scholarly journals Cervical musculoskeletal impairments in migraine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhiqi Liang ◽  
Lucy Thomas ◽  
Gwendolen Jull ◽  
Julia Treleaven
Keyword(s):  
Neck Pain ◽  
Current Evidence ◽  
Patient Specific ◽  
Main Body ◽  
Moderating Effects ◽  
Pain Mechanisms ◽  
Musculoskeletal Impairments ◽  
Underlying Causes ◽  
Symptom Complex

Abstract Background Neck pain is common and disabling amongst individuals with migraine. Cervical musculoskeletal interventions are often sought but there is currently no evidence to support such interventions for this population. Improved understanding of how cervical musculoskeletal impairments present in migraine can elucidate neck pain mechanisms and guide clinicians and researchers in the management of patients with migraine and neck pain. Main body Migraine hypersensitivity is a major consideration when assessing for cervical impairments as it can aggravate migraine and confound findings. Current evidence of cervical impairments in migraine is limited by disregard for the different underlying causes of neck pain and possible influence of hypersensitivity. Findings of cervical musculoskeletal impairments are mixed within and across studies, indicating that different forms of neck pain are present in migraine. Some migraineurs have neck pain that is part of the migraine symptom complex and therefore exhibit little or no cervical musculoskeletal impairment. Others have a cervical source of neck pain and therefore exhibit a pattern of cervical musculoskeletal impairments akin to that of cervical disorders. The presence of cervical musculoskeletal dysfunction may or may not be related to migraine but knowledge of this is currently lacking which impacts decision making on management. Cervical musculoskeletal interventions may be indicated for migraineurs with identified cervical dysfunction but other factors requiring further clarification include determination of i) patient specific outcomes, ii) impact of co-existing migraine referred neck pain, and iii) potential moderating effects of migraine hypersensitivity on treatment efficacy. Conclusions Physiotherapists should seek a combination of cervical impairments through skilful assessment to identify if cervical musculoskeletal dysfunction is present or not in individual patients. The relevance of cervical dysfunction to migraine and influence of co-existing migraine referred neck pain need to be established through detailed evaluation of pain behaviours and further research. Future clinical trials should define expected treatment outcomes and select individuals with cervical musculoskeletal dysfunction when investigating the efficacy of cervical musculoskeletal interventions.

scholarly journals Pathophysiological In Vitro Profile of Neuronal Differentiated Cells Derived from Niemann-Pick Disease Type C2 Patient-Specific iPSCs Carrying the NPC2 Mutations c.58G>T/c.140G>T

2021 ◽  
Vol 22 (8) ◽  
pp. 4009
Author(s):  
Maik Liedtke ◽  
Christin Völkner ◽  
Alexandra V. Jürs ◽  
Franziska Peter ◽  
Michael Rabenstein ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Transmembrane Protein ◽  
Hereditary Disease ◽  
Cholesterol Homeostasis ◽  
Patient Specific ◽  
Differentiated Cells ◽  
Npc1 Gene ◽  
Niemann Pick

Niemann-Pick type C2 (NP-C2) disease is a rare hereditary disease caused by mutations in the NPC2 gene. NPC2 is a small, soluble protein consisting of 151 amino acids, primarily expressed in late endosomes and lysosomes (LE/LY). Together with NPC1, a transmembrane protein found in these organelles, NPC2 accomplishes the exclusion of cholesterol; thus, both proteins are essential to maintain cellular cholesterol homeostasis. Consequently, mutations in the NPC2 or NPC1 gene result in pathophysiological accumulation of cholesterol and sphingolipids in LE/LY. The vast majority of Niemann-Pick type C disease patients, 95%, suffer from a mutation of NPC1, and only 5% display a mutation of NPC2. The biochemical phenotype of NP-C1 and NP-C2 appears to be indistinguishable, and both diseases share several commonalities in the clinical manifestation. Studies of the pathological mechanisms underlying NP-C2 are mostly based on NP-C2 animal models and NP-C2 patient-derived fibroblasts. Recently, we established induced pluripotent stem cells (iPSCs), derived from a donor carrying the NPC2 mutations c.58G>T/c.140G>T. Here, we present a profile of pathophysiological in vitro features, shared by NP-C1 and NP-C2, of neural differentiated cells obtained from the patient specific iPSCs. Profiling comprised a determination of the NPC2 protein level, detection of cholesterol accumulation by filipin staining, analysis of oxidative stress, and determination of autophagy. As expected, the NPC2-deficient cells displayed a significantly reduced amount of NPC2 protein, and, accordingly, we observed a significantly increased amount of cholesterol. Most notably, NPC2-deficient cells displayed only a slight increase of reactive oxygen species (ROS), suggesting that they do not suffer from oxidative stress and express catalase at a high level. As a site note, comparable NPC1-deficient cells suffer from a lack of catalase and display an increased level of ROS. In summary, this cell line provides a valuable tool to gain deeper understanding, not only of the pathogenic mechanism of NP-C2, but also of NP-C1.

scholarly journals Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms—A Scoping Review

2021 ◽  
Vol 10 (10) ◽  
pp. 2189
Author(s):  
Thomas Perreault ◽  
César Fernández-de-las-Peñas ◽  
Mike Cummings ◽  
Barry C. Gendron
Keyword(s):  
Neuropathic Pain ◽  
Effective Treatment ◽  
Scoping Review ◽  
Reference Lists ◽  
Current Evidence ◽  
Review Of The Literature ◽  
Dry Needling ◽  
Pain Mechanisms ◽  
Literature Searches ◽  
Cochrane Database

