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Sample records for bloqueio neuromuscular produzido

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

    OpenAIRE

    Braga,Angélica de Fátima de Assunção; Braga,Franklin Sarmento da Silva; Potério,Glória Maria Braga; Frias,José Aristeu Fachini; Pedro,Fernanda Maria Silva; Munhoz,Derli Conceição

    2013-01-01

    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 (propofo...

  2. 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.

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

    OpenAIRE

    Angélica de Fátima de Assunção Braga; Franklin Sarmento da Silva Braga; Glória Maria Braga Potério; José Aristeu Fachini Frias; Fernanda Maria Silva Pedro; Derli Conceição Munhoz

    2013-01-01

    BACKGROUND AND OBJECTIVE: Different drugs, including hypnotics, may influence the pharmacodynamic effects of neuromuscular blockers (NMB). The aim of this study was to evaluate the influence of propofol and etomidate on cisatracurium-induced neuromuscular blockade. METHOD: We included 60 patients, ASA I and II, undergoing elective surgery under general anesthesia in the study and randomly allocated them into two groups, according to their hypnotic drug: GI (propofol) and GII (etomidate). Pati...

  5. 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

    OpenAIRE

    Angélica de Fátima de Assunção Braga; Franklin Sarmento da Silva Braga; Glória Maria Braga Potério; José Aristeu Fachini Frias; Fernanda Maria Silva Pedro; Derli Conceição Munhoz

    2013-01-01

    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 (propofo...

  6. Influência da nifedipina no bloqueio neuromuscular produzido pelo atracúrio e pelo cisatracúrio: estudo em preparações nervo frênico-diafragma de rato

    OpenAIRE

    Sousa, Silmara Rodrigues de; Braga, Angélica de Fátima de Assunção; Potério, Glória Maria Braga; Braga, Franklin Sarmento da Silva; Loyola, Yolanda Christina S; Fernandes, Samanta Cristina Antoniassi

    2006-01-01

    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 bloqueado...

  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 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. Efeitos neuromusculares in vitro e in vivo do atracúrio e do rocurônio em ratos submetidos a tratamento de sete dias com carbamazepina

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

    2008-01-01

    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 acor...

  15. Tromboprofilaxia e bloqueio regional

    Directory of Open Access Journals (Sweden)

    Américo Massafuni Yamashita

    2001-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: No contexto das doenças vasculares periféricas, a doença venosa tromboembólica tem assumido maior importância, à medida em que se apresenta com freqüência e morbi-mortalidade elevadas e, sobretudo, pela possibilidade de alteração de sua evolução quando há reconhecimento e tratamento adequados. O uso cada vez mais freqüente de tromboprofiláticos tornou-se um problema para os anestesiologistas, uma vez que esses agentes têm aumentado a incidência de hematoma espinhal, quando associados a bloqueios regionais. Este trabalho tem o propósito de apresentar aos anestesiologistas, a partir de ampla revisão de literatura, aspectos farmacológicos e bioquímicos dos anticoagulantes mais comumente utilizados e orientações quando houver necessidade de bloqueio regional nos pacientes em esquema de anticoagulação. CONTEÚDO: São apresentadas as características dos diferentes anticoagulantes e implicações no bloqueio regional. No final da descrição de cada fármaco, seguem-se considerações a respeito das recomendações mais importantes. CONCLUSÕES: A realização de bloqueio regional, na vigência de tromboprofilaxia, exige redimensionamento das cautelas, principalmente nos aspectos concernentes à utilização de cateter peridural, punções repetidas e traumáticas; pois, nestes casos, o risco da ocorrência de hematoma espinhal estará aumentado. Adicionalmente, fazem-se necessárias ampla comunicação e preparo das equipes médica e de enfermagem quanto aos pacientes recebendo anticoagulantes, a fim de diminuir os riscos das complicações hemorrágicas. Esses pacientes devem ser monitorizados minuciosamente, a fim de que sejam detectados precocemente sinais incipientes de compressão medular. Se houver suspeita de hematoma espinhal, a confirmação radiográfica deverá ser providenciada imediatamente, devido ao risco de isquemia medular irreversível.

  16. 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

    Directory of Open Access Journals (Sweden)

    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

  17. Neuromuscular Disorders

    Science.gov (United States)

    Neuromuscular disorders affect the nerves that control your voluntary muscles. Voluntary muscles are the ones you can ... function and your ability to breathe. Examples of neuromuscular disorders include Amyotrophic lateral sclerosis Multiple sclerosis Myasthenia ...

  18. Neuromuscular Scoliosis

    Science.gov (United States)

    ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Common Questions & Glossary Resources ... Radiation Exposure in Scoliosis Kyphosis Adolescent Back Pain Spondylolysis For Adolescents For Adults Neuromuscular Scoliosis Neuromuscular scoliosis ...

  19. Neuromuscular Scoliosis

    Science.gov (United States)

    ... irregular spinal curvature caused by disorders of the brain, spinal cord, and muscular system. Nerves and muscles are unable to maintain appropriate balance / alignment of the spine and trunk. Neuromuscular curves are often associated with pelvic obliquity, ...

  20. Endarterectomia carotídea sob bloqueio loco-regional

    OpenAIRE

    Guillaumon,Ana Terezinha; Oliveira,Nara Gelle; Freire,Lucas Marcelo Dias; Baldini Neto,Luis; Martins,Aline Meira; Rocha,Eduardo Faccini

    2005-01-01

    OBJETIVO: Os autores objetivam descrever os resultados nas cirurgias de endarterectomia carotídea, utilizando-se anestesia loco-regional, emprego seletivo de shunt e proteção farmacológica intra-operatória. MÉTODO: Foram estudados doentes submetidos à endarterectomia carotídea sob bloqueio loco-regional, no Hospital das Clínicas da Universidade Estadual de Campinas (UNICAMP), no período de março de 1996 a maio de 2004. Este estudo é composto de 119 endarterectomias (108 doentes), sendo 69 doe...

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

    Directory of Open Access Journals (Sweden)

    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

  2. Influence of nifedipine on the neuromuscular block produced by atracurium and cistracurium: study in rat phrenic-diaphragmatic nerve preparation

    OpenAIRE

    Sousa, Silmara Rodrigues de; Braga, Angélica de Fátima de Assunção; Potério, Glória Maria Braga; Braga, Franklin Sarmento da Silva; Loyola, Yolanda Christina S; Fernandes, Samanta Cristina Antoniassi

    2006-01-01

    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 bloqueado...

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

    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.

  4. Bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba: relato de caso

    Directory of Open Access Journals (Sweden)

    E.R. Santos

    Full Text Available RESUMO Os bloqueios regionais vêm sendo explorados e difundidos no dia a dia da medicina veterinária. O presente trabalho relata a execução do bloqueio de plexo braquial em um bugio-ruivo (Alouatta guariba submetido à amputação de três dígitos. Foi utilizada ropivacaína para o bloqueio, com o paciente sob anestesia geral, com auxílio de neuroestimulador periférico. Quatro horas após a cirurgia e cinco horas após o bloqueio, o paciente não apresentava desconforto ou evitava a manipulação do membro operado e não foram observadas complicações. O bloqueio do plexo braquial é mais comumente utilizado quando se pretende promover analgesia e relaxamento muscular do membro torácico em procedimentos cirúrgicos distais à articulação escápulo-umeral. Há carência em estudos anatômicos sobre diversos primatas, incluindo o bugio-ruivo (Alouatta guariba. Apesar da crescente expansão da clínica de animais silvestres, ainda há lacunas no que diz respeito à execução de técnicas anestésicas em diversas espécies.

  5. Sleep in Neuromuscular Diseases.

    Science.gov (United States)

    Fermin, Anna Monica; Afzal, Umair; Culebras, Antonio

    2016-03-01

    Sleep disorders in neuromuscular disorders are generally caused by respiratory dysfunction associated with these diseases. Hypoventilation in neuromuscular diseases results from both respiratory muscle weakness and reduced chemoreceptor sensitivity, which is required for ventilatory drive. This condition results in repeated arousals, sleep fragmentation, and nocturnal hypoxemia, manifesting most commonly as excessive daytime somnolence. Polysomnography can identify sleep disordered breathing in patients with neuromuscular disorders and treatment with noninvasive ventilation may improve quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  8. Southern Hemisphere atmospheric blocking diagnostic by ECMWF and NCEP/NCAR data Diagnóstico de bloqueios atmosféricos no Hemisférico Sul com reanálises do ECWMF e NCEP/NCAR

    Directory of Open Access Journals (Sweden)

    Monica Cristina Damião Mendes

    2012-09-01

    Full Text Available An assessment of blocking episodes over the Southern Hemisphere, selected from the Era-40 and NCEP/NCAR reanalysis are presented in this study. Blocking can be defined by an objective index based on two 500 hPa geopotential height meridional gradients. The seasonal cycle and preferential areas of occurrence are well reproduced by the two data sets. In both reanalysis used in this study, South Pacific and Oceania were the preferred regions for blocking occurrence, followed by the Atlantic Ocean. However the results revealed differences in frequencies of occurrences, which may be related to the choice of assimilation scheme employed to produce the reanalysis data sets. It is important to note that the ERA 40 and NCEP/NCAR reanalysis were produced using consistent models and assimilation schemes throughout the whole reanalyzed period, which are different for each set.Neste artigo é apresentada uma comparação de episódios de bloqueio no Hemisfério Sul, obtidos das reanálises do ERA 40 e NCEP/NCAR. A definição de bloqueio foi obtida a partir de um índice que se baseia em dois gradientes meridionais da altura geopotencial em 500 hPa. O ciclo sazonal e as áreas preferenciais de ocorrência são bem reproduzidos pelos dois conjuntos de dados. Em ambas as reanálises foi possível notar que o Pacífico Sul e Oceania são as regiões preferenciais de ocorrência de bloqueio, seguido pelo Oceano Atlântico. No entanto, os resultados revelaram diferenças nas frequências de ocorrências, que pode estar relacionada com a assimilação adotada para a produção de conjuntos de dados. É importante notar que os dados do ERA-40 e NCEP/NCAR são produzidos através de modelos consistentes e esquemas de assimilação ao longo do período, que são diferentes para cada conjunto.

  9. 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

  10. Neuromuscular Disorders - Multiple Languages

    Science.gov (United States)

    ... Health Information Translations Spanish (español) Expand Section Neuromuscular Disorders: MedlinePlus Health Topic - English ... Health Information Translations Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  11. [Residual neuromuscular blockade].

    Science.gov (United States)

    Fuchs-Buder, T; Schmartz, D

    2017-06-01

    Even small degrees of residual neuromuscular blockade, i. e. a train-of-four (TOF) ratio >0.6, may lead to clinically relevant consequences for the patient. Especially upper airway integrity and the ability to swallow may still be markedly impaired. Moreover, increasing evidence suggests that residual neuromuscular blockade may affect postoperative outcome of patients. The incidence of these small degrees of residual blockade is relatively high and may persist for more than 90 min after a single intubating dose of an intermediately acting neuromuscular blocking agent, such as rocuronium and atracurium. Both neuromuscular monitoring and pharmacological reversal are key elements for the prevention of postoperative residual blockade.

  12. Neuromuscular blockade in children

    Directory of Open Access Journals (Sweden)

    Almeida João Fernando Lourenço de

    2000-01-01

    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.

  13. 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.

  14. 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.

  15. 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.

  16. Hereditary neuromuscular diseases

    International Nuclear Information System (INIS)

    Oezsarlak, O.; Schepens, E.; Parizel, P.M.; Goethem, J.W. van; Vanhoenacker, F.; Schepper, A.M. de; Martin, J.J.

    2001-01-01

    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

  17. Estudo comparativo dos bloqueios intercostal e interpleural para analgesia pós-operatória em colecistectomias abertas

    Directory of Open Access Journals (Sweden)

    Vieira Antonio Mauro

    2003-01-01

    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 de analgesia foi de 505 minutos no grupo IP e 620 minutos no grupo IC, não havendo diferença estatística entre eles. Náuseas, vômitos e dor abdominal leve foram as queixas pós-operatórias mais freqüentes. Não se constatou qualquer complicação pós-operatória associada exclusivamente aos bloqueios, assim como não foi evidenciado nenhum caso de pneumotórax. CONCLUSÕES: Concluiu-se que as técnicas promoveram analgesia satisfatória após colecistectomia, sendo que o bloqueio interpleural apresentou maior facilidade de execução.

  18. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso

    OpenAIRE

    Morais, Bruno Salomé de; Cruvinel, Marcos Guilherme Cunha; Silva, Yerkes Pereira; Diniz, Dener Augusto; Castro, Carlos Henrique Viana de

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente...

  19. Neuromuscular complications in cancer.

    Science.gov (United States)

    Grisold, W; Grisold, A; Löscher, W N

    2016-08-15

    Cancer is becoming a treatable and even often curable disease. The neuromuscular system can be affected by direct tumor invasion or metastasis, neuroendocrine, metabolic, dysimmune/inflammatory, infections and toxic as well as paraneoplastic conditions. Due to the nature of cancer treatment, which frequently is based on a DNA damaging mechanism, treatment related toxic side effects are frequent and the correct identification of the causative mechanism is necessary to initiate the proper treatment. The peripheral nervous system is conventionally divided into nerve roots, the proximal nerves and plexus, the peripheral nerves (mono- and polyneuropathies), the site of neuromuscular transmission and muscle. This review is based on the anatomic distribution of the peripheral nervous system, divided into cranial nerves (CN), motor neuron (MND), nerve roots, plexus, peripheral nerve, the neuromuscular junction and muscle. The various etiologies of neuromuscular complications - neoplastic, surgical and mechanic, toxic, metabolic, endocrine, and paraneoplastic/immune - are discussed separately for each part of the peripheral nervous system. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Purinoceptors in neuromuscular transmission

    NARCIS (Netherlands)

    Henning, RH

    1997-01-01

    At the neuromuscular junction, P-2-purinoceptors mediate the actions of the co-transmitter ATP and P-1-purinoceptors, those of its degradation product adenosine. The classification of the subtypes of P-1- and P-2-purinoceptors and their signal transduction routes is presented. Purinoceptor mediated

  1. [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.

  2. Pneumotórax pós-bloqueio de plexo braquial guiado por ultrassonografia: relato de caso

    Directory of Open Access Journals (Sweden)

    Beatriz L. S. Mandim

    2012-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial é usado para anestesia nos membros superiores. O uso da ultrassonografia (USG como técnica de bloqueio vem se popularizando nos últimos anos, facilitando a realização do bloqueio por fornecer imagens em tempo real do plexo e das estruturas circunjacentes, além de minimizar as complicações. O objetivo deste relato foi descrever um caso de pneumotórax após bloqueio interescalênico guiado por ultrassonografia. RELATO DE CASO: Paciente masculino, 49 anos, 62 kg e 1,72 m, longilíneo, tabagista, assintomático, ASA II E. Submetido a tratamento cirúrgico de fratura exposta de ulna direita com bloqueio de plexo braquial via interescalênica guiada por USG com complementação por via axilar. Após sedação e antissepsia, foi colocado o probe linear do aparelho de USG perpendicular à fenda interescalênica (12 Hz e introduzido stimucath A50, in plane. Após visualização dos troncos nervosos, foi feita injeção de 20 mL de Ropivacaína 0,5% com complementação do bloqueio via axilar (mesmo volume e concentração de anestésico. Ao término da cirurgia, o paciente queixou-se de dor torácica ventilatório-dependente associada à dispneia e queda da oximetria de pulso (91% em ar ambiente, mantendo-se, entretanto, estável hemodinamicamente (PA = 130/70 e FC = 84 bpm. Apesar de ausculta pulmonar normal, o RX de tórax solicitado evidenciou presença de pneumotórax à direita. Feita drenagem torácica fechada em selo d'água, após a qual o paciente referiu melhoria dos sintomas. Alta em bom estado geral após oito dias. CONCLUSÃO: Apesar da visualização dinâmica das estruturas cervicais com o aparelho de USG, o bloqueio interescalênico pode resultar em pneumotórax. A cúpula pleural mais elevada do que o habitual, devido a um pulmão hiperinsuflado (tabagismo, provavelmente facilitou a punção pleural inadvertida.

  3. 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.

  4. Anesthetic consideration for neuromuscular diseases.

    Science.gov (United States)

    Katz, Jeffery A; Murphy, Glenn S

    2017-06-01

    The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients. The use of succinylcholine should be avoided in muscular dystrophies, motor neuron diseases, and intrinsic muscle disease due to a risk of malignant hyperthermia, hyperkalemia, rhabdomyolysis, and cardiac arrest. The use of quantitative neuromuscular monitoring should be strongly considered whenever nondepolarizing neuromuscular blocking agents are administered. A number of case series and reports have been recently published demonstrating that sugammadex can be safely used in patients with neuromuscular disease; the risk of residual neuromuscular is nearly eliminated when this agent is administered intraoperatively. Careful assessment and management of patients with underlying neuromuscular diseases is required to reduce postoperative complications. This article reviews the anesthetic implications of patients undergoing surgery with neuromuscular disorder.

  5. MRI in neuromuscular disorders

    International Nuclear Information System (INIS)

    Fischmann, Arne

    2014-01-01

    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.)

  6. Neuromuscular junction disorders.

    Science.gov (United States)

    Verschuuren, Jan; Strijbos, Ellen; Vincent, Angela

    2016-01-01

    Diseases of the neuromuscular junction comprise a wide range of disorders. Antibodies, genetic mutations, specific drugs or toxins interfere with the number or function of one of the essential proteins that control signaling between the presynaptic nerve ending and the postsynaptic muscle membrane. Acquired autoimmune disorders of the neuromuscular junction are the most common and are described here. In myasthenia gravis, antibodies to acetylcholine receptors or to proteins involved in receptor clustering, particularly muscle-specific kinase, cause direct loss of acetylcholine receptors or interfere with the agrin-induced acetylcholine receptor clustering necessary for efficient neurotransmission. In the Lambert-Eaton myasthenic syndrome (LEMS), loss of the presynaptic voltage-gated calcium channels results in reduced release of the acetylcholine transmitter. The conditions are generally recognizable clinically and the diagnosis confirmed by serologic testing and electromyography. Screening for thymomas in myasthenia or small cell cancer in LEMS is important. Fortunately, a wide range of symptomatic treatments, immunosuppressive drugs, or other immunomodulating therapies is available. Future research is directed to understanding the pathogenesis, discovering new antigens, and trying to develop disease-specific treatments. © 2016 Elsevier B.V. All rights reserved.

  7. Perineal neuromuscular fatigue.

    Science.gov (United States)

    Deffieux, X; Hubeaux, K; Damphousse, M; Raibaut, P; Sheikh Ismael, S; Thoumie, P; Amarenco, G; Lapeyre, E; Jousse, M

    2006-07-01

    The physiology of urinary continence during stress is complex and the role of passive and active mechanisms remains unclear. Coughing leads to a contraction of urethral rhabdomyosphincter and pelvic floor muscles leading to a positive urethro-vesical gradient and continence. Neuromuscular fatigue can involve all striated muscles, including rhabdomyosphincter, peri-urethral and pelvic floor muscles. This article reviews results of studies assessing perineal muscular fatigue in urinary incontinence. A systematic review of the literature (Medline, Pascal and Embase) with use of the MESH keywords fatigue, stress, urinary incontinence, pelvic floor, urethra, urethral pressure, and muscle. Animal models have shown that the pelvic muscles (iliococcygeus and pubococcygeous) exhibit more neuromuscular fatigue than classical skeletal striated muscles (i.e. soleus muscle). Although the human external urethral sphincter is considered to be a highly fatigue-resistant muscle with its high proportion of slow muscle fibers, repeated coughing seems to lead to decreased urethral pressure in numerous women affected with stress urinary incontinence. In this case, "urethral fatigue" might be a possibility. Although few studies have focused on perineal muscular fatigue, such increased fatigue in pelvic floor muscles may play a role in the pathophysiologic features of stress urinary incontinence in women.

  8. 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.

  9. Bloqueio vascular de hastes de gérberas cv. Patrizia

    Directory of Open Access Journals (Sweden)

    Rose Beatriz Antes

    2009-08-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2009v22n2p1 O objetivo do presente trabalho foi demonstrar, com o auxílio da microscopia eletrônica de varredura (MEV, os bloqueios vasculares relacionados com o rápido declínio da vida em vaso e avaliar a eficiência de diferentes concentrações de um conservante floral comercial sobre a longevidade de gérberas de corte (Gerbera jamesonii cv. Patrizia. Os tratamentos: T1 – controle (água potável; T2 – água e frascos esterilizados; T3 – 0,75%; T4 – 1,0% e T5 – 1,5% do produto comercial Flower® foram aplicados em delineamento experimental inteiamente casualizado com quatro repetições e unidades experimentais de cinco hastes de 50cm cada. A vida em vaso não foi significativamente ampliada como resultado do uso do conservante floral. Todas as concentrações do produto comercial proporcionaram uma redução significativa do número de UFC/mL da solução. Como resultado deste controle da população de bactérias, a absorção de água manteve-se maior durante os três primeiros dias naqueles tratamentos onde foi adicionado o conservante floral. Nas imagens da MEV observa-se a proliferação de bactérias no xilema das hastes não tratadas com o conservante floral. A adição do produto comercial na solução de manutenção das hastes é recomendável por controlar o crescimento de bactérias e diminuir o bloqueio dos vasos do xilema de gérberas.

  10. 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.

  11. 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.

  12. CONECTIVIDADE DA PAISAGEM NA BACIA DO RIO SANA (RJ: RELAÇÃO ENTRE ÁREAS DE CAPTAÇÃO EFETIVA E TIPOS DE BLOQUEIOS

    Directory of Open Access Journals (Sweden)

    Nathalia Silva Duarte

    2017-10-01

    Full Text Available A transferência de água e sedimentos em um sistema fluvial é influenciada, dentre outros aspectos, por bloqueios que interrompem o transporte desses materiais e diminuem a conectividade da paisagem em bacias hidrográficas. O estudo identifica a natureza desses bloqueios e sua influência na área de captação efetiva e conectividade da Bacia do rio Sana, afluente do rio Macaé, localizado na região norte do estado do Rio de Janeiro. A metodologia estabelece a declividade das encostas como principal fator controlador do processo, determina especificações para o mapeamento dos bloqueios e da área de captação efetiva, e, ainda, indica parâmetros para classificação do grau de conectividade de bacias hidrográficas. Foram identificados seis tipos de bloqueios, classificados como Zona Tampão (impedem a conectividade encosta-canal ou Barreiras (interferem no fluxo de água e sedimentos entre tributários e canal principal, incorporados separadamente à modelagem da área de captação efetiva, devido às suas particularidades na influência do aporte de sedimento e água ao sistema fluvial. Neste contexto, a Bacia do rio Sana apresentou-se conectada quando considerados os bloqueios do tipo Zona Tampão e desconectada, quando adicionados os bloqueios do tipo Barreiras. Considerando os resultados alcançados, pode-se dizer que a utilização da abordagem de conectividade na escala de análise de bacia hidrográfica demonstrou-se adequada, pois contempla os processos naturais e antrópicos na evolução da paisagem.

  13. 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.

  14. Bloqueio do nervo supraescapular: procedimento importante na prática clínica. Parte II

    OpenAIRE

    Fernandes,Marcos Rassi; Barbosa,Maria Alves; Sousa,Ana Luiza Lima; Ramos,Gilson Cassem

    2012-01-01

    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 ...

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

    OpenAIRE

    Lima, Isabel Flor de; Linda, Filipe; Santos, Ângela dos; Lages, Neusa; Correia, Carlos

    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. We present as an option for epidural analgesia and intravenous opioid infusion a clinical case of transversus abdominis plane (TAP) bl...

  16. Bloqueio do Plano Transverso Abdominal Contínuo Bilateral em Doente com Cirurgia Abdominal Prévia

    OpenAIRE

    Lima, Isabel Flor de; Linda, Filipe; dos Santos, Ângela; Lages, Neusa; Correia, Carlos

    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.

  17. Bloqueio do nervo maxilar para redução de fraturas do osso zigomático e assoalho da órbita

    Directory of Open Access Journals (Sweden)

    Geier Karl Otto

    2003-01-01

    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.

  18. 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

  19. Palliative care in neuromuscular diseases

    NARCIS (Netherlands)

    de Visser, Marianne; Oliver, David J.

    2017-01-01

    Purpose of review Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. Neuromuscular disorders (NMDs) are characterized by progressive muscle weakness, leading to pronounced and incapacitating

  20. 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

    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

  1. Vocational perspectives and neuromuscular disorders

    NARCIS (Netherlands)

    Andries, F.; Wevers, C. W.; Wintzen, A. R.; Busch, H. F.; Höweler, C. J.; de Jager, A. E.; Padberg, G. W.; de Visser, M.; Wokke, J. H.

    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

  2. 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

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

    OpenAIRE

    Pereira, Ivan Dias Fernandes; Grando, Marcela Miguel; Vianna, Pedro Thadeu Galvão; Braz, José Reinaldo Cerqueira; Castiglia, Yara Marcondes Machado; Vane, Luís Antônio; Módolo, Norma Sueli Pinheiro; Nascimento Júnior, Paulo do; Amorim, Rosa Beatriz; Rodrigues Júnior, Geraldo Rolim; Braz, Leandro Gobbo; Ganem, Eliana Marisa

    2011-01-01

    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 obstétri...

  4. Myths and facts in neuromuscular pharmacology - New developments in reversing neuromuscular blockade

    NARCIS (Netherlands)

    Fink, H.; Hollmann, M. W.

    2012-01-01

    Pharmacologic reversal of neuromuscular blockade is a topic nor very well acknowledged and controversially discussed. Reasons for this are numerous and include missing perception of the potential complications of residual neuromuscular paralysis including an increased morbidity and mortality, as

  5. Neuromuscular disorders and chronic ventilation.

    Science.gov (United States)

    Alexiou, Stamatia; Piccione, Joseph

    2017-08-01

    Morbidity and mortality have decreased in patients with neuromuscular disease due to implementation of therapies to augment cough and improve ventilation. Infants with progressive neuromuscular disease will eventually develop respiratory complications as a result of muscle weakness and their inability to compensate during periods of increased respiratory loads. The finding of nocturnal hypercapnia is often the trigger for initiating non-invasive ventilation and studies have shown that its use not only may improve sleep-disordered breathing, but also that it may have an effect on daytime function, symptoms related to hypercapnia, and partial pressure of CO 2 . It is important to understand the respiratory physiology of this population and to understand the benefits and limitations of assisted ventilation. Copyright © 2017. Published by Elsevier Ltd.

  6. [Respiratory treatments in neuromuscular disease].

    Science.gov (United States)

    Martínez Carrasco, C; Cols Roig, M; Salcedo Posadas, A; Sardon Prado, O; Asensio de la Cruz, O; Torrent Vernetta, A

    2014-10-01

    In a previous article, a review was presented of the respiratory pathophysiology of the patient with neuromuscular disease, as well as their clinical evaluation and the major complications causing pulmonary deterioration. This article presents the respiratory treatments required to preserve lung function in neuromuscular disease as long as possible, as well as in special situations (respiratory infections, spinal curvature surgery, etc.). Special emphasis is made on the use of non-invasive ventilation, which is changing the natural history of many of these diseases. The increase in survival and life expectancy of these children means that they can continue their clinical care in adult units. The transition from pediatric care must be an active, timely and progressive process. It may be slightly stressful for the patient before the adaptation to this new environment, with multidisciplinary care always being maintained. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  7. Neuromuscular blockade in the elderly.

    Science.gov (United States)

    Stankiewicz-Rudnicki, Michał

    2016-01-01

    The aim of the presented review is to highlight the clinical problem of postoperative residual curarization (PORC) following general anaesthesia in the elderly. Possible complications of PORC are described along with age-induced changes in pharmacokinetics of long and intermediate-acting neuromuscular blocking agents. This is intended to facilitate the selection and to promote appropriate intraoperative use of muscle relaxants in patients over the age of 65 years.

  8. Dengue-associated neuromuscular complications

    OpenAIRE

    Ravindra Kumar Garg; Hardeep Singh Malhotra; Amita Jain; Kiran Preet Malhotra

    2015-01-01

    Dengue is associated with many neurological dysfunctions. Up to 4% of dengue patients may develop neuromuscular complications. Muscle involvement can manifest with myalgias, myositis, rhabdomyolysis and hypokalemic paralysis. Diffuse myalgia is the most characteristic neurological symptom of dengue fever. Dengue-associated myositis can be of varying severity ranging from self-limiting muscle involvement to severe dengue myositis. Dengue-associated hypokalemic paralysis often has a rapidly evo...

  9. 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...

  10. Recent advances in neuromuscular block during anesthesia.

    Science.gov (United States)

    Boon, Martijn; Martini, Christian; Dahan, Albert

    2018-01-01

    Muscle relaxation is a routine part of anesthesia and has important advantages. However, the lingering effects of muscle relaxants in the postoperative period have historically been associated with postoperative adverse events. Neuromuscular reversal, together with neuromuscular monitoring, is a recognized strategy to reduce the rate of postoperative residual relaxation but has only marginally improved outcome in the past few decades. Sugammadex, a novel reversal agent with unique encapsulating properties, has changed the landscape of neuromuscular reversal and opened up new opportunities to improve patient care. By quickly and completely reversing any depth of neuromuscular block, it may reduce the rate of residual relaxation and improve respiratory recovery. In addition, sugammadex has made the use of deep neuromuscular block possible during surgery. Deep neuromuscular block may improve surgical working conditions and allow for a reduction in insufflation pressures during selected laparoscopic procedures. However, whether and how this may impact outcomes is not well established.

  11. BIOLOGY OF SOME NEUROMUSCULAR DISORDERS

    Directory of Open Access Journals (Sweden)

    Gerta Vrbova

    2004-12-01

    Full Text Available In order to understand and possibly interfere/ treat neuromuscular disorders it is important to analyze the biological events that may be causing the disability. We illustrate such attempts on two examples of genetically determined neuromuscular diseases: 1 Duchenne muscular dystrophy (DMD, and 2 Spinal muscular atrophy (SMA.DMD is an x-linked hereditary muscle disease that leads to progressive muscle weakness. The altered gene in DMD affects dystrophin, a muscle membrane associated proteine. Attempts were made to replace the deficient or missing gene/ protein into muscles of Duchenne children. Two main strategies were explored: 1 Myoblast and stem cell transfer and 2 Gene delivery. The possible use of methods other than the introduction of the missing gene for dystrophin into muscle fibres are based on the knowledge about the adaptive potential of muscle to different functional demands and the ability of the muscle to express a new set of genes in response to such stimuli. Stretch or overload is now known to lead to changes of gene expression in normal muscle, and the success of muscle stretch in the management of Duchenne boys is most likely to be due to such adaptive changes. Electrical stimulation of muscles is also a powerful stimulus for inducing the expression of new genes and this method too has produced beneficial effects on the progress of the disease in mice and men.SMA is a heterogeneous group of hereditary neuromuscular disorders where the loss of lower motoneurones leads to progressive weakness and muscle atrophy. The disease subdivides into 3 forms according to the severity of the symptoms and age of onset. All three forms of SMA have been mapped to chromosome 5q11.2-13.2. Clinical features of all these forms of SMA include hypotonia shortly after birth, symmetrical muscle weakness and atrophy, finger tremor, areflexia or hyporeflexia and later contractures. In patients with SMA 1 and 2 the development of all parts of the motor

  12. Kinship and interaction in neuromuscular pharmacology

    NARCIS (Netherlands)

    Schiere, Sjouke

    2006-01-01

    The background of this thesis is presented in the introductory chapters and stafts with a brief history of neuromuscular relaxants. It is followed by a short description of the neuromuscular physiology and pharmacology in chapters 2 and 3, respectively. In chapter 4 the aim of the thesis is

  13. Anaesthesia in children with inherited neuromuscular diseases

    OpenAIRE

    Simić Dušica; Bogićević Dragana; Milojević Irina; Budić Ivana; Marković Marija

    2010-01-01

    Children with inherited neuromuscular diseases often require anaesthesia for diagnostic or therapy procedures. These patients have an increased risk of perioperative complications due to the nature of the disease and medications administered during anaesthesia. Many anaesthetics and muscle relaxants can aggravate the underlying disease and trigger life-threatening reactions (cardiorespiratory complications, malignant hyperthermia). Besides, the neuromuscular disorders are associated wit...

  14. 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...

  15. Sugammadex Improves Neuromuscular Function in Patients ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... with a modified gamma-cyclodextrin structure offers a viable alternative to the traditional decurarization by cholinesterase inhibitors in the context of the use of steroidal neuromuscular blocking agents. Sugammadex shows its effects through encapsulation of the steroidal neuromuscular blockers, its effects ...

  16. 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 eig...

  17. Neuromuscular Monitoring in the Perioperative Period.

    Science.gov (United States)

    Murphy, Glenn S

    2018-02-01

    Neuromuscular monitoring devices were introduced into clinical practice in the 1970s. Qualitative neuromuscular monitors, or peripheral nerve stimulators, provide an electrical stimulus to a motor nerve and the response of corresponding muscle subjectively evaluated. A standard peripheral nerve stimulator provides several patterns of nerve stimulation, including train-of-four (TOF), double-burst, tetanic, and post-tetanic count. Qualitative (and quantitative) monitors are needed to determine onset of neuromuscular blockade, maintain the required depth of muscle relaxation during the surgical procedure, and assess an appropriate dose of reversal agent. However, absence of fade measured with a peripheral nerve stimulator does not exclude residual neuromuscular block; TOF ratios as low as 0.4-0.6 may be present when fade is no longer observed. In addition, the risk of incomplete neuromuscular recovery may be influenced by monitoring site. The adductor pollicis is more sensitive to the effects of neuromuscular blocking agents (compared to the muscles surrounding the eye), and monitoring at this site may more accurately reflect recovery of pharyngeal muscles (the last muscles to recover from the effects of neuromuscular blocking agents, in which dysfunction may persist even at a TOF ratio of 1.0). Quantitative monitors are devices that measure and quantify the degree of muscle weakness and display the results numerically. Several different technologies have been developed, including mechanomyography, electromyography, acceleromyography, kineograph, and phonomyography. Lower doses of anticholinesterases may be used to effectively reverse neuromuscular blockade at TOF ratios of 0.4-0.6; quantitative monitoring is required to determine that this level of neuromuscular recovery has occurred. As clinical tests of muscle strength, peripheral nerve stimulators are unable to determine whether full recovery of neuromuscular function is present at the end of the surgical

  18. 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... neuromuscular stimulator. (a) Identification. An implanted neuromuscular stimulator is a device that provides... Administration on or before July 13, 1999 for any implanted neuromuscular stimulator that was in commercial...

  19. Neuromuscular NMDA Receptors Modulate Developmental Synapse Elimination.

    Science.gov (United States)

    Personius, Kirkwood E; Slusher, Barbara S; Udin, Susan B

    2016-08-24

    At birth, each mammalian skeletal muscle fiber is innervated by multiple motor neurons, but in a few weeks, all but one of those axons retracts (Redfern, 1970) and differential activity between inputs controls this phenomenon (Personius and Balice-Gordon, 2001; Sanes and Lichtman, 2001; Personius et al., 2007; Favero et al., 2012). Acetylcholine, the primary neuromuscular transmitter, has long been presumed to mediate this activity-dependent process (O'Brien et al., 1978), but glutamatergic transmission also occurs at the neuromuscular junction (Berger et al., 1995; Grozdanovic and Gossrau, 1998; Mays et al., 2009). To test the role of neuromuscular NMDA receptors, we assessed their contribution to muscle calcium fluxes in mice and tested whether they influence removal of excess innervation at the end plate. Developmental synapse pruning was slowed by reduction of NMDA receptor activation or expression and by reduction of glutamate production. Conversely, pruning is accelerated by application of exogenous NMDA. We also found that NMDA induced increased muscle calcium only during the first 2 postnatal weeks. Therefore, neuromuscular NMDA receptors play previously unsuspected roles in neuromuscular activity and synaptic pruning during development. In normal adult muscle, each muscle fiber is innervated by a single axon, but at birth, fibers are multiply innervated. Elimination of excess connections requires neural activity; because the neuromuscular junction (NMJ) is a cholinergic synapse, acetylcholine has been assumed to be the critical mediator of activity. However, glutamate receptors are also expressed at the NMJ. We found that axon removal in mice is slowed by pharmacological and molecular manipulations that decrease signaling through neuromuscular NMDA receptors, whereas application of exogenous NMDA at the NMJ accelerates synapse elimination and increases muscle calcium levels during the first 2 postnatal weeks. Therefore, neuromuscular NMDA receptors play

  20. 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.

  1. Neuromuscular complications of diabetes mellitus.

    Science.gov (United States)

    Bril, Vera

    2014-06-01

    Diabetes mellitus has become a modern global epidemic, with steadily increasing prevalence rates related to lifestyle such that 27% of individuals aged 65 years or older have diabetes mellitus, 95% of whom have type 2. This article reviews the effects of diabetes mellitus on the neuromuscular system. Diabetes mellitus leads to diverse forms of peripheral neuropathy as the major neuromuscular complication. Both focal and diffuse types of neuropathy can develop, with the most common form being diabetic sensorimotor polyneuropathy. Small fibers are damaged early in the development of diabetic sensorimotor polyneuropathy and are not assessed by nerve conduction studies. Small fiber damage occurs even in the prediabetes stage. No disease-modifying therapy for diabetic sensorimotor polyneuropathy is available at this time, but this complication can be limited in patients who have type 1 diabetes mellitus with strict glycemic control; the same outcome is not clearly observed in patients who have type 2 diabetes mellitus. Recently, the evidence base for symptomatic treatments of painful diabetic sensorimotor polyneuropathy underwent systematic review. Effective evidence-based treatments include some anticonvulsants (eg, pregabalin, gabapentin), antidepressants (eg, amitriptyline, duloxetine), opioids (eg, morphine sulfate, oxycodone), capsaicin cream, and transcutaneous electrical nerve stimulation. This article reviews the increasing prevalence of diabetes mellitus and diabetic sensorimotor polyneuropathy and discusses recent consensus opinion on the objective confirmation needed for the diagnosis in the clinical research setting. The evidence from clinical trials shows that intensive glycemic control reduces prevalence of diabetic sensorimotor polyneuropathy in patients with type 1 diabetes mellitus, but variable outcomes are observed in patients with type 2 diabetes mellitus. Finally, despite the lack of disease-modifying treatment, effective evidence-based therapy can

  2. FUNCTIONS OF A NEUROMUSCULAR CENTRE

    Directory of Open Access Journals (Sweden)

    Janez Zidar

    2004-12-01

    Full Text Available Main functions of a neuromuscular (NM centre are making diagnosis, treatment and counselling. Some other functions, e. g. forming a register and epidemiological endeavours, could be added. All these activities are expected to be achieved by multidisciplinary approach with the idea that members use the same guidelines and share the same knowledge.NM diseases affect lower levels of the nervous system that is motor units (motor cells in the brainstem and spinal cord, nerve roots, cranial and peripheral nerves, neuromuscular junction, and muscles. There are many such diseases; a few are more common others are rare.Rational approach in making a diagnosis can be divided into several steps. The process begins with a person with clinical symptoms and signs which raise the suspicion of NM disease. The first step is the description of the predominant pattern of muscular wasting and weakness (e. g. limb-girdle, distal, ocular, facio-scapulo-humeral. Each of these syndromes require a differential diagnosis within the motor unit territory what is achieved by means of EMG and muscle biopsy. The latter is even more important to define the nature of the abnormality. Disease nature can also be determined biochemically and, as NM disorders are commonly genetically determined, at the molecular genetic level. Treatment modalities include drugs (causative and symptomatic and other measures such as promoting and maintaining good general health, preventing skeletal deformities, physiotherapy, orthoses, surgery, and prevention of respiratory and cardiac functions. Counselling is mainly by social workers that focus on the practical aspects of coping with illness and disability and by genetic counsellors who gave advise on family planning.

  3. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys...

  4. Neuromuscular complications of immune checkpoint inhibitor therapy.

    Science.gov (United States)

    Kolb, Noah A; Trevino, Christopher R; Waheed, Waqar; Sobhani, Fatemeh; Landry, Kara K; Thomas, Alissa A; Hehir, Mike

    2018-01-17

    Immune checkpoint inhibitor (ICPI) therapy unleashes the body's natural immune system to fight cancer. ICPIs improve overall cancer survival, however, the unbridling of the immune system may induce a variety of immune-related adverse events. Neuromuscular immune complications are rare but they can be severe. Myasthenia gravis and inflammatory neuropathy are the most common neuromuscular adverse events but a variety of others including inflammatory myopathy are reported. The pathophysiologic mechanism of these autoimmune disorders may differ from that of non-ICPI-related immune diseases. Accordingly, while the optimal treatment for ICPI-related neuromuscular disorders generally follows a traditional paradigm, there are important novel considerations in selecting appropriate immunosuppressive therapy. This review presents 2 new cases, a summary of neuromuscular ICPI complications, and an approach to the diagnosis and treatment of these disorders. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

  5. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys......INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic...

  6. Eccentric Exercise to Enhance Neuromuscular Control.

    Science.gov (United States)

    Lepley, Lindsey K; Lepley, Adam S; Onate, James A; Grooms, Dustin R

    Neuromuscular alterations are a major causal factor of primary and secondary injuries. Though injury prevention programs have experienced some success, rates of injuries have not declined, and after injury, individuals often return to activity with functionality below clinical recommendations. Considering alternative therapies to the conventional concentric exercise approach, such as one that can target neuromuscular injury risk and postinjury alterations, may provide for more effective injury prevention and rehabilitation protocols. Peer-reviewed sources available on the Web of Science and MEDLINE databases from 2000 through 2016 were gathered using searches associated with the keywords eccentric exercise, injury prevention, and neuromuscular control. Eccentric exercise will reduce injury risk by targeting specific neural and morphologic alterations that precipitate neuromuscular dysfunction. Clinical review. Level 4. Neuromuscular control is influenced by alterations in muscle morphology and neural activity. Eccentric exercise beneficially modifies several underlying factors of muscle morphology (fiber typing, cross-sectional area, working range, and pennation angle), and emerging evidence indicates that eccentric exercise is also beneficial to peripheral and central neural activity (alpha motorneuron recruitment/firing, sarcolemma activity, corticospinal excitability, and brain activation). There is mounting evidence that eccentric exercise is not only a therapeutic intervention influencing muscle morphology but also targets unique alterations in neuromuscular control, influencing injury risk.

  7. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning

    DEFF Research Database (Denmark)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel

    2017-01-01

    and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel....... A neuromuscular monitoring e-learning module might support consistent use of neuromuscular monitoring devices. OBJECTIVE: The aim of the study is to assess the effect of a neuromuscular monitoring e-learning module on anesthesia staff's use of objective neuromuscular monitoring and the incidence of residual...... departments in the Zealand Region of Denmark are included, and data from all patients receiving a muscle relaxant are collected from the anesthesia information management system MetaVision. We will assess the effect of the module on all levels of potential effect: staff's knowledge and skills, patient care...

  8. 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.

  9. 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

  10. Genome Editing of Monogenic Neuromuscular Diseases

    Science.gov (United States)

    Long, Chengzu; Amoasii, Leonela; Bassel-Duby, Rhonda; Olson, Eric N.

    2017-01-01

    IMPORTANCE Muscle weakness, the most common symptom of neuromuscular disease, may result from muscle dysfunction or may be caused indirectly by neuronal and neuromuscular junction abnormalities. To date, more than 780 monogenic neuromuscular diseases, linked to 417 different genes, have been identified in humans. Genome-editing methods, especially the CRISPR (clustered regularly interspaced short palindromic repeats)–Cas9 (CRISPR-associated protein 9) system, hold clinical potential for curing many monogenic disorders, including neuromuscular diseases such as Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1. OBJECTIVES To provide an overview of genome-editing approaches; to summarize published reports on the feasibility, efficacy, and safety of current genome-editing methods as they relate to the potential correction of monogenic neuromuscular diseases; and to highlight scientific and clinical opportunities and obstacles toward permanent correction of disease-causing mutations responsible for monogenic neuromuscular diseases by genome editing. EVIDENCE REVIEW PubMed and Google Scholar were searched for articles published from June 30, 1989, through June 9, 2016, using the following keywords: genome editing, CRISPR-Cas9, neuromuscular disease, Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, andmyotonic dystrophy type 1. The following sources were reviewed: 341 articles describing different approaches to edit mammalian genomes; 330 articles describing CRISPR-Cas9–mediated genome editing in cell culture lines (in vitro) and animal models (in vivo); 16 websites used to generate single-guide RNA; 4 websites for off-target effects; and 382 articles describing viral and nonviral delivery systems. Articles describing neuromuscular diseases, including Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1

  11. Bloqueio neurolítico subaracnoideo em paciente com dor oncológica refratária: relato de caso

    OpenAIRE

    Barbosa Neto,José Osvaldo; Sousa,Ângela Maria; Tahamtani,Silvia Maria Machado; Ashmawi,Hazem Adel

    2013-01-01

    JUSTIFICATIVA E OBJETIVOS: O uso de bloqueio neurolítico subaracnoideo no controle de dor tem diminuído nos últimos anos devido à introdução de novas técnicas, mas ainda tem importância no controle de dor oncológica refratária. O objetivo deste estudo foi apresentar um caso de dor oncológica, em que esta técnica foi utilizada para controle da dor. RELATO DO CASO: Paciente do sexo masculino, 45 anos, diagnosticado com carcinoma espinocelular de canal anal localmente avançado e lesão ulcerada e...

