Journal articles on the topic 'Muscles – Wounds and injuries'
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1
Kholodnyi, R. D. "MODELING THE SKELETAL MUSCLE INJURY IN RATS." International Journal of Veterinary Medicine, no. 3 (October 18, 2022): 253–57. http://dx.doi.org/10.52419/issn2072-2419.2022.3.253.
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Muscles are the most important executive organs - effectors. Both according to morphological and functional characteristics, muscles are divided into two types - striated and smooth. Striated muscles, in turn, are usually divided into skeletal and cardiac. Striated muscles form the motor apparatus of the skeleton, oculomotor, chewing and other motor systems in animals. The striated muscles, with the exception of the heart muscle, are completely controlled by the central nervous system, they are devoid of automatism.The problem of damage to skeletal muscles is very relevant and widespread. These injuries disrupt the musculoskeletal function of animals, up to its complete loss. To search for methods for restoring the structure and function of muscles, experiments are being carried out on laboratory animals. This article is devoted to the selection of the optimal model of skeletal muscle injury, performed on laboratory rats. The study was conducted on Wistar rats. The choice of the muscle on which the models will be worked out, as well as the surgical access to it, is substantiated. Three options for inflicting damage to muscle tissue (cut wounds directed parallel to muscle fibers; cut wounds directed across muscle fibers; crushed wounds of muscle tissue) and the timing of healing of these injuries are proposed. The result of the study showed that the gastrocnemius muscle is the most suitable for modeling damage to muscle tissue in rats, and a crushed wound has the longest healing time.
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Chauhan, D. C., P. S. Chari, G. K. Khuller, and Dalbir Singh. "Correlation of renal complications with extent and progression of tissue damage in electrical burns." Indian Journal of Plastic Surgery 37, no. 02 (July 2004): 099–104. http://dx.doi.org/10.1055/s-0039-1697236.
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ABSTRACTElectrical injuries due to high-tension voltage (>1000 volts) cause destruction at the point of contact with massive necrosis of deeper structures such as muscles, vessels and nerves. Rhabdomyolysis due to massive breakdown of skeletal muscles may lead to acute renal failure secondary to myoglobinuria. The study was undertaken to observe the correlation of renal complications with extent and progression of tissue damage in high-tension voltage electrical burns. Renal biochemical parameters as predictors of acute renal failure were also studied. Thirty two patients of high tension voltage electrical burn injuries presenting during one year period 1-1-2001 to 31-12-2001 were studied. Low-tension voltage electrical injuries (< 1000 volts) mimic thermal burns were excluded from the study. The electrical wound assessment and the renal biochemical parameters were done daily for the first seven days and then on alternate days for another seven days. Assessment of progression of wounds and correlation with the renal biochemical parameters was done. Patients who died following electrical burns were subjected to autopsy and histopathological examination of both kidneys. Out of the thirty-two patients, six (18.75%) went into acute renal failure. Five out of these six patients died because of renal failure (mortality rate 83.33%). There was definite progression of electric burn wounds. There was no correlation between progression of electrical burn wounds and acute renal failure. Serum creatinine was found to be the most important biochemical parameter as a prognostic indicator of acute renal failure.
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Saha, Srinjoy. "Minimally Invasive Successful Reconstruction of a Severely Traumatized Upper Extremity Using Platelet-Rich Plasma and Tissue Scaffold: A Case Report." Surgery Journal 08, no. 01 (January 2022): e28-e33. http://dx.doi.org/10.1055/s-0041-1742176.
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AbstractMinimally invasive reconstruction combines principles of tissue engineering and regenerative medicine for healing complex wounds. This approach was successfully demonstrated on a 64-year-old diabetic and hypertensive male patient, who was brought unconscious to our emergency after surviving an automobile collision with severe brain and right-dominant upper extremity injuries. Uncontrolled hyperglycemia, severe anemia, diffuse axonal brain injury, wrist drop, and loss of thumb extension and abduction were noted. Extensive degloving, skin necrosis, extensor and flexor forearm muscle crush injuries, and ruptured extensor tendons were observed. Serial wound debridement combined with platelet-poor plasma injection into the muscles, platelet-rich plasma injections into the tendons and subcutis, and low-negative pressure wound therapy were performed sequentially to salvage the injured soft-tissues. Improvements were noticed during the second exploration after 5 days. Surviving muscles showed adequate vascularization and revival of innervation during the third exploration after another 5 days. Thereafter, absorbable synthetic tissue scaffold was applied over a sizeable 270 cm2 wound as a flap-alternative. Tissues regenerated well within the scaffold during the next 2 months, halving the wound area to 132 cm2. A thick split-skin graft was applied over the remaining granulating neodermis, which “took” completely. Six months postoperatively, the patient regained most hand functions and performed all activities satisfactorily, while the grafted area appeared almost identical to surroundings. Minimally invasive reconstruction thus produced satisfying results with fewer shorter simpler surgeries, minimal anesthesia, short-duration hospitalization, lower health care costs, lesser risks, and excellent patient-reported outcomes.
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Lee, Chang Woo, Kazumasa Fukushima, Arvydas Usas, Lin Xin, Dalip Pelinkovic, Vladimir Martinek, George Somogyi, Paul D. Robbins, Freddie H. Fu, and Johnny Huard. "BIOLOGICAL INTERVENTION BASED ON CELL AND GENE THERAPY TO IMPROVE MUSCLE HEALING AFTER LACERATION." Journal of Musculoskeletal Research 04, no. 04 (December 2000): 265–77. http://dx.doi.org/10.1142/s0218957700000264.
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Muscle laceration is a challenging problem in traumatology and is common in sports injuries, with functional recovery remaining slow and incomplete. Even though muscles retain their ability to regenerate after injury, muscles' healing process after such injuries has been found to be very slow and often leads to incomplete muscle recovery. Growth factors may have a role in enhancing recovery. Our previous study showed that IGF-1, β-FGF and NGF can improve myoblast proliferation and differentiation in vitro. We then investigated whether the delivery of IGF-1 would improve muscle healing after injuries. We observed that muscle regeneration was enhanced in lacerated muscles treated with IGF-1 protein, which consequently led to an improvement in muscle healing. However, the rapid clearance and short biological half-lives of these proteins may have limited the success of this approach. We then investigated the efficiency of gene therapy based on adenovirus to deliver a stable expression of the growth factor IGF-1. Although a slight improvement in the healing process occurred in the muscle injected with adenovirus (AIGF), the combination of myoblast transplantation and gene therapy with the ex vivo approach further improved the healing process. The injection of normal myoblasts into the injured muscle led to the best improvement of muscle healing at two weeks post-injection. Implantation of normal minced muscle into mdx mice was also capable of improving muscle healing at 2–4 weeks post-implantation. These studies will further our understanding of muscle healing post-injury and help in the development of strategies to promote efficient muscle healing and complete functional recovery after common muscle injuries.
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de Rooster, H., O. Taeymans, H. van Bree, and M. Risselada. "Penetrating injuries in dogs and cats." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 05 (2008): 434–39. http://dx.doi.org/10.3415/vcot-07-02-0019.
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SummaryThe objective of this retrospective study was to assess radiographical and surgical findings, surgical management and outcome of penetrating injuries in dogs and cats by evaluating patient records. Sixteen patients were identified (15 dogs and one cat), four with gunshot wounds, and 12 with fight wounds (11 with bite wounds, one struck by a claw). The thoracic cavity was affected in six patients, the abdominal cavity in three cases. Both cavities were affected in five dogs and the trachea in two cases. All of the patients with fight wounds were small breed dogs. Multiple injuries to internal organs that required intervention were found surgically after gunshot wounds and a high amount of soft tissue trauma requiring reconstruction was present after fight wounds. Radiography diagnosed body wall disruption in two cases. All of the affected thoracic body walls in the fight group had intercostal muscle disruptions which was diagnosed surgically. Fourteen patients survived until discharge and had a good outcome. In conclusion, penetrating injuries should be explored as they are usually accompanied by severe damage to either the internal organs or to the body wall. A high level of awareness is required to properly determine the degree of trauma of intercostal muscle disruption in thoracic fight wounds.
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Leiva-Cepas, Fernando, Alberto Benito-Ysamat, Ignacio Jimena, Fernando Jimenez-Diaz, Maria Jesus Jesus Gil-Belmonte, Ignacio Ruz-Caracuel, Rafael Villalba, and Jose Peña-Amaro. "Ultrasonographic and Histological Correlation after Experimental Reconstruction of a Volumetric Muscle Loss Injury with Adipose Tissue." International Journal of Molecular Sciences 22, no. 13 (June 22, 2021): 6689. http://dx.doi.org/10.3390/ijms22136689.
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Different types of scaffolds are used to reconstruct muscle volume loss injuries. In this experimental study, we correlated ultrasound observations with histological findings in a muscle volume loss injury reconstructed with autologous adipose tissue. The outcome is compared with decellularized and porous matrix implants. Autologous adipose tissue, decellularized matrix, and a porous collagen matrix were implanted in volumetric muscle loss (VML) injuries generated on the anterior tibial muscles of Wistar rats. Sixty days after implantation, ultrasound findings were compared with histological and histomorphometric analysis. The muscles with an autologous adipose tissue implant exhibited an ultrasound pattern that was quite similar to that of the regenerative control muscles. From a histological point of view, the defects had been occupied by newly formed muscle tissue with certain structural abnormalities that would explain the differences between the ultrasound patterns of the normal control muscles and the regenerated ones. While the decellularized muscle matrix implant resulted in fibrosis and an inflammatory response, the porous collagen matrix implant was replaced by regenerative muscle fibers with neurogenic atrophy and fibrosis. In both cases, the ultrasound images reflected echogenic, echotextural, and vascular changes compatible with the histological findings of failed muscle regeneration. The ultrasound analysis confirmed the histological findings observed in the VML injuries reconstructed by autologous adipose tissue implantation. Ultrasound can be a useful tool for evaluating the structure of muscles reconstructed through tissue engineering.
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Lee, Kyung-Sun, Mobasshira Zaman, and Jaejin Hwang. "Reduced Muscle Activity of the Upper Extremity in Individuals with Spinal Cord Injuries." International Journal of Environmental Research and Public Health 19, no. 8 (April 13, 2022): 4708. http://dx.doi.org/10.3390/ijerph19084708.
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Compromised physical ability due to musculoskeletal impairment among spinal cord injury (SCI) patients is known to negatively affect their quality of life. It is essential to comprehensively understand the muscle strength of the upper extremity among patients with SCI to enhance muscle function and capacity to engage in an active lifestyle. The objective of this study was to evaluate the muscle strength of 15 upper extremity muscles among patients with SCI and compare the relative weakness of individual muscles to the control group. Seven male patients with SCI with ASIA impairment scale D and E and 33 males in the control group participated in this study. Each participant performed maximal voluntary contraction of individual muscles, and the electromyography data were recorded. The results showed that the majority of the upper extremity muscles (12 out of 15) showed considerable weakness (24 to 53%) relative to the control group. Furthermore, the relative strength (ranking) of individual muscles among 15 upper extremity muscles was different between patients with SCI and the control group. This information would be useful to the selective strengthening of specific muscles as an intensive rehabilitation effort and prevent overuse and adverse injuries due to excessive muscle training.
