Stabilization of lumbo-pelvic region and electromyography of the abdominal muscles

It is usual to find athletes that can perform de curl up test easily, but are unable to maintain the stabilization of the low back during the double straight leg lowering (DSLL). In spite of having strong abdominal muscles, its stabilization role seems not to be effective. Thus, the purpose of this study was to verify the relation among individuals with strong abdominal muscles and the ability in perform posterior pelvic tilt (PPT); the ability to stabilize the low back during the DSLL and the eletromyographic activity of the abdominal muscles. Eighteen male subjects (aged 19.27 ± 3.5), without history of muscle skeletal dysfunction, performed both the PPT and DSLL tests. During these tests electromyographic signals of the rectus abdominis (RA), obliquus internus abdominis (01) and obliquus externus abdominis (OE) were recorded, the angle of the hip and the pressure under the low back were measured The results of analyses of variance (ANOVA) show that most volunteers accomplished the PPT test, actively flattening the low back with regular or good quality. However, none of them was able to stabilize the low back during the DSLL test. During the PPT test all abdominal muscle portions analysed were activated without significant differences. In an attempt of maintaining the lumbo-pelvic region stabilized during the DSLL, it was observed a tendency of higher bilateral activation of OE when compared to RA and 01 muscle portions between 70 and 20 degrees of hip flexion.

Nonthermal activation of transient receptor potential vanilloid-1 channels in abdominal viscera tonically inhibits autonomic cold-defense effectors

An involvement of the transient receptor potential vanilloid (TRPV) 1 channel in the regulation of body temperature (T b) has not been established decisively. To provide decisive evidence for such an involvement and determine its mechanisms were the aims of the present study. We synthesized a new TRPV1 antagonist, AMG0347 [(E)-N-(7-hydroxy-5,6,7,8-tetrahydronaphthalen-1- yl)-3-(2-(piperidin-1-yl)-6-(trifluoromethyl)pyridin-3-yl)acrylamide], and characterized it in vitro. We then found that this drug is the most potent TRPV1 antagonist known to increase T b of rats and mice and showed (by using knock-out mice) that the entire hyperthermic effect of AMG0347 is TRPV1 dependent. AMG0347-induced hyperthermia was brought about by one or both of the two major autonomic cold-defense effector mechanisms (tail-skin vasoconstriction and/or thermogenesis), but it did not involve warmth-seeking behavior. The magnitude of the hyperthermic response depended on neither T b nor tail-skin temperature at the time of AMG0347 administration, thus indicating that AMG0347-induced hyperthermia results from blockade of tonic TRPV1 activation by nonthermal factors. AMG0347 was no more effective in causing hyperthermia when administered into the brain (intracerebroventricularly) or spinal cord (intrathecally) than when given systemically (intravenously), which indicates a peripheral site of action. We then established that localized intra-abdominal desensitization of TRPV1 channels with intraperitoneal resiniferatoxin blocks the T b response to systemic AMG0347; the extent of desensitization was determined by using a comprehensive battery of functional tests. We conclude that tonic activation of TRPV1 channels in the abdominal viscera by yet unidentified nonthermal factors inhibits skin vasoconstriction and thermogenesis, thus having a suppressive effect on T b. Copyright © 2007 Society for Neuroscience.

Lumbo-pelvic stability and electromyography of abdominal muscles in ballet dancers

Evaluating the ability to rectify and maintain lumbar adjustment can contribute toward the understanding of the behavior of abdominal muscles and their participation in the stability of pelvic muscles in dancers during the posterior pelvic tilt and double straight leg lowering tests. Nine healthy volunteers (male and female ballet dancers; age mean: 25.9 ±7.37 years) underwent maximal isometric voluntary contraction (MIVC), isometric voluntary contraction at 50% of MIVC, posterior pelvic tilt (PPT) and double straight leg lowering (DSLL) tests. The tests were carried out in a single day, with 3 repetitions each. During the tests, electromygraphic signals of the rectus abdominis, obliquus internus and obliquus externus were recorded. The signal acquisition system was made up of bipolar surface electrodes, electrogoniometer and an electromechanic device (pressure sensor), which were connected to a signal conditioner module. Root mean square values of each muscle during the DSLL and PPT were converted into percentage of activation of 50% MIVC. Lower back pressure was submitted to the same process. ANOVA with repeated measures was performed, with the level of significance set at p < 0.05. The results revealed that all dancers were able to maintain posterior pelvic tilt and there was trend toward greater activation of the bilateral obliquus internus muscle. In an attempt to keep the pelvic region stabilized during DSLL, there was a greater contribution from the obliquus externus muscle in relation to other abdominal muscles.

