quadriplegic myopathy syndrome (AQMS. The goal of this study was to address a hypothetical question via computer modeling: Would a reduction in intubation time of 6 hours and/or a reduction in the incidence of AQMS from 25% to 21%, provide enough benefit to justify a drug with an additional expenditure of $267 (the difference in acquisition cost between a generic and brand name neuromuscular blocker? Methods The base case was a 55 year-old man in the ICU with ARDS who receives neuromuscular blockade for 3.5 days. A Markov model was designed with hypothetical patients in 1 of 6 mutually exclusive health states: ICU-intubated, ICU-extubated, hospital ward, long-term care, home, or death, over a period of 6 months. The net monetary benefit was computed. Results Our computer simulation modeling predicted the mean cost for ARDS patients receiving standard care for 6 months to be $62,238 (5% – 95% percentiles $42,259 – $83,766, with an overall 6-month mortality of 39%. Assuming a ceiling ratio of $35,000, even if a drug (that cost $267 more hypothetically reduced AQMS from 25% to 21% and decreased intubation time by 6 hours, the net monetary benefit would only equal $137. Conclusion ARDS patients receiving a neuromuscular blocker have a high mortality, and unpredictable outcome, which results in large variability in costs per case. If a patient dies, there is no benefit to any drug that reduces ventilation time or AQMS incidence. A prospective, randomized pharmacoeconomic study of neuromuscular blockers in the ICU to asses AQMS or intubation times is impractical because of the highly variable clinical course of patients with ARDS.

  9. Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

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    Lara Maris Nápolis

    2011-01-01

    Full Text Available BACKGROUND: High-frequency neuromuscular electrical stimulation increases exercise tolerance in patients with advanced chronic obstructive pulmonary disease (COPD patients. However, it is conceivable that its benefits are more prominent in patients with better-preserved peripheral muscle function and structure. OBJECTIVE: To investigate the effects of high-frequency neuromuscular electrical stimulation in COPD patients with better-preserved peripheral muscle function. Design: Prospective and cross-over study. METHODS: Thirty COPD patients were randomly assigned to either home-based, high-frequency neuromuscular electrical stimulation or sham stimulation for six weeks. The training intensity was adjusted according to each subject's tolerance. Fat-free mass, isometric strength, six-minute walking distance and time to exercise intolerance (Tlim were assessed. RESULTS: Thirteen (46.4% patients responded to high-frequency neuromuscular electrical stimulation; that is, they had a post/pre Δ Tlim >10% after stimulation (unimproved after sham stimulation. Responders had a higher baseline fat-free mass and six-minute walking distance than their seventeen (53.6% non-responding counterparts. Responders trained at higher stimulation intensities; their mean amplitude of stimulation during training was significantly related to their fat-free mass (r = 0.65; p<0.01. Logistic regression revealed that fat-free mass was the single independent predictor of Tlim improvement (odds ratio [95% CI] = 1.15 [1.04-1.26]; p<0.05. CONCLUSIONS: We conclude that high-frequency neuromuscular electrical stimulation improved the exercise capacity of COPD patients with better-preserved fat-free mass because they tolerated higher training stimulus levels. These data suggest that early training with high-frequency neuromuscular electrical stimulation before tissue wasting begins might enhance exercise tolerance in patients with less advanced COPD.

  10. Armazenamento sob condições ambiente e aceitabilidade do melão 'F1 Jangada' produzido em sistema hidropônico Storage under atmosphere conditions and acceptability of the melon 'F1 Jangada' croped in hydroponic system

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    Maria M. Rinaldi

    2006-12-01

    Full Text Available O objetivo deste trabalho foi determinar o período de armazenamento pós-colheita e a aceitabilidade pelo consumidor de melão híbrido 'F1 Jangada' (Cucumis melo L., produzido em sistema hidropônico, mantido em condições ambiente (22 ± 2 ºC e umidade relativa de 40 ± 5%. O experimento compreendeu o período de 21-6-2005 a 2-8-2005. Foi utilizado o esquema fatorial 5 x 2, em delineamento experimental inteiramente casualizado, com cinco períodos de armazenamento (0; 7; 21; 28 e 42 dias e dois tipos de substrato (areia e fibra de coco, com três repetições, em que cada repetição consistiu em cinco frutos de meloeiro. Foram avaliados o pH, a acidez titulável, os sólidos solúveis, a perda de massa fresca, a análise sensorial e a decisão de compra dos melões. Foram verificados efeitos do tipo de substrato e tempo de armazenamento sobre os valores de pH dos melões. A acidez titulável dos melões diminuiu significativamente nos primeiros sete dias de armazenamento, em ambos os substratos. Não foram verificados efeitos do tipo de substrato e tempo de armazenamento nos sólidos solúveis dos melões durante o armazenamento. Não houve diferença de perda de massa fresca dos frutos produzidos nos dois substratos, sendo de 7,1 ± 0,2%, durante os 42 dias de armazenamento. O tipo de substrato não interferiu na aparência geral, cor, textura e sabor dos melões. Aos 42 dias de armazenamento, os melões produzidos nos dois tipos de substrato apresentaram-se aceitáveis pelo consumidor. No entanto, os produzidos no substrato com areia apresentaram melhor aceitabilidade e decisão de compra ao longo do armazenamento.The objective of this work was to evaluate the storage period postharvest and acceptability by consumer of hybrid melon 'F1 Jangada' (Cucumis melo L., produced in hydroponic system, stored in atmosphere conditions (22 ± 2 ºC and 40 ± 5% relative humidity. The research was carried from June 21st to August 2nd, 2005. It was

  11. Caracterização de biopolímeros produzidos por Beijerinckia sp. 7070 em diferentes tempos de cultivo Characterization of biopolymers produced by Beijerinckia sp 7070 at different culture times

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    Caroline Dellinghausen Borges

    2004-09-01

    Full Text Available Biopolímeros são polissacarídeos microbianos. O biopolímero produzido por Beijerinckia sp. 7070 possui comportamento pseudoplástico e apresenta alta viscosidade em baixas velocidades de deformação, conferindo ao polímero excelentes características de suspensão. O objetivo desse trabalho foi caracterizar o biopolímero produzido por Beijerinckia sp. 7070 em diferentes tempos de cultivo, quanto à produção total, produção de polímeros de fibra longa e curta, produtividade, viscosidade e composição química. Os polímeros produzidos em meio YM líquido foram recuperados em diferentes tempos de cultivo, secos e pesados para determinação da produção e produtividade. O tipo de fibra produzido durante o cultivo foi avaliado microscopicamente. Viscosidades aparentes de solução aquosa 1% foram determinadas a 6, 12, 30 e 60rpm, a 25º C, em um viscosímetro Brookfield. A composição do biopolímero foi determinada por cromatografia em camada delgada comparativa. As maiores produções totais encontradas foram em 30 e 72h, a maior produtividade em 48h e a maior viscosidade em 72h. Os polímeros de fibra longa apresentaram uma tendência de tornarem-se mais longos com o tempo. A viscosidade do polímero de fibra longa foi maior que a do de fibra curta. Todos os biopolímeros apresentaram os mesmos componentes (glucose, galactose, fucose e ácido glucurônico mas em concentrações diferentes.Biopolymers are microbial polysaccharides. The biopolymer produced by Beijerinckia sp 7070 has pseudoplastic behaviour and shows high viscosity at low deformation rates, giving to polymer excellent suspension characteristics. The objective of this work was to characterize the biopolymer produced at different culture times by Beijerinckia sp 7070 in relation to total production, production of short and long fiber polymers, productivity, viscosity and chemical composition. The polymers produced in liquid YM medium were recovered at different

  12. Does perioperative tactile evaluation of the train-of-four response influence the frequency of postoperative residual neuromuscular blockade?

    DEFF Research Database (Denmark)

    Pedersen, T; Viby-Mogensen, J; Bang, U

    1990-01-01

    The authors conducted a randomized controlled clinical trial to evaluate the usefulness of perioperative manual evaluation of the response to train-of-four (TOF) nerve stimulation. A total of 80 patients were divided into four groups of 20 each. For two groups (one given vecuronium and one...... pancuronium), the anesthetists assessed the degree of neuromuscular blockade during operation and during recovery from neuromuscular blockade by manual evaluation of the response to TOF nerve stimulation. In the other two groups, one of which received vecuronium and the other pancuronium, the anesthetists...

  13. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes

    DEFF Research Database (Denmark)

    Zebis, Mette K; Andersen, Lars L; Brandt, Mikkel;

    2016-01-01

    BACKGROUND: Adolescent female football and handball players are among the athletes with the highest risk of sustaining anterior cruciate ligament (ACL) injuries. AIM: This study evaluated the effects of evidence-based lower extremity injury prevention training on neuromuscular and biomechanical...... risk factors for non-contact ACL injury. METHODS: 40 adolescent female football and handball players (15-16 years) were randomly allocated to a control group (CON, n=20) or neuromuscular training group (NMT, n=20). The NMT group performed an injury prevention programme as a warm-up before their usual...

