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Intensive physical exercise may cause muscular injury and increase oxidative stress. The purpose of this study was to examine the effect of an antioxidant, coenzyme Q10 (CoQ10), on muscular injury and oxidative stress during exercise training. Eighteen male students, all elite Japanese kendo athletes, were randomly assigned to either a CoQ10 group (n 10) or a placebo group (n 8) in a double-blind manner. Subjects in the CoQ10 group took 300 mg CoQ10 per d for 20 d, while subjects in the placebo group took the same dosage of a placebo. All subjects practised kendo 5·5 h per d for 6 d during the experimental period. Blood samples were taken 2 weeks before, during (1 d, 3 d, 5 d) and 1 week after the training. Serum creatine kinase (CK) activity and myoglobin (Mb) concentration significantly increased in both groups (at 3 d and 5 d). Serum CK (at 3 d), Mb (at 3 d) and lipid peroxide (at 3 d and 5 d) of the CoQ10 group were lower than those of the placebo group. The leucocyte counts in the placebo group significantly increased (at 3 d) and neutrophils significantly increased in both groups (at 3 d and 5 d). Serum scavenging activity against superoxide anion did not change in either group. These results indicate that CoQ10 supplementation reduced exercise-induced muscular injury in athletes.

The COVID-19 pandemic has shocked the entire planet. The soccer world has also suffered major upheavals, and many professional soccer players have been infected with the virus. The aim of this study was to evaluate the incidence of injuries in Italian Serie A professional soccer players before and during the COVID-19 pandemic. Methods: We evaluated the incidence of muscle injuries between four competitive seasons of the Italian Serie A (2016–2017, 2017–2018, and 2018–2019 pre-COVID-19 vs. 2020/2021 post-COVID-19) in professional soccer players. Results: Significant differences were found in muscular injuries between the post-COVID-19 season and the previous seasons (p < 0.001). The median split of the players’ positivity duration was of 15 days. The players’ long positivity (PLP) group showed a significant number of muscular injuries compared to the players’ short positivity (PSP) group (p < 0.0014, ES = 0.81, Large). The total teams’ days of positivity were significantly related to the total team number of muscular injuries (r = 0.86; CI 95% 0.66 to 0.94; p < 0.0001). In conclusion, this data showed that the competitive season post-COVID-19 lockdown has a higher incidence of muscle injuries in Italian Serie A soccer players compared to the pre-pandemic competitive season.

Background This study aimed to evaluate injury rates among Serie A soccer players across three seasons, highlighting the impact of the COVID-19 pandemic. Methods Fifty-four professional soccer players in the Italian Serie were assessed over the course of three seasons, including the 2019/2020 season, which was affected by the pandemic. Injuries were categorized into muscular, skeletal, and articular, and were analyzed according to player roles (defenders, midfielders, and forwards). They were also stratified by the period of the competitive season: (1) preseason, (2) first half of the season, (3) second half of the season, and (4) end of the season. Results The results indicate a sharp increase in injuries during the post-COVID-19 season (2020/2021), with increases in articular injuries (65%), skeletal injuries (120%), and muscular injuries (65%), compared to the previous seasons. Among player roles, defenders were the most affected by injuries, with a notable increase in the second half of the post-COVID season (36% more injuries compared to the pre-COVID season). The injury rate among midfielders increased by 46% in the post-COVID season compared to the pre-COVID season, with the highest number of injuries occurring at the end of the season. Conclusions This increased injury rate in defenders and midfielders, who often position themselves in the defensive zone, could be due to muscle mass loss. Further studies are needed to explore this aspect of injury epidemiology in soccer. Ultimately, careful, and gradual training is crucial for preventing injuries and maintaining the quality of soccer players’ performances.