Mesh cancer: long-term mesh infection leading to squamous-cell carcinoma of the abdominal wall

Purpose: It is recognized that chronic inflammation can cause cancer. Even though most of the available synthetic meshes are considered non-carcinogenic, the inflammatory response to an infected mesh plays a constant aggression to the skin. Chronic mesh infection is frequently the result of misuse of mesh, and due to the challenging nature of this condition, patients usually suffer for years until the infected mesh is removed by surgical excision. Methods: We report two cases of squamous-cell carcinoma (SCC) of the abdominal wall, arising in patients with long-term mesh infection. Results: In both patients, the degeneration of mesh infection into SCC was presumably caused by the long-term inflammation secondary to infection. Patients presented with advanced SCC behaving just like the Marjolin's ulcers of burns. Radical surgical excision was the treatment of choice. The involvement of the bowel played an additional challenge in case 1, but it was possible to resect the tumor and the involved bowel and reconstruct the abdominal wall using polypropylene mesh as onlay reinforcement, in a single stage operation. He is now under adjuvant chemotherapy. The big gap in the midline after tumor resection in case 2 required mesh bridging to close the defect. The poor prognosis of case 2 who died months after the operation, and the involvement of the armpit, groin and mesenteric nodes in case 1 shows how aggressive this disease can be. Conclusion: Infected mesh must be treated early, by complete excision of the mesh. Long-standing mesh infection can degenerate into aggressive squamous-cell carcinoma of the skin. © 2013 Springer-Verlag France.

Alloxan diabetes alters the tensile strength, morphological and morphometric parameters of abdominal wall healing in rats

PURPOSE:To investigate the effects of alloxan diabetes on the abdominal wall healing of rats undergoing laparotomy.METHODS:Ninety-six male Wistar rats weighing between 200 and 300 grams, divided into two groups: non-diabetic group (G1) and another with untreated diabetes (G2). Three months after diabetes induction, the animals underwent a 5cm-long- laparotomy and 5.0 nylon monofilament suture. After the surgery, 12 animals from each group were euthanized on days 4, 14, 21 and 30 corresponding to the moments M1, M2, M3 and M4. In each moment a fragment of the abdominal wall containing the scar was removed for tensile strength measurement, histological and morphometric study. Clinical and biochemical parameters were also analyzed.RESULTS:G2 animals showed parameters compatible with severe diabetes and decreased plasma levels of insulin. The tensile strength in G2 was significantly smaller in M2 and M4, with a tendency to fall in the other two. Through light microscope, diabetic animals showed more difficulty to increase collagen density and contraction. G2 animals showed high cellularity of fibroblasts in later healing moments, with collagen thinning in M2 and M4.CONCLUSION:The abdominal wound healing in untreated diabetic animals was altered and led to a higher incidence of dehiscence and infections.