  14. Processing quality of potato tubers produced during autumn and spring and stored at different temperatures Qualidade de processamento de tubérculos de batata produzidos no outono e na primavera e armazenados em diferentes temperaturas

    Directory of Open Access Journals (Sweden)

    Sergio T de Freitas

    2012-03-01

    Full Text Available The objective of this work was to access processing quality of potato clones (Solanum tuberosum Asterix, SMINIA793101-3, and Missaukee cultivated during spring and autumn growing seasons and stored at 4, 8, 12, or 25ºC. Clones grown in spring had shorter dormancy than clones grown in autumn. Potato tubers grown in spring and autumn and stored at 4ºC, as well as tubers grown in autumn and stored at 8ºC had no sprouting for six months. Among clones grown in autumn, the longest dormancy period during storage at 12ºC was observed in the clone SMINIA793101-3, and at 25ºC was in the clone Asterix. In potato tubers grown in spring, the longest dormancy period during storage at 8ºC was observed in the clones SMINIA793101-3 and Missaukee, at 12ºC was in the clone SMINIA793101-3, and at 25ºC was in the clones Asterix and Missaukee. Potato tubers grown in spring had higher dry matter, starch content, and respiration rates, and lower reducing sugar, and total polyphenol content. The only exception was the Missaukee that had similar dry matter content in both growing seasons. In general, storage at 4ºC and 8ºC were more effective in reducing respiration rates and maintaining higher dry mater content of potato tubers. Chip darkening, reducing sugars, and total polyphenol content increased during storage of potato tubers. Darker chip color, higher reducing sugars and polyphenol content were obtained during storage at temperatures of 4ºC and 8ºC. These results suggest that the best storage temperature depends on genotype, tuber physiological age, and growing conditions.O objetivo deste trabalho foi determinar a qualidade de processamento dos clones de batata (Solanum tuberosum Asterix, SMINIA793101-3, e Missaukee cultivados durante outono e primavera e armazenados a 4, 8, 12, ou 25ºC. Clones produzidos na primavera tiveram menor período de dormência que clones produzidos no outono. Tubérculos produzidos na primavera e outono e armazenados a 4º

  15. Assessing tetraplegic patients' neuro-muscular adaptations to a six-week physiotherapeutic programme.

    Science.gov (United States)

    Oke, Kayode Israel; Kubeyinje, Oluwaseun S; Agwubike, Elias O

    2012-07-05

    Spinal cord injury is a life-transforming condition of sudden onset that can have devastating consequences. A multidisciplinary, functional goal-oriented programme is required to enable the tetraplegic patient live as fully and independently life as possible. Physiotherapy is a very important part of the multidisciplinary team required to prevent many of the immobilization complications that may result in serious functional limitations, reduce overall morbidity and achieve well patterned recovery. This study therefore highlights the neuromuscular adaptations of tetraplegic patients to physiotherapy over a period of six weeks. Fifteen patients participated in this study and the results showed that even though changes in the musculoskeletal parameters are inevitable in tetraplegics, the extent/degree of reduction of these parameters was grossly minimized in the studied subjects through the administration of physiotherapeutic measures. However, further research using a large sample size will be required to evaluate the physiologic adaptations of the neuromuscular system to the physiotherapy interventions among patients with spinal cord injury.

  16. Speed adaptation in a powered transtibial prosthesis controlled with a neuromuscular model

    Science.gov (United States)

    Markowitz, Jared; Krishnaswamy, Pavitra; Eilenberg, Michael F.; Endo, Ken; Barnhart, Chris; Herr, Hugh

    2011-01-01

    Control schemes for powered ankle–foot prostheses would benefit greatly from a means to make them inherently adaptive to different walking speeds. Towards this goal, one may attempt to emulate the intact human ankle, as it is capable of seamless adaptation. Human locomotion is governed by the interplay among legged dynamics, morphology and neural control including spinal reflexes. It has been suggested that reflexes contribute to the changes in ankle joint dynamics that correspond to walking at different speeds. Here, we use a data-driven muscle–tendon model that produces estimates of the activation, force, length and velocity of the major muscles spanning the ankle to derive local feedback loops that may be critical in the control of those muscles during walking. This purely reflexive approach ignores sources of non-reflexive neural drive and does not necessarily reflect the biological control scheme, yet can still closely reproduce the muscle dynamics estimated from biological data. The resulting neuromuscular model was applied to control a powered ankle–foot prosthesis and tested by an amputee walking at three speeds. The controller produced speed-adaptive behaviour; net ankle work increased with walking speed, highlighting the benefits of applying neuromuscular principles in the control of adaptive prosthetic limbs. PMID:21502131

  17. Selective innervation of fast and slow muscle regions during early chick neuromuscular development.

    Science.gov (United States)

    Rafuse, V F; Milner, L D; Landmesser, L T

    1996-11-01

    The electrical properties of adult motoneurons are well matched to the contractile properties of the fast or slow muscle fibers that they innervate. How this precise matching occurs developmentally is not known. To investigate whether motoneurons exhibit selectivity in innervating discrete muscle regions, containing either fast or slow muscle fibers during early neuromuscular development, we caused embryonic chick hindlimb muscles to become innervated by segmentally inappropriate motoneurons. We used the in vitro spinal cord-hindlimb preparation to identify electrophysiologically the pools of foreign motoneurons innervating the posterior iliotibialis (pITIB), an all-fast muscle, and the iliofibularis (IFIB), a partitioned muscle containing discrete fast and slow regions. The results showed that the pITIB and the fast region of the IFIB were exclusively innervated by motoneurons that normally supply fast muscles. In contrast, the slow region of the IFIB was always innervated by motoneuron pools that normally supply slow muscles. Some experimental IFIB muscles lacked a fast region and were innervated solely by "slow" motoneurons. In addition, the intramuscular nerve branching patterns were always appropriate to the fast-slow nature of the muscle (region) innervated. The selective innervation was found early in the motoneuron death period, and we found no evidence that motoneurons grew into appropriate muscle regions, but failed to form functional contacts. Together, these results support the hypothesis that different classes of motoneurons exhibit molecular differences that allow them to project selectively to, and innervate, muscle fibers of the appropriate type during early neuromuscular development.

  18. Chronic respiratory failure in patients with neuromuscular diseases: diagnosis and treatment.

    Science.gov (United States)

    Paschoal, Ilma Aparecida; Villalba, Wander de Oliveira; Pereira, Mônica Corso

    2007-01-01

    Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid), as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respiratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available in Brazil to these patients, it can be said that the high rates of morbidity and mortality in these individuals are more often related to the fact that they cough inefficiently rather than to the fact that they ventilate poorly. In this review, with the objective of presenting the options of devices available to support and substitute for natural ventilation in patients with neuromuscular diseases, we have compiled a brief history of the evolution of orthopedic braces and prostheses used to aid respiration since the end of the 19th century. In addition, we highlight the elements that are fundamental to the diagnosis of alveolar hypoventilation and of failure of the protective cough mechanism: taking of a clinical history; determination of peak cough flow; measurement of maximal inspiratory and expiratory pressures; spirometry in two positions (sitting and supine); pulse oximetry; capnography; and polysomnography. Furthermore, the threshold values available in the literature for the use of nocturnal ventilatory support and for the extension of this support through the daytime period are presented. Moreover, the maneuvers used to increase cough efficiency, as well as the proper timing of their introduction, are discussed.

  19. Intravenous immunoglobulin in the treatment of autoimmune neuromuscular diseases: present status and practical therapeutic guidelines.

    Science.gov (United States)

    Dalakas, M C

    1999-11-01

    This review summarizes the current status of intravenous immunoglobulin (IVIg) in the treatment of autoimmune neuromuscular disorders and the possible mechanisms of action of the drug based on work in vivo, in vitro, and in animal models. Supply of idiotypic antibodies, suppression of antibody production, or acceleration of catabolism of immunoglobulin G (IgG) are relevant in explaining the efficacy of IVIg in myasthenia gravis (MG), Lambert-Eaton myasthenic syndrome (LEMS), and antibody-mediated neuropathies. Suppression of pathogenic cytokines has putative relevance in inflammatory myopathies and demyelinating neuropathies. Inhibition of complement binding and prevention of membranolytic attack complex (MAC) formation are relevant in dermatomyositis (DM), Guillain-Barré syndrome (GBS), and MG. Modulation of Fc receptors or T-cell function is relevant in chronic inflammatory demyelinating polyneuropathy (CIDP), GBS, and inflammatory myopathies. The clinical efficacy of IVIg, based on controlled clinical trials conducted in patients with GBS, CIDP, multifocal motor neuropathy (MMN), DM, MG, LEMS, paraproteinemic IgM anti-myelin-associated glycoprotein (anti-MAG) demyelinating polyneuropathies, and inclusion body myositis is summarized and practical issues related to each disorder are addressed. The present role of IVIg therapy in other disorders based on small controlled or uncontrolled trials is also summarized. Finally, safety issues, risk factors, adverse reactions, spurious results or serological tests, and practical guidelines associated with the administration of IVIg in the treatment of neuromuscular disorders are presented.

