IntroductionNon-pharmacological approaches have shown promising results in improving symptoms and quality of life of patients with fibromyalgia. However, these approaches may not be easily accessible ...or feasible for everyone. eHealth interventions may offer a more convenient and cost-effective approach to reach a wider range of patients with fibromyalgia and improve their outcomes. As eHealth tools become more prevalent in clinical practice, it is crucial to understand their effectiveness, limitations and how they can be integrated into standard care to optimise clinical outcomes. This systematic review aims to evaluate the effectiveness of eHealth therapeutic education interventions in managing fibromyalgia.Methods and analysisRandomised controlled trials including eHealth therapeutic education interventions for individuals ≥18 years old with fibromyalgia, published in English or Spanish, will be retrieved by searching the databases PubMed, CINAHL Plus, EMBASE, Scopus, ISI Web of Science, PsycINFO and the Cochrane Central Register of Controlled Trials. Covidence software will be used for the selection of studies and data extraction. The risk of bias and the certainty of evidence will be assessed using the Cochrane Risk of Bias Assessment tool. We plan to perform a meta-analysis contingent on the number of studies retrieved and the interstudy heterogeneity, which will be explored with I2 statistics.Ethics and disseminationThis protocol and the subsequent systematic review will not collect individual-level data and do not require approval by an ethical committee. We intend to disseminate the study results via peer-reviewed scientific journals and relevant (inter)national conferences.PROSPERO registration numberCRD42022343373.
The scientific evidence highlights the difficulties that healthcare professionals experience when managing patients with chronic pain. One of the causes of this difficulty could be related to the ...acquired training and the lack of knowledge about the neurophysiology of pain. In the present study, we assessed the effectiveness of a gamified web platform in acquiring knowledge about pain neurophysiology and determining the satisfaction and motivation of students of the Degree in Physiotherapy at the University of Lleida.
A quasi-experimental study was carried out with a sample of 60 students who had access to a gamified web platform that included notes, videos, and clinical cases prepared by the teaching staff and was based on a previous study that included patients and healthcare professionals.
The results show that after the intervention, there was a statistically significant increase in knowledge about the neurophysiology of pain, and the effect size was in the desired area of effect. Likewise, many students considered that their motivation had increased as a result of the methodology used in the present study.
The results support the use of this methodology to promote knowledge about the neurophysiology of pain while improving students' motivation.
Los ámbitos centrales de ciudades como Granada están sometidos a fuertes presiones del mercado turístico y sufren la amenaza constante de la gentrificación, la pérdida de diversidad social, y el ...deterioro y pérdida de carácter de su espacio urbano. Para contrarrestar esto, el urbanismo necesita aprovechar las potencialidades que posee la ciudad histórica, máxime en contextos como el español, donde los instrumentos y las políticas adecuadas de regeneración urbana vienen resultando insuficientes, principalmente desde la crisis de la segunda década del siglo XXI, agravada por la pandemia de la Covid19. Por ello, creemos obligada la optimización de sus recursos turísticos, dándole al patrimonio el papel urbano de activación y dinamización que es capaz de asumir. La investigación trabaja el potencial estratégico del patrimonio arquitectónico para la regeneración urbana integral, desde una perspectiva espacial, funcional y paisajística. Se parte de un conjunto de claves que disciplinar e internacionalmente se vienen poniendo en marcha en las últimas décadas para la interpretación y puesta en valor de la “ciudad-patrimonio”, consideraciones que buscan orientar la vinculación de esta arquitectura catalogada entre sí y con su entorno espacial: el turismo urbano, espacio público central como lugar flexible y compartido, los efectos de la gentrificación, la paseabilidad, etc. Situados en Granada, se analiza el vaciamiento poblacional de su centro, la estandarización y pérdida de calidad de su espacio público, su evidente tematización y la falta de perspectiva integral del planeamiento desarrollado, para plantear la configuración de vinculaciones diacrónicas, reflejo de la evolución de la ciudad a través del tiempo, mediante una aproximación cartográfica, un análisis funcional y una caracterización patrimonial que prioriza los entornos. Se propone así un instrumento de evaluación-diagnóstico que añade nuevos significados a la dimensión patrimonial e intensifica su rol urbano, formulando una propuesta de secuencias, cuya topología es orientada por el juego relacional entre forma urbana, topografía, realidad social y funcional, y paisaje urbano. Se concluye con una sistematización de atributos multidimensionales del patrimonio en la secuencia elegida que posibilite impulsar estrategias futuras de regeneración urbana, superando así la lógica aislada y estática de la visión cataloguista para adentrarse en una re-significación dinámica y relacional.
The temporomandibular joint is responsible for fundamental functions. However, mechanical overload or microtraumas can cause temporomandibular disorders (TMD). In addition to external factors, it is ...known that these conditions are involved in complex biological mechanisms, such as activation of the immune system, activation of the inflammatory process, and degradation of extracellular matrix (ECM) components. The ECM is a non-cellular three-dimensional macromolecular network; its most studied components is hyaluronic acid (HA). HA is naturally found in many tissues, and most of it has a high molecular weight. HA has attributed an essential role in the viscoelastic properties of the synovial fluid and other tissues. Additionally, it has been shown that HA molecules can contribute to other mechanisms in the processes of injury and healing. It has been speculated that the degradation product of high molecular weight HA in healthy tissues during injury, a low molecular weight HA, may act as damage-associated molecular patterns (DAMPs). DAMPs are multifunctional and structurally diverse molecules that play critical intracellular roles in the absence of injury or infection. However, after cellular damage or stress, these molecules promote the activation of the immune response. Fragments from the degradation of HA can also act as immune response activators. Low molecular weight HA would have the ability to act as a pro-inflammatory marker, promoting the activation and maturation of dendritic cells, the release of pro-inflammatory cytokines such as interleukin 1 beta (IL-1β), and tumor necrosis factor α (TNF-α). It also increases the expression of chemokines and cell proliferation. Many of the pro-inflammatory effects of low molecular weight HA are attributed to its interactions with the activation of toll-like receptors (TLRs 2 and 4). In contrast, the high molecular weight HA found in healthy tissues would act as an anti-inflammatory, inhibiting cell growth and differentiation, decreasing the production of inflammatory cytokines, and reducing phagocytosis by macrophages. These anti-inflammatory effects are mainly attributed to the interaction of high-weight HA with the CD44 receptor. In this study, we review the action of the HA as a DAMP and its functions on pain control, more specifically in orofacial origin (e.g., TMD).
