Trigger point dry needling versus strain-counterstrain technique for upper trapezius myofascial trigger points: a randomised controlled trial.

BACKGROUND: Treatment of active myofascial trigger points includes both invasive and non-invasive techniques. OBJECTIVES: To compare the effects of upper trapezius trigger point dry needling (DN) and strain-counterstrain (SCS) techniques versus sham SCS. STUDY DESIGN: Randomised controlled trial. METHOD: 34 study subjects with active trigger points were randomly assigned to one of three treatment groups, and received either three sessions of DN (n=12), six sessions of SCS (n=10), or sham SCS (n=12) over a 3-week period. Subjective pain response and subjects' own ratings of perceived disability were measured. RESULTS: The analysis of variance mixed model showed a significant time effect for pain (p<0.001), elicited pain (p<0.001), pain pressure threshold (p<0.01), and neck disability index (p=0.016). Pain at rest decreased in all groups, as follows: DN 18.5 mm (95% CI 4.3 to 32.7 mm); SCS 28.3 mm (95% CI 12.4 to 44.1 mm); sham SCS 21.9 mm (95% CI 3.5 to 40.1 mm). Reductions in disability score (points) were significant in the SCS group (5.5, 95% CI 1.6 to 9.4) but not in the DN (1.4, 95% CI -4.9 to 2.1) or sham SCS (1.8, 95% CI -6.4 to 2.7) groups. There was no significant group×time interaction effect for any variables studied. CONCLUSIONS: There were no differences between the sham SCS, SCS, and DN groups in any of the outcome measures. DN relieved pain after fewer sessions than SCS and sham SCS, and thus may be a more efficient technique. Future studies should include a larger sample size. TRIAL REGISTRATION NUMBER: NCT01290653.

Factors affecting oocyte quality: who is driving the follicle?

Mammalian ovaries contain a large stock of oocytes enclosed in primordial follicles. Ovarian cyclic activity induces some of these follicles to initiate growth towards a possible ovulation. However, most of these follicles terminate their growth at any moment and degenerate through atresia. In growing follicles, only a subset of oocytes are capable to support meiosis, fertilization and early embryo development to the blastocyst stage, as shown through embryo in vitro production experiments. This proportion of competent oocytes is increasing along with follicular size. Growing lines of evidence suggest that oocyte competence relies on the storage of gene products (messenger RNA or protein) that will be determinant to support early stages of embryo development, before full activation of embryonic genome. Given these facts, the question is: are these gene products stored in oocytes during late folliculogenesis, allowing an increasing proportion of them to become competent? Alternatively, these transcripts may be stored during early folliculogenesis as the oocyte grows and displays high transcription activity. Several arguments support this latter hypothesis and are discussed in this review: (i) many attempts at prolonged culture of oocytes from antral follicles have failed to increase developmental competence, suggesting that developmental competence may be acquired before antral formation; (ii) the recent discovery of oocyte secreted factors and of their ability to regulate many parameters of surrounding somatic cells, possibly influencing the fate of follicles between ovulation or atresia, suggests a central role of oocyte quality in the success of folliculogenesis. Finally, in addition to their role in interfollicular regulation of ovulation rate, late folliculogenesis regulation and atresia could also be seen as a selective process aimed at the elimination through follicular atresia of oocytes that did not succeed to store proper gene products set during their growth.

Localization of Neuropeptide Y-like immunoreactive structures in the brain of the pejerrey, Odontesthes bonariensis (Teleostei, Atheriniformes).

The aim of this study was to determine the distribution of Neuropeptide-Y (NPY) immunoreactive neurons and fibres in the brain and pituitary of Odontesthes bonariensis by immunohistochemical methods. A wide distribution of immunoreactive NPY (ir-NPY) cells and fibres in the forebrain and midbrain was observed. A prominent ir-NPY nucleus was found in the ventral telencephalon and other ir-NPY cells groups were recognized at the dorso-medial telencephalon. The diencephalon showed ir-NPY cells in the Nucleus entopeduncularis, the Nucleus preopticus periventricularis and in the Nucleus lateralis tuberis. Ir-NPY fibres were conspicuous in the preoptic region and the hypothalamus. There were also numerous ir-NPY fibres at the epithalamic level running ventrally to the hypothalamus and the pituitary stalk. At the rhomboencephalic level, the ir-NPY neurons were observed in the Locus coeruleus. Double-labelled immunostaining showed a close association between ir-NPY fibres that reach the adenohypophysis and growth hormone (GH)- and gonadotropin (GtH)-expressing cells. Although our results exhibit some relevant differences when compared to other fish groups, they support the existence of a conserved NPY system in teleosts.