  20. Alternative NF-κB Isoforms in the Drosophila Neuromuscular Junction and Brain.

    Directory of Open Access Journals (Sweden)

    Bo Zhou

    Full Text Available The Drosophila NF-κB protein Dorsal is expressed at the larval neuromuscular junction, where its expression appears unrelated to known Dorsal functions in embryonic patterning and innate immunity. Using confocal microscopy with domain-specific antisera, we demonstrate that larval muscle expresses only the B isoform of Dorsal, which arises by intron retention. We find that Dorsal B interacts with and stabilizes Cactus at the neuromuscular junction, but exhibits Cactus independent localization and an absence of detectable nuclear translocation. We further find that the Dorsal-related immune factor Dif encodes a B isoform, reflecting a conservation of B domains across a range of insect NF-κB proteins. Carrying out mutagenesis of the Dif locus via a site-specific recombineering approach, we demonstrate that Dif B is the major, if not sole, Dif isoform in the mushroom bodies of the larval brain. The Dorsal and Dif B isoforms thus share a specific association with nervous system tissues as well as an alternative protein structure.

  1. A training program to improve neuromuscular indices in female high school volleyball players.

    Science.gov (United States)

    Noyes, Frank R; Barber-Westin, Sue D; Smith, Stephanie T; Campbell, Thomas

    2011-08-01

    The purpose of this study was to determine if a sports-specific training program could improve neuromuscular indices in female high school volleyball players. We combined components from a previously published knee ligament injury prevention intervention program for jump and strength training with additional exercises and drills to improve speed, agility, overall strength, and aerobic conditioning. We hypothesized that this sports-specific training program would lead to significant improvements in neuromuscular indices in high school female volleyball players. Thirty-four athletes (age 14.5 years ± 1.0) participated in the supervised 6-week program, 3 d·wk(-1) for approximately 90-120 minutes per session. The program was conducted on the school's volleyball court and weight room facilities. The athletes underwent a video drop-jump test, multistage fitness test, vertical jump test, and sit-up test before and after training. A significant increase was found in the mean VO2max score (p volleyball programs.

  2. Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

    Directory of Open Access Journals (Sweden)

    Sébastien Pesenti

    2016-01-01

    Full Text Available The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP and muscular dystrophy (DMD. Patient’s preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking and 30 DMD patients (24 nonwalking. Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases. No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperative management strategy should decrease postoperative complications and increases outcome. A standardized preoperative patient evaluation and preparation including respiratory capacity and nutritional, digestive, and musculoskeletal status are mandatory prior to surgery.

  3. Neuromuscular responses to mild-muscle damaging eccentric exercise in a low glycogen state.

    Science.gov (United States)

    Gavin, James P; Myers, Stephen D; Willems, Mark E T

    2015-02-01

    The aim of this study was to examine the effect of low muscle glycogen on the neuromuscular responses to maximal eccentric contractions. Fourteen healthy men (22 ± 3 years) performed single-leg cycling (20 min at ~75% maximal oxygen uptake (V̇O2 max); eight 90 s sprints at a 1:1 work-to-rest ratio (5% decrements from 90% to 55% V̇O2 max until exhaustion) the evening before 100 eccentric (1.57 rads(-1)) with reduced (RED) and normal glycogen (NORM). Neuromuscular responses were measured during and up to 48 h after with maximal voluntary and involuntary (twitch, 20 Hz and 50 Hz) isometric contractions. During eccentric contractions, peak torque decreased (RED: -16.1 ± 2.5%; NORM: -6.2 ± 5.1%) and EMG frequency increased according to muscle length. EMG activity decreased for RED only. After eccentric contractions, maximal isometric force was reduced up to 24h for NORM (-13.5 ± 5.8%) and 48 h for RED (-7.4 ± 10.9%). Twelve hours after eccentric contractions, twitch force and the 20:50 Hz ratio were decreased for RED but not for NORM. Immediate involuntary with prolonged voluntary force loss suggests that reduced glycogen is associated with increased susceptibility to mild muscle-damaging eccentric exercise with contributions of peripheral and central mechanisms to be different during recovery.

  4. Quisqualate-activated single channel currents in neuromuscular preparations of small and large crayfish.

    Science.gov (United States)

    Finger, W; Martin, C; Pareto, A

    1988-06-01

    Single channel currents elicited by 1-5 mumol/l quisqualate in neuromuscular preparations in large (greater than 16 month old) and small (1-3 month old) crayfish were recorded by means of the patch-clamp technique. In preparations from large crayfish single channel currents of variable amplitude (-1 to -12 pA) were induced by quisqualate. The mean burst lengths of these currents were tau approximately equal to 1-2 ms. In the opener muscle of the first walking leg and the contractor epimeralis muscle of small crayfish the mean burst lengths of single channel currents evoked by quisqualate were prolonged by a factor of about 4 (tau approximately equal to 5 ms). Moreover, in the opener muscle of the first walking leg of small crayfish single channel currents of small amplitude (-0.5 to -2.5 pA) were preferentially evoked by quisqualate. By contrast, in the contractor epimeralis muscle of small crayfish mainly single channel currents of large amplitude (-10 to -12 pA) were elicited by quisqualate. The results suggest that at the stage of neuromuscular development characterizing the small crayfish, gating properties of excitatory postsynaptic channels are different from those in adult crayfish. Furthermore, the results obtained in the opener muscle of the first walking leg of small crayfish are consistent with those obtained previously by means of the noise analysis technique.

  5. Neuromuscular fatigue is not different between constant and variable frequency stimulation.

    Directory of Open Access Journals (Sweden)

    Maria Papaiordanidou

    Full Text Available This study compared fatigue development of the triceps surae induced by two electrical stimulation protocols composed of constant and variable frequency trains (CFTs, VFTs, 450 trains, 30 Hz, 167 ms ON, 500 ms OFF and 146 ms ON, 500 ms OFF respectively. For the VFTs protocol a doublet (100 Hz was used at the beginning of each train. The intensity used evoked 30% of a maximal voluntary contraction (MVC and was defined using CFTs. Neuromuscular tests were performed before and after each protocol. Changes in excitation-contraction coupling were assessed by analysing the M-wave [at rest (Mmax and during MVC (Msup] and associated peak twitch (Pt. H-reflex [at rest (Hmax and during MVC (Hsup] and the motor evoked potential (MEP during MVC were studied to assess spinal and corticospinal excitability of the soleus muscle. MVC decrease was similar between the protocols (-8%, P<0.05. Mmax, Msup and Pt decreased after both protocols (P<0.01. Hmax/Mmax was decreased (P<0.05, whereas Hsup/Msup and MEP/Msup remained unchanged after both protocols. The results indicate that CFTs and VFTs gave rise to equivalent neuromuscular fatigue. This fatigue resulted from alterations taking place at the muscular level. The finding that cortical and spinal excitability remained unchanged during MVC indicates that spinal and/or supraspinal mechanisms were activated to compensate for the loss of spinal excitability at rest.

  6. Experience in Perioperative Management of Patients Undergoing Posterior Spine Fusion for Neuromuscular Scoliosis

    Science.gov (United States)

    Peltier, Emilie; Launay, Franck; Fuentes, Stéphane; Bollini, Gérard; Viehweger, Elke; Jouve, Jean-Luc

    2016-01-01

    The objective of this investigation was to determine the outcome of spine fusion for neuromuscular (NM) scoliosis, using Unit Rod technique, with emphasis on complications related to preoperative general health. Between 1997 and 2007, 96 consecutive patients with neuromuscular scoliosis operated on with Unit Rod instrumentation were retrospectively reviewed. The inclusion criteria were diagnosis of NM scoliosis due to cerebral palsy (CP) and muscular dystrophy (DMD). Patient's preoperative general health, weight, and nutrition were collected. Different radiographic and clinical parameters were evaluated. There were 66 CP patients (59 nonwalking) and 30 DMD patients (24 nonwalking). Mean age at surgery was 16.5 years and 13.9 years, respectively. All radiographic measurements improved significantly. Wound infection rate was 16.7% (11% of reoperation rate in CP; 10% in DMD; 3 hardware removal cases). No pelvic fracture due to rod irritation was observed. Unit Rod technique provides good radiographic and clinical outcomes even if this surgery is associated with a high complication rate. It is a quick, simple, and reliable technique. Perioperative management strategy should decrease postoperative complications and increases outcome. A standardized preoperative patient evaluation and preparation including respiratory capacity and nutritional, digestive, and musculoskeletal status are mandatory prior to surgery. PMID:28058256

  7. Sport-specific functional movement can simulate aspects of neuromuscular fatigue occurring in team sports.

    Science.gov (United States)

    Wilke, Jan; Fleckenstein, Johannes; Krause, Frieder; Vogt, Lutz; Banzer, Winfried

    2016-06-01

    Fatigue protocols have been used over the years to examine muscular exhaustion. As an alternative to approaches in laboratory settings, functional agility protocols claiming to mimic the multifaceted loads of athletic activity have been proposed. This study aimed to examine the effects of a functional agility short-term fatigue protocol (FAST-FP) on neuromuscular function. Twenty-eight healthy sports students (15 males, aged 24.3 ± 2.4 years) completed the FAST-FP, which consists of four components: three counter-movement jumps (90% of individual maximum), a 20-s bout of step-ups, three bodyweight squats and an agility run. Tasks were repeated until the participants no longer achieved the required jump height in two consecutive sets. Outcomes (pre-post) encompassed subjective exhaustion (visual analogue scale [VAS]), maximum isometric voluntary force of the knee extensors (MIVF), reactive strength index (RSI), mean power frequency (MPF, measured using surface electromyography) and maximum knee range of motion (ROM). Post-intervention, VAS (+54 mm) increased significantly, while MIVF (-6.1%), RSI (-10.7%) and MPF (-4.1%) were reduced (p  0.05). The FAST-FP induces small-to-moderate impairments in neuromuscular function and considerable self-perceived fatigue. Current evidence on exhaustion developing in team sports suggests that this magnitude of fatigue is similar. The protocol might thus be valuable in the evaluation of treatments counteracting post-match fatigue in team sports.

