European Journal of Translational Myology <p>The <strong>European Journal of Translational Myology</strong> (formerly known as <em>Basic and Applied Myology</em>) is the European reference forum for Translational Myology. The <strong>European Journal of Translational Myology</strong>&nbsp;is a multifaceted journal studying myology from various perspectives: basic, cellular and molecular, genetic, clinical, and translational proper.</p> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> (Francesca Savio) (Tiziano Taccini) Tue, 07 Apr 2020 00:00:00 +0000 OJS 60 2020PMD, 30-years of Translational Mobility Medicine at the time of COVID-19 outbreak: Last-minute forewords from the editor <p>In the autumn of 2019, the organizers of the 2020 Padua Muscle Days planned an intense program, which was to be held from March 18 to March 21, 2020. The program included eight Scientific Sessions to occur over three full days at either Padova University or the Hotel Augustus on Euganei Hills (Padova), Italy. Abruptly, however, in early January the Coronavirus COVID-19 outbreak started in China and changed the world perspectives and expectations. In Italy, it started in Lombardy and Veneto, two main industrial areas of the country with intense connections and interchanges of people and commercial activities with China. Indeed, the virus was first isolated from a couple of Chinese tourists, who inadvertently incubated the infection during their visit to many towns in Italy. Within the following two weeks, the epidemic had the first Italian cases and victims in an area south of Milan and in a Village of the Euganei Hills (Vo Euganeo, Padova). The village was immediately quarantined, but it was too late. The virus had escaped the area. Thus, it was a mandatory, though difficult decision (made even before the Italian National Government posted rules to be followed to decrease spread of the infection), to post-pone the Padua Muscle Days meeting from 18-21 March, 2020 to 25-28 November, 2020. Luckily, the vast majority of organizers, chairs, speakers, and attendees accepted the decision and have assured their presence in late November, despite the coincidence with the Thanksgiving holiday in the US. Currently, the only changes in the program are the new dates; however, it is difficult to forecast the future. Anyhow, the rationale of the decision to post-pone 2020PMD was reinforced by the actions of many organizers of international events. One of the most recent examples is the March 6, 2020 decision of the leaders of the Experimental Biology Host Societies to cancel Experimental Biology (EB) 2020, set to take place April 4–7 in San Diego, California, USA. All these active civil responses to world dangers are mandatory to avoid those military responses that are easy to start, but provide the worst results. How do we not lose half of the 2020 year? The option is to try to achieve some of the goals of the meeting by long-distance communications. Thus, the Collection of Abstracts will be, as originally planned, e-published in this 30(1) 2020 Issue of the European Journal of Translational Myology (EJTM) together with the many EJTM Communications submitted by speakers and attendees of the 2020PMD. We may also start the process that will implement EMMA, the European Mobility Medicine Association, by circulating a proposal and inviting comments.</p> Ugo Carraro ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Thirty years of translational research in Mobility Medicine: Collection of abstracts of the 2020 Padua Muscle Days <p>More that half-century of skeletal muscle research is continuing at the Padua University (Italy) under the auspices of the Interdepartmental Research Centre of Myology (CIR-Myo), the European Journal of Translational Myology (EJTM) and recently also with the support of the AandC M-C Foundation for Translational Myology, Padova, Italy. The Volume 30 (1), 2020 of EJTM opens with the collection of abstracts of the conference “2020 Padua Muscle Days: Mobility Medicine 30 years of Translational Research”, an International Conference, that will be held March 18-21, 2020 in Euganei Hills and Padova (Italy). These abstracts are excellent examples of translational research and of the multidimensional approaches that are needed to classify and manage in both the acute and chronic phases Mobility Medicine diseases that span from neurologic, metabolic, traumatic syndromes to the biological process of aging. Their excellent contents grant the high scientific profiles of researchers and clinicians who are eager to present their results at the PaduaMuscleDays. A series of EJTM Communications will add to this preliminary evidence.</p> <p>&nbsp;</p> <p><strong><a href="" target="_blank" rel="noopener">Here</a></strong> you can find the Announcement details.