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Heliyon Jun 2024The botulinum toxin is an extremely potent substance that impacts the nervous system. There has been a rise in cases of medical poisoning associated with it,...
BACKGROUND
The botulinum toxin is an extremely potent substance that impacts the nervous system. There has been a rise in cases of medical poisoning associated with it, particularly in the field of plastic and aesthetic procedures, in recent years.
CASE DESCRIPTION
A 51-year-old woman underwent a facial wrinkle reduction procedure with an unauthorized injection of 100 U of botulinum toxin at an unlicensed medical facility six days prior to hospitalization. Over time, her toxicity symptoms intensified, impacting her respiratory muscles, and she did not receive antitoxin treatment. She was concurrently diagnosed with a COVID-19 infection during this period. Nonetheless, she experienced a full recovery 86 days after the injection.
CONCLUSION
Currently, there is no effective antidote for botulism. Nevertheless, the timely administration of antitoxin can contribute to reducing the duration of the illness, alleviating symptoms, and preventing its recurrence. It is essential to recognize that individual responses may vary, and in this instance, the absence of antitoxin treatment did not significantly prolong the course of the disease. Accurate diagnosis of medical poisoning can be based on injection history and clinical symptoms. Early indications like fatigue and dry mouth warrant particular attention, emphasizing the importance of immediate medical intervention. To address emergencies, the Center for Disease Control (CDC) should maintain an accessible supply of antitoxin. Patients with severe poisoning should be hospitalized until their respiratory muscle strength is fully restored.
PubMed: 38933984
DOI: 10.1016/j.heliyon.2024.e32237 -
Heliyon Jun 2024Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast...
A evidence-based approach to selecting post-exercise cryostimulation techniques for improving exercise performance and fatigue recovery: A systematic review and meta-analysis.
RATIONALE
Cryostimulation involves using water environments and low temperatures as intervention mediums, with main methods including CWI (cold water immersion), CWT (contrast water therapy), and WBC (whole-body cryostimulation). Previous systematic reviews focused on the effect of cryostimulation on muscle fatigue and sports performance. However, studies on the selection of different cryostimulation methods and their intervention effects present inconsistent results.
INTRODUCTION
To systematically review and methodologically appraise the quality and effectiveness of existing intervention studies that the effects of various cryostimulation methods, including CWI, CWT, and WBC, on exercise performance and fatigue recovery.
METHODS
Following PRISMA guidelines, we conducted searches in PubMed, Embase, The Cochrane Library, Web of Science, and EBSCO databases to gather randomized controlled trials or self-controlled trials involving CWI/CWT/WBC and their effects on exercise performance or fatigue recovery. The search period ranged from November 2013 to November 2, 2023. Literature screening was performed using EndNote X9.1, and the quality of included studies was assessed using the Cochrane risk of bias assessment tool. Meta-analysis was conducted using RevMan 5.3 software.
RESULTS
This study included a total of 18 articles, included a total of 499 healthy participants, comprising 479 males and 20 females. Among them, participants underwent cryostimulation, including 102 using CWT, using CWI, and 58 using WBC. Compared to the control group, cryostimulation can significantly alleviate muscle pain intensity (SMD -0.45, 95% CL -0.82 to 0.09, P = 0.01). Specifically, CWI significantly reduced muscle pain intensity (SMD = -0.45, 95% CI: 0.820.09, P = 0.01), WBC significantly decreased C-reactive protein levels (SMD = -1.36, 95% CI: 2.350.36, P = 0.008). While, CWT showed no significant differences from the control group in exercise performance and fatigue recovery indicators (P > 0.05).
CONCLUSION
Cryostimulation can significantly reduce muscle pain intensity and perceived fatigue. Specifically, CWI significantly alleviates muscle pain intensity, WBC significantly lowers markers of inflammation caused by fatigue after exercise, in contrast, CWT does not significantly improve exercise performance and fatigue recovery. After exercise, compared with rest, using cryostimulation may have more noticeable benefits for muscle fatigue and muscle pain, with recommendations prioritizing WBC and CWI particularly for addressing inflammation and muscle pain. However, all cryostimulation may have no significant influence on exercise performance.