  8. APP-dependent glial cell line-derived neurotrophic factor gene expression drives neuromuscular junction formation.

    Science.gov (United States)

    Stanga, Serena; Zanou, Nadège; Audouard, Emilie; Tasiaux, Bernadette; Contino, Sabrina; Vandermeulen, Gaëlle; René, Frédérique; Loeffler, Jean-Philippe; Clotman, Frédéric; Gailly, Philippe; Dewachter, Ilse; Octave, Jean-Noël; Kienlen-Campard, Pascal

    2016-05-01

    Besides its crucial role in the pathogenesis of Alzheimer's disease, the knowledge of amyloid precursor protein (APP) physiologic functions remains surprisingly scarce. Here, we show that APP regulates the transcription of the glial cell line-derived neurotrophic factor (GDNF). APP-dependent regulation of GDNF expression affects muscle strength, muscular trophy, and both neuronal and muscular differentiation fundamental for neuromuscular junction (NMJ) maturation in vivo In a nerve-muscle coculture model set up to modelize NMJ formation in vitro, silencing of muscular APP induces a 30% decrease in secreted GDNF levels and a 40% decrease in the total number of NMJs together with a significant reduction in the density of acetylcholine vesicles at the presynaptic site and in neuronal maturation. These defects are rescued by GDNF expression in muscle cells in the conditions where muscular APP has been previously silenced. Expression of GDNF in muscles of amyloid precursor protein null mice corrected the aberrant synaptic morphology of NMJs. Our findings highlight for the first time that APP-dependent GDNF expression drives the process of NMJ formation, providing new insights into the link between APP gene regulatory network and physiologic functions.-Stanga, S., Zanou, N., Audouard, E., Tasiaux, B., Contino, S., Vandermeulen, G., René, F., Loeffler, J.-P., Clotman, F., Gailly, P., Dewachter, I., Octave, J.-N., Kienlen-Campard, P. APP-dependent glial cell line-derived neurotrophic factor gene expression drives neuromuscular junction formation.

  9. Myosin VI contributes to synaptic transmission and development at the Drosophila neuromuscular junction

    Directory of Open Access Journals (Sweden)

    Campbell Shelagh

    2011-07-01

    Full Text Available Abstract Background Myosin VI, encoded by jaguar (jar in Drosophila melanogaster, is a unique member of the myosin superfamily of actin-based motor proteins. Myosin VI is the only myosin known to move towards the minus or pointed ends of actin filaments. Although Myosin VI has been implicated in numerous cellular processes as both an anchor and a transporter, little is known about the role of Myosin VI in the nervous system. We previously recovered jar in a screen for genes that modify neuromuscular junction (NMJ development and here we report on the genetic analysis of Myosin VI in synaptic development and function using loss of function jar alleles. Results Our experiments on Drosophila third instar larvae revealed decreased locomotor activity, a decrease in NMJ length, a reduction in synaptic bouton number, and altered synaptic vesicle localization in jar mutants. Furthermore, our studies of synaptic transmission revealed alterations in both basal synaptic transmission and short-term plasticity at the jar mutant neuromuscular synapse. Conclusions Altogether these findings indicate that Myosin VI is important for proper synaptic function and morphology. Myosin VI may be functioning as an anchor to tether vesicles to the bouton periphery and, thereby, participating in the regulation of synaptic vesicle mobilization during synaptic transmission.

  10. Neuromuscular performance of elite rugby union players and relationships with salivary hormones.

    Science.gov (United States)

    Crewther, Blair T; Lowe, Tim; Weatherby, Robert P; Gill, Nicholas; Keogh, Justin

    2009-10-01

    This study compared the neuromuscular performance (speed, power, strength) of elite rugby union players, by position, and examined the relationship between player performance and salivary hormones, by squad and position. Thirty-four professional male rugby players were assessed for running speed (10-m, 20-m or 30-m sprints), concentric mean (MP) and peak power (PP) during a 70-kg squat jump (SJ) and 50-kg bench press throw (BT), and estimated 1 repetition maximum (1RM) strength for a box squat (BS) and bench press (BP). Tests were performed on separate days with absolute and normalized (power and strength only) values computed. Saliva was collected before each test and assayed for testosterone (Sal-T) and cortisol (Sal-C). In absolute terms, the backs demonstrated greater speed and BT MP, whereas the forwards produced greater SJ PP and MP and BS 1RM (p 0.05). A comparison (absolute and normalized) of BT PP showed no positional differences (p > 0.05), whereas BP 1RM was greater for the forwards (p neuromuscular performance and hormone secretion patterns. Based on these findings, it was suggested that training to increase whole-body and muscle mass might facilitate general performance improvements. Training prescription might also benefit from acute and chronic hormone monitoring to identify those individuals likely to respond more to hormonal change.

  11. Effects of strength and power training on neuromuscular variables in older adults.

    Science.gov (United States)

    Wallerstein, Lilian França; Tricoli, Valmor; Barroso, Renato; Rodacki A, L F; Russo, Luciano; Aihara, André Yui; da Rocha Correa Fernandes, Artur; de Mello, Marco Tulio; Ugrinowitsch, Carlos

    2012-04-01

    The purpose of this study was to compare the neuromuscular adaptations produced by strength-training (ST) and power-training (PT) regimens in older individuals. Participants were balanced by quadriceps cross-sectional area (CSA) and leg-press 1-repetition maximum and randomly assigned to an ST group (n = 14; 63.6 ± 4.0 yr, 79.7 ± 17.2 kg, and 163.9 ± 9.8 cm), a PT group (n = 16; 64.9 ± 3.9 yr, 63.9 ± 11.9 kg, and 157.4 ± 7.7 cm), or a control group (n = 13; 63.0 ± 4.0 yr, 67.2 ± 10.8 kg, and 159.8 ± 6.8 cm). ST and PT were equally effective in increasing (a) maximum dynamic and isometric strength (p < .05), (b) increasing quadriceps muscle CSA (p < .05), and (c) decreasing electrical mechanical delay of the vastus lateralis muscle (p < .05). There were no significant changes in neuromuscular activation after training. The novel finding of the current study is that PT seems to be an attractive alternative to regular ST to maintain and improve muscle mass.

  12. Neuromuscular and inflammatory responses to handball small-sided games: the effects of physical contact.

    Science.gov (United States)

    Dello Iacono, A; Eliakim, A; Padulo, J; Laver, L; Ben-Zaken, S; Meckel, Y

    2016-09-30

    The aim of this study was to investigate the influence of physical contact on neuromuscular impairments and inflammatory response during handball small-sided games. Using a counterbalanced design, 12 elite male junior handball players were divided into two groups: contact (C-SSG) and no-contact (NC-SSG), performing both contact and no-contact small-sided games, in reverse order on two training sessions separated by 5 days. The methodology and rules were identical for the two SSG regimens, with the only difference being the inclusion or prohibition of upper body use for physical contacts. Upper and lower body neuromuscular performances and blood concentrations of inflammatory cytokine IL-6 were assessed before and immediately after the games. During small-sided games, video analysis was used to establish the physical contact counts. Significant differences were found in most upper and lower limbs muscles kinetic variables and in the physical contact events (all P handball players. These outcomes outline the specific physiological profile of C-SSG that, in turn, might be used by practitioners and coaches as a practical approach to strategically select exercises in athlete's overall training program.