  12. Reflexo extensor radial do carpo e tibial cranial pré e pós bloqueio anestésico em gatos (Felis cattus).

    OpenAIRE

    Marcella Luiz de Figueiredo Barbosa

    2014-01-01

    Os reflexos extensor radial do carpo e o tibial cranial são considerados reflexos miotáticos, mas recentemente isto tem sido colocado em dúvida em trabalho realizado em cães. Objetivou-se verificar e qualificar a resposta ao teste do reflexo extensor radial do carpo e tibial cranial em gatos, antes e após o bloqueio anestésico do plexo braquial e plexo lombossacral, evidenciando depender ou não do arco reflexo miotático. Foram utilizados 55 gatos normais ao exame neurológico, sem distinção de...

  13. Bloqueio do plexo braquial por via axilar com neuroestimulador: verificação da latência e da eficácia

    Directory of Open Access Journals (Sweden)

    Itagyba Martins Miranda Chaves

    2001-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo braquial por via axilar, embora bastante difundido por ter menor incidência de complicações, apresenta três inconvenientes que limitam seu uso: índice de falhas, latência longa e restrição a cirurgias de antebraço e mão. O objetivo deste estudo foi verificar o tempo de latência e a eficácia do bloqueio do plexo braquial por via axilar empregando-se um estimulador de nervo. MÉTODO: Participaram do estudo, aberto, prospectivo, 38 pacientes, estado físico ASA I, II e III, com idades entre 13 e 74 anos, submetidos a cirurgia de membro superior. Na sala de operação, após monitorização, venóclise, sedação com 1 a 3 mg de midazolam por via venosa, os pacientes foram submetidos ao bloqueio do plexo braquial por via axilar, após emprego de estimulador de nervo, com amperagens decrescentes a partir de 0,9 mA e injetando-se o anestésico local, após obtenção de resposta motora dos dedos da mão, com menor amperagem. Foram observadas as latências sensitiva e motora, a eficácia e falhas sensitiva e motora, parciais ou totais, e efeitos colaterais. RESULTADOS: As latências sensitiva e motora foram, respectivamente, 5,2 + 3,8 e 4,6 + 3,3 minutos. As falhas parciais sensitivas foram em número de seis, as motoras dez e completas duas, enquanto que em vinte casos não ocorreram falhas. Apenas em dois casos foi necessário converter para anestesia geral. CONCLUSÕES: Concluímos que, nas condições deste estudo, o uso do estimulador de nervo mostrou-se útil para a realização do bloqueio, sendo que, na maioria dos casos, não foi necessário estímulo maior que 0,3 mA.

  14. Vocational perspectives and neuromuscular disorders.

    Science.gov (United States)

    Andries, F; Wevers, C W; Wintzen, A R; Busch, H F; Höweler, C J; de Jager, A E; Padberg, G W; de Visser, M; Wokke, J H

    1997-09-01

    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 types of NMD were selected: dystrophia myotonica (DM), hereditary motor and sensory neuropathy, (HMSN), spinal muscular atrophy (SMA) and myasthenia gravis (MG). Results show that a labour career is in reach of most NMD patients, even for those with severe limitations. It is concluded that physical limitations seem not to be decisive in that respect. The loss of the quality of communication, the loss of mental abilities and the effect of the diseases on the facial expression, as with some DM patients, are also important for chances on the labour market. Though the labour participation of NMD patients tends to decrease after the age of 34, the availability of work adaptations makes it possible to prolong the labour career. Analysis of the actual work situation of NMD patients shows that both disorder-related limitations and work characteristics play an important role in the amount of physical work problems encountered. It is argued that physical labour has to be regarded as generally unsuitable for NMD patients. This has implications for the sort and level of education to be attained by NMD patients. Career counselling as a focus point for the choice of an educational programme may improve labour market opportunities as well as quality of employment of NMD patients. Allowing for and accepting the possible effects of the disorder in the work situation are considered to be important in respect to labour participation and work satisfaction of workers with NMD. Reducing time pressure demands and increasing the freedom to organize one's work, are measures to be given especial consideration.

  15. Intrauterine neuromuscular blockade in fetus.

    Science.gov (United States)

    Fan, S Z; Huang, F Y; Lin, S Y; Wang, Y P; Hsieh, F J

    1990-03-01

    Antenatal intrauterine fetal therapy has now become the target of numerous invasive diagnostic and therapeutic maneuvers. Fetal motion during intrauterine fetal therapy not only makes these procedures technically more difficult but also increases the likelihood of trauma to the umbilical vessels and the fetus. Combination of high doses of sedatives, tranquilizers, and narcotics rarely results in adequate suppression of fetal movement. Such medication puts the mother at risk of respiratory depression, regurgitation and aspiration. The use of pancuronium or atracurium to temporarily arrest fetal movement in ten fetus is reported. After an initial ultrasound assessment of fetal lie, placental location, and umbilical cord insertion site, the fetal weight was calculated by the ultrasound parameters of biparietal diameter and abdominal circumference. Under ultrasound guidance, we injected pancuronium 0.15 mg/kg or atracurium 1.0 mg/kg using a 23-gauge spinal needle into the fetal gluteal muscle. Short-term paralysis of the fetus was induced in all cases. Fetal movement stopped by sonographic observation within 5.8 +/- 2.3 min in the pancuronium group and 4.7 +/- 1.8 min in the atracurium group. Fetal movements returned both to maternal sensation or ultrasonic observation by 92 +/- 23 min in the first group and 36 +/- 11 min in the second group. No adverse effect of the relaxant has been observed in any of the mothers. There was no evidence of local soft tissue, nerve or muscle damage at the site of injection on initial examination of the neonates after delivery. The use of neuromuscular relaxant in fetus was a safe and useful method.

  16. 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.

  17. 21 CFR 882.5810 - External functional neuromuscular stimulator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External functional neuromuscular stimulator. 882.5810 Section 882.5810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... External functional neuromuscular stimulator. (a) Identification. An external functional neuromuscular...

  18. 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

  19. 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

  20. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

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

    2015-01-01

    : 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......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...

  1. Computed tomography (CT) in neuromuscular disorders

    International Nuclear Information System (INIS)

    Novak, M.; Ambler, Z.

    1997-01-01

    For 24 patients with confirmed neuromuscular disorders, the clinical picture of the disease was complemented with CT examination. It is concluded, in accordance with the literature, that CT has a supplementary value as regards the extent and degree of disorder of the affected muscle groups. The basic pathological picture includes muscular atrophies, dystrophies, hypertrophies, and their combinations. The CT images are non-specific for the individual neuromuscular disorders and are of minor importance in the diagnostic process. 1 tab., 7 figs., 6 refs

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Neuromuscular hamartoma arising in the brachial plexus

    International Nuclear Information System (INIS)

    Lai, P.H.; Chen, C.; Yeh, L.R.; Pan, H.B.; Ho, J.T.; Hsu, S.S.; Lin, S.L.

    2004-01-01

    We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit. (orig.)

  5. Neuromuscular contributions to age-related weakness

    Science.gov (United States)

    Age-related physiological change of neuromuscular function is not a linear process and is likely influenced by various biological and behavioral factors (e.g., genetics, nutrition, physical activity level, comorbidities, etc.). These factors contribute to heterogeneity among older adults, which chal...

  6. Dynamic Flexibility and Proprioceptive Neuromuscular Facilitation.

    Science.gov (United States)

    Hardy, Lew; Jones, David

    1986-01-01

    Two experiments are described which investigated whether results obtained in studies of static flexibility tranfer to dynamic flexibility. In both experiments, subjects were assigned to a group receiving proprioceptive neuromuscular facilitation training, ballistic stretching technique training or a control group. Results are presented and…

  7. Sugammadex Improves Neuromuscular Function in Patients ...

    African Journals Online (AJOL)

    2018-02-23

    Feb 23, 2018 ... aminoglycosides), history of allergy to neuromuscular blocking agents, opioids or other drugs, and alcohol and drug dependence. Patients were divided into two ... titration microcalorimetry investigated the likelihood of the formation of complexes between sugammadex and other steroidal and nonsteroidal ...

  8. MRC Centre Neuromuscular Biobank (Newcastle and London): Supporting and facilitating rare and neuromuscular disease research worldwide.

    Science.gov (United States)

    Reza, Mojgan; Cox, Daniel; Phillips, Lauren; Johnson, Diana; Manoharan, Vaishnavi; Grieves, Michael; Davis, Becky; Roos, Andreas; Morgan, Jennifer; Hanna, Michael G; Muntoni, Francesco; Lochmüller, Hanns

    2017-11-01

    Neuromuscular diseases are both genetic and acquired conditions resulting in progressive muscle weakness and wasting which lead to disability and reduced survival. The availability of high-quality human biomaterial is crucial to support biomedical research with potential applications at all stages of development, from molecular pathophysiology to drug discovery, clinical trials and evaluation of biomarkers. Although significant progress has been made over the last few years in the diagnosis of these rare conditions, the genetic defect and underlying pathological abnormality remain unknown in approximately 1/3 of cases. Moreover, to date no definitive cure is available for most neuromuscular disorders, nor are there sufficiently reliable and specific biomarkers to monitor disease progression and response to treatment. This is in part due to the rarity and genetic heterogeneity of neuromuscular diseases and the lack of access to patient samples. The availability of the national MRC Centre Biobank for Neuromuscular Diseases in Newcastle and London has addressed this bottleneck and supported neuromuscular research. Nine years after the establishment of the MRC Centre Biobank, many high profile research publications have highlighted the positive impact of neuromuscular biobanking for translational research and proven this facility to be a unique repository source for diagnostics, basic science research, industry, drug development, and therapy. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  9. AVALIAÇÃO DO RENDIMENTO E MATURAÇÃO DE QUEIJOS PECORINO PRODUZIDOS COM LEITE DE VACA E LIPASES DE CABRITO E CORDEIRO

    OpenAIRE

    URZEDO, Ana Carolina Borges de

    2008-01-01

    O presente trabalho teve como objetivo avaliar: a fabricação de queijos Pecorino com leite de vaca, o rendimento de fabricação dos queijos produzidos, a proteólise e lipólise ao longo da maturação, a preferência e aceitação dos queijos produzidos e caracterizar o queijo Pecorino com leite de vaca, após 45 dias de maturação. Foram produzidos queijos Pecorino em três tratamentos: sem lipase, com lipase de cabrito e com lipase de cabrito e cordeiro. Foi analisado o rendimento das ...

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina

    OpenAIRE

    Fonseca, Neuber Martins; Ruzi, Roberto Araújo; Ferreira, Fernando Xavier; Arruda, Fabrício Martins

    2003-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pelo acesso perivascular inguinal, chamado de bloqueio 3 em 1, tem sido utilizado para analgesia pós-operatória. O objetivo deste estudo foi comparar a analgesia pós-operatória do bloqueio 3 em 1 a da morfina subaracnóidea em pacientes submetidos a cirurgias ortopédicas em membro inferior (MI). MÉTODO: Foram estudados 40 pacientes escalados para cirurgia ortopédica de MI, de ambos os sexos, estado físico ASA I e II, com idades entre 15 e 7...

  13. Anticoagulantes e bloqueios espinhais

    OpenAIRE

    Chaves, Itagyba Martins Miranda; Chaves, Leandro Fellet Miranda

    2001-01-01

    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 ao...

  14. Anticoagulantes e bloqueios espinhais

    Directory of Open Access Journals (Sweden)

    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.

  15. Residual Neuromuscular Blockade in the Critical Care Setting.

    Science.gov (United States)

    Stawicki, Nicole; Gessner, Patty

    2018-01-01

    Residual neuromuscular blockade is a widespread challenge for providers in the acute care setting that, if left unrecognized or untreated, places patients at higher risk for morbidity and mortality. The condition is estimated to occur in 26% to 88% of patients undergoing general anesthesia. The role of the advanced practice nurse in the acute care setting is to facilitate a safe recovery process by identifying early signs of deterioration and supporting the patient until full muscular strength has returned. This article discusses the prevalence of residual neuromuscular blockade and associated complications and patient risk factors. A review is included of the current uses for neuromuscular blockade, pathophysiology of the neuromuscular junction, pharmacologic characteristics of neuromuscular blocking agents (including drug-drug interactions), monitoring modalities, and effectiveness of reversal agents. Treatment recommendations pertinent to residual neuromuscular blockade are outlined. ©2018 American Association of Critical-Care Nurses.

  16. Influência da anestesia geral e bloqueio peribulbar em trabeculectomias: comparação visual e pressórica

    Directory of Open Access Journals (Sweden)

    Carlos Buhler

    2012-04-01

    Full Text Available OBJETIVO: Avaliar os resultados de trabeculectomias (TRECs com anestesia geral e bloqueio peribulbar, visando definir de forma indireta a influência das técnicas anestésicas no resultado da cirurgia. MÉTODOS: Foram analisados os prontuários de 25 pacientes com glaucoma não controlado submetidos à trabeculectomia (TREC, sendo 11 com anestesia geral e 14 com anestesia peribulbar. Foram incluídos somente pacientes pseudofácicos com glaucoma e sem outras patologias oculares como retinopatia diabética ou doença macular relacionada a idade. A acuidade visual (AV, pressão intraocultar (PIO, número de medicações utilizadas, além de dados demográficos foram coletados retrospectivamente com 7, 30, 6 meses e 1 ano de pós-operatório. RESULTADOS: Ambos os grupos foram semelhantes nos quesitos demográficos, onde não houve diferença estatisticamente significante entre idade, sexo e raça. Não foram encontradas diferenças significativas nas variáveis estudadas em todas as avaliações, com significância estatística (p<0,05. CONCLUSÃO: Não encontramos diferenças entre os resultados de TRECs com anestesia geral e com bloqueio peribulbar, porém mais estudos com um número maior de pacientes são necessários para comprovar este achado.

  17. Concretos secos produzidos com agregados reciclados de RCD separados por densidade

    Directory of Open Access Journals (Sweden)

    Raphael Baldusco da Silva

    Full Text Available ResumoO uso de agregados reciclados de resíduos de construção e demolição (RCD em blocos de concreto permite compatibilizar as diferentes características de composição e porosidade desses agregados com os diferentes níveis de exigência mecânica em uso dos blocos. Paralelamente, concretos secos são pouco estudados porque a energia de prensagem obtida em vibroprensas não é facilmente reprodutível em escala de laboratório; porém, parte dessa limitação pode ser superada, realizando-se a avaliação do comportamento da mistura (sob confinamento com prensas de laboratório com controle de deformação. Assim, o objetivo deste artigo foi analisar o comportamento do concreto seco (no estado fresco e endurecido produzido com agregados de RCD (separados ou não por densidade, empregando-se esse método laboratorial de prensagem. Com substituição total do agregado natural pelo agregado reciclado misto obtido por processo de jigagem obteve-se resistências à compressão comparáveis às dos concretos de referência. A influência das características dos agregados e das formulações de concretos secos foi identificada pela técnica de compactação laboratorial. A redução da porosidade do agregado reciclado e a otimização da granulometria da mistura seca (cimento e agregados foram os parâmetros mais importantes para o incremento de resistência observado.

  18. 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...... neuromuscular block suctioning the lungs elicited brief periods of abdominal EMG activity. No difference was found in the force needed to close the fascia when comparing no neuromuscular block with intense neuromuscular block. Furthermore, no significant differences were found in the width of the diastase...... not influence the force needed to close the fascia....

  19. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning

    DEFF Research Database (Denmark)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel

    2017-01-01

    BACKGROUND: Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an......-learning module can increase anesthetists' use of neuromuscular monitoring. TRIAL REGISTRATION: Clinicaltrials.gov NCT02925143; https://clinicaltrials.gov/ct2/show/NCT02925143 (Archived by WebCite® at http://www.webcitation.org/6s50iTV2x)....

  20. Urgencias en patología neuromuscular Emergencies in neuromuscular pathology

    OpenAIRE

    T. Ayuso; I. Jericó

    2008-01-01

    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...

  1. 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.

  2. 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.

  3. Classification of neuromuscular blocking agents in a new neuromuscular preparation of the chick in vitro

    NARCIS (Netherlands)

    Riezen, H. van

    1968-01-01

    A neuromuscular preparation of the chick is described: 1. 1. The sciatic nerve-tibilis anterior muscle preparation of the 2–10 days old chick fulfils all criteria of an assay preparation and differentiates between curare-like and decamethonium-like agents. 2. 2. The preparation responds to

  4. Estudo da (não-)conformidade de concretos produzidos no Brasil e sua influência na confiabilidade estrutural

    OpenAIRE

    Wagner Carvalho Santiago

    2011-01-01

    Este trabalho apresenta um estudo da (não-)conformidade dos concretos estruturais produzidos no Brasil, bem como uma investigação da segurança de pilares curtos de concreto armado submetidos à compressão simples levando em conta a influência da (não-)conformidade da resistência do concreto. Esta investigação tem como base ensaios de resistência de mais de seis mil corpos-de-prova de diferentes localidades do Brasil. Estes ensaios mostram que parte significativa dos concretos atualmente produz...

  5. Obtenção de compostos de aroma, enzimas e biossurfactantes produzidos por bacillus subtilis em manipueira

    OpenAIRE

    Francisco Fabio Cavalcante Barros

    2011-01-01

    Resumo: Um notável desenvolvimento dos bioprocessos tem sido alcançado nas últimas décadas. Entre os principais objetivos da aplicação desses processos está a obtenção de compostos de elevado valor agregado. Somado a isso há, atualmente, uma crescente demanda por materiais e energia, fato que resulta em desequilíbrios ambientais, especialmente quando esses bens são produzidos a partir de fontes não renováveis como o petróleo, por exemplo. Entre as diferentes estratégias para o desenvolvimento...

  6. ConsciÃncia Corporal e Ancestralidade Africana: Conceitos SociopoÃticos Produzidos por Pessoas de Santo

    OpenAIRE

    Norval Batista Cruz

    2009-01-01

    Este estudo apresenta os conceitos sociopoÃticos produzidos por uma comunidade de terreiro de candomblÃ, Ilà Axà Omo TifÃ, localizada no bairro de Jangurussu, na periferia de Fortaleza-Ce. O tema gerador da pesquisa à consciÃncia corporal e ancestralidade africana. Noto que, apesar dos terreiros de candomblÃ, em principio estarem mais conectados com a cultura de matriz africana, nem sempre se encontra uma prÃtica de consciÃncia corporal associada à ancestralidade africana e Ãs vezes, hà uma d...

  7. Influência da codeína, associada ou não ao anestésico local, na duração do bloqueio sensitivo, motor e proprioceptivo do nervo ciático de rato

    OpenAIRE

    Talita Girio Carnaval

    2011-01-01

    A melhora na eficácia do bloqueio sensitivo induzida pela associação ou injeção prévia do opióide tramadol foi comprovada em animais e em humanos, sugerindo potencialização ou sinergismo de efeitos. No entanto, ainda não há estudos sobre a influência da associação da codeína ao anestésico local (AL) injetada concomitante ou previamente ao bloqueio funcional (sensitivo, motor e proprioceptivo) do nervo ciático. Dessa forma, o objetivo deste trabalho foi estudar a influência do analgésico opiói...

  8. Neuromuscular electrical stimulation for thromboprophylaxis: A systematic review.

    Science.gov (United States)

    Hajibandeh, S; Hajibandeh, S; Antoniou, G A; Scurr, J R H; Torella, F

    2015-10-01

    To evaluate the effect of neuromuscular electrical stimulation on lower limb venous blood flow and its role in thromboprophylaxis. Systematic review of randomised and non-randomised studies evaluating neuromuscular electrical stimulation, and reporting one or more of the following outcomes: incidence of venous thromboembolism, venous blood flow and discomfort profile. Twenty-one articles were identified. Review of these articles showed that neuromuscular electrical stimulation increases venous blood flow and is generally associated with an acceptable tolerability, potentially leading to good patient compliance. Ten comparative studies reported DVT incidence, ranging from 2% to 50% with neuromuscular electrical stimulation and 6% to 47.1% in controls. There were significant differences, among included studies, in terms of patient population, neuromuscular electrical stimulation delivery, diagnosis of venous thromboembolism and blood flow measurements. Neuromuscular electrical stimulation increases venous blood flow and is well tolerated, but current evidence does not support a role for neuromuscular electrical stimulation in thromboprophylaxis. Randomised controlled trials are required to investigate the clinical utility of neuromuscular electrical stimulation in this setting. © The Author(s) 2015.

  9. Medical back belt with integrated neuromuscular electrical stimulation

    NARCIS (Netherlands)

    Bottenberg, E. (Eliza); Brinks, G.J. (Ger); Hesse, J. (Jenny)

    2014-01-01

    The medical back belt with integrated neuromuscular electrical stimulation is anorthopedic device, which has two main functions. The first function is to stimulate the backmuscles by using a neuromuscular electrical stimulation device that releases regular,electrical impulses. The second function of

  10. ATRACURIUM-INDUCED NEUROMUSCULAR BLOCK IN THE ISOLATED ARM

    NARCIS (Netherlands)

    ERIKSSON, LI; VANDENBROM, RHG; LENNMARKEN, C; AGOSTON, S

    1992-01-01

    A modification of the isolated arm technique was applied in 10 females under opioid-based i.v. anaesthesia for comparison of the offset of an atracurium-induced neuromuscular block in an isolated arm to an arm with maintained circulation. The neuromuscular blocking effect of a bolus dose of

  11. Recent achievements in restorative neurology: Progressive neuromuscular diseases

    International Nuclear Information System (INIS)

    Dimitrijevic, M.R.; Kakulas, B.A.; Vrbova, G.

    1986-01-01

    This book contains 27 chapters. Some of the chapter titles are: Computed Tomography of Muscles in Neuromuscular Disease; Mapping the Genes for Muscular Dystrophy; Trophic Factors and Motor Neuron Development; Size of Motor Units and Firing Rate in Muscular Dystrophy; Restorative Possibilities in Relation to the Pathology of Progressive Neuromuscular Disease; and An Approach to the Pathogenesis of some Congenital Myopathies

  12. Neuromuscular Manifestations of West Nile Virus Infection

    Directory of Open Access Journals (Sweden)

    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

  13. Acute neuromuscular weakness associated with dengue infection

    Directory of Open Access Journals (Sweden)

    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.

  14. Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients.

    Science.gov (United States)

    Silva, Mauro Prado DA; Matsui, Christiano; Kim, Daniel Dongiou; Vieira, Joaquim Edson; Malheiros, Carlos Alberto; Mathias, Ligia Andrade Silva Telles

    2017-01-01

    to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. trinta e um pacientes foram

  15. 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...

  16. 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).

  17. 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......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: Pub.......71 %) followed by implant complications (PR = 12.51 %), infections (PR = 10.91 %), neurological complications (PR = 3.01 %) and pseudoarthrosis (PR = 1.88 %). Revision, removal and extension of implant had highest PR (7.87 %) followed by malplacement of the pedicle screws (4.81 %). Rates of individual studies....... In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2+ to 2-; the subsequent recommendations are level C. CONCLUSION: NMS patients have diverse and high complication rates after scoliosis surgery. High PRs...

  18. Neuromuscular imaging in inherited muscle diseases

    International Nuclear Information System (INIS)

    Wattjes, Mike P.; Kley, Rudolf A.; Fischer, Dirk

    2010-01-01

    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.)

  19. Next generation sequencing in neuromuscular diseases

    Science.gov (United States)

    Efthymiou, S; Manole, A; Houlden, H

    2016-01-01

    Purpose of review Neuromuscular diseases are clinically and genetically heterogeneous and probably contains the greatest proportion of causative Mendelian defects than any other group of conditions. These disorders affect muscle and/or nerves with neonatal, childhood or adulthood onset, with significant disability and early mortality. Along with heterogeneity, unidentified and often very large genes, require complementary and comprehensive methods in routine molecular diagnosis. Inevitably this leads to increased diagnostic delays and challenges in the interpretation of genetic variants. Recent findings The application of next-generation sequencing, as a research and diagnostic strategy has made significant progress into solving many of these problems. The analysis of these data is by no means simple and the clinical input is essential to interpret results. Summary In this review, we describe using examples the recent advances in the genetic diagnosis of neuromuscular disorders, in research and clinical practice and the latest developments that are underway in NGS. We also discuss the latest collaborative initiatives such as the Genomics England genome sequencing project that combine rare disease clinical phenotyping with genomics, with the aim of defining the vast majority of rare disease genes in patients as well as modifying risks and pharmacogenomics factors. PMID:27588584

  20. 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.)

  1. 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.

  2. Neuromuscular Dysfunction in Experimental Sepsis and Glutamine.

    Science.gov (United States)

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

    2016-05-01

    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. We aimed to assess the changes in neuromuscular transmission in the early stage of sepsis after glutamine supplementation. Animal experimentation. 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. 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). 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.

  3. Neuromuscular Dysfunction in Experimental Sepsis and Glutamine

    Directory of Open Access Journals (Sweden)

    İlkin Çankayalı

    2016-06-01

    Full Text Available 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.

  4. 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

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. Neuromuscular electrical stimulation for the prevention of venous thromboembolism.

    Science.gov (United States)

    Ravikumar, Raveena; Williams, Katherine J; Babber, Adarsh; Moore, Hayley M; Lane, Tristan Ra; Shalhoub, Joseph; Davies, Alun H

    2017-01-01

    Objective Venous thromboembolism, encompassing deep vein thrombosis and pulmonary embolism, is a significant cause of morbidity and mortality, affecting one in 1000 adults per year. Neuromuscular electrical stimulation is the transcutaneous application of electrical impulses to elicit muscle contraction, preventing venous stasis. This review aims to investigate the evidence underlying the use of neuromuscular electrical stimulation in thromboprophylaxis. Methods The Medline and Embase databases were systematically searched, adhering to PRISMA guidelines, for articles relating to electrical stimulation and thromboprophylaxis. Articles were screened according to a priori inclusion and exclusion criteria. Results The search strategy identified 10 randomised controlled trials, which were used in three separate meta-analyses: five trials compared neuromuscular electrical stimulation to control, favouring neuromuscular electrical stimulation (odds ratio of deep vein thrombosis 0.29, 95% confidence interval 0.13-0.65; P = .003); three trials compared neuromuscular electrical stimulation to heparin, favouring heparin (odds ratio of deep vein thrombosis 2.00, 95% confidence interval 1.13-3.52; P = .02); three trials compared neuromuscular electrical stimulation as an adjunct to heparin versus heparin only, demonstrating no significant difference (odds ratio of deep vein thrombosis 0.33, 95% confidence interval 0.10-1.14; P = .08). Conclusion Neuromuscular electrical stimulation significantly reduces the risk of deep vein thrombosis compared to no prophylaxis. It is inferior to heparin in preventing deep vein thrombosis and there is no evidence for its use as an adjunct to heparin.

  9. Surgical advances in the treatment of neuromuscular scoliosis.

    Science.gov (United States)

    Canavese, Federico; Rousset, Marie; Le Gledic, Benoit; Samba, Antoine; Dimeglio, Alain

    2014-04-18

    Neuromuscular disorders are a group of diseases affecting the neuro-musculo-skeletal system. Children with neuromuscular disorders frequently develop progressive spinal deformities with cardio-respiratory compromise in the most severe cases. The incidence of neuromuscular scoliosis is variable, inversely correlated with ambulatory abilities and with a reported risk ranging from 80% to 100% in non-ambulatory patients. As surgical and peri-operative techniques have improved, more severely affected children with complex neuromuscular deformities and considerable co-morbidities are now believed to be candidates for extensive surgery for spinal deformity. This article aimed to provide a comprehensive review of how neuromuscular spinal deformities can affect normal spine balance and how these deformities can be treated with segmental instrumentation and sub-laminar devices. Older concepts have been integrated with newer scientific data to provide the reader with a basis for better understanding of how treatment of neuromuscular scoliosis has evolved over the past few decades. Recent advances, as well as challenges that remain to be overcome, in the surgical treatment of neuromuscular curves with sub-laminar devices and in the management of post-operative infections are outlined.

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

    DEFF Research Database (Denmark)

    Brueckmann, B; Sasaki, N; Grobara, P

    2015-01-01

    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...... 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...... neuromuscular blockade at PACU admission, defined as a train-of-four (TOF) ratio

  11. Neuromuscular hamartoma: imaging features of a rare paediatric craniofacial tumour

    International Nuclear Information System (INIS)

    Oeppen, Rachel S.; Harden, Stephen P.; Argent, Julie D.

    2003-01-01

    Neuromuscular hamartoma (also referred to as neuromuscular choristoma or benign triton tumour) has not previously been described in the radiological literature. It is a rare benign lesion composed of mature elements of striated muscle and neural tissue. We report a case of neuromuscular hamartoma involving the skull base, nasopharynx, orbit and maxilla in a 2.5-year-old child who presented with facial swelling. The CT and MRI appearances of this unusual soft-tissue tumour are emphasized, together with a discussion of the pathological findings, differential diagnosis and review of the literature. (orig.)

  12. Morangos produzidos no semiárido de Minas Gerais: qualidade do fruto e da polpa congelados

    Directory of Open Access Journals (Sweden)

    Ariane Castricini

    2017-08-01

    Full Text Available Resumo O congelamento de morangos inteiros ou em polpa pode fornecer matéria-prima para sua utilização em iogurtes, recheios, coberturas, sorvetes e sucos, fora da safra. Entretanto, ainda que o consumo não seja in natura, a qualidade do produto final deve ser satisfatória. Objetivou-se avaliar a qualidade de morangos produzidos no Semiárido de Minas Gerais, congelados inteiros e em polpa, durante o armazenamento. Frutos das cultivares Tudla, Oso Grande, Albion e Portola foram produzidos em Mocambinho, distrito de Jaíba-MG, após a colheita, foram lavados, embalados (inteiros ou polpa a vácuo e congelados por até 180 dias. Os tratamentos foram constituídos por cultivares (c e dias de armazenamento (d, constituindo fatorial duplo c × d, em que se utilizaram três repetições de 10 frutos por parcela ou três polpas embaladas, para as avaliações de frutos congelados inteiros e em polpa, respectivamente. A intensidade da cor vermelha dos morangos inteiros ou em polpa reduziu-se durante o armazenamento (redução de °hue; quando inteiros, ‘Tudla’, ‘Oso Grande’ e ‘Portola’ foram vermelhos mais claros que ‘Albion’, mas, em polpa, não ocorreu diferença entre ‘Tudla’ e ‘Albion’. Morangos ‘Oso Grande’ armazenados inteiros ou em polpa tiveram maior teor de sólidos solúveis em relação àqueles das demais cultivares, e ‘Portola’, o menor teor e a menor acidez titulável (quando inteiros. ‘Tudla’ apresentou frutos e polpa mais ácidos. Durante o armazenamento de morangos congelados inteiros ou em polpa, produzidos no Semiárido de Minas Gerais, ocorreram modificações nos parâmetros cor, sólidos solúveis e acidez titulável.

  13. Computed tomography of muscles in neuromuscular disease

    International Nuclear Information System (INIS)

    Serratrice, G.

    1986-01-01

    137 patients with neuromuscular diseases were studied by CT scan. Four levels were chosen: mid-calf, mid-thigh, pelvic girdle, and spinal muscles. The scans were compared with normal control scans taken from the same sites. The patients were divided into those with myogenic diseases and those with neurogenic diseases. Of the 102 patients with myogenic changes, 17 had X-linked dystrophy, 13 had facio-scapulo-humeral dystrophy, 22 had limb girdle dystrophy, 19 had myotonic dystrophy, 14 had inflammatory muscle diseases, and 17 had miscellaneous muscular diseases. Of the 35 patients with neurogenic changes, 8 had amyotrophic lateral sclerosis (ALS), 16 had chronic spinal amyotrophies, 9 had peripheral neuropathies, and 2 had Friedreich's disease. The analysis of muscles changes (volume, outline, density) was established on the following muscles: tibialis anterior, peroneus, soleus, gastrocnemius mediale, gastrocnemius laterale, quadriceps, semitendinosus, semimembranosus, sartorius, adductor, gracilis, gluteus, spine extensors, and psoas

  14. Deep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Istre, Olav; Springborg, Henrik Halvor

    2017-01-01

    INTRODUCTION: Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB...

  15. The Role of AMPK in Neuromuscular Biology and Disease.

    Science.gov (United States)

    Dial, Athan G; Ng, Sean Y; Manta, Alexander; Ljubicic, Vladimir

    2018-03-20

    AMP-activated protein kinase (AMPK) is a primary regulator of cellular metabolism. Recent studies have revealed that AMPK also mediates the maintenance and plasticity of α-motoneurons, the neuromuscular junction, and skeletal muscle. Furthermore, AMPK stimulation by either genetic, pharmacological, or physiological approaches elicits beneficial phenotypic remodeling in neuromuscular disorders (NMDs). Here, we review the role of AMPK as a governor of neuromuscular biology, and present evidence for AMPK as an effective molecular target for therapeutic pursuit in the context of the most prevalent NMDs, including Duchenne muscular dystrophy, spinal muscular atrophy, and myotonic dystrophy type 1. This information may be useful for engineering AMPK-targeted pharmacological- or lifestyle-based strategies to treat disorders of the neuromuscular system. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. 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. © The Author(s) 2015.

  17. 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

  18. Neuromuscular function during a forward lunge in meniscectomized patients

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Damgaard, Jacob; Roos, Ewa M.

    2012-01-01

    This study aimed to investigate differences in knee joint kinematics, ground reaction force kinetics and neuromuscular activity including muscle coactivation, and medial versus lateral muscle activity during a forward lunge between the operated and contralateral legs of meniscectomized patients...

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

    NARCIS (Netherlands)

    Minis, M.A.H; Cup, E.H.C.; Heerkens, Y.H.; Engels, J.A.; Engelen, B.G.M. van; Oostendorp, R.A.B.

    2012-01-01

    Minis MA, Cup EH, Heerkens YF, Engels JA, van Engelen BG, Oostendorp RA. Exploring employment in consultation reports of patients with neuromuscular diseases. OBJECTIVES: To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients

  20. [Neuromuscular relaxation and CCMDP. The Zilgrei and Feldenkrais methods 2].

    Science.gov (United States)

    Santoro, F; Maiorana, C; Faccin, C

    1989-10-31

    The Authors show two neuromuscular release methods employed in the treatment of cranio-cervico-mandibular syndrome; these methods work at the place of origin of the pathology resolving the symptoms in different districts of the body.

  1. Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

    OpenAIRE

    Borji , Rihab; Zghal , Firas; Zarrouk , Nidhal; Martin , Vincent; Sahli , Sonia; Rebai , Haithem

    2017-01-01

    International audience; Purpose: This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction.Methods: Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhaus...

  2. Practical approach to the patient with acute neuromuscular weakness.

    Science.gov (United States)

    Nayak, Rajeev

    2017-07-16

    Acute neuromuscular paralysis (ANMP) is a clinical syndrome characterized by rapid onset muscle weakness progressing to maximum severity within several days to weeks (less than 4 wk). Bulbar and respiratory muscle weakness may or may not be present. It is a common neurological emergency which requires immediate and careful investigations to determine the etiology because accurate diagnosis has significant impact on therapy and prognosis. Respiratory failure caused by neuromuscular weakness is considered as more critical than lung disease because its development may be insidious or subtle until sudden decompensation leads to life threatening hypoxia. Also, the arterial blood gas finding of severe hypoxemia, hypercapnia, and acidosis may not be apparent until respiratory failure is profound. Hence, the requirement for respiratory assistance should also be intensively and promptly investigated in all patients with neuromuscular disease. The disorder is classified based on the site of defect in motor unit pathway, i.e ., anterior horn cells, nerve root, peripheral nerve, neuromuscular junction or muscle. Identification of the cause is primarily based on a good medical history and detailed clinical examination supplemented with neurophysiologic investigations and sometimes few specific laboratory tests. Medical history and neurological examination should be focused on the onset, progression, pattern and severity of muscle weakness as well as cranial nerves testing and tests for autonomic dysfunction. Associated non neurological features like fever, rash or other skin lesions etc. should also be noted. Globally, Guillain-Barré syndrome is the most frequent cause of ANMP and accounts for the majority of cases of respiratory muscles weakness associated with neuromuscular disorders. Newly acquired neuromuscular weakness in intensive care unit patients consist of critical illness polyneuropathy, critical illness myopathy and drug induced neuromuscular weakness which may

  3. Formation of neuromuscular junctions in rat embryo cell cultures

    International Nuclear Information System (INIS)

    Koenig, Jeanine

    1978-01-01

    The morphological evidence of the primary nerve muscle contacts are described. They consist of areas of cholinesterase activity (detected histochemically) localized on the myotube membranes and of multiple clusters of ACh receptors whose 125 I-α-bungarotoxin binding sites are revealed by radioautography. After the stage of the primary nerve muscle contacts, some of which seem transient, characteristic neuromuscular junctions appear. These neuromuscular junctions which possess subneural infoldings are similar to the end-plates of the rat in vivo [fr

  4. Management of Cardiac Involvement in NeuroMuscular Diseases: Review

    OpenAIRE

    Bouhouch, Rachida; Elhouari, Tarik; Oukerraj, Latifa; Fellat, Ibtissam; Zarzur, Jamila; Bennani, Rajaa; Arharbi, Mhamed

    2008-01-01

    Neuromuscular Diseases are a heterogeneous molecular, clinical and prognosis group. Progress has been achieved in the understanding and classification of these diseases. Cardiac involvement in neuromuscular diseases namely conduction disorders, ventricular dilatation and dilated cardiomyopathy with its impact on prognosis, is often dissociated from the peripheral myopathy. Therefore, close surveillance is mandatory in the affected patients. In this context, preventive therapy (beta-blockers a...

  5. Ageing and neurotrophic signalling effects on diaphragm neuromuscular function

    Science.gov (United States)

    Greising, Sarah M; Ermilov, Leonid G; Sieck, Gary C; Mantilla, Carlos B

    2015-01-01

    The age-related mechanisms underlying sarcopenia are largely unknown. We hypothesize that age-related neuromuscular changes depend on brain-derived neurotrophic factor (BDNF) acting through the tropomyosin-related kinase receptor B (TrkB). Maximal specific force and neuromuscular transmission failure were assessed at 6, 18 and 24 months following control, BDNF or phosphoprotein phosphatase 1 derivative (1NMPP1) treatment in male TrkBF616A mice. Phosphoprotein phosphatase-1 derivatives such as 1NMPP1 inhibit TrkB kinase activity as a result of this single amino acid mutation in the ATP binding domain. Maximal twitch and isometric tetanic force were reduced at 24 months compared to 6 and 18 months (P Neuromuscular transmission failure significantly increased at 18 and 24 months compared to 6 months (age × treatment interaction: P Neuromuscular transmission was improved following BDNF at 6 and 18 months and was impaired only at 6 months following 1NMPP1 treatment. Age and inhibition of TrkB kinase activity had similar effects on neuromuscular transmission failure, supporting a critical role for BDNF/TrkB signalling on neuromuscular changes in ageing. These results suggest that an age-related loss of endogenous BDNF precedes reductions in TrkB kinase activity in the diaphragm muscle. PMID:25630263

  6. Neuromuscular Blocking Agents and Neuromuscular Dysfunction Acquired in Critical Illness: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Price, David R; Mikkelsen, Mark E; Umscheid, Craig A; Armstrong, Ehrin J

    2016-11-01

    The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy. PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, and bibliographies of included studies were searched from database inception until September 24, 2015. Randomized controlled trials and prospective observational studies examining the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, or critical illness myopathy. One author screened titles/abstracts. Two authors independently reviewed full text and extracted data from included studies. Meta-analysis was performed using the DerSimonian-Laird random effects model (OpenMetaAnalyst 10.10 for OS.X). We assessed reporting bias with funnel plots and heterogeneity with the I statistic. Of 2,170 titles/abstracts screened, 99 full texts were selected for review, yielding one randomized controlled trial and 18 prospective observational studies, for a total of 2,254 patients. The randomized controlled trial did not show an association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness (odds ratio, 1.21; 95% CI, 0.67-2.19), but pooled data from all included studies suggested a modest association (odds ratio, 1.25; 95% CI, 1.06-1.48; I = 16%). Funnel plots suggested reporting bias, and sensitivity analyses showed a disproportionate contribution from critical illness polyneuropathy/critical illness myopathy and severe sepsis/septic shock studies. This meta-analysis suggests a modest association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness; limitations include studies with a high risk of bias and a

  7. Objective neuromuscular monitoring of neuromuscular blockade in Denmark: an online-based survey of current practice.

    Science.gov (United States)

    Söderström, C M; Eskildsen, K Z; Gätke, M R; Staehr-Rye, A K

    2017-07-01

    Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark. We conducted an anonymous Internet-based survey distributed through e-mails to Danish public anaesthesia departments. The survey consisted of 15-17 short questions regarding the use of objNMM. A total of 653 (27%) anaesthetists from 90% of the hospitals answered the questionnaire. ObjNMM was always used by 58% of the anaesthetists and 86% used objNMM at least 75% of the times. Despite the frequent use, 75% of the anaesthetists experienced difficulties with objNMM in at least 25% of the cases. The likelihood of using objNMM was higher among nurse anaesthetists vs. anaesthesiologists (odds ratio (OR) 2.24 [95% confidence interval (CI): 1.62-3.08]), if the department had an employee with special interest in objNMM (OR 1.66 [95% CI: 1.12-2.47]), if the anaesthetist had < 5 years of experience (OR 1.88 [95% CI: 1.29-2.73]), or if experiencing difficulties with objNMM < 25% of the cases (OR 1.60 [95% CI: 1.00-2.57]). In this survey, Danish anaesthetists frequently, in an international perspective, use objNMM, but the use is often associated with technical difficulties. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Neuromuscular Electrical Stimulation and Anabolic Signaling in Patients with Stroke.

    Science.gov (United States)

    Mettler, Joni A; Bennett, Sydney M; Doucet, Barbara M; Magee, Dillon M

    2017-12-01

    Stroke results in limited ability to produce voluntary muscle contraction and movement on one side of the body, leading to further muscle wasting and weakness. Neuromuscular electrical stimulation is often used to facilitate involuntary muscle contraction; however, the effect of neuromuscular electrical stimulation on muscle growth and strengthening processes in hemiparetic muscle is not clear. This study examined the skeletal muscle anabolic response of an acute bout of neuromuscular electrical stimulation in individuals with chronic stroke and healthy older adults. Eleven individuals (59.8 ± 2.7 years old) were divided into a chronic stroke group (n = 5) and a healthy older adult control group (n = 6). Muscle biopsies were obtained before and after stimulation from the vastus lateralis of the hemiparetic leg for the stroke group and the right leg for the control group. The neuromuscular electrical stimulation protocol consisted of a 60-minute, intermittent stimulation train at 60 Hz. Phosphorylation of mammalian target of rapamycin and ribosomal protein S6 kinase beta-1 were analyzed by Western blot. An acute bout of neuromuscular electrical stimulation increased phosphorylation of mammalian target of rapamycin (stroke: 56.0%; control: 51.4%; P = .002) and ribosomal protein S6 kinase beta-1 (stroke: 131.2%; control: 156.3%; P = .002) from resting levels to post-neuromuscular electrical stimulation treatment, respectively. Phosphorylated protein content was similar between stroke and control groups at both time points. Findings suggest that paretic muscles of patients with chronic stroke may maintain ability to stimulate protein synthesis machinery in response to neuromuscular electrical stimulation. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Stem cell route to neuromuscular therapies.

    Science.gov (United States)

    Partridge, Terence A

    2003-02-01

    As applied to skeletal muscle, stem cell therapy is a reincarnation of myoblast transfer therapy that has resulted from recent advances in the cell biology of skeletal muscle. Both strategies envisage the reconstruction of damaged muscle from its precursors, but stem cell therapy employs precursors that are earlier in the developmental hierarchy. It is founded on demonstrations of apparently multipotential cells in a wide variety of tissues that can assume, among others, a myogenic phenotype. The main demonstrated advantage of such cells is that they are capable of colonizing many tissues, including skeletal and cardiac muscle via the blood vascular system, thereby providing the potential for a body-wide distribution of myogenic progenitors. From a practical viewpoint, the chief disadvantage is that such colonization has been many orders of magnitude too inefficient to be useful. Proposals for overcoming this drawback are the subject of much speculation but, so far, relatively little experimentation. This review attempts to give some perspective to the status of the stem cell as a therapeutic instrument for neuromuscular disease and to identify issues that need to be addressed for application of this technology.

  11. Neuromuscular Fatigue During 200 M Breaststroke

    Directory of Open Access Journals (Sweden)

    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.