</p> Ugo Carraro ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 The Arianna thread: the matching of S-100 family with the RyR’s muscle receptor <p>The functional state of RyR depends on the intracellular calcium concentration and on the oxidation state of its protein components in some particular sites and of some sentinel amino acids. In addition to the regulation of the RyR channel by exogenous substances (caffeine, ryanodine), ions environmental situations (oxidative state), other components, such as some endogenous proteins present in the sarcoplasm and/or in muscle membranes that are able to determine changes in Ca2+ channel activity. Among these, calmodulin and S-100A could determine modifications in the status of RyR channel in the skeletal muscle. The currently available data can be justified the use of a simplified S-100/CaM and RyR interaction model for the regulation of Ca2+ release in skeletal muscle. Under resting conditions, the CaM/S100A1 binding domain on RyR1 is predominantly dependent on S100A1. Vice versa when the intracellular Ca2+ concentration becomes high as well as during repetitive (tetanus) stimulation, the Ca-CaM bond becomes dominant, shifting S100A1 from RyR1 and promoting channel inactivation. This may be one of the mechanism of muscle fatigue.</p> Stefania Fulle, Silvia Belia, Giorgio Fanò Illic ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Neurohypophyseal hormones and skeletal muscle: a tale of two faces <p>The neurohypophyseal hormones vasopressin and oxytocin were invested, in recent years, with novel functions upon striated muscle, regulating its differentiation, trophism, and homeostasis. Recent studies highlight that these hormones not only target skeletal muscle but represent novel myokines. We discuss the possibility of exploiting the muscle hypertrophying activity of oxytocin to revert muscle atrophy, including cancer cachexia muscle wasting. Furthermore, the role of oxytocin in cardiac homeostasis and the possible role of cardiac atrophy as a concause of death in cachectic patients is discussed.</p> Alexandra Benoni, Alessandra Renzini, Giorgia Cavioli, Sergio Adamo ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Anti-aging and anti-tumor effect of FPP® supplementation <p>The beneficial effect of FPP® as antioxidant is known. Here we summarize recent data supporting future implementation of FPP® in tumor treatment and in controlling aging at the molecular level. We first showed that oral FPP® is able to control tumor growth and with inducing a potent and systemic anti-oxidant reaction (i.e. reduced ROS and increased GSH and SOD-1). Then we showed that FPP® is able to markedly increase the body anti-oxidant reaction together with increasing both telomerase activity in the blood and the telomeres length in bone marrow and ovary of treated mice as compared to the untreated mice.</p> Mariantonia Logozzi, Rossella Di Raimo, Davide Mizzoni, Stefano Fais ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Inhibition of Activin/Myostatin signalling induces skeletal muscle hypertrophy but impairs mouse testicular development <p>Numerous approaches are being developed to promote post-natal muscle growth based on attenuating Myostatin/Activin signalling for clinical uses such as the treatment neuromuscular diseases, cancer cachexia and sarcopenia. However there have been concerns about the effects of inhibiting Activin on tissues other than skeletal muscle. We intraperitoneally injected mice with the Activin ligand trap, sActRIIB, in young, adult and a progeric mouse model. Treatment at any stage in the life of the mouse rapidly increased muscle mass. However at all stages of life the treatment decreased the weights of the testis. Not only were the testis smaller, but they contained fewer sperm compared to untreated mice. We found that the hypertrophic muscle phenotype was lost after the cessation of sActRIIB treatment but abnormal testis phenotype persisted. In summary, attenuation of Myostatin/Activin signalling inhibited testis development. Future use of molecules based on a similar mode of action to promote muscle growth should be carefully profiled for adverse side-effects on the testis. However the effectiveness of sActRIIB as a modulator of Activin function provides a possible therapeutic strategy to alleviate testicular seminoma development.