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Hashim, Warqaa, Tahani G. Al-Sultan, Azza Alhialy, Zaid H. Al-Sawaff, and Fatma Kandimerli. "New Biomedical Applications Approach using Shape Memory Polymers for Muscles Rehabilitation and the Accompanying Wounds after Severe Bone Fractures." International Journal on Recent and Innovation Trends in Computing and Communication 10, no. 12 (December 31, 2022): 26–34. http://dx.doi.org/10.17762/ijritcc.v10i12.5838.
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This article introduces a new approach for modern applications of medical devices using shape memory polymers to aid in the rehabilitation of muscles and injuries attached to severe fractures. The group of heaters connected with the splint controls the temperature and humidity inside the affected area. Microcontrollers were attached to the polymer plate in order to directly control the required parameters and changes in addition to giving direct commands to the connected sensors. Because of the property of changing the outer shape of the polymer after being exposed to a certain temperature and returning to the normal shape after the removal of the external influence, the designed polymer plate applies light intermittent pressure on the wound area, muscles, and surrounding tissues, which helps to speed up the rehabilitation of these muscles, especially after She suffered from stiffness due to lack of movement during the period of treatment.
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Ziv, I., R. Mosheiff, A. Zeligowski, M. Liebergal, J. Lowe, and D. Segal. "Crush Injuries of the Foot with Compartment Syndrome: Immediate One-Stage Management." Foot & Ankle 9, no. 4 (February 1989): 185–89. http://dx.doi.org/10.1177/107110078900900407.
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Severe crush injuries with compartment syndrome were treated in five patients by an immediate one-stage procedure. This procedure included the assessment of skin flap viability with accurate debridement of devascularized tissues. It was performed according to the split-thickness skin excision technique. Compartment pressures were measured and the fasciotomies were performed through open wounds or separate medial and lateral incisions. The medial incision was extended to release the tarsal tunnel. Fractures were reduced and internally fixed and exposed bones were covered with locally transposed muscles. Skin grafts, taken earlier for the skin viability assessment, were meshed and applied to replace skin loss. All wounds and fractures healed uneventfully with no major functional loss. In multiple trauma, the physician should maintain a high index of suspicion for early diagnosis and treatment of severe foot injuries. Early treatment leads to more desirable results, shorter hospitalization, and faster rehabilitation.
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Strafun, S. S., I. M. Kurinnyi, N. O. Borzykh, Ya V. Tsymbaliuk, and V. G. Shypunov. "Tactics of Surgical Treatment of Wounded with Gunshot Injuries of the Upper Limb in Modern Conditions." Visnyk Ortopedii Travmatologii Protezuvannia, no. 2(109) (October 12, 2021): 10–17. http://dx.doi.org/10.37647/0132-2486-2021-109-2-10-17.
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Summary. Our study aimed to optimize the tactics of surgical treatment of wounded with gunshot wounds of the upper extremity by determining the factors influencing the outcome of treatment of servicemen in modern conditions of specialized and highly specialized medical care.
Materials and Methods. Surgical treatment of 123 patients with gunshot wounds of the upper extremity who were treated at the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” and the National Military Medical Clinical Center “Main Military Clinical Hospital” of the Ministry of Defense of Ukraine was analyzed. The mean age of patients was (35.3±8.7). At the level III of medical care, the largest share was occupied by wound closure (28.0%) and surgeries on the skeletal system (6.7%). At the level IV of medical care, the largest share was occupied by surgical procedures for closing unhealed wounds – 28%, due to the consequences of gunshot nerve injuries – 11.5%, fractures – 10.7%, and restorative interventions on muscles – 5.5%.
Results. By calculating the odds ratio (Odds Ratio, OR), it was found that the presence of compartment syndrome reduces the probability of obtaining a positive result by 11 times (OR=11.3), and late treatment at the level IV of care reduces the effectiveness of treatment by 9 times (OR=9.1). In the group of patients with peripheral nerve damage, satisfactory results were 6.9 times less than in the group without such damage (OR=6.9); the presence of a tissue defect worsened the prognosis of treatment by almost 5 times (OR=4.7). The average time to start surgical treatment after a gunshot wound was 2.8±5.0 days at the level III and 47.2±70.4 days at the level IV. It was found that for patients admitted to the level IV facilities for up to 30 days, the percentage increase in upper extremity function was 42.6±11.8 after treatment and 28.5±10.0 at a later start of treatment.
Conclusions. The results of the study of the factors influencing the outcome of treatment prove the need for early (up to 3 weeks) admission of wounded with gunshot wounds to the level IV of medical care.
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Telischi, Fred F., and Michael L. Patete. "Blast Injuries to the Facial Nerve." Otolaryngology–Head and Neck Surgery 111, no. 4 (October 1994): 446–49. http://dx.doi.org/10.1177/019459989411100409.
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The recommended treatment of penetrating traumatic facial nerve injuries associated with Immediate, total paralysis of the ipsilateral facial muscles generally includes facial nerve exploration and repair. We reviewed our experience with bullet injuries to the extratemporal facial nerve to determine the efficacy of this approach. Five patients with immediate, total facial nerve paralysis caused by bullet wounds near the extratemporal facial nerve were seen between July 1990 and December 1992. Of four patients who underwent surgical exploration, only one demonstrated complete transection of the facial nerve. Two of these four were followed up with serial electroneuronography, which demonstrated complete degeneration within the first week after injury. The fifth patient was followed up with serial electroneuronography without complete degeneration, and partial recovery was observed. We conclude that penetrating bullet injuries with immediate, total facial paralysis may not necessarily be associated with transection of the facial nerve. We propose a method of treating patients with these Injuries using electroneuronography.
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Simanjuntak, Lisdayanti. "The Relationship Of Javanese Culture And belief in Care Of Perineal Wounds in Post partum Mothers at pratama nabila Clinik year 2021." Science Midwifery 9, no. 2 (April 30, 2021): 606–8. http://dx.doi.org/10.35335/midwifery.v9i2.957.
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Perineal wounds are perineal injuries to the urogenital diaphragm and laterol ani muscles, postpartum period after delivery is complete up to 6 weeks or 42 days. Care for perineal wounds must be paid close attention because the 60% maternal mortality rate occurs during the puerperium. The relationship between culture and health is very closely related. Trust is a belief in one of the psychological states when someone considers a rationale or reason to be correct. Purpose To find out whether there is a relationship between Javanese Culture and Belief in Perineal Wound Care in Post Partum Mothers. The research design is analytic with a cross-sectional design, in this study the researcher made observations or measured variables at one particular moment. Research Methods The author's research collected data through primary secondary data by conducting interviews with the research instrument in the form of a questionnaire.
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Sung, Kun Yong, Seung Je Lee, and Hong Sil Joo. "Treatment Strategy for an Electrical Burn Patient with Multiple Fourth-Degree Wounds." Journal of Wound Management and Research 16, no. 2 (June 30, 2020): 121–24. http://dx.doi.org/10.22467/jwmr.2020.01032.
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Electrical burns, especially high-voltage burns, usually cause necrosis of the subcutaneous fat, fascia, muscle, and bone. The reconstruction of electrical injuries often involves multiple surgeries. We present the case of a 56-year-old man who was injured by a high-voltage current resulting in multiple soft tissue defects on the left ankle and plantar area. The wounds on the malleolar and lateral plantar areas had burned the muscle, tendon, and bone. Because the patient had multiple wounds and unstable vessels, we took the strategy of operating in stages. The primary aim of treatment was wound healing and maintaining the support structure for mobility. Several rounds of wide debridement and negative-pressure wound therapy, followed by application of acellular dermal matrix and split-thickness skin graft were performed as part of the first stage. At the 1-year follow-up, the patient could walk independently wearing a splint to prevent foot drop. A second reconstructive surgery is possible, if necessary.
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Badiul, P. O., S. V. Sliesarenko, O. V. Nosulko, and O. I. Rudenko. "Surgical management of a dog bite in a patient with comorbidities. Case study." General Surgery, no. 1 (April 30, 2022): 66–70. http://dx.doi.org/10.30978/gs-2022-1-66.
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Millions of people worldwide require urgent medical care annually due to bites and injuries inflicted by wild or domestic animals. Injured patients most frequently suffer from extensive and deep wounds resulting in traumatic shock of different degrees. The extensive wounds are characterized by severe damage to fascial muscles, tendons, bones, major vessels and nerve trunks. Therefore, the management of patients attacked by wild or domestic animals includes the elimination of life‑threatening conditions and the application of various techniques and methods of reconstructive plastic surgery and their combinations to preserve the injured areas of the body (most commonly limbs). In each particular case, the prognosis and the choice of the most effective reconstructive surgery technique for the treatment of a wound defect depend on the state of the deep structures of the injured limb. The «reconstructive ladder principle» ensures the selection of the most appropriate treatment strategy, as it focuses on the nature of the injury and the patient’s overall health status, thus providing an adequate assessment of all possible surgical risks, general postoperative complications and challenges in wound healing. This algorithm allows prioritizing the most beneficial techniques from simple to difficult, as well as considering the «second line» methods. The «second line» methods are defined as simpler techniques that may be applied in case of some complications occurring after the administration of the primary method. Some additional difficulties may be experienced throughout the period of wound management in children and the elderly, in patients with complicated comorbidities and exacerbation of chronic diseases.This article presents a case study of a patient undergoing the treatment for an extensive and deep bite wound that is complicated by acute coronary syndrome and severe cardiogenic shock in the early postoperative period.
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Pankevych, V. V., U. D. Matolych, S. V. Ushtan, Z. P. Putko, and Yu B. Dmytryshyn. "Characteristics of Muscle Recovery under Experimental Post-Traumatic Contracture." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 6, no. 5 (October 27, 2021): 110–15. http://dx.doi.org/10.26693/jmbs06.05.110.