  12. Genome Editing of Monogenic Neuromuscular Diseases: A Systematic Review.

    Science.gov (United States)

    Long, Chengzu; Amoasii, Leonela; Bassel-Duby, Rhonda; Olson, Eric N

    2016-11-01

    Muscle weakness, the most common symptom of neuromuscular disease, may result from muscle dysfunction or may be caused indirectly by neuronal and neuromuscular junction abnormalities. To date, more than 780 monogenic neuromuscular diseases, linked to 417 different genes, have been identified in humans. Genome-editing methods, especially the CRISPR (clustered regularly interspaced short palindromic repeats)-Cas9 (CRISPR-associated protein 9) system, hold clinical potential for curing many monogenic disorders, including neuromuscular diseases such as Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1. To provide an overview of genome-editing approaches; to summarize published reports on the feasibility, efficacy, and safety of current genome-editing methods as they relate to the potential correction of monogenic neuromuscular diseases; and to highlight scientific and clinical opportunities and obstacles toward permanent correction of disease-causing mutations responsible for monogenic neuromuscular diseases by genome editing. PubMed and Google Scholar were searched for articles published from June 30, 1989, through June 9, 2016, using the following keywords: genome editing, CRISPR-Cas9, neuromuscular disease, Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1. The following sources were reviewed: 341 articles describing different approaches to edit mammalian genomes; 330 articles describing CRISPR-Cas9-mediated genome editing in cell culture lines (in vitro) and animal models (in vivo); 16 websites used to generate single-guide RNA; 4 websites for off-target effects; and 382 articles describing viral and nonviral delivery systems. Articles describing neuromuscular diseases, including Duchenne muscular dystrophy, spinal muscular atrophy, amyotrophic lateral sclerosis, and myotonic dystrophy type 1, were also reviewed. Multiple proof

  13. Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion-extension.

    Science.gov (United States)

    Sánchez-Zuriaga, Daniel; Artacho-Pérez, Carla; Biviá-Roig, Gemma

    2016-06-01

    Various stimuli such as the flexibility of lumbopelvic structures influence the neuromuscular responses of the trunk musculature, leading to different load sharing strategies and reflex muscle responses from the afferents of lumbopelvic mechanoreceptors. This link between flexibility and neuromuscular response has been poorly studied. The aim of this study was to investigate the relationship between lumbopelvic flexibility and neuromuscular responses of the erector spinae, hamstring and abdominal muscles during trunk flexion-extension. Lumbopelvic movement patterns were measured in 29 healthy women, who were separated into two groups according to their flexibility during trunk flexion-extension. The electromyographic responses of erector spinae, rectus abdominis and biceps femoris were also recorded. Subjects with greater lumbar flexibility had significantly less pelvic flexibility and vice versa. Subjects with greater pelvic flexibility had a higher rate of relaxation and lower levels of hamstring activation during maximal trunk flexion. The neuromuscular response patterns of the hamstrings seem partially modulated by pelvic flexibility. Not so with the lumbar erector spinae and lumbar flexibility, despite the assertions of some previous studies. The results of this study improve our knowledge of the relationships between trunk joint flexibility and neuromuscular responses, a relationship which may play a role in low back pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

    Viby-Mogensen, J.; Østergaard, D.; Donati, F.

    2000-01-01

    Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design......Good Clinical Research Practice (GCRP), neuromuscular blocking agents, pharmacokinetics, pharmacokinetic/pharmacodynamic modeling, population pharmacokinetics, statistics, study design...

  15. Loss of adult skeletal muscle stem cells drives age-related neuromuscular junction degeneration.

    Science.gov (United States)

    Liu, Wenxuan; Klose, Alanna; Forman, Sophie; Paris, Nicole D; Wei-LaPierre, Lan; Cortés-Lopéz, Mariela; Tan, Aidi; Flaherty, Morgan; Miura, Pedro; Dirksen, Robert T; Chakkalakal, Joe V

    2017-06-06

    Neuromuscular junction degeneration is a prominent aspect of sarcopenia, the age-associated loss of skeletal muscle integrity. Previously, we showed that muscle stem cells activate and contribute to mouse neuromuscular junction regeneration in response to denervation (Liu et al., 2015). Here, we examined gene expression profiles and neuromuscular junction integrity in aged mouse muscles, and unexpectedly found limited denervation despite a high level of degenerated neuromuscular junctions. Instead, degenerated neuromuscular junctions were associated with reduced contribution from muscle stem cells. Indeed, muscle stem cell depletion was sufficient to induce neuromuscular junction degeneration at a younger age. Conversely, prevention of muscle stem cell and derived myonuclei loss was associated with attenuation of age-related neuromuscular junction degeneration, muscle atrophy, and the promotion of aged muscle force generation. Our observations demonstrate that deficiencies in muscle stem cell fate and post-synaptic myogenesis provide a cellular basis for age-related neuromuscular junction degeneration and associated skeletal muscle decline.

  16. Intraoperative neuromuscular monitoring site and residual paralysis.

    Science.gov (United States)

    Thilen, Stephan R; Hansen, Bradley E; Ramaiah, Ramesh; Kent, Christopher D; Treggiari, Miriam M; Bhananker, Sanjay M

    2012-11-01

    Residual paralysis is common after general anesthesia involving administration of neuromuscular blocking drugs (NMBDs). Management of NMBDs and reversal is frequently guided by train-of-four (TOF) monitoring. We hypothesized that monitoring of eye muscles is associated with more frequent residual paralysis than monitoring at the adductor pollicis. This prospective cohort study enrolled 180 patients scheduled for elective surgery with anticipated use of NMBDs. Collected variables included monitoring site, age, gender, weight, body mass index, American Society of Anesthesiologists physical status class, type and duration of surgery, type of NMBDs, last and total dose administered, TOF count at time of reversal, dose of neostigmine, and time interval between last dose of NMBDs to quantitative measurement. Upon postanesthesia care unit admission, we measured TOF ratios by acceleromyography at the adductor pollicis. Residual paralysis was defined as a TOF ratio less than 90%. Multivariable logistic regression was used to account for unbalances between the two groups and to adjust for covariates. 150 patients received NMBDs and were included in the analysis. Patients with intraoperative TOF monitoring of eye muscles had significantly greater incidence of residual paralysis than patients monitored at the adductor pollicis (P paralysis was observed in 51/99 (52%) and 11/51 (22%) of patients, respectively. The crude odds ratio was 3.9 (95% CI: 1.8-8.4), and the adjusted odds ratio was 5.5 (95% CI: 2.1-14.5). Patients having qualitative TOF monitoring of eye muscles had a greater than 5-fold higher risk of postoperative residual paralysis than those monitored at the adductor pollicis.

  17. Neuromuscular transmission in the athymic nude mouse.

    Science.gov (United States)

    Schofield, G G; Marshall, I G

    1980-10-01

    No major differences were observed in the mechanical properties of diaphragm, extensor digitorum longus and soleus muscles from athymic nude and control mice. Denervated soleus muscles from nudes and controls showed no significant differences in their sensitivities to the cholinoceptor agonists acetylcholine and carbachol, either in the absence or presence of the anticholinesterase, physostigmine, suggesting that postjunctional receptor function is essentially normal. Phrenic nerve-diaphragm preparations from nudes were less sensitive to the twitch-augmenting effects of neostigmine. No difference in the time course of endplate potentials (epps) between nudes and controls was seen either in the absence or presence of neostigmine. Hence the observed differences in twitch augmentation are unlikely to be due to differences in acetylcholinesterase activity in the two muscles. In normal mice miniature endplate potential (mepp) amplitude decreased and mepp frequency increased with age. These changes were associated with an increase in muscle fibre diameter and a concomitant decrease in membrane resistance. Such changes did not occur in nude mice; thus mepp amplitude remained, high as in young normal muscle. It is suggested that the thymus may play a role in muscle development and that the effects on neuromuscular transmission are secondary to changes in development. In cut diaphragm muscles transmitter reversal potentials in nudes and controls were not different. Although there was no difference in the amplitude of the first epp of a train, or in the immediately releasable acetylcholine store, the quantal content of the first epp, the probability of transmitter release, the total nerve terminal acetylcholine store and the transmitter mobilization rate were all reduced. It is considered probable that all the measurable differences in transmitter release can be explained in terms of the nude muscle fibre diameter being small and being associated with a small nerve terminal

  18. Tratamento cirúrgico de fraturas em martelo por bloqueio da extensão com fio de Kirschner Surgical treatment of mallet fractures with the extension block Kirschner wire technique

    Directory of Open Access Journals (Sweden)

    Metin Uzun

    2012-01-01

    Full Text Available OBJETIVO: Avaliar a eficácia do tratamento da fratura em martelo, pelo método de Ishiguro de bloqueio de extensão com fio de Kirschner. MÉTODOS: Trinta e oito pacientes foram tratados prospectivamente. O acompanhamento médio foi 18 meses e todos os pacientes foram avaliados radiológica e clinicamente, de acordo com os critérios de Crawford. RESULTADOS: A união da fratura foi obtida em todos os pacientes. Os resultados alcançados foram satisfatórios em 34 casos e não satisfatórios em quatro casos. CONCLUSÃO: Consideramos que a técnica de bloqueio de extensão é segura e eficaz e pode ser usada em todas as fraturas em martelo. Nível de Evidência IV, Série de CasosOBJECTIVE: To evaluate the effectiveness of treating the mallet fracture with the Ishiguro extension block Kirschner wire method. METHODS: Thirty-eight patients were treated prospectively. The mean follow-up was 18 months and all patients were evaluated radiologically and clinically according to Crawford’s criteria. RESULTS: Union was obtained in all patients. The results obtained were satisfactory in 34 cases and unsatisfactory in four cases. CONCLUSION: We consider the extension block technique a safe and effective method that can be used in all mallet fractures. Level of Evidence IV, Case Series.

  19. 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 in narrative form. We have shared our analysis and text with the authors of the 'Con-' side of these paired position papers during the preparation of the manuscripts. RESULTS: There are a few low risk of bias studies indicating that use of deep neuromuscular blockade improve surgical conditions and improve...... patient outcomes such as post-operative pain in laparoscopic surgery. CONCLUSION: Our interpretation of recent findings is that there is reason to believe that there may be some patient benefit of deep neuromuscular blockade in this context, and more detailed study is needed....

  20. Neuromuscular economy, strength, and endurance in healthy elderly men.

    Science.gov (United States)

    Cadore, Eduardo Lusa; Pinto, Ronei Silveira; Alberton, Cristine Lima; Pinto, Stephanie Santana; Lhullier, Francisco Luiz Rodrigues; Tartaruga, Marcus Peikriszwili; Correa, Cleiton Silva; Almeida, Ana Paula Viola; Silva, Eduardo Marczwski; Laitano, Orlando; Kruel, Luiz Fernando Martins

    2011-04-01

    Declines in muscular strength resulting from reduced neural activity may influence the reduction in aerobic capacity in older men. However, there has been little investigation into the relationship between muscular strength and economy of movement during aerobic exercise in elderly subjects. Thus, the purpose of this study was to investigate the possible relationship between strength, aerobic performance, and neuromuscular economy in older men. Twenty-eight aged men (65 ± 4 years old) were evaluated in dynamic (1 repetition maximum test), isometric strength (maximal voluntary contraction), and rate of force development. Peak oxygen uptake, maximal workload, and ventilatory threshold were determined during a ramp protocol on a cycle ergometer. Throughout the same protocol, the neuromuscular economy (electromyographic signal) of the vastus lateralis was measured. Significant correlations were found between muscular strength, cardiorespiratory fitness, and neuromuscular economy (r = 0.43-0.64, p economy of movement are associated with muscular strength during aging.

  1. Hexosamine Biosynthetic Pathway Mutations Cause Neuromuscular Transmission Defect

    Science.gov (United States)

    Senderek, Jan; Müller, Juliane S.; Dusl, Marina; Strom, Tim M.; Guergueltcheva, Velina; Diepolder, Irmgard; Laval, Steven H.; Maxwell, Susan; Cossins, Judy; Krause, Sabine; Muelas, Nuria; Vilchez, Juan J.; Colomer, Jaume; Mallebrera, Cecilia Jimenez; Nascimento, Andres; Nafissi, Shahriar; Kariminejad, Ariana; Nilipour, Yalda; Bozorgmehr, Bita; Najmabadi, Hossein; Rodolico, Carmelo; Sieb, Jörn P.; Steinlein, Ortrud K.; Schlotter, Beate; Schoser, Benedikt; Kirschner, Janbernd; Herrmann, Ralf; Voit, Thomas; Oldfors, Anders; Lindbergh, Christopher; Urtizberea, Andoni; von der Hagen, Maja; Hübner, Angela; Palace, Jacqueline; Bushby, Kate; Straub, Volker; Beeson, David; Abicht, Angela; Lochmüller, Hanns

    2011-01-01

    Neuromuscular junctions (NMJs) are synapses that transmit impulses from motor neurons to skeletal muscle fibers leading to muscle contraction. Study of hereditary disorders of neuromuscular transmission, termed congenital myasthenic syndromes (CMS), has helped elucidate fundamental processes influencing development and function of the nerve-muscle synapse. Using genetic linkage, we find 18 different biallelic mutations in the gene encoding glutamine-fructose-6-phosphate transaminase 1 (GFPT1) in 13 unrelated families with an autosomal recessive CMS. Consistent with these data, downregulation of the GFPT1 ortholog gfpt1 in zebrafish embryos altered muscle fiber morphology and impaired neuromuscular junction development. GFPT1 is the key enzyme of the hexosamine pathway yielding the amino sugar UDP-N-acetylglucosamine, an essential substrate for protein glycosylation. Our findings provide further impetus to study the glycobiology of NMJ and synapses in general. PMID:21310273

  2. ATIVIDADE ANTIMICROBIANA E HEMOLÍTICA DO EXTRATO BRUTO PRODUZIDO POR Bacillus amyloliquefaciens

    Directory of Open Access Journals (Sweden)

    D. SCHULZ

    2008-09-01

    Full Text Available

    Avaliou-se a atividade antimicrobiana e hemolítica do extrato bruto produzido por Bacillus amyloliquefaciens, a ser utilizado como bioconservador em alimentos, previamente padronizado pela dosagem de proteínas; a qual foi quantificada pelo halo de hemólise e inibição do crescimento de Listeria monocytogenes NCTC 098630. As concentrações de proteína responsáveis por 50% da atividade antimicrobiana e hemolítica máxima foram de 22,54 e 20,88 mg (de proteína, respectivamente, sugerindo que a substância antimicrobiana presente no extrato bruto seja relacionada, também com a atividade hemolítica.

  3. Brincadeiras no Parque: sentidos produzidos a partir de vivências na educação infantil

    Directory of Open Access Journals (Sweden)

    Valdete Côco

    2016-09-01

    Full Text Available Resumo: Considerando as assertivas sobre o brincar na constituição do trabalho educativo na Educação Infantil, neste texto sintetizamos pesquisa, articulada à extensão, buscando compreender os sentidos atribuídos pelas crianças às brincadeiras no parque. Com ancoragem em pressupostos teórico-metodológicos de Bakhtin e Vigostsky, numa abordagem qualitativa exploratória, o estudo envolveu uma turma de crianças de uma instituição de Educação Infantil num município do Espírito Santo, produzindo relatórios das vivências com as crianças, desenhos e fotografias acerca do parque. Os dados indicam a multiplicidade de sentidos produzidos nas vivências, marcando a relevância do parque como espaço privilegiado de interação e brincadeira. Palavras-Chave: Brincadeira. Educação Infantil. Formação de professores. Parque.

  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...

  5. Magnetic resonance imaging of myoedema in neuromuscular diseases

    International Nuclear Information System (INIS)

    Schedel, H.; Vogel, T.; Lissner, J.; Reimers, C.C.

    1992-01-01

    Magnetic resonance imaging was done in 100 patients suffering from various generalized neuromuscular diseases. 30 (30%) showed higher signal intensities on T2-weighted images compared to T1-weighted images without contrast medium, indicating muscle edema. In inflammatory myopathies diffuse and severe muscle edema were found, whereas local and slight or moderate muscle edema were unspecific findings. In 10 patients also contrast enhanced T1-weighted images were done, showing no more sensitivity than T2-weighted images. In conclusion, we think that magnetic resonance imaging may contribute to differential diagnosis of neuromuscular diseases. (orig.) [de

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

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Samani, Afshin; Olesen, Jens Lykkegaard

    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)....

  7. 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....

  8. Clinical neuropsychiatric and neuromuscular manifestations in systemic lupus erythematosus.

    Science.gov (United States)

    Omdal, R; Mellgren, S I; Husby, G

    1988-01-01

    Thirty patients with SLE were studied retrospectively and subjected to clinical neurological examination. The accumulated neurological manifestations from the beginning of the disease until the time of examination were thus collected. Twenty-five patients (83%) had experienced neuropsychiatric manifestations while 11 patients (37%) had neuromuscular manifestations. The most frequent single symptom was migraine which had occurred in 40% of the patients. This was followed by severe protracted headache in 20%, vertigo in 20%, and psychiatric problems in 17%. Carpal tunnel syndrome and muscular weakness both occurring in 23% of the patients were the most prevalent neuromuscular manifestations, followed by myositis in 10%.

  9. Neuromuscular disorders in acute leukemia and lymphoma treatment

    Directory of Open Access Journals (Sweden)

    E. A. Politova

    2014-07-01

    Full Text Available Different mechanisms of neuromuscular complications, their clinical presentation, methods of diagnosis, prognosis and treatment options arepresented. The material is presented according to the level of nervous system damage, with inclusion of different clinical entities. Authors revieweda wide range of disease – disease of the spinal cord, peripheral nerves and plexus, neuromuscular junction and muscle – as a result of chemotherapy and radiation therapy. Systemic effects of drugs on peripheral nervous system, various departments of which can be simultaneously involved in the pathological process, were also highlighted.

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

    OpenAIRE

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

    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...

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia

    Science.gov (United States)

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

    2015-01-01

    Synopsis 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. PMID:26522909

  16. Neuromuscular stimulation after stroke: from technology to clinical deployment

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; Renzenbrink, Gerbert J.; Geurts, Alexander C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  17. Neuromuscular stimulation after stroke: from technology to clinical deployment.

    NARCIS (Netherlands)

    IJzerman, M.J.; Renzenbrink, G.J.; Geurts, A.C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades

  18. Roles of neuro-exocytotic proteins at the neuromuscular junction

    NARCIS (Netherlands)

    Sons-Michel, Michèle S.

    2011-01-01

    The aim of the studies described in the thesis was to elucidate the roles of several neuro-exocytotic proteins at the motor nerve terminal in neuromuscular synaptic transmission, making use of genetic knockout (KO) mice, each missing one (or more) neuro-exocytotic proteins. In addition, it was

  19. Validation of the ICF core set for neuromuscular diseases

    NARCIS (Netherlands)

    Bos, Isaac; Stallinga, H. A.; Middel, B.; Kuks, J. B. M.; Wynia, K.

    Background. Understanding of the consequences of a neuromuscular disease (NMD) can improve when a valid sample of disease-specific categories based on the International Classification of Functioning, Disabilities, and Health (ICF) is available. Objective. To examine the content validity of the

  20. Validation of the ICF core set for neuromuscular diseases

    NARCIS (Netherlands)

    K. Wynia; J.B. Kuks; H.A. Stallinga; B. Middel; I. Bos

    2013-01-01

    BACKGROUND: Understanding of the consequences of a neuromuscular disease (NMD) can improve when a valid sample of disease-specific categories based on the International Classification of Functioning, Disabilities, and Health (ICF) is available. OBJECTIVE: To examine the content validity of the

  1. 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

  2. Diagnostic value of CT scanning in neuromuscular diseases

    International Nuclear Information System (INIS)

    Bulcke, J.A.L.; Leuven Univ.; Herpels, V.

    1983-01-01

    The diagnosis of myopathies has become easier since the CT technique is available. In this article the possibilities of CT for diagnostic procedures of neuromuscular diseases are pointed out. Density measurements increase differentiation of atrophy or hypertrophy of muscles as well as other pathological changes. (orig.)

  3. Deep neuromuscular block improves the surgical conditions for laryngeal microsurgery.

    Science.gov (United States)

    Kim, H J; Lee, K; Park, W K; Lee, B R; Joo, H M; Koh, Y W; Seo, Y W; Kim, W S; Yoo, Y C

    2015-12-01

    Adequate neuromuscular block is required throughout laryngeal microsurgery. We hypothesized that the surgical conditions would improve under a deeper level of rocuronium-induced neuromuscular block. Seventy-two patients undergoing laryngeal microsurgery were randomly allocated to either the 'post-tetanic counts 1-2' (PTC1-2) group or the 'train-of-four counts 1-2' (TOFcount1-2) group according to the level of neuromuscular block used. Two different doses of rocuronium (1.2 or 0.5 mg kg(-1)) were used after anaesthetic induction, and two respective targets of neuromuscular block (post-tetanic counts ≤2 or train-of-four count of 1 or 2) were used. Surgical conditions were assessed by the surgeon using a five-point rating scale (extremely poor/poor/acceptable/good/optimal), and clinically acceptable surgical conditions were defined as those which were rated acceptable, good, or optimal. The occurrence of vocal cord movement and postoperative adverse events was assessed. The surgical conditions were significantly different between the PTC1-2 and TOFcount1-2 groups (extremely poor/poor/acceptable/good/optimal: 0/2/1/7/26 and 3/10/2/14/7, respectively, Pneuromuscular block (post-tetanic count of 1-2) surgical conditions in patients undergoing laryngeal microsurgery improves. NCT01980069. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Neuromuscular function during stair descent in meniscectomized patients and controls

    DEFF Research Database (Denmark)

    Thorlund, Jonas Bloch; Roos, Ewa M; Aagaard, Per

    2011-01-01

    The aim of this study was to identify differences in knee range of motion (ROM), movement speed, ground reaction forces (GRF) profile, neuromuscular activity, and muscle coactivation during the transition between stair descent and level walking in meniscectomized patients at high risk of knee...

  5. 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.

  6. Use of nondepolarizing neuromuscular blocking agents in mechanically ventilated patients.

    Science.gov (United States)

    Buck, M L; Reed, M D

    1991-01-01

    The pharmacology and history of development of nondepolarizing neuromuscular blocking agents are presented, and the pharmacokinetics and pharmacodynamics of these agents, administration guidelines for mechanically ventilated patients, adverse effects, factors affecting paralysis, and methods for blockade reversal are reviewed. Nondepolarizing neuromuscular blocking agents (tubocurarine, metocurine, pancuronium, vecuronium, and atracurium) are frequently used to induce prolonged pharmacologic paralysis in patients in the intensive-care unit (ICU). These agents are poorly absorbed after oral administration and must be administered by injection, preferably by the i.v. route. Individualized adjustment of the dose is necessary to maintain the desired degree of paralysis. Dosing modifications may be necessary in patients with underlying renal or hepatic diseases and in pediatric and geriatric patients. Patients with thermal burns require larger doses of these drugs than other patients. These agents can cause several important adverse effects, including histamine release, cardiovascular changes, and muscle atrophy. Pathophysiologic variables and drug interactions can affect the degree of paralysis. Generally, patients no longer requiring paralysis in the ICU will be allowed to spontaneously regain muscle function after drug therapy has been discontinued. If the effects of the nondepolarizing neuromuscular blocking agents must be reversed more rapidly, acetylcholinesterase-inhibiting agents such as physostigmine, neostigmine, pyridostigmine, and edrophonium can be used. Nondepolarizing neuromuscular blocking agents can be used to paralyze mechanically ventilated patients, facilitating optimal oxygenation and ventilation.

  7. Imaging of respiratory muscles in neuromuscular disease: A review.

    Science.gov (United States)

    Harlaar, L; Ciet, P; van der Ploeg, A T; Brusse, E; van der Beek, N A M E; Wielopolski, P A; de Bruijne, M; Tiddens, H A W M; van Doorn, P A

    2018-03-01

    Respiratory muscle weakness frequently occurs in patients with neuromuscular disease. Measuring respiratory function with standard pulmonary function tests provides information about the contribution of all respiratory muscles, the lungs and airways. Imaging potentially enables the study of different respiratory muscles, including the diaphragm, separately. In this review, we provide an overview of imaging techniques used to study respiratory muscles in neuromuscular disease. We identified 26 studies which included a total of 573 patients with neuromuscular disease. Imaging of respiratory muscles was divided into static and dynamic techniques. Static techniques comprise chest radiography, B-mode (brightness mode) ultrasound, CT and MRI, and are used to assess the position and thickness of the diaphragm and the other respiratory muscles. Dynamic techniques include fluoroscopy, M-mode (motion mode) ultrasound and MRI, used to assess diaphragm motion in one or more directions. We discuss how these imaging techniques relate with spirometric values and whether these can be used to study the contribution of the different respiratory muscles in patients with neuromuscular disease. Copyright © 2017. Published by Elsevier B.V.

  8. Comparison of the Effect of Neuromuscular Electrical Stimulation ...

    African Journals Online (AJOL)

    Children with cerebral palsy (CP) often demonstrate poor hand function due to spasticity. Thus spasticity in the wrist and finger flexors poses a great deal of functional limitations. This study was therefore designed to compare the effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on spasticity ...

  9. 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

  10. 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

  11. neuromuscular disease mimicking myasthenia gravis in a nigerian

    African Journals Online (AJOL)

    neuromuscular diseases characterized by abnormal neurotransmission at the motor endplate resulting .... Gait was normal. An assessment of background Myasthenia Gravis in remission with Cor Pulmonale to rule out. Cardiomyopathy and Chronic renal failure was made. She was commenced on intravenous frusemide ...

  12. Biochemistry of Neuromuscular Diseases: A Course for Undergraduate Students

    Science.gov (United States)

    Ohlendieck, Kay

    2002-01-01

    This article outlines an undergraduate course focusing on supramolecular membrane protein complexes involved in the molecular pathogenesis of neuromuscular disorders. The emphasis of this course is to introduce students to the key elements involved in the ion regulation and membrane stabilization during muscle contraction and the role of these…

  13. Selective activation of neuromuscular compartments within the human trapezius muscle

    DEFF Research Database (Denmark)

    Holtermann, A; Roeleveld, K; Mork, P J

    2009-01-01

    to >12% and selective activation of at least one of the four anatomical subdivisions of the trapezius...... of the human trapezius muscle can be independently activated by voluntary command, indicating neuromuscular compartmentalization of the trapezius muscle. The independent activation of the upper and lower subdivisions of the trapezius is in accordance with the selective innervation by the fine cranial and main...

  14. Organizing Multidisciplinary Care for Children with Neuromuscular Diseases

    NARCIS (Netherlands)

    van der Velde, M.F.; Kortbeek, Nikky; Litvak, Nelli

    The Academic Medical Center (AMC) in Amsterdam, The Netherlands, recently opened the `Children's Muscle Center Amsterdam' (CMCA). The CMCA diagnoses and treats children with neuromuscular diseases. These patients require care from a variety of clinicians. Through the establishment of the CMCA,

  15. Staphylococcus aureus e Salmonella sp. em queijos de coalho artesanais produzidos em São Rafael, Rio Grande do Norte

    Directory of Open Access Journals (Sweden)

    Tarciara Magley da Fonseca Pereira

    2017-06-01

    Full Text Available O queijo de coalho artesanal é produto de origem animal muito consumido principalmente na região Nordeste do Brasil. É comumente fabricado com leite cru, não pasteurizado, como matéria prima, sem a utilização de boas práticas higiênicas, podendo veicular micro-organismos patogênicos ao consumidor. Assim, objetivou-se avaliar a presença de Salmonella sp. e quantificar Staphyloccocus aureus em queijos de coalho produzidos artesanalmente no município de São Rafael Rio Grande do Norte.Foram realizadas coletas em triplicata em sete queijarias artesanais do município, e, em seguida, os queijos foram transportados imediatamente em caixas isotérmicas, ao Laborátório de Biotecnologia Industrial da Universidade Federal Rural do Semi-Árido, onde foram submetidos à análise microbiológica de forma asséptica, conforme metodologia recomendada pela Instrução Normativa nº 62, de 26 de agosto de 2003, do Ministério da Agricultura, Pecuária e Abastecimento. Todas as amostras apresentaram elevadas contagens de Staphylococcus aureus, estando em desconformidade com o padrão exigido pela legislação brasileira para este grupo microbiano. Foi constatado ausência de Salmonella sp. nas amostras avaliadas. As análises microbiológicas evidenciaram péssimas condições de higiene de todos os queijos estudados, já que os mesmos apresentaram grande contaminação por Staphylococcus aureus, o que pode representar riscos à saúde pública.

  16. Comportamento de blocos cerâmicos estruturais produzidos a partir da mistura de lama vermelha e argila

    Directory of Open Access Journals (Sweden)

    Alcebíades Negrão Macêdo

    Full Text Available A utilização de novas técnicas de aproveitamento de resíduos tem-se tornado cada vez mais importante na construção civil, principalmente quando se trata da utilização de resíduos de outros segmentos industriais e da redução de consumo de matérias-primas naturais. O objetivo deste estudo foi avaliar a utilização da lama vermelha, resíduo proveniente da produção de alumina metalúrgica, na produção de blocos cerâmicos vazados estruturais. A produção dos blocos foi realizada em uma indústria cerâmica, a partir de uma mistura de 60% de lama vermelha (LV e de 40% de argila. Após a produção dos blocos, realizaram-se ensaios de acordo com as normas técnicas, tais como absorção de água e compressão axial simples. A partir da análise dos resultados, observou-se que os blocos estruturais produzidos a partir da mistura de LV e argila atenderam aos parâmetros normativos quanto ao índice de absorção de água e de resistência à compressão, e que as resistências médias e características desses blocos foram superiores às dos blocos cerâmicos de referência.

  17. CARACTERÍSTICAS FÍSICO-QUÍMICAS DE SOROS DE QUEIJO E RICOTA PRODUZIDOS NO VALE DO TAQUARI, RS

    Directory of Open Access Journals (Sweden)

    Júlio André Bald

    2014-11-01

    Full Text Available O Rio Grande do Sul é um dos maiores produtores de leite do país e o Vale do Taquari contribui com aproximadamente 7% da produção do estado. O queijo e a ricota são alguns dos principais derivados do leite produzidos na região, que geram nos seus processos de fabricação quantidades elevadas de soros de queijo e de ricota, respectivamente. Por sua elevada carga orgânica estes soros devem ser tratados antes do lançamento em corpos hídricos, no entanto estudos indicam que esses subprodutos podem ser reaproveitados. Portanto, o objetivo desse trabalho foi avaliar as características físico-químicas de soros de queijo e de ricota coletados em uma indústria de laticínios do Vale do Taquari visando o aproveitamento na elaboração de novos produtos alimentícios. As amostras foram submetidas às determinações de acidez, pH, cinzas, umidade, proteínas, gordura, demanda química de oxigênio, carbono e nitrogênio total e lactose. Os parâmetros avaliados apresentaram variações, provavelmente em função dos soros serem provenientes de processos de fabricação de diferentes tipos de queijo e de ricota. Além disso, o soro de queijo apresentou maior carga orgânica. As concentrações de proteínas e lactose dos soros indicam que estes podem ser reaproveitados no desenvolvimento de novos produtos e processos.

  18. 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.

  19. Episódios de bloqueios no hemisfério sul: comparação entre reanálises do NCEP/NCAR e modelo HADCM3 Blocking episodes in the southern hemisphere: comparasion between the NCEP/NCAR reanalysis and HADCM3 model

    Directory of Open Access Journals (Sweden)

    Monica Cristina Damião Mendes

    2009-09-01

    Full Text Available Nesse artigo é apresentada uma comparação entre o diagnóstico de bloqueios para o Hemisfério Sul, identificados em uma simulação com o modelo de circulação geral do Hadley Centre (HadCM3, e aqueles obtidos das reanálises do NCEP/NCAR, para o período de 1960 a 2000. A definição de bloqueio usada baseia-se no cálculo de dois gradientes meridionais da altura geopotencial em 500 hPa. O ciclo sazonal e as regiões preferenciais de ocorrência dos bloqueios foi bem simulada pelo modelo. Semelhante ao que foi encontrado a partir das reanálises, o modelo identificou como área preferencial de ocorrência de bloqueios o Pacífico Sul e Oceania. A freqüência dos bloqueios simulada pelo modelo foi semelhante à observada, com maior atividade verificada no inverno e início da primavera (junho até setembro.A comparison of blocking episodes for the Southern Hemisphere obtained from the Hadley Centre (HadCM3 model results and from NCEP/NCAR reanalysis for the period from 1960 to 2000, is discussed in this study. The definition of blocking is obtained by using an objective index based on two, 500 hPa geopotential height, meridional gradients. The seasonal cycle and preferential areas of occurrence are well reproduced by the model. Similar to the reanalysis results, the South Pacific and Oceania were the preferred regions of blocking occurrence. The frequency of blocking episodes simulated by the model was also similar to the observed, with higher blocking occurrences in the winter and beginning of spring (from June to September.

  20. Analgesia pós-operatória em cirurgia ortopédica: estudo comparativo entre o bloqueio do plexo lombar por via perivascular inguinal (3 em 1) com ropivacaína e a analgesia subaracnóidea com morfina Analgesia pós-operatoria en cirugía ortopédica: estudio comparativo entre el bloqueo del plexo lombar por vía perivascular inguinal (3 en 1) con ropivacaína y la analgesia subaracnóidea con morfina Postoperative analgesia following orthopedic surgery: a study comparing perivascular lumbar plexus inguinal block with ropivacaine (3 in 1) and spinal anesthesia with morphine

    OpenAIRE

    Neuber Martins Fonseca; Roberto Araújo Ruzi; Fernando Xavier Ferreira; Fabrício Martins Arruda

    2003-01-01

    JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo lombar pelo acesso perivascular inguinal, chamado de bloqueio 3 em 1, tem sido utilizado para analgesia pós-operatória. O objetivo deste estudo foi comparar a analgesia pós-operatória do bloqueio 3 em 1 a da morfina subaracnóidea em pacientes submetidos a cirurgias ortopédicas em membro inferior (MI). MÉTODO: Foram estudados 40 pacientes escalados para cirurgia ortopédica de MI, de ambos os sexos, estado físico ASA I e II, com idades entre 15 e 7...

  1. Desenvolvimento e caracterização de salgadinho produzido a partir de gritz de milho nixtamalizado

    Directory of Open Access Journals (Sweden)

    L. A. M. Pinto

    2015-10-01

    Full Text Available Neste trabalho, buscou-se o enriquecimento nutricional de salgadinhos produzidos a partir da extrusão do gritz de milho, para tanto, duas diferentes formulações foram testadas. A primeira formulação consistiu em utilizar o gritz de milho aplicando-se o processo de nixtamalização; processo este conhecido pelo tratamento do gritz alcalinamente, utilizando o hidróxido de cálcio como agente de tratamento, enquanto que a segunda formulação, foi desenvolvida com gritz sem tratamento. Para a caracterização dos salgadinhos foram realizadas análises da composição centesimal e mineral, cor, textura e índice de expansão. Em relação à composição centesimal e concentração de cálcio, a amostra nixtamalizada apresentou diferença significativa para os parâmetros de cinzas, fibras e cálcio. Os valores obtidos para cinzas, foram de 0,44%±0,02 para os salgadinhos tratados e de 0,24%±0,08 para os não tratados. Para o teor de fibra os valores alcançados foram de 0,83%±0,16 e 0,40%±0,03, para os salgadinhos produzidos com tratamento e sem tratamento, respectivamente. Para o teor de cálcio, constatou-se um aumento superior a 6 vezes entre as formulações, em que 3,02±0,01 (gCa/Kgsnack foram obtidos para o salgadinho nixtamalizado e 0,49±0,003 (gCa/Kgsnack para os salgadinhos produzidos pelo gritz sem aplicação do tratamento. Os teores de umidade, proteínas e lipídeos, não apresentaram diferença significativa entre as formulações. A análise de cor mostrou que o salgadinho não sofreu influência do tratamento alcalino, porém a amostra tratada apresentou croma mais intensa. Já para a textura, a nixtamalização exerceu influência significativa para este parâmetro, em que os valores obtidos variaram de 1,95±0,49 N a 0,74±0,16 N para a amostra tratada e para a amostra sem tratamento, respectivamente. O índice de expansão (IE está diretamente relacionado com a crocância dos salgadinhos, dessa maneira, o (IE

  2. Does a mental training session induce neuromuscular fatigue?

    Science.gov (United States)

    Rozand, Vianney; Lebon, Florent; Papaxanthis, Charalambos; Lepers, Romuald

    2014-10-01

    Mental training, as physical training, enhances muscle strength. Whereas the repetition of maximal voluntary contractions (MVC) induces neuromuscular fatigue, the effect of maximal imagined contractions (MIC) on neuromuscular fatigue remains unknown. Here, we investigated neuromuscular alterations after a mental training session including MIC, a physical training session including MVC, and a combined training session including both MIC and MVC of the elbow flexor muscles. Ten participants performed 80 MIC (duty cycle, 5-s MIC and 10-s rest), 80 MVC (identical duty cycle), or 80 MVC and 80 MIC (5-s MVC, 2-s rest, 5-s MIC, and 3-s rest) in three separate sessions. MVC torque was assessed five times over the course of the training and 10 min after the end of the training in the three protocols. Central activation ratio (CARc), reflecting central fatigue, and corticospinal excitability, at rest and during MIC, were estimated using transcranial magnetic stimulation. Both the physical training and the combined training induced an approximately 40% drop of MVC torque, accompanied with an approximately 10% decrease of CARc without significant difference between the two sessions. On the contrary, the repetition of MIC did not reduce maximal force production capacity and did not alter CARc. Corticospinal excitability was always facilitated during MIC compared with that during rest, ensuring that the participants imagined the desired movement. These results suggested that one session of mental training alone or combined with physical training do not induce (additional) neuromuscular fatigue despite the repetitive activation of the corticospinal track. Motor imagery may be added to physical practice to increase the total workload without exacerbating neuromuscular fatigue.

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

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    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.

  4. BLOQUEIO DO ÓXIDO NÍTRICO COM L-NAME COMPROMETE A MICROCIRCULAÇÃO HEPÁTICA DURANTE ENDOTOXINEMIA Blockade of NO with L-NAME jeopardize hepatic microcirculation during endotoxemia

    Directory of Open Access Journals (Sweden)

    Carlos Otavio Corso

    1999-04-01

    Full Text Available O bloqueio da produção do óxido nítrico durante endotoxinemia permanece controvertido. Visando avaliar o efeito do bloqueio do óxido nítrico na microcirculação hepática, ratos Sprague-Dawley machos receberam LPS e depois de 2h foram tratados com L-NAME (10 mg/kg, n=6 ou solução salina (NS, n=7. A perfusão sinusoidal foi avaliada pela microscopia intravital, sangue foi colhido das veias hepáticas para determinação do equilíbrio ácido-básico, e a bile produzida durante todo o experimento foi mensurada. Depois de 1h de tratamento L-NAME acentuou a falência da perfusão sinusoidal induzida pelo LPS (p ml/g/min. O bloqueio não-seletivo do óxido nítrico na endotoxinemia aumenta a falência da perfusão sinusoidal, piora o equilíbrio ácido-básico do fígado e tende a acentuar a deficiência da função excretora.The blockade of NO production during endotoxemia remains controversial. To evaluate the effect of NO blockade on the liver microcirculation, Sprague-Dawley male rats received LPS and 2h after they were treated by injections of L-NAME (10 mg/kg BW, n=6 or normal saline (NS, n=7. Intravital microscopy (IVM assessed sinusoidal perfusion, blood samples were taken from the hepatic vein to determine base excess, and bile was collected. After 1h treatment L-NAME increased the LPS-induced sinusoidal perfusion failure (p ml/g/min. Non-selective NO blockade in endotoxemia enhances the sinusoidal perfusion failure, impairs acid-basic status of the liver and shows a tendency of impairment of the excretory function.

  5. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. DOSE-RESPONSE RELATION, NEUROMUSCULAR BLOCKING ACTION, INTUBATION CONDITIONS, AND CARDIOVASCULAR EFFECTS OF ORG-9273, A NEW NEUROMUSCULAR BLOCKING-AGENT

    NARCIS (Netherlands)

    VANDENBROEK, L; LAMBALK, LM; RICHARDSON, FJ; WIERDA, JMKH

    The ED50 and the ED90, the time-course of the neuromuscular block, the intubation conditions, and the cardiovascular effects of Org 9273, a new steroidal nondepolarizing neuromuscular blocking agent, have been evaluated in 41 anesthetized patients. From cumulative dose-response curves the ED50 and

  7. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  10. Efeito da flunixina meglumina, somatotropina recombinante bovina e sincronização de receptoras sobre a taxa de prenhez de embriões bovinos produzidos in vitro.

    OpenAIRE

    Humberto Fernandes Veloso Neto

    2013-01-01

    A variabilidade do sucesso das transferências de embriões produzidos in vitro ainda é um dos entraves para sua expansão, onde alguns dos problemas são relacionados à mortalidade embrionária precoce. O objetivo com estes trabalhos foi avaliar a aplicação da flunixina meglumina e da somatotropina recombinante bovina e observar o efeito de algumas variáveis como grau de desenvolvimento do embrião, sincronia do embrião com a receptora e classificação do corpo lúteo da receptora no momento da tran...

  11. Comentários escritos produzidos pelos alunos na aula de matemática: um estudo no ensino básico

    OpenAIRE

    Leite, Cristiana Pinto; Pires, Manuel Vara

    2017-01-01

    No âmbito do relatório final de estágio do Mestrado em ensino do 1.º e do 2.º ciclo do ensino básico, foi desenvolvido um estudo exploratório centrado na capacidade de comunicação escrita dos alunos em sala de aula, envolvendo todas as áreas disciplinares do estágio profissional. O estudo teve o propósito de identificar e analisar aspetos da capacidade dos alunos comentarem, por escrito, trabalhos produzidos em grupo pelos colegas, sob a forma de galeria ou de diário de bordo. Este texto foca...

  12. Dosimetria e monitoração de feixes estreitos de raios-X, produzidos por acelerador linear de particulas, para aplicação em radiocirurgia

    OpenAIRE

    Jose Carlos Ferraz de Campos

    1986-01-01

    Resumo: O presente trabalho teve como objetivo principal investigar as características principais de dosimetria e monitoração de feixes finos de raios-x, e sua aplicação a um Acelerador Linear de Partículas de 4 MV, para seu emprego na Radiocirurgia. Com esta finalidade, construiu-se um sistema de colimação adicional, composto de 3 colimadores de Chumbo, que permite, a partir do campo mínimo protocolar produzido pelo acelerador, obter os feixes finos de 6, 10 e 15 mm de diâmetros. Um siste...

  13. TEOR DE SÓDIO E GORDURA SATURADA EM PÃES DE QUEIJO PRODUZIDOS EM PANIFICADORAS DA REGIÃO CENTRAL DE GOIÂNIA-GOIÁS

    OpenAIRE

    Carvalho, Ana Clara Martins e Silva; Silva, Patrícia Naves

    2015-01-01

    O objetivo deste trabalho foi avaliar os teores de sódio e gordura saturada em pães de queijos produzidos em panificadoras de Goiânia-Goiás. Foram estudadas sete panificadoras escolhidas aleatoriamente, cada panificadora foram avaliadas três vezes em dias diferentes. Foi realizado o acompanhamento da preparação, desde o início do processamento até o produto final. A composição nutricional do pão de queijo foi calculada por meio de tabelas de composição de alimentos. Não foi encontrada diferen...

  14. Theory of multichannel magnetic stimulation: toward functional neuromuscular rehabilitation.

    Science.gov (United States)

    Ruohonen, J; Ravazzani, P; Grandori, F; Ilmoniemi, R J

    1999-06-01

    Human excitable cells can be stimulated noninvasively with externally applied time-varying electromagnetic fields. The stimulation can be achieved either by directly driving current into the tissue (electrical stimulation) or by means of electro-magnetic induction (magnetic stimulation). While the electrical stimulation of the peripheral neuromuscular system has many beneficial applications, peripheral magnetic stimulation has so far only a few. This paper analyzes theoretically the use of multiple magnetic stimulation coils to better control the excitation and also to eventually mimic electrical stimulation. Multiple coils allow electronic spatial adjustment of the shape and location of the stimulus without moving the coils. The new properties may enable unforeseen uses for peripheral magnetic stimulation, e.g., in rehabilitation of patients with neuromuscular impairment.

  15. Learning disabilities in neuromuscular disorders: a springboard for adult life.

    Science.gov (United States)

    Astrea, Guja; Battini, Roberta; Lenzi, Sara; Frosini, Silvia; Bonetti, Silvia; Moretti, Elena; Perazza, Silvia; Santorelli, Filippo M; Pecini, Chiara

    2016-10-01

    Although the presence of cognitive deficits in Duchenne muscular dystrophy or myotonic dystrophy DM1 is well established in view of brain-specific expression of affected muscle proteins, in other neuromuscular disorders, such as congenital myopathies and limb-girdle muscular dystrophies, cognitive profiles are poorly defined. Also, there are limited characterization of the cognitive profile of children with congenital muscular dystrophies, notwithstanding the presence of cerebral abnormality in some forms, and in spinal muscular atrophies, with the exception of distal spinal muscular atrophy (such as the DYN1CH1- associated form). Starting from the Duchenne muscular dystrophy, which may be considered a kind of paradigm for the co-occurrence of learning disabilities in the contest of a progressive muscular involvement, the findings of neuropsychological (or cognitive) dysfunctions in several forms of neuromuscular diseases will be examined and reviewed.