</p> Danielle Vaughan, Olli Ritvos, Robert Mitchell, Oliver Kretz, Maciej Lalowski, Helge Amthor, David Chambers, Antonios Matsakas, Arja Pasternack, Henry Collins-Hooper, Randy Ballesteros, Tobias B. Huber, Bernd Denecke, Darius Widera, Abir Mukherjee, Ketan Patel ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Behavior of oxygen saturation and blood filling in the venous capillary system of the biceps brachii muscle during a fatiguing isometric action <p>The objective of the study is to develop a better understanding of the capillary circulation in contracting muscles. Ten subjects were measured during a submaximal fatiguing isometric muscle action by use of the O2C spectrophotometer. In all measurements the capillary-venous oxygen saturation of hemoglobin (SvO<sub>2</sub>) decreases immediately after the start of loading and levels off into a steady state. However, two different patterns (type I and type II) emerged. They differ in the extent of deoxygenation (–10.37 ±2.59 percent points (pp) vs. –33.86 ±17.35 pp, P = .008) and the behavior of the relative hemoglobin amount (rHb). Type I reveals a positive rank correlation of SvO<sub>2</sub> and rHb (ρ = 0.735, P &lt;.001), whereas a negative rank correlation (ρ = –0.522, P &lt;.001) occurred in type II, since rHb decreases until a reversal point, then increases averagely 13% above the baseline value and levels off into a steady state. The results reveal that a homeostasis of oxygen delivery and consumption during isometric muscle actions is possible. A rough distinction in two types of regulation is suggested.</p> Silas Dech, Frank Bittmann, Laura Schaefer ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 The effectiveness of two different multimodal training modes on physical performance in elderly <p>The study compared the effect of 12-week multimodal training programme performed twice a week at the regular exercise facility (REF) with the 12-week multimodal training programme performed three times per week as a part of the research programme (EX). Additionally, the study analysed how the experimental training programme affect the physical performance of cognitive healthy and mild cognitive impaired elderly (MCI). The REF training group included 19 elderly (65.00±3.62 years). The experimental training programme combined cognitively healthy (EXH: n=16; 66.3±6.42 years) and age-matched individuals with MCI (EXMCI: n=14; 66.00±4.79 years). 10m maximal walking speed (10mMWS), Five Times Sit-to-Stand Test (FTSS), maximal and relative voluntary contraction (MVC and rel. MVC) were analysed. The REF group improved in 10mMWS (t=2.431, p=.026), the MVC (t=-3.528, p=.002) and relative MVC (t=3.553, p=.002). The EXH group improved in FTSS (t=5.210, P=.000), MVC (t=2.771, p=.018) and relative MVC (t=-3.793, p=.004). EXMCI improved in FTSS (t=2.936, p=.012) and MVC (t=-2.276, p=.040). According to results, both training programmes sufficiently improved walking speed and muscle strength in cognitively healthy elderly. Moreover, the experimental training programme improved muscle strength in MCI elderly.</p> Ľudmila Oreská, Lucia Slobodova, Matej Vajda, Adriana Kaplánová, Veronika Tirpáková, Ján Cvečka, Gabriel Buzgó, Jozef Ukropec, Barbara Ukropcová, Milan Sedliak ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 The importance of sonographic evaluation of muscle depth and thickness prior to the ‘tiny percutaneous needle biopsy’ <p>Biopsy of human skeletal muscle tissue is a widely used method in many research studies, where ‘the tiny percutaneous needle biopsy’ (TPNB) is one of the relatively simplest and safest procedures currently available. By using and contrasting ultrasound images of vastus lateralis of young and elderly subjects, this work highlights further the safety aspects of TPNB and stresses the importance of prior ultrasound evaluation of muscle depth and thickness in order to prevent wrong muscle group or tissue sampling in subsequent laboratory analyses.</p> Tereza Jandova, Danilo Bondi, Vittore Verratti, Marco Narici, Michal Steffl, Tiziana Pietrangelo ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Gender difference of aging performance decay rate in normalized Masters World Records of Athletics: much less than expected <p>Aging behaviours differ in females and males. Females are weaker but survive longer. We report gender decay of skeletal muscle performance by comparing World Records of Master athletes. Master athletes compete in age groups of 5 years till 100 years. The Master World Records are lists of 16 data that, after normalization, show trends of aging decline of muscle performance indicating only minimal gender differences in the process. All trend-lines tend to zero at about 110 years. Since hormons poorly influence aging performance decay, other fundamental bioregulators, e.g., those of cell energy metabolism, seems to be relevant.