This case report describes the acceleration of an Olympic decathlete's return to competition induced via high-frequency Blood Flow Restriction (BFR) training. BFR has gained popularity as an innovative rehabilitation method for promoting muscle repair and adaptation through anabolic and regenerative pathways when high mechanical loading is not possible. A 26-year-old elite decathlete with nine years of international experience sustained a Grade 2b strain of the semimembranosus and semitendinosus (a 9 mm central tendon tear) during a hurdle sprint. The injury was confirmed via MRI two days post-injury. Grade 2b hamstring injuries with intramuscular tendon involvement commonly require up to 4 weeks of rehabilitation before full training can be resumed. With the athlete due to complete in an Olympic Games competition 17 days post-injury, an intensive BFR-assisted rehabilitation program was initiated. Over 12 consecutive days, the athlete completed 3-6 BFR sessions per day (20-30 min each) at 50% limb occlusion pressure, along with physiotherapy and pain-limited functional testing. BFR was applied passively for recovery, during conditioning, and in low-load strength sessions. By day 12, sprint velocity reached 95% maximum, and the athlete successfully completed the decathlon, with no adverse effects or reinjury. This case illustrates how high-frequency BFR-assisted rehabilitation may facilitate accelerated recovery from a hamstring injury, enabling an effective return to elite competition within condensed timelines.

BackgroundEndoscopic submucosal dissection (ESD) is a safe and effective technique for the treatment of gastrointestinal tumors, including rectal neuroendocrine tumors (r-NETs). However, the relative advantages of traction-assisted ESD for the treatment of small rectal lesions are still debated.AimsWe conducted a study to compare the efficacy and safety of rubber band traction-assisted ESD (RBT-ESD) to conventional ESD (C-ESD).MethodsThis study retrospectively analyzed consecutive patients with r-NET treated with ESD between October 2021 and October 2023. Our study assessed differences between the groups in the complete resection rate of lesions, muscular layer injury, surgical complications, operation time, resection speed, time to liquid diet, postoperative hospital stay, hospital cost, and recurrence rate.ResultsA total of 119 patients with r-NETs participated in this study (RBT-ESD group, n = 27; C-ESD group, n = 92). The operation time in RBT-ESD group was shorter than in C-ESD group, but the difference was not statistically significant (16.0 min [9.0–22.0 min] vs. 18.0 min [13.3–27.0 min], P = 0.056). However, the resection speed was significantly faster in the RBT-ESD group (6.7 vs. 4.1 mm2/min, P = 0.005). Furthermore, the RBT-ESD group showed significantly less muscular layer injury (P = 0.047) and faster diet recovery (P = 0.035). No significant differences were observed in the complete resection rate, surgical complications, postoperative hospital stay, hospital cost, or recurrence rate between the two groups.ConclusionFor r-NETs of < 2 cm in size, the RBT method did not significantly shorten the operation time but resulted in faster resection speed, less muscular layer injury, and earlier postoperative recovery to a liquid diet.

ABSTRACT The treatment and rehabilitation after acute skeletal muscle injuries remain major challenges of sports medicine practice and further studies could provide more information for effective treatment of this pathological condition. In this study, adult rats were divided into four groups namely natural healing (control), exercise and massage, massage only and exercise only and received acute skeletal contusion to the right tibialis anterior, followed by corresponding rehabilitation methods. The injured muscular tissues and blood samples were collected pre-injury and post-injury on day 1, 2, 4, 6, 9, 12 and 15. The exercise and massage group showed the fastest recovery reflected by muscular histological structure and C-reactive protein levels, followed by the other three groups. C-reactive protein decrease in exercise and massage, massage only or exercise only groups was significantly different comparing to control group (p<0.05). Combined treatment of exercise and massage therapy showed the best effect in inflammation suppression, skeletal muscle regeneration, control of skeletal muscle fibrosis and muscular tissue re-construction. The skeletal muscular structure and C-reactive protein level could reflect the recovery process after skeletal muscles injury with high sensitivity in groups with the four different rehabilitation methods.

