Efficacy of electrotherapy in Bell's palsy treatment: A systematic review.

BACKGROUND: Up to now there is not enough evidence that supports the use of electrotherapy in the treatment of Bell's palsy. OBJECTIVE: Through a systematic review, we aimed to verify whether the use of electrotherapy is effective for treating Bell's palsy or peripheral paralysis. METHODS: Publications were searched in PubMed, EBSCO and Web of Science. The present systematic review included studies that analyzed the electrotherapy as a therapeutic method for treating individuals with Bell's palsy, in order to recover the function of facial muscles. RESULTS: Seven studies involving a total of 131 cases and 113 controls were included in this systematic review. In the studies analyzed, patients received electrotherapy combined with other treatments such as hot-wet facial napkins, massages and muscle reeducation. Although the effect of electrotherapy alone was not evaluated, the use of electrotherapy combined with other treatments produced a significant improvement in the individuals evaluated. CONCLUSIONS: Due to the diverse methodologies used and the small number of individuals included in the studies, we could not fully prove the efficacy of electrotherapy for treating Bell's Palsy. Future studies with larger samples and homogenous populations should be performed to obtain conclusive results.

Relación entre las concentraciones de la leptina y la actividad de la enfermedad en pacientes con artritis reumatoide / Relationship between leptin concentrations and disease activity in patients with rheumatoid arthritis

Introducción y objetivo: Múltiples estudios han encontrado una relación directa entre las concentraciones de leptina y la actividad de la enfermedad en artritis reumatoide. Pacientes y métodos: Se estudiaron 77 pacientes con artritis reumatoide, la determinación de la leptina fue a través de inmunoanálisis enzimático. Se evaluó la actividad de la enfermedad mediante el DAS-28 PCR. Se realizó un modelo de regresión logística multivariante para determinar la asociación entre las variables significativas y las concentraciones de leptina. Resultados: El 40,3% de los pacientes estaban en remisión, el 41,6% actividad leve, el 11,7% actividad moderada y el 6,5% actividad grave. Se encontró una relación independiente entre mayores concentraciones de leptina y la actividad de la enfermedad (RR 1,7; IC al 95%: 1,4-3,2; p = 0,03), el número de articulación tumefactas (RR 4,6; IC al 95%: 1,7-8,3; p = 0,000), el número de articulaciones dolorosas (RR 3,4; IC al 95%: 1,6-4,6; p = 0,000) y a presencia de síndrome metabólico (RR 1,3; IC al 95%: 1,2-1,9; p = 0,045). Conclusiones: Los datos obtenidos sugieren que la leptina sérica está elevada en pacientes con AR activa

Background and objective: Multiple studies have found a direct relationship between leptin concentrations and disease activity in rheumatoid arthritis. Patients and methods: We studied 77 patients with the diagnosis of rheumatoid arthritis; the leptin determination was through an enzyme immunoassay. Disease activity was assessed by the DAS-28 CRP. A multivariate logistic regression model was used to determine the association between significant variables and leptin concentrations. Results: 40.3% of the patients were in remission, 41.6% were mildly active, 11.7% were moderately active and 6.5% were severely active. The results show an independent association between higher concentrations of leptin and disease activity (OR 1.7; 95% CI 1.4-3.2; p .03), the number of swollen joints (OR 4.6; 95% CI 1.7-8.3; p .000), the number of painful joints (OR 3.4; 95% CI 1.6-4.6; p .000), and the presence of metabolic syndrome (OR 1.3; 95% IC 1.2-1,9; p .045). Conclusion: The data suggest that serum leptin is elevated in patients with active RA

Relationship between leptin concentrations and disease activity in patients with rheumatoid arthritis. / Relación entre las concentraciones de la leptina y la actividad de la enfermedad en pacientes con artritis reumatoide.