The intricate role of mast cell proteases and the annexin A1-FPR1 system in abdominal wall endometriosis

Endometriosis is a continuous and progressive disease with a poorly understood aetiology, pathophysiology and natural history. This study evaluated the histological differences between eutopic and ectopic endometria (abdominal wall endometriosis) and the expression of mast cell proteases (tryptase and chymase), annexin A1 (ANXA1) and formyl peptide receptor 1 (FPR1). Ectopic endometrium from 18 women with abdominal wall endometriosis and eutopic endometrium from 10 women without endometriosis were obtained. The endometrial samples were analysed by histopathology, immunohistochemistry and ultrastructural immunogold labeling to determine mast cell heterogeneity (tryptase and chymase positive cells) and the expression levels of ANXA1 and FPR1. Histopathological analysis of the endometriotic lesions showed a glandular pattern of mixed differentiation and an undifferentiated morphology with a significant influx of inflammatory cells and a change in mast cell heterogeneity, as evidenced by a significant increase in the number of chymase-positive cells and endogenous chymase expression. The undifferentiated glandular pattern of endometriotic lesions was positively associated with a marked increase and co-localization of ANXA1 and FPR1 in the epithelial cells. In conclusion, the co-upregulated expression of mast cell chymase and ANXA1–FPR1 system in ectopic endometrium suggests their involvement in the development of endometriotic lesions.

Comparação entre pericárdio bovino preservado em glicerina e malha de poliéster no reparo de falhas da parede abdominal em ratos

OBJETIVO: Comparar uma malha comercial de poliéster com o pericárdio bovino preservado em glicerina na reconstituição de defeitos da parede abdominal. MÉTODOS: Foram utilizados 30 ratos, divididos em dois grupos eqüitativos. Efetuou-se uma excisão retangular de 2,5 x 2 cm, incluindo toda a musculatura abdominal e peritônio. No grupo I a parede abdominal foi reparada com malha de poliéster e no grupo II com pericárdio bovino conservado em glicerina. Os animais foram sacrificados aos 15, 60 e 90 dias de pós-operatório, sendo o local cirúrgico avaliado macroscópica e histologicamente. RESULTADOS: Os animais do grupo I apresentaram aderências mais severas e em maior número quando comparados aos do grupo II; porém, sem comprometimento funcional. A análise histológica revelou incorporação dos tecidos aos implantes, com maior resposta fibroblástica nos animais do grupo I. CONCLUSÃO: A malha de poliéster oferece maior resistência estrutural e resposta fibroblástica mais intensa; contudo, promove grande quantidade de aderências às vísceras abdominais, quando comparada ao pericárdio bovino.

O uso da prótese na correção das hérnias da parede abdominal é um avanço, mas o seu uso indiscriminado, um abuso

The objective is to alert the surgeon about the indiscriminate use of synthetic prosthesis in the correction of inguinal and incisional hernias. The authors provide a brief history of surgery on hernias and a review of the literature, showing the importance of classifying inguinal hernias to fit the type of surgical correction with the defect found, abstaining from treating all hernias, with the same type of surgical procedure. In our opinion, small indirect inguinal hernias (type 1 and 2 of Gilbert) and hernias in women must not, in general, be treated with prostheses. The synthetic material should be reserved for direct and large indirect hernias. Even so, this attitude, besides determining a higher cost for the procedure, can lead to important complications such as infection, rejection, fistula formation, chronic pain, alterations in spermatogenesis and the possibility of carcinogenesis, according to more recent reports. The physiology and anatomy of the abdominal wall should be considered when dealing with incisional hernia corrections, where the surgeon can choose among many techniques to correct those defects, and in selected cases, utilize synthetic material. We conclude that although the use of biomaterials has constituted a great advance in surgery for abdominal wall hernia corrections because they decrease recurrences, and permit treatment of large abdominal hernias, the indiscriminate prosthesis usage is an abuse, and it can determine many serious complications, certainly avoidable with a well indicated non mesh technique .

Estudo comparativo entre a sutura contínua e a com pontos separados na parede abdominal de ratos

O objetivo deste experimento foi comparar a sutura contínua e a sutura com pontos separados no fechamento da parede abdominal. Foram utilizados 48 ratos machos Wistar, submetidos a laparotomia com técnica de diérese padronizada, 24 submetidos a sutura da parede abdominal por técnica contínua e 24 com pontos separados, com fio polidioxanona. No 7º e 14º dia de pós-operatório foram submetidos a eutanásia 12 animais de cada grupo e deles retirados a camada músculo-fascial abdominal envolvendo a cicatriz operatória e dividida aleatoriamente em dois segmentos (cranial e caudal), um para ser submetido a avaliação da força de rotura mediante o uso de tensiômetro e outro para exame histológico, onde foi realizada a avaliação quantitativa de colágeno na linha de sutura. Os resultados encontrados foram analisados estatisticamente. Concluiu-se que no 7º dia de pós-operatório a parede abdominal suturada com pontos separados é mais resistente, porém sem diferenças significantes na quantidade de colágeno, do que a suturada por técnica contínua, e no 14º dia, ambas se equivalem nos dois parâmetros estudados, em ratos.