  16. 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.

  17. Muscle edema in MR imaging of neuromuscular diseases

    International Nuclear Information System (INIS)

    Schedel, H.; Reimers, C.D.; Vogl, T.; Witt, T.N.

    1995-01-01

    The purpose of this study was to examine the frequency of muscle edema and the diagnostic usefulness of Gd-DTPA in neuromuscular diseases. 144 consecutive patients with various generalized neuromuscular diseases were examined by MR imaging. Areas of high signal intensity, relative to normal muscle, were seen in 36% of T2-weighted images, whereas the corresponding T1-weighted images showed normal or lower signal intensities. These edema-like abnormalities -enlargement of the extracellular fluid space-were found more often in inflammatory and metabolic myopathies, but were also seen in degenerative myopathies. Contrast-enhanced T1-weighted images in 25 patients were not more sensitive than plain T2-weighted images. (orig.)

  18. Neuromuscular paralysis for newborn infants receiving mechanical ventilation.

    Science.gov (United States)

    Cools, F; Offringa, M

    2005-04-18

    Ventilated newborn infants breathing in asynchrony with the ventilator are at risk for complications during mechanical ventilation, such as pneumothorax or intraventricular hemorrhage, and are exposed to more severe barotrauma, which consequently could impair their clinical outcome. Neuromuscular paralysis, which eliminates spontaneous breathing efforts of the infant, has potential advantages in this respect. However, a number of complications have been reported with muscle relaxation in infants, so that concerns exist regarding the safety of prolonged neuromuscular paralysis in newborn infants. To determine whether routine neuromuscular paralysis of newborn infants receiving mechanical ventilation compared with no routine paralysis results in clinically important benefits or harms. The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2004), MEDLINE (from 1966 to April 2004) and EMBASE (from 1988 to April 2004) were searched. References of review articles were hand searched. Language restriction was not imposed. All trials using random or quasi-random patient allocation, in which the routine use of neuromuscular blocking agents during mechanical ventilation was compared to no paralysis or selective paralysis in newborn infants. Methodological quality was assessed blindly and independently by the two authors. Data were abstracted using standard methods of the Cochrane Collaboration and its Neonatal Review Group, with independent evaluation of trial quality, and abstraction and synthesis of data by both authors. Treatment effect was analysed using relative risk, risk difference and weighted mean difference. Ten possibly eligible trials were identified, of which six were included in the review. All the included trials studied preterm infants ventilated for respiratory distress syndrome, and used pancuronium as the neuromuscular blocking agent. In the analysis of the results of all trials, no significant difference was found in

  19. [Neuromuscular disease: respiratory clinical assessment and follow-up].

    Science.gov (United States)

    Martínez Carrasco, C; Villa Asensi, J R; Luna Paredes, M C; Osona Rodríguez de Torres, F B; Peña Zarza, J A; Larramona Carrera, H; Costa Colomer, J

    2014-10-01

    Patients with neuromuscular disease are an important group at risk of frequently suffering acute or chronic respiratory failure, which is their main cause of death. They require follow-up by a pediatric respiratory medicine specialist from birth or diagnosis in order to confirm the diagnosis and treat any respiratory complications within a multidisciplinary context. The ventilatory support and the cough assistance have improved the quality of life and long-term survival for many of these patients. In this paper, the authors review the pathophysiology, respiratory function evaluation, sleep disorders, and the most frequent respiratory complications in neuromuscular diseases. The various treatments used, from a respiratory medicine point of view, will be analyzed in a next paper. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  20. High gender -specific susceptibility to curare- a neuromuscular blocking agent

    Directory of Open Access Journals (Sweden)

    Santosh K Maurya

    2013-01-01

    Full Text Available Curare, a selective skeletal muscle relaxant, has been used clinically to reduce shivering and as an anesthetic auxiliary in abdominal surgery. It is also widely used in animal experiments to block neuromuscular junction activity. Effective doses of curare diminish muscle contraction without affecting brain function, but at higher doses it is known to be lethal. However, the exact dose of curare initiating muscle relaxation vs. lethal effect has not been fully characterized in mice. In this study we carefully examined the dose-response for achieving muscle inactivity over lethality in both male and female mice (C57BL6/J. The most striking finding of this study is that female mice were highly susceptible to curare; both the EDm and LDm were at least 3-fold lower than male littermates. This study shows that gender-specific differences can be an important factor when administering skeletal muscle relaxants, particularly curare or other analogous agents targeted to the neuromuscular junction.

  1. Neuromuscular stimulation after stroke: from technology to clinical deployment.

    OpenAIRE

    IJzerman, M.J.; Renzenbrink, G.J.; Geurts, A.C.H.

    2009-01-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades various clinical applications have been used for the upper and lower limb. Despite a growing body of literature on the use of NMES, its application in stroke is still limited to a few clinical groups ...

  2. Vertebral column resection in children with neuromuscular spine deformity.

    Science.gov (United States)

    Sponseller, Paul D; Jain, Amit; Lenke, Lawrence G; Shah, Suken A; Sucato, Daniel J; Emans, John B; Newton, Peter O

    2012-05-15

    Retrospective analysis. To determine, in pediatric patients with neuromuscular deformity undergoing vertebral column resection (VCR), the (1) characteristics of the surgery performed; (2) amount of pelvic obliquity restoration, and coronal and sagittal correction achieved; (3) associated blood loss and complications; and (4) extent to which curve type and VCR approach influenced correction, blood loss, and complications. VCR allows for correction of severe, rigid spinal deformity. This technique has not been previously reported in children with neuromuscular disorders. We retrospectively reviewed the records of 23 children with neuromuscular disorders (mean age, 15 years) and spinal deformities (severe scoliosis, 9; global kyphosis or angular kyphosis, 4; kyphoscoliosis, 10) who underwent VCR. The Student t test was used to compare correction differences (statistical significance, P < 0.05). A mean 1.5 vertebrae (27 thoracic and 6 lumbar) were resected per patient. Significant corrections were achieved in pelvic obliquity (11°, from 19° ± 13° to 8° ± 7°), in major coronal curve (56°, from 94° ± 36° to 38° ± 20°), and in major sagittal curve (46°, from 86° ± 37° to 40° ± 19°). There was no difference in correction between various curve types. VCR was associated with substantial blood loss (mean, 76% [estimated blood loss per total blood volume]), which correlated with patient weight and operating time. Overall, 6 patients experienced major complications: spinal cord injury, pleural effusion requiring chest tube insertion, pneumonia, pancreatitis, deep wound infection, and prominent implant requiring revision surgery. There were no deaths or permanent neurological injuries. VCR achieved significant pelvic obliquity restoration and coronal and sagittal correction in children with neuromuscular disorders and severe, rigid spinal deformity. However, this challenging procedure involves the potential for major complications.

  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. Treatment of neuromuscular channelopathies: Current concepts and future prospects

    OpenAIRE

    Cleland, James C.; Griggs, Robert C.

    2008-01-01

    Our understanding of the molecular pathogenesis of the neuromuscular ion channelopathies has increased rapidly over the past two decades due to the identification of many of the genes whose mutation causes these diseases. These molecular discoveries have facilitated identification and classification of the hereditary periodic paralyses and the myotonias, and are likely to shed light on acquired ion channelopathies as well. Despite our better understanding of the pathogenesis of these disorder...

  5. Reduced neuromuscular performance in amenorrheic elite endurance athletes

    DEFF Research Database (Denmark)

    Tornberg, Åsa B; Melin, Anna; Manderson Koivula, Fiona

    2017-01-01

    INTRODUCTION: Secondary functional hypothalamic amenorrhea (SFHA) is common among female athletes, especially in weight-sensitive sports. The aim of this study was to investigate the link between SFHA and neuromuscular performance in elite endurance athletes. METHODS: Sixteen eumenorrheic (EUM......) and 14 SFHA athletes from national teams and competitive clubs participated. Methods included gynecological examination; body composition (DXA);; resting metabolic rate and work efficiency; exercise capacity; knee muscular strength (KMS) and knee muscular endurance (KME); reaction time (RT); blood...

  6. 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.

  7. Computed tomography of skeletal muscles in neuromuscular disease

    International Nuclear Information System (INIS)

    Rodiek, S.O.; Kuether, G.; Muenchen Univ.

    1985-01-01

    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. (orig.) [de

  8. Chronic Resistance Training Does Not Ameliorate Unloading-Induced Decrements in Neuromuscular Function.

    Science.gov (United States)

    Deschenes, Michael R; McCoy, Raymond W; Mangis, Katherine A

    2017-08-01

    The aim of this study was to assess the efficacy of long-term resistance training in preventing the detrimental effects of muscle unloading on neuromuscular function. Eleven untrained men and 11 men with extensive backgrounds in resistance training were tested for several parameters of neuromuscular function at various isokinetic contractile velocities before and after 7 days of muscle unloading. Measurements included muscle mass, strength, power, total work, electromyography, and neuromuscular transmission efficiency using superimposed electrical stimulation of maximally contracting muscles. Muscle performance was superior in resistance-trained subjects before and after unloading. In both groups of participants, unloading resulted in significantly (P neuromuscular transmission efficiency was significantly altered by unloading in trained or untrained participants. Chronic resistance training was found to be ineffective in neutralizing the deleterious effects of unloading on neuromuscular function. It appears that positive adaptations associated with long-term resistance training provide no prophylactic effect when neuromuscular systems are subjected to unloading.

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

    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.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

  10. Neuromuscular interactions around the knee in children, adults and elderly

    Science.gov (United States)

    Kellis, Eleftherios; Mademli, Lida; Patikas, Dimitrios; Kofotolis, Nikolaos

    2014-01-01

    Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by which children or the elderly differ compared with adults. Both children and elderly display a lower absolute muscle strength capacity than adults which cannot fully be explained by differences in muscle mass. Quadriceps activation failure is a common symptom of all knee injuries, irrespective of age but it is likely that its effect is more evident in children or adults. While one might expect that antagonist co-activation would differ between age categories, it appears that this is not the case. Although hamstring: quadriceps ratio levels are altered after knee injury, it is not clear whether this is an age specific response. Finally, evidence suggests that both children and the elderly display less stiffness of the quadriceps muscle-tendon unit than adults which affects their knee joint function. PMID:25232523

  11. Neuromuscular signs associated with acute hypophosphatemia in a dog.

    Science.gov (United States)

    Claus, Kimberly N; Day, Thomas K; Wolf, Christina

    2015-01-01

    The purpose of this report was to describe the successful recognition and management of neuromuscular dysfunction secondary to severe, acute hypophosphatemia in an adult dog with a 2 day history of vomiting, anorexia, and abdominal pain. Radiographs were suggestive of a foreign body obstruction, and surgery was recommended. Resection and anastomosis of the distal duodenum and proximal jejunum was performed. The dog recovered uneventfully, but approximately 36 hr postoperatively, he was found to have significant weakness and muscle tremors that were accompanied by hyperthermia. The only significant abnormality on a serum biochemical profile was a phosphorous level of 0.26 mmol/L. Within 6 hr of initiating phosphorous supplementation, the patient fully recovered and had no residual signs of neuromuscular dysfunction. Signs of neurologic dysfunction secondary to hypophosphatemia are commonly recognized in human patients. Reports of patients with severe muscle weakness, some of which necessitate ventilation due to weakening of muscles of respiration, are common throughout the literature. Less commonly, tremors are noted. This is the first known report of neuromuscular signs recognized and rapidly corrected in a dog. Although it is likely to be uncommon, hypophosphatemia should be recognized as a differential diagnosis in patients with tremors and/or muscle weakness.

  12. 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.

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

    International Nuclear Information System (INIS)

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

    1983-01-01

    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

  14. 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.

  15. Magnetic resonance imaging (MRI) in the diagnosis of neuromuscular diseases

    International Nuclear Information System (INIS)

    Schalke, B.C.G.; Rohkamm, R.; Kaiser, W.

    1990-01-01

    In the last few years imaging procedures became also important in the diagnosis of neuromuscular diseases. We examined more than 150 patients with different neuromuscular diseases with MRI. Conventional diagnostic procedures like EMG, muscle biopsy can not be replaced by imaging procedures. MRI gives the chance to get additional diagnostic informations. It is possible to determine exact distribution and intensity of pathological changes in the muscle. Inflammatory muscle diseases can be differrentiated by T1/T2 values from atrophic/dystrophic diseases. The resolving power is very high and allows the exact detection of affected areas even in a single muscle. This can help to reduce false negative muscle biopsies. This is very useful in children and young adults. MRI can be used for the early detection of genetic myopathies and neuropathies. MRI allows to examine all muscles, including the heart, bone artefacts are absent. Heart muscle involvement in neuromuscular diseases can directly be shown by this method without any risk for the patient. In addition P-spectroscopy can be done for better understanding of pathogenesis, especially if the exact distribution of pathological changes is known. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Premature awakening and underuse of neuromuscular monitoring in a registry of patients with butyrylcholinesterase deficiency

    DEFF Research Database (Denmark)

    Thomsen, J L; Nielsen, C V; Palmqvist, D F

    2015-01-01

    if neuromuscular monitoring was not applied before awakening. METHODS: We retrospectively included patients referred to the Danish Cholinesterase Research Unit between 2004 and 2012 on suspicion of BChE deficiency. We collected data on genotype, BChE activity, neuromuscular blocking agents administered......, neuromuscular monitoring, and postoperative respiratory complications, defined as arterial oxygen desaturation ... paralysed. RESULTS: We included 123 patients. Neuromuscular monitoring was applied before awakening in 48 (39%) patients. A nerve stimulator was never used or only after attempted awakening in the remaining 75 (61%) patients. Premature awakening occurred in 75 (100%) and 14 (29%) of the unmonitored...

  18. Specialized neuromuscular training to improve neuromuscular function and biomechanics in a patient with quiescent juvenile rheumatoid arthritis.

    Science.gov (United States)

    Myer, Gregory D; Brunner, Hermine I; Melson, Paula G; Paterno, Mark V; Ford, Kevin R; Hewett, Timothy E

    2005-08-01

    The purpose of this case report is to describe a novel multidisciplinary approach for evaluating and preparing a patient with quiescent juvenile rheumatoid arthritis (JRA) for safe sports participation. The patient was a 10-year-old girl with a history of bilateral knee arthritis who desired to participate in soccer and basketball. Range of motion and manual muscle testing of the lower extremity were within normal limits. Neuromuscular testing included kinematic and kinetic testing, isokinetic assessment, and postural stability testing. The patient's gait was near normal; however, she had narrowed step width and increased knee flexion at heel-strike. Landing analysis during a box drop vertical jump task showed increased and imbalanced (right versus left lower extremity) peak impact forces. The testing was followed by specialized neuromuscular training (SNT). Following SNT, heel-strike and step width were within normal limits, peak impact forces on the box drop test decreased by 31%, imbalance decreased by 46%, and vertical jump increased 15%. The isokinetic strength ratio between knee flexors and extensors and the overall balance measures were within normal limits and equal bilaterally. Patients with quiescent JRA may have abnormal biomechanics, which could place them at increased risk for injury or future articular cartilage damage. Specialized neuromuscular training may have helped to decrease the patient's risk for future injury or disease progression.

  19. 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

  20. 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

  1. Estudo da (não-conformidade de concretos produzidos no Brasil e sua influência na confiabilidade de pilares curtos

    Directory of Open Access Journals (Sweden)

    W. C. Santiago

    Full Text Available Este artigo apresenta um estudo da (não-conformidade dos concretos estruturais produzidos no Brasil, bem como do impacto da não-conformidade na redução da confiabilidade de pilares curtos submetidos a compressão simples. Esta investigação tem como base ensaios de resistência de mais de cinco mil corpos-de-prova de diferentes localidades do Brasil. Estes ensaios mostram que parte significativa dos concretos atualmente produzidos no Brasil não atingem a resistência característica (fck especificada em projeto. Como resultado, estes concretos deveriam ser considerados não-conformes, e medidas de mitigação deveriam ser aplicadas. O trabalho investiga ainda o impacto da não-conformidade dos concretos produzidos no Brasil na confiabilidade de pilares curtos de concreto armado submetidos a compressão simples, quando medidas de reforço e recuperação não são adotadas. Em concreto armado, pilares curtos são os elementos estruturais cuja resistência mais diretamente depende da resistência à compressão do concreto. Uma consequência da não-conformidade dos concretos é que a equação teórica de norma, que relaciona a resistência média com o valor característico especificado em projeto, não pode ser utilizada na análise de confiabilidade. Utilizando equação equivalente, determinada a partir dos resultados experimentais, verifica-se uma redução significativa da confiabilidade dos pilares curtos em função da não-conformidade dos concretos. Estes resultados reforçam a necessidade de um controle rigoroso no recebimento do concreto, bem como na fiscalização das medidas de mitigação no caso dos concretos não-conformes.

  2. Fatigue in neuromuscular disorders: Focus on Guillain-Barré syndrome and Pompe disease

    NARCIS (Netherlands)

    J.M. de Vries (Juna); M.L.C. Hagemans (Marloes); J.B.J. Bussmann (Hans); A.T. van der Ploeg (Ans); P.A. van Doorn (Pieter)

    2010-01-01

    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

  3. A new approach to anesthesia management in myasthenia gravis: reversal of neuromuscular blockade by sugammadex.

    NARCIS (Netherlands)

    Boer, H.D. de; Egmond, J. van; Driessen, J.J.; Booij, L.H.D.J.

    2010-01-01

    A neuromuscular blocking drug (NMBD) induced neuromuscular blockade (NMB) in patients with myasthenia gravis usually dissipates either spontaneously or by administration of neostigmine. We administered sugammadex to a patient with myasthenia gravis to reverse a rocuronium-induced profound NMB. NMBDs

  4. The development of a model of fatigue in neuromuscular disorders: a longitudinal study.

    NARCIS (Netherlands)

    Kalkman, J.S.; Schillings, M.L.; Zwarts, M.J.; Engelen, B.G.M. van; Bleijenberg, G.

    2007-01-01

    BACKGROUND: Severe fatigue is reported by the majority of patients with three relatively common types of neuromuscular disorders. OBJECTIVE: This study aimed to identify predictors of fatigue in a longitudinal study and to develop a model of fatigue in patients with three neuromuscular disorders.

  5. The Dutch neuromuscular database CRAMP (Computer Registry of All Myopathies and Polyneuropathies) : Development and preliminary data

    NARCIS (Netherlands)

    van Engelen, B. G. M.; van Veenendaal, H.; van Doorn, P. A.; van der Hoeven, J. H.; Janssen, N. G.; Notermans, N. C.; van Schaik, I. N.; Visser, L. H.; Verschuuren, J. J. G. M.

    Each of the various neuromuscular diseases is rare. Consequently, solid epidemiological data are not available and it is often difficult to find sufficient patients for studies. For this reason, the Dutch neuromuscular database, CRAMP (Computer Registry of All Myopathies and Polyneuropathies), was

  6. The Dutch neuromuscular database CRAMP (Computer Registry of All Myopathies and Polyneuropathies): development and preliminary data.

    NARCIS (Netherlands)

    Engelen, B.G.M. van; Veenendaal, H. van; Doorn, P.A. van; Faber, C.G.; Hoeven, J.H. van; Janssen, N.G.; Notermans, N.C.; Schaik, I.N. van; Visser, L.H.; Verschuuren, J.J.

    2007-01-01

    Each of the various neuromuscular diseases is rare. Consequently, solid epidemiological data are not available and it is often difficult to find sufficient patients for studies. For this reason, the Dutch neuromuscular database, CRAMP (Computer Registry of All Myopathies and Polyneuropathies), was

  7. 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

  8. Model to describe the degree of twitch potentiation during neuromuscular monitoring

    NARCIS (Netherlands)

    Eleveld, D.J.; Kopman, A.F.; Proost, Johannes H; Wierda, J.MKH

    Background Neuromuscular block is estimated by comparing the evoked peak twitch with a control value measured in the absence of neuromuscular block. In practice, this control value is often difficult to determine because repeated motor nerve stimulation enhances the evoked mechanical response of the

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

    Science.gov (United States)

    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 fun...

  10. 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

  11. CLINICAL-PHARMACOLOGY OF ORG-7617, A SHORT-ACTING NONDEPOLARIZING NEUROMUSCULAR BLOCKING-AGENT

    NARCIS (Netherlands)

    VANDENBROEK, L; WIERDA, JMKH; PROOST, JH; HOMMES, FDM; AGOSTON, S

    The dose-response relationship and the time course of action of Org 7617, a short acting non-depolarizing neuromuscular blocking agent, were evaluated during thiopentone, fentanyl, halothane and N2O anaesthesia. Neuromuscular transmission was monitored mechanomyographically. The ED(50) and ED(90)

  12. Does neuromuscular activation capability explain mobility function among older men and women?

    Science.gov (United States)

    Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults. However, it is unclear to what extent impaired neuromuscular activation independently accounts for decline of mobility function. The hypothesis of this study is that capability to produce rap...

  13. Does quadriceps neuromuscular activation capability explain mobility function among older men and women?

    Science.gov (United States)

    Age-related impairment of neuromuscular activation has been shown to contribute to weakness in older adults. However, it is unclear to what extent impaired neuromuscular activation independently accounts for decline of mobility function. The hypothesis of this study is that capability to produce rap...

  14. Quality of life after surgery for neuromuscular scoliosis

    Directory of Open Access Journals (Sweden)

    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.

  15. 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

    2014-12-09

    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 (10.4 ± 2.7 mmol L-1) and the 15th min (6.4 ± 2.5 mmol L-1) 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.

  16. Antivenom for Neuromuscular Paralysis Resulting From Snake Envenoming.

    Science.gov (United States)

    Silva, Anjana; Hodgson, Wayne C; Isbister, Geoffrey K

    2017-04-19

    Antivenom therapy is currently the standard practice for treating neuromuscular dysfunction in snake envenoming. We reviewed the clinical and experimental evidence-base for the efficacy and effectiveness of antivenom in snakebite neurotoxicity. The main site of snake neurotoxins is the neuromuscular junction, and the majority are either: (1) pre-synaptic neurotoxins irreversibly damaging the presynaptic terminal; or (2) post-synaptic neurotoxins that bind to the nicotinic acetylcholine receptor. Pre-clinical tests of antivenom efficacy for neurotoxicity include rodent lethality tests, which are problematic, and in vitro pharmacological tests such as nerve-muscle preparation studies, that appear to provide more clinically meaningful information. We searched MEDLINE (from 1946) and EMBASE (from 1947) until March 2017 for clinical studies. The search yielded no randomised placebo-controlled trials of antivenom for neuromuscular dysfunction. There were several randomised and non-randomised comparative trials that compared two or more doses of the same or different antivenom, and numerous cohort studies and case reports. The majority of studies available had deficiencies including poor case definition, poor study design, small sample size or no objective measures of paralysis. A number of studies demonstrated the efficacy of antivenom in human envenoming by clearing circulating venom. Studies of snakes with primarily pre-synaptic neurotoxins, such as kraits ( Bungarus spp.) and taipans ( Oxyuranus spp.) suggest that antivenom does not reverse established neurotoxicity, but early administration may be associated with decreased severity or prevent neurotoxicity. Small studies of snakes with mainly post-synaptic neurotoxins, including some cobra species ( Naja spp.), provide preliminary evidence that neurotoxicity may be reversed with antivenom, but placebo controlled studies with objective outcome measures are required to confirm this.

  17. Rapid synthesis of acetylcholine receptors at neuromuscular junctions.

    Science.gov (United States)

    Ramsay, D A; Drachman, D B; Pestronk, A

    1988-10-11

    The rate of acetylcholine receptor (AChR) degradation in mature, innervated mammalian neuromuscular junctions has recently been shown to be biphasic; up to 20% are rapidly turned over (RTOs; half life less than 1 day) whereas the remainder are lost more slowly ('stable' AChRs; half life 10-12 days). In order to maintain normal junctional receptor density, synthesis and insertion of AChRs should presumably be sufficiently rapid to replace both the RTOs and the stable receptors. We have tested this prediction by blocking pre-existing AChRs in the mouse sternomastoid muscle with alpha-bungarotoxin (alpha-BuTx), and monitoring the subsequent appearance of 'new' junctional AChRs at intervals of 3 h to 20 days by labeling them with 125I-alpha-BuTx. The results show that new receptors were initially inserted rapidly (16% at 24 h and 28% at 48 h). The rate of increase of 'new' 125I-alpha-BuTx binding sites gradually slowed down during the remainder of the time period studied. Control observations excluded possible artifacts of the experimental procedure including incomplete blockade of AChRs, dissociation of toxin-receptor complexes, or experimentally induced alteration of receptor synthesis. The present demonstration of rapid synthesis and incorporation of AChRs at innervated neuromuscular junctions provides support for the concept of a subpopulation of rapidly turned over AChRs. The RTOs may serve as precursors for the larger population of stable receptors and have an important role in the metabolism of the neuromuscular synapse.

  18. Neuromuscular Responses to Simulated Brazilian Jiu-Jitsu Fights

    Directory of Open Access Journals (Sweden)

    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.

  19. Neuromuscular activity of Bothrops fonsecai snake venom in vertebrate preparations

    Science.gov (United States)

    Fernandes, Carla T; Giaretta, Vânia MA; Prudêncio, Luiz S; Toledo, Edvana O; da Silva, Igor RF; Collaço, Rita CO; Barbosa, Ana M; Hyslop, Stephen; Rodrigues-Simioni, Léa; Cogo, José C

    2014-01-01

    The neuromuscular activity of venom from Bothrops fonsecai, a lancehead endemic to southeastern Brazil, was investigated. Chick biventer cervicis (CBC) and mouse phrenic nerve-diaphragm (PND) preparations were used for myographic recordings and mouse diaphragm muscle was used for membrane resting potential (RP) and miniature end-plate potential (MEPP) recordings. Creatine kinase release and muscle damage were also assessed. In CBC, venom (40, 80 and 160μg/ml) produced concentration- and time-dependent neuromuscular blockade (50% blockade in 85±9 min and 73±8 min with 80 and 160μg/ml, respectively) and attenuated the contractures to 110μM ACh (78–100% inhibition) and 40mM KCl (45–90% inhibition). The venom-induced decrease in twitch-tension in curarized, directly-stimulated preparations was similar to that in indirectly stimulated preparations. Venom (100 and 200μg/ml) also caused blockade in PND preparations (50% blockade in 94±13 min and 49±8 min with 100 and 200μg/ml, respectively) but did not alter the RP or MEPP amplitude. In CBC, venom caused creatine kinase release and myonecrosis. The venom-induced decrease in twitch-tension and in the contractures to ACh and K+ were abolished by preincubating venom with commercial antivenom. These findings indicate that Bothrops fonsecai venom interferes with neuromuscular transmission essentially through postsynaptic muscle damage that affects responses to ACh and KCl. These actions are effectively prevented by commercial antivenom. PMID:25028603

  20. Clinical use of creatine in neuromuscular and neurometabolic disorders.

    Science.gov (United States)

    Tarnopolsky, Mark A

    2007-01-01

    Many of the neuromuscular (e.g., muscular dystrophy) and neurometabolic (e.g., mitochondrial cytopathies) disorders share similar final common pathways of cellular dysfunction that may be favorably influenced by creatine monohydrate (CrM) supplementation. Studies using the mdx model of Duchenne muscular dystrophy have found evidence of enhanced mitochondrial function, reduced intra-cellular calcium and improved performance with CrM supplementation. Clinical trials in patients with Duchenne and Becker's muscular dystrophy have shown improved function, fat-free mass, and some evidence of improved bone health with CrM supplementation. In contrast, the improvements in function in myotonic dystrophy and inherited neuropathies (e.g., Charcot-Marie-Tooth) have not been significant. Some studies in patients with mitochondrial cytopathies have shown improved muscle endurance and body composition, yet other studies did not find significant improvements in patients with mitochondrial cytopathy. Lower-dose CrM supplementation in patients with McArdle's disease (myophosphorylase deficiency) improved exercise capacity, yet higher doses actually showed some indication of worsened function. Based upon known cellular pathologies, there are potential benefits from CrM supplementation in patients with steroid myopathy, inflammatory myopathy, myoadenylate deaminase deficiency, and fatty acid oxidation defects. Larger randomized control trials (RCT) using homogeneous patient groups and objective and clinically relevant outcome variables are needed to determine whether creatine supplementation will be of therapeutic benefit to patients with neuromuscular or neurometabolic disorders. Given the relatively low prevalence of some of the neuromuscular and neurometabolic disorders, it will be necessary to use surrogate markers of potential clinical efficacy including markers of oxidative stress, cellular energy charge, and gene expression patterns.

  1. 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.

  2. Preventing Ischial Pressure Ulcers: I. Review of Neuromuscular Electrical Stimulation

    Directory of Open Access Journals (Sweden)

    Hilton M. Kaplan

    2011-01-01

    Full Text Available Objective: Pressure ulcers (PUs are common and debilitating wounds that arise when immobilized patients cannot shift their weight. Treatment is expensive and recurrence rates are high. Pathophysiological mechanisms include reduced bulk and perfusion of chronically atrophic muscles as well as prolonged occlusion of blood flow to soft tissues from lack of voluntary postural shifting of body weight. This has suggested that PUs might be prevented by reanimating the paralyzed muscles using neuromuscular electrical stimulation (NMES. A review of the published literature over the past 2 decades is detailed.

  3. 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. Copyright © 2013 Elsevier GmbH. All rights reserved.

  4. 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...... 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...

  5. Diagnostics of neuromuscular diseases with the aid of computerized tomography

    International Nuclear Information System (INIS)

    Visser, M. de; Verbeeten, B.J. Jr.

    1988-01-01

    In this article the diagnosis of neuromuscular diseases with the aid of computerized tomography is treated. Computerized tomography of skeletal muscles give no information which is pathognomonic for particular diseases. But the technique can be used in the following aspects: to choose a muscle for a biopsy; when it is not possible to examine the function of a muscle, a CT scan can visualize morphological deviations; in the differentiation of muscle hypertrophy and pseudo-hypertrophy. For some cases as Becker-type muscular dystrophy, facioscapulohumeral dystrophy and Kugelberg-Welander type spinal muscular atrophy computerized tomography gives characteristic images. 10 refs.; 6 figs

  6. PREVENTION AND MANAGEMENT OF LIMB CONTRACTURES IN NEUROMUSCULAR DISEASES

    Science.gov (United States)

    Skalsky, Andrew J.; McDonald, Craig M.

    2012-01-01

    Synopsis Limb contractures are a common impairment in neuromuscular diseases (NMD). They contribute to increased disability due to decreased motor performance, mobility limitations, reduced functional range of motion, loss of function for activities of daily living (ADL), and increased pain. The pathogenesis of contractures is multifactorial. Myopathic conditions are associated with more severe limb contractures in comparison to neuropathic disorders. Although the evidence supporting the efficacy of multiple interventions to improve ROM in NMD 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 the contractures. PMID:22938881

  7. Nonextensivity and self-affinity in the mammalian neuromuscular junction

    Science.gov (United States)

    da Silva, A. J.; Lima, R. F.; Moret, M. A.

    2011-10-01

    We study time series and the spontaneous miniature end-plate potentials (MEPPs) of mammals recorded at neuromuscular junctions using two different approaches: generalized thermostatistics and detrended fluctuation analysis (DFA). Classical concepts establish that the magnitude of these potentials is characterized by Gaussian statistics and that their intervals are randomly displayed. First we show that MEPP distributions adequately satisfy the q-Gaussian distributions that maximize the Tsallis entropy, indicating their nonextensive and nonequilibrium behavior. We then examine the intervals between the miniature potentials via DFA, where the profile of the intervals between events configures a deviation from the expected random behavior. Some possible physiological substrates for these findings are discussed.

  8. 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.)

  9. Neuromuscular ultrasound in polyneuropathies and motor neuron disease.

    Science.gov (United States)

    Hobson-Webb, Lisa D

    2013-06-01

    Current standards for diagnosing polyneuropathies (PN) and motor neuron disease (MND) sometimes lack early sensitivity and result in delayed diagnosis and treatment. Neuromuscular ultrasound (NMUS), already established in the diagnosis of entrapment neuropathies, may offer another means of diagnosis and monitoring response to therapy. This review of current evidence discusses diffuse nerve hypertrophy in hereditary demyelinating neuropathies, multifocal nerve enlargement in acquired demyelinating PN and the lack of readily apparent structural change in axonal neuropathies. NMUS detection of fasciculations and muscular change in MND is also reviewed, along with the need for further research to better define the role of nerve imaging in patients with PN. Copyright © 2013 Wiley Periodicals, Inc.

  10. Resúmenes de los trabajos sobre las Enfermedades Neuromusculares

    OpenAIRE

    Congreso Nacional de Neurología

    2010-01-01

    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...

  11. 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.

  12. 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

    BACKGROUND: Acceleromyography (AMG) is increasingly being used in neuromuscular research, including in studies establishing the potency of neuromuscular blocking and reversal agents. However, AMG is insufficiently validated for use interchangeably with the gold standard, mechanomyography (MMG...... 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...... difference between AMG and MMG is so small that it justifies AMG to be used for establishing the potency of neuromuscular blocking agents. However, the wide CIs show that we cannot rule out a 13% higher ED(50) and a 26% higher ED(95) for AMG....

  13. Use of neuromuscular monitoring to detect prolonged effect of succinylcholine or mivacurium

    DEFF Research Database (Denmark)

    Cassel, J; Staehr-Rye, A K; Nielsen, C V

    2014-01-01

    Mutations in the butyrylcholinesterase gene can lead to a prolonged effect of the neuromuscular blocking agents, succinylcholine and mivacurium. If the anaesthesiologist is not aware of this condition, it may result in insufficient respiration after tracheal extubation. However, this can be avoided...... allowed a prolonged neuromuscular blockade to be discovered prior to tracheal extubation of the patient. The patient was extubated after successful reversal of the neuromuscular blockade. On the contrary, neuromuscular monitoring was not used during anaesthesia in the second patient; hence, the prolonged...... effect of the neuromuscular blocking agent was not discovered until after extubation. In the third patient, the lack of response to nerve stimulation was interpreted as a technical failure and the prolonged effect of succinylcholine was discovered when general anaesthesia was terminated. Both patients...

  14. 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

  15. Effects of a short proprioceptive neuromuscular facilitation stretching bout on quadriceps neuromuscular function, flexibility, and vertical jump performance.

    Science.gov (United States)

    Place, Nicolas; Blum, Yannick; Armand, Stéphane; Maffiuletti, Nicola A; Behm, David G

    2013-02-01

    The inclusion of relatively long bouts of stretching (repeated static stretches of ∼30 seconds) in the warm-up is usually associated with a drop in muscle performance. The purpose of this study was to assess the effect of a novel self-administered proprioceptive neuromuscular facilitation (PNF) paradigm with short periods of stretching and contraction on quadriceps neuromuscular function, vertical jump performance, and articular range of motion (ROM). Twelve healthy men (age: 27.7 ± 7.3 years, height: 178.4 ± 10.4 cm, weight: 73.8 ± 16.9 kg) volunteered to participate in a PNF session and a control session separated by 2-7 days. The PNF stretching lasted 2 minutes and consisted of 4 sets of 5-second isometric hamstring contraction immediately followed by 5 seconds of passive static stretch of the quadriceps immediately followed by 5 seconds isometric quadriceps contraction for each leg. For the control session, the participants were asked to walk at a comfortable speed for 2 minutes. Active ROM of knee flexion, vertical jump performance, and quadriceps neuromuscular function were tested before, immediately after, and 15 minutes after the intervention. The PNF stretching procedure did not affect ROM, squat jump, and countermovement jump performances. Accordingly, we did not observe any change in maximal voluntary contraction force, voluntary activation level, M-wave and twitch contractile properties that could be attributed to PNF stretching. The present self-administered PNF stretching of the quadriceps with short (5-second) stretches is not recommended before sports where flexibility is mandatory for performance.

  16. 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.

  17. Vitrificação de oócitos e embriões bovinos produzidos in vitro e expostos à citocalasina B

    Directory of Open Access Journals (Sweden)

    Alceu Mezzalira

    2002-01-01

    Full Text Available Foi avaliada a influência da citocalasina B na vitrificação de oócitos e embriões bovinos produzidos in vitro. No Experimento I, 956 oócitos foram maturados por 22h, sendo imediatamente vitrificados (tratamento Vitri ou expostos por 15 a 20 minutos, à solução com 7,5µg/mL (tratamento CB7,5Vitri ou 45µg/mL (tratamento CB45Vitri de citocalasina B, antes da vitrificação. Após 30 segundos de exposição à SV1 [400µl TCM-Hepes com 10% soro fetal (SF, 50µl etilenoglicol (EG e 50µl DMSO], e 20 segundos à SV2 (300µl trealose 1,0M + 20% SF, 100µl EG e 100µl DMSO, os oócitos foram vitrificados em palhetas estiradas (OPS. O reaquecimento foi realizado a 37-38ºC em duas etapas de 5 minutos cada, em trealose 0,3M e 0,15M. Não houve diferenças (P>;0,05 nos percentuais de clivagem e desenvolvimento embrionário entre os tratamentos Vitri, Cito7,5Vitri e Cito45Vitri, os quais foram inferiores (P;0,05 no percentual de re-expansão e eclosão entre os grupos Vitri e CB45Vitri, os quais foram inferiores (P<0,05 ao grupo controle. Os resultados indicam que, independentemente da dose utilizada, a exposição a citocalasina B não produz efeito benéfico na vitrificação de oócitos ou blastocistos bovinos produzidos in vitro.

  18. Circuit modeling of the electrical impedance: I. Neuromuscular disease

    International Nuclear Information System (INIS)

    Shiffman, C A; Rutkove, S B

    2013-01-01

    Multifrequency electrical impedance myography (MFEIM) in the 3–300 kHz range was applied to 68 subjects representing 19 different neuromuscular diseases, and the impedances analyzed using the 5-element circuit model. Depending on severity, the ‘cellular’ parameters r 2 , r 3 , 1/c 1 and 1/c 2 were found to be as much as 10- to 20-fold larger than for normal subjects (taking age and girth into account), but in almost every case the extracellular fluid parameter r 1 was at most only marginally affected. Strong correlations are found between r 2 and 1/c 1, but in the case of ALS that breaks down when c 1 (representing the muscle fiber membrane capacitance) falls below half the normal value. Also, c 2 (tentatively associated with intracellular organelle membranes) was found to be the most sensitive to disease progress in ALS, about three times more so than the 50 kHz phase, already suggested for use in clinical drug testing. We conclude that following parameters obtained using the combined MFEIM/5-element circuit analysis scheme offer a reliable, non-invasive and objective way of characterizing muscle in neuromuscular disease or during clinical drug testing. (paper)

  19. A neuromuscular monitoring system based on a personal computer.

    Science.gov (United States)

    White, D A; Hull, M

    1992-07-01

    We have developed a computerized neuromuscular monitoring system (NMMS) using commercially available subsystems, i.e., computer equipment, clinical nerve stimulator, force transducer, and strip-chart recorder. This NMMS was developed for acquisition and analysis of data for research and teaching purposes. Computer analysis of the muscle response to stimulation allows graphic and numeric presentation of the twitch response and calculated ratios. Since the system can store and recall data, research data can be accessed for analysis and graphic presentation. An IBM PC/AT computer is used as the central controller and data processor. The computer controls timing of the nerve stimulator output, initiates data acquisition, and adjusts the paper speed of the strip chart recorder. The data processing functions include establishing control response values (when no neuromuscular blockade is present), displaying force versus time and calculated data graphically and numerically, and storing these data for further analysis. The general purpose nature of the computer and strip chart recording equipment allow modification of the system primarily by changes in software. For example, new patterns of nerve stimulation, such as the posttetanic count, can be programmed into the computer system along with appropriate data display and analysis routines. The NMMS has functioned well in the operating room environment. We have had no episodes of electrocautery interference with the computer functions. The automated features have enhanced the utility of the NMMS.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. The neuromuscular approach towards interdisciplinary cooperation in medicine.

    Science.gov (United States)

    Yurchenko, Maksim; Hubálková, Hana; Klepáček, Ivo; Machoň, Vladimír; Mazánek, Jiří

    2014-02-01

    The contemporary approach of dentistry towards interdisciplinary cooperation is based on the neuromuscular concept. In recent years many authors have pointed out a correlation between orthopaedic and dental findings. Furthermore, there is an intimate biomechanical interrelationship of occlusion with cerebral fluid circulation, left and right equilibrium, gaze stabilisation and headache. The influence of a dental occlusion and temporomandibular joint (TMJ) status on general health has been widely analysed in the current scientific literature. The aim of this analytic study was to display the deep relationship between dentistry and other fields of medicine, and to show the necessity of wide cooperation between dentists and physicians. This study was based on a review of 41 sources, including specialised articles and books. The significance of different anatomical and physiological preconditions (occlusion, muscles and TMJ status) was considered and evaluated separately. However, as a result of modern concepts of general body health, extending cooperation between different fields of medicine is essential. The practical application of the principles of neuromuscular dentistry enables one to increase greatly the treatment efficiency of aches in muscles, headaches, postural dysfunctions as well as of many other diseases. However, the dentist's contribution to the development of an interdisciplinary approach is underestimated. Many theoretical aspects of the interdisciplinary relationship have not been sufficiently examined, hence the practical consequences remain unclear. Further research in the field is urgently needed. © 2013 FDI World Dental Federation.

  1. Contralaterally Controlled Neuromuscular Electrical Stimulation for Recovery of Ankle Dorsiflexion

    Science.gov (United States)

    Knutson, Jayme S.; Hansen, Kristine; Nagy, Jennifer; Bailey, Stephanie N.; Gunzler, Douglas D.; Sheffler, Lynne R.; Chae, John

    2013-01-01

    Objective Compare the effects of contralaterally controlled neuromuscular electrical stimulation (CCNMES) versus cyclic neuromuscular electrical stimulation (NMES) on lower extremity impairment, functional ambulation, and gait characteristics. Design Twenty-six stroke survivors with chronic (≥6mo) footdrop during ambulation were randomly assigned to six weeks of CCNMES or cyclic NMES. Both groups had ten sessions per week of self-administered home application of either CCNMES or cyclic NMES plus two sessions per week of gait training with a physical therapist. Primary outcomes included lower extremity Fugl-Meyer score, modified Emory Functional Ambulation Profile, and gait velocity. Assessments were made at pretreatment, posttreatment, and at 1 and 3 months posttreatment. Results There were no significant differences between groups in the outcome trajectories for any of the measures. With data from both groups pooled, there were significant but modest and sustained improvements in the Fugl-Meyer score and the modified Emory Functional Ambulation Profile, but not in gait velocity. Conclusions The results support the hypothesis that gait training combined with either CCNMES or cyclic NMES reduces lower extremity impairment and functional ambulation, but do not support the hypothesis that CCNMES is more effective than cyclic NMES in chronic patients. PMID:23867888

  2. Neuromuscular compensation mechanisms in vocal fold paralysis and paresis.

    Science.gov (United States)

    Dewan, Karuna; Vahabzadeh-Hagh, Andrew; Soofer, Donna; Chhetri, Dinesh K

    2017-07-01

    Vocal fold paresis and paralysis are common conditions. Treatment options include augmentation laryngoplasty and voice therapy. The optimal management for this condition is unclear. The objective of this study was to assess possible neuromuscular compensation mechanisms that could potentially be used in the treatment of vocal fold paresis and paralysis. In vivo canine model. In an in vivo canine model, we examined three conditions: 1) unilateral right recurrent laryngeal nerve (RLN) paresis and paralysis, 2) unilateral superior laryngeal nerve (SLN) paralysis, and 3) unilateral vagal nerve paresis and paralysis. Phonatory acoustics and aerodynamics were measured in each of these conditions. Effective compensation was defined as improved acoustic and aerodynamic profile. The most effective compensation for all conditions was increasing RLN activation and decreasing glottal gap. Increasing RLN activation increased the percentage of possible phonatory conditions that achieved phonation onset. SLN activation generally led to decreased number of total phonation onset conditions within each category. Differential effects of SLN (cricothyroid [CT] muscle) activation were seen. Ipsilateral SLN activation could compensate for RLN paralysis; normal CT compensated well in unilateral SLN paralysis; and in vagal paresis/paralysis, contralateral SLN and RLN displayed antagonistic relationships. Methods to improve glottal closure should be the primary treatment for large glottal gaps. Neuromuscular compensation is possible for paresis. This study provides insights into possible compensatory mechanisms in vocal fold paresis and paralysis. NA Laryngoscope, 127:1633-1638, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  3. [Six-minute walk test in children with neuromuscular disease.

