Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis.

BACKGROUND: Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength. OBJECTIVE: This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength. METHODS: We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence. CONCLUSIONS: Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.

Human papillomavirus infection and lung adenocarcinoma: special benefit is observed in patients treated with immune checkpoint inhibitors.

BACKGROUND: Human papilloma virus (HPV) has been associated with the development and modulation of response in a series of neoplasms. In the case of lung adenocarcinoma, its role in etiology and pathogenesis is still controversial. Considering that this infection brings foreign epitopes, it could be of prognostic significance in patients with lung adenocarcinoma treated with immunotherapy. METHODS: In a retrospective cohort study we evaluated the presence of HPV genomic material in lung adenocarcinoma primary lesions with the INNO-LiPA platform. Viral replication was also evaluated by detecting the presence of oncoprotein E6/E7 messenger RNA (mRNA) by quantitative RT-PCR. To confirm possible hypotheses regarding viral oncogenesis, vascular endothelial growth factor (VEGF) and hypoxia-inducible factor 1 (HIF1) were evaluated with stromal fibrosis and immunoscore. RESULTS: A total of 133 patients were included in the analysis, of whom 34 tested positive for HPV, reaching an estimated prevalence of 25.6% [95% confidence interval (CI) 18.2% to 32.9%]. E6/7 mRNA was identified in 28 out of the 34 previously positive cases (82.3%). In immune checkpoint inhibitor (ICI)-treated patients, the median overall survival reached 22.3 months [95% CI 19.4 months- not reached (NR)] for HPV-negative and was not reached in HPV-positive (HPV+) ones (95% CI 27.7-NR; P = 0.008). With regard to progression-free survival, HPV- patients reached a median of 9.2 months (95% CI 7.9-11.2 months) compared to 14.3 months (95% CI 13.8-16.4 months) when HPV was positive (P = 0.001). The overall response rate for HPV+ patients yielded 82.4% compared to 47.1% in negative ones. No differences regarding programmed death-ligand 1, VEGF, HIF1, stromal fibrosis, or immunoscore were identified. CONCLUSIONS: In patients with HPV+ lung adenocarcinoma, a significant benefit in overall response and survival outcomes is observed.

Effects of eccentric exercise on muscle architecture in adults: a systematic review / Efectos del ejercicio excéntrico en la arquitectura muscular en adultos: una revisión sistemática

SUMMARY: The purpose of this systematic review was to determine the effects of eccentric training on muscle architecture in the adult population. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with architecture muscular and eccentric training. Four databases were used: PubMed, Scopus, SPORTDiscus and Web of Science. Methodological quality was assessed using the PEDro scale. A total of 1260 articles were retrieved, 18 included in this review. The parameters most frequently evaluated in the studies consulted were pennation angle (PA), fascicle length (FL), and muscle thickness (MT). These were assessed mainly in lower limb muscles such as biceps femoris long head (BFlh), vastus lateralis (VL), medial gastrocnemius (MG) and lateral gastrocnemius (LG), respectively. Eccentric training for at least four weeks generates adaptations in these parameters, mainly by increasing MT with FL and decreasing PA, determining muscle function. These results provide evidence on the effects of eccentric training on muscle architecture, which could be helpful to prevent injuries and favor muscle recovery processes.