PubMed: 38933969
DOI: 10.1016/j.heliyon.2024.e32196 -
Sensors (Basel, Switzerland) Jun 2024This study aims to implement a set of wearable technologies to record and analyze the surgeon's physiological and ergonomic parameters during the performance of... (Comparative Study)
Comparative Study
BACKGROUND
This study aims to implement a set of wearable technologies to record and analyze the surgeon's physiological and ergonomic parameters during the performance of conventional and robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures.
METHODS
This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion. Different wearable technologies were used to record the surgeons' posture, muscle activity, electrodermal activity and electrocardiography signal during the surgical practice.
RESULTS
The simulator study involved six surgeons: three experienced (>100 laparoscopic procedures performed; 36.33 ± 13.65 years old) and three novices (<100 laparoscopic procedures; 29.33 ± 8.39 years old). Three surgeons of different surgical specialties with experience in laparoscopic surgery (>100 laparoscopic procedures performed; 37.00 ± 5.29 years old), but without experience in surgical robotics, participated in the experimental model study. The participating surgeons showed an increased level of stress during the robotic-assisted surgical procedures. Overall, improved surgeon posture was obtained during robotic-assisted surgery, with a reduction in localized muscle fatigue.
CONCLUSIONS
A set of wearable technologies was implemented to measure and analyze surgeon physiological and ergonomic parameters. Robotic-assisted procedures showed better ergonomic outcomes for the surgeon compared to conventional laparoscopic surgery. Ergonomic analysis allows us to optimize surgeon performance and improve surgical training.
Topics: Humans; Ergonomics; Robotic Surgical Procedures; Laparoscopy; Adult; Surgeons; Male; Wearable Electronic Devices; Posture; Female; Middle Aged
PubMed: 38931624
DOI: 10.3390/s24123840 -
Nutrients Jun 2024Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically,... (Review)
Review
BACKGROUND
Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance.
METHODS
A systematic review was performed including studies whose participants' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve.
RESULTS
a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time.
CONCLUSIONS
Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.
Topics: Humans; Hand Strength; Muscle Strength Dynamometer; Female; Male; Muscle Fatigue; Aged; Muscle, Skeletal; Muscle Strength; Middle Aged; Sarcopenia; Time Factors; Adult
PubMed: 38931305
DOI: 10.3390/nu16121951 -
Nutrients Jun 2024Physical fatigue (peripheral fatigue), which affects a considerable portion of the world population, is a decline in the ability of muscle fibers to contract effectively...
Bioactive Compounds in Peel Are Potential Candidates for Alleviating Physical Fatigue through a Triad Approach of Network Pharmacology, Molecular Docking, and Molecular Dynamics Modeling.
Physical fatigue (peripheral fatigue), which affects a considerable portion of the world population, is a decline in the ability of muscle fibers to contract effectively due to alterations in the regulatory processes of muscle action potentials. However, it lacks an efficacious therapeutic intervention. The present study explored bioactive compounds and the mechanism of action of peel (CR-P) in treating physical fatigue by utilizing network pharmacology (NP), molecular docking, and simulation-based molecular dynamics (MD). The bioactive ingredients of CR-P and prospective targets of CR-P and physical fatigue were obtained from various databases. A PPI network was generated by the STRING database, while the key overlapping targets were analyzed for enrichment by adopting KEGG and GO. The binding affinities of bioactive ingredients to the hub targets were determined by molecular docking. The results were further validated by MD simulation. Five bioactive compounds were screened, and 56 key overlapping targets were identified for CR-P and physical fatigue, whereas the hub targets with a greater degree in the PPI network were AKT1, TP53, STAT3, MTOR, KRAS, HRAS, JAK2, IL6, EGFR, and ESR1. The findings of the enrichment analysis indicated significant enrichment of the targets in three key signaling pathways, namely PI3K-AKT, MAPK, and JAK-STAT. The molecular docking and MD simulation results revealed that the bioactive compounds of CR-P exhibit a stronger affinity for interacting with the hub targets. The present work suggests that bioactive compounds of CR-P, specifically Hesperetin and Sitosterol, may ameliorate physical fatigue via the PI3K-AKT signaling pathway by targeting AKT1, KRAS, and MTOR proteins.