  13. Effectiveness of neuromuscular electrical stimulation in the functional knee rehabilitation in soldiers

    Directory of Open Access Journals (Sweden)

    R. Castillo-Lozano

    2015-12-01

    Full Text Available Background: The versatility of military physical therapist practice enables them not only to diagnose knee injuries but also to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. The aim this study was to evaluate the effectiveness of interventions by Neuromuscular Electrical Stimulation (NMES in the functional knee rehabilitation in soldiers and describe the main predictors and determinants in each intervention. Methods: A systematic search of the literature about NMES in physiotherapy was performed using the following electronic databases: Web of Science, PubMed, Cochrane, Physiotherapy Evidence Database (PEDro and CINAHL. The search strategy was: "neuromuscular electrical stimulation" and "physical therapy" and "strengthening" and "knee". Inclusion criteria were: original articles published and peer reviewed between 2004-2015, focusing on physiotherapy interventions by NMES on subjects older than 18 years. A total resulting from 46 studies was included in the study. Results: The results show the evidence on the effectiveness of NMES therapeutic/preventive purposes in the muscular system; and the importance of physical therapy in the army. Conclusion: As a method of functional knee rehabilitation, NMES proves effective in achieving the therapeutic/preventive objectives in soldiers. Level of Evidence: II. Systematic review of randomized clinical trials with homogeneity.

  14. INFLUENCE OF ALLOFERIN ON NEUROMUSCULAR FUNCTION IN MYASTHENIA PATIENTS UNDERGOING THYMECTOMY

    Institute of Scientific and Technical Information of China (English)

    罗霞; 叶铁虎; 罗爱伦; 任洪智; 金永芳

    1994-01-01

    Myasthenia gravis patients are hypersensitive to nondepolarizing relaxants,such as alcuronium,an intermedi-ate-long nondepolarizing agent. This study observed the effects of alcuronium treatment in myasthenia gravis pa-tients as compared with non-MG patients during operation.Ten MG patients (Ossermann class Ⅰ-Ⅳ,scheduled for thymectomy)and 10non-MG patients(ASA class Ⅰ-Ⅱ,scheduled for operation)were selected.An induc-tion dose of alcuronium 0.2 mg/kg and thiopental 4-6 mg/kg was given,followed by intubation and ventilation with 50% nitrous oxide in oxygen and 0.5-1.5% ethrane.Neuromuscular transmission was monitored using an accelerogragh and degrees of neuromuscular function at different depths were recorded.There were statistically significant differences between the tow groups.The effect of alloferin in the MG group was quicker and deeper.This study also found a relation between MG class and the recovery of respiration: Respiratory recovery was quicker in classes Ⅰ-Ⅱ than in classes Ⅲ-Ⅳ.

  15. Distinct neural and neuromuscular strategies underlie independent evolution of simplified advertisement calls.

    Science.gov (United States)

    Leininger, Elizabeth C; Kelley, Darcy B

    2013-04-07

    Independent or convergent evolution can underlie phenotypic similarity of derived behavioural characters. Determining the underlying neural and neuromuscular mechanisms sheds light on how these characters arose. One example of evolutionarily derived characters is a temporally simple advertisement call of male African clawed frogs (Xenopus) that arose at least twice independently from a more complex ancestral pattern. How did simplification occur in the vocal circuit? To distinguish shared from divergent mechanisms, we examined activity from the calling brain and vocal organ (larynx) in two species that independently evolved simplified calls. We find that each species uses distinct neural and neuromuscular strategies to produce the simplified calls. Isolated Xenopus borealis brains produce fictive vocal patterns that match temporal patterns of actual male calls; the larynx converts nerve activity faithfully into muscle contractions and single clicks. In contrast, fictive patterns from isolated Xenopus boumbaensis brains are short bursts of nerve activity; the isolated larynx requires stimulus bursts to produce a single click of sound. Thus, unlike X. borealis, the output of the X. boumbaensis hindbrain vocal pattern generator is an ancestral burst-type pattern, transformed by the larynx into single clicks. Temporally simple advertisement calls in genetically distant species of Xenopus have thus arisen independently via reconfigurations of central and peripheral vocal neuroeffectors.

  16. Neuromuscular characteristics and fatigue in endurance and sprint athletes during a new anaerobic power test.

    Science.gov (United States)

    Paavolainen, L; Häkkinen, K; Nummela, A; Rusko, H

    1994-01-01

    The purpose of this study was to investigate neuromuscular and energy performance characteristics of anaerobic power and capacity and the development of fatigue. Ten endurance and ten sprint athletes performed a new maximal anaerobic running power test (MARP), which consisted of n x 20-s runs on a treadmill with 100-s recovery between the runs. Blood lactate concentration [la-]b was measured after each run to determine submaximal and maximal indices of anaerobic power (P3 mmol.l-1, P5 mmol.l-1, P10 mmol.l-1 and Pmax) which was expressed as the oxygen demand of the runs according to the American College of Sports Medicine equation: the oxygen uptake (ml.kg-1.min-1) = 0.2 x velocity (m.min-1) + 0.9 x slope of treadmill (frac) x velocity (m.min-1) + 3.5. The height of rise of the centre of gravity of the counter movement jumps before (CMJrest) and during (CMJ) the MARP test, as well as the time of force production (tF) and electromyographic (EMG) activity of the leg muscles of CMJ performed after each run were used to describe the neuromuscular performance characteristics. The maximal oxygen uptake (VO2max), anaerobic and aerobic thresholds were determined in the VO2max test, which consisted of n x 3-min runs on the treadmill.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Neuromuscular alterations in the dilated ileum of an adult patient with segmental lymphangiectasia.

    Science.gov (United States)

    Paggi, Silvia; Ferrero, Stefano; Braidotti, Paola; de Rai, Paolo; Conte, Dario; Basilisco, Guido

    2008-09-01

    Intestinal lymphangiectasia is a rare condition, which is characterized by the dilation of small bowel lymphatics and presents with signs and symptoms of protein-losing enteropathy. Some patients have complained of occlusive symptoms attributable to the mechanical obstruction caused by the considerable mucosal edema associated with the lymphatic dilation. On the basis of the hypothesis that alterations in the neuromuscular structures controlling clearance function or gut tone may play a role in ileal dilation, we examined the resected ileum of a 48-year-old male patient with segmental lymphangiectasia histologically, immunohistochemically (for S100 protein, PGP 9.5, Bcl-2, neuron-specific enolase, neurofilaments, synaptophysin, and CD117/C-kit), and by means of electron microscopy. Histology showed pseudocystic dilation of the mucosal, submucosal, and muscular lymphatics with fragmentation of the circular and longitudinal muscle layers. Hardly any neural expression of synaptophysin was observed, but the neural structures were otherwise morphologically normal and reacted normally to the other neural markers. This case shows that neuromuscular alterations can be found in the dilated ileum of patients with segmental lymphangiectasia.

  18. Antagonism by hemoglobin of effects induced by L-arginine in neuromuscular preparations from rats

    Directory of Open Access Journals (Sweden)

    C.R. Ambiel

    2001-04-01

    Full Text Available Nitric oxide (NO-synthase is present in diaphragm, phrenic nerve and vascular smooth muscle. It has been shown that the NO precursor L-arginine (L-Arg at the presynaptic level increases the amplitude of muscular contraction (AMC and induces tetanic fade when the muscle is indirectly stimulated at low and high frequencies, respectively. However, the precursor in muscle reduces AMC and maximal tetanic fade when the preparations are stimulated directly. In the present study the importance of NO synthesized in different tissues for the L-Arg-induced neuromuscular effects was investigated. Hemoglobin (50 nM did not produce any neuromuscular effect, but antagonized the increase in AMC and tetanic fade induced by L-Arg (9.4 mM in rat phrenic nerve-diaphragm preparations. D-Arg (9.4 mM did not produce any effect when preparations were stimulated indirectly at low or high frequency. Hemoglobin did not inhibit the decrease of AMC or the reduction in maximal tetanic tension induced by L-Arg in preparations previously paralyzed with d-tubocurarine and directly stimulated. Since only the presynaptic effects induced by L-Arg were antagonized by hemoglobin, the present results suggest that NO synthesized in muscle acts on nerve and skeletal muscle. Nevertheless, NO produced in nerve and vascular smooth muscle does not seem to act on skeletal muscle.

  19. Excitatory effects of Buthus C56 toxin on Drosophila larval neuromuscular junction

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    S. P. Gawade

    2003-01-01

    Full Text Available Buthus C56 toxin from venom of the Indian red scorpion Mesobuthus tamulus was studied for its effects on spontaneous miniature excitatory junctional potentials (MEJP on Drosophila larval neuromuscular junctions. C56 toxin was isolated on CM-Cellulose with linear gradient of ammonium acetate buffer, pH 6.0. Toxin purity was determined on SDS slab gel electrophoresis. Effective concentration of C56 toxin was based on contraction paralysis units (CPU in Drosophila 3rd instar larvae by microinjection (0.1 CPU/ml = 2 x 10-6 g/ml. The toxin-induced excitatory junctional potentials were studied for calcium dependency (0.2 mM to 1.2 mM Ca2+ in Drosophila Ringer. Excitatory junctional potential amplitude was increased with increasing calcium concentration; maximum increase in the frequency at 0.4 mM Ca2+/4 mM Mg2+ Drosophila Ringer. It was suggested that while amplitude of excitatory junctional potentials was increased with concentration, maximum frequency increase at 0.4 mMCa2+/4 mM Mg2+ Drosophila Ringer may be due to augmented Ca2+ influx in 0.4 mM Ca2+, when NMDA receptors were maximally activated in C56 toxin-treated Drosophila larval neuromuscular junction.