RESUMEN: El propósito de esta revisión sistemática fue determinar los efectos del entrenamiento excéntrico sobre la arquitectura muscular en la población adulta. Se siguieron las recomendaciones del Ìtems de referencia para publicar Revisiones Sistemáticas y Metaanálisis (PRISMA) utilizando palabras clave asociadas con la arquitectura muscular y el entrenamiento excéntrico en cuatro bases de datos: PubMed, Scopus, SPORTDiscus y Web of Science. La calidad metodológica se evaluó mediante la escala PEDro. Se encontró un total de 1260 artículos, del los cuales, 18 fueron incluidos en esta revisión. Los parámetros más frecuentemente evaluados en los estudios fueron el ángulo de penación (AP), la longitud del fascículo (LF) y el grosor muscular (Gm). Estos fueron evaluados principalmente en músculos de los miembros inferiores como la cabeza larga del bíceps femoral (CLBf), el vasto lateral (VL), el gastrocnemio medial (GM) y el gastrocnemio lateral (GL), respectivamente. El entrenamiento excéntrico durante al menos cuatro semanas genera adaptaciones en estos parámetros, principalmente aumentando el GM con la LF y disminuyendo el AP, determinando de esta manera la función muscular. Estos resultados aportan evidencias sobre los efectos del entrenamiento excéntrico en la arquitectura muscular, que podrían ser útiles para prevenir lesiones y favorecer los procesos de recuperación muscular.

Neurotransmitters, neuropeptides and their receptors interact with immune response in healthy and psoriatic skin.

Psoriasis is a chronic inflammatory disease with a multifactorial origin that affects the skin. It is characterized by keratinocyte hyperproliferation, which results in erythemato-squamous plaques. Just as the immune system plays a fundamental role in psoriasis physiopathology, the nervous system maintains the inflammatory process through the neuropeptides and neurotransmitters synthesis, as histamine, serotonin, calcitonin gene-related peptide, nerve growth factor, vasoactive intestinal peptide, substance P, adenosine, glucagon-like peptide, somatostatin and pituitary adenylate cyclase polypeptide. In patients with psoriasis, the systemic or in situ expression of these chemical mediators and their receptors are altered, which affects the clinical activity of patients due to its link to the immune system, provoking neurogenic inflammation. It is important to establish the role of the nervous system since it could represent a therapeutic alternative for psoriasis patients. The aim of this review is to offer a detailed review of the current literature about the neuropeptides and neurotransmitters involved in the physiopathology of psoriasis.

Biomarkers of resistance to radiation therapy: a prospective study in cervical carcinoma.

BACKGROUND: Clinical parameters and proteins have recently been suggested as possible causes of radiotherapy (RT) resistance in cervical carcinoma (CC). The objective of the present study was to validate prognostic biomarkers of radiation resistance. METHODS: The present prospective study included patients undergoing RT with curative intent for histologically proven locally advanced squamous cell CC. Tissues and blood samples were systematically collected before RT initiation. Immuno-histochemistry was performed (IGF-IR α and ß, GAPDH, HIF-1 alpha, Survivin, GLUT1, CAIX, hTERT and HKII). Response to radiation was assessed through tumour response 3 months after RT completion, through overall survival (OS) and through progression-free survival (PFS). RESULTS: One hundred forty nine patients with a mean age of 46 years were included, with FIGO IIB (n = 53) and FIGO IIIB (n = 96) CCs. 61 patients were treated with exclusive RT + brachytherapy and 88 underwent chemo-radiotherapy + brachytherapy. Our findings suggest an association between hemoglobin level (Hb) (>11 g/dL) and 3 months complete response (p = 0.02). Hb level < 11 g/dL was associated with decreased PFS (p = 0.05) and OS (p = 0.08). Overexpression of IGF-1R ß was correlated with a decreased OS (p = 0.007). Overexpression of GLUT1 was marginally correlated with reduced OS (p = 0.05). PFS and OS were significantly improved in patients undergoing chemoradiation versus exclusive radiotherapy (PFS: p = 0.04; OS: p = 0.01). CONCLUSIONS: IGF-1R ß overexpression and Hb level (≤11 g/dl) were associated with poor prognosis, and thus appear to be possible interesting biomarkers of radiation resistance. Our results corroborate previous pre-clinical studies suggesting IGF-1R and hypoxia to be part of the biological pathways leading to radio-resistance.

