Association between Genetic Variants of CELSR2-PSRC1-SORT1 and Cardiovascular Diseases: A Systematic Review and Meta-Analysis.

A cluster of three genes CELSR2, PSRC1, and SORT1 has been associated with cardiovascular diseases. Thus, the aim of this study was (i) to perform a systematic review and updated meta-analysis of the association of three polymorphisms (rs646776, rs599839, and rs464218) of this cluster with cardiovascular diseases, and (ii) to explore by PheWAS signals of the three SNPs in cardiovascular diseases and to evaluate the effect of rs599839 with tissue expression by in silico tools. Three electronic databases were searched to identify eligible studies. The meta-analysis showed that the rs599839 (allelic OR 1.19, 95% CI 1.13-1.26, dominant OR 1.22, 95% CI 1.06-1.39, recessive OR 1.23, 95% CI 1.15-1.32), rs646776 (allelic OR 1.46, 95% CI 1.17-1.82) polymorphisms showed an increased risk for cardiovascular diseases. PheWas analysis showed associations with coronary artery disease and total cholesterol. Our results suggest a possible involvement of the CELSR2-PSRC1-SORT1 cluster variants in the risk association of cardiovascular diseases, particularly coronary artery disease.

Efficacy of ozone injections for reducing musculoskeletal pain in comparison with corticosteroid injections: A systematic review and meta-analysis.

BACKGROUND: Corticosteroid injections are frequently used in the short-term treatment of musculoskeletal pain, but their use is controversial as repeated exposures to corticosteroids can lead to deleterious effects on musculoskeletal tissue. Ozone injections have been proposed as a possible treatment for musculoskeletal pain; however, their effectiveness has not been compared with corticosteroids. OBJECTIVE: To evaluate the effectiveness of ozone injections for reducing pain in individuals with musculoskeletal pain in comparison with corticosteroid injections through a meta-analysis. METHODS: An online systematic search was performed using electronic databases up to September 2023. We searched for studies that compared corticosteroid injections with ozone injections in the treatment of musculoskeletal pain of diverse origins. RESULTS: Eleven studies were included comprising a total of 534 individuals. In the overall pooled analysis, a pain reduction in favor of corticosteroid injections was found in the short term (d= 0.31, 95% CI 0.01 to 0.60, p (z) 0.04, I2 = 32%). In the medium term, no significant differences were found in reducing pain between groups (d=-0.17, 95% CI -0.42 to 0.07, p (z) 0.15, I2 = 0%). CONCLUSIONS: Our results suggest that corticosteroids injections are more effective in reducing musculoskeletal pain in the short term, but equally effective in the medium term when compared with ozone injections. Nonetheless, better-quality clinical trials are necessary to corroborate these results.

Reproducibility and safety of the 30" sit to stand test in individuals with obesity and cardiovascular risk factors.

BACKGROUND: The 30″ sit to stand test is a submaximal exercise test that assesses functional capacity and it has been validated for various pathologies. Although it has been used in individuals with obesity, its reproducibility in this population has not yet been determined. The main objective of this study was to determine the reproducibility and safety of the 30″ sit to stand test in individuals with overweight or obesity and with cardiovascular risk factors. METHODS: A cross-sectional study was performed. Individuals with obesity or overweight who also presented cardiovascular risk factors were evaluated with the 30″ sit to stand test. The reproducibility and safety of the 30" sit to stand test were determined, as well as its association with other functional tests and anthropometric characteristics. RESULTS: 59 individuals (27 men, 32 women) with obesity or overweight and cardiovascular risk factors, aged 57.93 (9.62) years, were included in the study. The 30″ sit to stand test showed good overall reproducibility (0.907 ICC) and significant correlation with the 6-minute walk test, handgrip strength test, body fat percentage and waist - height index, with a similar hemodynamic response to the 6-minute walk test. CONCLUSION: The 30" sit to stand test is a highly reproducible and safe test for individuals with obesity and cardiovascular risk factors, with a significant correlation to anthropometric characteristics and other functional tests regularly used for the evaluation of individuals with obesity.

Efficacy of prolotherapy in pain control and function improvement in individuals with lateral epicondylitis: A Systematic Review and Meta-analysis.