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The frequency of traumatic injuries of the maxillofacial area and the degree of their severity, have been increasing in recent years. The introduction of modern methods of treatment made it possible to improve the results of treatment and shorten its duration. Myogenic contractures develop as a complication after facial injuries, soft tissue injuries, in particular, masticatory muscles. The gastrocnemius muscle of a rat has the same striated structure as the pterygoideus medialis muscle of a person. The purpose of the work is to study the regeneration of striatal muscles with post-traumatic contractures on the basis of combined treatment of laboratory rats. Materials and methods. The study was carried out on 45 sexually mature 12 months old outbred white male rats, which weighed 180-200 g. In animals, reflex post-traumatic muscle contractures (traumatic myositis) resulting from the slaughter of calf muscles (without violating the integrity of muscle tissue) were simulated on the posterior left leg. The rats were divided into two groups. Group 1 included 21 animals that did not receive treatment and whose wounds healed by secondary intention. Group 2 included 24 rats that received combined treatment: on the 2nd day after surgery – general (oral) administration of the drug with the active substance cyclobenzaprine hydrochloride – 0.15 mg, once a day with daily procedures of magnetic laser therapy on the affected hind limb. Results and discussion. Depending on the signs of pain behavior (changes in behavior, restriction of movement, increased sensitivity, pain), the intensity of myogenic pain syndrome was assessed (low, moderate, high, very high). It was found that the use of combined treatment (magnetic laser therapy and the use of cyclobenzaprine hydrochloride) led to the normalization of behavioral and motor reactions by the 28th day: 56% of rats didn’t feel any pain and 44% had a low level of pain. The animals with the same trauma, which weren’t treated, showed a high and moderate level of pain. On the 28th day these animals could lean on their hind limbs while they were moving. However, they could not fully move due to a sharp restriction of their left hind limb function. The obtained results are the basis for the development of new approaches to improving the methods of prevention and rehabilitation treatment of contractures using magnetic laser therapy and central muscle relaxants. Conclusion. It was found that the use of magnetic laser therapy and cyclobenzaprine hydrochloride inhibited the development of an acute inflammatory reaction in the damaged muscle tissue of the hind limb of animals, accelerated and optimized reparative processes, which prevented excessive, functionally significant growth of connective tissue
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Bokhari, Faran, Kimberly Nagy, Roxxane Roberts, Scott Brakenridge, Robert Smith, Kimberly Joseph, Gary An, and John Barrett. "The Ultrasound Screen for Penetrating Truncal Trauma." American Surgeon 70, no. 4 (April 2004): 316–21. http://dx.doi.org/10.1177/000313480407000410.
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A prospective blinded pilot study was performed at an urban level 1 trauma center to evaluate the efficacy of ultrasound in ruling out penetrating visceral truncal injury. For 8 months, 49 nonconsecutive patients who presented with truncal gunshot and stab wounds were evaluated by a 10-MHz ultrasound tranducer probe. The deepest muscle bundle and the fascia enveloping it was examined by ultrasound. These images were compared to the equivalent contralateral unaffected side of the patient. All the patients then underwent standard testing to evaluate for potential intracavitary injury. Forty-nine patients with a mean age of 28 years (SD, 8.8) were evaluated by ultrasound. A total of 58 injuries were evaluated of which 37 were stab wounds and 21 were gunshot wounds. Thoracoabdominal and back and flank injuries were the most commonly evaluated injuries. There were 20 true positives, 20 false positives, and 18 true negatives, each with approximately twice as many stab as gunshot wounds. There were no false negatives. The sensitivity and negative predictive value of ultrasound in determining clinically significant truncal visceral injury in penetrating truncal trauma is 100 per cent. The specificity and positive predictive value are both approximately 50 per cent. Ultrasonic examination of the injured abdominal wall layers in truncal penetrating trauma is an excellent screening tool. Simple comparative assessment with the unaffected contralateral side allows a highly sensitive method of decreasing the number of potentially morbid, time consuming, and expensive tests that are currently employed to rule out visceral injury.
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Piper, Ann-Katrin, Reece A. Sophocleous, Samuel E. Ross, Frances J. Evesson, Omar Saleh, Adam Bournazos, Joe Yasa, et al. "Loss of calpains-1 and -2 prevents repair of plasma membrane scrape injuries, but not small pores, and induces a severe muscular dystrophy." American Journal of Physiology-Cell Physiology 318, no. 6 (June 1, 2020): C1226—C1237. http://dx.doi.org/10.1152/ajpcell.00408.2019.
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The ubiquitous calpains, calpain-1 and -2, play important roles in Ca2+-dependent membrane repair. Mechanically active tissues like skeletal muscle are particularly reliant on mechanisms to repair and remodel membrane injury, such as those caused by eccentric damage. We demonstrate that calpain-1 and -2 are master effectors of Ca2+-dependent repair of mechanical plasma membrane scrape injuries, although they are dispensable for repair/removal of small wounds caused by pore-forming agents. Using CRISPR gene-edited human embryonic kidney 293 (HEK293) cell lines, we established that loss of both calpains-1 and -2 ( CAPNS1−/−) virtually ablates Ca2+-dependent repair of mechanical scrape injuries but does not affect injury or recovery from perforation by streptolysin-O or saponin. In contrast, cells with targeted knockout of either calpain-1 ( CAPN1−/−) or -2 ( CAPN2−/−) show near-normal repair of mechanical injuries, inferring that both calpain-1 and calpain-2 are equally capable of conducting the cascade of proteolytic cleavage events to reseal a membrane injury, including that of the known membrane repair agent dysferlin. A severe muscular dystrophy in a murine model with skeletal muscle knockout of Capns1 highlights vital roles for calpain-1 and/or -2 for health and viability of skeletal muscles not compensated for by calpain-3 ( CAPN3). We propose that the dystrophic phenotype relates to loss of maintenance of plasma membrane/cytoskeletal networks by calpains-1 and -2 in response to directed and dysfunctional Ca2+-signaling, pathways hyperstimulated in the context of membrane injury. With CAPN1 variants associated with spastic paraplegia, a severe dystrophy observed with muscle-specific loss of calpain-1 and -2 activity identifies CAPN2 and CAPNS1 as plausible candidate neuromuscular disease genes.
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TSIOLI (Β. ΤΣΙΩΛΗ), V., and E. DERMISIADOU (Ε. ΔΕΡΜΙΣΙΑΔΟΥ). "Management of distal limb skin defects in dogs and cats." Journal of the Hellenic Veterinary Medical Society 67, no. 1 (January 29, 2018): 5. http://dx.doi.org/10.12681/jhvms.15618.
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Skin defects on the lower limb are common and their management is usually challenging. All trauma patients should be initially assessed for concurrent injuries and stabilized. Debridement and cleansing is performed in all wounds. The most important factors for decision making on wound closure are the wound size, the extent of soft tissue damage, the presence of contamination and impaired perfusion. Primary closure is the preferred choice although; it is seldom applicable in wounds on the distal limbs. Delayed primary closure, secondary closure or second intention healing can be undertaken under certain circumstances in such wounds. When these options are not feasible local pedicle flaps, axial pattern flaps, distant flaps, grafts, muscle or myocutaneous flaps and microvascular free tissue transfer can provide coverage.
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Mitkovic, Milorad, Marko Bumbasirevic, Sasa Milenkovic, Ivan Micic, Predrag Stojiljkovic, Igor Kostic, Sasa Karalejic, et al. "Nature and results of treatment of war wounds caused by cluster bombs." Acta chirurgica Iugoslavica 60, no. 2 (2013): 41–47. http://dx.doi.org/10.2298/aci1302041m.
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The aim of this study is to describe the nature of war wounds with fracture caused by cluster bombs and to suggest treatment options for such injuries. The nature of wounds caused by cluster bombs differs from those caused by conventional arms (they are more severe). The sides of the wounds are represented by conquasated soft tissues (such as fat and muscle) with thick dead tissues, ordinarily with a thickness of 0.5-4.5 cm. Another main characteristic of such injuries is the high percentage of amputations needed due to the high rate of neurovascular damage. This paper investigates the cases of 81 patients who sustained a total of 99 war wounds with fractures. The average age of the patients was 32.7 years while the youngest was 20 and the oldest, 77. According to The International Committee of the Red Cross (ICRC) classification of war wounds, 14 patients had grade I injuries, 48 patients grade II, and 29 patients, grade III. Mitkovic external fixation system, known also as the "War Fixator" was used for all fractures fixation. One protocol, which was a modification of the ICRC?s protocol adapted to our specific conditions, was used throughout the study. For solving soft tissue defects, a rotator fasciocutan flap was the most frequently used. For solving of bones defect Mitkovic reconstructive external fixation device was used. All fractures we treated healed. We concluded that shortening the procedural time and being a very simple, immediate using of Mitkovic versatile external fixator ("War Fixator") is , leads to desirable results.
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Grin, A. A., A. K. Kaykov, A. Yu Kordonskiy, V. A. Karanadze, O. A. Levina, and L. V. Popkova. "Results of using the infection avoidance Protocol for postoperative wounds in spinal surgery." Russian journal of neurosurgery 22, no. 3 (September 28, 2020): 51–56. http://dx.doi.org/10.17650/1683-3295-2020-22-3-51-56.
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Background. We developed a Protocol based on the results of a previous study of risk factors for infection of a postoperative wound: do not use monopolar coagulation on the skin and subcutaneous fat; remove hemostatic material from the wound; relax the established wound expander every 65 minutes; refuse to suture the muscles in the area of laminectomy, refuse to use an intradermal suture.The study objective is a verification of the received Protocol.Materials and methods. A comprehensive retrospective cohort study evaluated the results of surgical treatment of 575 spinal patients who were under the authors’ supervision in 2014–2016. Patients were divided into groups: operated in the period from 2014 to 2016 (control group), operated in 2017, in the treatment of which the Protocol for reducing complications was applied (main group).Results. It was found that after the introduction of the Protocol, the percentage of patients with postoperative wound infection decreased from 6.0 to 1.3 %.Conclusion. The resulting Protocol is an effective tool for reducing wound infection and can be recommended for prevention of the postoperative wound infection in patients with spinal with diseases and injuries.
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Alibardi, Lorenzo, and Victor Benno Meyer-Rochow. "Regeneration in Reptiles Generally and the New Zealand Tuatara in Particular as a Model to Analyse Organ Regrowth in Amniotes: A Review." Journal of Developmental Biology 9, no. 3 (August 30, 2021): 36. http://dx.doi.org/10.3390/jdb9030036.
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The ability to repair injuries among reptiles, i.e., ectothermic amniotes, is similar to that of mammals with some noteworthy exceptions. While large wounds in turtles and crocodilians are repaired through scarring, the reparative capacity involving the tail derives from a combined process of wound healing and somatic growth, the latter being continuous in reptiles. When the tail is injured in juvenile crocodilians, turtles and tortoises as well as the tuatara (Rhynchocephalia: Sphenodon punctatus, Gray 1842), the wound is repaired in these reptiles and some muscle and connective tissue and large amounts of cartilage are regenerated during normal growth. This process, here indicated as “regengrow”, can take years to produce tails with similar lengths of the originals and results in only apparently regenerated replacements. These new tails contain a cartilaginous axis and very small (turtle and crocodilians) to substantial (e.g., in tuatara) muscle mass, while most of the tail is formed by an irregular dense connective tissue containing numerous fat cells and sparse nerves. Tail regengrow in the tuatara is a long process that initially resembles that of lizards (the latter being part of the sister group Squamata within the Lepidosauria) with the formation of an axial ependymal tube isolated within a cartilaginous cylinder and surrounded by an irregular fat-rich connective tissue, some muscle bundles, and neogenic scales. Cell proliferation is active in the apical regenerative blastema, but much reduced cell proliferation continues in older regenerated tails, where it occurs mostly in the axial cartilage and scale epidermis of the new tail, but less commonly in the regenerated spinal cord, muscles, and connective tissues. The higher tissue regeneration of Sphenodon and other lepidosaurians provides useful information for attempts to improve organ regeneration in endothermic amniotes.