Efecto de 8 semanas de corriente TENS modificada y la corriente rusa, sobre la fuerza muscular y la composición corporal / Efeito de 8 semanas de corrente TENS modificada e corrente russa sobre a força e composição corporal / Effects of 8 weeks of modified TENS current and russian current, on muscle strength and body composition

Objetivo. Comparar el efecto de 2 métodos de electroestimulación en las siguientes variables: fuerza y antropometría. Método. Se realizó una investigación experimental, aleatoria y simple ciego. Se evaluó a 18 sujetos, distribuidos en: Grupo Corriente TENS Modificada (CTM: n = 6), Grupo Corriente Rusa (CR: n = 6) y Grupo Control (TC: n = 6, sometido a corriente TENS Convencional, considerada en la presente investigación como placebo). Resultados. Al cabo de 8 semanas, solo CTM incrementó la fuerza máxima (p < 0.035) y redujo el grosor del pliegue subcutáneo de la pierna derecha (p < 0.03). Conclusiones. La técnica de electroestimulación con corriente TENS Modificada es efectiva para el entrenamiento muscular (AU)

Objetivo. Comparar o efeito de 2 métodos de eletroestimulação nas seguintes variáveis: força e antropometria. Método. Um estudo experimental, randomizado, cego simples. Foram avaliados 18 indivíduos, distribuídos em: grupo de corrente TENS modificada (CTM: n = 6), grupo corrente russa (CR: n = 6) e grupo controle (TC: n = 6, submetido a corrente TENS convencional, considerada nesta investigação como placebo). Resultados. Após 8 semanas, CTM aumentou a força máxima (p < 0,035) e reduziu a espessura de pregas subcutâneas da coxa direita (p < 0,03). Conclusões. A técnica de eletroestimulação com corrente TENS modificada é eficaz para treinamento muscular (AU)

Objective. To compare the effect of two methods of electrostimulation on the following variables: strength and anthropometry. Method. An experimental, randomized, and simple blind investigation was performed. Eighteen subjects were evaluated distributed into a Modified TENS Current Group (CTM: n = 6), Russian Current Group (CR: n = 6), and a Control Group (TC: n = 6, submitted to traditional TENS current, considered as placebo in this research). Results. After 8 weeks, only CTM obtained an increase in maximal strength (p < 0.035), and a reduction in the subcutaneous fat thickness of the right thigh (p < 0.03). Conclusions. A Modified TENS Current is effective for muscular training (AU)

Medical hazards of the tear gas CS. A case of persistent, multisystem, hypersensitivity reaction and review of the literature.

A 30-year-old incarcerated man was sprayed with the "tear gas" ortho-chlorobenzylidene malononitrile (CS). He was hospitalized 8 days later with erythroderma, wheezing, pneumonitis with hypoxemia, hepatitis with jaundice, and hypereosinophilia. During the subsequent months he continued to suffer from generalized dermatitis, recurrent cough and wheezing consistent with reactive airways dysfunction syndrome, and eosinophilia. These abnormalities responded to brief courses of systemic corticosteroid but recurred off therapy. The dermatitis resolved gradually over 6-7 months, but the patient still had asthma-like symptoms a year following exposure. Patch testing confirmed sensitization to CS. The mechanism of the patient's prolonged reaction is unknown but may involve cell-mediated hypersensitivity, perhaps to adducts of CS (or a metabolite) and tissue proteins. This is the first documented case in which CS apparently caused a severe, multisystem illness by hypersensitivity rather than direct tissue toxicity. Both the ethics and safety of CS use remain controversial, in part because of the difficulty documenting sporadic injuries received in the field, and also because the charged circumstances surrounding CS use may lead to both underreporting and exaggerated claims of medical harm. The medical literature on CS focuses mainly on its immediate irritant effects and on transient dermal and ocular injuries, with only 2 prior case reports of acute lung injury related to CS exposure. Given the paucity of documented lasting effects despite its widespread use for more than 3 decades, CS appears to be safe when deployed (outdoors) in a controlled manner, but it can cause important injuries if misused or if applied to a sensitized individual.