BACKGROUND AND OBJECTIVE: Multiple studies have found a direct relationship between leptin concentrations and disease activity in rheumatoid arthritis. PATIENTS AND METHODS: We studied 77 patients with the diagnosis of rheumatoid arthritis; the leptin determination was through an enzyme immunoassay. Disease activity was assessed by the DAS-28 CRP. A multivariate logistic regression model was used to determine the association between significant variables and leptin concentrations. RESULTS: 40.3% of the patients were in remission, 41.6% were mildly active, 11.7% were moderately active and 6.5% were severely active. The results show an independent association between higher concentrations of leptin and disease activity (OR 1.7; 95% CI 1.4-3.2; p .03), the number of swollen joints (OR 4.6; 95% CI 1.7-8.3; p .000), the number of painful joints (OR 3.4; 95% CI 1.6-4.6; p .000), and the presence of metabolic syndrome (OR 1.3; 95% IC 1.2-1,9; p .045). CONCLUSION: The data suggest that serum leptin is elevated in patients with active RA.

Association between leptin and IL-6 concentrations with cardiovascular risk in patients with rheumatoid arthritis.

Pro-inflammatory cytokines such as leptin and IL-6 play an important role in the development of cardiovascular risk. Determine the relationship between leptin and IL-6 concentrations with cardiovascular risk in patients with rheumatoid arthritis. We determined IL-6 and leptin levels in 77 patients with the diagnosis of rheumatoid arthritis. The cardiovascular risk was calculated using the modified Framingham scale. Statistical analysis was performed using SPSS 22 considering a significant p < 0.05. Serum leptin concentrations and cardiovascular risk (CVR) factors were compared and found that there was a significant difference between higher leptin values and disease activity (p 0.047), obesity (p 0.038), positive rheumatoid factor (p 0.009), tobacco (p 0.009), and metabolic syndrome (p 0.001). Likewise, a significant relationship was found between lower leptin concentrations and hydroxychloroquine consumption (p = 0.023). We found significant difference between IL-6 concentrations and disease activity (p 0.028), hypertriglyceridemia (p 0.023), LDL-C (p 0.029), and smoking (0.005). Similarly, an association between hydroxychloroquine consumption and low concentrations of IL-6 was found (p 0.005). Framingham CVR was calculated and the result obtained was multiplied by 1.5. The 35.2% of the population studied had a low Framingham CVR, 38.9% moderate, and 25.9% presented a high risk. We compared the level of CVR and serum leptin and IL-6 concentrations, finding that the highest CVR was the leptin and IL-6 values. There is a positive association between CVR and serum leptin concentrations. It is also significantly associated with traditional and non-traditional risk factors.

Exploring the association between BDNF Val66Met polymorphism and suicidal behavior: Meta-analysis and systematic review.

Suicide is a serious worldwide health problem of critical consequences. Nowadays genetic factors are considered to be an important cause of suicide. The association between Val66Met (rs6265) polymorphism of the BDNF gene and suicide behavior has been increasingly studied. The aim of this study was to perform a meta-analysis in order to unravel the possible association between BDNF gene Val66Met polymorphism and suicide behavior. These meta-analysis and systematic review were performed using 23 articles that searched for a genetic association between Val66Met and suicide behavior, including 4532 cases and 5364 control subjects. The association was analyzed following the models: allelic, homozygous, heterozygous, dominant and recessive. Also, analyses by ethnicity (Caucasian and Asian populations) were done following the same four models. When the overall population was evaluated, we found no evidence of association between the polymorphism Val66Met of BDNF (rs6265) and suicide behavior (Met vs. Val: OR: 1.01; 95% CI = 0.92-1.10). However, a significant increased risk was found in the subgroup analysis by ethnicity in Caucasian populations (Met-Met vs. Met-Val + Val-Val: OR: 1.96; 95% CI = 1.58-2.43) and Asian populations (Val-Val vs. Val-Met + Met: OR: 1.36; 95% CI = 1.04-1.78). Our results suggest there is no association between the BDNF gene Val66Met (rs6265) and suicide behavior in the overall population. However, ethnic differences can be observed and the BDNF Val66Met might increase the risk for suicide behavior in Asian and Caucasian populations. Further studies with larger samples are necessary in order to have conclusive outcomes.