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Marjanovic, Zoran, Maja Raicevic, Dragoljub Zivanovic, Danijela Djeric, and Nikola Bojovic. "Hand injuries in children and adolescents." Srpski arhiv za celokupno lekarstvo 149, no. 5-6 (2021): 311–15. http://dx.doi.org/10.2298/sarh181121016m.
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Introduction/Objective. The objective of the study was to determinate which groups in the population of children are most prone to hand injuries and to identify the causes of the injuries with the aim of further developing better means of severe injuries prevention that can lead to invalidity. Methods. A retrospective epidemiological study was carried out, and included all children with hand injuries admitted to our hospital between January 1, 2010 and December 31, 2017; The data were collected and analyzed statistically using SPSSR. Significance was defined as p < 0.05. Results. The total number of patients was 254, 202 boys and 52 girls, with a mean age for both sexes 10.13 years (range1?17). The majority of patients were from an urban population 56.7% and 43.3% were from a rural area. Regarding the month in the year when the injury occurred, there were two peaks, in January and in May. The right hand was more affected, 53.2%, than the left, 45.6%, and both hands were affected in 1.8% of cases. Isolated soft tissue injuries (skin, muscles, tendons) were present in 59% of cases, isolated bone injuries (phalangeal and metacarpal bone fractures) in 15.3%, and both soft tissue and bone injuries in 25.7% of cases. The little finger was the most affected, followed by the long finger and thumb, index and ring finger, respectively. The most serious injuries were from explosive wounds caused by firecrackers and handling agricultural tools and engines. Conclusion. Hand injuries in childhood are common and can have devastating consequences. Developing prevention program by raising awareness about this issue is of vital importance.
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Hallgren, Richard C., and Jacob J. Rowan. "Assessment of potential strain injury to rectus capitis posterior minor muscles during whiplash type distortions of the cervical spine." Journal of Osteopathic Medicine 121, no. 9 (June 4, 2021): 747–53. http://dx.doi.org/10.1515/jom-2021-0094.
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Abstract Context Whiplash type injuries resulting from a rear end motor vehicle accident (REMVA) are thought to be caused by excessive loading and displacement of structural components of the cervical spine. On impact, the seat propels the driver’s torso forward relative to the head, resulting in forced flexion of the occipitoatlantal (OA) joint, accompanied by forced stretching of the rectus capitis posterior minor (RCPm) muscles. Flexion of the OA joint and stretching of the RCPm muscles continues to increase until the vehicle’s headrest strikes the back of the driver’s head. It is known that externally applied forces that attempt to move the OA joint beyond its anatomic barrier can result in fracture, dislocation, or soft tissue damage to its structural components. However, the magnitude of headrest backset, defined as the distance between the driver’s head and the vehicle’s headrest, that would result in RCPm muscles being stretched to a length that would put them at risk for a muscle strain injury is unknown. Objectives To quantify the relationships among flexion of the OA joint, RCPm muscle stretch, and backset, and to quantify the biomechanical response of RCPm muscles to increasing levels of axial load due to stretching. Methods Unembalmed head and neck specimens from three White females aged 85, 63, and 70 years were obtained from the Anatomical Services Division at the University of Maryland. Donors had provided written consent allowing use of their body for research purposes. Using an analytic model of the OA joint, the relationships between flexion of the OA joint and RCPm muscle stretch as a function of backset were estimated. RCPm muscles were removed from the cadavers and forcibly stretched using a servomechanism controlled hydraulic testing machine to quantify the load/displacement properties. After testing, the tissues were sectioned, mounted, and stained using Masson’s trichrome to selectively stain muscle fibers red and collagen blue. Results Forced flexion of the OA joint was seen to be directly related to the magnitude of headrest backset. For values of backset greater than 7.2 cm, biomechanical testing of the RCPm muscles revealed that strain injuries ranged from the tearing of a few muscle fibers to complete rupture of the muscle and separation of the tendon at the posterior process of C1. Conclusions Results showed that headrest backset at the time of vehicle impact is an important factor in estimating the risk of muscle strain injury to RCPm muscles. Muscle strain injury would be expected to impact the functional relationship between the RCPm muscles and the pain sensitive spinal dura. Physicians should be alert to the possibility that cervicogenic pain patients who have experienced whiplash associated with REMVA may show clinically relevant structural damage to the RCPm muscles on MRI.
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Zhang, Ying, Jing Yu, Jiefeng Zhang, and Yongxin Hua. "Simvastatin With PRP Promotes Chondrogenesis of Bone Marrow Stem Cells In Vitro and Wounded Rat Achilles Tendon–Bone Interface Healing In Vivo." American Journal of Sports Medicine 47, no. 3 (January 22, 2019): 729–39. http://dx.doi.org/10.1177/0363546518819108.
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Background: Tendons and ligaments are joined to bone in a specialized interface that transmits force from muscle to bone and permits body movement. Tendon/ligament injuries always occur in the interface areas, and injured tendons/ligaments have a limited healing response because the insertion site is composed of a fibrocartilaginous zone. Purpose: To study the effect of simvastatin with platelet-rich plasma (PRP) on chondrogenesis of rat bone marrow stem cells (BMSCs) in vitro and wounded rat Achilles tendon–bone interface healing in vivo. Study Design: Controlled laboratory study. Methods: The in vitro model was performed by the culture of rat BMSCs with various concentrations of simvastatin (0, 10, 50, 100 nM) for 2 weeks. The effect of simvastatin on the chondrogenic differentiation of the BMSCs was examined by histochemical analysis and real-time quantitative reverse transcription polymerase chain reaction. The in vivo model was carried out by testing the healing effect of simvastatin with PRP on 12 wounded rat Achilles tendon–bone interfaces. Results: Simvastatin induced chondrogenic differentiation of rat BMSCs in a concentration-dependent manner as evidenced by histological staining and real-time quantitative reverse transcription polymerase chain reaction. The wounds treated with simvastatin alone or with simvastatin-containing PRP gel healed much faster than the wounds treated with saline alone or PRP alone. Histological analysis showed that higher percentages of healed tissues were positively stained with safranin O and fast green in wounds treated with simvastatin-containing PRP gel than in the other 3 groups. Immunohistochemical analysis further demonstrated these findings, as evidenced by more positively stained healed tissues with collagen I and II antibodies in the wound areas treated with simvastatin-containing PRP gel than the other 3 groups. Conclusion: The combination of simvastatin with PRP induced chondrogenesis of BMSCs in vitro and enhanced fibrocartilage formation in vivo. The simvastatin–PRP gel treatment promotes wounded tendon-bone interface healing in clinical treatment. Clinical Relevance: The combination of simvastatin with PRP may be a good clinical treatment for wounded tendon/ligament junction healing, especially for acute sports-related tendon/ligament injuries.
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Zhu, Ringo Tang-Long, Pei-Zhao Lyu, Shuai Li, Cheuk Ying Tong, Yan To Ling, and Christina Zong-Hao Ma. "How Does Lower Limb Respond to Unexpected Balance Perturbations? New Insights from Synchronized Human Kinetics, Kinematics, Muscle Electromyography (EMG) and Mechanomyography (MMG) Data." Biosensors 12, no. 6 (June 18, 2022): 430. http://dx.doi.org/10.3390/bios12060430.
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Making rapid and proper compensatory postural adjustments is vital to prevent falls and fall-related injuries. This study aimed to investigate how, especially how rapidly, the multiple lower-limb muscles and joints would respond to the unexpected standing balance perturbations. Unexpected waist-pull perturbations with small, medium and large magnitudes were delivered to twelve healthy young adults from the anterior, posterior, medial and lateral directions. Electromyographical (EMG) and mechanomyographical (MMG) responses of eight dominant-leg muscles (i.e., hip abductor/adductors, hip flexor/extensor, knee flexor/extensor, and ankle dorsiflexor/plantarflexors) together with the lower-limb joint angle, moment, and power data were recorded. The onset latencies, time to peak, peak values, and/or rate of change of these signals were analyzed. Statistical analysis revealed that: (1) agonist muscles resisting the delivered perturbation had faster activation than the antagonist muscles; (2) ankle muscles showed the largest rate of activation among eight muscles following both anteroposterior and mediolateral perturbations; (3) lower-limb joint moments that complied with the perturbation had faster increase; and (4) larger perturbation magnitude tended to evoke a faster response in muscle activities, but not necessarily in joint kinetics/kinematics. These findings provided insights regarding the underlying mechanism and lower-limb muscle activities to maintain reactive standing balance in healthy young adults.
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Lyons, John D., David V. Feliciano, Amy D. Wyrzykowski, and Grace S. Rozycki. "Modern Management of Penetrating Tracheal Injuries." American Surgeon 79, no. 2 (February 2013): 188–93. http://dx.doi.org/10.1177/000313481307900230.
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Complications after tracheal repair in the past have included wound infections, tracheal stenosis, “spitting” of sutures, and tracheoesophageal fistulas. Modern operative approaches have significantly decreased the incidence of these complications. We conducted retrospective data collection using the TRACS database. Changes that preceded the time interval of the study included the following: 1) an emphasis on clinical (rather than endoscopic) recognition of injury; 2) minimal peritracheal dissection and repair with absorbable sutures; 3) limited use of “protective” tracheostomies; and 4) use of muscle buttresses to cover tracheal repairs, especially in patients with combined injuries. From 1997 to 2010, 22 patients were treated for wounds to the trachea (cervical 20, thoracic 2). The mechanism of injury was a gunshot wound in 15 patients and a stab wound in seven. A clinical diagnosis of the need for cervical operation or of a tracheal injury was made in 19 patients (86%), whereas three patients had positive diagnostic studies. Direct tracheal repair (No. 19) or evaluation of a superficial injury (No. 1) was performed in 20 patients, and three (15%) had a tracheostomy performed. Combined injuries were present in 12 patients (55%), most commonly to the esophagus (10 of 12 [83%]), and 10 of these 12 patients had vascularized buttresses applied to the tracheal repair. There were seven significant complications in patients with combined injuries to the esophagus or carotid artery. One patient (4.5%) died. Patients with penetrating tracheal injuries most commonly present with overt findings. Modern techniques of repair have eliminated many of the complications noted in the past.
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Rosero Salazar, Doris H., René E. M. van Rheden, Manon van Hulzen, Paola L. Carvajal Monroy, Frank A. D. T. G. Wagener, and Johannes W. Von den Hoff. "Fibrin with Laminin-Nidogen Reduces Fibrosis and Improves Soft Palate Regeneration Following Palatal Injury." Biomolecules 11, no. 10 (October 19, 2021): 1547. http://dx.doi.org/10.3390/biom11101547.
