Clinical Physiology and Functional Imaging最新文献

Introduction: Laryngopharyngeal reflux (LPR) management guidelines are currently derived from the management of gastroesophageal reflux disease (GORD) which has been shown to be poorly effective in controlling symptoms for these patients. Erythromycin is a macrolide antibiotic that has been used extensively as a prokinetic agent for the gastrointestinal tract. The management of LPR with prokinetics is a novel therapy being investigated with regard to its effectiveness. The purpose of this pilot study was to observe the effect of erythromycin on oesophageal motility with high resolution manometry (HRM) to establish if further study is warranted regarding its utility in management.

Methods: Consecutive patients were retrospectively identified from a prospectively maintained database at a single centre of patients with findings suggestive of LPR who had also undergone HRM. These patients all received lifestyle modification and erythromycin 250 mg BD with repeat HRM after 6 weeks of therapy.

Results: 16 patients met inclusion criteria. Mean age was 56.2 ± 14.9. Mean ineffective swallows were 54.38% ± 41.3% compared with 34.4% ± 35.2% pre and post-erythromycin therapy (p = 0.018). Mean distal contractile integral at baseline was 793.61 ± 854.96 mmHg at baseline increasing to 1347 ± 1094.73 mmHg after erythromycin therapy (p = 0.013). IRP also showed improvement from 8.99 ± 7.58 increasing to 10.93 ± 7.9 mmHg (p = 0.045). Subgroup analysis of patients with ineffective oesophageal motility reinforced above findings as well as increase in the amount of 'normal' peristalsis.

Conclusion: This pilot study shows early evidence that erythromycin improves oesophageal motility. Further study is warranted to explore these findings in more detail.

The present study examined the relationships between trunk tissue distribution, metabolic risk factors, and physical performance in young Japanese individuals using cross-sectional and longitudinal analyses. Thirty-six healthy Japanese men (n = 20, body mass index [BMI]: 20.8 ± 2.0 kg/m²) and women (n = 16, BMI: 19.6 ± 2.0 kg/m²) aged 20-26 years old visited our laboratory twice with an interval of 1 year. The thicknesses of skeletal muscle (MT), subcutaneous adipose tissue (SCAT), and the intra-abdominal cavity (IAT) were assessed by ultrasound imaging and adjusted by body mass^1/3 (BM^1/3). Blood properties related to hepatic function or metabolic syndrome, brachial-ankle pulse wave velocity, hand grip strength, two-step-length/height scores, and sit-and-reach test scores were also measured. As a result of the cross-sectional analysis, significant relationships were observed between SCAT/BM^1/3 and indices of glucose metabolism (HOMA-IR and QUICKI) in men (r = 0.513 and -0.583), and between IAT/BM^1/3 and fasting blood glucose in women (r = 0.524). Longitudinal analyses of women showed that changes (%) in IAT and MT/IAT correlated with % changes in the indices of hepatic function (AST) and glucose metabolism (HOMA-IR and HOMA-β) (r = -0.673 to 0.686). Significant correlations were also observed between MT/IAT and walking ability (two-step-length/height) in cross-sectional and longitudinal analyses of men (r = 0.463 and 0.525). In conclusion, the trunk tissue distribution could be used to detect the early symptoms of metabolic risks and declines in physical performance in young men and women.

Background: Delayed onset muscle soreness (DOMS) is a well-established phenomenon characterized by ultrastructural muscle damage that typically develops following unfamiliar or high-intensity exercise. DOMS manifests with a constellation of symptoms, including muscle tenderness, stiffness, edema, mechanical hyperalgesia, and a reduced range of joint motion. In recent years, the application of blood flow restriction (BFR) has garnered attention for its potential impact on DOMS.

Objective: This study aimed to investigate the effects of different BFR intensities on biomechanical alterations induced by DOMS in healthy individuals.

Design and methods: Thirty participants were split into two groups receiving either 80% or 20% BFR applied during low-intensity resistance exercise following DOMS induction. Pain perception, pressure pain threshold, muscle biometric characteristics, and strength were assessed before DOMS, after DOMS, and following BFR application at 24, 48, and 72 h.

Results: The 80% BFR group experienced faster reductions in pain perception compared to the 20% BFR group. Muscle strength recovery was also statistically faster in the 80% BFR group. No significant differences were observed between groups in muscle stiffness, flexibility, or other mechanical properties.

Conclusions: These findings suggest that BFR, particularly at higher intensities, may alleviate DOMS symptoms and accelerate muscle strength recovery. However, the lack of a control group and limitations in muscle property assessment warrant further research to definitively determine BFR's efficacy in managing DOMS.

Doppler ultrasound can be used to evaluate leg blood flow (Q̇_leg), especially of interest when investigating peripheral vascular limitations in patients with chronic obstructive pulmonary disease (COPD). However, the within-session repeatability, a subdomain of test-retest reliability, of this method remains unknown. This study aimed to provide within-session repeatability estimates of Doppler ultrasound-based Q̇_leg at rest and during single-leg knee-extensor exercise (KEE) in patients with COPD, and to compare these estimates to matched healthy controls. In this case-controlled study, 16 participants with COPD were matched based on sex and age with 16 healthy controls. All participants underwent measurement of Q̇_leg using Doppler ultrasound in a KEE setup at various intensities with the same measurement being performed again separated by 10 s. Smallest real difference (SRD) was lowest at rest in both groups and increased during exercise, reaching values ranging from 164 to 231 mL in COPD and 122–180 mL in the control group. The coefficient of variance (CV) was highest at rest and decreased during exercise to values ranging from 4.0% to 5.0% in COPD and 2.6%–3.2% in the control group. The CV was significantly lower in the control group during 0 watt and exercise at 20% of max watt, but apart from that, no reliability estimates were different between groups. To conclude, Doppler ultrasound showed nearly equal within-session repeatability when evaluating Q̇_leg in COPD patients and healthy individuals with a CV not exceeding 5% during exercise for both groups.