Morfologia e morfometria dos tipos de fibras do músculo reto abdominal de cadelas (canis familiaris) durante a gestação

The present paper deals with the evaluation of morphological and morphometric alterations of slow-twist (I) and fast-twitch (II) fibers of rectus abdominis muscle of adult female dog during pregestational phase, at 30 and 60 days of pregnancy and at 30 days after the parturition. At the every phases, using the open biopsy technique, muscle samples were collected. The samples were plunged. Histological sections were cut in a microtome. For general morphology, some sections were stained with HE. Subsequent sections were reacted for myofibrillar ATPase (m-ATPase), after alkaline (pH 10.4) and acid (pH 4.4) pre-incubations, in order to identificate type I and II fibers. In the pre-gestational phase, muscle tissue revealed to be composed by fibers with different diameters, presenting polygonal outlines and one or more periphery nuclei. At 30 days of pregnancy, muscle fiber characteristics were similar. At 60 days, in addition to the existence of normal fibers, polymorphic and small diameter fibers were frequent. At 30 days after the parturation, the morphology of muscle fiber were similar to that observed in the pre-gestational phase. In the four phases, type II fiber diameters were lager than type I. The diameters of both fiber types showed a significant reduction in the 30 days phase and a significative increasing at 60 days. The expansion of the abdominal wall during the pregnancy represents a chronic stimulus, induced changes in the morphology and in the fiber type diameters.

O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal

Context - Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. Objectives - To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. Methods - Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. Results - Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. Conclusion - Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity.

Avaliação morfométrica, realizada pelo exame ultrassonográfico, da veia porta, veia cava caudal e aorta abdominal em cães saudáveis de diferentes pesos corpóreos

The diameters and areas of portal vein, caudal vena cava and abdominal aorta are useful measurements in dogs. These values can be easily measured by ultrasonographic exam, and variations of normality can be an important indicator of hepatic or extra-hepatic alterations. This study aimed to measure the diameter and areas of portal vein, caudal vena cava and abdominal aorta in healthy dogs, with normal corporal score, divided in groups according to the body weight, and assess whether the data are influenced by animal weight. Thirty dogs were examined and divided into three groups (Group A: ≤ 10 kg Group B: from 10.1 to 20.0 kg; Group C: ≥ 20.1 kg). To measure the diameters and areas of portal vein, caudal vena cava and abdominal aorta, the animal was kept in left lateral decubitus position and the transducer was placed on the right lateral abdominal wall, at approximately the 10 th or 11 th intercostal space, in the porta hepatis region. The diameters and areas of the portal vein, caudal vena cava and abdominal aorta were significantly lower for dogs in Group A with respect to other groups and the dogs from Groups B and C had similar results with each other. The diameters and areas of the portal vein, caudal vena cava and abdominal aorta may vary with the animal size, and reference values must be specific for small, medium and large dogs.

Resistência da parede abdominal após a remoção cirúrgica dos músculos retos abdominais: estudos experimental em ratos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Morfologia e estereologia do peritônio de paca conservado em solução supersaturada de açúcar a 300% ou glicerina a 98% implantados na parede abdominal de ratos

Pós-graduação em Cirurgia Veterinária - FCAV

Avaliação moroflógica e estereológica comparativa do implante da tela de polipropileno e peritônio de pacas (Cuniculus paca, L. 1766) na correção de defeitos da parede abdominal de ratos Wistar

Pós-graduação em Cirurgia Veterinária - FCAV