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This study aimed to analyze the effects of fibrin constructs enhanced with laminin-nidogen, implanted in the wounded rat soft palate. Fibrin constructs with and without laminin-nidogen were implanted in 1 mm excisional wounds in the soft palate of 9-week-old rats and compared with the wounded soft palate without implantation. Collagen deposition and myofiber formation were analyzed at days 3, 7, 28 and 56 after wounding by histochemistry. In addition, immune staining was performed for a-smooth muscle actin (a-SMA), myosin heavy chain (MyHC) and paired homeobox protein 7 (Pax7). At day 56, collagen areas were smaller in both implant groups (31.25 ± 7.73% fibrin only and 21.11 ± 6.06% fibrin with laminin-nidogen)) compared to the empty wounds (38.25 ± 8.89%, p < 0.05). Moreover, the collagen area in the fibrin with laminin-nidogen group was smaller than in the fibrin only group (p ˂ 0.05). The areas of myofiber formation in the fibrin only group (31.77 ± 10.81%) and fibrin with laminin-nidogen group (43.13 ± 10.39%) were larger than in the empty wounds (28.10 ± 11.68%, p ˂ 0.05). Fibrin-based constructs with laminin-nidogen reduce fibrosis and improve muscle regeneration in the wounded soft palate. This is a promising strategy to enhance cleft soft palate repair and other severe muscle injuries.
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Hamid, Almas, Alizae Salaam Ahmad, Sarah Dar, Sana Sohail, Faiza Akram, and Mariya Irfan Qureshi. "Ergonomics Hazards and Musculoskeletal Disorders Among Workers of Health Care Facilities." Current World Environment 13, no. 2 (August 25, 2018): 251–58. http://dx.doi.org/10.12944/cwe.13.2.10.
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The present study is conducted to determine occupational health and safety hazards with special focus on ergonomic hazards among healthcare facility (HCF) workers. A structured questionnaire survey was conducted among 200 workers in five HCFs of Lahore, Pakistan. Among the reported ergonomic hazards, muscle aches/ sprains (76.5%), elbow/ wrist/ neck pain (56.0%), body posture issues (56.0%), excessive stretching of muscles (67.5%) and bending/ twisting at work (55.5%) were commonly encountered. Biological hazards included incidences of cuts/wounds/ lacerations (69.0%), contact with specimens (56.0%), exposure of airborne diseases (64.0%) and other infections (72.0%) inspite of the fact that majority (90.0%) were aware of procedures where needle stick injuries are most likely to occur and knowledgeable on occupational infections. Physical hazards included slips/trips/falls (65.0%), high noise levels (64.0%) and chemical spills (54.0%). A significant percentage of workers experienced psychosocial hazards including work related stress (77.0%) and some form of psychosocial or physical abuse (68.5%). Despite workers awareness about occupational health hazards and implementation of control measures by HCF to mitigate hazards (especially biological) prevalence of hazards was reported. Hence, there is a need to improve working standards and conditions to reduce the occurrence of ergonomic and psychosocial hazards.
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Corrêa, Daniela Gallon, Juliana T. Okita, Hilana Rickli Fiuza Martins, and Anna Raquel Silveira Gomes. "Effects of GaAs laser and stretching on muscle contusion in rats." Fisioterapia e Pesquisa 23, no. 1 (March 2016): 3–11. http://dx.doi.org/10.1590/1809-2950/13903823012016.
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ABSTRACT Laser and stretching are used to treat skeletal muscle injuries. This study aimed to evaluate the effects of GaAs laser and stretching in the morphology of the tibialis anterior (TA) muscle after contusion. Thirty-six male rats (349±23g) were divided into six groups (n=6): control group (CG); lesion group (LG); lesion and laser group (LLG); lesion and stretching group (LSG); lesion, laser and stretching group (LLSG); and stretching group (SG). TA was wounded by a contusion apparatus. We used GaAs laser 4.5 J/cm2 dose for 32 s each, beginning 48 h after lesion, for 7 days, once a day. Manual passive stretching was applied by 10 repetitions for 1 minute, initiating on the 8th day, once a day, 3 times a week, during 3 weeks. After 4 weeks, rats were euthanized and we analyzed: muscle weight and length, cross sectional area of muscle fibers (CSAMF), serial sarcomere number (SSN), sarcomere length, and percentage of connective tissue. Comparisons among groups were made by ANOVA and post hoc Tukey tests, with the significance level set at ≤ 0.05. The serial sarcomere number of LLSG was higher than LSG. The sarcomere length of LSG was superior to LLG, LLSG, and SG. SG increased SSN compared to CG, while the percentage of connective tissue of SG decreased in comparison to LLSG. Thus, the sarcomerogenesis of injured muscles was enhanced by laser therapy, stretching, and association of both. The stretching protocol was enough to increase SSN of intact muscles.
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McCauley, Ross, Faisal Shariff, Michael Steinberg, Thomas B. Bemenderfer, Patrick Davis, Mark Thompson, Christopher Lesh, Mark Walsh, and Edward Evans. "Blunt Thoracic Trauma-Induced Mitral Papillary Muscle Avulsion with Pericardial Rupture and Cardiac Herniation: Difficult and Delayed Diagnoses." Case Reports in Surgery 2020 (June 22, 2020): 1–4. http://dx.doi.org/10.1155/2020/3268253.
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Blunt thoracic trauma (BTT) and the resultant isolated mitral papillary muscle avulsion, pericardial rupture, and cardiac herniation injuries are each rarely diagnosed clinical entities. We describe the first case of combined pericardial tear with cardiac herniation and ruptured mitral papillary muscles following BTT. Preoperative transesophageal echocardiography (TEE) diagnosed the delayed mitral papillary muscle rupture while all previous diagnostic modalities failed to delineate the pericardial rupture and cardiac herniation. Particular emphasis is placed on the clinical and radiologic aspects of the case that would heighten clinical suspicion in the emergency setting where blunt cardiac injury sequelae are suspected and frequently missed.
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Alonso-Fernández, Diego, Rosana Fernández-Rodríguez, Yaiza Taboada-Iglesias, and Águeda Gutiérrez-Sánchez. "Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility." International Journal of Environmental Research and Public Health 19, no. 11 (May 27, 2022): 6563. http://dx.doi.org/10.3390/ijerph19116563.
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Groin injuries are one of the most prevalent in sports, especially due to the hip adductor muscles’ weakness, which is considered as a risk factor. The Copenhagen adduction exercise (CAE) has been demonstrated to increase the strength of adductor muscles, but its effects on the architectural characteristics and flexibility of the adductors has been little studied. The aim of the present study was to analyse the impact on the muscular architecture and flexibility of the adductor musculature after 8 weeks of CAE-based training and after 4 weeks of subsequent detraining. A sample of 45 active subjects (26.1 ± 2.8 years old) were randomly divided into a control group with no intervention and an experimental group with an intervention based on 8 weeks of CAE training and 4 weeks of subsequent detraining. The muscle thickness of adductors was measured before and after training and detraining using ultrasound imaging and hip abduction range with goniometry. A significant increase in muscle thickness (left leg: +17.83%, d = 1.77, p < 0.001//right leg: +18.38%, d = 1.82, p < 0.001) and adductor flexibility was found in the experimental group (left leg: +7.3%, d = 0.96, p < 0.05//right leg: +7.15%, d = 0.94, p < 0.05), and after detraining, both variables returned to their initial values. These results could indicate that CAE would be a suitable strategy to modify the architecture of the adductors and thus form part of training protocols designed for the prevention and rehabilitation of muscle injuries.
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Fagenbaum, Ray, and Warren G. Darling. "Jump Landing Strategies in Male and Female College Athletes and the Implications of Such Strategies for Anterior Cruciate Ligament Injury." American Journal of Sports Medicine 31, no. 2 (March 2003): 233–40. http://dx.doi.org/10.1177/03635465030310021301.
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Background: Female athletes are more likely than male athletes to injure the anterior cruciate ligament. Causes of this increased injury incidence in female athletes remain unclear, despite numerous investigations. Hypothesis: Female athletes will exhibit lower hamstring muscle activation and smaller knee flexion angles than male athletes during jump landings, especially when the knee muscles are fatigued. Study Design: Controlled laboratory study. Methods: Eight female and six male varsity college basketball athletes with no history of knee ligament injury performed jump landings on the dominant leg from a maximum height jump and from 25.4 cm and 50.8 cm high platforms under nonfatigued and fatigued conditions. Knee joint angle and surface electromyographic signals from the quadriceps, hamstring, and gastrocnemius muscles were recorded. Results: Women landed with greater knee flexion angles and greater knee flexion accelerations than men. Knee muscle activation patterns were generally similar in men and women. Conclusion: As compared with male college basketball players, female college basketball players did not exhibit altered knee muscle coordination characteristics that would predispose them to anterior cruciate ligament injury when landing from jumps. This conclusion is made within the parameters of this study and based on the observation that hamstring muscle activation was similar for both groups. The greater knee flexion we observed in the female subjects would be expected to decrease their risk of injury. Clinical Relevance: Factors other than those evaluated in this study need to be considered when attempting to determine the reasons underlying the increased incidence of anterior cruciate ligament injuries consistently observed in elite female athletes.
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Gumucio, Jonathan P., Michael D. Flood, Anthony C. Phan, Susan V. Brooks, and Christopher L. Mendias. "Targeted inhibition of TGF-β results in an initial improvement but long-term deficit in force production after contraction-induced skeletal muscle injury." Journal of Applied Physiology 115, no. 4 (August 15, 2013): 539–45. http://dx.doi.org/10.1152/japplphysiol.00374.2013.
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Transforming growth factor-β (TGF-β) is a proinflammatory cytokine that regulates the response of many tissues following injury. Previous studies in our lab have shown that treating muscles with TGF-β results in a dramatic accumulation of type I collagen, substantial fiber atrophy, and a marked decrease in force production. Because TGF-β promotes atrophy and fibrosis, our objective was to investigate whether the inhibition of TGF-β after injury would enhance the recovery of muscle following injury. We hypothesized that inhibiting TGF-β after contraction-induced injury would improve the functional recovery of muscles by preventing muscle fiber atrophy and weakness, and by limiting the accumulation of fibrotic scar tissue. To test this hypothesis, we induced an injury using a series of in situ lengthening contractions to extensor digitorum longus muscles of mice treated with either a bioneutralizing antibody against TGF-β or a sham antibody. Compared with controls, muscles from mice receiving TGF-β inhibitor showed a greater recovery in force 3 days and 7 days after injury but had a decrease in force compared with controls at the 21-day time point. The early enhancement in force in the TGF-β inhibitor group was associated with an initial improvement in tissue morphology, but, at 21 days, while the control group was fully recovered, the TGF-β inhibitor group displayed an irregular extracellular matrix and an increase in atrogin-1 gene expression. These results indicate that the inhibition of TGF-β promotes the early recovery of muscle function but is detrimental overall to full muscle recovery following moderate to severe muscle injuries.
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Lin, Jian-Zhi, Yu-An Lin, Wei-Hsun Tai, and Chung-Yu Chen. "Influence of Landing in Neuromuscular Control and Ground Reaction Force with Ankle Instability: A Narrative Review." Bioengineering 9, no. 2 (February 10, 2022): 68. http://dx.doi.org/10.3390/bioengineering9020068.