IntroductionThe gradual changes over the decades in the longevity and ageing of European society as a whole can be directly related to the prolonged decline in the birth rate and increase in the life ...expectancy. According to the WHO, there is an increased risk of dementia or other cognitive disorders as the population ages, which have a major impact on public health. Mild cognitive impairment (MCI) is described as a greater than expected cognitive decline for an individual’s age and level of education, but that does not significantly interfere with activities of daily living. Patients with MCI exhibit a higher risk of dementia compared with others in the same age group, but without a cognitive decline, have impaired walking and a 50% greater risk of falling.The urban lifestyle and advent of smartphones, mobility and immediate access to all information via the internet, including health information, has led to a totally disruptive change in most general aspects.This systematic review protocol is aimed at evaluating the effectiveness of technology-based interventions in the detection, prevention, monitoring and treatment of patients at risk or diagnosed with MCI.Methods and analysisThis review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. The search will be performed on MEDLINE (PubMed), CENTRAL, CINAHL Plus, ISI Web of Science and Scopus databases from 2010 to 2020. Studies of interventions either randomised clinical trials or pre–post non-randomised quasi-experimental designs, published in English and Spanish will be included. Articles that provide relevant information on the use of technology and its effectiveness in interventions that assess improvements in early detection, prevention, follow-up and treatment of the patients at risk or diagnosed with MCI will be included.Ethics and disseminationEthics committee approval not required. The results will be disseminated in publications and congresses.
Alzheimer's disease (AD) is a neurodegenerative disorder that leads to impaired memory and cognitive deficits. Spine loss as well as changes in spine morphology correlates with cognitive impairment ...in this neurological disorder. Many studies in animal models and
cultures indicate that amyloid β-peptide (Aβ) oligomers induce synaptic damage early during the progression of the disease. Here, in order to determine the events that initiate synaptic alterations, we acutely applied oligomeric Aβ to primary hippocampal neurons and an
model of organotypic hippocampal cultures from a mouse after targeted expression of EGFP to allow high-resolution imaging and algorithm-based evaluation of spine changes. Dendritic spines were classified as thin, stubby or mushroom, based on morphology.
, time-lapse imaging showed that the three spine types were relatively stable, although their stability significantly decreased after treatment with Aβ oligomers. Unexpectedly, we observed that the density of total dendritic spines increased in organotypic hippocampal slices treated with Aβ compared to control cultures. Specifically, the fraction of stubby spines significantly increased, while mushroom and thin spines remained unaltered. Pharmacological tools revealed that acute Aβ oligomers induced spine changes through mechanisms involving CaMKII and integrin β1 activities. Additionally, analysis of dendritic complexity based on a 3D reconstruction of the whole neuron morphology showed an increase in the apical dendrite length and branching points in CA1 organotypic hippocampal slices treated with Aβ. In contrast to spines, the morphological changes were affected by integrin β1 but not by CaMKII inhibition. Altogether, these data indicate that the Aβ oligomers exhibit early dual effects by acutely enhancing dendritic complexity and spine density.
Abstract
Background
Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the ...functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain.
Methods
A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group.
Results
For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle.
Conclusion
A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU.
Trial registration
Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.
Tapia G, Sanz C, Mate J L, Muñoz‐Mármol A M & Ariza A (2012) Histopathology 60, 768–773 Improved clonality detection in Hodgkin lymphoma using the BIOMED‐2‐based heavy and kappa chain assay: a ...paraffin‐embedded tissue study
Aims: Although BIOMED‐2 polymerase chain reaction (PCR) standardization protocols allow clonality detection in nearly 100% of non‐Hodgkin B cell lymphomas, they have not been widely validated for Hodgkin lymphoma (HL). Our aim was to assess BIOMED‐2 protocol sensitivity when using non‐microdissected, formalin‐fixed, paraffin‐embedded (FFPE) tissue from HL cases.
Methods and results: We studied 69 consecutive HL cases, of which 61 corresponded to classic HL (cHL) and eight to nodular lymphocyte‐predominant HL (NLPHL). CD30‐positive cell numbers (<10, 10–25 or >25 per ×200 field), background CD20‐positive cell density (low or high) and tumour cell immunophenotype were evaluated. IGH and IGK clonality was assessed on FFPE tissue following BIOMED‐2 protocols. Of the 58 assessable cHL cases, 15 (25.9%) exhibited IGH and/or IGK clonality; IGH clonality was shown by nine (15.5%) and IGK clonality by 12 (20.7%). Clonality detection rates in cHL improved as CD30‐positive Reed–Sternberg (RS) cell density increased and CD20‐positive B cell density decreased, although these correlations did not reach statistical significance. Of the eight NLPHL cases studied, none showed clonal rearrangement.
Conclusions: Combined study of IGH and IGK rearrangement according to BIOMED‐2 protocols improves clonality detection rate (up to 25% of cases) in HL, even when working on non‐microdissected FFPE tissue.
PDF