    Science.gov (United States)

    Cruz-Anleu, Israel Didier; Baños-Mejía, Benjamín Omar; Galicia-Amor, Susana

    2013-01-01

    Background: neuromuscular diseases affect the motor unit. When they evolve, respiratory complications are common; the six-minute walk test plays an important role in the assessment of functional capacity. Methods: prospective, transversal, descriptive and observational study. We studied seven children with a variety of neuromuscular diseases and spontaneous ambulation. We tested their lung function, and administered a six-minute walk test and a test of respiratory muscle strength to these children. Results: the age was 9.8 ± 2.4 years. All patients were males. Forced vital capacity decreased in three patients (42.8 %), forced expiratory volume during the first second (2.04 ± 1.4 L) and peak expiratory flow (4.33 ± 3.3 L/s) were normal. The maximum strength of respiratory muscles was less than 60 % of predicted values. The distance covered in the six-minute walk test was lower when compared with healthy controls (29.9 %). Conclusions: the six-minute walk test can be a useful tool in early stages of this disease, since it is easy to perform and well tolerated by the patients.

  4. Synaptic Homeostasis and Its Immunological Disturbance in Neuromuscular Junction Disorders

    Directory of Open Access Journals (Sweden)

    Masaharu Takamori

    2017-04-01

    Full Text Available In the neuromuscular junction, postsynaptic nicotinic acetylcholine receptor (nAChR clustering, trans-synaptic communication and synaptic stabilization are modulated by the molecular mechanisms underlying synaptic plasticity. The synaptic functions are based presynaptically on the active zone architecture, synaptic vesicle proteins, Ca2+ channels and synaptic vesicle recycling. Postsynaptically, they are based on rapsyn-anchored nAChR clusters, localized sensitivity to ACh, and synaptic stabilization via linkage to the extracellular matrix so as to be precisely opposed to the nerve terminal. Focusing on neural agrin, Wnts, muscle-specific tyrosine kinase (a mediator of agrin and Wnts signalings and regulator of trans-synaptic communication, low-density lipoprotein receptor-related protein 4 (the receptor of agrin and Wnts and participant in retrograde signaling, laminin-network (including muscle-derived agrin, extracellular matrix proteins (participating in the synaptic stabilization and presynaptic receptors (including muscarinic and adenosine receptors, we review the functional structures of the synapse by making reference to immunological pathogenecities in postsynaptic disease, myasthenia gravis. The synapse-related proteins including cortactin, coronin-6, caveolin-3, doublecortin, R-spondin 2, amyloid precursor family proteins, glia cell-derived neurotrophic factor and neurexins are also discussed in terms of their possible contribution to efficient synaptic transmission at the neuromuscular junction.

  5. Innervation and neuromuscular control in ageing skeletal muscle

    Science.gov (United States)

    Rice, Charles L.

    2015-01-01

    Abstract Changes in the neuromuscular system affecting the ageing motor unit manifest structurally as a reduction in motor unit number secondary to motor neuron loss; fibre type grouping due to repeating cycles of denervation‐reinnervation; and instability of the neuromuscular junction that may be due to either or both of a gradual perturbation in postsynaptic signalling mechanisms necessary for maintenance of the endplate acetylcholine receptor clusters or a sudden process involving motor neuron death or traumatic injury to the muscle fibre. Functionally, these changes manifest as a reduction in strength and coordination that precedes a loss in muscle mass and contributes to impairments in fatigue. Regular muscle activation in postural muscles or through habitual physical activity can attenuate some of these structural and functional changes up to a point along the ageing continuum. On the other hand, regular muscle activation in advanced age (>75 years) loses its efficacy, and at least in rodents may exacerbate age‐related motor neuron death. Transgenic mouse studies aimed at identifying potential mechanisms of motor unit disruptions in ageing muscle are not conclusive due to many different mechanisms converging on similar motor unit alterations, many of which phenocopy ageing muscle. Longitudinal studies of ageing models and humans will help clarify the cause and effect relationships and thus, identify relevant therapeutic targets to better preserve muscle function across the lifespan. PMID:26437581

  6. Fundamental Molecules and Mechanisms for Forming and Maintaining Neuromuscular Synapses

    Science.gov (United States)

    Huijbers, Maartje G.; Remedio, Leonor

    2018-01-01

    The neuromuscular synapse is a relatively large synapse with hundreds of active zones in presynaptic motor nerve terminals and more than ten million acetylcholine receptors (AChRs) in the postsynaptic membrane. The enrichment of proteins in presynaptic and postsynaptic membranes ensures a rapid, robust, and reliable synaptic transmission. Over fifty years ago, classic studies of the neuromuscular synapse led to a comprehensive understanding of how a synapse looks and works, but these landmark studies did not reveal the molecular mechanisms responsible for building and maintaining a synapse. During the past two-dozen years, the critical molecular players, responsible for assembling the specialized postsynaptic membrane and regulating nerve terminal differentiation, have begun to be identified and their mechanism of action better understood. Here, we describe and discuss five of these key molecular players, paying heed to their discovery as well as describing their currently understood mechanisms of action. In addition, we discuss the important gaps that remain to better understand how these proteins act to control synaptic differentiation and maintenance. PMID:29415504

  7. [Controlled dynamic weight training in patients with neuromuscular disorders].

    Science.gov (United States)

    Kelm, J; Ahlhelm, F; Regitz, T; Pape, D; Schmitt, E

    2001-08-01

    The question posed was whether individually adapted, controlled dynamic weight training, in accordance with training principles and methods from sports science, applied for a limited time, can lead to an improvement in the stimulation and release of muscular strength in patients with neuromuscular disorders. The muscles of the pelvic girdle and the lower extremity of 10 patients (5 with dystrophic muscle disease and 5 with neurogenic muscular atrophy) were exercised provisionally for a period of 6 weeks on various weight training machines. The training routine was 3 sessions (TS) per week at an intensity range of 40-60% of the respective best performance for the exercise (One Repetition Maximum; ORM), at 8-12 repetitions/set and 2-4 sets/exercise. Body weight and ORM were determined before, during and after the training period (TP), the different load criteria/TS were documented. It was possible to train the patients in accordance with principles of training known from sports science. Over the entire TP it was possible to increase the load criteria significantly (p rehabilitation, it represents a supplementary form of therapy in the symptomatic treatment of neuromuscular disorders.

  8. Antisense Oligonucleotide-Based Therapy for Neuromuscular Disease

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    Valentina Sardone

    2017-04-01

    Full Text Available Neuromuscular disorders such as Duchenne Muscular Dystrophy and Spinal Muscular Atrophy are neurodegenerative genetic diseases characterized primarily by muscle weakness and wasting. Until recently there were no effective therapies for these conditions, but antisense oligonucleotides, a new class of synthetic single stranded molecules of nucleic acids, have demonstrated promising experimental results and are at different stages of regulatory approval. The antisense oligonucleotides can modulate the protein expression via targeting hnRNAs or mRNAs and inducing interference with splicing, mRNA degradation, or arrest of translation, finally, resulting in rescue or reduction of the target protein expression. Different classes of antisense oligonucleotides are being tested in several clinical trials, and limitations of their clinical efficacy and toxicity have been reported for some of these compounds, while more encouraging results have supported the development of others. New generation antisense oligonucleotides are also being tested in preclinical models together with specific delivery systems that could allow some of the limitations of current antisense oligonucleotides to be overcome, to improve the cell penetration, to achieve more robust target engagement, and hopefully also be associated with acceptable toxicity. This review article describes the chemical properties and molecular mechanisms of action of the antisense oligonucleotides and the therapeutic implications these compounds have in neuromuscular diseases. Current strategies and carrier systems available for the oligonucleotides delivery will be also described to provide an overview on the past, present and future of these appealing molecules.

  9. Treatment of vocal fold bowing using neuromuscular electrical stimulation.

    Science.gov (United States)

    Lagorio, Lisa A; Carnaby-Mann, Giselle D; Crary, Michael A

    2010-04-01

    To investigate the clinical effectiveness and safety of a novel behavioral voice therapy program combining structured vocal exercise with adjunctive neuromuscular electrical stimulation for rehabilitating dysphonia secondary to vocal fold bowing. Prospective interventional clinical case series with a 3-month follow-up. Outpatient speech and hearing clinic in an academic medical center. Convenience sample of 7 patients diagnosed by an otolaryngologist as having chronic dysphonia for at least 3 months due to bilateral vocal fold bowing. A novel voice therapy program incorporating exercise principles and sustained phonations of increasing length, volume, and pitch paired with concurrent transcutaneous neuromuscular electrical stimulation. Change in maximum phonation time, highest attainable pitch, glottal closure, supraglottic compression, and Voice Handicap Index. Maximum phonation time for /i/ increased significantly (z = -2.201, P vocal fold bowing, resulting in improved acoustic, laryngeal, and patient-centered outcomes. Maximum phonation time and glottal closure results imply increased vocal fold tension secondary to enhanced thyroarytenoid or cricothyroid muscle function after voice therapy.

  10. Neuromuscular rate of force development deficit in Parkinson disease.

    Science.gov (United States)

    Hammond, Kelley G; Pfeiffer, Ronald F; LeDoux, Mark S; Schilling, Brian K

    2017-06-01

    Bradykinesia and reduced neuromuscular force exist in Parkinson disease. The interpolated twitch technique has been used to evaluate central versus peripheral manifestations of neuromuscular strength in healthy, aging, and athletic populations, as well as moderate to advanced Parkinson disease, but this method has not been used in mild Parkinson disease. This study aimed to evaluate quadriceps femoris rate of force development and quantify potential central and peripheral activation deficits in individuals with Parkinson disease. Nine persons with mild Parkinson Disease (Hoehn & Yahr≤2, Unified Parkinson Disease Rating Scale total score=mean 19.1 (SD 5.0)) and eight age-matched controls were recruited in a cross-sectional investigation. Quadriceps femoris voluntary and stimulated maximal force and rate of force development were evaluated using the interpolated twitch technique. Thirteen participants satisfactorily completed the protocol. Individuals with early Parkinson disease (n=7) had significantly slower voluntary rate of force development (p=0.008; d=1.97) and rate of force development ratio (p=0.004; d=2.18) than controls (n=6). No significant differences were found between groups for all other variables. Persons with mild-to-moderate Parkinson disease display disparities in rate of force development, even without deficits in maximal force. The inability to produce force at a rate comparable to controls is likely a downstream effect of central dysfunction of the motor pathway in Parkinson disease. Copyright © 2017. Published by Elsevier Ltd.

  11. 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

  12. 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)

    Carlos Escobar Vásquez

    2002-11-01

    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

  13. Volumes efetivos de anestésicos locais para o bloqueio do compartimento da fáscia ilíaca: estudo comparativo duplamente encoberto entre ropivacaína a 0,5% e bupivacaína a 0,5%

    Directory of Open Access Journals (Sweden)

    Helayel Pablo Escovedo

    2006-01-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do compartimento da fáscia ilíaca é amplamente empregado como parte das técnicas anestésicas para intervenções cirúrgicas de quadril, coxa e joelho. A maioria dos estudos tem utilizado volumes fixos de ropivacaína ou de bupivacaína. Este estudo teve como objetivo calcular os volumes de ropivacaína a 0,5% e de bupivacaína a 0,5% efetivos em 50% (VE50, 95% (VE95 e 99% (VE99 dos casos para realização de bloqueios do compartimento da fáscia ilíaca. MÉTODO: Cinqüenta e um adultos agendados para intervenções cirúrgicas eletivas do quadril, diáfise femoral e joelho foram submetidos ao bloqueio do compartimento da fáscia ilíaca. Os pacientes foram aleatoriamente distribuídos e receberam ropivacaína a 0,5% (n = 25 ou bupivacaína a 0,5% (n = 26. O sucesso do bloqueio foi definido como bloqueio sensitivo completo das regiões anterior, medial e lateral da coxa. O volume anestésico foi determinado pelo método up-and-down de Massey e Dixon e os volumes efetivos foram calculados pelas fórmulas de Massey e Dixon (VE50 e por regressão de probits (VE50, VE95 e VE99. RESULTADOS: Os volumes anestésicos capazes de produzir bloqueio nervoso efetivo em 50% dos casos, calculados pela formula de Massey e Dixon, foram 28,79 mL (IC 95%: 26,31 - 31,5 mL para ropivacaína e 29,56 mL (IC 95%: 25,22 - 34,64 mL para bupivacaína (p = 0,62. Os volumes efetivos de ropivacaína capazes de bloquear 50%, 95% e 99% dos casos foram estimados pela regressão de probits como 28,8 mL (27,2 - 30,4, 34,3 mL (32,5 - 37,3 e 36,6 mL (34,3 - 40,5, respectivamente. Os volumes correspondentes de bupivacaína foram 29,5 mL (28,1 - 31,1, 36,1 mL (33,5 - 38,1, e 37,3 mL (35,1 - 41,3 (p < 0,05. CONCLUSÕES: Os volumes necessários de ropivacaína a 0,5% e bupivacaína a 0,5% com adrenalina 1:200.000 para o bloqueio do compartimento da fáscia ilíaca são similares.

  14. Reversal agents: do we need to administer with neuromuscular monitoring - an observational study.

    Science.gov (United States)

    Goyal, Shilpa; Kothari, Nikhil; Chaudhary, Deepak; Verma, Shilpi; Bihani, Pooja; Rodha, Mahaveer Singh

    2018-03-01

    In clinical practice, in the majority of patients, recovery from the effect of muscle relaxants is assessed using subjective methods such as head lift, eye-opening, or by sustained hand grip after giving anticholinesterases (neostigmine) at the end of surgery. We planned a prospective observational cohort study to test the hypothesis that objective neuromuscular monitoring can help us in avoiding the use of anticholinesterases for reversal. The patients posted for surgery of neuromuscular monitoring of recovery (train-of-four [TOF] ratio of 0.9 or more; exposed group) and the patients who were not exposed to objective neuromuscular monitoring (non-exposed group) acting as a control. Using objective neuromuscular monitoring, the time required for recovery from muscle relaxation when neostigmine was not given for reversal was noted and it was then compared with that of the control group. A total of 190 patients were enrolled over a period of 3 years. With the use of TOF ratio of 0.9 for extubation, patients safely recovered from neuromuscular blockade, without using neostigmine, with no difference in the mean recovery time (14.48 ± 1.138 min) as compared to the control group (12.14 ± 1.067 min, P = 0.139). There was no incidence of reintubation in post-operative period. With objective neuromuscular monitoring, we can ensure complete recovery from the neuromuscular blockade while avoiding the use of anticholinesterases.

  15. Evaluation of the Effectiveness of Neuromuscular Electrical Stimulation After Total Knee Arthroplasty: A Meta-Analysis.

    Science.gov (United States)

    Bistolfi, Alessandro; Zanovello, Jessica; Ferracini, Riccardo; Allisiardi, Fabrizio; Lioce, Elisa; Magistroni, Ernesta; Berchialla, Paola; Da Rold, Ilaria; Massazza, Giuseppe

    2018-02-01

    The aim of the study was to evaluate the efficacy of the use of the neuromuscular electrical stimulation after total knee arthroplasty. The study used a systematic review of randomized controlled trials (MEDLINE, PubMed, Cochrane Library, and PEDro) using Patient Population or Problem, Intervention, Comparison, Outcomes, Setting approach to formulate the research question, controlled terms, and Boolean operators. Inclusion and exclusion criteria were defined in advance. "Neuromuscular electrical stimulation" and "total knee arthroplasty" were used as keywords. The overall risk of bias was determined according to the following: random sequence generation, concealment, blinding mass of participants and staff, commissioning blind assessment results, incomplete data, and loans received. Of the 36 identified studies, six were included in the review (496 participants). In these studies, one group of patients followed a rehabilitation protocol (control group) and the other followed a rehabilitation program plus a session of neuromuscular electrical stimulation (neuromuscular electrical stimulation group). Patients of neuromuscular electrical stimulation groups got the best scores (timed up and go test, stair climbing test, and walk test). Neuromuscular electrical stimulation benefits were strong in the first postoperative weeks/months and gradually diminished. Neuromuscular electrical stimulation allows a slightly better functional recovery after total knee arthroplasty, especially in the first period, with more evident benefits in patients with a severe lack of muscular activation. Nevertheless, there is no difference at medium-long term.

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

    Directory of Open Access Journals (Sweden)

    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

  17. The Preparation Period in Basketball: Training Load and Neuromuscular Adaptations.

    Science.gov (United States)

    Ferioli, Davide; Bosio, Andrea; Bilsborough, Johann C; Torre, Antonio La; Tornaghi, Michele; Rampinini, Ermanno

    2018-01-18

    To investigate the 1) effect of the preparation period on the neuromuscular characteristics of 12 professional (PRO) and 16 semi-professional (SEMI-PRO) basketball players; 2) relationships between training load indices and changes in neuromuscular physical performance. Prior to and following the preparation period, players underwent a counter-movement jump (CMJ) test, followed by a repeated change of direction (COD) test consisting of 4 levels with increasing intensities. The peripheral neuromuscular functions of the knee extensors (peak torque, PT) were measured using electrical stimulations after each level (PT1, PT2, PT3 and PT4). Furthermore, PT Max (the highest value of PT) and PT Dec (PT decrement from PT Max to PT4) were calculated. Trivial-to-small (effect size, ES: -0.17 to 0.46) improvements were found in CMJ variables, regardless of the competitive levels. After the preparation period, peripheral fatigue induced by a COD test was similarly reduced in both PRO (PT Dec: from 27.8±21.3% to 11.4±13.7%, ES±90%CI= -0.71±0.30) and SEMI-PRO (PT Dec: from 26.1±21.9% to 10.2±8.2%, ES±90%CI= -0.69±0.32). Moderate-to-large relationships were found between session rating of perceived exertion training load and changes in PPO measured during the CMJs (r s ±90%CI: PPOabs, -0.46±0.26; PPOrel, -0.53±0.23) and in some PTs measured during the COD test (PT1, -0.45±0.26; PT2, -0.44±0.26; PT3, -0.40±0.27 and PT Max, -0.38±0.28). Preparation period induced minimal changes in the CMJ, while the ability to sustain repeated COD efforts was improved. Reaching high session rating of perceived exertion training loads might partially and negatively affect the ability to produce strength and power.

  18. Prevalence of polysaccharide storage myopathy in horses with neuromuscular disorders.

    Science.gov (United States)

    McCue, M E; Ribeiro, W P; Valberg, S J

    2006-08-01

    Controversy exists as to the prevalence of polysaccharide storage myopathy (PSSM) in breeds of horses and its impact on performance. To determine 1) the prevalence of PSSM in horses that presented with a neuromuscular disorder, as well as breed, sex and age distributions and clinical signs 2) effect of diagnostic criteria on prevalence, breed distribution and age of horses diagnosed with PSSM. Fresh frozen biopsies (n = 1426) submitted to the Neuromuscular Diagnostic Laboratory at the University of Minnesota were searched to identify horses diagnosed with PSSM. Horses with and without histological evidence of PSSM were compared. Biopsies were classified as Grade 1, containing aggregates of granular glycogen or Grade 2, containing periodic acid Schiff's (PAS) positive inclusions, traditionally resistant to amylase digestion. Horses (n = 572 : 40.1%) were identified with PSSM, of which 62.9% were Quarter Horse related breeds (QHR), 11.5% Draught breeds (DB) and 8.9% Warmblood breeds (WB). Exertional rhabdomyolysis was more prevalent in QHR than DB and WB, whereas QHR were less likely to have muscle atrophy compared to DB. QHR were less likely to have gait abnormalities than DB and WB. The highest within breed prevalence of PSSM was in DB at 63/116, WB 58/111 and QHR 360/753. Exclusion of Grade 1 criteria decreased the overall prevalence of PSSM to 21.7% of biopsy submissions, and decreased the within breed prevalence in each breed category. The within breed prevalence decreased most substantially in the breeds less commonly diagnosed with PSSM, Thoroughbreds (4.5%) and Arabians (2.5%). PSSM is a common cause of neuromuscular disease in QHR, DB and WB related breeds. Inclusion of granular glycogen as the sole diagnostic criterion may increase the sensitivity of this diagnostic test, but conversely it may decrease the specificity of the diagnosis resulting in the inclusion of horses of Thoroughbred, Arabian and other breeds. PSSM is an important differential diagnosis

  19. [Contribution of histochemistry to the classification of neuromuscular diseases].

    Science.gov (United States)

    Scarlato, G

    1975-01-01

    For a long time after the first muscle biopsy performed on man by Bilroth in 1965, histological study of the muscle has been linked to out of date patterns of interpretation most of them without any importance for clinical diagnosis. The use of histochemical techniques in the study of muscle was introduced quite recently and consequently in the last 15 years it has been possible to collect an enormous amount of very important data for the clinical diagnosis of many neuromuscular disorders. The classification of muscle fibers into different types which was possible first of all using the myofibrillar ATPase reaction by Padykula and Hermann permitted pathological interpretation leading to specific correlations between histological and EMG results. Furthermore the use of different histoenzymological methods in the study of mitochondrial enzymes activity and of the enzymes for the glycogen breakdown and synthesis, promoted a more elaborate fibre typing system. Thank to the development of cryostatic microtomy, the above mentioned methods became easy to be performed in the laboratory routine work. The use of the cryostat, which allows a better preservation of muscular tissue, led to a more accurate diagnostic interpretation particularly in relation to morphology. The study of fiber typing revealed many alterations: single fiber type atrophy, type one or type two predominance, type grouping, hypertrophy of a single fiber type and so on, giving to the clinicians the possibility not only of a more elaborate pathogenetic interpretation, but also of a much more precise diagnosis than in the past. Important results have been achieved using the above mentioned histoenzymological methods in the study of the single muscle fibers. Anglo-Saxon Authors provided us with many significant terms, in order to point out alterations of the enzymes distribution within the single muscle fiber: moth eaten, target fiber, rods, central core, subsarcolemmal blebs. Some of these alterations, seen

  20. A neuromuscular exercise programme versus standard care for patients with traumatic anterior shoulder instability

    DEFF Research Database (Denmark)

    Eshøj, Henrik; Rasmussen, Sten; Frich, Lars Henrik

    2017-01-01

    -based exercise programmes. In similar, high-impact injuries (e.g. anterior cruciate ligament tears in the knee) neuromuscular exercise has shown large success in improving physical function and QoL. Thus, the objective of this trial is to compare a nonoperative neuromuscular exercise shoulder programme...... dislocations due to at least one traumatic event will be randomised to 12 weeks of either a standardised, individualised or physiotherapist-supervised neuromuscular shoulder exercise programme or standard care (self-managed shoulder exercise programme). Patients will be stratified according to injury status...

  1. Improving Neuromuscular Monitoring and Reducing Residual Neuromuscular Blockade With E-Learning: Protocol for the Multicenter Interrupted Time Series INVERT Study.

    Science.gov (United States)

    Thomsen, Jakob Louis Demant; Mathiesen, Ole; Hägi-Pedersen, Daniel; Skovgaard, Lene Theil; Østergaard, Doris; Engbaek, Jens; Gätke, Mona Ring

    2017-10-06

    Muscle relaxants facilitate endotracheal intubation under general anesthesia and improve surgical conditions. Residual neuromuscular blockade occurs when the patient is still partially paralyzed when awakened after surgery. The condition is associated with subjective discomfort and an increased risk of respiratory complications. Use of an objective neuromuscular monitoring device may prevent residual block. Despite this, many anesthetists refrain from using the device. Efforts to increase the use of objective monitoring are time consuming and require the presence of expert personnel. A neuromuscular monitoring e-learning module might support consistent use of neuromuscular monitoring devices. The aim of the study is to assess the effect of a neuromuscular monitoring e-learning module on anesthesia staff's use of objective neuromuscular monitoring and the incidence of residual neuromuscular blockade in surgical patients at 6 Danish teaching hospitals. In this interrupted time series study, we are collecting data repeatedly, in consecutive 3-week periods, before and after the intervention, and we will analyze the effect using segmented regression analysis. Anesthesia departments in the Zealand Region of Denmark are included, and data from all patients receiving a muscle relaxant are collected from the anesthesia information management system MetaVision. We will assess the effect of the module on all levels of potential effect: staff's knowledge and skills, patient care practice, and patient outcomes. The primary outcome is use of neuromuscular monitoring in patients according to the type of muscle relaxant received. Secondary outcomes include last recorded train-of-four value, administration of reversal agents, and time to discharge from the postanesthesia care unit as well as a multiple-choice test to assess knowledge. The e-learning module was developed based on a needs assessment process, including focus group interviews, surveys, and expert opinions. The e

  2. Neuromuscular blockade for improvement of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Scheppan, Susanne; Kissmeyer, Peter

    2015-01-01

    INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep neuromus......INTRODUCTION: During laparotomy, surgeons frequently experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. This issue is particularly pertinent while closing the fascia and placing the intestines into the abdominal cavity. Establishment of a deep...... neuromuscular blockade (NMB), defined as a post-tetanic-count (PTC) of 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesised that deep NMB (PTC 0-1) would improve surgical conditions during upper laparotomy as compared to standard NMB with bolus administration. METHODS...

  3. Neuromuscular Electrical Stimulation Therapy for Dysphagia Caused by Wilson's Disease

    Science.gov (United States)

    Lee, Seon Yeong; Yang, Hee Seung; Lee, Seung Hwa; Jeung, Hae Won; Park, Young Ok

    2012-01-01

    Wilson's disease is an autosomal recessive disorder of abnormal copper metabolism. Although dysphagia is a common complaint of patients with Wilson's disease and pneumonia is an important cause of death in these patients, management of swallowing function has rarely been reported in the context of Wilson's disease. Hence, we report a case of Wilson's disease presenting with dysphagia. A 33-year-old man visited our hospital with a complaint of difficulty in swallowing, since about last 7 years and which had worsened since the last 2-3 months. He was diagnosed with Wilson's disease about 13 years ago. On the initial VFSS, reduced hyoid bone movement, impaired epiglottic movement and moderate amount of residue in the valleculae during the pharyngeal phase were noted. After 10 sessions of neuromuscular electrical stimulation for 1 hour per day, decreased amount of residue was observed in the valleculae during the pharyngeal phase on the follow-up VFSS. PMID:22837979

  4. Computed tomography (CT) of skeletal muscle in neuromuscular disorders

    International Nuclear Information System (INIS)

    Nagao, Hideo; Morimoto, Takehiko; Takahashi, Mitsugi; Habara, Shinji; Nagai, Hironao; Matsuda, Hiroshi

    1987-01-01

    We investigated whether or not computerized tomography (CT) of skeletal muscle was of value for the diagnosis of neuromuscular disorders, through a comparison of CT findings in the skeletal muscle with histological findings in the muscle obtained by surgical biopsy. There were clear histological lesions even in cases in which low density areas were not seen on CT of the skeletal muscle. The muscle exhibiting remarkably low density areas showed high proliferation of the connective tissue and high accumulation of fat, but contained no muscle fibers. Therefore, the most suitable site for a biopsy was the muscle which exhibited mildly low density areas on CT. In floppy infants, the CT value was helpful for the diagnosis, even if low density areas did not appear because of remarkable muscle atrophy and monotonous lesions of the whole muscle. (author)

  5. Effect of ionizing radiation on neuromuscular junctions in mouse tongues

    International Nuclear Information System (INIS)

    Gorodetsky, R.; Amir, G.; Yarom, R.

    1992-01-01

    Radiation damage to neuromuscular junctions (NMJs) in mouse tongues was studied using local x-irradiation of the tongues with the rest of the body shielded. Transmission electron microscopy (TEM) revealed no significant morphological changes in fine structures and organelles of the NMJs given 4Gy. A dose of 8Gy produced degenerative morphological changes associated with axon terminal sprouting as early as 2 and 7 days following irradiation. Subsequently, 1-11 weeks later, severe degenerative changes were observed. The number of mitochondria was significantly decreased with increased occurrence of degenerative membranal features. The number of synaptic footplates without terminals or with multiple small terminals within one groove increased gradually with time. Most changes persisted for at least 3 months after irradiation. However, the myofibres, blood vessels and interstitial cells appeared unaffected throughout the period follow-up. (author)

  6. Cellular and Molecular Anatomy of the Human Neuromuscular Junction

    Directory of Open Access Journals (Sweden)

    Ross A. Jones

    2017-11-01

    Full Text Available The neuromuscular junction (NMJ plays a fundamental role in transferring information from lower motor neuron to skeletal muscle to generate movement. It is also an experimentally accessible model synapse routinely studied in animal models to explore fundamental aspects of synaptic form and function. Here, we combined morphological techniques, super-resolution imaging, and proteomic profiling to reveal the detailed cellular and molecular architecture of the human NMJ. Human NMJs were significantly smaller, less complex, and more fragmented than mouse NMJs. In contrast to mice, human NMJs were also remarkably stable across the entire adult lifespan, showing no signs of age-related degeneration or remodeling. Super-resolution imaging and proteomic profiling revealed distinctive distribution of active zone proteins and differential expression of core synaptic proteins and molecular pathways at the human NMJ. Taken together, these findings reveal human-specific cellular and molecular features of the NMJ that distinguish them from comparable synapses in other mammalian species.

  7. 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.

  8. Exercise Stress Testing in Children with Metabolic or Neuromuscular Disorders

    Directory of Open Access Journals (Sweden)

    Tim Takken

    2010-01-01

    Full Text Available The role of exercise as a diagnostic or therapeutic tool in patients with a metabolic disease (MD or neuromuscular disorder (NMD is relatively underresearched. In this paper we describe the metabolic profiles during exercise in 13 children (9 boys, 4 girls, age 5–15 yrs with a diagnosed MD or NMD. Graded cardiopulmonary exercise tests and/or a 90-min prolonged submaximal exercise test were performed. During exercise, respiratory gas-exchange and heart rate were monitored; blood and urine samples were collected for biochemical analysis at set time points. Several characteristics in our patient group were observed, which reflected the differences in pathophysiology of the various disorders. Metabolic profiles during exercises CPET and PXT seem helpful in the evaluation of patients with a MD or NMD.

  9. 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...... extensor and calf muscle activation did not differ between groups. Flexion-extension and medial-lateral co-activation ratio during flexions were higher for girls with GJH than NGJH girls. CONCLUSIONS: Girls with GJH had higher capacity to rapidly generate force than NGJH girls which may reflect motor...

  10. EFFECT OF NEUROMUSCULAR TRAINING ON BALANCE AMONG UNIVERSITY ATHLETES

    Directory of Open Access Journals (Sweden)

    Mohansundar Sankaravel

    2016-06-01

    Full Text Available Background: Proprioceptive deficiency followed by lateral ankle sprain leads to poor balance is not uncommon. It has been linked with increased injury risk among young athletes. Introducing neuromuscular training programs for this have been believed as one of the means of injury prevention. Hence, this study was aimed to determine the effects of six weeks progressive neuromuscular training (PNM Training on static balance gains among the young athletes with a previous history of ankle sprains. Methods: This study was an experimental study design, with pre and post test method to determine the effects of PNM Training on static balance gains. All data were collected at university’s sports rehabilitation lab before and after six weeks of intervention period. There were 20 male and female volunteer young athletes (20.9 ± 0.85 years of age with a previous history of ankle sprain involving various sports were recruited from the University community. All the subjects were participated in a six week PNM Training that included stability, strength and power training. Outcome measures were collected by calculating the errors on balance error scoring system made by the athletes on static balance before and after the six weeks of intervention period. Static balance was tested in firm and foam surfaces and recorded accordingly. Results: The researchers found a significant decrease (2.40 ± 0.82 in total errors among the samples at the post test compared with their pre test (P >0.05. Conclusions: The study demonstrates that a PNM Training can improve the static balance on both the firm and foam surfaces among the young athletes with a previous history of ankle sprains.

  11. 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

  12. Aerobic influence on neuromuscular function and tolerance during passive hyperthermia.

    Science.gov (United States)

    Morrison, Shawnda A; Sleivert, Gordon G; Cheung, Stephen

    2006-10-01

    To determine the role of aerobic fitness on central neuromuscular activation and maximal voluntary contractile force during hyperthermia. Thirty-seven healthy males in three distinct groups based on aerobic fitness and training history were passively heated using a liquid conditioning garment in a hot (35 degrees C, 50% RH) environment with the intention of testing neuromuscular function with whole-body hyperthermia. Of these initial participants, 11 of the 13 highly fit (HF; VO2max = 71.2 +/- 5.9 mL x kg(-1) x min(-1), body fat = 5.6 +/- 1.9%), 11 of the 13 moderately fit (MF; 57.2 +/- 4.2 mL x kg(-1) x min(-1), 11 +/- 3.4%), and 4 of the 11 lower-fit (LF; 49.6 +/- 1.1 mL x kg(-1) x min(-1), 19.4 +/- 2.6%) individuals tolerated heating to 39.0 degrees C, with the remainder terminating the experimental protocol early. Maximal force output and voluntary activation were examined during a 10-s maximal isometric knee extension. Passive heating attenuated force production (-61.7 +/- 69.6 N change from initial values) and decreased voluntary activation (8.6 (12.6), 18.1 (12.4), and 6.1 (3.1)% for HF, MF, and LF training groups, respectively). Cardiovascular strain moderately increased to 60 +/- 14% (P heating (98 +/- 15, 99 +/- 7, and 79 +/- 5 mm Hg for HF, MF, and LF, respectively; P heating to 39.0 degrees C (and above) differed between the HF and MF compared with LF, despite no difference in their psychophysical rankings of thermal sensations and/or (dis)comfort. Low aerobic fitness and activity level are associated with a decreased tolerance to passive hyperthermia. However, at high body temperatures, maximum force production and voluntary activation were impaired to an equal level regardless of training status.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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

  15. 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.C. 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,

  16. Impaired voluntary neuromuscular activation limits muscle power in mobility-limited older adults

    Science.gov (United States)

    Background. Age-related alterations of neuromuscular activation may contribute to deficits in muscle power and mobility function. This study assesses whether impaired activation of the agonist quadriceps and antagonist hamstrings, including amplitude- and velocity-dependent characteristics of activa...

  17. Deep neuromuscular blockade leads to a larger intraabdominal volume during laparoscopy

    DEFF Research Database (Denmark)

    Lindekaer, Astrid Listov; Halvor Springborg, Henrik; Istre, Olav

    2013-01-01

    for measuring the intra-abdominal space available to the surgeon during laproscopy, in order to examine whether the relaxation produced by deep neuromuscular blockade can increase the working surgical space sufficiently to permit a reduction in the CO2 insufflation pressure. Using the laproscopic grasper......, the distance from the promontory to the skin is measured at two different insufflation pressures: 8 mm Hg and 12 mm Hg. After the initial measurements, a neuromuscular blocking agent (rocuronium) is administered to the patient and the intra-abdominal volume is measured again. Pilot data collected from 15...... patients shows that the intra-abdominal space at 8 mm Hg with blockade is comparable to the intra-abdominal space measured at 12 mm Hg without blockade. The impact of neuromuscular blockade was not correlated with patient height, weight, BMI, and age. Thus, using neuromuscular blockade to maintain a steady...

  18. Dutch pediatricians' views on the use of neuromuscular blockers for dying neonates: a qualitative study

    NARCIS (Netherlands)

    ten Cate, K.; van de Vathorst, S.

    2015-01-01

    To assess Dutch pediatricians' views on neuromuscular blockers for dying neonates. Qualitative study involving in-depth interviews with 10 Dutch pediatricians working with severely ill neonates. Data were analyzed using appropriate qualitative research techniques. Participants explained their view

  19. 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...

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

    NARCIS (Netherlands)

    Mullender, M. G.; Blom, N. A.; de Kleuver, M.; Fock, J. M.; Hitters, W. M. G. C.; Horemans, A. M. C.; Kalkman, C. J.; Pruijs, J. E. H.; Timmer, R. R.; Titarsolej, P. J.; van Haasteren, N. C.; van Tol-de Jager, M. J.; van Vught, A. J.; van Royen, B. J.

    2008-01-01

    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

  1. Effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction

    OpenAIRE

    Shim, Jae-Kwang; Choi, Ho-Suk; Shin, Jun-Ho

    2015-01-01

    [Purpose] This study examined the effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 16 adults who underwent arthroscopic anterior cruciate reconstruction and neuromuscular training. The Lysholm scale was used to assess functional disorders on the affected knee joint. A KT-2000 arthrometer was used to measure anterior displacement of the tibia against the femur. Surface electromyography was used t...

  2. Suicide Risk and Depressive Symptoms among Parents of Children with Neuromuscular Disease

    OpenAIRE

    Agredano, Miguel; Valencia, Amelia; Loyo, Luis

    2017-01-01

    To correlate clinical, social, demographic characteristics and depressive symptoms with suicide risk among parents of patients with neuromuscular diseases in rehabilitation. The study design was prospective, transversal and analytic the study was conducted on parents of children with neuromuscular diseases (NMD), from the Teletón Childrens rehabilitation centre of Western Mexico (Centro de Rehabilitación Teletón de Occidente), through the use of individual validated standardised tests, Becks ...

  3. Relationship between neuromuscular and perceived fatigue and locomotor performance in patients with multiple sclerosis.

    Science.gov (United States)

    Hameau, Sophie; Zory, Raphael; Latrille, Christophe; Roche, Nicolas; Bensmail, Djamel

    2017-12-01

    Fatigue is a common problem in patients with multiple sclerosis; however, the impact of neuromuscular and perceived fatigue on locomotor performance is currently unknown in these patients. The aim of this study was: 1) to determine the relationship between perceived and neuromuscular fatigue and locomotor performance in patients with multiple sclerosis; 2) to determine if neuromuscular and perceived fatigue depend on the severity of the pathology defined by the Expanded disability status scale score (EDSS). Observational study. Outpatients from a hospital rehabilitation department. Thirty patients with multiple sclerosis underwent clinical (spasticity, strength, perceived fatigue and locomotor performance) and isokinetic evaluations (peak torque of knee flexor and extensor muscles and neuromuscular fatigue of knee extensor muscles). The main outcome measures were perceived and neuromuscular fatigue and locomotor performance. Secondary outcomes were strength of the weakest limb and peak isometric torque of knee flexor and extensor muscles, spasticity, EDSS. There were no significant correlations between perceived or neuromuscular fatigue and locomotor performance. Locomotor performance was correlated with EDSS, spasticity, strength of the weakest limb and peak isometric torque of knee flexor and extensor muscles. Eighty‑three percent of the variance of the 6MWT could be explained by EDSS score, strength of the weakest limb (MRCsum), torque produced during the last five contractions of the fatigue protocol and peak isometric torque of knee flexor muscles. Patients with moderate disability (EDSS Score 4-6) had greater levels of neuromuscular fatigue than patients with mild disability (neuromuscular fatigue was found to be higher in more disabled patients, locomotor performance was correlated with strength and spasticity but not with fatigue. Nevertheless, fatigue was related to 6MWT performance since torque produced during the last five contractions of the fatigue

  4. Mutations in the Mitochondrial Citrate Carrier SLC25A1 are Associated with Impaired Neuromuscular Transmission

    Science.gov (United States)

    Chaouch, Amina; Porcelli, Vito; Cox, Daniel; Edvardson, Shimon; Scarcia, Pasquale; De Grassi, Anna; Pierri, Ciro L.; Cossins, Judith; Laval, Steven H.; Griffin, Helen; Müller, Juliane S.; Evangelista, Teresinha; Töpf, Ana; Abicht, Angela; Huebner, Angela; von der Hagen, Maja; Bushby, Kate; Straub, Volker; Horvath, Rita; Elpeleg, Orly; Palace, Jacqueline; Senderek, Jan; Beeson, David; Palmieri, Luigi; Lochmüller, Hanns

    2016-01-01

    Background and Objective Congenital myasthenic syndromes are rare inherited disorders characterized by fatigable weakness caused by malfunction of the neuromuscular junction. We performed whole exome sequencing to unravel the genetic aetiology in an English sib pair with clinical features suggestive of congenital myasthenia. Methods We used homozygosity mapping and whole exome sequencing to identify the candidate gene variants. Mutant protein expression and function were assessed in vitro and a knockdown zebrafish model was generated to assess neuromuscular junction development. Results We identified a novel homozygous missense mutation in the SLC25A1 gene, encoding the mitochondrial citrate carrier. Mutant SLC25A1 showed abnormal carrier function. SLC25A1 has recently been linked to a severe, often lethal clinical phenotype. Our patients had a milder phenotype presenting primarily as a neuromuscular (NMJ) junction defect. Of note, a previously reported patient with different compound heterozygous missense mutations of SLC25A1 has since been shown to suffer from a neuromuscular transmission defect. Using knockdown of SLC25A1 expression in zebrafish, we were able to mirror the human disease in terms of variable brain, eye and cardiac involvement. Importantly, we show clear abnormalities in the neuromuscular junction, regardless of the severity of the phenotype. Conclusions Based on the axonal outgrowth defects seen in SLC25A1 knockdown zebrafish, we hypothesize that the neuromuscular junction impairment may be related to pre-synaptic nerve terminal abnormalities. Our findings highlight the complex machinery required to ensure efficient neuromuscular function, beyond the proteomes exclusive to the neuromuscular synapse. PMID:26870663

  5. 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

    explosive force production declined (P force development and soleus EMG activity rise values remained unchanged. In football, match-induced alterations in maximal and rapid......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 temperate...

  6. 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...

  7. Responsiveness of a Neuromuscular Recovery Scale for Spinal Cord Injury: Inpatient and Outpatient Rehabilitation

    Science.gov (United States)

    2013-10-01

    635-659. 10. Velozo CA, Woodbury ML. Translating measurement findings into rehabilitation practice: an example using Fugl - Meyer Assessment-Upper...Proposal No. SC090246, Award No. W81XWH-10-1-0959 Responsiveness of a Neuromuscular Recovery Scale for Spinal Cord Injury: Inpatient and...AD_________________ Award Number: W81XWH-10-1-0959 TITLE: Responsiveness of a Neuromuscular Recovery Scale for Spinal Cord Injury: Inpatient and

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

    Science.gov (United States)

    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 suggest that a combination of these four mechanisms enhance range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises. When this stretching technique is performed consistently and post exercise, it increases athletic performance, along with range of motion. Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature. As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions. These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently. PMID:23487249

  9. Effects of nitric oxide on neuromuscular properties of developing zebrafish embryos.

    Directory of Open Access Journals (Sweden)

    Michael Jay

    Full Text Available Nitric oxide is a bioactive signalling molecule that is known to affect a wide range of neurodevelopmental processes. However, its functional relevance to neuromuscular development is not fully understood. Here we have examined developmental roles of nitric oxide during formation and maturation of neuromuscular contacts in zebrafish. Using histochemical approaches we show that elevating nitric oxide levels reduces the number of neuromuscular synapses within the axial swimming muscles whilst inhibition of nitric oxide biosynthesis has the opposite effect. We further show that nitric oxide signalling does not change synapse density, suggesting that the observed effects are a consequence of previously reported changes in motor axon branch formation. Moreover, we have used in vivo patch clamp electrophysiology to examine the effects of nitric oxide on physiological maturation of zebrafish neuromuscular junctions. We show that developmental exposure to nitric oxide affects the kinetics of spontaneous miniature end plate currents and impacts the neuromuscular drive for locomotion. Taken together, our findings implicate nitrergic signalling in the regulation of zebrafish neuromuscular development and locomotor maturation.

  10. Profile of sugammadex for reversal of neuromuscular blockade in the elderly: current perspectives.

    Science.gov (United States)

    Carron, Michele; Bertoncello, Francesco; Ieppariello, Giovanna

    2018-01-01

    The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients. Therefore, neuromuscular blockade in the elderly should be carefully monitored and completely reversed before awakening patients at the end of anesthesia. Acetylcholinesterase inhibitors are traditionally used for reversal of neuromuscular blockade. Although the risk of residual neuromuscular blockade is reduced by reversal with neostigmine, it continues to complicate the postoperative course. Sugammadex represents an innovative approach to reversal of neuromuscular blockade induced by aminosteroid neuromuscular-blocking agents, particularly rocuronium, with useful applications in clinical practice. However, aging is associated with certain changes in the pharmacokinetics of sugammadex, and to date there has been no thorough evaluation of the use of sugammadex in elderly patients. The aim of this review was to perform an analysis of the use of sugammadex in older adults based on the current literature. Major issues surrounding the physiologic and pharmacologic effects of aging in elderly patients and how these may impact the routine use of sugammadex in elderly patients are discussed.