</p> Paolo Gava, Walter Giuriati, Barbara Ravara ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Sport medicine and safety at work <p>As humans become more and more sedentary, physical capacities also become lost along with aerobic fitness, muscular strength, coordination, and action-reaction time. This situation can lead to not only absence from work (back pain is the most common reason in European Union (EU), but especially, workplace accidents. In this article, we want to combine our experience with exercise physiology and physical capacities with our medical work in a critical environment. We tested over ten years, the fitness profile of 1200 Italian Alpine Soldiers, and gave them a scientific training program. We obtained a trained and homogeneous team (homogeneous, in terms of aerobic and anaerobic fitness). Here, we detail changes to aerobic and anaerobic fitness resulting because of soldiers’ participation in a training program. We consider this method necessary for safe work in a critical environment.</p> Paola V. Gigliotti, Alexander Piratinskij, Saadsaoud Foued, Igor Diemberger, Rezhna Adil Rasheed, Giorgio Fanò-Illic, Francesco Coscia ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 The role of the styloid apophysis of the temporal bone in the biomechanics of the tongue, mandible, hyoid system: a case study <p>Temporomandibular disorders are characterized by ear pain, tinnitus, difficulty in chewing, dysphagia and also dizziness, cervical limitation of range of movement (ROM) and other less common disorders. Numerous recent studies associate the presence of these signs and symptoms with an elongated styloid apophysis, as in the case of Eagle syndrome. The purpose of this clinical case is to support the thesis of a common syndrome that temporomandibular joint (TMJ) disorders with an elongated styloid process affirming the relationship between temporal bone, mandibule, hyoid bone and tongue. The patient was a 57-year-old woman who reported having ear algia and tinnitus all on the right side with difficulty chewing accompanied by odynophagia and dysphagia of solid and liquid foods, as well as cervical disorders. Computed tomography (CT) scans of the neck showed elongation and ossification of the styloid processes of the temporal bone. Magnetic resonance imaging (MRI) showed an anterior right dislocation of the TMJ articular disc. The patient presented classic symptoms of temporomandibular disorders, with the primary examinations showing an anterior right dislocation of the articular disc of the TMJ, as well as a longer styloid process on the same side. We therefore suggested that, in this case report, TMJ disorders may be associated with a longer styloid process on the same side.</p> Giuseppe Messina ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Correlation between ETFDH mutations and dysregulation of serum myomiRs in MADD patients <p>Multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare fatty acids oxidation disorder which is often associated with deficiency of electron transfer flavoprotein dehydrogenase (ETFDH). In this study we reported clinical features and evaluation of expression profile of circulating muscle-specific miRNAs (myomiRs) in two MADD patients carrying different ETFDH gene mutations. Patient 1 was a compound heterozygote for two missense mutations. She showed a late onset MADD clinical phenotype and a significant increase of serum myomiRs. Patient 2, carrying a missense and a frameshift mutation, displayed early onset symptoms and a slight increase of some serum myomiRs.</p> Sara Missaglia, Valentina Pegoraro, Roberta Marozzo, Daniela Tavian, Corrado Angelini ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Machine learning predictive system based upon radiodensitometric distributions from mid-thigh CT images <p>The nonlinear trimodal regression analysis (NTRA) method based on radiodensitometric CT images distributions was developed for the quantitative characterization of soft tissue changes according to the lower extremity function of elderly subjects. In this regard, the NTRA method defines 11 subject-specific soft tissue parameters and has illustrated high sensitivity to changes in skeletal muscle form and function. The present work further explores the use of these 11 NTRA parameters in the construction of a machine learning (ML) system to predict body mass indexand isometric leg strength using tree-based regression algorithms. Results obtained from thesemodels demonstrate that when using an ML approach, these soft tissue features have a significant predictive value for these physiological parameters. These results further support the use of NTRA-based ML predictive assessment and support the future investigation of other physiological parametersand comorbidities.