Platelet-Derived Growth Factor BB Influences Muscle Regeneration in Duchenne Muscle Dystrophy.

Duchenne muscular dystrophy (DMD) is characterized by a progressive loss of muscle fibers, and their substitution by fibrotic and adipose tissue. Many factors contribute to this process, but the molecular pathways related to regeneration and degeneration of muscle are not completely known. Platelet-derived growth factor (PDGF)-BB belongs to a family of growth factors that regulate proliferation, migration, and differentiation of mesenchymal cells. The role of PDGF-BB in muscle regeneration in humans has not been studied. We analyzed the expression of PDGF-BB in muscle biopsy samples from controls and patients with DMD. We performed in vitro experiments to understand the effects of PDGF-BB on myoblasts involved in the pathophysiology of muscular dystrophies and confirmed our results in vivo by treating the mdx murine model of DMD with repeated i.m. injections of PDGF-BB. We observed that regenerating and necrotic muscle fibers in muscle biopsy samples from DMD patients expressed PDGF-BB. In vitro, PDGF-BB attracted myoblasts and activated their proliferation. Analysis of muscles from the animals treated with PDGF-BB showed an increased population of satellite cells and an increase in the number of regenerative fibers, with a reduction in inflammatory infiltrates, compared with those in vehicle-treated mice. Based on our results, PDGF-BB may play a protective role in muscular dystrophies by enhancing muscle regeneration through activation of satellite cell proliferation and migration.

Cuestionarios de evaluación e intervención espiritual en cuidados paliativos: una revisión crítica / Evaluation and spiritual intervention questionnaires in palliative care: a critical review

OBJETIVO: El presente estudio tiene 2 objetivos. El primero, ofrecer una revisión de las herramientas de medida de espiritualidad en el contexto español de los cuidados paliativos. El segundo, comparar el constructo de los instrumentos revisados desde la perspectiva antropológica del modelo de espiritualidad propuesto por el Grupo de Espiritualidad de la Sociedad Española de Cuidados Paliativos. MÉTODO: La revisión sigue 5 pasos: 1. identificar las medidas de espiritualidad que se han utilizado en estudios relevantes; 2. conocer aquellos instrumentos con propiedades psicométricas adecuadas; 3. clasificar las medidas en función del tipo de instrumento; 4. identificar los instrumentos de medida de espiritualidad que han sido validados en población española; y 5. estudiar el contenido espiritual de las medidas validadas transculturalmente. RESULTADOS: Las bases de datos consultadas recogían 751 artículos científicos, 128 de los cuales se identificaron como relevantes. De estos, se obtuvieron 57 herramientas de medida de espiritualidad, que se categorizaron en: medidas multidimensionales generales (n = 22), medidas funcionales de espiritualidad (n = 21) y medidas sustantivas de espiritualidad (n = 14). De estas, 9 habían sido validadas transculturalmente. El análisis del contenido espiritual de los 9 instrumentos mostró la presencia de las dimensiones de la espiritualidad definidas por el Grupo de Espiritualidad: intra, inter y transpersonal. DISCUSIÓN: Los resultados encontrados se ponen en relación con la literatura actual, evidenciándose algunas de las limitaciones que detentan actualmente los instrumentos de medida y cómo estas se intentan paliar con el nuevo modelo que aporta el Grupo de Espiritualidad de la Sociedad Española de Cuidados Paliativos

AIM: The current study has 2 AIMS: The first one is to present a review of the measures of spirituality in the Spanish palliative care context. The second, to compare the construct of the tools reviewed from the anthropological approach provided by the spirituality model of the Spirituality Group of the Spanish Society for Palliative Care. METHOD: The review followed 5 steps: 1. To identify the spirituality measures used in relevant studies; 2. To determine the tools with the appropriate psychometric properties; 3. To classify these measures depending on the type of tool; 4. To identify the spirituality measures that have been validated in a Spanish sample; and 5. To study the spiritual content of the transculturally validated measures. RESULTS: The data bases collected 751 scientific papers, 128 of which were identified as relevant. Among them, 57 spirituality measures were obtained, which were categorised into: general multidimensional measures (n = 22), functional spirituality measures (n = 21), and substantive spirituality measures (n = 14). Among these, 9 tools were transculturally validated. The spiritual content analysis of these 9 tools showed the presence of the spirituality dimensions defined by the Spirituality Group: intra-, inter-, and trans-personal. DISCUSSION: The results found were put in relationship with the current literature, and some of the limitations of the measurement tools are shown, and also how the Spirituality Group of the Spanish Society for Palliative Care attempts to mitigate them

Development and validation of a new tool for the assessment and spiritual care of palliative care patients.

CONTEXT: Spiritual assessment tools and interventions based on holistic approaches are needed to promote healing. Such tools must be adapted to the wide cultural backgrounds of contemporary Western society. OBJECTIVES: To develop and validate a new brief measure, simultaneously featuring clinical applicability and adequate psychometric properties. The tool uses six initial questions to establish a climate of trust with patients before they complete an eight-item, five-point Likert scale. The questionnaire is based on a model of spirituality generated by the Spanish Society of Palliative Care (SECPAL) Task Force on Spiritual Care (Grupo de Espiritualidad de la SECPAL), which aims to recognize, share, and assess the spiritual resources and needs of palliative care patients. METHODS: Multidisciplinary professionals from 15 palliative care teams across Spain interviewed 108 patients using the Grupo de Espiritualidad de la SECPAL questionnaire. Confirmatory factor analysis techniques were used to study the new tool factor structure and reliability. Additionally, concurrent criterion validity coefficients were estimated considering spiritual well-being, anxiety, depression, resilience, and symptoms. Descriptive statistics on questionnaire applicability were reported. RESULTS: Analyses supported a three-factor structure (intrapersonal, interpersonal, transpersonal) with an underlying second-order factor representing a spirituality construct. Adequate reliability results and evidence for construct validity were obtained. CONCLUSION: The new questionnaire, based on empirical research and bedside experience, showed good psychometric properties and clinical applicability.