Topics: Citrus; Molecular Docking Simulation; Network Pharmacology; Molecular Dynamics Simulation; Humans; Fruit; Hesperidin; Plant Extracts; Fatigue; Protein Interaction Maps; Signal Transduction; Phytochemicals
PubMed: 38931288
DOI: 10.3390/nu16121934 -
Cancers Jun 2024Cancer is associated with increased muscle weakness, reduced physical functioning, increased fatigue, but also sleep disturbances, including insomnia, that affect... (Review)
Review
Cancer is associated with increased muscle weakness, reduced physical functioning, increased fatigue, but also sleep disturbances, including insomnia, that affect quality of life (QoL). Physical activity demonstrated benefits on functional capacity, resilience and cancer-related fatigue, but there is a paucity of available data regarding its effects on insomnia in patients with cancer. This systematic review aims to examine the efficacy of exercise levels with insomnia in cancer patients. A systematic search was performed for articles published in PubMed and Cochrane Library databases from December 2013 to February 2023. Included studies explored insomnia during or after cancer treatment, with various exercise interventions. The search identified nine studies included in this review. Due to substantial heterogeneity in the interventions across studies, meta-analysis was not performed. Three studies reported positive results for insomnia reduction by self-reported outcomes under a supervised aerobic exercise program alone or combined with strength training. The present systematic review establishes the role of exercise interventions for reducing cancer-related insomnia. Further studies are indeed warranted to improve the level of evidence for exercise interventions for implementation in the care of cancer-related insomnia.
PubMed: 38927946
DOI: 10.3390/cancers16122241 -
Sports (Basel, Switzerland) Jun 2024(1) Background: The aim of this paper is to analyze the acute effects of different velocity loss (VL) thresholds during a full squat (SQ) with blood-flow restriction...
(1) Background: The aim of this paper is to analyze the acute effects of different velocity loss (VL) thresholds during a full squat (SQ) with blood-flow restriction (BFR) on strength performance, neuromuscular activity, metabolic response, and muscle contractile properties. (2) Methods: Twenty strength-trained men performed four protocols that differed in the VL achieved within the set (BFR0: 0% VL; BFR10: 10% VL; BFR20: 20% VL; and BFR40: 40% VL). The relative intensity (60% 1RM), recovery between sets (2 min), number of sets (3), and level of BFR (50% of arterial occlusion pressure) were matched between protocols. Tensiomyography (TMG), blood lactate, countermovement jump (CMJ), maximal voluntary isometric SQ contraction (MVIC), and performance with the absolute load required to achieve 1 m·s at baseline measurements in SQ were assessed before and after the protocols. (3) Results: BFR40 resulted in higher EMG alterations during and after exercise than the other protocols ( < 0.05). BFR40 also induced greater impairments in TMG-derived variables and BFR10 decreased contraction time. Higher blood lactate concentrations were found as the VL within the set increased. BFR0 and BFR10 showed significantly increased median frequencies in post-exercise MVIC. (4) Conclusions: High VL thresholds (BFR40) accentuated metabolic and neuromuscular stress, and produced increased alterations in muscles' mechanical properties. Low VL could potentiate post-exercise neuromuscular activity and muscle contractile properties.
PubMed: 38921865
DOI: 10.3390/sports12060171 -
Sports (Basel, Switzerland) Jun 2024Cold water immersion (CWI) and percussive massage therapy (PMT) are commonly used recovery techniques in team sports. In particular, despite its wide use, PMT has been...
Cold water immersion (CWI) and percussive massage therapy (PMT) are commonly used recovery techniques in team sports. In particular, despite its wide use, PMT has been scarcely investigated in the literature, especially regarding neuromuscular measures and in comparison with other techniques. This study aimed to evaluate and compare the acute and short-term effects (24 h) of CWI and PMT on muscle strength, contractile properties, and soreness after exercise. A randomized crossover study was performed on sixteen male soccer players (22 years, 20-27) who participated in three experimental sessions involving a fatiguing protocol consisting of a Yo-Yo Intermittent Endurance Test followed by 3 × 10 squat jumps and a wall sit for 30 s, and 12 min of recovery including CWI (10 °C water), bilateral PMT on the anterior and posterior thigh, or passive resting. Outcomes were assessed immediately after the exercise protocol, after the recovery intervention, and at 24 h. Isometric knee extension (IKE) and flexion (IKF) and tensiomyography (TMG) were assessed. Muscle soreness and fatigue were scored from 0 to 10. PMT increased strength after the treatment ( = 0.004) and at 24 h ( = 0.007), whereas no significant differences were found for the other two recovery modalities. At post-recovery, compared to CON, CWI resulted in a longer TMG contraction time ( = 0.027). No significant differences were found at 24 h. Finally, PMT and CWI enhanced muscle soreness recovery compared to passive rest (F = 3.095, = 0.022, η = 0.171). Preliminary results from this study suggest that PMT might improve isometric strength after strenuous exercise, and both PMT and CWI reduce muscle soreness perception, while the effects on TMG parameters remain controversial.