</p> Marco Recenti, Carlo Ricciardi, Kyle Edmunds, Magnus K. Gislason, Paolo Gargiulo ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Speed-power based training in the elderly and its potential for daily movement function enhancement <p>Resistance exercise is widely recommended strategy to improve functional ability and quality of life of the elderly. Novel resistance exercises approaches, such as flywheel exercise have recently emerged as superior alternatives to traditional methods. Eccentic exercise methods are well documented to elicit different and often the more pronounced effect on physical ability and function of the elderly. By reviewing the relevant scientific literature, we found that only limited studies have investigated the effects of flywheel exercise in the elderly, however, the results are very promising. Thus, more research is desired to explore the effect of flywheel exercise type in elderly individuals.</p> Nejc Šarabon, Darjan Smajla, Žiga Kozinc, Helmut Kern ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Kinematic bidimensional analysis of the propulsion technique in wheelchair rugby athletes <p>Wheelchair rugby is a sport ideated for individuals with cervical spinal cord injury (CSCI) which is extremely important for maintaining their neuromuscular abilities and improving their social and psychological wellbeing. However, due to the frequent changes in direction and speed it considerably stresses the players’ upper limbs. 13 athletes have undergone two sports-related tests on an inertial drum bench and several kinematic parameters have been registered. Most athletes use a semi-circular pattern which is considered protective for the upper limb. With increasing speed, range of motion (ROM) increases. Release angles increment and contact angles reduce, displacing the push angle forward to increase speed. Instead, the more anterior late push angle used to increase velocity is a factor which further loads the shoulder joint. However, other factors affecting propulsion technique, such as posture and wheelchair set up should be studied to further reduce loading on the upper limb.</p> Sara Maria Franchin, Federico Giordani, Michele Tonellato, Michael Benazzato, Giuseppe Marcolin, Paolo Sacerdoti, Francesco Bettella, Alfredo Musumeci, Nicola Petrone, Stefano Masiero ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Using high density EEG to assess TMS treatment in patients with schizophrenia <p>We present preliminary results from the ongoing study entitled “Icelandic AVH-TMS” which aim is to study the effectiveness of repetitive transcranial magnetic stimulation (rTMS) treatment for patients with schizophrenia and with persistent auditory verbal hallucinations (AVH) using symptoms and psychometric scales and high-density EEG system (256 channels). The aim of the present work was to describe cortical topography of the auditory evoked responses like P50 and N100-P300 complex in healthy participants and patients with schizophrenia and to define a robust methodology of signal quantification using dense-array EEG. Preliminary data is shown for three healthy participants and three patients in baseline conditions and for two patients we show the results recorded before and after 10 days rTMS treatment. Our results show differences in sensory gating (P50 suppresion) and a stronger N100-P300 response to rare audio stimulus after the treatment. Moreover we show the value of assessing brain electrical activity from high-density EEG (256 channels) analyzing the results in different regions of interest. However, it is premature and hazardous to assume that rTMS treatment effectiveness in patients with AVH can be assessed using P50 suppression ratio.</p> Sara Marcu, Elena Pegolo, Eysteinn Ívarsson, Aron D. Jónasson, Viktor D. Jónasson, Romain Aubonnet, Paolo Gargiulo, Ovidiu Constantin Banea ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Magnetic resonance imaging based muscle strain rate mapping during eccentric contraction to study effects of unloading induced by unilateral limb suspension <p>Age- and disuse- related loss of muscle force is disproportionately larger than the loss of muscle mass. Earlier studies reported that comparing concentric and eccentric contractions, there is a significant age-related decrease in force only in concentric contractions. Magnetic Resonance Imaging enables mapping of muscle deformation and has been used to study isometric but not eccentric contractions. We report MRI based strain rate mapping of the medial gastrocnemius in subjects pre- and post-unloading induced by Unilateral Limb Suspension. In contrast to isometric contraction, no difference in strain rate indices were observed post-unloading, in conformance with preserved force during eccentric contractions.