Decrease in brain-derived neurotrophic factor at plasma level but not in serum concentrations in suicide behavior: A systematic review and meta-analysis.

INTRODUCTION: Suicide is known as a major health concern worldwide. There is evidence for the role of brain-derived neurotrophic factor (BDNF) in suicide behavior. Therefore, this factor has been proposed as a biomarker for suicide behavior. Clinical studies have measured BDNF concentrations at central and peripheral levels. As a consequence, the aim of this study was to assess BDNF levels in blood plasma and serum to see whether there is a difference in concentrations in patients with suicide behavior when compared to those in controls, using a meta-analysis approach. METHODS: We conducted a systematic review and meta-analysis. The search strategy was performed using three databases: PubMed, EBSCO and ScienceDirect. The meta-analysis included a total of nine case-control studies, six measured the BDNF level in serum and three in plasma in suicide behavior. RESULTS: A decrease in BDNF levels in plasma was observed (d = -0.73, 95% CI -1.42 to -0.03 pg/ml). In the case of serum concentrations, no BDNF differences were encountered between cases and controls (d = 0.09, 95% CI -0.31 to 0.13 ng/ml, p(Q) = .92). CONCLUSIONS: According to the results found in the present meta-analysis, the plasma BDNF level could be suggest as a potential biomarker in suicide behavior. However, since the number of studies included in the analysis is limited, a larger number is necessary to determine conclusively the role of BDNF as a biomarker in suicide behavior.

Leptina y artritis reumatoide, influencia de esta adipocina en la enfermedad

La artritis reumatoide es una enfermedad autoinmune inflamatoria, en cuya fisiopatología participan tanto factores ambientales como genéticos, teniendo como principales citocinas involucradas la interleucina 1, interleucina 6 y el factor de necrosis tumoral. Los pacientes con artritis reumatoide tienen hasta 2 a 3 veces mayor riesgo cardiovascular que la población en general, este riesgo es equiparable al de los pacientes con diabetes mellitus. Este aumento en la morbilidad cardiovascular se explica tanto por una mayor prevalencia de los factores de riesgo tradicionales, como por factores de riesgo no tradicionales. La obesidad o el exceso de tejido adiposo es un factor de riesgo que puede influir en el aumento del riesgo cardiovascular, esto debido a una mala regulación metabólica, aumento de la hipertensión arterial, dislipidemia, ácidos grasos libres circulantes y a la producción de citocinas. Últimamente ha surgido un amplío interés en estudiar la relación entre la artritis reumatoide y las adipocinas, sin embargo los resultados han sido heterogéneos, debido a la poca homogeneidad en los grupos de estudio. El objetivo de la siguiente revisión es hablar acerca de la influencia que tiene la leptina en la artritis reumatoide, en su fisiopatología, en la actividad de la enfermedad y en el aumento del riesgo cardiovascular.

Rheumatoid arthritis is an inflammatory autoimmune disease which physiopathology both an environmental and genetic factors are involved, having as main cytokines involved the interleukin 1, interleukin 6 and tumor necrosis factor. Patients with rheumatoid arthritis have up to 2 - 3 times higher cardiovascular risk than the overall population, this risk is comparable to that of patients with diabetes mellitus. This increase in cardiovascular morbidity is explained by a higher prevalence of traditional risk factors, as well as non-traditional risk factors. Obesity or excessive fat tissue is a risk factor that can influence the increased cardiovascular risk, this due to poor metabolic regulation, increased blood pressure, dyslipidemia, free fatty acids circulating and cytokine production. Lately has emerged a broad interest in studying the relationship between rheumatoid arthritis and adipokines, however the results have been heterogeneous, due to the lack of homogeneity in the study groups. The aim of the following review is to talk about the influence of leptin in rheumatoid arthritis, in its pathophysiology, in the disease activity and in the increased cardiovascular risk.