Effect of a Nutritional Support System to Increase Survival and Reduce Mortality in Patients with COVID-19 in Stage III and Comorbidities: A Blinded Randomized Controlled Clinical Trial.

The COVID-19 evolution depends on immunological capacity. The global hospital mortality rate is 15-20%, but in México it is 46%. There are several therapeutic protocols, however, integral nutrition is not considered. In this study, a Nutritional Support System (NSS) was employed to increase survival and reduce mortality in patients with stage III COVID-19. A randomized, blinded, controlled clinical trial was performed. Eighty patients (aged 30 to 75 years, both sexes) were assigned to (1) "Control Group" (CG) hospital diet and medical treatment or (2) "Intervention Group" (IG) hospital diet, medical treatment, and the NSS (vitamins, minerals, fiber, omega-3, amino acids, B-complex, and probiotics). IG significantly increased survival and reduced mortality compared to CG (p = 0.027). IG decreased progression to Mechanical Ventilation Assistance (MVA) by 10%, reduced the intubation period by 15 days, and increased survival in intubated patients by 38% compared to CG. IG showed improvement compared to CG in decrease in supplemental oxygen (p = 0.014), the qSOFA test (p = 0.040), constipation (p = 0.014), the PHQ-9 test (p = 0.003), and in the follow-up, saturation with oxygen (p = 0.030). The NSS increases survival and decreases mortality in patients with stage III COVID-19.

What we know so far about postural balance training: An exploratory scoping review of nomenclature and related issues.

BACKGROUND: Different terms are used to refer to postural balance training, but the ontological debate involving the concepts to pursue nomenclature consensus is unusual. OBJECTIVE: The goal of this study was to analyze how often the terms balance, neuromuscular, proprioceptive, functional and sensorimotor training/exercise are used in the literature, and to propose a conceptual critical appraisal to determine the most appropriate terminology to address postural balance exercises. METHODS: A literature search was conducted in the Scopus electronic database. Eligibility criteria: papers with the selected expressions on the title or keywords, published in English, were included. RESULTS: The most used term was balance training (471 of 1105 included papers). Europe, followed by Asia and North America, had the highest number of publications. In the 21st century, the number of publications increased considerably. However, the terms have conceptual differences and controversies regarding its use. CONCLUSION: Despite a large variety of exercise types and divergences, balance training seems to be the most suitable term, given it refers to postural equilibrium exercises.

Is somatosensory electrical stimulation effective in relieving spasticity? A systematic review.

Spasticity is a sensorimotor disorder widely recognized as one of the features that contribute to patients' disability. Transcutaneous electric neural stimulation (TENS/SES) has been adopted in spasticity rehabilitation as an alternative to pharmacological agents. Although previous studies have reported clinical benefits of TENS/SES in relieving spasticity, there is no clarity on how and whether this therapeutic modality affects specific neural circuitries. Thus, this systematic review aimed to verify the efficacy of TENS/SES in the control of spasticity and its consequences in spinal and corticospinal excitability. This study was carried out according to PRISMA recommendations using SCOPUS, PubMed, BVS, Google Scholar and BASE databases screening, which provided 483 references. Six additional records were found from other sources. All these records were submitted to a filtering process following the eligibility criteria, and 44 studies were selected for further analysis. Ten were replicas. Consequently, 34 studies were read in full with the aim of checking their eligibility criterion, which resulted in 10 manuscripts for qualitative synthesis. Even though they evaluated the effects of TENS/SES both at the spinal and/or corticospinal levels, the electrophysiological results seem to be inconsistent, corroborating the lack of agreement between them and with clinical outcomes.

Store-Operated Calcium Entry via STIM1 Contributes to MRGPRX2 Induced Mast Cell Functions.