  20. Neuromuscular Responses to 14 Weeks of Traditional and Daily Undulating Resistance Training.

    Science.gov (United States)

    Ullrich, B; Holzinger, S; Soleimani, M; Pelzer, T; Stening, J; Pfeiffer, M

    2015-06-01

    This study compared traditional (TP) and daily undulating (DUP) periodization on muscle strength, EMG-estimated neural drive and muscle architecture of the quadriceps femoris (QF). 10 non-athletic females (24.4±3.2 years) performed 14 weeks of isometric training for the QF exercising 1 leg using TP and the contralateral leg using DUP. Intensities varied from 60% to 80% of MVC and the intensity zones and training volume were equated for each leg. Knee extension MVC, maximal voluntary QF-EMG activity and vastus lateralis (VL) muscle architecture were measured in both legs before, after 6 weeks and after 14 weeks of training using dynamometry, surface EMG and ultrasonography. Isometric MVC and maximal QF-EMG remained unaltered after 6 weeks of training, but were significantly (PMVC: TP 24%, DUP 23%; QF-EMG: TP 45%, DUP 46%). VL-architecture remained unchanged following 6 weeks of training, but VL-muscle thickness (TP 17%, DUP 16%) and fascicle length (TP 16%, DUP 17%) displayed significant (P<0.05) enlargements after 14 weeks in both legs. Importantly, these temporal neuromuscular alterations displayed no significant differences between the training legs. Therefore, periodization may not act as a key trigger for neuromuscular adaptations.

  1. Safety and Efficacy of Subcutaneous Immunoglobulin in the Treatment of Neuromuscular Disorders.

    Science.gov (United States)

    Salameh, Johnny S; Deeb, Wissam; Burawski, Lauren; Wright, Suzanne; Souayah, Nizar

    2016-03-01

    Many neuromuscular diseases may be treated with immunoglobulins. In the United States, the major form of immunoglobulin used is intravenous (IV). Recently, there has been an increased interest in research regarding the use of subcutaneous immunoglobulin (SCIg), mainly for improved patient quality of life, convenience, potential for fewer systemic adverse events, and avoiding wear-off. The widespread use of the subcutaneous formulation in neurology has been affected by some limitations, mainly the smaller volume and higher frequency of infusions compared to IV administration. Also, there are different pharmacokinetic properties that should be considered to evaluate whether they change the immunomodulatory effect. There are several formulations available that address some limitations. Several studies have assessed efficacy, safety, and quality of life of SCIg in neurology. This review article summarizes the current evidence for the use of SCIg in neuromuscular diseases. It also addresses the pharmacokinetic differences and the different formulations available. The current available preliminary evidence indicates that SCIg is at least as effective as the IV formulations.

  2. Severe neuromuscular denervation of clinically relevant muscles in a mouse model of spinal muscular atrophy.

    Science.gov (United States)

    Ling, Karen K Y; Gibbs, Rebecca M; Feng, Zhihua; Ko, Chien-Ping

    2012-01-01

    Spinal muscular atrophy (SMA), a motoneuron disease caused by a deficiency of the survival of motor neuron (SMN) protein, is characterized by motoneuron loss and muscle weakness. It remains unclear whether widespread loss of neuromuscular junctions (NMJs) is involved in SMA pathogenesis. We undertook a systematic examination of NMJ innervation patterns in >20 muscles in the SMNΔ7 SMA mouse model. We found that severe denervation (<50% fully innervated endplates) occurs selectively in many vulnerable axial muscles and several appendicular muscles at the disease end stage. Since these vulnerable muscles were located throughout the body and were comprised of varying muscle fiber types, it is unlikely that muscle location or fiber type determines susceptibility to denervation. Furthermore, we found a similar extent of neurofilament accumulation at NMJs in both vulnerable and resistant muscles before the onset of denervation, suggesting that neurofilament accumulation does not predict subsequent NMJ denervation. Since vulnerable muscles were initially innervated, but later denervated, loss of innervation in SMA may be attributed to defects in synapse maintenance. Finally, we found that denervation was amendable by trichostatin A (TSA) treatment, which increased innervation in clinically relevant muscles in TSA-treated SMNΔ7 mice. Our findings suggest that neuromuscular denervation in vulnerable muscles is a widespread pathology in SMA, and can serve as a preparation for elucidating the biological basis of synapse loss, and for evaluating therapeutic efficacy.

  3. Effects of Dynamic Neuromuscular Analysis Training on Static and Dynamic Balance in Indian Female Basketball Players

    Directory of Open Access Journals (Sweden)

    Archna Sharma

    2013-04-01

    Full Text Available The aim of this paper was to investigate the effects of dynamic neuromuscular analysis on static and dynamic balance of Indian state level female athletes. It was hypothesized that the training protocol would improve both static and dynamic components of the balance, improving dynamic balance more than static. A total of 43 randomly selected state level female basketball players aged 16 -18 years participated in the study. The subjects were further divided into two groups, viz. Dynamic Neuromuscular Analysis (DNA group (n=23 and control group (n = 20. Pre and post static balance was tested to all the subjects by Stork Balance Test (SBT and Balance Error Scoring System (BESS, and dynamic balance was measured by Star Excursion Balance Test (SEBT. DNA intervention of 90 minutes was given for 6 weeks while the control group followed traditional training. Results showed a significant improvement both in static and dynamic balance (p<0.001. It might be concluded that 6 week DNA training designed for the prevention of ACL injuries could also improve both static and dynamic balance in Indian female basketball players.

  4. Consecuencias clínicas de las alteraciones neuromusculares en el paciente crítico Clinical consequences of neuromuscular impairments in critically ill patients

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    A. Mesejo

    2006-05-01

    Full Text Available La patología neuromuscular en el paciente crítico se desarrolla en dos contextos: enfermedades neurológicas primarias que requieren su ingreso en Medicina Intensiva por necesitar vigilancia estricta o ventilación mecánica y manifestaciones del sistema nervioso periférico secundarias a enfermedades sistémicas críticas. En el primer grupo son las más frecuentes el Síndrome de Guillain-Barré y la Miastenia Gravis y en el segundo la Polineuropatía y la Miopatía del paciente crítico. El patrón clínico común más frecuente consiste en el desarrollo de un cuadro de acusada debilidad y cuadriparesia cuya manifestación más típica es la necesidad de respiración asistida o la dificultad/imposibilidad para su retirada. Se consideran factores desencadenantes el fracaso multiorgánico y la sepsis en la polineuropatía y los esteroides y bloqueantes neuromusculares en la miopatía, actuando como coadyuvantes en ambos casos la malnutrición, particularmente la hipoalbimunemia, y la hiperglucemia. Considerando que la afectación neuropática y miopática coexisten con frecuencia, se ha acuñado el término polineuromiopatía del paciente crítico. Tanto el Síndrome de Guillain-Barré como la polineuropatía del paciente crítico se localizan a nivel del nervio periférico, por lo que debe efectuarse un diagnóstico diferencial entre ambos. La forma de presentación es diferente ya que el primero es una patología aguda que motiva su ingreso en UCI, mientras que la polineuropatía se adquiere durante la hospitalización. En el primero es frecuente la afectación del sistema nervioso autónomo y la disociación albúmino-citológica en el LCR, lo que no se da en la polineuropatía. Los estudios electrofisiológicos muestran signos de desmelinización con disminución de la velocidad de conducción y normalidad en la amplitud de potenciales motores en el Síndrome de Guillain- Barré frente a velocidad de conducción normal y amplitud reducida

  5. Eletroestimulação neuromuscular na reabilitação da disfagia orofaríngea Neuromuscular electrical stimulation in the rehabilitation of oropharyngeal dysphagia

    Directory of Open Access Journals (Sweden)

    Bruno Tavares de Lima Guimarães

    2010-12-01

    Full Text Available A reabilitação da disfagia orofaríngea ganhou um novo instrumento terapêutico, a eletroestimulação neuromuscular (EENM, sendo que os mais renomados pesquisadores têm estudado a indicação e os resultados desta abordagem. O objetivo deste trabalho foi apresentar revisão bibliográfica sobre a aplicabilidade da EENM na reabilitação da disfagia orofaríngea. Realizou-se amplo levantamento bibliográfico em bases de dados, englobando as duas últimas décadas de pesquisa na área. Este artigo de revisão mostrou que ainda não há consenso sobre o uso da EENM na reabilitação da disfagia. Constatou-se que a maioria dos trabalhos descreveu o uso da EENM de forma isolada, não relatou as técnicas fonoaudiológicas associadas à eletroterapia e utilizou amostras heterogêneas que agrupavam disfagias orofaríngeas mecânicas e neurogênicas. Somente recentemente programas específicos têm sido delineados e testados em populações mais homogêneas.The rehabilitation of oropharyngeal dysphagia has a new therapeutic tool, the neuromuscular electrical stimulation (NMES, and the most renowned researchers have been studying the applicability and the results of this approach. The aim of this study was to present a literature review regarding the applicability of NMES in the rehabilitation of oropharyngeal dysphagia. An extensive literature review was carried out, considering the last two decades of research in the area. The review showed that there is still no consensus on the use of NMES in the rehabilitation of dysphagia. It was found that most studies described the use of NMES in isolation, did not describe the techniques associated with speech-language therapy associated to electrotherapy, and used heterogeneous samples that clustered mechanical and neurogenic oropharyngeal dysphagia. Only recently specific programs have been designed and tested in more homogeneous populations.