  11. Developmental and adult-specific processes contribute to de novo neuromuscular regeneration in the lizard tail.

    Science.gov (United States)

    Tokuyama, Minami A; Xu, Cindy; Fisher, Rebecca E; Wilson-Rawls, Jeanne; Kusumi, Kenro; Newbern, Jason M

    2018-01-15

    Peripheral nerves exhibit robust regenerative capabilities in response to selective injury among amniotes, but the regeneration of entire muscle groups following volumetric muscle loss is limited in birds and mammals. In contrast, lizards possess the remarkable ability to regenerate extensive de novo muscle after tail loss. However, the mechanisms underlying reformation of the entire neuromuscular system in the regenerating lizard tail are not completely understood. We have tested whether the regeneration of the peripheral nerve and neuromuscular junctions (NMJs) recapitulate processes observed during normal neuromuscular development in the green anole, Anolis carolinensis. Our data confirm robust axonal outgrowth during early stages of tail regeneration and subsequent NMJ formation within weeks of autotomy. Interestingly, NMJs are overproduced as evidenced by a persistent increase in NMJ density 120 and 250 days post autotomy (DPA). Substantial Myelin Basic Protein (MBP) expression could also be detected along regenerating nerves indicating that the ability of Schwann cells to myelinate newly formed axons remained intact. Overall, our data suggest that the mechanism of de novo nerve and NMJ reformation parallel, in part, those observed during neuromuscular development. However, the prolonged increase in NMJ number and aberrant muscle differentiation hint at processes specific to the adult response. An examination of the coordinated exchange between peripheral nerves, Schwann cells, and newly synthesized muscle of the regenerating neuromuscular system may assist in the identification of candidate molecules that promote neuromuscular recovery in organisms incapable of a robust regenerative response. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2012-03-01

    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 suggest that a combination of these four mechanisms enhance range of motion. When completed prior to exercise, proprioceptive neuromuscular facilitation decreases performance in maximal effort exercises. When this stretching technique is performed consistently and post exercise, it increases athletic performance, along with range of motion. Little investigation has been done regarding the theoretical mechanisms of proprioceptive neuromuscular facilitation, though four mechanisms were identified from the literature. As stated, the main goal of proprioceptive neuromuscular facilitation is to increase range of motion and performance. Studies found both of these to be true when completed under the correct conditions. These mechanisms were found to be plausible; however, further investigation needs to be conducted. All four mechanisms behind the stretching technique explain the reasoning behind the increase in range of motion, as well as in strength and athletic performance. Proprioceptive neuromuscular facilitation shows potential benefits if performed correctly and consistently.

  13. Bloqueio bilateral do nervo pudendo para hemorroidectomia em paciente acondroplásico: relato de caso Bloqueo bilateral del nervio pudendo para hemorroidectomía en paciente acondroplásico: relato de caso Bilateral blockade of the pudend nerve to hemorrhoidectomy in achondroplasic patient: case report

    OpenAIRE

    Bruno Salomé de Morais; Marcos Guilherme Cunha Cruvinel; Yerkes Pereira Silva; Dener Augusto Diniz; Carlos Henrique Viana de Castro

    2006-01-01

    JUSTIFICATIVA E OBJETIVOS: O nanismo acondroplásico ou acondroplasia é a forma mais comum de nanismo e ocorre na maioria dos casos por alteração genética espontânea. A anestesia desses pacientes apresenta várias particularidades. O objetivo do presente relato foi descrever um caso de paciente acondroplásico, com história prévia de intervenção cirúrgica da coluna para descompressão medular, submetido a hemorroidectomia através de bloqueio bilateral dos nervos pudendos. RELATO DO CASO: Paciente...

  14. CARACTERIZAÇÃO Tecnológica de Blocos Cerâmicos de Alvenaria de Vedação Produzidos Por empresas Cerâmicas do Estado do Espírito Santo

    OpenAIRE

    POSSES, I. P.

    2013-01-01

    Este trabalho tem por objetivo a caracterização tecnológica de blocos cerâmicos destinados à alvenaria de vedação, produzidos em 17 indústrias cerâmicas do estado do Espírito Santo, das quais foram avaliados blocos vazados com dimensões nominais de 90 mm X190 mm X190 mm. A contribuição deste projeto é revelar ao consumidor capixaba a qualidade dos blocos de alvenaria de vedação produzidos no Estado, e apresentar sugestões de modificações nos processos para aprimoramento dos padrões de qualida...

  15. AVALIAÇÃO DA QUALIDADE MICROBIOLÓGICA DO QUEIJO MINAS FRESCAL PRODUZIDO POR LATICÍNIOS DO ESTADO DE MINAS GERAIS

    Directory of Open Access Journals (Sweden)

    Thaís Conceição Custódio Apolinário

    2015-01-01

    Full Text Available Este trabalho avaliou a presença de coliformes totais e termotolerantes, Salmonella spp., estafilococos coagulase positiva e Listeria monocytogenes em queijos Minas Frescal, produzidos por diferentes indústrias da região da Zona da Mata Mineira fiscalizadas por Serviços de Inspeção Federal, Estadual ou Municipal, num total de 31 amostras de queijos Minas Frescal. Foram encontradas 77,4% das amostras com contagens superiores ao preconizado pela legislação para coliformes totais, 54,8% para coliformes termotolerantes, 16,12% para estafilococos coagulase positiva e 9,6% para Listeria monocytogenes. Nenhuma das amostras apresentou contaminação por Salmonella spp. Diante disso, 80,6% das amostras analisadas encontravam-se imprópria para o consumo, por apresentar contagem de pelo menos um dos microrganismos analisados fora dos limites especificados pela legislação. Conclui-se que os queijos Minas Frescais não apresentam qualidade microbiológica satisfatória, o que compromete a segurança do alimento para o consumidor.

  16. Caracterização de blocos cerâmicos acústicos produzidos com incorporação de lodo de lavanderia têxtil

    Directory of Open Access Journals (Sweden)

    Thiago Morais de Castro

    2015-03-01

    Full Text Available Características físicas (absorção de água, mecânicas (resistência à compressão, de toxicidade e de superfície (microscopia eletrônica de varredura foram avaliadas em blocos cerâmicos acústicos, fabricados por meio do processo de solidificação/estabilização (S/E, a partir da incorporação de lodo proveniente de estação de tratamento de efluentes têxteis. Os blocos cerâmicos acústicos foram produzidos com incorporação de 5, 10, 15, 20, 25, 30 e 35% de lodo têxtil na massa de argila, bem como o bloco controle. Os resultados indicaram a porcentagem de 20% de lodo como o limite para fornecer material com características de acordo com os padrões estabelecidos pela legislação brasileira. O processo de S/E foi eficiente no aproveitamento/tratamento do lodo têxtil, uma vez que permitiu a imobilização dos poluentes na massa de argila, os quais não foram lixiviados, tampouco solubilizados.

  17. 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.

  18. Neuromuscular effect of dexmedetomidine on sevoflurane: an open-label, dose-escalation clinical trial.

    Science.gov (United States)

    Ke, Hui-Hua; Wu, Huang-Hui; Zhu, Qi; Zhang, Yan; Xiao, Jin-Rong; Su, Xiu-Zhu; Zheng, Wan-Jing; Cai, Yu-Ping; Wu, Xiao-Zhi; Wang, Yu-Tong; Chen, Guo-Zhong

    2017-08-01

    Sevoflurane presents reliable central neuromuscular effects. However, little knowledge is available regarding the interaction between sevoflurane and demedetomidine. We evaluated the neuromuscular effect of dexmedetomidine on sevoflurane in patients with normal neuromuscular transmission and calculated the 50% effective concentration (EC50). One-hundred and forty-four ASA grade I~II patients with normal neuromuscular transmission, aged 20~60 years old, undergoing lower limbs surgery were enrolled in this open-label, dose-escalation clinical trial. Patients were randomly assigned into 12 groups. Each patient received intravenous 0, 0.5, or 1.0 μg/kg dexmedetomidine 15 min after inhaling 0.7, 1.0, 1.4, or 2.0 MAC sevoflurane. Neuromuscular monitoring was recorded from the adductor pollicis muscle by using acceleromyography with train-of-four (TOF) stimulation of the ulnar nerve (2 Hz every 20 s). TOF ratio was recorded before inhaling sevoflurane, 15 min after keeping constant at target MAC of sevoflurane, 30 min after receiving target dose of dexmedetomidine, and 15 min after sevoflurane washing out. Sevoflurane produced a concentration-dependent decrease in TOF ratio. Mean TOF ratio in 0.7, 1.0, 1.4, and 2.0 MAC groups was 97.9%, 94.9%, 84.7%, and 77.2%, respectively. Neuromuscular EC50 of sevoflurane was 1.31 MAC (95% CI: 1.236~1.388 MAC). Intravenous 0.5 and 1.0 μg/kg dexmedetomidine decreased 3.1% (EC50: 1.27 MAC [95% CI: 1.206~1.327 MAC]) and 10.7% (EC50: 1.17 MAC [95% CI: 1.122~1.217 MAC]) of neuromuscular EC50, respectively. Sevoflurane has a concentration-dependent central neuromuscular effect in patients with normal neuromuscular transmission. Intravenous dexmedetomidine dose-dependently decreases the neuromuscular EC50 of sevoflurane.

  19. Characterization of cervical neuromuscular response to head-neck perturbation in active young adults.

    Science.gov (United States)

    Alsalaheen, Bara; Bean, Ryan; Almeida, Andrea; Eckner, James; Lorincz, Matthew

    2018-04-01

    The majority of studies examining the role of cervical muscles on head-neck kinematics focused on musculoskeletal attributes (e.g. strength). Cervical neuromuscular response to perturbation may represent a divergent construct that has not been examined under various perturbation conditions. This study examined the association between cervical musculoskeletal attributes and cervical neuromuscular response of the sternocleidomastoid (SCM) to perturbation. Furthermore, this study examined the effect of anticipation and preload on the SCM neuromuscular response. Nineteen participants completed measurement of SCM muscle size, cervical flexion maximal voluntary isometric contraction, and the neuromuscular response of the SCM to cervical perturbation. Cervical perturbation was delivered by dropping a 1.59 kg mass from a loading apparatus. The impulsive load was delivered under four conditions: (1) Anticipated perturbation with no preload (A-NP), (2) Unanticipated perturbation with no preload (U-NP), (3) Anticipated perturbation with preload (A-P), and (4) Unanticipated perturbation with preload (U-P). None of the cervical musculoskeletal attributes were correlated with the SCM cervical neuromuscular response. This study demonstrated significant effect of preloading and anticipation on baseline EMG amplitude and EMG onset latency for the SCM. Furthermore, there was a significant effect of preloading on average EMG response amplitude for the SCM. The findings of this study indicate that cervical neuromuscular response of the SCM is different from musculoskeletal attributes and is influenced by perturbation conditions. These findings provide conceptual support to examine the neuromuscular response of the SCM in mitigating head-neck kinematics. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Neuromuscular adaptations to sprint interval training and the effect of mammalian omega-3 fatty acid supplementation.

    Science.gov (United States)

    Lewis, Evan J H; Stucky, Frédéric; Radonic, Peter W; Metherel, Adam H; Wolever, Thomas M S; Wells, Greg D

    2017-03-01

    Sprint interval training (SIT) stimulates rapid metabolic adaptations within skeletal muscle but the nature of neuromuscular adaptions is unknown. Omega-3 polyunsaturated fatty acids (N-3 PUFA) are suggested to enhance neuromuscular adaptations to exercise. We measured the neuromuscular adaptations to SIT (Study-1) and conducted a placebo-controlled randomized double blinded study to determine the effect of N-3 PUFA supplementation on neuromuscular adaptations to SIT (Study-2). In Study-1, seven active men (24.4 ± 2.6 years, VO 2 peak 43.8 ± 8.7 ml kg min -1 ) completed 2-weeks of SIT with pre- and post-training 10 km cycling time trials (TT). In Study-2, 30 active men (24.5 ± 4.2 years, VO 2 peak 41.0 ± 5.1 ml kg min -1 ) were randomly assigned to receive N-3 PUFA (2330 mg day -1 ) (n = 14) or olive oil (n = 16) during 2-weeks of SIT with pre- and post-training TTs. Four week post-training, a SIT session and TT were also performed. Change in neuromuscular function was assessed from resting twitches, quadriceps maximal voluntary contraction (MVC) force, and potentiated twitch force (Q tw ). Study-1 showed that SIT did not elicit significant neuromuscular adaptations. Study-2 showed that N-3 PUFA supplementation had no significant effect on neuromuscular adaptations. Training caused lower MVC force [mean ± SD; N-3 PUFA -9 ± 11%, placebo -9 ± 13% (p training in all groups [Study-1 -10%, Study-2 N-3 PUFA -8%, placebo -12% (p training adaptations.

  1. The extremity function index (EFI), a disability severity measure for neuromuscular diseases: psychometric evaluation.

    Science.gov (United States)

    Bos, Isaäc; Wynia, Klaske; Drost, Gea; Almansa, Josué; Kuks, Jan B M

    2018-06-01

    To adapt and to combine the self-report Upper Extremity Functional Index and Lower Extremity Function Scale, for the assessment of disability severity in patients with a neuromuscular disease and to examine its psychometric properties in order to make it suitable for indicating disease severity in neuromuscular diseases. A cross-sectional postal survey study was performed among patients diagnosed with a neuromuscular disease. Patients completed both adapted extremity function scales, questionnaires for psychometric evaluation, and disease-specific questions. Confirmatory factor analysis was performed, and reliability and validity were examined. Response rate was 70% (n = 702). The Extremity Function Index model with a two-factor structure - for upper and lower extremities - showed an acceptable fit. The Extremity Function Index scales showed good internal consistency (alphas: 0.97-0.98). The known-groups validity test confirmed that Extremity Function Index scales discriminate between categories of "Extent of limitations" and "Quality of Life." Convergent and divergent validity tests confirmed that Extremity Function Index scales measure the physical impact of neuromuscular diseases. Relative validity tests showed that the Extremity Function Index scales performed well in discriminating between subgroups of patients with increasing "Extent of limitations" compared to concurrent measurement instruments. The Extremity Function Index proved to be a sound and easy to apply self-report disability severity measurement instrument in neuromuscular diseases. Implications for rehabilitation The Extremity Function Index reflects the functioning of all muscles in the upper and lower extremities involved in activities of daily living. The Extremity Function Index is an easy to administer and patient-friendly disability severity measurement instrument that has the ability to evaluate differences in disability severity between relevant neuromuscular disease subgroups. The

  2. Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents.

    Science.gov (United States)

    Kim, Yong Byum; Sung, Tae-Yun; Yang, Hong Seuk

    2017-10-01

    Neuromuscular blockade plays an important role in the safe management of patient airways, surgical field improvement, and respiratory care. Rapid-sequence induction of anesthesia is indispensable to emergency surgery and obstetric anesthesia, and its purpose is to obtain a stable airway, adequate depth of anesthesia, and appropriate respiration within a short period of time without causing irritation or damage to the patient. There has been a continued search for new neuromuscular blocking drugs (NMBDs) with a rapid onset of action. Factors that affect the onset time include the potency of the NMBDs, the rate of NMBDs reaching the effect site, the onset time by dose control, metabolism and elimination of NMBDs, buffered diffusion to the effect site, nicotinic acetylcholine receptor subunit affinity, drugs that affect acetylcholine (ACh) production and release at the neuromuscular junction, drugs that inhibit plasma cholinesterase, presynaptic receptors responsible for ACh release at the neuromuscular junction, anesthetics or drugs that affect muscle contractility, site and methods for monitoring neuromuscular function, individual variability, and coexisting disease. NMBDs with rapid onset without major adverse events are expected in the next few years, and the development of lower potency NMBDs will continue. Anesthesiologists should be aware of the use of NMBDs in the management of anesthesia. The choice of NMBD and determination of the appropriate dosage to modulate neuromuscular blockade characteristics such as onset time and duration of neuromuscular blockade should be considered along with factors that affect the effects of the NMBDs. In this review, we discuss the factors that affect the onset time of NMBDs.

  3. ANTAGONIST VERSUS AGONIST MUSCLE NEUROMUSCULAR ELECTRICAL STIMULATION ON SPASTICITY IN STROKE PATIENTS

    Directory of Open Access Journals (Sweden)

    Suchetha P. S

    2017-12-01

    Full Text Available Background: Spasticity is the common problem encountered in the treatment of hemiplegic patients. Various treatment techniques have been developed to reduce spasticity, neuromuscular electrical stimulation is one of them. Several studies have proved that stimulation of either spastic muscle or stimulation of antagonist muscle to spastic muscle results in a reduction of spasticity. However, there is no literature available on a comparative study to suggest which method is more effective in spasticity reduction. Hence this study was undertaken to find out the efficacy of each technique and to compare the two techniques of Neuromuscular electrical stimulation to determine the most effective technique. Methods: In this study with pre and post-experimental design 30 post-stroke patients were selected and they were randomly assigned into two groups. Group A received anatagonist (triceps muscle Neuromuscular electrical stimulation and Group B received agonist (biceps brachii muscle Neuromuscular electrical stimulation for 2 weeks, one session per day for a duration of 30 minutes. Outcome measures were recorded using modified Ashworth scale and deep tendon reflex grading scale. Results: Statistical analysis was carried out by using Wilcoxon signed rank sum test and Mann-Whitney U test at 0.05 level of significance. There was a significant recovery after the treatment based on the Modified Ashworth Scale and deep tendon reflex grading scale scores before and after the intervention within the groups and between the groups with p-value< 0.001. The group receiving the antagonist muscle neuromuscular electrical stimulation showed better recovery with a mean difference of 1.8 and 1.2 on Modified Ashworth Scale and reflex grading scale respectively. Conclusion: The study concluded that both the techniques resulted in reduction of spasticity and on comparison it was found that antagonist muscle (triceps Neuromuscular electrical stimulation reduced spasticity

  4. Neuromuscular strategies contributing to faster multidirectional agility performance.

    Science.gov (United States)

    Spiteri, Tania; Newton, Robert U; Nimphius, Sophia

    2015-08-01

    The aim of this study was to first determine differences in neuromuscular strategy between a faster and slower agility performance, and second compare differences in muscle activation strategy employed when performing two closely executed agility movements. Participants recruited from an elite female basketball team completed an ultrasound to determine quadriceps muscle-cross sectional area; reactive isometric mid-thigh pull to determine the rate of muscle activation, rate of force development, pre-motor time and motor time; and multidirectional agility tests completing two directional changes in response to a visual stimulus. Peak and average relative muscle activation of the rectus femoris, vastus medialis, vastus lateralis, biceps femoris, semitendinosus and gastrocnemius were measured 100ms prior to heel strike (pre-heel strike) and across stance phase for both directional changes. Faster agility performance was characterized by greater pre-heel strike muscle activity and greater anterior muscle activation during stance phase resulting in greater hip and knee extension increasing propulsive impulse. Differences between directional changes appear to result from processing speed, where a greater delay in refractory times during the second directional change resulted in greater anterior muscle activation, decelerating the body while movement direction was determined. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Noninvasive Respiratory Management of Patients With Neuromuscular Disease.

    Science.gov (United States)

    Bach, John R

    2017-08-01

    This review article describes definitive noninvasive respiratory management of respiratory muscle dysfunction to eliminate need to resort to tracheotomy. In 2010 clinicians from 22 centers in 18 countries reported 1,623 spinal muscular atrophy type 1 (SMA1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis users of noninvasive ventilatory support (NVS) of whom 760 required it continuously (CNVS). The CNVS sustained their lives by over 3,000 patient-years without resort to indwelling tracheostomy tubes. These centers have now extubated at least 74 consecutive ventilator unweanable patients with DMD, over 95% of CNVS-dependent patients with SMA1, and hundreds of others with advanced neuromuscular disorders (NMDs) without resort to tracheotomy. Two centers reported a 99% success rate at extubating 258 ventilator unweanable patients without resort to tracheotomy. Patients with myopathic or lower motor neuron disorders can be managed noninvasively by up to CNVS, indefinitely, despite having little or no measurable vital capacity, with the use of physical medicine respiratory muscle aids. Ventilator-dependent patients can be decannulated of their tracheostomy tubes.

  6. Validity of the Neuromuscular Recovery Scale: a measurement model approach.

    Science.gov (United States)

    Velozo, Craig; Moorhouse, Michael; Ardolino, Elizabeth; Lorenz, Doug; Suter, Sarah; Basso, D Michele; Behrman, Andrea L

    2015-08-01

    To determine how well the Neuromuscular Recovery Scale (NRS) items fit the Rasch, 1-parameter, partial-credit measurement model. Confirmatory factor analysis (CFA) and principal components analysis (PCA) of residuals were used to determine dimensionality. The Rasch, 1-parameter, partial-credit rating scale model was used to determine rating scale structure, person/item fit, point-measure item correlations, item discrimination, and measurement precision. Seven NeuroRecovery Network clinical sites. Outpatients (N=188) with spinal cord injury. Not applicable. NRS. While the NRS met 1 of 3 CFA criteria, the PCA revealed that the Rasch measurement dimension explained 76.9% of the variance. Ten of 11 items and 91% of the patients fit the Rasch model, with 9 of 11 items showing high discrimination. Sixty-nine percent of the ratings met criteria. The items showed a logical item-difficulty order, with Stand retraining as the easiest item and Walking as the most challenging item. The NRS showed no ceiling or floor effects and separated the sample into almost 5 statistically distinct strata; individuals with an American Spinal Injury Association Impairment Scale (AIS) D classification showed the most ability, and those with an AIS A classification showed the least ability. Items not meeting the rating scale criteria appear to be related to the low frequency counts. The NRS met many of the Rasch model criteria for construct validity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. Neuromuscular stimulation after stroke: from technology to clinical deployment.

    Science.gov (United States)

    IJzerman, Maarten J; Renzenbrink, Gerbert J; Geurts, Alexander C H

    2009-04-01

    Since the early 1960s, electrical or neuromuscular electrical stimulation (NMES) has been used to support the rehabilitation of stroke patients. One of the earliest applications of NMES included the use of external muscle stimulation to correct drop-foot after stroke. During the last few decades various clinical applications have been used for the upper and lower limb. Despite a growing body of literature on the use of NMES, its application in stroke is still limited to a few clinical groups that provide dedicated clinical services. Some explanations for the limited use are the sometimes conflicting clinical evidence, the size of the effects or the complicated use of the technology itself. This review points out three directions for future research. First, we need to expand our knowledge on brain plasticity and the use of different electrical stimulation strategies to modulate the neural system. Second, we foresee an increase in therapies combining different training principles, for example, the combination of NMES and robotics or neuromodulating drugs. Finally, with the ever-increasing pressure on healthcare budgets, it is expected that clinical and economic evidence will become more relevant in transferring these interventions to a wider community.

  8. Active zones of mammalian neuromuscular junctions: formation, density, and aging.

    Science.gov (United States)

    Nishimune, Hiroshi

    2012-12-01

    Presynaptic active zones are synaptic vesicle release sites that play essential roles in the function and pathology of mammalian neuromuscular junctions (NMJs). The molecular mechanisms of active zone organization use presynaptic voltage-dependent calcium channels (VDCCs) in NMJs as scaffolding proteins. VDCCs interact extracellularly with the muscle-derived synapse organizer, laminin β2 and interact intracellularly with active zone-specific proteins, such as Bassoon, CAST/Erc2/ELKS2alpha, ELKS, Piccolo, and RIMs. These molecular mechanisms are supported by studies in P/Q- and N-type VDCCs double-knockout mice, and they are consistent with the pathological conditions of Lambert-Eaton myasthenic syndrome and Pierson syndrome, which are caused by autoantibodies against VDCCs or by a laminin β2 mutation. During normal postnatal maturation, NMJs maintain the density of active zones, while NMJs triple their size. However, active zones become impaired during aging. Propitiously, muscle exercise ameliorates the active zone impairment in aged NMJs, which suggests the potential for therapeutic strategies. © 2012 New York Academy of Sciences.

  9. Neuromuscular transmission and muscle fatigue changes by nanostructured oxygen.

    Science.gov (United States)

    Ivannikov, Maxim V; Sugimori, Mutsuyuki; Llinás, Rodolfo R

    2017-04-01

    Oxygen (O 2 ) nanobubbles offer a new method for tissue oxygenation. The effects of O 2 nanobubbles on transmission at neuromuscular junctions (NMJs) and muscle function were explored in murine diaphragm. Electrophysiological parameters, NMJ ultrastructure, muscle force, and muscle fatigue were studied during superfusion with solutions with different oxygen levels or oxygen nanobubbles. High frequency nerve stimulation of muscles superfused with O 2 nanobubble solution slowed neurotransmission decline over those with either control or hyperoxic solution. O 2 nanobubble solution increased the amplitude of evoked end plate potentials and quantal content but did not affect spontaneous activity. Electron microscopy of stimulated O 2 nanobubble treated NMJs showed accumulation of large synaptic vesicles and endosome-like structures. O 2 nanobubble solution had no effects on isometric muscle force, but it significantly decreased fatigability and maximum force recovery time in nerve stimulated muscles. O 2 nanobubbles increase neurotransmission and reduce the probability of neurotransmission failure in muscle fatigue. Muscle Nerve 55: 555-563, 2017. © 2016 Wiley Periodicals, Inc.

  10. The mode of neuromuscular blocking action of chlorpromazine

    Science.gov (United States)

    Su, C.; Lee, C. Y.

    1960-01-01

    The inhibitory action of chlorpromazine on skeletal muscle has been studied with isolated preparations. In the nerve-muscle preparations of the frog sartorius and the rat diaphragm, the twitch responses to indirect stimulation are much more strongly depressed by chlorpromazine than those to direct stimulation. The conductivity of the nerve trunk is unaffected. The contractures of the frog rectus abdominis muscle caused by acetylcholine are depressed by chlorpromazine,but the contractures due to KCl are not influenced. Larger doses of chlorpromazine cause contracture by themselves, and this cannot be prevented by tubocurarine. In the sartorius muscle of the toad, the depolarization due to acetylcholine is reduced by chlorpromazine. The paralysing action of chlorpromazine adds to that of tubocurarine, and is antagonized to some extent by eserine or neostigmine. Muscles treated with chlorpromazine do not completely recover on washing. High concentrations of chlorpromazine depress the release of acetylcholine by motor-nerve stimulation, although they do not affect the enzymic synthesis of acetylcholine by acetone-dried powder of guinea-pig brain. The differences between the neuromuscular block produced by chlorpromazine and that by tubocurarine are discussed. PMID:13835490

  11. A Modified Dynamic Surface Controller for Delayed Neuromuscular Electrical Stimulation.

    Science.gov (United States)

    Alibeji, Naji; Kirsch, Nicholas; Dicianno, Brad E; Sharma, Nitin

    2017-08-01

    A widely accepted model of muscle force generation during neuromuscular electrical stimulation (NMES) is a second-order nonlinear musculoskeletal dynamics cascaded to a delayed first-order muscle activation dynamics. However, most nonlinear NMES control methods have either neglected the muscle activation dynamics or used an ad hoc strategies to tackle the muscle activation dynamics, which may not guarantee control stability. We hypothesized that a nonlinear control design that includes muscle activation dynamics can improve the control performance. In this paper, a dynamic surface control (DSC) approach was used to design a PID-based NMES controller that compensates for EMD in the activation dynamics. Because the muscle activation is unmeasurable, a model based estimator was used to estimate the muscle activation in realtime. The Lyapunov stability analysis confirmed that the newly developed controller achieves semi-global uniformly ultimately bounded (SGUUB) tracking for the musculoskeletal system. Experiments were performed on two able-bodied subjects and one spinal cord injury subject using a modified leg extension machine. These experiments illustrate the performance of the new controller and compare it to a previous PID-DC controller that did not consider muscle activation dynamics in the control design. These experiments support our hypothesis that a control design that includes muscle activation improves the NMES control performance.

  12. Neuromuscular fiber segmentation through particle filtering and discrete optimization

    Science.gov (United States)

    Dietenbeck, Thomas; Varray, François; Kybic, Jan; Basset, Olivier; Cachard, Christian

    2014-03-01

    We present an algorithm to segment a set of parallel, intertwined and bifurcating fibers from 3D images, targeted for the identification of neuronal fibers in very large sets of 3D confocal microscopy images. The method consists of preprocessing, local calculation of fiber probabilities, seed detection, tracking by particle filtering, global supervised seed clustering and final voxel segmentation. The preprocessing uses a novel random local probability filtering (RLPF). The fiber probabilities computation is performed by means of SVM using steerable filters and the RLPF outputs as features. The global segmentation is solved by discrete optimization. The combination of global and local approaches makes the segmentation robust, yet the individual data blocks can be processed sequentially, limiting memory consumption. The method is automatic but efficient manual interactions are possible if needed. The method is validated on the Neuromuscular Projection Fibers dataset from the Diadem Challenge. On the 15 first blocks present, our method has a 99.4% detection rate. We also compare our segmentation results to a state-of-the-art method. On average, the performances of our method are either higher or equivalent to that of the state-of-the-art method but less user interactions is needed in our approach.

  13. An examination of neuromuscular and metabolic fatigue thresholds

    International Nuclear Information System (INIS)

    Bergstrom, Haley C; Housh, Terry J; Cochrane, Kristen C; Jenkins, Nathaniel D M; Lewis, Robert W Jr; Traylor, Daniel A; Schmidt, Richard J; Johnson, Glen O; Cramer, Joel T; Zuniga, Jorge M

    2013-01-01

    This study examined the relationships among the physical working capacity at the fatigue threshold (PWC FT ), the power outputs associated with the gas exchange threshold (PGET) and the respiratory compensation point (PRCP), and critical power (CP) to identify possible physiological mechanisms underlying the onset of neuromuscular fatigue. Ten participants (mean ± SD age: 20 ± 1 years) performed a maximal incremental cycle ergometer test to determine the PWC FT , PGET, and PRCP. CP was determined from the 3 min all-out test. The PWC FT (197 ± 55 W), PRCP (212 ± 50 W), and CP (208 ± 63 W) were significantly greater than the PGET (168 ± 40 W), but there were no significant differences among the PWC FT , PRCP, and CP. All thresholds were significantly inter-4 (r = 0.794–0.958). The 17% greater estimates for the PWC FT than PGET were likely related to differences in the physiological mechanisms that underlie these fatigue thresholds, while the non-significant difference and high correlation between the PWC FT and the PRCP suggested that hyperkalemia may underlie both thresholds. Furthermore, it is possible that the 5% lower estimate of the PWC FT than CP could more accurately reflect the demarcation of the heavy from severe exercise intensity domains. (paper)

  14. Neurologic and neuromuscular functional disorders of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Wuttge-Hannig, A.; Hannig, C.

    2007-01-01

    Neurologic swallowing disorders are an increasing diagnostic problem in our overaged population. Undiagnosed chronic aspiration pneumonia is the cause of death in 20-40% of all inhabitants of nursing homes. In neurologic diseases of the pharynx, the physiologic interaction of pharyngeal contraction, closure of the pharynx, and esophageal motility are frequently disturbed. This may be due to cortical, bulbar, or cerebellar brain damage of ischemic or traumatic origin. Furthermore diseases or peripheral nerves, muscles, and synapses cause disturbances. The most life-threatening complication of these disturbances is tracheal aspiration, which requires an iso-osmolar contrast medium for imaging studies that cause no or minimal pulmonary problems. Utilizing fast dynamic documentation we can analyze the swallowing act in 35 images within the passage time of 0.7 s. This requires digital frame sequences from 15-50 images/s, which can be provided by DSI or videofluoroscopy. Neurologic and neuromuscular patterns are demonstrated with and without tracheal aspiration. The differentiation of aspiration in a so-called pre-, intra-, and postdeglutitive form is possible. We distinguish four grades of severity of aspiration, which is also of great clinical impact for the differential rehabilitation therapy. The efficiency of the rehabilitation protocol can be assessed by the dynamic swallowing studies. (orig.) [de

  15. Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease.

    Science.gov (United States)

    Khirani, Sonia; Ramirez, Adriana; Delord, Vincent; Leroux, Karl; Lofaso, Frédéric; Hautot, Solène; Toussaint, Michel; Orlikowski, David; Louis, Bruno; Fauroux, Brigitte

    2014-09-01

    Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P ventilator. Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation. Copyright © 2014 by Daedalus Enterprises.

  16. An Innovative Ergometer to Measure Neuromuscular Fatigue Immediately after Cycling.

    Science.gov (United States)

    Doyle-Baker, Douglas; Temesi, John; Medysky, Mary E; Holash, Robert J; Millet, Guillaume Y

    2018-02-01

    When assessing neuromuscular fatigue (NMF) from dynamic exercise using large muscle mass (e.g., cycling), most studies have delayed measurement for 1 to 3 min after task failure. This study aimed to determine the reliability of an innovative cycling ergometer permitting the start of fatigue measurement within 1 s after cycling. Twelve subjects participated in two experimental sessions. Knee-extensor NMF was assessed by electrical nerve and transcranial magnetic stimulation with both a traditional chair setup (PRE- and POST-Chair, 2 min postexercise) and the new cycling ergometer (PRE, every 3 min during incremental exercise and POST-Bike, at task failure). The reduction in maximal voluntary contraction force POST-Bike (63% ± 12% PRE; P 0.05). Vastus lateralis and rectus femoris M-wave and motor-evoked potential areas showed fair to excellent reliability (ICC, 0.45-0.88). The reduction in maximal voluntary contraction and Db100 was greater on the cycling ergometer than the isometric chair. The innovative cycling ergometer is a reliable tool to assess NMF during and immediately postexercise. This will allow fatigue etiology during dynamic exercise with large muscle mass to be revisited in various populations and environmental conditions.

  17. HEMODYNAMIC AND LACTIC ACID RESPONSES TO PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION EXERCISE

    Directory of Open Access Journals (Sweden)

    Zuhal Gültekin

    2006-09-01

    Full Text Available The hemodynamic and metabolic responses to proprioceptive neuromuscular facilitation (PNF exercise were examined in 32 male university students (aged 19-28 years. Ten repetitions of PNF exercises were applied to the subjects' dominant upper extremities in the following order: as an agonist pattern flexion, adduction and external rotation; and as an antagonist pattern extension, abduction and internal rotation. Heart rate (HR, systolic blood pressure (SBP, diastolic blood pressure (DBP, double product (DP, and blood lactate concentration (La were determined before, immediately after, and at 1st, 3rd, and 5th minutes after PNF exercise. A one-way ANOVA with repeated measures indicated significant differences in HR, SBP, DBP, DP and La immediately after PNF exercise. HR increased from 81 (±10 to 108 (±15 b·min-1 (p < 0.01, SBP increased from 117 (±10 to 125 (±11 mmHg (p < 0.01, DBP increased from 71 (±10 to 75 (±8 mmHg (p < 0.01, DP increased from 96 (±16 to 135 (±24 (p < 0.01, and La increased from 0.69 (±0.31 to 3.99 (±14.63 mmol·L-1 (p < 0.01. Thus PNF exercise resulted in increased hemodynamic responses and blood lactate concentration that indicate a high strain on the cardiovascular system and anaerobic metabolism in healthy subjects

  18. Effect of calcium on excitatory neuromuscular transmission in the crayfish

    Science.gov (United States)

    Bracho, H.; Orkand, R. K.

    1970-01-01

    1. The effects of varying the external Ca concentration from 1·8 to 30 mM/l. (⅛-2 times normal) have been studied at the in vitro crayfish excitatory neuromuscular junction. Electrophysiological techniques were used to record transmembrane junctional potentials from muscle fibres and extracellular junctional currents from the vicinity of nerve terminals. 2. The excitatory junctional potential amplitude was proportional to [Ca]0n, where n varied between 0·68 and 0·94 (mean 0·82) when [Ca]0 was varied from 1·8 to 15 mM/l. 3. The increase in junctional potential amplitude on raising [Ca]0 resulted primarily from an increase in the average number of quanta of excitatory transmitter released from the presynaptic nerve terminal by the nerve impulse. 4. The size of the quanta, synaptic delay, presynaptic potential and electrical properties of the muscle membrane were little affected by changes in calcium concentration in the range studied. PMID:5498460

  19. Development of neuromuscular organization in the ctenophore Pleurobrachia bachei.

    Science.gov (United States)

    Norekian, Tigran P; Moroz, Leonid L

    2016-01-01

    The phylogenetic position of the phylum Ctenophora and the nature of ctenphore nervous systems are highly debated topics in modern evolutionary biology. However, very little is known about the organization of ctenophore neural and muscular systems, and virtually nothing has been reported about their embryogenesis. Here we have characterized the neural and muscular development of the sea gooseberry, Pleurobrachia bachei, starting from the cleavage stages to posthatching larvae. Scanning electron microscopy and immunochemistry were used to describe the formation of the embryonic mouth, tentacles, combs, aboral organ, and putative sensory cells. The muscles started their specification at the end of the first day of Pleurobrachia development. In contrast, neurons appeared 2 days after myogenesis, just before the hatching of fully formed cydippid larvae. The first tubulin-immunoreactive neurons, a small group of four to six cells with neuronal processes, was initially recognized at the aboral pole during the third day of development. Surprisingly, this observed neurogenesis occurred after the emergence of distinct behavioral patterns in the embryos. Thus, the embryonic behavior associated with comb cilia beatings and initial muscle organization does not require morphologically defined neurons and their elongated neurites. This study provides the first description of neuromuscular development in the enigmatic ctenophores and establishes the foundation for future research using emerging genomic tools and resources. © 2015 Wiley Periodicals, Inc.

  20. Neuromuscular factors related to success in Olympic wrestling

    Directory of Open Access Journals (Sweden)

    Alfonso Martínez-Moreno

    2011-03-01

    Full Text Available Abstract This 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.

  1. 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.

  2. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players.

    Science.gov (United States)

    Fort-Vanmeerhaeghe, Azahara; Gual, Gabriel; Romero-Rodriguez, Daniel; Unnitha, Viswanath

    2016-04-01

    The primary objective of the present study was to evaluate the agreement between the dominant leg (DL) (determined subjectively) and the stronger leg (SL) (determined via a functional test) in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL) and the SL vs the weaker (WL) leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years) performed three single-leg vertical countermovement jumps (SLVCJ) on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI) were determined. Only 32 (40%) of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (pjump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  3. 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.

  4. Effects of vision and lumbar posture on trunk neuromuscular control.

    Science.gov (United States)

    Maaswinkel, Erwin; van Drunen, Paul; Veeger, Dirk-Jan H E J; van Dieën, Jaap H

    2015-01-21

    The goal of this study was to determine the effects of vision and lumbar posture on trunk neuromuscular control. Torso perturbations were applied with a pushing device while the subjects were restrained at the pelvis in a kneeling-seated position. Torso kinematics and the muscle activity of the lumbar part of the M. Longissimus were recorded for 14 healthy subjects. Four conditions were included: a flexion, extension and neutral lumbar posture with eyes closed and the neutral posture with eyes open. Frequency response functions of the admittance and reflexes showed that there was no significant difference between the eyes open and eyes closed conditions, thereby confirming that vision does not play a role in the stabilization of the trunk during small-amplitude trunk perturbations. In contrast, manipulating posture did lead to significant differences. In particular, the flexed condition led to a lower admittance and lower reflex contribution compared to the neutral condition. Furthermore, the muscle pre-activation (prior to the onset of the perturbation) was significantly lower in the flexed posture compared to neutral. This confirms that flexing the lumbar spine increases the passive tissue stiffness and decreases the contribution of reflex activity to trunk control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. 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.

  6. The rapid evolution of molecular genetic diagnostics in neuromuscular diseases.

    Science.gov (United States)

    Volk, Alexander E; Kubisch, Christian

    2017-10-01

    The development of massively parallel sequencing (MPS) has revolutionized molecular genetic diagnostics in monogenic disorders. The present review gives a brief overview of different MPS-based approaches used in clinical diagnostics of neuromuscular disorders (NMDs) and highlights their advantages and limitations. MPS-based approaches like gene panel sequencing, (whole) exome sequencing, (whole) genome sequencing, and RNA sequencing have been used to identify the genetic cause in NMDs. Although gene panel sequencing has evolved as a standard test for heterogeneous diseases, it is still debated, mainly because of financial issues and unsolved problems of variant interpretation, whether genome sequencing (and to a lesser extent also exome sequencing) of single patients can already be regarded as routine diagnostics. However, it has been shown that the inclusion of parents and additional family members often leads to a substantial increase in the diagnostic yield in exome-wide/genome-wide MPS approaches. In addition, MPS-based RNA sequencing just enters the research and diagnostic scene. Next-generation sequencing increasingly enables the detection of the genetic cause in highly heterogeneous diseases like NMDs in an efficient and affordable way. Gene panel sequencing and family-based exome sequencing have been proven as potent and cost-efficient diagnostic tools. Although clinical validation and interpretation of genome sequencing is still challenging, diagnostic RNA sequencing represents a promising tool to bypass some hurdles of diagnostics using genomic DNA.

  7. Neuromuscular diversity in archosaur deep dorsal thigh muscles.

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    Gatesy, S M

    1994-01-01

    The living members of the clade Archosauria, crocodilians and birds, differ markedly in the morphology of their deep dorsal thigh muscles. To investigate whether this diversity is accompanied by differences in motor pattern and muscle function, the hindlimbs of representative archosaurs were studied by electromyography and cineradiography during terrestrial locomotion. In a crocodilian, Alligator, the iliofemoralis and pubo-ischio-femoralis internus part 2 are both active during the swing phase of the stride cycle. This appears to be the primitive motor pattern for archosaurs. There are four avian homologues of these muscles in the helmeted guineafowl, Numida. These are primarily active in the propulsive phase (iliotrochantericus caudalis and iliotrochantericus medius), the swing phase (iliotrochantericus cranialis) and a speed-dependent combination of the propulsive and/or swing phases (iliofemoralis externus). Differences between Alligator and Numida in the number and attachment of deep dorsal muscles are associated with dissimilar motor patterns and functions. Evolutionary modifications of neuromuscular control must be recognized when evaluating avian locomotor history, but are rarely considered by paleontologists. Even within the deep dorsal thigh muscles of Numida, developmentally and anatomically similar muscles are active out-of-phase. Therefore, although the actions of two adjacent muscles appear equivalent, their functions may differ dramatically. The diversity of deep dorsal thigh muscles in modern birds may be a good model for studying the relationship between activity pattern and peripheral morphology.

  8. 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

  9. Avaliação de potenciais fragmentados em presença de bloqueio de ramo direito sem alterações estruturais miocárdicas ventriculares. Estudo pelo eletrocardiograma de alta resolução no domínio da freqüência

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    Ginefra Paulo

    1998-01-01

    Full Text Available OBJETIVO: Em ausência de alterações estruturais miocárdicas (AEM, avaliar se o bloqueio de ramo direito (BRD gera potenciais fragmentados (PF e turbulência espectral (TE no eletrocardiograma de alta resolução (ECGAR. MÉTODOS: Doze crianças com comunicação inter-atrial (CIA e bloqueio incompleto do ramo direito (BIRD sem AEM (Grupo I, foram comparadas com 17 crianças com tetralogia de Fallot (TF operada, BCRD e AEM, 5 com extra sístoles ventriculares e 2 com taquicardia ventricular sustentada (Grupo II. Todas fizeram ECGAR nos domínios do tempo (DT e da freqüência (DF, com cinco variáveis analisadas. RESULTADOS: Os pacientes do grupo I tiveram as variáveis normais apesar do BIRD. No grupo II, 4 das cinco variáveis foram anormais, sugerindo a presença de PF e TE atribuíveis a AEM inerentes à malformação e ao ato cirúrgico. CONCLUSÃO: Na CIA o BIRD não complicado de AEM não gera PF e TE, não constituindo fator de risco para taquicardia ventricular sustentada.

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

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    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

  11. Níveis de organoclorados em queijos produzidos no Estado do Rio Grande do Sul Organochlorine levels in the cheese produced in Rio Grande do Sul State

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    Joice Sifuentes dos Santos

    2006-04-01

    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.Organochlorine compounds are pesticides used in agriculture, for the control of biological vectors of diseases and of livestock ectoparasites. Their use in Brazil is now prohibited, except for control of biological vectors in epidemics. However, residues of such compounds can still be found in the environment and in foodstuffs. For this reason, the presence of organochlorine compounds in cheese produced in Rio Grande do Sul state (Brazil, as well as the differences

  12. Estudo de grautes produzidos com agregado reciclado de resíduo de bloco cerâmico incorporando teores de cal hidratada

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    Sandra Elisa Gieseler

    Full Text Available Em geral, um volume significativo de resíduo proveniente de blocos cerâmicos é gerado na execução de alvenaria de vedação ou estrutural, mesmo quando o sistema construtivo é racionalizado. Assim, incorporar este resíduo sob a forma de agregado reciclado aos grautes pode ser uma boa alternativa. Comumente utilizada em argamassas, a cal hidratada também tem uso recomendado em grautes, objetivando manter a trabalhabilidade da mistura e melhorar a aderência com o substrato, ao auxiliar na hidratação do cimento. Aliando essa capacidade de retenção e absorção de água ao aproveitamento do resíduo cerâmico em grautes, este estudo apresenta uma avaliação da influência do teor da cal hidratada em grautes produzidos com substituição de 30% de agregado graúdo natural por reciclado. Foram utilizados os teores de 2%, 4% e 6% de cal hidratada, além de produzir um graute referência, sem adição. No estado fresco foi verificada a perda de abatimento. Os traços com cal hidratada apresentaram maior manutenção de consistência. No estado endurecido foram realizados ensaios de velocidade de propagação de onda ultrassônica, compressão axial e absorção de água por capilaridade. Os melhores resultados em ambos os estados foram obtidos com 4% de adição, para os traços pobre e rico, e com 2%, para o traço pobre.