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Ankle sprains are generally the most common injuries that are frequently experienced by competitive athletes. Ankle sprains, which are the main cause of ankle instability, can impair long-term sports performance and cause chronic ankle instability (CAI). Thus, a comprehensive understanding of the key factors involved in repeated ankle strains is necessary. During jumping and landing, adaptation to the landing force and control of neuromuscular activation is crucial in maintaining ankle stability. Ankle mobility provides a buffer during landing, and peroneus longus activation inhibits ankle inversion; together, they can effectively minimize the risk of ankle inversion injuries. Accordingly, this study recommends that ankle mobility should be enhanced through active and passive stretching and muscle recruitment training of the peroneus longus muscles for landing strategies should be performed to improve proprioception, which would in turn prevent ankle sprain and injury to neighboring joints.
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Mathieu, Laurent, Georges Pfister, James Charles Murison, Christophe Oberlin, and Zoubir Belkheyar. "Missile Injury of the Sciatic Nerve: Observational Study Supporting Early Exploration and Direct Suture With Flexed Knee." Military Medicine 184, no. 11-12 (April 20, 2019): e937-e944. http://dx.doi.org/10.1093/milmed/usz087.
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Abstract Missile injuries of the sciatic nerve are frequently encountered in modern violent conflicts. Gunshot and fragment wounds may cause large nerve defects, for which management is challenging. The great size of the sciatic nerve, in both diameter and length, explains the poor results of nerve repair using autografts or allografts. To address this issue, we used a simple technique consisting of a direct suture of the sciatic nerve combined with knee flexion for 6 weeks. Despite a published series showing that this procedure gives better results than sciatic nerve grafting, it remains unknown or underutilized. The purpose of this cases study is to highlight the efficiency of direct sciatic nerve coaptation with knee flexed through three cases with missile injuries at various levels. At the follow-up of two years, all patients were pain free with a protective sensory in the sole and M3+ or M4 gastrocnemius muscles, regardless of the injury level. Recovery was also satisfying in the fibular portion, except for the very proximal lesion. No significant knee stiffness was noticed, including in a case suffering from an associated distal femur fracture. Key points to enhance functional recovery are early nerve repair (as soon as definitive bone fixation and stable soft-tissue coverage are achieved) and careful patient selection.
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Padua, Darin A., David R. Bell, and Micheal A. Clark. "Neuromuscular Characteristics of Individuals Displaying Excessive Medial Knee Displacement." Journal of Athletic Training 47, no. 5 (September 1, 2012): 525–36. http://dx.doi.org/10.4085/1062-6050-47.5.10.
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Context Knee-valgus motion is a potential risk factor for certain lower extremity injuries, including anterior cruciate ligament injury and patellofemoral pain. Identifying neuromuscular characteristics associated with knee-valgus motion, such as hip and lower leg muscle activation, may improve our ability to prevent lower extremity injuries. Objective We hypothesized that hip and lower leg muscle-activation amplitude would differ among individuals displaying knee valgus (medial knee displacement) during a double-legged squat compared with those who did not display knee valgus. We further suggested that the use of a heel lift would alter lower leg muscle activation and frontal-plane knee motion in those demonstrating medial knee displacement. Design Descriptive laboratory study. Setting Research laboratory. Patients or Other Participants A total of 37 healthy participants were assigned to the control (n = 19) or medial-knee-displacement (n = 18) group based on their double-legged squat performance. Main Outcome Measure(s) Muscle-activation amplitude for the gluteus maximus, gluteus medius, adductor magnus, medial and lateral gastrocnemius, and tibialis anterior was measured during 2 double-legged squat tasks. The first task consisted of performing a double-legged squat without a heel lift; the second consisted of performing a double-legged squat task with a 2-in (5.08-cm) lift under the heels. Results Muscle-activation amplitude for the hip adductor, gastrocnemius, and tibialis anterior was greater in those who displayed knee valgus than in those who did not (P < .05). Also, use of heel lifts resulted in decreased activation of the gluteus maximus, hip adductor, gastrocnemius, and tibialis anterior muscles (P < .05). Use of heel lifts also eliminated medially directed frontal-plane knee motion in those displaying medial knee displacement. Conclusions Medial knee displacement during squatting tasks appears to be associated with increased hip-adductor activation and increased coactivation of the gastrocnemius and tibialis anterior muscles.
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Xie, Tanyan, Yan Zhang, Jan Awrejcewicz, and Yaodong Gu. "Lower Extremity Muscle Morphology and Plantar Loading During Squatting with Different Heel Heights." Journal of Medical Imaging and Health Informatics 10, no. 5 (May 1, 2020): 1210–15. http://dx.doi.org/10.1166/jmihi.2020.2999.
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Objective: Although it is widely reported that high-heeled changes gait pattern in terms of motions and forces throughout the body, the biomechanics while high-heeled squatting has not been examined. This study aimed to explore the acute effects of different heel heights on muscle morphology and plantar loading during high-heeled squatting. Methods: Fourteen healthy females performed squats on high-heeled shoes with different heights: flat (0.8 cm), moderate (4.0 cm), and high (7.0 cm). Muscle thickness and pennation angle of selected lower limb muscles were measured by ultrasound imaging. Plantar pressure distribution and COP trajectory during an entire squatting motion were recorded. Results: As the heel height increased, the average and peak pressure consistently increased in the heel and hallux regions, while reversely changed in MF and LF regions. In addition, the selected lower limb muscles except for the lateral gastrocnemius and vastus medialis showed significant differences in muscle thickness and pennation angle between heel heights. Conclusion: The findings of this study indicate that increased heel height would enhance the immediate effects on muscle morphology as well as plantar pressure redistribution potentially causing lower limb muscle fatigue and injuries.
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Podgornyak, M. Yu, M. A. Protchenkov, M. S. Mitichkin, and O. A. Pavlov. "A tactics for treating large skin wounds on the head." Wounds and wound infections. The prof. B.M. Kostyuchenok journal 8, no. 4 (June 7, 2022): 24–29. http://dx.doi.org/10.25199/2408-9613-2021-8-4-24-29.
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An open wound on the head is an injury (skin tear) of all scalp external layers including dermis, subcutaneous fatty tissue, aponeurosis, muscles, vessels and nerves with intact skull bones and intact neurological reactions [1].Extensive wounds of the external head layers, in addition to a standard threat to the human health, bear an additional risk due to their close localization to the brain. Because of the abundant blood supply to scalp soft tissues, high rate of volumetric blood flow (50–60 milliliters per 100 g of brain tissue), numerous extra-, intracranial arterial and venous anastomoses, there is a real danger of spreading the infection inside the skull and developing meningitis or encephalitis.Problems of care of patients with extensive head wounds, risk of complications that can cause severe consequences determine the relevance of the issue presented in this work.Objective. To analyze treatment results of patients admitted to the emergency department of Mariinskaya State City Hospital in St. Petersburg within three months in 2021 and to develop an optimal tactics for treating patients with extensive wounds of the scalp.Material and research methods. 2245 patients with various types of head injury were admitted to the hospital; 610 (27.2 %) of them had damage of the external scalp layers. Each patient had standard clinical and laboratory examination and multislice computed tomography (MSCT) examination of the head at 64-slice Definition AS (Siemens, Germany) CT scanner. In the emergency department, all patients who were injured by high-energy traumatic objects had the primary surgical debridement; all patients who were injured by low-energy traumatic objects had wound toilet and wound suturing. Three most representative cases with extensive wounds of the external scalp (over 10 cm) with illustrations are presented in the article as clinical examples.Results. All patients had good outcomes. There were no any signs of wound infection either.Conclusion. A thorough primary surgical debridement of scalp wounds with their drainage followed by observation and treatment in the hospital is a necessary condition for successful healing of large scalp wounds.
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Šniurevičienė, Veronika, Laura Baumann, and Laura Žlibinaitė. "Pilates Exercise Impact on Functional Movements, Core Stability and Risk of Injuries in Handball Players." Reabilitacijos mokslai: slauga, kineziterapija, ergoterapija 1, no. 26 (May 31, 2022): 63–72. http://dx.doi.org/10.33607/rmske.v1i26.1185.
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Background. Handball is a dynamic and physically demanding sport, especially due to the excessive contact of players during the game. The high velocity of the game, high number of matches and the athletic conditioning puts a strain on the musculoskeletal system, leading to a high risk of injury. Prior research substantiates the belief that a better spinal stabilization function due to the application of Pilates exercises would help to achieve better sports results and reduce the risk of injuries.
The aim. To evaluate the impact of a Pilates exercise program on functional movements, core stability and risk of injuries in young handball players.
Methods. 12 professional handball players aged 18.25 ± 0.45 years participated in the study. A Pilates exercise program was applied in addition to the regular handball training. The program lasted for 8 weeks, with the sessions organized on-line, twice a week for 60 minutes. Before and after the program, functional movements were assessed using the Functional Movement Screen (FMS) method, core stability was assessed by McGill core muscle isometric endurance tests, dynamic stability and associated injury risk was assessed by modified star excursion balance test.
Results. After the application of the Pilates exercise program, the evaluation of functional movements according to FMS scores significantly improved (p < 0.05). The isometric endurance ratio of the right and left side core muscles significantly improved (p < 0.05), and the isometric strength endurance ratio between the right side and back muscles also improved (p < 0.05). No significant change in either the total index of dynamic stability of the arms or legs, which indicates the risk of injury was found after the Pilates exercise program.
Conclusion. This study illustrates the idea that a Pilates exercise program improved quality of the handball players’ functional movements and the isometric strength of some core-stabilizing muscles, while the risk of injuries did not change.
Keywords: movement quality, static endurance, dynamic stability, athletes, core stabilization exercise.
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Gotner, Kacper, Robert Gotner, Agnieszka Pedrycz-Wieczorska, Dominika Wilczyńska, Grażyna Jastrzębowska, and Marcin Dornowski. "HYPERBARIC THERAPY INFLUENCE ON PSYCHOMOTOR ABILITIES EFFECTIVENESS DEVELOPMENT – TWO CASES STUDY." Acta Neuropsychologica 16, no. 2 (May 8, 2018): 213–19. http://dx.doi.org/10.5604/01.3001.0012.2053.
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Background: Hyperbaric therapy is a relatively new non-invasive therapeutic method. It involves inhaling the patient with pure oxygen using a pressure of 2 to 3 absolute atmospheres (ATA). The main purpose of this therapy is to improve the healing mechanisms and repairing processes in the case of various types of wounds and diseases. While in medicine this method is quite popular, in sport it is rarely used today and if so than mainly for the purposes of faster return to full fitness of athletes after injuries or after heavy, intense training conditions. Case study: Two subjects took part in the experiment. Training sessions were performed based on the selected original set of exercises within 29 days. Experiment participant was under conditions of increased pressure (2.5 ATA), during the session he breathed 100% oxygen, provided by the individual respiratory system. The measurement of muscle strength level of selected muscle groups, in selected motor tasks was estimated in (maximum weight – which is the maximum external resistance defeated in one repetition). It was found that there were increases in the level of muscle strength in selected muscles groups in first participant as a result of the applied set of exercises (motor tasks) and the effect of the hyperbaric sessions. Conclusions: The results of the study show that there was a visible/significant influence of the hyperbaric session on increasing the muscle function based on strength training example. This method in combination with adequate strength training sessions could be used in many areas connected with psychomotor development of human abilities.