The awareness of muscular adverse drug reactions (ADRs) increased since the withdrawal of cerivastatin, a HMG-CoA reductase inhibitor, from the market in August 2001. Our objectives were to assess the detection and incidence of muscular ADRs in a University Hospital using biochemical laboratory data and to evaluate the underreporting rate of drug-induced muscular disorders. A prospective study was undertaken at Toulouse University Hospital, France, for 1 week per month from November 2001 to October 2002. Patients were selected by means of a computerized process using biochemical laboratory data based on serum creatine phosphokinase (CPK) values (over twofold normal). Medical records of all selected patients were then consulted. During the period of the study, 2017 CPK tests were performed, among which 171 values were over twofold normal corresponding to 129 patients. Because of lack of data, 26 patients were excluded. Among these patients ( n=103), 28 cases of muscular ADRs were suspected, 22 of which were detected in outpatient departments. Four patients were totally asymptomatic and five had an increase of CPK over fivefold normal. Nine cases were classified as \"serious\". Withdrawal of suspected drugs were done in 16 cases with regression of ADRs in 13 cases. According to hospitalization data, the incidence of muscular ADRs was estimated as 7.2 (2.6-15.7) per 10,000 inpatients and 9.3 (5.8-14.1) per 10,000 outpatients over 12 weeks. The involved drugs were mainly: statins (46.4%), fibrates (14.3%), antiretrovirals (14.3%), angiotensin-II receptor antagonists (10.7%), immunosuppressants (7.1%) or hydroxychloroquine (7.1). Only two cases, judged as \"serious\", were spontaneously reported by physicians during the same period. The results of this survey underline the importance to take into account drug hypothesis in muscular injuries diagnosis.

Sustained chronic inflammation induces activation of genes involved in cellular proliferation and apoptosis, thereby causing skeletal muscle degeneration. To investigate in vitro effects of isolated pentacyclic triterpenes from Eugenia punicifolia ( Ep - CM ) upon signaling pathways involved in the regulation of skeletal muscle cell line proliferation, and in vivo muscular tissue remodeling. C2C12 cells were seeded on eight-well plates and [ 3 H]-thymidine incorporation, TUNEL assays, mitochondria viability, zymography for matrix metalloproteases (MMPs), Western blot analysis for MAPKinase signaling pathway, NFκB activation and HMGB1 production subsequently determined under basal conditions and after Ep - CM treatment. A polymer containing Ep - CM was implanted on the volar surface of gastrocnemius muscles subjected to acute injury induced by bupivacaine for local slow and gradual release of bioactive compounds, and mice killed 4 days after surgery. Ep - CM inhibited proliferation of C2C12 myoblast cell line in a dose-dependent manner, confirmed by reduction of [ 3 H]-thymidine uptake without affecting cell viability or inducing apoptosis. The cytostatic effect of Ep - CM occurred mainly via inhibition of phosphorylated extracellular signal-regulated kinase (pERK) activation and DNA synthesis, possibly inhibiting the G1 phase of the cell cycle, since Ep - CM increased pAkt and p27 kip1 but reduced Cyclin D1. Ep - CM in vitro treatment increased MMP-9 and MMP-2 activities of C2C12 myoblast cells, but reduced in vivo MMP-9 activity and acute muscular inflammation. Besides cytostatic and anti-inflammatory effects, Ep - CM pentacyclic triterpenes also contributed to degradation of basement membrane components by activating mechanisms of skeletal muscle remodeling in response to local injury.

Fibro-adipogenic progenitors (FAPs) are typically activated in response to muscle injury, and establish functional interactions with inflammatory and muscle stem cells (MuSCs) to promote muscle repair. We found that denervation causes progressive accumulation of FAPs, without concomitant infiltration of macrophages and MuSC-mediated regeneration. Denervation-activated FAPs exhibited persistent STAT3 activation and secreted elevated levels of IL-6, which promoted muscle atrophy and fibrosis. FAPs with aberrant activation of STAT3–IL-6 signalling were also found in mouse models of spinal cord injury, spinal muscular atrophy, amyotrophic lateral sclerosis (ALS) and in muscles of ALS patients. Inactivation of STAT3–IL-6 signalling in FAPs effectively countered muscle atrophy and fibrosis in mouse models of acute denervation and ALS (SOD G93A mice). Activation of pathogenic FAPs following loss of integrity of neuromuscular junctions further illustrates the functional versatility of FAPs in response to homeostatic perturbations and suggests their potential contribution to the pathogenesis of neuromuscular diseases. Madaro et al. show that denervation induces accumulation of IL-6–STAT3-activated fibro-adipogenic progenitors without inflammation or muscle regeneration, leading to muscle atrophy and fibrosis.