AIM: The objective of this study was to evaluate the efficacy of prolotherapy when treating individuals with lateral epicondylitis through a systematic review and meta-analysis. METHODS: The search for articles was carried out in electronic databases including PUBMED, CENTRAL, WEB OF SCIENCE, SCIELO and Google Scholar, published up to July 2021. We used the following keywords: prolotherapy OR proliferation therapy OR hypertonic dextrose injections AND tennis elbow OR lateral epicondylitis. The effectiveness was expressed as mean difference or standardized mean difference ((d) and 95% CI). MAJOR RESULTS: Nine clinical trials that used prolotherapy in the treatment of lateral epicondylitis were included. In the pooled analysis, prolotherapy was effective in pain control in the medium (d = -0.85, 95% CI -1.29 to -0.41, p (z) 0.0001) and long terms (d = -1.05, 95% CI -2.06 to -0.03, p (z) 0.04). It was also effective in improving function in the medium term (d = -1.21, 95% CI -1.64 to -0.78, p (z) 0.00001). CONCLUSIONS: Prolotherapy was effective for reducing pain in the medium and long terms, as well as for improving function in the medium term, in individuals with lateral epicondylitis. However, the risk of bias of the studies caused that the quality of evidence was moderate; more studies with a low risk of bias are necessary to corroborate the efficacy of prolotherapy in patients with lateral epicondylitis.

Weak Hand Grip Strength Is Associated with Alexithymia in Outpatients in a Mexican Population.

Hand grip strength has been considered as a possible marker for metabolic and psychiatric disease. To date, however, no research has focused on the association between alexithymia and hand grip strength. The objective of the present study was to investigate the correct association between hand grip strength and alexithymia. A cross-sectional study was carried out in Comalcalco, Tabasco, México. A total of 246 individuals were included. Hand grip strength was evaluated in the dominant hand using a Takei® portable digital dynamometer. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Two linear regression models adjusted by confounders were used to determine the association between alexithymia and hand grip strength. The rate for positive alexithymia was 39.0% (n = 94). Individuals with alexithymia showed a weaker hand grip strength than the comparison group (t = 2.4, 244 df, p = 0.01). Individuals with alexithymia had significantly reduced levels of hand grip strength (ß = -0.39 ± 0.14; p = 0.006); after additional adjustment for clinical variables, decreased hand grip strength remained (ß = 8.00 ± 1.86; p ≤ 0.001). Our results suggest that a decrease in hand grip strength could be associated with alexithymia. This measurement could be useful as a predictive marker for the identification of alexithymia in Mexican individuals who attend outpatient clinics.

Hypertonic Dextrose Prolotherapy, an Alternative to Intra-Articular Injections With Hyaluronic Acid in the Treatment of Knee Osteoarthritis: Systematic Review and Meta-analysis.

ABSTRACT: Intra-articular injections with hyaluronic acid are recommended in the treatment of knee osteoarthritis; however, hypertonic dextrose prolotherapy has been reported as effective and safe. The aim was to evaluate the effectiveness of hypertonic dextrose prolotherapy for pain reduction and improvement of function in individuals with knee osteoarthritis in comparison with hyaluronic acid by meta-analysis. The search was performed in electronic databases. Six studies were included (395 participants). No statistically significant differences were found between prolotherapy and hyaluronic acid in pain control in the short-term; however, in the subanalysis that included only the studies that used intra-articular injection within the prolotherapy scheme, an effect was found in favor of the prolotherapy groups ( d = -1.33; 95% confidence interval, -2.50 to -0.16; P ( z ) = 0.03). Also, an effect was found in favor of the prolotherapy group in the improvement in function ( d = -1.05; 95% confidence interval, -2.03 to -0.08; P ( z ) = 0.03). No major adverse reactions or side effects were reported in any of the studies. Hypertonic dextrose prolotherapy seems to be an effective intervention to decrease pain and improve function in knee osteoarthritis, with efficacy similar to intra-articular injections with hyaluronic acid in the short-term follow-up. Nonetheless, better-quality clinical trials are necessary.

Is Ozone therapy an adjunct treatment for SARS-CoV-2 / COVID-19 infection?