  6. Muscles in a mouse model of spinal muscular atrophy show profound defects in neuromuscular development even in the absence of failure in neuromuscular transmission or loss of motor neurons.

    Science.gov (United States)

    Lee, Young Il; Mikesh, Michelle; Smith, Ian; Rimer, Mendell; Thompson, Wesley

    2011-08-15

    A mouse model of the devastating human disease "spinal muscular atrophy" (SMA) was used to investigate the severe muscle weakness and spasticity that precede the death of these animals near the end of the 2nd postnatal week. Counts of motor units to the soleus muscle as well as of axons in the soleus muscle nerve showed no loss of motor neurons. Similarly, neither immunostaining of neuromuscular junctions nor the measurement of the tension generated by nerve stimulation gave evidence of any significant impairment in neuromuscular transmission, even when animals were maintained up to 5days longer via a supplementary diet. However, the muscles were clearly weaker, generating less than half their normal tension. Weakness in 3 muscles examined in the study appears due to a severe but uniform reduction in muscle fiber size. The size reduction results from a failure of muscle fibers to grow during early postnatal development and, in soleus, to a reduction in number of fibers generated. Neuromuscular development is severely delayed in these mutant animals: expression of myosin heavy chain isoforms, the elimination of polyneuronal innervation, the maturation in the shape of the AChR plaque, the arrival of SCs at the junctions and their coverage of the nerve terminal, the development of junctional folds. Thus, if SMA in this particular mouse is a disease of motor neurons, it can act in a manner that does not result in their death or disconnection from their targets but nonetheless alters many aspects of neuromuscular development.

  7. Neuromuscular Scoliosis

    Science.gov (United States)

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  8. Increased rate of force development and neuromuscular activity after high-load resistance training in patients undergoing dialysis

    DEFF Research Database (Denmark)

    Molsted, Stig; Andersen, Jesper L.; Eidemak, Inge;

    2013-01-01

    AimThe aim of this study was to investigate the effects of high-load resistance training on the rate of force development and neuromuscular function in patients undergoing dialysis. MethodsTwenty-nine patients were tested before and after 16 weeks of resistance training. The rate of force develop...

  9. Effect of Early Physical Activity Programs on Motor Performance and Neuromuscular Development in Infants Born Preterm: A Randomized Clinical Trial

    Science.gov (United States)

    Valizadeh, Leila; Sanaeefar, Mahnaz; Hosseini, Mohammad Bager; Asgari Jafarabadi, Mohammad; Shamili, Aryan

    2017-01-01

    Introduction: Although the survival rate of infants born preterm has increased, the prevalence of developmental problems and motor disorders among this population of infants remains the same. This study investigated the effect of physical activity programs in and out of water on motor performance and neuromuscular development of infants born preterm and had induced immobility by mechanical ventilation. Methods: This study was carried out in Al-Zahra hospital, Tabriz. 76 premature infants were randomly assigned into four groups. One group received daily passive range of motion to all extremities based on the Moyer-Mileur protocol. Hydrotherapy group received exercises for shoulders and pelvic area in water every other day. A combination group received physical activity programs in and out of water on alternating days. Infants in a containment group were held in a fetal position. Duration of study was two weeks ‘from 32 through 33 weeks post menstrual age (PMA). Motor outcomes were measured by the Test of Infant Motor Performance. Neuromuscular developmental was assessed by New Ballard scale and leg recoil and Ankle dorsiflexion items from Dubowitz scale. Data were analyzed using SPSS version 13. Results: TIMP and neuromuscular scores improved in all groups. Motor performance did not differ between groups at 34 weeks PMA. Postural tone of leg recoil was significantly higher in physical activity groups post intervention. Conclusion: Physical activities and containment didn’t have different effects on motor performance in infants born preterm. Leg recoil of neuromuscular development items was affected by physical activity programs. PMID:28299299

  10. Futsal match-related fatigue affects running performance and neuromuscular parameters but not finishing kick speed or accuracy

    DEFF Research Database (Denmark)

    Milioni, Fabio; Vieira, Luiz H P; Barbieri, Ricardo A;

    2016-01-01

    the finishing kicks were not significantly affected. Conclusion: Therefore, we conclude that despite the decline in running performance and neuromuscular variables presenting an important manifestation of central fatigue, this condition apparently does not affect the speed and accuracy of finishing kicks....

  11. Reversal of rocuronium-induced neuromuscular block by sugammadex is independent of renal perfusion in anesthetized cats

    NARCIS (Netherlands)

    Staals, L.M.; Boer, H.D. de; Egmond, J. van; Hope, F.; Pol, F.M. van de; Bom, A.H.; Driessen, J.J.; Booij, L.H.D.J.

    2011-01-01

    PURPOSE: Sugammadex is a selective relaxant binding agent designed to encapsulate the aminosteroidal neuromuscular blocking agent rocuronium, thereby reversing its effect. Both sugammadex and the sugammadex-rocuronium complex are eliminated by the kidneys. This study investigated the effect of sugam

  12. Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes.

    NARCIS (Netherlands)

    Barendrecht, M.; Lezeman, H.C.; Duysens, J.E.J.; Smits-Engelsman, B.C.M.

    2011-01-01

    The purpose of this study was to investigate the effects of added neuromuscular training (NMT), as compared to just regular training (RT), on lower extremity kinematics and single leg stability in adolescent team handball players of both sexes and to investigate whether these effects are more eviden

  13. Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study.

    LENUS (Irish Health Repository)

    Walls, Raymond J

    2010-01-01

    Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve quadriceps femoris muscle (QFM) strength and clinical function in subjects with knee osteoarthritis (OA) however it has not been previously investigated as a prehabilitation modality.

  14. Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial.

    Science.gov (United States)

    Balcı, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

    2016-04-01

    [Purpose] The aim of our study was to compare the initial effects of scapular proprioceptive neuromuscular facilitation techniques and classic exercise interventions with physiotherapy modalities on pain, scapular dyskinesis, range of motion, and function in adhesive capsulitis. [Subjects and Methods] Fifty-three subjects were allocated to 3 groups: scapular proprioceptive neuromuscular facilitation exercies and physiotherapy modalities, classic exercise and physiotherapy modalities, and only physiotherapy modalities. The intervention was applied in a single session. The Visual Analog Scale, Lateral Scapular Slide Test, range of motion and Simple Shoulder Test were evaluated before and just after the one-hour intervention in the same session (all in one session). [Results] All of the groups showed significant differences in shoulder flexion and abduction range of motion and Simple Shoulder Test scores. There were statistically significant differences in Visual Analog Scale scores in the proprioceptive neuromuscular facilitation and control groups, and no treatment method had significant effect on the Lateral Scapular Slide Test results. There were no statistically significant differences between the groups before and after the intervention. [Conclusion] Proprioceptive neuromuscular facilitation, classic exercise, and physiotherapy modalities had immediate effects on adhesive capsulitis in our study. However, there was no additional benefit of exercises in one session over physiotherapy modalities. Also, an effective treatment regimen for shoulder rehabilitation of adhesive capsulitis patients should include scapular exercises.

  15. DEVELOPMENT AND TESTING PSYCHOMETRIC PROPERTIES OF AN ICF-BASED HEALTH MEASURE : THE NEUROMUSCULAR DISEASE IMPACT PROFILE

    NARCIS (Netherlands)

    Bos, Isaac; Kuks, Jan B. M.; Wynia, Klaske

    2015-01-01

    Objectives: To develop a measure that is based on the International Classification of Functioning, Disability and Health (ICF) and reflects the prevalence and severity of disabilities related to neuromuscular disorders, and to evaluate the psychometric properties of this measure. Methods: A prelimin

  16. Bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5% Bloqueo del plexo braquial por la vía posterior con el uso de neuroestimulador y ropivacaína a 0,5% Posterior brachial plexus block with nerve stimulator and 0.5% ropivacaine

    Directory of Open Access Journals (Sweden)