</p> Usha Sinha, Vadim Malis, Robert Csapo, Marco Narici, Shantanu Sinha ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Can MRI quantify the volume changes of denervated facial muscles? <p>Could manual segmentation of magnetic resonance images be used to quantify the effects of transcutaneous electrostimulation and reinnervation of denervated facial muscle? Five patients with unilateral facial paralysis were scanned during the study while receiving a daily surface electrostimulation of the paralytic cheek region, but also after reinnervation. Their facial muscles were identified in 3D (coronal, sagittal, and axial) and segmented in magnetic resonance imaging (MRI) data for in total 28 time points over the 12 months of study. A non-significant trend of increasing muscle volume were detected after reinnervation. MRI is a valuable technique in the facial paralysis research.</p> Valeria Mastryukova, Dirk Arnold, Daniel Güllmar, Orlando Guntinas-Lichius, Gerd Fabian Volk ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Ultrasound imaging of a scar on the knee: Sonopalpation for fascia and subcutaneous tissues <p>Persistent scar pain associated with healed surgical incisions after a trauma is a common and potentially debilitating type of fascial pain. At present, there is no universally effective treatment for persistent surgical or post-trauma scar pain. Herein we describe the successful objective diagnosis of debilitating scar pain by Ultrasound (US) imaging. The sonopalpation of the fasciae and subcutaneous tissues seems to be relevant to diagnose the real cause of the pain and why not to monitor the treatment.</p> Carmelo Pirri, Antonio Stecco, Caterina Fede, Raffaele De Caro, Carla Stecco, Levent Özçakar ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Comparison of Spasticity in Spinal Cord Injury and Stroke Patients using Reflex Period in Pendulum Test <p>Spasticity is a motor impairment present in patients with both stroke and spinal cord injury. In this research, the results from the Wartenberg pendulum test, performed on stroke and spinal cord injury patients using goniometers and electromyogram recordings of the quadriceps, were reviewed and a new parameter to quantify spasticity was extracted. The Reflex Period (RP) of the pendulum test was defined as the time span from 50% of the maximum velocity of the leg swing to the activation of muscle contraction in the quadriceps, determined from the EMG. The results suggest that the reflex period in stroke patients is generally shorter than in those suffering from spinal cord injury.</p> Kristjana Kristinsdottir, Gigja Magnusdottir, Belinda Chenery, Vilborg Gudmundsdottir, Halla Kristin Gudfinnsdottir, Halldor Karason, Gudbjorg Ludvigsdottir, Thordur Helgason ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Clinical guidelines for traumatic brain injuries in children and boys <p>The main aim of management of pediatric traumatic brain injury (TBI) &nbsp;is to hold normal ranges for optimizing the most proper outcomes. However, for providing physiologic requirements of an injured brain it is very important to enhance the quality of recovery and minimize secondary injury. Within this study it is tried to regulate the most proper guidelines for management of pediatric TBI. A comprehensive research was conducted on some biomedical and pharmacological bibliographic database of life sciences such as PubMed, EMBASE, MEDLINE, LILACS database, global independent network of Cochrane, Science Direct and global health library of Global Index Medicus (GIM). By referencing these databases, a universal literature review was carried out through combining various recent studies in terms of pediatric traumatic brain injury, epidemiology, management and related clinical guidelines in accordance with various related articles published from 2000 to 2019 which could cover this area of recommendations.Based on the main objective of this study for providing a comprehensive review around available clinical practice guidelines for more precise management of TBI. These guidelines can be administered especially for pediatric population which possibly could improve the quality of clinical practice guidelines for TBI. The guidelines of TBI could be applied worldwide in various traditional demographic and geographic boundaries which could affect pediatric populations in various ranges of ages. Accordingly, advances in civil foundation and reforms of explicit health policy could decrease the pediatric TBI socioeconomic burdens.