Mast cells are inflammatory immune cells that play an essential role in mediating allergic reactions in humans. It is well-known that mast cell activation is critically regulated by intracellular calcium ion (Ca2+) concentrations. MAS-related G-protein coupled receptor-X2 (MRGPRX2) is a G-protein coupled receptor (GPCR) expressed on mast cells that is activated by various ligands, including several FDA approved drugs; consequently, this receptor has been implicated in causing pseudo-allergic reactions in humans. MRGPRX2 activation leads to an increase in intracellular Ca2+ levels; however, the Ca2+ mobilizing mechanisms utilized by this receptor are largely unknown. Previous reports showed that store-operated Ca2+ entry (SOCE) via the calcium sensor, stromal interaction molecule 1 (STIM1), regulates mast cell response induced by the high-affinity IgE receptor (FcεRI). In this study, using complementary pharmacologic and genetic ablation approaches we demonstrate that SOCE through STIM1 promotes MRGPRX2-induced human mast cell response in vitro. Importantly, SOCE also critically modulates MrgprB2 (mouse ortholog of human MRGPRX2) dependent inflammation in in vivo mouse models of pseudo-allergy. Collectively, our data suggests that MRGPRX2/MrgprB2 activation of mast cells is dependent on SOCE via STIM1, and further characterization of the MRGPRX2-SOCE-STIM1 pathway will lead to the identification of novel targets for the treatment of pseudo-allergic reactions in humans.

Myofascial trigger point therapy: laser therapy and dry needling.

The aim of the present review is to discuss two forms of treatment for myofascial pain: laser therapy and dry needling. Although studies have reported the deactivation of myofascial trigger points with these two methods, clinical trials demonstrating their efficacy are scarce. The literature reports greater efficacy with the use of laser over dry needling. It has been suggested that improvements in microcirculation through the administration of laser therapy may favor the supply of oxygen to the cells under conditions of hypoxia and help remove the waste products of cell metabolism, thereby breaking the vicious cycle of pain, muscle spasm and further pain. While laser therapy is the method of choice for patients with a fear of needles and healthcare professionals inexperienced with the dry needling technique, further controlled studies are still needed to prove the greater efficacy of this method.

Laser therapy and needling in myofascial trigger point deactivation.

The aim of this study was to evaluate different approaches to deactivating myofascial trigger points (MTPs). Twenty-one women with bilateral MTPs in the masseter muscle were randomly divided into three groups: laser therapy, needle treatment and control. Treatment effectiveness was evaluated after four sessions with intervals ranging between 48 and 72 h. Quantitative and qualitative methods were used to measure pain perception/sensation. The Wilcoxon test based on results expressed on a visual analog scale (VAS) demonstrated a significant (P < 0.05) decrease in pain only in the laser and needle treatments groups, although a significant increase in the pressure pain threshold was evident only for needling with anesthetic injection (P = 0.0469), and laser therapy at a dose of 4 J/cm² (P = 0.0156). Based on these results, it was concluded that four sessions of needling with 2% lidocaine injection with intervals between 48 and 72 h without a vasoconstrictor, or laser therapy at a dose of 4 J/cm², are effective for deactivation of MTPs.

Perspective-taking in blindness: electrophysiological evidence of altered action representations.

It is well established that the mental simulation of actions involves visual and/or somatomotor representations of those imagined actions. To investigate whether the total absence of vision affects the brain activity associated with the retrieval of motor representations, we recorded the readiness potential (RP), a marker of motor preparation preceding the execution, as well as the motor imagery of the right middle-finger extension in the first-person (1P; imagining oneself performing the movement) and in the third-person (3P; imagining the experimenter performing the movement) modes in 19 sighted and 10 congenitally blind subjects. Our main result was found for the single RP slope values at the Cz channel (likely corresponding to the supplementary motor area). No difference in RP slope was found between 1P and 3P in the sighted group, suggesting that similar motor preparation networks are recruited to simulate our own and other people's actions in spite of explicit instructions to perform the task in 1P or 3P. Conversely, reduced RP slopes in 3P compared with 1P found in the blind group indicated that they might have used an alternative, nonmotor strategy to perform the task in 3P. Moreover, movement imagery ability, assessed both by means of mental chronometry and a modified version of the Movement Imagery Questionnaire-Revised, indicated that blind and sighted individuals had similar motor imagery performance. Taken together, these results suggest that complete visual loss early in life modifies the brain networks that associate with others' action representations.