Abstract Up to today, there is no specific treatment against SARS-CoV-2 / COVID-19 infection; there the necessity to search for alternatives that help patients with COVID-19. The objective of this study was to review the use of ozone therapy as adjunct treatment for SARS-CoV-2 / COVID-19 infection, highlighting the mechanisms of action, forms of application and current clinical evidence. A systematic review was conducted in electronic databases, searching the terminology Ozone "or" Ozone therapy "and" SARS-CoV-2 or COVID-19 or Coronavirus. Results: nineteen studies were included; ten were editorials, comments, brief reports or reviews, and nine clinical studies. We found that ozone therapy could be favorable for treating patients infected with SARS-CoV-2 / COVID-19, through a direct antiviral effect, regulation of oxidative stress, immunomodulation and improvement of oxygen metabolism. Patients who were treated with ozone therapy responded favorably; therefore, ozone therapy appears to be a promising treatment for patients infected with SARS-CoV-2 / COVID-19. Its mechanism of action justifies its use as an adjuvant therapy; however, scientific evidence is based on case series and clinical trials are necessary to corroborate its effectiveness and safety.

Efficacy of hypertonic dextrose infiltrations for pain control in rotator cuff tendinopathy: systematic review and meta-analysis.

INTRODUCTION: The aim of our study was to assess the efficacy of hypertonic dextrose infiltrations for pain control in individuals with rotator cuff tendinopathy and to assess the characteristics of the treatment and the presence of side effects or adverse reactions through a systematic review and meta-analysis. METHODS: The search for the articles was performed in the electronic databases PUBMED, EMBASE, SCOPUS, SCIELO, DIALNET and Google Scholar, published up to August 2020. The keywords used were "prolotherapy" or "proliferation therapy" or "hypertonic dextrose infiltrations" or "hypertonic dextrose injection" and "Rotator Cuff" or "Rotator Cuff Injury" or "Rotator Cuff Tear" or "Rotator Cuff Tendinosis" or "supraspinatus". The effectiveness of hypertonic dextrose infiltrations was expressed as standardized mean difference (d) and 95% CI. RESULTS: In the pooled analysis, hypertonic dextrose infiltrations were an effective intervention to reduce long-term pain in patients with rotator cuff tendinopathy when compared to controls; furthermore, in the individual analyses, hypertonic dextrose infiltrations were more effective in the short, medium and long terms than non-invasive treatments, and more effective in the long-term than infiltrations with local anesthetics. On the other hand, hypertonic dextrose infiltrations were not more effective than injections with corticosteroids or PRP. Finally, no complications or serious adverse effect were observed when hypertonic dextrose infiltrations were used. CONCLUSIONS: We found that hypertonic dextrose infiltrations reduced pain in individuals with rotator cuff in the long-term. Hypertonic dextrose infiltrations could be an alternative to non-invasive treatments when no favorable results can be achieve. However, due to the small number of studies included in this meta-analysis, new studies are necessary to clarify the efficacy and safety of this intervention.

Higher risk of depression in individuals with type 2 diabetes and obesity: Results of a meta-analysis.

The aim of this study was to determine the risk of having significant depressive symptoms in subjects with obesity and type 2 diabetes mellitus through a meta-analysis. Our results showed that individuals with obesity and diabetes have an increased risk of having significant symptoms of depression. In subgroup analyses, we observed that Caucasian populations have an increased risk of having these symptoms. Our meta-analysis suggests that obesity is associated with an increased risk of having significant depressive symptoms in patients with type 2 diabetes, and they could be even higher in Caucasian populations.

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.

Papel del especialista en Medicina Física y Rehabilitación en los procesos de rehabilitación en el deporte / Role of the specialist in Physical Medicine and Rehabilitation in the rehabilitation process in sports

El deporte actual se caracteriza por una alta carga competitiva y, en consecuencia, la recuperación tras una lesión debe ser rápida y eficiente, por lo que los modelos convencionales de rehabilitación en el deporte(RD) probablemente resulten insuficientes.El objetivo de esta carta editorial es reflexionar sobre el papel del especialista en Medicina Física y Rehabilitación (EMFR) en el proceso de RD

Today's sport is characterized by a high competitive load and, consequently, recovery from injury must be fast and efficient, so that conventional models of rehabilitation in sport (RD) are likely to be insufficient. The aim of this editorial letter is to reflect on the role of the specialist in Physical Medicine and Rehabilitation (EMFR) in the DR process.

Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials.