</p> Hojjat Derakhshanfar, Elham Pourbakhtyaran, Samane Rahimi, Samira Sayyah, Zahra Soltantooyeh, Fereshteh Karbasian ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 A narrative review on the management of Acute Heart Failure in Emergency Medicine Department <p>The main urgent symptom presented to anemergency departmentis acute heart failure (AHF). In that considerable risksof morbidity and mortality, it isimportant to plan precision medicine to achieve the most suitable outcomes. The object of this review is to provide a summary of contemporary management proceduresof emergency medicine in a department of acute heart failure. Heart failure could be presented with a broad range of symptoms, in particular a sudden worsening of those of Chronic Obstructive Pulmonary Disease. The treatment should focus on acute and chronic underlying disorders with instructions focusing on haemodynamics and blood pressure status. Treatment of patients suffering with worsening symptoms of AHF mainly focuses on intravenous diuretics. In emergency situations, patients suffering with AHF with low blood pressure must receive emergency consultation and a primary fluid bolus therapy (range 250–500 mL) followed by inotropic therapy with or without antihypotensive agents. For treatment of severe heart failure and cardiogenic shock in patients treated with noradrenalin, when blood pressure support is required, a direct-acting inotropic agent, dobutamine, could be applied effectively. When non-invasive positive pressure ventilation is needed, suppliers must track for any possibility of sudden worsening, <em>i.e</em>., for acute de compensated heart failure. When cardiac output is high the disorder could be treated with vasopressor.</p> Amin Saberinia, Ali Vafaei, Parvin Kashani ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Clinical guidelines on pediatric asthma exacerbation in emergency department, a narrative review <p>Asthma has been known as a prevalent chronic-type inflammatory disease in children, because of their narrower respiratory airways. The present study aimed to identify guidelines for children asthma treatments. Extensive research was conducted on biomedical and pharmacological bibliographic database PubMed, EMBASE, MEDLINE, LILACS database, global independent network of Cochrane, Science Direct and global health library of Global Index Medicus. A comprehensive literature review was carried out using the terms Pediatric Asthma, epidemiology, management, and related clinical guidelines published from 2000 to 2019. After the primary assessment, quick diagnosis, clinical practice guidelines are useful tools for proper management of pediatric Asthma. By setting proper guidelines for this particular population, a higher improvement in quality of management of of pediatric Asthma is expected. Given the differences between the recommendations arisen by BTS/SIGN and NICE guidelines, critical comparison of the evidence-base guidelines provide suggestions that have more in common than what might seems at the first glance. The analysis of the variations presented in the present article will assist clinicians to make accurate decisions regarding their patients.</p> Shabahang Jafarnejad, Hamidreza Khoshnezhad Ebrahimi ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Investigation of the association between metabolic syndrome and breast cancer patients <p>One of the most serious cancers among women is breast cancer. This disease is the first reason for the death of women due to cancer. Increasing breast cancer risk may associate with many factors including genetic, reproductive factors, people's lifestyle, metabolic syndrome (MS) and hormones. MS has been known as a risk factor for prostate, pancreatic, breast and colorectal cancers. The purpose of this review is to identify the relationship between MS components and breast cancer individually. This study was performed by researching electronic database references including PubMed, Google Scholar, CINAHL ProQuest, and web of science through 2019. The effect of MS with its components and breast cancer was reported in many studies.<br>Nevertheless, a thorough understanding of the mechanisms involved remains a challenge.<br>However, one can take several preventive measures, including a proper diet, which is one of the most important determinants of metabolic status. Also, general preventive recommendations are including reducing alcohol consumption, red meat and total fat in the diet. Moreover, increasing the consumption of vegetable and fruit reduce the proportion of MS patients to improve the outcome of breast cancer patients.