PubMed: 38921861
DOI: 10.3390/sports12060167 -
Sports (Basel, Switzerland) May 2024Stretch-induced force deficit suggests an acute stretch-specific strength capacity loss, which is commonly attributed to EMG reductions. Since those deficits could also...
PURPOSE
Stretch-induced force deficit suggests an acute stretch-specific strength capacity loss, which is commonly attributed to EMG reductions. Since those deficits could also be attributed to general fatigue induced by overloading the muscle, this study aimed to compare stretching with an exhausting calf raise programme to compare strength and stretching responses.
METHOD
This study included 16 participants with different, high-duration calf muscle stretching effects (10, 20, 30 min of stretching) with resistance training (RT) (3 × 12 repetitions) performed until muscle failure, by using a cross-over study design with pre-post comparisons. Strength was tested via isometric plantar flexor diagnostics, while flexibility was assessed using the knee-to-wall test (KtW) and an isolated goniometer test.
RESULTS
Using a three-way ANOVA, RT strength decreases were greater compared to 10 and 20 min of stretching ( = 0.01-0.02), but similar to those of 30 min of stretching. ROM in the KtW showed no specific stretch-induced increases, while only the stretching conditions enhanced isolated tested ROM ( < 0.001-0.008). No RT-related isolated ROM increases were observed.
CONCLUSIONS
The results showed both interventions had similar effects on strength and ROM in the calf muscles. More holistic explanatory approaches such as fatigue and warm-up are discussed in the manuscript and call for further research.
PubMed: 38921839
DOI: 10.3390/sports12060145 -
Journal of Functional Morphology and... Jun 2024This study aimed to compare neuromuscular fatigability of the elbow flexors and extensors between athletes with amputation (AMP) and athletes with spinal cord injury...
This study aimed to compare neuromuscular fatigability of the elbow flexors and extensors between athletes with amputation (AMP) and athletes with spinal cord injury (SCI) for maximum voluntary force (MVF) and rate of force development (RFD). We recruited 20 para-athletes among those participating at two training camps (2022) for Italian Paralympic veterans. Ten athletes with SCI (two with tetraplegia and eight with paraplegia) were compared to 10 athletes with amputation (above the knee, N = 3; below the knee, N = 6; forearm, N = 1). We quantified MVF, RFD at 50, 100, and 150 ms, and maximal RFD (RFDpeak) of elbow flexors and extensors before and after an incremental arm cranking to voluntary fatigue. We also measured the RFD scaling factor (RFD-SF), which is the linear relationship between peak force and peak RFD quantified in a series of ballistic contractions of submaximal amplitude. SCI showed lower levels of MVF and RFD in both muscle groups (all values ≤ 0.045). Despite this, the decrease in MVF (Cohen's d = 0.425, < 0.001) and RFDpeak (d = 0.424, = 0.003) after the incremental test did not show any difference between pathological conditions. Overall, RFD at 50 ms showed the greatest decrease (d = 0.741, < 0.001), RFD at 100 ms showed a small decrease (d = 0.382, = 0.020), and RFD at 150 ms did not decrease ( = 0.272). The RFD-SF decreased more in SCI than AMP ( < 0.0001). Muscle fatigability impacted not only maximal force expressions but also the quickness of ballistic contractions of submaximal amplitude, particularly in SCI. This may affect various sports and daily living activities of wheelchair users. Early RFD (i.e., ≤50 ms) was notably affected by muscle fatigability.
PubMed: 38921644
DOI: 10.3390/jfmk9020108