BACKGROUND: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. MAIN BODY: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. CONCLUSIONS: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

Short-Term Therapeutic Effects of Ozone in the Management of Pain in Knee Osteoarthritis: A Meta-Analysis.

BACKGROUND: Ozone therapy has been used widely to decrease pain related to osteoarthritis, but the effectiveness of this treatment has not been evaluated. OBJECTIVE: To evaluate the effectiveness of ozone therapy in the reduction of pain in patients with knee osteoarthritis, according to the type of intervention and duration of the effect. TYPE: Meta-analysis. LITERATURE SURVEY: We performed an online search using PUBMED, DIALNET, SCIELO, MEDIGRAPHIC, and ISCO3 databases. We searched for articles published up to January 2018. PARTICIPANTS: We selected eight studies including a total of 355 patients and 363 controls. METHODOLOGY: Only randomized-controlled trials that assessed the efficacy of intraarticular or periarticular infiltrations with ozone to treat knee osteoarthritis in humans were included in the analysis. The results are expressed as standardized mean difference and 95% confidence intervals. The meta-analysis was performed in accordance with the statement of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. SYNTHESIS: We observed that ozone treatment had a therapeutic effect when compared with placebo (d = -0.81, 95% CI -1.06 to -0.55, I2 = 34.79, P(Q) = .47) or other noninvasive treatments. No significant effects were found in favor of the ozone treatment when compared with the use of hyaluronic acid or platelet-rich plasma. However, the use of ozone had a significant short-term benefit reducing knee pain (d = -2.26, 95% CI -2.26 to -3.72, I2 = 97, P(Q) < .001). Pain relief benefits lasted between 3 and 6 months. CONCLUSION: Our results indicate that intraarticular infiltrations of ozone can be used as an optional effective treatment for the management of pain related to knee osteoarthritis. There are short-term effect benefits that peak at around 1 month of treatment, with a gradual decline in efficacy after 3 to 6 months of treatment. More studies are needed to improve our understanding of the efficacy of this interventional treatment. LEVEL OF EVIDENCE: I.

Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials

Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

LA ACTIVIDAD FÍSICA REDUCE EL RIESGO DE MUERTE EN PACIENTES CON HIPERTENSIÓN / PHYSICAL ACTIVITY REDUCES THE RISK OF DEATH IN PATIENTS WITH HYPERTENSION

El objetivo de esta revisión fue establecer una asociación entre el nivel de actividad física realizada y la reducción del riesgo de muerte en pacientes hipertensos. Para la identificación de los documentos de esta revisión se realizó una búsqueda que abarcó estudios epidemiológicos tipo cohorte; las publicaciones relevantes fueron identificadas en las bases de datos biomédicas PubMed y Cochrane Collaboration, la estrategia de búsqueda siguió las recomendaciones de PRISMA. Los resultados mostraron que existe una asociación entre el nivel de actividad física y el riesgo de muerte en pacientes hipertensos. Se encontró una disminución del riesgo de muerte que oscila entre el 17-67% en los hipertensos que realizan altos niveles de actividad física. Los resultados apoyan la teoría de que la actividad física regular se asocia con la reducción del riesgo de muerte en pacientes hipertensos y se sugiere que este efecto protector puede ser para muerte por enfermedad cardiovascular y para muerte por cualquier causa, además se observó que en los estudios que consideraron edades de 40 a 80 años, la reducción del riesgo relativo fue del 28-67%. Por lo que se sugiere que probablemente la actividad física genere mayores beneficios en los grupos etarios de mayor edad.

The objective or aim of this review was to determine a relation between the level of realized physical activity and the reduction of the risk of death in hypertensive patients. A search was conducted for the identification of the documents from this review that included epidemiological cohort studies, relevant publications were identified in the biomedical databases PubMed and Cochrane Collaboration, the search strategy follows the recommendations of PRISMA. The results showed that an association exists between the level of physical activity and the risk of death in patients with hypertension. There was a diminution of death that ranges between 17-67 % in the hypertensive ones that do high physical activity levels. The results support the theory that regular physical activity is associated with a reduction in the rates of mortality in hypertensive patients and it is suggested that this protective effect can be of great benefit in a lower incidence of disease and cardiovascular death. In addition it is noted that the studies that consider ages of 40 to 80 years, the reduction of relative risk was 28-67%. Thus it is suggested that physical activity is likely to generate higher profits in the older age groups.