Selection of a seed orchard of Eucalyptus dunnii based on genetic diversity criteria calculated using molecular markers.

A Eucalyptus dunnii Maiden breeding population of 46 accessions originated in Australia and selected for fitness to subtropical and cold environments was screened by Amplified Fragment Length Polymorphism (AFLP) and microsatellite markers to obtain quantitative estimates of genetic diversity. A randomly chosen group of AFLP primers generated 205 AFLP bands that were used to fingerprint the genotypes and to evaluate genetic relationships among accessions. Sixty-eight percent (140) of the bands were polymorphic markers. The mean diversity index (DI) was 0.33 and about 52% of the loci had values greater than 0.4. Cluster analysis derived from similarity indices (SI) revealed no particular grouping among accessions suggesting the absence of closely related genotypes, except for five pairs of genotypes. Bootstrap analysis results confirmed the suitability of AFLP to describe genetic relationships in this breeding population. In addition, four highly informative microsatellites were used to construct an identification matrix that discriminated nearly all of the genotypes. Mean values for the number of alleles per locus, DI and SI among accessions were 13, 0.78 and 0.19, respectively, indicating that the breeding population has high genetic diversity. However, several genotypes showed the presence of single microsatellite bands suggesting a putatively important degree of homozygosity. Molecular data were used to design a clonal seed orchard. To achieve this aim, the nine most divergent pairs of genotypes were chosen, thereby retaining 95.2% of the total number of alleles from the 140 polymorphic AFLP loci and the four microsatellite loci analyzed. Mean DI and SI for AFLP and microsatellites showed no significant differences between the original breeding population and the selected seed orchard, confirming that a seed orchard can be designed with a limited number of individuals, which allows similar accessions to be discarded and avoids inbreeding.

Un paciente con dolor

El dolor es una sensación subjetiva desagradable que interfiere en la calidad de vida de los pacientes y en su evolución; por ello, en la actualidad se da una gran importancia a su manejo y tratamiento.Actualmente existe un arsenal muy cuantioso de medicamentos disponibles en el mercado para solventar estos problemas; no obstante, todavía no se ha conseguido controlarlo en todos los casos. Existe una serie de enfermedades que se asocian a dolores intensos y cuyo manejo es muy difícil.No obstante, un mejor conocimiento de las mismas conlleva un tratamiento más acertado.Otro de los problemas respecto al dolor es su cuantificación, ya que al tratarse de una sensación subjetiva, y a pesar de que se ha intentado cuantificar, todavía no se ha logrado un medio objetivo.En este artículo pretendemos dar unas pautas de actuación y de conocimientos farmacológicos que permitan al clínico enfrentarse ante este problema de una manera más eficaz (AU)

Las úlceras de decúbito

Las úlceras de decúbito o presión se producen por la compresión sostenida en una determinada zona corporal. Esto implica una disminución local de la circulación sanguínea y la consecuente isquemia de los tejidos que conducen a la necrosis. Existen otros factores de riesgo asociados que contribuyen a favorecer la aparición de estas lesiones, como la inmovilidad, la humedad, las deficiencias asistenciales, las deficiencias nutricionales y la propia patología inherente al individuo.Un adecuado manejo del paciente inmovilizado y una buena actitud ante la aparición de los primeros signos premonitorios pueden disminuir tanto la incidencia como la gravedad de estas lesiones. No obstante, la aparición de úlceras de decúbito no es un buen marcador de calidad, en cuanto a asistencia de los profesionales sanitarios, si no se tiene en cuenta las características de estos pacientes, su estado general y otros factores asociados.En este artículo, pretendemos hacer un recordatorio respecto a este problema, que tantas veces se olvida en la praxis sanitaria (AU)