    Lúcia Beato

    2005-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Existem várias maneiras de abordar o plexo braquial dependendo da experiência do anestesiologista e da região a ser operada. O bloqueio do plexo braquial pela via posterior pode representar uma alternativa para cirurgias de ombro, clavícula e úmero proximal. O objetivo deste estudo foi mostrar os resultados observados em pacientes submetidos a bloqueio do plexo braquial pela via posterior com uso de neuroestimulador e ropivacaína a 0,5%. MÉTODO: Vinte e dois pacientes com idade entre 17 e 76 anos, estado físico ASA I e II, submetidos a cirurgias ortopédicas envolvendo o ombro, clavícula e úmero proximal foram anestesiados com bloqueio de plexo braquial pela via posterior utilizando neuroestimulador a partir de 1 mA. Obtida a contração desejada, a corrente foi diminuída para 0,5 mA e, permanecendo a resposta contrátil, foram injetados 40 mL de ropivacaína a 0,5%. Foram avaliados os seguintes parâmetros: latência, analgesia, duração da cirurgia, duração da analgesia e do bloqueio motor, complicações e efeitos colaterais. RESULTADOS: O bloqueio foi efetivo em 20 dos 22 pacientes; a latência média foi de 15,52 min; a duração média da cirurgia foi de 1,61 hora. A média de duração da analgesia foi de 15,85 horas e do bloqueio motor 11,16 horas. Não foram observados sinais e sintomas clínicos de toxicidade do anestésico local e nenhum paciente apresentou efeitos adversos do bloqueio. CONCLUSÕES: Nas condições deste estudo o bloqueio de plexo braquial pela via posterior com o uso do neuroestimulador e ropivacaína a 0,5% demonstrou ser uma técnica efetiva, confortável para o paciente e de fácil realização.JUSTIFICATIVA Y OBJETIVOS: Existen varios modos de abordar el plexo braquial dependiendo de la experiencia del anestesiologista y de la región que será operada. El bloqueo del plexo braquial por la vía posterior puede representar una alternativa para cirugías de hombro, clav

  17. Bloqueio do plexo braquial por via interescalênica: efeitos sobre a função pulmonar Bloqueo del plexo braquial por vía interescalénica: efectos sobre la función pulmonar Interscalene brachial plexus block: effects on pulmonary function

    Directory of Open Access Journals (Sweden)

    Alexandre Hortense

    2010-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A via interescalênica é um dos acessos mais comumente utilizados no bloqueio do plexo braquial. Todavia, tem-se demonstrado associação dessa técnica com o bloqueio do nervo frênico ipsilateral. A disfunção diafragmática daí resultante provoca alterações na mecânica pulmonar, potencialmente deletérias em pacientes com limitação da reserva ventilatória. O objetivo do estudo foi avaliar a repercussão do bloqueio interescalênico sobre a função pulmonar por meio da medida da capacidade vital forçada (CVF. MÉTODO: Estudo duplamente encoberto com 30 pacientes, estado físico I ou II (ASA, distribuídos aleatoriamente em dois grupos de15. Foi administrada solução a 0,5% de ropivacaína (Grupo Ropi ou bupivacaína a 0,5% com epinefrina (Grupo Bupi. O bloqueio foi realizado utilizando estimulador de nervo periférico e sendo injetados 30 mL de anestésico local. Quatro espirometrias foram realizadas em cada paciente: antes do bloqueio, 30 minutos, 4 e 6 horas após. Os pacientes não receberam sedação. RESULTADOS: Um paciente do Grupo Ropi e três pacientes do Grupo Bupi foram excluídos do estudo por falha de bloqueio. A redução da CVF no Grupo Ropi foi máxima aos 30 minutos (25,1% e a partir de então houve tendência progressiva à recuperação. Já com bupivacaína, a redução da CVF pareceu ser menos acentuada nos diversos momentos estudados; observou-se redução adicional entre 30 minutos (15,8% e 4 horas (17,3%, sendo esta sem diferença estatística. A partir de 4 horas, notou-se tendência à recuperação. Em ambos os grupos, após 6 horas de bloqueio a CVF encontra-se ainda abaixo dos valores prévios. CONCLUSÕES: O bloqueio interescalênico reduz a CVF na maioria dos casos; as alterações foram mais acentuadas no Grupo Ropivacaína.JUSTIFICATIVA Y OBJETIVOS: La vía interescalénica es uno de los accesos más a menudo utilizados en el bloqueo del plexo braquial. Sin embargo, se ha

  18. Therapeutic effects of anti-spastic medication on neuromuscular abnormalities in SCI: a system identification approach.

    Science.gov (United States)

    Mirbagheri, M M; Kindig, M; Niu, X; Varoqui, D

    2013-01-01

    Previous attempts to investigate the effects of antispastic medications are limited to clinical studies using that use clinical evaluations to assess. Since these measures are neither objective nor quantitative, the therapeutic effects of such medications on neuromuscular properties have not been fully evaluated. In this study, as a first attempt, we examined the effect of tizanidine, an anti-spastic medication, on modification of the neuromuscular properties of patients with chronic incomplete spinal cord injury (SCI). Each patient was administered 2 mg of tizanidine four times per day for four weeks. The spastic ankle of each patient was evaluated at baseline (prior to any medication, and then 1, 2, and 4 weeks after the start of medication. The ankle was perturbed with a small-amplitude Pseudo-Random Binary Sequence (PRBS) perturbation at various positions over the ankle range-of-motion. A parallel-cascade system identification technique, which provides an objective and quantitative measure of neuromuscular properties, was used to calculate the intrinsic and reflex stiffness. The stiffness vs. joint angle trends were then calculated for each evaluation; these curves were compared across the intervention time to determine the recovery pattern (i.e. change over time) due to the tizanidine intervention. All patients exhibited decreases in reflex stiffness (which abnormally increase after SCI) due to the medication; however, patients were observed to exhibit multiple recovery patterns. For some patients, the reflex stiffness continuously reduced over the four-week intervention period, while for other patients, the decrease during the first week (i.e. between the baseline and 1-Week evaluations) was most pronounced. Also, some patients presented a significant decrease with time, while others presented no improvement in the intrinsic stiffness. These findings suggest that tizanidine may be effective in reducing not only reflex stiffness, but also the subject

  19. 4-Aminopyridine inhibits the neuromuscular effects of nitric oxide and 8-Br-cGMP

    Directory of Open Access Journals (Sweden)

    Queiroz R.N.

    2003-01-01

    Full Text Available The effects induced by nitric oxide (NO in different tissues depend on direct and/or indirect interactions with K+ channels. The indirect interaction of NO is produced by activation of guanylyl cyclase which increases the intracellular cGMP. Since NO, cGMP and 4-aminopyridine alone induce tetanic fade and increase amplitude of muscular contractions in isolated rat neuromuscular preparations, the present study was undertaken to determine whether or not the neuromuscular effects of NO and 8-Br-cGMP can be modified by 4-aminopyridine. Using the phrenic nerve and diaphragm muscle isolated from male Wistar rats (200-250 g, we observed that L-arginine (4.7 mM and 8-Br-cGMP (18 µM, in contrast to D-arginine, induced an increase in the amplitude of muscle contraction (10.5 ± 0.7%, N = 10 and 8.0 ± 0.7%, N = 10 and tetanic fade (15 ± 2.0%, N = 8 and 11.6 ± 1.7%, N = 8 at 0.2 and 50 Hz, respectively. N G-nitro-L-arginine (4 mM, N = 8 and 8 mM, N = 8 antagonized the effects of L-arginine. 4-Aminopyridine (1 and 10 µM caused a dose-dependent increase in the amplitude of muscle contraction (15 ± 1.8%, N = 9 and 40 ± 3.1%, N = 10 and tetanic fade (17.7 ± 3.3%, N = 8 and 37.4 ± 1.3%, N = 8. 4-Aminopyridine (1 µM, N = 8 did not cause any change in muscle contraction amplitude or tetanic fade of preparations previously paralyzed with d-tubocurarine or stimulated directly. The effects induced by 4-aminopyridine alone were similar to those observed when the drug was administered in combination with L-arginine or 8-Br-cGMP. The data suggest that the blockage of K+ channels produced by 4-aminopyridine inhibits the neuromuscular effects induced by NO and 8-Br-cGMP. Therefore, the presynaptic effects induced by NO seem to depend on indirect interactions with K+ channels.

  20. Estudo comparativo dos bloqueios intercostal e interpleural para analgesia pós-operatória em colecistectomias abertas Estudio comparativo de los bloqueos intercostal e interpleural para analgesia pós-operatoria en colecistectomias abiertas Comparative study of intercostal and interpleural block for post-cholecystectomy analgesia

    Directory of Open Access Journals (Sweden)

    Antonio Mauro Vieira

    2003-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A analgesia no pós-operatório é desejada pelos pacientes e tem sido praticada pela maioria dos anestesiologistas. Além dos opióides, os anestésicos locais têm sido utilizados nos bloqueios periféricos e centrais para se obter a analgesia pós-operatória. O objetivo deste estudo foi comparar duas técnicas de bloqueio dos nervos intercostais para analgesia pós-operatória em colecistectomias abertas. MÉTODO: Sessenta pacientes foram submetidos a colecistectomias abertas com incisão subcostal e receberam bloqueio intercostal (Grupo IC, n=30 ou bloqueio interpleural (Grupo IP, n=30, ambos com 100 mg de bupivacaína a 0,5% com adrenalina, para analgesia pós-operatória. Foram avaliados os tempos de analgesia e as queixas relatadas pelos pacientes. RESULTADOS: A qualidade da analgesia foi considerada boa para ambas as técnicas. A duração média