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Khomenko, I. P., V. Y. Shapovalov, O. S. Herasymenko, R. V. Gybalo, and R. V. Yenin. "Ventral hernia repair surgery after abdominal gunshot wound." General Surgery, no. 2 (December 30, 2022): 29–38. http://dx.doi.org/10.30978/gs-2022-2-29.
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Gunshot wounds to the abdomen frequently result in significant damage to the abdominal organs, which is accompanied by peritonitis and the further development of different complications (anastomotic leakage, formation of abscesses, repeated bleeding, etc.), which require repeated surgical interventions that contribute to the formation of postoperative ventral hernias. The surgical management of ventral hernias is challenging due to severe adhesion in the abdominal cavity (irrespective of the time period since the injury and the last surgical interventions), the difficulties in closing massive defects of the muscle‑aponeurotic component of the anterior abdominal wall, contracture of the anterior abdominal wall, and the development of the abdominal compartment syndrome in the postoperative period. As a result, there is still some debate over the best surgical treatment for postoperative ventral hernias. Objective — to carry out a comparative analysis of open and video‑assisted laparoscopic operations for the selection of the most optimal surgical strategy for the management of ventral hernias after gunshot wounds to the abdomen. Materials and methods. We analyzed the surgical treatment of 45 wounded patients with postoperative ventral hernias that developed after operations for abdominal gunshot wounds. The patients were treated at the Military Medical Clinical Center of the Southern Region (Odesa) from 2014 to 2021; 32 of them had penetrating gunshot wounds, and 13 patients had a closed gunshot wound to the abdomen with injuries to the abdominal organs. 66.7 % of those injured had one operation on their abdominal organs, 22.2 % had two operations, 6.7 % had three operations, and 4.4 % had five operations. The size of the hernia orifices and severity of recurrence risk were determined according to the SWE classification: W1 (width of the hernia orifices up to 4 cm) — 28.9 %, W2 (from 4 to 10 cm) — 44.4 %, and W3 (over 10 cm) — 26.7 % of patients. The patients who had laparoscopic hernia repair (LHR) (IPOM‑Plus method — 17 patients, sIPOM — 2 patients) belonged to the LHR group (n = 19). The patients who had open hernia repair (OHR) (IPOM‑Plus method — 7 patients, sublay technique — 11 patients, onlay technique — 8 patients) were added to the OHR group (n = 26). The patients of both groups did not statistically differ by age, nature of a gunshot injury, number of operations before hernia repair, or hernia parameters (all p > 0.05). Results. Postoperative hernias after gunshot wounds are associated with pronounced adhesions in the abdominal cavity. The mean value of the peritoneal adhesion index averaged 11.7 ± 0.7 points (from 5 to 23 points) and did not statistically differ between groups: in the OHR group — 12.4 ± 0.9 points, in the LHR group — 10.8 ± 0.9 points (p = 0.339). Laparoscopic and open hernia repair in injured patients did not differ in the frequency of intraoperative complications — 19.2 % and 15.8 %, respectively (p = 0.766). There were fewer postoperative complications (10.5 % vs. 38.5 %, p = 0.036), a shorter operation duration — 79.5 ± 6.8 min vs. 105.9 ± 4.7 min, p = 0.002, a shorter bed‑day — 8.6 ± 0.4 days vs. 10.8 ± 0.5 days, p = 0.004, and fewer patients required narcotic analgesics within the first two days after surgery (p < 0.05). During the one‑year follow‑up, no hernia recurrence or adhesion signs were detected in the groups. Conclusions. In the structure of postoperative ventral hernias after gunshot wounds to the abdomen, patients with open gunshot injuries predominate and amount to 71.1 % (р = 0.007). Among them, patients with combined and multiple wounds make up 65.6 %, while those with isolated wounds make up 34.4 % (р = 0.112); 33.3 % of patients require more than one operation before hernia repair. The laparoscopic IPOM‑Plus technique should be considered the operation of choice in the treatment of hernias after gunshot wounds to the abdomen. At the same time, for extensive cosmetic defects of the anterior abdominal wall, open operations are preferable, especially the IPOM‑Plus technique. If this is technically impossible, a sublay or onlay hernia repair using the tension‑free allohernioplasty technique should be performed.
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Ratnicka, Izabela, Karolina Kondej, Justyna Jończyk, Magdalena Graczyk, Barbara Chrzanowska, and Jerzy Jankau. "Negative pressure wound therapy as a „bridge” forthe final reconstruction of tissue defect following adegloving injury of the forearm – a case report." Negative Pressure Wound Therapy Journal 6, no. 3 (October 14, 2019): 4–7. http://dx.doi.org/10.18487/npwtj.v6i3.52.
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Degloving injuries are traumatic avulsions usually resulting in large areas of soft tissue defects. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. The complex nature of these injuries requires a patient-oriented multidisciplinary surgical approach and a wide variety of therapeutic options. Negative pressure wound therapy can be of benefit at every stage of the long-lasting treatment.
In this paper, we present a case of a 29-year-old male after an occupational accident with a conveyor belt leading to a degloving injury of the right forearm treated in the Department of Plastic Surgery of the Medical University in Gdańsk.
The use of NPWT, hyperbaric oxygen therapy, dermal regeneration templates, skin grafting, and early rehabilitation resulted in an excellent functional and aesthetic outcome.
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Schuermans, Joke, Lieven Danneels, Damien Van Tiggelen, Tanneke Palmans, and Erik Witvrouw. "Proximal Neuromuscular Control Protects Against Hamstring Injuries in Male Soccer Players: A Prospective Study With Electromyography Time-Series Analysis During Maximal Sprinting." American Journal of Sports Medicine 45, no. 6 (March 1, 2017): 1315–25. http://dx.doi.org/10.1177/0363546516687750.
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Background: With their unremittingly high incidence rate and detrimental functional repercussions, hamstring injuries remain a substantial problem in male soccer. Proximal neuromuscular control (“core stability”) is considered to be of key importance in primary and secondary hamstring injury prevention, although scientific evidence and insights on the exact nature of the core-hamstring association are nonexistent at present. Hypothesis: The muscle activation pattern throughout the running cycle would not differ between participants based on injury occurrence during follow-up. Study Design: Case-control study; Level of evidence, 3. Methods: Sixty amateur soccer players participated in a multimuscle surface electromyography (sEMG) assessment during maximal acceleration to full-speed sprinting. Subsequently, hamstring injury occurrence was registered during a 1.5-season follow-up period. Hamstring, gluteal, and trunk muscle activity time series during the airborne and stance phases of acceleration were evaluated and statistically explored for a possible causal association with injury occurrence and absence from sport during follow-up. Results: Players who did not experience a hamstring injury during follow-up had significantly higher amounts of gluteal muscle activity during the front swing phase ( P = .027) and higher amounts of trunk muscle activity during the backswing phase of sprinting ( P = .042). In particular, the risk of sustaining a hamstring injury during follow-up lowered by 20% and 6%, with a 10% increment in normalized muscle activity of the gluteus maximus during the front swing and the trunk muscles during the backswing, respectively ( P < .024). Conclusion: Muscle activity of the core unit during explosive running appeared to be associated with hamstring injury occurrence in male soccer players. Higher amounts of gluteal and trunk muscle activity during the airborne phases of sprinting were associated with a lower risk of hamstring injuries during follow-up. Hence, the present results provide a basis for improved, evidence-based rehabilitation and prevention, particularly focusing on increasing neuromuscular control of the gluteal and trunk muscles during sport-specific activities (eg, sprint drills, agility drills).
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Roth, Philipp von, Georg N. Duda, Piotr Radojewski, Bernd Preininger, Kristin Strohschein, Eric Röhner, Carsten Perka, and Tobias Winkler. "Intra-Arterial MSC Transplantation Restores Functional Capacity After Skeletal Muscle Trauma." Open Orthopaedics Journal 6, no. 1 (August 10, 2012): 352–56. http://dx.doi.org/10.2174/1874325001206010352.
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Introduction: Skeletal muscle trauma leads to severe functional deficits, which cannot be addressed by current treatment options. Our group could show the efficacy of local transplantation of mesenchymal stroma cells (MSCs) for the treatment of injured muscles. While local application of MSCs has proven to be effective, we hypothesized that a selective intra-arterial transplantation would lead to a better distribution of the cells and so improved physiological recovery of muscle function. Materials and Methodology: 18 female Sprague Dawley rats received an open crush trauma of the left soleus muscle. Autologous MSC were transduced using dsCOP-GFP and 2.5 x 106cells were transplanted into the femoral artery of 9 animals one week after trauma. Control animals (n=9) received a saline injection. Cell tracking, analysis of tissue fibrosis and muscle force measurements were performed after 3 weeks. Results: Systemic MSC-therapy improved the muscle force significantly compared to control (fast twitch: 82.4%, tetany: 61.6%, p = 0.02). The histological analysis showed no differences in the quantity of fibrotic tissue. Histological examination revealed no cells in the traumatized muscle tissue 21 days after transplantation. Conclusions: The present study demonstrated an effect of systemically administered MSCs in the treatment of skeletal muscle injuries. For possible future therapeutic approaches a systemic application of MSCs seems to present an alternative to a local administration. Such systemic treatment would be preferable since it allows functional improvement and possible cellular concentration at injury sites that are not easily accessible
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Cox, James J., C. Geoffrey Woods, and Ingo Kurth. "Peripheral sensory neuropathies – pain loss vs. pain gain." Medizinische Genetik 32, no. 3 (September 1, 2020): 233–41. http://dx.doi.org/10.1515/medgen-2020-2039.
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Abstract Peripheral sensory neurons are afferent neurons that innervate the skin, joints, bones, muscles, and mucosal tissues. By converting different stimuli into action potentials, they transmit signals for the sensing of temperature, touch, pressure, or pain. This review discusses the known Mendelian disorders which affect pain sensing in humans. For painlessness, these disorders can be classified as developmental, neurodegenerative, or functional, where pain-sensing neurons (nociceptors) are present but cannot be activated or produce action potentials. Affected patients suffer from numbness with recurrent injuries, burns, and poorly healing wounds. For Mendelian disorders of excess pain, aberrant overactivity of nociceptors is a hallmark and leads to paroxysmal or continuous pain states. Again, the effect can be functional or, as in small fiber neuropathies, can be accompanied by degeneration of small unmyelinated nerve fibers in the skin. About 20 different genes are known to cause Mendelian pain disorders and the molecules involved are of general interest for human pain research and as analgesic targets. Comprehensive genetic testing is the key to early diagnosis and adaptation of clinical management.