  13. Survey of the functional priorities in patients with disability due to neuromuscular disorders.

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    Jerath, Nivedita U; Simoens, Kevin; Mann, Dylan; Kollasch, Steph; Grosland, Nicole; Malik, Karim A; Reddy, Chandan G

    2017-12-08

    Survey of the functional priorities in patients with disability due to neuromuscular disorders. This study attempts to determine the functional priorities for patients with neuromuscular disorders. A survey asking about functional priorities with respect to activities of daily living, ankle foot orthotic design, and assistive device design, was distributed to patients with neuromuscular disorders to assess the needs of patients from their perspectives. Descriptive statistics were used to analyse answers. A total of 171 subjects with neuromuscular disorders responded to the questionnaire. Of the respondents with weakness in both the upper and lower extremities, 45% stated that if they had to choose between correction of one or the other, they would prefer that of their lower extremities. Activities that patients most frequently wanted to gain independence with were mobility and transfers (46%), followed by toilet use and hygiene (32%). The most popular control mechanism of an assistive device was voice activation (35%). This study assessed the functional priorities of those with neuromuscular disorders. Although such individuals can experience a range of weakness in the upper and/or lower extremities, common functional priorities were reported: independence with mobility, transfers, toilet use and hygiene. Knowledge of these priorities will help guide development of assistive devices that will restore function in the future. Implications for Rehabilitation     Neuromuscular Disorders  • Neuromuscular disorders result in disabling weakness; there are few cures and many are unable to carry out activities of daily living.  • Information that would be helpful in determining functional priorities is limited.  • In a survey of 171 patients with neuromuscular disorders, functional priorities included mobility and transfers (46%), followed by toilet use and hygiene (32%).  • Of the respondents with weakness in both the upper and lower

  14. Pilates and Proprioceptive Neuromuscular Facilitation Methods Induce Similar Strength Gains but Different Neuromuscular Adaptations in Elderly Women.

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    Teixeira de Carvalho, Fabiana; de Andrade Mesquita, Laiana Sepúlveda; Pereira, Rafael; Neto, Osmar Pinto; Amaro Zangaro, Renato

    2017-01-01

    Background/Study Context: The aging process is associated with a decline in muscle mass, strength, and conditioning. Two training methods that may be useful to improve muscle function are Pilates and proprioceptive neuromuscular facilitation (PNF). Thus, the present study aimed to compare the influence of training programs using Pilates and PNF methods with elderly women. Sixty healthy elderly women were randomly divided into three groups: Pilates group, PNF group, and control group. Pilates and PNF groups underwent 1-month training programs with Pilates and PNF methods, respectively. The control group received no intervention during the 1 month. The maximal isometric force levels from knee extension and flexion, as well as the electromyography (EMG) signals from quadriceps and biceps femoris, were recorded before and after the 1-month intervention period. A two-way analysis of variance revealed that the Pilates and PNF methods induced similar strength gains from knee flexors and extensors, but Pilates exhibited greater low-gamma drive (i.e., oscillations in 30-60 Hz) in the EMG power spectrum after the training period. These results support use of both Pilates and PNF methods to enhance lower limb muscle strength in older groups, which is very important for gait, postural stability, and performance of daily life activities.

  15. 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

  16. Effects of involuntary eccentric contraction training by neuromuscular electrical stimulation on the enhancement of muscle strength.

    Science.gov (United States)

    Son, Jongsang; Lee, Dongyeop; Kim, Youngho

    2014-08-01

    Neuromuscular electrical stimulation is well-known as a modality to improve the performance of neuromuscular system, but its clinical value on muscle strengthening remains equivocal. In this study, we designed a system for an involuntary eccentric contraction of biceps brachii muscles using continuous passive movement and commercial neuromuscular electrical stimulation devices. To investigate the effects of involuntary eccentric contraction training by neuromuscular electrical stimulation on the enhancement of muscle strength, seven healthy men between the ages of 24 and 29 years participated in this study. Participants were trained two times per week for 12 weeks. Each exercise session was performed for 30 min with no rest intervals. Isometric elbow flexion torque and biceps brachii muscle thickness were chosen as evaluation indices, and were measured at pre-/post-training. After the 12-week training, the isometric elbow flexion torque of the trained side significantly increased by approximately 23% compared to the initial performance (Pcontraction (P<0.01). The developed system and the technique show promising results, suggesting that it has the potential to be used to increase the muscle strength in patients with neuromuscular disease and to be implemented in design rehabilitative protocols. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. [Deep versus moderate neuromuscular block during one-lung ventilation in lung resection surgery].

    Science.gov (United States)

    Casanova, Javier; Piñeiro, Patricia; De La Gala, Francisco; Olmedilla, Luis; Cruz, Patricia; Duque, Patricia; Garutti, Ignacio

    Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious. A prospective, longitudinal observational study was made in which each patient served as both treated subject and control. 76 consecutive patients programmed for lung resection surgery in Gregorio Marañon Hospital along the year of 2013 who required one-lung ventilation in lateral decubitus were included. Ventilator data, hemodynamic parameters were registered in different moments according to train-of-four response (intense, deep and moderate blockade) during one-lung ventilation. Peak, plateau and mean pressures were significantly lower during the intense and deep blockade. Besides, compliance and peripheral oxygen saturation were significantly higher in those moments. Heart rate was significantly higher during deep blockade. No mechanical ventilation parameters were modified during measurements. Deep neuromuscular blockade attenuates the poor lung mechanics observed during one-lung ventilation. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  18. Neuromuscular disease and respiratory physiology in children: putting lung function into perspective.

    Science.gov (United States)

    Fauroux, Brigitte; Khirani, Sonia

    2014-08-01

    Neuromuscular diseases represent a heterogeneous group of disorders of the muscle, nerve or neuromuscular junction. The respiratory muscles are rarely spared in neuromuscular diseases even if the type of muscle involvement, severity and time course greatly varies among the different diseases. Diagnosis of respiratory muscle weakness is crucial because of the importance of respiratory morbidity and mortality. Presently, routine respiratory evaluation is based on non-invasive volitional tests, such as the measurement of lung volumes, spirometry and the maximal static pressures, which may be difficult or impossible to obtain in some young children. Other tools or parameters are thus needed to assess the respiratory muscle weakness and its consequences in young children. The measurement of oesogastric pressures can be helpful as they allow the diagnosis and quantification of paradoxical breathing, as well as the assessment of the strength of the inspiratory and expiratory muscles by means of the oesophageal pressure during a maximal sniff and of the gastric pressure during a maximal cough. Sleep assessment should also be part of the respiratory evaluation of children with neuromuscular disease with at least the recording of nocturnal gas exchange if polysomnography is not possible or unavailable. This improvement in the assessment of respiratory muscle performance may increase our understanding of the respiratory pathophysiology of the different neuromuscular diseases, improve patient care, and guide research and innovative therapies by identifying and validating respiratory parameters. © 2014 Asian Pacific Society of Respirology.

  19. Functional Connectivity under Optogenetic Control Allows Modeling of Human Neuromuscular Disease.

    Science.gov (United States)

    Steinbeck, Julius A; Jaiswal, Manoj K; Calder, Elizabeth L; Kishinevsky, Sarah; Weishaupt, Andreas; Toyka, Klaus V; Goldstein, Peter A; Studer, Lorenz

    2016-01-07

    Capturing the full potential of human pluripotent stem cell (PSC)-derived neurons in disease modeling and regenerative medicine requires analysis in complex functional systems. Here we establish optogenetic control in human PSC-derived spinal motorneurons and show that co-culture of these cells with human myoblast-derived skeletal muscle builds a functional all-human neuromuscular junction that can be triggered to twitch upon light stimulation. To model neuromuscular disease we incubated these co-cultures with IgG from myasthenia gravis patients and active complement. Myasthenia gravis is an autoimmune disorder that selectively targets neuromuscular junctions. We saw a reversible reduction in the amplitude of muscle contractions, representing a surrogate marker for the characteristic loss of muscle strength seen in this disease. The ability to recapitulate key aspects of disease pathology and its symptomatic treatment suggests that this neuromuscular junction assay has significant potential for modeling of neuromuscular disease and regeneration. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 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.

  1. 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

  2. Sensory threshold neuromuscular electrical stimulation fosters motor imagery performance.

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    Corbet, Tiffany; Iturrate, Iñaki; Pereira, Michael; Perdikis, Serafeim; Millán, José Del R

    2018-04-21

    Motor imagery (MI) has been largely studied as a way to enhance motor learning and to restore motor functions. Although it is agreed that users should emphasize kinesthetic imagery during MI, recordings of MI brain patterns are not sufficiently reliable for many subjects. It has been suggested that the usage of somatosensory feedback would be more suitable than standardly used visual feedback to enhance MI brain patterns. However, somatosensory feed-back should not interfere with the recorded MI brain pattern. In this study we propose a novel feedback modality to guide subjects during MI based on sensory threshold neuromuscular electrical stimulation (St-NMES). St-NMES depolarizes sensory and motor axons without eliciting any muscular contraction. We hypothesize that St-NMES does not induce detectable ERD brain patterns and fosters MI performance. Twelve novice subjects were included in a cross-over design study. We recorded their EEG, comparing St-NMES with visual feed-back during MI or resting tasks. We found that St-NMES not only induced significantly larger desynchronization over sensorimotor areas (p<0.05) but also significantly enhanced MI brain connectivity patterns. Moreover, classification accuracy and stability were significantly higher with St-NMES. Importantly, St-NMES alone did not induce detectable artifacts, but rather the changes in the detected patterns were due to an increased MI performance. Our findings indicate that St-NMES is a promising feedback in order to foster MI performance and cold be used for BMI online applications. Copyright © 2018. Published by Elsevier Inc.

  3. Recovery of central and peripheral neuromuscular fatigue after exercise.

    Science.gov (United States)

    Carroll, T J; Taylor, J L; Gandevia, S C

    2017-05-01

    Sustained physical exercise leads to a reduced capacity to produce voluntary force that typically outlasts the exercise bout. This "fatigue" can be due both to impaired muscle function, termed "peripheral fatigue," and a reduction in the capacity of the central nervous system to activate muscles, termed "central fatigue." In this review we consider the factors that determine the recovery of voluntary force generating capacity after various types of exercise. After brief, high-intensity exercise there is typically a rapid restitution of force that is due to recovery of central fatigue (typically within 2 min) and aspects of peripheral fatigue associated with excitation-contraction coupling and reperfusion of muscles (typically within 3-5 min). Complete recovery of muscle function may be incomplete for some hours, however, due to prolonged impairment in intracellular Ca 2+ release or sensitivity. After low-intensity exercise of long duration, voluntary force typically shows rapid, partial, recovery within the first few minutes, due largely to recovery of the central, neural component. However, the ability to voluntarily activate muscles may not recover completely within 30 min after exercise. Recovery of peripheral fatigue contributes comparatively little to the fast initial force restitution and is typically incomplete for at least 20-30 min. Work remains to identify what factors underlie the prolonged central fatigue that usually accompanies long-duration single joint and locomotor exercise and to document how the time course of neuromuscular recovery is affected by exercise intensity and duration in locomotor exercise. Such information could be useful to enhance rehabilitation and sports performance. Copyright © 2017 the American Physiological Society.

  4. 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.

  5. Neuromuscular Electrical Stimulation Superimposed on Movement Early after ACL Surgery.

    Science.gov (United States)

    Labanca, Luciana; Rocchi, Jacopo Emanuele; Laudani, Luca; Guitaldi, Rita; Virgulti, Alessandro; Mariani, Pier Paolo; Macaluso, Andrea

    2018-03-01

    Quadriceps weakness and asymmetrical loading of lower limbs are two major issues after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to evaluate the effectiveness of a 6-wk training protocol involving neuromuscular electrical stimulations (NMES) of the quadriceps muscle superimposed on repeated sit-to-stand-to-sit exercises (STSTS), as an additional treatment to standard rehabilitation, from the 15th to the 60th day after ACLR. Sixty-three ACLR patients were randomly allocated to one of the three treatment groups: NMES superimposed on STSTS (NMES + STSTS), STSTS only, or no additional treatment (NAT) to standard rehabilitation. Maximal isometric strength of the knee extensor and flexor muscles was measured 60 and 180 d after surgery. Asymmetry in lower extremity loading was measured during a sit-to-stand movement at 15, 30, 60, and 180 d after surgery and during a countermovement jump 180 d after surgery by means of two adjacent force platforms placed under each foot. The NMES + STSTS participants showed higher muscle strength of the knee extensors, which was accompanied by lower perception of pain and higher symmetry in lower extremity loading compared with STSTS-only and NAT participants after both 60 and 180 d from surgery. Participants in the STSTS-only treatment group showed higher symmetry in lower extremity loading compared with those in the NAT group 60 d after surgery. These results suggest that an early intervention based on NMES superimposed to repeated STSTS exercises is effective for recovering quadriceps strength and symmetry in lower extremity loading by the time of return to sport.

  6. Treatment and Neuromuscular Rehabilitatin of Facial Palsy in 80 Cases

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Hosseinian

    2001-06-01

    Full Text Available Objective: Patients with facial palsy lose normal facial muscle movement in the paralyzed side. A condition which is treated using different methods of treatment. Materials & Methods: Over of a period of five years, a total of 80 facial palsy cases referred to the hospital. 22 were treated by high dose of prednisolon and physiotherapy. 58 cases were treated by different surgical procedures, that 38 cases had developed the condition due to trauma, and the remaining 20 due to bell's palsy, brain tumor, or congenital conditions. Surgical procedures used in treating these patients were end to end anastomosis, nerve graft between the severed nerve, neurotization of the contralateral healthy side to the paralyzed side, and nurotization with hypoglossal or accessory nerve of the paralyzed side. Muscle transplant to the paralyzed region, such as temporal or free gracilis muscle was also used in some patients. Results: In acute phase of bell's palsy, after head trauma or facial palsy because of very cold weather, prednisolon in high dose and neuromuscular rehabilitation for some patients showed very good results. Operative technique using nerve graft or end to end anastomosis of the severed nerve showed very good results, and neurotization of the paralyzed side to the contralateral healthy side gave acceptable to good results. The use of muscles or hypoglossal nerve of the paralyzed region did not result in symmetric facial muscle movement. Conclusion: Our data shows the best operative technique for patients with chronic facial palsy is the use of free gracilis muscle. Patients treated with this method were able to regain their involuntary and symmetric facial muscle movement.

  7. Proprioceptive neuromuscular facilitation stretching : mechanisms and clinical implications.

    Science.gov (United States)

    Sharman, Melanie J; Cresswell, Andrew G; Riek, Stephan

    2006-01-01

    Proprioceptive neuromuscular facilitation (PNF) stretching techniques are commonly used in the athletic and clinical environments to enhance both active and passive range of motion (ROM) with a view to optimising motor performance and rehabilitation. PNF stretching is positioned in the literature as the most effective stretching technique when the aim is to increase ROM, particularly in respect to short-term changes in ROM. With due consideration of the heterogeneity across the applied PNF stretching research, a summary of the findings suggests that an 'active' PNF stretching technique achieves the greatest gains in ROM, e.g. utilising a shortening contraction of the opposing muscle to place the target muscle on stretch, followed by a static contraction of the target muscle. The inclusion of a shortening contraction of the opposing muscle appears to have the greatest impact on enhancing ROM. When including a static contraction of the target muscle, this needs to be held for approximately 3 seconds at no more than 20% of a maximum voluntary contraction. The greatest changes in ROM generally occur after the first repetition and in order to achieve more lasting changes in ROM, PNF stretching needs to be performed once or twice per week. The superior changes in ROM that PNF stretching often produces compared with other stretching techniques has traditionally been attributed to autogenic and/or reciprocal inhibition, although the literature does not support this hypothesis. Instead, and in the absence of a biomechanical explanation, the contemporary view proposes that PNF stretching influences the point at which stretch is perceived or tolerated. The mechanism(s) underpinning the change in stretch perception or tolerance are not known, although pain modulation has been suggested.

  8. Hemodynamic and lactic Acid responses to proprioceptive neuromuscular facilitation exercise.

    Science.gov (United States)

    Gültekin, Zuhal; Kin-Isler, Ayse; Sürenkök, Ozgür

    2006-01-01

    The hemodynamic and metabolic responses to proprioceptive neuromuscular facilitation (PNF) exercise were examined in 32 male university students (aged 19-28 years). Ten repetitions of PNF exercises were applied to the subjects' dominant upper extremities in the following order: as an agonist pattern flexion, adduction and external rotation; and as an antagonist pattern extension, abduction and internal rotation. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), double product (DP), and blood lactate concentration (La) were determined before, immediately after, and at 1(st), 3(rd), and 5(th) minutes after PNF exercise. A one-way ANOVA with repeated measures indicated significant differences in HR, SBP, DBP, DP and La immediately after PNF exercise. HR increased from 81 (±10) to 108 (±15) b·min(-1) (p < 0.01), SBP increased from 117 (±10) to 125 (±11) mmHg (p < 0.01), DBP increased from 71 (±10) to 75 (±8) mmHg (p < 0.01), DP increased from 96 (±16) to 135 (±24) (p < 0.01), and La increased from 0.69 (±0.31) to 3.99 (±14.63) mmol·L(-1) (p < 0.01). Thus PNF exercise resulted in increased hemodynamic responses and blood lactate concentration that indicate a high strain on the cardiovascular system and anaerobic metabolism in healthy subjects. Key PointsPNF exercises resulted in increased hemodynamic responses.Repeated PNF exercises resulted in an increased blood lactate concentration.

  9. Computed tomography of the skeletal muscles in neuromuscular diseases

    International Nuclear Information System (INIS)

    Nagao, Hideo; Takahashi, Mitsugi; Habara, Shinji; Nagai, Yoshinao; Matsuda, Hiroshi

    1986-01-01

    Computed tomographic (CT) scans of the shoulder girdle, upper arm, waist, pelvic girdle, thigh, and lower leg were obtained in a total of 21 patients with neuromuscular diseases, including 10 with Duchenne muscle dystrophy (DMD), 3 with Fukushima type congenital muscular dystrophy (FCMD), 3 with Werdnig-Hoffmann's disease (WH), 3 with autosomal recessive muscular dystrophy in childhood (childhood MC), one with nemaline myopathy (NM), and one with myositis ossificans circumscripta (MOC). Age-dependent changes in CT findings were examined in the 10 DMD patients ranging in age from 3 to 15 years. Each muscle of the shoulder girdle and upper arm was seen as a low density area on CT in patients 9 years of age when the arms are difficult to elevate. Changes in the m. quadriceps femoris occurring in all the patients were visible earlist on CT, followed by those in the m. gluteus maximus, m. gastrocnemius, and m. soleus. CT scans of the thigh was thus considered most useful in diagnosing DMD. CT scans of the lower leg showed low density areas in the m. gastrocnemius and m. soleus in both WH and FCMD patients, while a low density area seen in the m. gluteus maximum on CT was restricted to FCMD patients. This suggests the potential of CT in the differentiation of WH from FCMD. In patients with childhood ARMD, there were various CT findings including normal and extremely low density areas. CT findings in NM patients were similar to those in DMD patients. High density areas were seen along the fascia of the trunk in MOC patients. (Namekawa, K.)

  10. Deep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy.

    Science.gov (United States)

    Madsen, Matias Vested; Istre, Olav; Springborg, Henrik Halvor; Staehr-Rye, Anne Kathrine; Rosenberg, Jacob; Lund, Jørgen; Gätke, Mona Ring

    2017-05-01

    Establishment of sufficient muscle relaxation is essential in laparoscopic surgery. During laparoscopy, surgeons can experience abdominal contractions in their patients. Deep neuromuscular block (NMB) has the potential to prevent such episodes. In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. This was a pre-planned secondary analysis of a randomized, controlled study. A total of 110 patients scheduled for laparoscopic hysterectomy were randomized to either deep NMB and 8 mmHg pneumoperitoneum (deep NMB group) or single-bolus NMB and 12 mmHg pneumoperitoneum (standard NMB group). NMB was established with rocuronium and reversed with sugammadex. Two gynaecologists registered episodes of sudden abdominal contractions, alarms from the insufflator due to increased intraabdominal pressure and incidences with tightness of the abdominal wall. No sudden abdominal contractions were detected in the deep NMB group as compared with 12 episodes in the standard NMB group (p deep and standard NMB group, respectively. The gynaecologists registered increasing abdominal tensions in no versus eight procedures (p = 0.006) in the deep and standard NMB group, respectively. Deep NMB in combination with 8 mmHg pneumoperitoneum prevented sudden abdominal contractions during laparoscopic hysterectomy. This work was funded in part by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp, USA. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The study was assigned with EudraCT number 2012-003787-51 and registered with clinicaltrials.gov (NCT01722097). Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any

  11. 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.

  12. Lower Limb Neuromuscular Asymmetry in Volleyball and Basketball Players

    Directory of Open Access Journals (Sweden)

    Fort-Vanmeerhaeghe Azahara

    2016-04-01

    Full Text Available The primary objective of the present study was to evaluate the agreement between the dominant leg (DL (determined subjectively and the stronger leg (SL (determined via a functional test in a group of basketball and volleyball players. The secondary objective was to calculate lower limb neuromuscular asymmetry when comparing the DL vs the non-dominant leg (NDL and the SL vs the weaker (WL leg in the whole group and when differentiating by sex. Seventy-nine male and female volleyball and basketball players (age: 23.7 ± 4.5 years performed three single-leg vertical countermovement jumps (SLVCJ on a contact mat. Vertical jump height and an inter-limb asymmetry index (ASI were determined. Only 32 (40% of the subjects had a concordance between the perception of their dominant leg and the limb reaching the highest jump height. Using the DL as the discriminating variable, significant (p<0.05 inter-limb differences were found in the total group of players. When comparing between sexes, significant differences (p<0.05 arose in the female group only. With regard to the WL vs. the SL, significant (p<0.05 differences were noted in the whole group and when stratified into males and females. The mean ASI ranged from 9.31% (males to 12.84% (females and from 10.49% (males to 14.26% (females, when comparing the DL vs. the NDL and the SL vs. the WL, respectively. Subjective expression of leg dominance cannot be used as a predictor of limb jump performance. Vertical jump asymmetry of 10-15% exists and this can be considered as a reference value for male and female basketball and volleyball players.

  13. Test-retest reliability of the Neuromuscular Recovery Scale.

    Science.gov (United States)

    Behrman, Andrea L; Velozo, Craig; Suter, Sarah; Lorenz, Doug; Basso, D Michele

    2015-08-01

    To determine the test-retest reliability of the Neuromuscular Recovery Scale (NRS), a measure to classify lower extremity and trunk recovery of individuals with spinal cord injury (SCI) to typical preinjury performance of functional tasks without use of external and behavioral compensation. Multicenter observational study. Five outpatient rehabilitation clinics. Physical therapists (N=13), trained and competent in conducting NRS, rated outpatients with SCI (N=69) using the NRS. Testing occurred on 2 days, separated by 24 to 48 hours, on the same patient by the same therapist. Not applicable. Spearman rank correlation coefficients to compare NRS results. The NRS scores of motor performance were based on normal, preinjury function on 11 items: 4 treadmill-based items (standing and stepping), 7 overground/mat items (sitting, sit-up, reverse sit-up, trunk extension, sit to stand, standing, walking). Test-retest reliability was very strong for the NRS items. Ten of the 11 items exhibited Spearman correlation coefficients ≥.92, and lower bounds of the 95% confidence intervals (CIs) for these items met or exceeded .83. The exception was stand retraining (ρ=.84; 95% CI, .68-.96). The test-retest reliability of the measurement model-derived summary score was very strong (ρ=.99; 95% CI, .96-.99). The NRS had excellent test-retest reliability when conducted by trained therapists in adults with chronic SCI across all levels of injury severity. All raters had undergone standardized training in use of the NRS. The minimal requirement of training to achieve test-retest reliability has not been established. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. 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. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Acute effect of scapular proprioceptive neuromuscular facilitation (PNF) techniques and classic exercises in adhesive capsulitis: a randomized controlled trial

    OpenAIRE

    Balc?, Nilay Comuk; Yuruk, Zeliha Ozlem; Zeybek, Aslican; Gulsen, Mustafa; Tekindal, Mustafa Agah

    2016-01-01

    [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...

  16. Effectiveness of electric toothbrushing in patients with neuromuscular disability: A randomized observer-blind crossover trial.

    Science.gov (United States)

    Ikeda, Tokuhei; Yoshizawa, Kunio; Takahashi, Kazuya; Ishida, Chiho; Komai, Kiyonobu; Kobayashi, Kazuhiko; Sugiura, Shirou

    2016-01-01

    To evaluate the effectiveness of an electric toothbrush for oral care in patients with neuromuscular disability. In this randomized observer-blind crossover trial, 30 patients with neuromuscular disease performed either electric or manual toothbrushing each for 4 weeks. Plaque status (plaque control record), periodontal pocket depth, oral status (oral assessment guide), salivary bacterial count, and toothbrushing time were assessed after each period and compared between the two groups by Wilcoxon signed-rank test. Twenty-eight patients completed the study, including 18 communicative patients. Periodontal pockets were significantly shallower and toothbrushing time was significantly shorter with electric toothbrush use than with manual toothbrush use. No significant differences in oral status and salivary bacterial counts were noted between the approaches, but plaque status significantly improved after electric toothbrushing in communicative patients. Electric toothbrushing is beneficial for maintaining oral health in patients with neuromuscular disability and reducing the caregivers' oral care burden. © 2015 Special Care Dentistry Association and Wiley Periodicals, Inc.

  17. 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.

  18. Congenital myopathies with secondary neuromuscular transmission defects; a case report and review of the literature.

    Science.gov (United States)

    Rodríguez Cruz, Pedro M; Sewry, Caroline; Beeson, David; Jayawant, Sandeep; Squier, Waney; McWilliam, Robert; Palace, Jacqueline

    2014-12-01

    Congenital myopathies are a clinically and genetically heterogeneous group of disorders characterized by early onset hypotonia, weakness and characteristic, but not pathognomonic, structural abnormalities in muscle fibres. The clinical features overlap with muscular dystrophies, myofibrillar myopathies, neurogenic conditions and congenital myasthenic syndromes. We describe a case of cap myopathy with myasthenic features due to a mutation in the TPM2 gene that responded to anticholinesterase therapy. We also review other published cases of congenital myopathies with neuromuscular transmission abnormalities. This report expands the spectrum of congenital myopathies with secondary neuromuscular transmission defects. The recognition of these cases is important since these conditions can benefit from treatment with drugs enhancing neuromuscular transmission. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. 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

    BACKGROUND: Female adolescents with patellofemoral pain are characterized by altered neuromuscular knee control and reduced maximal quadriceps torque. The purpose of this study is to investigate whether exercise therapy and patient education are associated with larger improvements in neuromuscular...... knee control and maximal quadriceps torque compared with patient education alone. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education and exercise therapy on self-reported recovery in 121 adolescents with patellofemoral pain...... flexion/extension kinematics and maximal quadriceps torque. FINDINGS: There was an 8-15% greater decrease in the complexity of surface electromyography suggesting an improvement in neuromuscular knee control among those randomized to exercise therapy (0.08exercise...

  20. Placebo response in pain, fatigue, and performance: Possible implications for neuromuscular disorders.

    Science.gov (United States)

    Shaibani, Aziz; Frisaldi, Elisa; Benedetti, Fabrizio

    2017-09-01

    The placebo response in neuromuscular disorders is not well understood. The only available data regarding its underlying mechanisms are related to neuropathic pain. In this review, we describe the factors that contribute to improved outcomes in the placebo arm, with specific attention to pain and fatigue, as well as some of the most important psychobiological mechanisms that may explain such a response. This approach may also improve our insight into the symptomatology and therapeutic responses of other neuromuscular disorders. The fact that >90% of tested analgesics for neuropathic pain have failed in advanced phases of clinical trials should prompt a greater investment of effort and resources into understanding the mechanisms and impact of placebos in clinical research. Such an endeavor will help improve the design of clinical trials and will provide information that informs clinical neuromuscular practice. Muscle Nerve 56: 358-367, 2017. © 2017 Wiley Periodicals, Inc.

  1. The use of in-flight foot pressure as a countermeasure to neuromuscular degradation

    Science.gov (United States)

    Layne, C. S.; Mulavara, A. P.; Pruett, C. J.; McDonald, P. V.; Kozlovskaya, I. B.; Bloomberg, J. J.

    The purpose of this study was to determine whether applying foot pressure to unrestrained subjects during space flight could enhance the neuromuscular activation associated with rapid arm movements. Four men performed unilateral arm raises while wearing —or not wearing—specially designed boots during a 81- or 115-day space flight. Arm acceleration and surface EMG were obtained from selected lower limb and trunk muscles. Pearson r coefficients were used to evaluate similarity in phasic patterns between the two in-flight conditions. In-flight data also were magnitude normalized to the mean voltage value of the muscle activation waveforms obtained during the no-foot-pressure condition to facilitate comparison of activation amplitude between the two in-flight conditions. Foot pressure enhanced neuromuscular activation and somewhat modified the phasic features of the neuromuscular activation during the arm raises.

  2. 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...

  3. Reliability of the 2- and 6-minute walk tests in neuromuscular diseases

    DEFF Research Database (Denmark)

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

    2017-01-01

    OBJECTIVE: The 2- and 6-minute walk tests are used to evaluate walking capacity, but reliability has been sparsely investigated in patients with neuromuscular diseases. The aim of this study was to investigate the relative and absolute reliability of the 2- and 6-minute walk tests in patients...... with neuromuscular diseases. DESIGN: Each patient performed a 2- and a 6-minute walk test on 2 test days separated by 1-2 weeks. SUBJECTS: A total of 93 adult patients (mean age 53 years, age range 22-83 years) with 12 different neuromuscular diseases were included. RESULTS: The mean walking distance increased by 4.......3 and 11.2 m (p walk tests, respectively. Intraclass correlation coefficient in the 2- and 6-minute walk tests was 0.99 (p walk test and 14.0 m in the 6-minute walk test. Minimal detectable difference...

  4. Robotic assessment of neuromuscular characteristics using musculoskeletal models: A pilot study.

    Science.gov (United States)

    Jayaneththi, V R; Viloria, J; Wiedemann, L G; Jarrett, C; McDaid, A J

    2017-07-01

    Non-invasive neuromuscular characterization aims to provide greater insight into the effectiveness of existing and emerging rehabilitation therapies by quantifying neuromuscular characteristics relating to force production, muscle viscoelasticity and voluntary neural activation. In this paper, we propose a novel approach to evaluate neuromuscular characteristics, such as muscle fiber stiffness and viscosity, by combining robotic and HD-sEMG measurements with computational musculoskeletal modeling. This pilot study investigates the efficacy of this approach on a healthy population and provides new insight on potential limitations of conventional musculoskeletal models for this application. Subject-specific neuromuscular characteristics of the biceps and triceps brachii were evaluated using robot-measured kinetics, kinematics and EMG activity as inputs to a musculoskeletal model. Repeatability experiments in five participants revealed large variability within each subjects evaluated characteristics, with almost all experiencing variation greater than 50% of full scale when repeating the same task. The use of robotics and HD-sEMG, in conjunction with musculoskeletal modeling, to quantify neuromuscular characteristics has been explored. Despite the ability to predict joint kinematics with relatively high accuracy, parameter characterization was inconsistent i.e. many parameter combinations gave rise to minimal kinematic error. The proposed technique is a novel approach for in vivo neuromuscular characterization and is a step towards the realization of objective in-home robot-assisted rehabilitation. Importantly, the results have confirmed the technical (robot and HD-sEMG) feasibility while highlighting the need to develop new musculoskeletal models and optimization techniques capable of achieving consistent results across a range of dynamic tasks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. 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.

  6. 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.

  7. 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

    BACKGROUND: Laparoscopic cholecystectomy performed during low intraabdominal pressure (conditions and safety of operating at lower pressures has not been adequately...... 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...... (rocuronium repeat bolus only for inadequate surgical conditions with spontaneous recovery of neuromuscular function). Patients received anesthesia with propofol, remifentanil, and rocuronium. The primary outcome was the proportion of procedures with optimal surgical space conditions (assessed by the surgeon...

  8. 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...

  9. Feeding and Swallowing Disorders in Pediatric Neuromuscular Diseases: An Overview.

    Science.gov (United States)

    van den Engel-Hoek, Lenie; de Groot, Imelda J M; de Swart, Bert J M; Erasmus, Corrie E

    2015-11-20

    Feeding and swallowing problems in infants and children have a great impact on health and wellbeing. The aim of this study was to provide an overview of recognized feeding and swallowing problems in different groups of children with neuromuscular diseases, based on relevant literature and expert opinion, and to propose recommendations for the assessment and treatment of these problems. Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist.

  10. 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...

  11. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis.

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E

    2016-10-01

    The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Systematic review and meta-regression. The literature search was performed in PubMed and EBSCO. Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2-17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  12. Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis

    Science.gov (United States)

    Sugimoto, Dai; Myer, Gregory D; Barber Foss, Kim D; Pepin, Michael J; Micheli, Lyle J; Hewett, Timothy E

    2017-01-01

    Objective The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses. Design Systematic review and meta-regression. Data sources The literature search was performed in PubMed and EBSCO. Eligibility criteria Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted. Results The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2–17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence). Conclusions Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes. PMID:27251898

  13. The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis.

    Science.gov (United States)

    Chen, Yi-Wen; Chang, Kwang-Hwa; Chen, Hung-Chou; Liang, Wen-Miin; Wang, Ya-Hui; Lin, Yen-Nung

    2016-01-01

    In this study, we intended to evaluate whether swallow treatment with neuromuscular electrical stimulation is superior to that without neuromuscular electrical stimulation, and whether neuromuscular electrical stimulation alone is superior to swallow therapy. We searched the PubMed and Scopus databases from their earliest record to 31 December 2014 for randomized and quasi-randomized controlled trials that used neuromuscular electrical stimulation to treat post-stroke dysphagia. The Jadad scale was used to assess the quality of the included studies. We extracted the mean differences and standard deviation (SD) between baseline and posttreatment or posttreatment mean and SD for selected outcomes measured in the experimental and control groups for subsequent meta-analyses. Eight studies were identified. For the comparison "swallow treatment with neuromuscular electrical stimulation vs. swallow treatment without neuromuscular electrical stimulation," we found a significant standardized mean difference (SMD) of 1.27 (95% confidence interval (CI) = 0.51-2.02, P = 0.001) with significant heterogeneity (I(2) = 85%). The meta-analysis for the comparison of neuromuscular electrical stimulation alone and swallow therapy demonstrated a non-significant SMD of 0.25 (95% CI = -0.16-0.65, P = 0.23) without significant heterogeneity (I(2) = 16%). Swallow treatment with neuromuscular electrical stimulation seems to be more effective than that without neuromuscular electrical stimulation for post-stroke dysphagia in the short term considering the limited number of studies available. Evidence was insufficient to indicate that neuromuscular electrical stimulation alone was superior to swallow therapy. © The Author(s) 2015.

  14. Qualitative Neuromuscular Monitoring: How to Optimize the Use of a Peripheral Nerve Stimulator to Reduce the Risk of Residual Neuromuscular Blockade.

    Science.gov (United States)

    Thilen, Stephan R; Bhananker, Sanjay M

    This review provides recommendations for anesthesia providers who may not yet have quantitative monitoring and sugammadex available and thus are providing care within the limitations of a conventional peripheral nerve stimulator (PNS) and neostigmine. In order to achieve best results, the provider needs to understand the limitations of the PNS. The PNS should be applied properly and early. All overdosing of neuromuscular blocking drugs should be avoided and the intraoperative neuromuscular blockade should be maintained only as deep as necessary. The adductor pollicis is the gold standard site and must be used for the pre-reversal assessment, also when the ulnar nerve and thumb were not accessible intraoperatively. Spontaneous recovery should be maximized and neostigmine should be administered after a TOF count of 4 has been confirmed at the adductor pollicis. Extubation should not occur within 10 min after administration of an appropriate dose of neostigmine.

  15. Avaliação da qualidade de méis de abelha produzidos e comercializados em Vitória da Conquista, Bahia

    Directory of Open Access Journals (Sweden)

    Manoel Nelson de Castro Filho

    2017-10-01

    Full Text Available O mel é um produto elaborado pelas abelhas, a partir do néctar das flores ou de secreções procedentes de partes vivas das plantas, que as abelhas recolhem, transformam e combinam com substâncias específicas próprias. Este alimento é nutritivo e energético, sendo apreciado, entre outros fatores, por suas propriedades terapêuticas. Açúcares, água, vitaminas, ácidos orgânicos e sais minerais são os principais constituintes do mel. Nesse sentido, as análises laboratoriais são utilizadas para inspeção, com o objetivo de conhecer a composição química do mel, identificando a qualidade do produto. O objetivo deste estudo foi avaliar a qualidade dos méis produzidos e comercializados na cidade de Vitória da Conquista - BA e sua adequabilidade em relação à identidade e qualidade padronizadas pela legislação brasileira. As amostras foram obtidas da Casa do Mel da Universidade Estadual do Sudoeste da Bahia, em Vitória da Conquista, e analisadas no laboratório de Química Analítica e Ambiental da mesma instituição. Foram analisados teor de umidade, acidez livre, açúcares redutores e não redutores, hidroximetilfurfural, sólidos solúveis totais, pH e reação de Fiehe e Lund  em 18 amostras de méis. Das amostras avaliadas, 66,67% apresentaram valores de HMF superiores aos aceitáveis pela legislação, 11,11% para acidez e 27,78% para o teste Fiehe. O resultado das demais análises apresentaram-se dentro dos valores permitidos.

  16. Tijolos vazados de solo-cimento produzidos com solo da Região do Arenito Caiuá do Paraná

    Directory of Open Access Journals (Sweden)

    Vladimir José Ferrari

    Full Text Available Pesquisas sobre materiais e técnicas de construção que considerem o contexto atual de preservação do meio ambiente e de desenvolvimento socioeconômico regional sustentável estão cada vez ganhando mais espaço na sociedade. Nesse aspecto, cita-se o caso das misturas de cimento ao solo para fins de emprego como material de construção. O presente trabalho tem por objetivo geral avaliar o solo da região do Arenito Caiuá do Noroeste do Paraná com vistas a sua incorporação com o cimento para produção de tijolos de solo-cimento. O efeito da substituição parcial do cimento pela cinza do bagaço da cana-de-açúcar na resistência à compressão dos tijolos e na capacidade de absorção de água também é avaliado no presente trabalho. Foram produzidos tijolos vazados de solo-cimento e de solo-cimento-cinza segundo as prescrições da NBR 10833 (ABNT, 2012a, e a propriedade mecânica de resistência a compressão simples e a capacidade de absorção de água foram determinadas segundo a NBR 8492 (ABNT, 1994. As condições exigíveis para esses parâmetros, considerando-se a aplicação de tais tijolos à execução de alvenaria sem função estrutural, são avaliadas com base nas prescrições da NBR 8491 (ABNT, 2012b. Os resultados indicam que o solo da região do Arenito Caiuá pode ser utilizado como matéria-prima para a fabricação de tijolos de solo-cimento.

  17. Modelo experimental de trauma medular agudo produzido por aparelho estereotáxico modificado Experimental model of acute spinal cord injury produced by modified steriotaxic equipment

    Directory of Open Access Journals (Sweden)

    B.B.J. Torres

    2010-02-01

    Full Text Available Foram utilizados 55 ratos machos da espécie Rattus novergicus, variedade Wistar, com o objetivo de propor um modelo experimental de trauma medular produzido por aparelho estereotáxico modificado, capaz de reproduzir clinicamente lesões medulares padronizadas. Após realização de laminectomia dorsal de T13, utilizou-se peso compressivo de 50,5g (25 animais - grupo I ou 70,5g (30 animais - grupo II, durante cinco minutos, comprimindo a medula espinhal. Os animais foram assistidos durante oito dias, por meio de testes comportamentais para avaliar a sensibilidade dolorosa, a capacidade motora, o posicionamento tátil e proprioceptivo e a capacidade de manter-se em plano inclinado. No grupo I, observaram-se déficits neurológicos moderados e transitórios, que variaram entre os animais. No grupo II, foi possível obter um trauma padronizado, caracterizado por paraplegia bilateral e simétrica dos membros posteriores, perda de propriocepção e da sensibilidade dolorosa de todos os animais. A utilização do aparelho estereotáxico desenvolvido permite reproduzir clinicamente trauma medular padronizado em ratos, de maneira simples, econômica e satisfatória, o que poderá proporcionar avanços nas investigações terapêuticas, abrangendo doenças neurodegenerativas, como é o caso do trauma medular agudo.Fifty-five male rats (Rattus novergicus, Wistar variety, were used with the purpose of suggesting an experimental model of spinal cord trauma performed by using a modified stereotaxic equipment capable to reproduce clinically (standardized pattern spinal cord injury. After dorsal laminectomy of T13, a compression was performed with 50.5g (25 animals - group I or 70.5g (30 animals - group II during five minutes on spinal cord. The animals were assisted during eight days by behavioral tests to evaluate painful sensibility, motor capacity, proprioceptive and tactil placing, and stability on inclined plan. In the group I, moderate and transitory

  18. CARACTERÍSTICAS FÍSICO-QUÍMICAS E SENSORIAS DO TOMATE (Lycopersicon esculentum PRODUZIDO POR CULTIVO ORGÂNICO EM COMPARAÇÃO AO CONVENCIONAL*

    Directory of Open Access Journals (Sweden)

    R. G. BORGUINI

    2009-03-01

    Full Text Available

    A pesquisa descreve as características físicoquímicas e sensoriais do tomate orgânico em comparação ao convencional. Amostras de tomate cultivares Carmem e Débora produzidos por cultivo orgânico e convencional foram avaliadas fisicamente, considerando-se a textura e cor, e quimicamente com relação ao pH, sólidos solúveis totais e acidez total titulável. As amostras foram também avaliadas sensorialmente quanto ao aroma, sabor, cor e aspecto geral. Os frutos de tomate cultivar Débora e Carmem não apresentaram diferenças com relação à tonalidade de vermelho dos frutos provenientes do cultivo orgânico quando comparado ao convencional. Quanto à textura, os resultados se mostraram similares, entre o lote orgânico (8,85 N x 105 e convencional (8,47 N x 105 do cultivar Carmem. Para o cultivar Débora foram observados valores de 10,28 N x 105 e 9,38 N x 105 para o cultivo orgânico e convencional, respectivamente. Quanto aos valores de pH, sólidos solúveis totais e acidez total titulável, foram observadas diferenças entre os dois tipos de cultivo. A análise sensorial dos frutos, revelou diferenças significativas (p<0,05 entre os cultivos orgânico e convencional apenas para os atributos de sabor e aspecto geral. PALAVRAS-CHAVE: Tomate; análise sensorial; alimentos orgânicos.

  19. Efeitos de farelo alimentar fibroso produzido a partir da linhaça em indivíduos com constipação intestinal

    Directory of Open Access Journals (Sweden)

    Fernanda S. Lopes

    2015-08-01

    Full Text Available A preocupação com o bem estar e a melhora da qualidade de vida tem levado as pessoas a consumirem alimentos mais saudáveis os chamados alimentos funcionais, no qual se destaca os que contêm fibra alimentar. Devido às propriedades fibrosas que a linhaça constitui, o presente trabalho teve por objetivo avaliar a eficácia da ingestão de um farelo alimentar rico em fibras, em indivíduos sedentários e não sedentários com constipação intestinal. O presente estudo apresentou caráter laboratorial e experimental com abordagem quantitativa utilizando-se o método da estatística descritiva. O farelo foi produzido à base da semente de linhaça, com adição de outros ingredientes fibrosos, foi embalado e rotulado, e em seguida distribuído para o consumo. De acordo com os dados obtidos, na análise da composição nutricional do farelo fibroso evidenciou-se um teor apreciável de fibra alimentar. Para a avaliação das características organolépticas do farelo foi observado uma maior aprovação para o sabor, textura e aroma. Quanto à avaliação da função intestinal dos indivíduos após consumir o farelo fibroso foi observado uma melhora significativa em todas as características observadas antes de consumir o farelo, sendo relatado um aumento no número das evacuações. Em relação aos indivíduos sedentários e não sedentários observou-se que independente da prática ou não de atividade física o mesmo foi bastante eficaz em ambos os casos, não sendo relatado nenhum tipo de reação adversa. Diante dos dados concluímos que o farelo fibroso foi bastante eficaz na melhora da constipação intestinal na maioria dos casos estudados.