</p> Delaram Eskandari, Niloofar Khodabandehloo, Abbas Gholami, Hosein Samadanifard, Alireza Hejrati ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Human privacy respect from viewpoint of hospitalized patients <p>Patient-oriented care is for nurses a holistic science, of which the patient's privacy respect is an essential part. The aim of this study was to determine the hospitalized patients' viewpoints concerning their privacy respect. This descriptive, analytic and cross-sectional research administered to 370 patients that were selected through a random-stratified sampling in an educational hospital in the Khorramabad in Iran in 2013-2014. Data were collected by a questionnaire about respect of the patient's privacy by hospital staff, including physical-corporeal, psycho-mental, and informational domains. Data were gathered through constructed interviews and analyzed with Independent t-test, One-way ANOVA and Pearson correlation statistical tests. The privacy of patients and its physical-corporeal and informational domains were sometimes observed, while the psycho-mental domain was often respected. The privacy respect was significantly lower for male patients (p=0.000) in the emergency department, and with patients who spoke with a local accent (p= 0.016). It seems necessary to train the health care providers to have more respect in terms of patient physical-corporeal and informational privacy, to observe male patient privacy and to use all interpersonal communication skills when dealing with non-Persian language patients. Furthermore, it seems necessary to revise the structure and design of emergency departments in order to protect the privacy of the patients.</p> Fatemeh Valizadeh, Seyyedeh Fatemeh Ghasemi ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 A randomized controlled trial on Aspirin and complex regional pain syndrome after radius fractures <p>Complex regional pain syndrome (CRPS) is often diagnosed in patients who are recovered with surgery or injury. CRPS is usually diagnosed in patients recovering from distal radius fractures. The aim of study was the effects of aspirin in prevention of the complex regional pain syndrome (CRPS) following a fracture of distal radius. In a double-blind, randomized controlled trial, 91 patients with unilateral extra-articular distal radius fractures were randomly allocated to receive either placebo (PLA) or 500 mg of aspirin (ASA) daily for 7 days. The effect of aspirin on the occurrence of CRPS was evaluated. The patients were assessed clinically and radiographically in the second, fourth and twelfth weeks by a physician who was unaware of the treatment allocation. Ninety-one patients (ASA, n=44; PLA, n=47) were enrolled in the study. The prevalence of CRPS in all patients was 16.5%. The prevalence of CRPS in the aspirin group was lower (13.6%) than the placebo group (19.1%), but this difference was not statistically significant. The only significant difference was the lower rate of regional osteoporosis seen in the radiographs of aspirin group. Mean age was significantly higher in the patients with CRPS. Also, comminuted distal radius fractures (A3-type) were significantly more common in the patients with CRPS. Administration of aspirin in patients with a distal radius fracture was associated with a lower incidence of CRPS, but, not statistically significant. Further investigations needs to be done with a larger sample size, longer follow-up period and multi-center design.</p> Amir Sobhani Eraghi, Amir Khazanchin, Nima Hosseinzadeh, Alireza Pahlevansabagh ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000 Wound healing effects of Persian walnut (Juglans regia L.) green husk on the incision wound model in rats <p>Walnut green husk (WGH) has been mentioned as a wound-healing agent in traditional Iranian medicine. Although previous studies indicated that WGH is a good source of pharmaceutical ingredients, they did not assess its wound healing activity; so the present study set out the scientific validation of the wound healing potential of the Persian walnut. Total phenolic content, reducing power, DPPH, and nitric oxide scavenging activity of aqueous ethanol extract of WGH was evaluated. Forty-eight male Wistar albino rats were divided into four groups of 12 each. An incision wound was created on the dorsal region of each rat. WGH extract (20% w/w), WGH burnt residues (20% w/w), Eucerin, and Phenytoin ointments were used in each group. Wound length, contraction percentage, and histopathological evaluations were recorded on days 3, 7, 10, and 14. Total phenolic content and EC50 values of reducing power, DPPH and nitric oxide scavenging activity of the WGH extract were 61.34 ± 0.64 mg/g dry extract, 0.95 ± 0.02 mg/mL, 0.35 ± 0.01 mg/mL, and 0.28 ± 0.01 mg/mL, respectively. Treated animals with WGH extract showed significantly (p ≤ 0.05) better results for physical and pathological parameters compared to the control group; overall, WGH extract showed better results than WGH burnt residues. The present study indicated that the WGH aqueous ethanol extract has a promising potential for wound healing in the animal model and could be a valuable resource for developing new wound-healing medicines for humans.</p> Ayat Taheri, Sayid Mahdi Mirghazanfari, Masoumeh Dadpay ##submission.copyrightStatement## Wed, 01 Apr 2020 00:00:00 +0000