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Shulepov, A. V., I. A. Shperling, Yu V. Yurkevich, N. V. Shperling, M. V. Vinogradov, A. S. Kourov, P. A. Romanov, and S. B. Vasiliev. "Microcirculatory Status and Metabolic Activity of Tissues after Local Administration of Autologous Plasma on the Model of Explosive Soft Tissue Wound in Rats." Kuban Scientific Medical Bulletin 29, no. 4 (August 29, 2022): 53–74. http://dx.doi.org/10.25207/1608-6228-2022-29-4-53-74.
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Background. The possibility of local application of autologous blood plasma (ABP) in soft tissue injuries is currently of particular interest.Objectives. Evaluation of the effects of peri-wound (perifocal) administration of ABP on red blood parameters, microcirculation and oxygen supply of soft tissues of the limb in experimental explosive wound (EW) in rats.Methods. EW was simulated on male Wistar rats (n=146) using a firecracker with a pyrotechnic mixture (patent RU No. 2741238 dated 22.01.2021). Animals were divided into 4 groups: control (2), comparison (1), main (1). The volume of blood loss in explosive wounds was 8 and 15% of the estimated circulating blood volume (CBV) of the animal. Blood was drawn from the rat tail to obtain ABP. 3 hours after the injury, ABP or 0.9% sodium chloride solution was injected intramuscularly into the explosive wound area at a rate of 2.0 ml/kg of animal weight. After 3, 7, 14, 28 days, the number of red blood cells, haemoglobin content, haematocrit were determined in the blood, and microcirculation and oxidative metabolism parameters were determined in the skeletal muscles of the injured area. The data were processed using Microsoft Excel 2013 (Microsoft, USA) and Statistica 10.0 (StatSoft Inc., USA).Results. Blood loss of 8% of the CBV in injured animals did not lead to changes in the quantitative composition of peripheral red blood. After an explosive wound with a blood loss of 15% of the CBV, there was a moderate decrease in the number of red blood cells (from 8.3×1012/l to 6.5×1012/l, p < 0.02), haemoglobin level (from 149.5 g/l to 118 g/l, p < 0.01), haematocrit (from 43.8% to 33.6%, p < 0.01) with recovery by day 7 of observation. The explosive soft tissue wound was characterized by marked post-traumatic microcirculatory disorders irrespective of the amount of blood loss. Perifocal intramuscular administration of ABP in animals with an explosive wound and blood loss of 15% CBV reduced the severity of post-traumatic microcirculatory and oxidative metabolic disorders mainly in the early post-traumatic period, as evidenced by an increase in the perfusion variation coefficient Kv by 1.2–1.3 times (p < 0.05), tissue oxygen consumption U by 20–22% (p < 0.05) and fluorescent oxygen consumption by FPC by 48% (p < 0.05).Conclusion. With an experimental explosive wound of the soft tissues of the thigh in rats, a single early (3 hours after the injury) peri-wound intramuscular administration of ABP reduces the severity of local post-traumatic microcirculatory and metabolic disorders in skeletal muscle.
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Santos-Cuadros, Silvia, Sergio Fuentes del Toro, Ester Olmeda, and José Luis San Román. "Surface Electromyography Study Using a Low-Cost System: Are There Neck Muscles Differences When the Passenger Is Warned during an Emergency Braking Inside an Autonomous Vehicle?" Sensors 21, no. 16 (August 9, 2021): 5378. http://dx.doi.org/10.3390/s21165378.
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Deaths and serious injuries caused by traffic accidents is a concerning public health problem. However, the problem can be mitigated by the Autonomous Emergency Braking (AEB) system, which can avoid the impact. The market penetration of AEB is exponentially growing, and non-impact situations are expected to become more frequent. Thus, new injury patterns must be analysed, and the neck is particularly sensitive to sudden acceleration changes. Abrupt braking would be enough to be a potential risk for cervical spine injury. There is controversy about whether or not there are differences in cervical behaviour depending on whether passengers are relaxed or contract their muscles before the imminent accident. In the present manuscript, 18 volunteers were subjected to two different levels of awareness during an emergency braking test. Cervical muscles (sternocleidomastoid and trapezius) were analysed by the sEMG signal captured by means of a low-cost system. The differences observed in the muscle response according to gender and age were notable when passengers are warned. Gender differences were more significant in the post-braking phase. When passengers were relaxed, subjects older than 35 registered higher sEMG values. Meanwhile, when passengers contract their muscles, subjects who were younger than or equal to 35 years old experienced an increment in the values of the sEMG signals.
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Borse, Ashish R., Hardik K. Bhoir, Nishant V. Gawad, Pritesh R. Jaiswal, and Prof Dipak J. Choudhari. "Design and Fabrication of Rehabilitation Instrument for Upper and Lower Limb." International Journal for Research in Applied Science and Engineering Technology 10, no. 5 (May 31, 2022): 150–58. http://dx.doi.org/10.22214/ijraset.2022.42053.
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Abstract: In today’s world, most of the people have a busy and hectic schedule. They hardly get time to look after their physical health which then affects them in their elderly age or in some cases at a young age. To take care of such physical problems rehabilitation is necessary. Rehabilitation improves and returns functional capacity and quality lifespan of people with physical injuries or disorders. Rehabilitation is not only used for treatment of physical diseases but also in sports industry. It helps in fast recovery of athletes and increases their performance on the field. Our project proposes a design of a rehabilitation instrument for upper and lower limbs. The upper limb rehabilitation instrument is designed for our shoulders and arm. It is designed to provide natural shoulder and arm movements in all directions possible. The lower limb rehabilitation instrument focuses mostly on knee and ankle joints and the EMS (Electro –Muscle Stimulator) is used to send external electric signals to the inactive muscles (muscles which have lost contact with the brain). The external electric signals sent are similar to the signals sent by brain to muscles. These signals help in contraction and expansion of muscles and thus, help in movement of that part of the body. The Rehabilitation instrument we are developing would be user-friendly, compact and budget friendly. Index Terms: Rehabilitation, Upper limb, Lower limb, Shoulder flexion, Shoulder extension, elbow inward rotation, elbow outward rotation, Paralysis, Physiotherapy.
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Krishnan, Kartik G., Thomas Pinzer, Friedemann Reber, and Gabriele Schackert. "Endoscopic Exploration of the Brachial Plexus: Technique and Topographic Anatomy—A Study in Fresh Human Cadavers." Neurosurgery 54, no. 2 (February 1, 2004): 401–9. http://dx.doi.org/10.1227/01.neu.0000103423.08860.a9.
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Abstract OBJECTIVE The indications for and timing of brachial plexus exploration in closed injuries are controversial. The time-consuming surgery proves its worth in some cases, whereas spontaneous regeneration might have been possible in others. The differentiation is difficult, because no investigational method reveals the exact morphological correlates of the nerve lesions. Minimally invasive, direct observation of the structures is a possible solution. Here we describe our surgical technique and the anatomic features of the normal brachial plexus appreciated with the endoscope. METHODS Twenty-one brachial plexus in 11 fresh cadavers were investigated. Endoscopic exploration was performed at the supraclavicular and infraclavicular levels. The method involves insertion of an optic shaft-integrated retractor through a stab wound; retraction of landmark muscles produces a working space, into which other instruments are introduced for dissection. After completion of endoscopic surgery, open dissection was performed to verify the endoscopically identified structures and to assess iatrogenic injuries. RESULTS The omohyoid muscle is a reliable landmark in the supraclavicular region, beneath which the suprascapular nerve can be observed. Following the suprascapular nerve proximally leads to the plexus trunks. Infraclavicular exploration first reveals the axillary artery. The plexus and its nerves are traced around this artery. The anatomic features were constant in all cases, with variations in fat accumulation depending on the corporeal constitution. We detected iatrogenic injuries to the medial circumflex humeral vessels in two cases. No nerve injuries were observed. CONCLUSION The endoscopic technique combined with intraoperative nerve stimulation studies might provide important information on the type of morphological damage in closed brachial plexus injuries and thus might become an important tool for determination of the surgical treatment strategy. Clinical work is under way.
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Belokrylov, N. M., A. N. Belokrylov, I. S. Mukhamadeev, A. S. Denisov, V. N. Kiryakov, and K. I. Gorkovets. "Damage to the major limb vessels with complete disturbance of blood flow in children (results of clinical observations)." Genij Ortopedii 28, no. 1 (February 25, 2022): 7–11. http://dx.doi.org/10.18019/1028-4427-2022-28-1-7-11.
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Background Trauma with associated damage to major arteries and veins typically occurs in adults; reports on such injuries in children are rare. In the organization of their treatment, difficulties are encountered such as formation of teams that must include angiosurgeons. The issues of restoring limb function after injuries with damage to muscle, nerve trunks or complete amputation of the limb remain relevant in children, despite their high abilities to recover. Each particular case in health care institutions has its own characteristics and difficulties for treatment, which was the reason for this communication. Purpose To share our clinical experience and details of providing urgent medical care to injured children with complete impairment of the main arteriovenous blood flow. Materials and methods Three cases with complete damage to major arteries and veins, including their defects, were studied. We describe the details of tactics and features of their surgical management. All patients underwent clinical and laboratory examination; emergency assistance was provided by orthopedic traumatologists and angiosurgeons. All patients were admitted in a state of hemorrhagic shock in stage 2 or 3. Surgical aid was provided in patients with a critical, almost terminal condition. Results On admission 40 minutes after the injury, one patient was diagnosed with a deep cut wound on the posterior surface of the right thigh with damage to the flexor muscles of the leg, femoral artery and vein with their defects up to 3 cm, and a cut wound on the right lower leg. Combined plasty of vascular defects with grafts from the great saphenous vein of the thigh and muscle suture were performed. An excellent result was noted after 3 months. In the second patient, there was an injury with glass in the area of the left axillary fossa with a transverse cut of all nerves, brachial artery and vein, tendons of the biceps and triceps muscles of the shoulder. An excellent result of primary reconstruction was diagnosed 1.5 years later. In the third case, the patient was admitted with a complete traumatic amputation of the right forearm in the lower third due to the use of a mechanical wood splitter; replantation began 5 hours after the cut off. Replantation was successful. It included 4 stages of treatment; the 2nd one was repeated revision and suture of the vessels 16 hours after the onset of thrombosis following the 1st operation. The next two stages included combined plastic surgery of muscles and tendons, first on the extensor and then of the flexor surface of the forearm. Movements appeared 6 months after the injury during the restoration of sensitivity. A completely satisfactory result of treatment was obtained; the patient began to use his hand in everyday life and to write after one year. Conclusion Damage to the main arteriovenous formations requires urgent surgical treatment, aimed at preserving the limb, restoring blood supply, nerve formations, and bone integrity. In complete amputation, restoration of muscle-tendon formations may be postponed for subsequent stages. In primary care, one should consider the need for subsequent, sometimes long-term rehabilitation, the result of which directly depends on the restoration of neurotrophic and sensitive functions.