  20. 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

  1. 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

  2. Pulmonary rehabilitation in neuromuscular disorders and spinal cord injury

    Directory of Open Access Journals (Sweden)

    John R. Bach

    2006-02-01

    Full Text Available Most patients with impairment of pulmonary function can be differentiated into those who have primarily oxygenation impairment with hypoxia due to predominantly intrinsic lung/airways disease and for whom hypercapnia is an end stage event, and those with lung ventilation impairment on the basis of respiratory muscle weakness for whom hypercapnia causes hypoxia. This distinction is important because, although many patients in the former category have been described to benefit from noninvasive ventilation in the acute care setting, long term use is more controversial. Patients with primarily ventilatory impairment, on the other hand, can benefit from the use of both inspiratory and expiratory muscle aids; and often avoid having any episodes of respiratory failure despite total respiratory muscle paralysis, do not require tracheostomy, and have excellent prognoses with long term home mechanical ventilation. Ventilatory muscle failure is defined by the inability of the inspiratory and expiratory muscles to sustain one’s respiration without resort to ventilator use. Patients with ventilatory muscle failure do not have unlimited breathing tolerance and require ventilatory support and other respiratory muscle aids.Inspiratory and expiratory muscle aids are devices and techniques that involve the manual or mechanical application of forces to the body or intermittent pressure changes to the airway to assist inspiratory or expiratory muscle function. The most important inspiratory aid is to receive air under pressure when one inhales (intermittent positive pressure ventilation or IPPV. The most important expiratory aid is to have a negative pressure (vacuum applied to the airway via the nose and mouth when one coughs along with a manual thrust to the belly to further increase cough flows. Illness and death in people with generalized weakness, such as patients with neuromuscular disease and high spinal cord injury, is almost always due to respiratory

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

    Directory of Open Access Journals (Sweden)

    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

  4. Neuromuscular responses to incremental caffeine doses: performance and side effects.

    Science.gov (United States)

    Pallarés, Jesús G; Fernández-Elías, Valentín E; Ortega, Juan F; Muñoz, Gloria; Muñoz-Guerra, Jesús; Mora-Rodríguez, Ricardo

    2013-11-01

    The purpose of this study was to determine the oral dose of caffeine needed to increase muscle force and power output during all-out single multijoint movements. Thirteen resistance-trained men underwent a battery of muscle strength and power tests in a randomized, double-blind, crossover design, under four different conditions: (a) placebo ingestion (PLAC) or with caffeine ingestion at doses of (b) 3 mg · kg(-1) body weight (CAFF 3mg), (c) 6 mg · kg(-1) (CAFF 6mg), and (d) 9 mg · kg(-1) (CAFF 9mg). The muscle strength and power tests consisted in the measurement of bar displacement velocity and muscle power output during free-weight full-squat (SQ) and bench press (BP) exercises against four incremental loads (25%, 50%, 75%, and 90% one-repetition maximum [1RM]). Cycling peak power output was measured using a 4-s inertial load test. Caffeine side effects were evaluated at the end of each trial and 24 h later. Mean propulsive velocity at light loads (25%-50% 1RM) increased significantly above PLAC for all caffeine doses (5.4%-8.5%, P = 0.039-0.003). At the medium load (75% 1RM), CAFF 3mg did not improve SQ or BP muscle power or BP velocity. CAFF 9mg was needed to enhance BP velocity and SQ power at the heaviest load (90% 1RM) and cycling peak power output (6.8%-11.7%, P = 0.03-0.05). The CAFF 9mg trial drastically increased the frequency of the adverse side effects (15%-62%). The ergogenic dose of caffeine required to enhance neuromuscular performance during a single all-out contraction depends on the magnitude of load used. A dose of 3 mg · kg(-1) is enough to improve high-velocity muscle actions against low loads, whereas a higher caffeine dose (9 mg · kg(-1)) is necessary against high loads, despite the appearance of adverse side effects.

  5. 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

  6. Estudo da variação da concentração de metano no biogás produzido a partir das águas residuárias do café

    OpenAIRE

    Prado,Marco Antônio Calil; Campos,Cláudio Milton Montenegro; Silva,Julia Ferreira da

    2010-01-01

    A água residuária do café (ARC), originada no processamento dos frutos do cafeeiro, produz quantidade considerável de biogás que pode e deve ser utilizado como fonte de energia alternativa e complementar. Neste trabalho, foi estudada a variação da concentração de metano do biogás produzido a partir das ARC, por tratamento anaeróbio, em reator UASB, em escala laboratorial. As amostras foram coletadas durante 86 dias. As análises da concentração de metano foram realizadas por cromatografia gás-...

  7. Características reológicas do exopolissacarídeo botiosferana produzido pelo Botryosphaeria rhodina MAMB-05 em três fontes de carbono: glucose, frutose e sacarose

    OpenAIRE

    Bongiovani, Raphael Alves Macedo [UNESP

    2008-01-01

    Os exopolissacarídeos (EPS) são polímeros produzidos por uma grande variedade de microrganismos e podem possuir propriedades físicas, estruturais e químicas diferentes. Considerando o interesse crescente das indústrias na busca de polissacarídeos que apresentem comportamento reológico compatível com sua aplicação, tanto nos setores de alimentos como farmacêutico, cosmético e têxtil, pesquisas vêm sendo realizadas com a esperança da descoberta de novas moléculas promissoras para tais aplicaçõe...

  8. Chocolate meio amargo produzido de amêndoas de cacau fermentadas com polpa de cajá, cupuaçu ou graviola: características fisico-químicas, reológicas e sensoriais

    OpenAIRE

    Sampaio, Simone Cristina Sant'anna

    2011-01-01

    A adição de polpa de frutas na fermentação das sementes de cacau constitui uma alternativa de obtenção de amêndoas com sabores diferenciados visando à elaboração de um chocolate com alta qualidade sensorial. Dentro desse contexto, o presente trabalho visou estudar a qualidade sensorial, bem como as características físico-químicas e reológicas, de chocolates meio amargo produzidos de amêndoas de cacau fermentadas com polpa de diferentes frutas. Quatro ensaios experimentais de fermentação foram...

  9. Avaliação das propriedades de painéis aglomerados produzidos com resíduos de serrarias de nove espécies de madeiras tropicais da Amazônia

    OpenAIRE

    Iwakiri,Setsuo; Vianez,Basílio Frasco; Weber,Cristiane; Trianoski,Rosilani; Almeida,Vanessa Coelho

    2012-01-01

    Esta pesquisa teve como objetivo avaliar a qualidade de painéis aglomerados produzidos com resíduos de processamento em serraria de nove espécies de madeiras tropicais da Amazônia. As espécies estudadas foram: Scleronema micranthum Ducke (Cardeiro), Ecclinusa guianensis Eyma (Caucho), Scleronema sp. (Castanha-de-paca), Copaifera multijuga Hayne (Copaíba), Ocotea sp. (Louro), Ocotea guianensis Aubl (Louro-espinho), Caryocar villosum Pers. (Piquiarana), Couratari oblongifolia Ducke & R. Knu...

  10. 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.

  11. 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.

  12. Neuromuscular correlates of subthalamic stimulation and upper limb freezing in Parkinson's disease

    NARCIS (Netherlands)

    Scholten, M.; Klotz, R.; Plewnia, C.; Wachter, T.; Mielke, K.P.; Bloem, B.R.; Braun, C.; Ziemann, U.; Govindan, R.B.; Gharabaghi, A.; Kruger, R.; Weiss, D.

    2016-01-01

    OBJECTIVE: The pathophysiology of deep brain stimulation mechanisms and resistant freezing phenomena in idiopathic Parkinson's disease (iPD) remains incompletely understood. Further studies on the neuromuscular substrates are needed. METHODS: We analyzed 16 patients with advanced iPD and bilateral

  13. Influence of deep neuromuscular block on the surgeonś assessment of surgical conditions during laparotomy

    DEFF Research Database (Denmark)

    Madsen, M V; Scheppan, S; Mørk, E

    2017-01-01

    Background: During laparotomy, surgeons may experience difficult surgical conditions if the patient's abdominal wall or diaphragm is tense. Deep neuromuscular block (NMB), defined as a post-tetanic-count (PTC) between 0-1, paralyses the abdominal wall muscles and the diaphragm. We hypothesized...

  14. Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation

    Science.gov (United States)

    Clark, Heather; Lazarus, Cathy; Arvedson, Joan; Schooling, Tracy; Frymark, Tobi

    2009-01-01

    Purpose: To systematically review the literature examining the effects of neuromuscular electrical stimulation (NMES) on swallowing and neural activation. The review was conducted as part of a series examining the effects of oral motor exercises (OMEs) on speech, swallowing, and neural activation. Method: A systematic search was conducted to…

  15. Beneficial effect of adipokinetic hormone on neuromuscular paralysis in insect body elicited by braconid wasp venom.

    Science.gov (United States)

    Shaik, Haq Abdul; Mishra, Archana; Kodrík, Dalibor

    2017-06-01

    The effect of Habrobracon hebetor venom and the role of the adipokinetic hormone (AKH) in poisoned adult females of the firebug Pyrrhocoris apterus were studied 24 and 48h after treatments. Venom application elicited total neuromuscular paralysis in firebugs, but the co-application of venom and Pyrap-AKH significantly reduced paralysis (up to 3.2 times) compared to the application of venom only. Although the mechanisms of their action are unknown, both agents might affect neuromuscular junctions. Venom application significantly increased the expression of both P. apterus Akh genes (Pyrap-Akh 5.4 times and Peram-Cah-II 3.6 times), as well as the level of AKHs in the central nervous system (2.5 times) and haemolymph (3.0 times). In the haemolymph, increased AKH levels might have led to the mobilization of stored lipids, which increased 1.9 times, while the level of free carbohydrates remained unchanged. Total metabolism, monitored by carbon dioxide production, significantly declined in paralysed P. apterus individuals (1.4 times and 1.9 times, 24 and 48h after the treatment, respectively), probably because of a malfunction of the muscular system. The results suggest an active role of AKH in the defence mechanism against the stress elicited by neuromuscular paralysis, and the possible involvement of this hormone in neuronal/neuromuscular signalling. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Lowland copperhead (Austrelaps superbus) envenomation causing severe neuromuscular paralysis in a dog.

    Science.gov (United States)

    Wright, L V; Indrawirawan, Y H

    2017-06-01

    A case of lowland copperhead snake (Austrelaps superbus) envenomation in a dog is described. The dog developed severe and prolonged neuromuscular paralysis, including ventilatory failure. The dog was treated successfully with antivenom, intravenous fluids and mechanical ventilation. The toxic components of lowland copperhead snake venom are reviewed. © 2017 Australian Veterinary Association.

  17. Performance and neuromuscular adaptations following differing ratios of concurrent strength and endurance training

    OpenAIRE

    Jones, Thomas W.; Howatson, Glyn; Russell, Mark; French, Duncan N.

    2013-01-01

    The interference effect attenuates strength and hypertrophic responses when strength and endurance training are conducted concurrently; however, the influence of training frequency on these responses remain unclear when varying ratios of concurrent strength and endurance training are performed. Therefore, the purpose of the study was to examine the strength, limb girth, and neuromuscular adaptations to varying ratios of concurrent strength and endurance training. Tw...

  18. Frequency of Use and Cost of Selected Anesthetic Induction and Neuromuscular Blocking Agents

    Science.gov (United States)

    1997-07-15

    have attempted to look at anesthetic choice. Katz ( 1973) and Broadman , Mesrobian, and McGill ( 1987) researched anesthetic choice among...1994). Adverse effects of depolarising neuromuscular blocking agents : Incidence, prevention and management. Drug Safety, lQ(S), 331-349. Broadman

  19. 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...... to define the population of impingement patients, as well as the methodological procedure being used, and the shoulder movement investigated....

  20. 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. PMID:22163515

  1. Abdominal Binding Improves Neuromuscular Efficiency of the Human Diaphragm during Exercise

    Directory of Open Access Journals (Sweden)

    Sara J. Abdallah

    2017-05-01

    Full Text Available We tested the hypothesis that elastic binding of the abdomen (AB would enhance neuromuscular efficiency of the human diaphragm during exercise. Twelve healthy non-obese men aged 24.8 ± 1.7 years (mean ± SE completed a symptom-limited constant-load cycle endurance exercise test at 85% of their peak incremental power output with diaphragmatic electromyography (EMGdi and respiratory pressure measurements under two randomly assigned conditions: unbound control (CTRL and AB sufficient to increase end-expiratory gastric pressure (Pga,ee by 5–8 cmH2O at rest. By design, AB increased Pga,ee by 6.6 ± 0.6 cmH2O at rest. Compared to CTRL, AB significantly increased the transdiaphragmatic pressure swing-to-EMGdi ratio by 85–95% during exercise, reflecting enhanced neuromuscular efficiency of the diaphragm. By contrast, AB had no effect on spirometric parameters at rest, exercise endurance time or an effect on cardiac, metabolic, ventilatory, breathing pattern, dynamic operating lung volume, and perceptual responses during exercise. In conclusion, AB was associated with isolated and acute improvements in neuromuscular efficiency of the diaphragm during exercise in healthy men. The implications of our results are that AB may be an effective means of enhancing neuromuscular efficiency of the diaphragm in clinical populations with diaphragmatic weakness/dysfunction.

  2. A robust neuromuscular system protects rat and human skeletal muscle from sarcopenia

    Science.gov (United States)

    Pannérec, Alice; Ireland, Alex; Piasecki, Mathew; Karaz, Sonia; Jacot, Guillaume; Métairon, Sylviane; Danenberg, Esther; Raymond, Frédéric; Descombes, Patrick; McPhee, Jamie S.; Feige, Jerome N.

    2016-01-01

    Declining muscle mass and function is one of the main drivers of loss of independence in the elderly. Sarcopenia is associated with numerous cellular and endocrine perturbations, and it remains challenging to identify those changes that play a causal role and could serve as targets for therapeutic intervention. In this study, we uncovered a remarkable differential susceptibility of certain muscles to age-related decline. Aging rats specifically lose muscle mass and function in the hindlimbs, but not in the forelimbs. By performing a comprehensive comparative analysis of these muscles, we demonstrate that regional susceptibility to sarcopenia is dependent on neuromuscular junction fragmentation, loss of motoneuron innervation, and reduced excitability. Remarkably, muscle loss in elderly humans also differs in vastus lateralis and tibialis anterior muscles in direct relation to neuromuscular dysfunction. By comparing gene expression in susceptible and non-susceptible muscles, we identified a specific transcriptomic signature of neuromuscular impairment. Importantly, differential molecular profiling of the associated peripheral nerves revealed fundamental changes in cholesterol biosynthetic pathways. Altogether our results provide compelling evidence that susceptibility to sarcopenia is tightly linked to neuromuscular decline in rats and humans, and identify dysregulation of sterol metabolism in the peripheral nervous system as an early event in this process. PMID:27019136

  3. Postoperative shoulder pain after laparoscopic hysterectomy with deep neuromuscular blockade and low-pressure pneumoperitoneum

    DEFF Research Database (Denmark)

    Madsen, Matias Vested; Istre, Olav; Staehr-Rye, Anne K

    2016-01-01

    indicate that the use of deep neuromuscular blockade (NMB) improves surgical conditions during a low-pressure pneumoperitoneum (8 mmHg). OBJECTIVE: The aim of this study was to investigate whether low-pressure pneumoperitoneum (8 mmHg) and deep NMB (posttetanic count 0 to 1) compared with standard...

  4. 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…

  5. 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…

  6. Comparative investigation of the pharmacology of fish and mammalian neuromuscular systems

    International Nuclear Information System (INIS)

    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 [ 125 I]α-BGT binding to tissue membranes. Scatchard analysis of [ 175 I]α-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 [ 125 I]-α-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

  7. Reversing neuromuscular blockade: inhibitors of the acetylcholinesterase versus the encapsulating agents sugammadex and calabadion.

    Science.gov (United States)

    Haerter, Friederike; Eikermann, Matthias

    2016-01-01

    Acetylcholinesterase inhibitors (neostigmine, edrophonium) and encapsulating agents (sugammadex and calabadion) can be used to reverse residual neuromuscular blockade (NMB). This review provides information about efficacy, effectiveness, and side effects of drugs (acetylcholinesterase inhibitors and encapsulating agents) used to reverse neuromuscular blocking agents (NMBAs). The therapeutic range of acetylcholinesterase-inhibitors is narrow and effectiveness studies demonstrate clinicians don't use these unspecific reversal agents effectively to increase postoperative respiratory safety. The encapsulating drugs sugammadex and calabadion reverse all levels of NMB, and complete recovery of muscle strength can be achieved almost immediately after administration. For this reason encapsulating agents can be used as a solution for "cannot intubate cannot ventilate"- situations. Poor binding selectivity of encapsulating agents carries the risk of displacement of the NMBA by a competitively binding drug, which may lead to recurarization. In order to avoid side-effects, related to unspecific binding of endogenous proteins and drugs administered perioperatively it is prudent to titrate the dose of reversal agents to the minimal effective dose, depending on the depth of neuromuscular transmission block identified by neuromuscular transmission monitoring. Calabadions provide a diversified (increased binding selectivity) and expanded (reversal of benzylisoquinolines) spectrum of possible indications.

  8. The epidemiology of neuromuscular disorders : Age at onset and gender in the Netherlands

    NARCIS (Netherlands)

    Deenen, Johanna C. W.; van Doorn, Pieter A.; Faber, Catharina G.; van der Kooi, Anneke J.; Kuks, Jan B. M.; Notermans, Nicolette C.; Visser, Leo H.; Horlings, Corinne G. C.; Verschuuren, Jan J. G. M.; Verbeek, Andre L. M.; van Engelen, Baziel G. M.

    Based on approximately eight years of data collection with the nationwide Computer Registry of All Myopathies and Polyneuropathies (CRAMP) in the Netherlands, recent epidemiologic information for thirty neuromuscular disorders is presented. This overview includes age and gender data for a number of

  9. Neuromuscular development of Aeolidiella stephanieae Valdéz, 2005 (Mollusca, Gastropoda, Nudibranchia)

    DEFF Research Database (Denmark)

    Kristof, Alen; Klussmann-Kolb, Annette

    2010-01-01

    data on opisthobranch gastropods we investigated the neuromuscular development in the nudibranch Aeolidiella stephanieae Valdéz, 2005 using immunocytochemistry as well as F-actin labelling in conjunction with confocal laser scanning microscopy (cLSM). RESULTS: The ontogenetic development of Aeolidiella...

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Influence of Resistance Training on Neuromuscular Function and Physical Capacity in ALS Patients

    DEFF Research Database (Denmark)

    Jensen, Line; Djurtoft, J.B.; Bech, Rune Dueholm

    2017-01-01

    not significantly affect the ALSFRS-R score, and loss of neuromuscular function (strength and power) increased following the training period. However, an improved functionality (chair rise) and an increase in greatly hypertrophied type II fibres combined with an increase in atrophied fibres following the training...

  13. 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

    2010-11-01

    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.

  14. Adaptation of neuromuscular activation patterns during treadmill walking after long-duration space flight

    Science.gov (United States)

    Layne, C. S.; Lange, G. W.; Pruett, C. J.; McDonald, P. V.; Merkle, L. A.; Mulavara, A. P.; Smith, S. L.; Kozlovskaya, I. B.; Bloomberg, J. J.

    The precise neuromuscular control needed for optimal locomotion, particularly around heel strike and toe off, is known to be compromised after short duration (8- to 15-day) space flight. We hypothesized here that longer exposure to weightlessness would result in maladaptive neuromuscular activation during postflight treadmill walking. We also hypothesized that space flight would affect the ability of the sensory-motor control system to generate adaptive neuromuscular activation patterns in response to changes in visual target distance during postflight treadmill walking. Seven crewmembers, who completed 3- to 6-month missions, walked on a motorized treadmill while visually fixating on a target placed 30 cm (NEAR) or 2 m (FAR) from the subject's eyes. Electronic foot switch data and surface electromyography were collected from selected muscles of the right lower limb. Results indicate that the phasic features of neuromuscular activation were moderately affected and the relative amplitude of activity in the tibialis anterior and rectus femoris around toe off changed after space flight. Changes also were evident after space flight in how these muscles adapted to the shift in visual target distance.

  15. Modulation of pain-induced neuromuscular trunk responses by pain expectations: a single group study.

    Science.gov (United States)

    Tétreau, Charles; Dubois, Jean-Daniel; Piché, Mathieu; Descarreaux, Martin

    2012-10-01

    The purpose of this study was to investigate the alteration of pain-induced neuromuscular trunk responses by expectations in healthy volunteers. Twenty-three asymptomatic participants performed series of flexion-extension movements in 3 different experimental conditions: innocuous heat stimulation (control) and noxious heat stimulation associated with expectations of low or high pain intensity. These stimuli were administered by a contact thermode placed over the lumbar region (L4 and L5) to assess the modulation of neuromuscular responses and kinematics during the flexion-extension task. Surface electromyography (EMG) of lumbar erector spinae at L2 and L3 and L4 and L5 as well as lumbopelvic kinematic variables were compared across conditions. Noxious stimulation significantly altered EMG responses but only in full trunk flexion. Interestingly, this alteration was significant only for muscles where noxious stimulation was applied (L4 and L5) and not for the other segment (L2 and L3). Conversely, expectations significantly altered EMG activity at L2 and L3 but not at the segment where noxious stimulation was applied. These results confirm previous findings and indicate that experimental pain can alter neuromuscular responses during a trunk flexion-extension task. Furthermore, this study suggests that expectations can alter some of these alterations. Future studies should determine whether neuromuscular changes induced by expectations may contribute to the transition from acute to chronic low-back pain. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  16. 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...

  17. The Effect of Proprioceptive Neuromuscular Facilitation on Learning Fine Motor Skills: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Shahabi Kaseb

    2016-09-01

    Full Text Available Introduction: Preparation of neuromuscular system prior to performing motor skills affects the learning of motor skills. The present study was conducted to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF on limb coordination and accuracy in dart throwing skill. Methods: Thirty two male students were randomly selected as study sample. Based on the pretest scores, the participants were divided into three groups: experimental (proprioceptive neuromuscular facilitation, first control (without warm-up, and second control (specific warm-up. During the acquisition phase, the participants first performed the preparation training related to their own group, then all groups performed the exercise program of dart throwing consisting of 6 blocks of 9 trials in 4 training sessions. Finally, 20 days following the last exercise session, the subjects took the retention and transfer tests. Results: The results of one-way ANOVA test for coordination variable in acquisition test showed no significant difference between the groups, while there was a statistically significant difference between groups regarding coordination variable in retention and transfer tests. Furthermore, the results of one-way ANOVA for the accuracy variable in acquisition and retention tests showed no statistically significant difference between the three groups, while there was a statistically significant difference between groups for accuracy variable in transfer test. Conclusion: It seems that proprioceptive neuromuscular facilitation, as a preparation method before performance, can enhance the efficacy of training to better learn the coordination pattern of fine motor skills.

  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. 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,

  20. 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.M. 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

  1. 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

  2. Chronic ventilation and social participation: experiences of men with neuromuscular disorders

    NARCIS (Netherlands)

    MSc S.S. van Huijzen; Dr. A.L. van Staa

    2013-01-01

    Objective: The purpose of this study was to investigate how mechanical ventilation-dependent adults with neuromuscular disorders experience their occupational and social participation. Methods: Data were collected through two successive focusgroup discussions with six men (aged 23–40 years) living

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

    DEFF Research Database (Denmark)

    Bencke, Jesper; Zebis, Mette K

    2011-01-01

    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...

  4. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks.

    Science.gov (United States)

    Chappell, Jonathan D; Limpisvasti, Orr

    2008-06-01

    Altered motor control strategies are a proposed cause of the female athlete's increased risk for noncontact anterior cruciate ligament injury. Injury prevention programs have shown promising results in decreasing the incidence of anterior cruciate ligament injury. To evaluate the effect of the Kerlan-Jobe Orthopaedic Clinic Modified Neuromuscular Training Program on the biomechanics of select jumping tasks in the female collegiate athlete. Controlled laboratory study. Thirty female National Collegiate Athletic Association Division I soccer and basketball players performed vertical jump, hopping tests, and 2 jumping tasks (drop jump and stop jump). All subjects completed a 6-week neuromuscular training program with core strengthening and plyometric training. Three-dimensional motion analysis and force plate data were used to compare the kinetics and kinematics of jumping tasks before and after training. Dynamic knee valgus moment during the stance phase of stop jump tasks decreased after completion of the neuromuscular training program (P = .04), but differences were not observed for the drop jump. Initial knee flexion (P = .003) and maximum knee flexion (P = .006) angles increased during the stance phase of drop jumps after training, but differences were not observed for the stop jump. The athletes showed improved performance in vertical jump (P training program improved select athletic performance measures and changed movement patterns during jumping tasks in the subject population. The use of this neuromuscular training program could potentially modify the collegiate athlete's motion strategies, improve performance, and lower the athlete's risk for injury.

  5. Organizing multidisciplinary care for children with neuromuscular diseases at the Academic Medical Center, Amsterdam : CASE STUDY

    NARCIS (Netherlands)

    Kortbeek, Nikky; van der Velde, M.F.; Litvak, Nelli Vladimirovna

    2017-01-01

    The Academic Medical Center (AMC) in Amsterdam, The Netherlands, recently opened the ‘Children’s Muscle Center Amsterdam’ (CMCA). The CMCA diagnoses and treats children with neuromuscular diseases. The patients with such diseases require care from a variety of clinicians. Through the establishment

  6. The Influence of Robotic Assistance on Reducing Neuromuscular Effort and Fatigue during Extravehicular Activity Glove Use

    Science.gov (United States)

    Madden, Kaci E.; Deshpande, Ashish D.; Peters, Benjamin J.; Rogers, Jonathan M.; Laske, Evan A.; McBryan, Emily R.

    2017-01-01

    The three-layered, pressurized space suit glove worn by Extravehicular Activity (EVA) crew members during missions commonly causes hand and forearm fatigue. The Spacesuit RoboGlove (SSRG), a Phase VI EVA space suit glove modified with robotic grasp-assist capabilities, has been developed to augment grip strength in order to improve endurance and reduce the risk of injury in astronauts. The overall goals of this study were to i) quantify the neuromuscular modulations that occur in response to wearing a conventional Phase VI space suit glove (SSG) during a fatiguing task, and ii) determine the efficacy of Spacesuit RoboGlove (SSRG) in reversing the adverse neuromuscular modulations and restoring altered muscular activity to barehanded levels. Six subjects performed a fatigue sequence consisting of repetitive dynamic-gripping interspersed with isometric grip-holds under three conditions: barehanded, wearing pressurized SSG, and wearing pressurized SSRG. Surface electromyography (sEMG) from six forearm muscles (flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), extensor digitorum (ED), extensor carpi radialis longus (ECRL), and extensor carpi ulnaris (ECU)) and subjective fatigue ratings were collected during each condition. Trends in amplitude and spectral distributions of the sEMG signals were used to derive metrics quantifying neuromuscular effort and fatigue that were compared across the glove conditions. Results showed that by augmenting finger flexion, the SSRG successfully reduced the neuromuscular effort needed to close the fingers of the space suit glove in more than half of subjects during two types of tasks. However, the SSRG required more neuromuscular effort to extend the fingers compared to a conventional SSG in many subjects. Psychologically, the SSRG aided subjects in feeling less fatigued during short periods of intense work compared to the SSG. The results of this study reveal the promise of the SSRG as a

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

    Science.gov (United States)

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

    2005-06-01

    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.Objective: To examine the short-term effects of static and proprioceptive neuromuscular facilitation stretching on peak torque (PT), mean power output (MP), active range of motion (AROM), passive range of motion (PROM), electromyographic (EMG) amplitude, and mechanomyographic (MMG) amplitude of the vastus lateralis and rectus femoris muscles during voluntary maximal concentric isokinetic leg extensions at 60 and 300 degrees .s.Design: A randomized, counterbalanced, cross-sectional, repeated-measures design.Setting: A university human research laboratory.Patients or Other Participants: Ten female (age, 23 +/- 3 years) and 9 male (age, 21 +/- 3 years) apparently healthy and recreationally active volunteers.Intervention(s): Four static or proprioceptive neuromuscular facilitation stretching exercises to stretch the leg extensor muscles of the dominant limb during 2 separate, randomly ordered laboratory visits.Main Outcome Measure(s): The PT and MP were measured at 60 and 300 degrees .s, EMG and MMG signals were recorded, and AROM and PROM were measured at the knee joint before and after the stretching exercises.Results: Static and proprioceptive neuromuscular facilitation stretching reduced PT (P = .051), MP (P = .041), and EMG amplitude (P = .013) from prestretching to poststretching at 60 and 300 degrees .s (P proprioceptive neuromuscular facilitation stretching. The MMG amplitude increased in the rectus femoris muscle in response to the static stretching at 60 degrees .s (P = .031), but no other changes in MMG amplitude were observed (P > .05).Conclusions: Both static and proprioceptive neuromuscular facilitation stretching caused similar deficits in strength, power output, and muscle activation at

  8. The use of an online support group for neuromuscular disorders: a thematic analysis of message postings.

    Science.gov (United States)

    Meade, Oonagh; Buchanan, Heather; Coulson, Neil

    2017-06-08

    People affected by neuromuscular disorders can experience adverse psychosocial consequences and difficulties accessing information and support. Online support groups provide new opportunities for peer support. The aim of this study was to understand how contributors used the message board function of a newly available neuromuscular disorders online support group. Message postings (n = 1951) from the first five months of the message board of a newly formed online support group for neuromuscular disorders hosted by a charitable organization were analyzed using inductive thematic analysis. Members created a sense of community through disclosing personal information, connecting with people with similar illness experiences or interests, welcoming others and sharing aspirations for the development of a resourceful community. Experiences, emotional reactions and support were shared in relation to: delayed diagnosis; symptom interpretation; illness management and progression; the isolating impact of rare disorders; and the influence of social and political factors on illness experiences. This study provided a novel insight into individuals' experiences of accessing a newly available online support group for rare conditions hosted by a charitable organization. The findings highlight how the online support group provided an important peer support environment for members to connect with others, exchange information and support and engender discussion on political and social issues unique to living with often-rare neuromuscular disorders. Online support groups may therefore provide an important and easily accessible support outlet for people with neuromuscular disorders as well as a platform for empowering members to raise awareness about the impact of living with these conditions. Further research is needed to examine member motivations for using such groups and any effects of participation in greater detail. Implications for rehabilitation Online support groups may

  9. Anestesia peridural lombar ou bloqueio do plexo lombar combinados à anestesia geral: eficácia e efeitos hemodinâmicos na artroplastia total do quadril Anestesia epidural lumbar o bloqueo del plexo lumbar combinados con la anestesia general: eficacia y efectos hemodinámicos en la artroplastia total de la cadera Epidural lumbar block or lumbar plexus block combined with general anesthesia: efficacy and hemodynamic effects on total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Leonardo Teixeira Domingues Duarte

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A anestesia para artroplastia total do quadril (ATQ constitui desafio devido à idade avançada e às doenças associadas dos pacientes. O objetivo do estudo foi avaliar se o bloqueio do plexo lombar combinado à anestesia geral se equivale à anestesia peridural lombar quanto à eficácia do bloqueio nociceptivo, efeitos hemodinâmicos secundários, dificuldade na sua execução e influência no sangramento operatório em pacientes submetidos à ATQ. MÉTODO: Pacientes estado físico ASA I a III foram alocados aleatoriamente nos grupos Peridural e Lombar. No grupo Peridural, foi realizada anestesia peridural lombar contínua com ropivacaína a 0,5% 10 a 15 mL. No grupo Lombar, foi realizado bloqueio do plexo lombar pela via posterior com ropivacaína a 0,5% 0,4 mL.kg-1. Todos os pacientes foram submetidos à anestesia geral. Foram estudados: a dificuldade na execução dos bloqueios, sua eficácia e efeitos hemodinâmicos secundários. RESULTADOS: 41 pacientes foram incluídos no estudo. O tempo para execução do bloqueio peridural foi menor, mas o número de tentativas de posicionamento da agulha foi semelhante nos dois grupos. O bloqueio peridural foi mais eficaz. No grupo Lombar, houve aumento da pressão arterial diastólica e média (PAM e no duplo produto após a incisão e o consumo anestésico durante a operação foi maior. Após o bloqueio, a PAM foi menor nos momentos 50, 60 e 70 minutos após a realização do bloqueio peridural. O sangramento foi semelhante nos dois grupos. CONCLUSÕES: A técnica peridural promoveu bloqueio nociceptivo mais eficaz sem se associar à instabilidade hemodinâmica quando combinada à anestesia geral. O bloqueio do plexo lombar mostrou-se uma técnica útil em combinação com a anestesia geral quando a anestesia peridural estiver contraindicada.JUSTIFICATIVA Y OBJETIVOS: La anestesia para la artroplastia total de la cadera (ATC, constituye un reto a causa de la edad

  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. O Bloqueio do plexo hipogástrico superior é eficaz no tratamento de dor pélvica crônica? ¿El bloqueo del plexo hipogástrico superior es eficaz en el tratamiento del dolor pélvico crónico? Is superior hypogastric plexus block effective for treatment of chronic pelvic pain?

    Directory of Open Access Journals (Sweden)

    André P Schmidt

    2005-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio do plexo hipogástrico tem sido apresentado como uma alternativa segura e eficaz no tratamento de pacientes portadores de dor pélvica crônica. Os estudos publicados e disponíveis no MedLine, abordando este tema, foram incluídos e analisados nesta revisão. CONTEÚDO: Alguns estudos documentaram a eficácia do bloqueio do plexo hipogástrico superior em reduzir a intensidade da dor e o consumo de opióides, principalmente em pacientes com câncer. No entanto, os estudos apresentam falhas em seus métodos ou desenhos. CONCLUSÕES: Novos estudos prospectivos melhor conduzidos ainda são necessários para ratificar a efetividade do bloqueio do plexo hipogástrico no alívio de condições dolorosas pélvicas. Esses estudos devem possuir critérios de inclusão mais rigorosos, seguimento mais prolongado, avaliação de outros sintomas e da qualidade de vida antes e após o procedimento. O bloqueio do plexo hipogástrico superior deve ser recomendado como uma alternativa e não como terapêutica principal.JUSTIFICATIVA Y OBJETIVOS: El bloqueo del plexo hipogástrico ha sido presentado como una alternativa segura y eficaz en el tratamiento de pacientes portadores de dolor pélvico crónico. Los estudios publicados y disponibles en el MedLine, abordando este tema, fueron incluidos y analizados en esta revisión. CONTENIDO: Algunos estudios documentaron la eficacia del bloqueo del plexo hipogástrico superior en reducir la intensidad del dolor y el consumo de opioides, principalmente en pacientes con cáncer. Sin embargo, los estudios presentan fallas en sus métodos o dibujos. CONCLUSIONES: Aún son necesarios nuevos estudios prospectivos y mejor conducidos, para poder ratificar la efectividad del bloqueo del plexo hipogástrico en el alivio de condiciones dolorosas pélvicas. Esos estudios deben poseer criterios de inclusión más rigurosos, seguimiento más prolongado, evaluación de otros síntomas y de la

  12. Does Intrathecal Baclofen Therapy Increase Prevalence and/or Progression of Neuromuscular Scoliosis?

    Science.gov (United States)

    Walker, Kevin R; Novotny, Susan A; Krach, Linda E

    2017-11-01

    Retrospective, case-matched review. Compare a group of individuals with cerebral palsy (CP) who had intrathecal baclofen (ITB) pumps to a group of individuals with CP who did not have ITB pumps in order to determine if there was a difference in the prevalence of new-onset neuromuscular scoliosis, an increased rate of progression of preexisting neuromuscular scoliosis, or an increased rate of posterior spine fusion surgery in skeletally immature individuals with CP who had ITB pumps. Various authors report conflicting findings, with some reporting an increased incidence or prevalence of scoliosis in individuals with CP who have ITB pumps whereas others report no difference in the rate of scoliosis between groups. Retrospective chart and radiographic case-matched study in which individuals were matched by gender and Gross Motor Function Classification Scale (GMFCS) level. We found no difference in the rates of new-onset neuromuscular scoliosis for those with CP and ITB pumps and those without ITB pumps. However, we did see a higher rate of progression as well as an increased rate of posterior spine fusion surgery in individuals with CP who had ITB pumps than for those with CP who did not have an ITB pump. We continue to recommend ITB pump therapy for individuals with severe spasticity associated with CP (GMFCS IV and V). There is a significant risk of complications for individuals in general. The risk of neuromuscular scoliosis is relatively high in this population. Our findings suggest that individuals with CP who have ITB pumps and who do or do not have preexisting scoliosis should be monitored closely for either developing new neuromuscular scoliosis or progression of preexisting scoliosis. Copyright © 2017 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

  13. Classification of Neuromuscular Disorders Based an Clinical Criteria , Molocular and Immunohistochemisty Analysis in Tehran Pateints

    Directory of Open Access Journals (Sweden)

    Kimia Kahrizi

    2005-10-01

    Full Text Available Objective: Neuromuscular disordres are a gorup of heterogenous inherited diseases. More than 150 types of these group of disorders have been known.The criticals that were used for classification of these disease include: age of onset, clinical course, disease progression and type of inheritance. Neuromuscular disorders have been classified in four categories: Myopaties (Muscular dystrophies Neuropathy (Charcot-Marie-Tooth dieseas, Motor neuron junction (Myasthenia Syndrome Motor neuron disorder (Spinal muscular atrophy. Objective of this study was classification of neuromuscular disorders based on clinical criteria, molecular and immunohistochemical analysis that reffered to Genetic Research Center. As a result of neuromuscular disorders was the second most common disabilities, more investigation in this group of disorders is necessary in Iranian population so this study was performed for the first time in Iranian patients. Materials & Methods: Total of 143 patient with neuromuscular deficiency that clinical, EMG and muscle enzymes have been tested and also in some cases molecular and immunohistochemical analysis was performed. Results: 82 patients with myotonic dystrophy, 19 patients with DMD/BMD, 6 patients with congenital muscular dystrophy, 3 patients with FSHD, 10 patients with SMA, 2 patients with CMS and 21 patients with LGMD. For the other cases we need more molecular and definite clinical analysis. Conclusion: For some cases that DM1 was not confirmed, study of DM2 is recommended. In patients with LGMD that analysis with 5 Abs were normal we advised multiple western blot for them (including calpain, sarcoglycans, dysferlin. Study of congenital muscular dystrophy besides merosin analysis, investigation for the other involved protein and molecular testing for mutation detection is considrable.

  14. Ammonia modifies enteric neuromuscular transmission through glial γ-aminobutyric acid signaling.

    Science.gov (United States)

    Fried, David E; Watson, Ralph E; Robson, Simon C; Gulbransen, Brian D

    2017-12-01

    Impaired gut motility may contribute, at least in part, to the development of systemic hyperammonemia and systemic neurological disorders in inherited metabolic disorders, or in severe liver and renal disease. It is not known whether enteric neurotransmission regulates intestinal luminal and hence systemic ammonia levels by induced changes in motility. Here, we propose and test the hypothesis that ammonia acts through specific enteric circuits to influence gut motility. We tested our hypothesis by recording the effects of ammonia on neuromuscular transmission in tissue samples from mice, pigs, and humans and investigated specific mechanisms using novel mutant mice, selective drugs, cellular imaging, and enzyme-linked immunosorbent assays. Exogenous ammonia increased neurogenic contractions and decreased neurogenic relaxations in segments of mouse, pig, and human intestine. Enteric glial cells responded to ammonia with intracellular Ca 2+ responses. Inhibition of glutamine synthetase and the deletion of glial connexin-43 channels in hGFAP :: Cre ER T2+/- /connexin43 f/f mice potentiated the effects of ammonia on neuromuscular transmission. The effects of ammonia on neuromuscular transmission were blocked by GABA A receptor antagonists, and ammonia drove substantive GABA release as did the selective pharmacological activation of enteric glia in GFAP::hM3Dq transgenic mice. We propose a novel mechanism whereby local ammonia is operational through GABAergic glial signaling to influence enteric neuromuscular circuits that regulate intestinal motility. Therapeutic manipulation of these mechanisms may benefit a number of neurological, hepatic, and renal disorders manifesting hyperammonemia. NEW & NOTEWORTHY We propose that local circuits in the enteric nervous system sense and regulate intestinal ammonia. We show that ammonia modifies enteric neuromuscular transmission to increase motility in human, pig, and mouse intestine model systems. The mechanisms underlying the

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

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    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.

  16. Partial neuromuscular blockade in humans enhances muscle blood flow during exercise independently of muscle oxygen uptake and acetylcholine receptor blockade

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Krustrup, Peter; Iaia, F Marcello

    2009-01-01

    This study examined the role of acetylcholine for skeletal muscle blood flow during exercise by use of the competitive neuromuscular blocking agent cisatracurium in combination with the acetylcholine receptor blocker glycopyrrone. Nine healthy male subjects performed a 10-min bout of one...... conductance during exercise, events that are not associated with either acetylcholine or an increased oxygen demand. The results do not support an essential role for acetylcholine, released form the neuromuscular junction, in exercise hyperaemia or for the enhanced blood flow during neuromuscular blockade...

  17. A novel neuromuscular form of glycogen storage disease type IV with arthrogryposis, spinal stiffness and rare polyglucosan bodies in muscle.

    Science.gov (United States)

    Malfatti, Edoardo; Barnerias, Christine; Hedberg-Oldfors, Carola; Gitiaux, Cyril; Benezit, Audrey; Oldfors, Anders; Carlier, Robert-Yves; Quijano-Roy, Susana; Romero, Norma B

    2016-10-01

    Glycogen storage disease type IV (GSD IV) is an autosomal recessive disorder causing polyglucosan storage in various tissues. Neuromuscular forms present with fetal akinesia deformation sequence, lethal myopathy, or mild hypotonia and weakness. A 3-year-old boy presented with arthrogryposis, motor developmental delay, weakness, and rigid spine. Whole body MRI revealed fibroadipose muscle replacement but sparing of the sartorius, gracilis, adductor longus and vastus intermedialis muscles. Polyglucosan bodies were identified in muscle, and GBE1 gene analysis revealed two pathogenic variants. We describe a novel neuromuscular GSD IV phenotype and confirm the importance of muscle morphological studies in early onset neuromuscular disorders. Copyright © 2016. Published by Elsevier B.V.

  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. 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

    Directory of Open Access Journals (Sweden)

    Leonardo Henrique Cunha Ferraro

    2010-08-01

    Full Text Available 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 anticoagulados. RELATO DOS CASOS: No primeiro caso, a cirurgia realizada consistiu na amputação de antepé esquerdo devido a necrose e sinais de infecção e, no segundo caso, em limpeza cirúrgica de joelho esquerdo. Os pacientes apr esentavam distúrbios de coagulação com atividade de protrombina e tempo de tromboplastina ativado acima dos valores da normalidade. Ambos os pacientes foram submetidos a bloqueio femoral e isquiático guiados por ultrassom, evoluindo sem alteração motora ou sensitiva nos territórios desses nervos e sem hematoma no local da punção. CONCLUSÕES: A anticoagulação impõe certas restrições à aplicação das técnicas anestésicas regionais clássicas. Com o avanço dos equipamentos e métodos de ultrassom, hoje é possível identificar com alta precisão estruturas vasculares e neurais. Isso possibilita que a punção guiada por ultrassom seja mais precisa, tanto para atingir a área de interesse como para minimizar os riscos de lesão vascular acidental. Até o presente, não se recomenda a realização de bloqueio periférico em pacientes anticoagulados ou portadores de coagulopatias. Entretanto, considerando que há poucos relatos sobre bloqueios regionais com ultrassom em situações de coagulopatias, a segurança de tal técnica nessas condições ainda não foi estabelecida.JUSTIFICATIVA Y OBJETIVOS: El uso del ultrasonido para guiar la punción en bloqueos de nervios periféricos se ha convertido

  20. AVALIAÇÃO DAS PROPRIEDADES DE PAINÉIS COMPENSADOS DE Melia azedarach L. PRODUZIDOS COM DIFERENTES GRAMATURAS E TEMPOS DE PRENSAGEM

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    Rosilani Trianoski

    2015-08-01

    Full Text Available RESUMOO Brasil é um grande produtor de painéis compensados, suas florestas de Pinus são as mais utilizadas nesse processo e grande parte dessa produção é destinada à indústria moveleira. Muitas espécies têm sido introduzidas no país para essa e outras finalidades, entre elas a Melia azedarach, que ainda requer diversos estudos tecnológicos para a melhor utilização de sua madeira. Nesse contexto, o objetivo desta pesquisa foi avaliar a viabilidade de utilização da Melia azedarach para a produção de painéis compensados e o efeito da gramatura de adesivo e do tempo de prensagem sobre as propriedades dos painéis. Foram utilizadas cinco árvores provenientes de um plantio experimental localizado em Corupá, SC, das quais foram obtidas amostras para determinação da densidade básica (COPANT 461/1972 e das propriedades químicas (TAPPI 204, 1997; 207, 1999; 280, 1999; 212, 2002; 252, 2002, bem como para a obtenção das lâminas. Os painéis foram produzidos com dimensões de 500 mm x 500 mm x 10 mm (cinco lâminas, segundo um delineamento em arranjo fatorial (3x2 com três gramaturas (320 g/m2,360g/m2 e 400 g/m2 e dois tempos de prensagem (8 e 10 min, adesivo ureia-formaldeído, pressão específica de 1 MPa e temperatura de 110 °C. As propriedades dos painéis foram avaliadas a partir do ensaio de flexão estática (EN:310:2002 e resistência da linha de cola ao cisalhamento (EN 3141:2004 e EN 314-2:2002. Os resultados indicaram diferença estatística significativa dos efeitos principais: a gramatura e tempo de prensagem apenas no módulo de elasticidade no sentido perpendicular e a inexistência de diferença estatística significativa entre as médias a partir da interação dessas duas variáveis de resposta. Concluiu-se que a espécie apresenta viabilidade técnica para a produção de painéis compensados, podendo maximizar a produtividade e minimizar os custos de produção, por meio da utilização da menor gramatura de