Sciatica is a condition often accompanied by neuropathic pain (NP). Acupuncture and dry needling are common treatments for pain, and the current literature supports acupuncture as an effective treatment for sciatica. However, it is unknown if the mechanisms of NP are considered in the delivery of needling interventions for sciatica. Our objective was to assess the efficacy and the effectiveness of needling therapies, to identify common needling practices and to investigate if NP mechanisms are considered in the treatment of sciatica. A scoping review of the literature on needling interventions for sciatica and a review of the literature on mechanisms related to NP and needling interventions were performed. Electronic literature searches were conducted on PubMed, MEDLINE, CINAHL and Cochrane Database of Systematic Reviews from inception to August, 2020 to identify relevant papers. Reference lists of included papers were also manually screened and a related-articles search through PubMed was performed on all included articles. Mapping of the results included description of included studies, summary of results, and identification of gaps in the existing literature. Ten articles were included. All studies used acupuncture for the treatment of sciatica, no studies on dry needling were identified. Current evidence supports the efficacy and effectiveness of acupuncture for sciatica, however, no studies considered underlying NP mechanisms in the acupuncture approach for sciatica and the rationale for using acupuncture was inconsistent among trials. This review reveals that neuropathic pain mechanisms are not routinely considered in needling approaches for patients with sciatica. Studies showed acupuncture to be an effective treatment for sciatic pain, however, further research is warranted to explore if needling interventions for sciatica and NP would be more effective if NP mechanisms are considered.

Psychological factors of student youth‘s responsible behavior.

2020 ◽  
Vol 89-90 (4-5) ◽  
pp. 93-101
Author(s):  
Tatyana Fadeeva ◽  
Keyword(s):  
Social Responsibility ◽  
Self Esteem ◽  
Psychological Characteristics ◽  
Educational Organizations ◽  
Social Desirability Scale ◽  
Self Confidence ◽  
Responsible Behavior ◽  
Symptom Complex ◽  
Similarities And Differences

The article considers the problem of studying the determinants of the types of responsible behavior of young people. It is assumed that there are similarities and differences in the determination of the types of responsible behavior of the youth. The study involved 70 students (average age – 22 years old, SD = 2.19; men – 12%). We used the standardized methods "Questionnaire for the diagnosis of the personal symptom complex of responsibility" (Kocharyan I.A.), "Methods for the study of self-attitude" (Panteleev S.R.), the questionnaire "Determining the level of self-esteem" (Kovalev S.V.), "Social Desirability Scale" (D. Crown, D. Marlowe). We established that the most pronounced types of social behavior of youth are "ethics" and "self-sacrifice". It is shown that the severity of the type of social responsibility is determined by various combinations of psychological characteristics. The most complex regression equation characterizes the type of responsible behavior “Normalizations”. The least pronounced prediction of responsible behavior was revealed in relation to its types: "Fidelity to principle" and "Self-confidence". The results of this study can be useful for further study of the problems of social responsibility, as well as for the development of programs for the formation of youth's social responsibility in educational organizations.

Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bruno Chrcanovic ◽  
Johan Larsson ◽  
Eva-Maj Malmström ◽  
Hans Westergren ◽  
Birgitta Häggman-Henrikson
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Exercise Therapy ◽  
Full Text ◽  
Meta Analysis ◽  
Current Evidence ◽  
Positive Effects ◽  
Current Evidence Base ◽  
Whiplash Associated Disorders ◽  
Neck Disability

Abstract Objectives Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list. Content The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers. Summary The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability. Outlook Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.

Reliability, validity, and responsiveness of the Japanese version of the Patient-Specific Functional Scale in patients with neck pain

2015 ◽  
Vol 24 (12) ◽  
pp. 2816-2820 ◽  
Author(s):  
Koji Nakamaru ◽  
Junya Aizawa ◽  
Takayuki Koyama ◽  
Osamu Nitta
Keyword(s):  
Neck Pain ◽  
Japanese Version ◽  
Patient Specific ◽  
Functional Scale

Factors associated with neck pain in fighter aircrew: a systematic review and meta-analysis

2021 ◽  
pp. oemed-2020-107103
Author(s):  
James B Wallace ◽  
Phil M Newman ◽  
Aoife McGarvey ◽  
Peter G Osmotherly ◽  
Wayne Spratford ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Data Availability ◽  
Computer Work ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Operational Capability ◽  
Factors Associated ◽  
Common Complaint ◽  
Meta Analyses

Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew. Six electronic databases were searched in June 2019 and updated in June 2020 utilising the maximum date ranges. Included studies were appraised for methodological quality, ranked according to level of evidence and relevant data extracted. Where methods were homogeneous and data availability allowed, meta-analyses were performed. A total of 20 studies (16 cross sectional, one case–control, one retrospective cohort and two prospective cohort) were eligible for inclusion. Of the 44 factors investigated, consistent evidence was reported for greater occurrence of neck pain among aircrew operating more advanced aircraft and those exposed to more desk/computer work, while another 12 factors reported consistent evidence for no association. Of the 20 factors where meta-analyses could be performed, greater occurrence of neck pain was indicated for aircrew: flying more advanced aircraft, undertaking warm-up stretching and not placing their head against the seat under greater +Gz. Despite many studies investigating factors associated with neck pain among fighter aircrew, methodological limitations limited the ability to identify those factors that are most important to future preventive programmes. High-quality prospective studies with consistent use of definitions are required before we can implement efficient and effective programmes to reduce the prevalence and impact of neck pain in fighter aircrew. PROSPERO registration number: CRD42019128952.Neck pain is a common complaint among fighter aircrew, impacting workforce health and operational capability. This systematic review aimed to identify, evaluate and synthesise the current evidence for factors associated with the occurrence of neck pain among fighter aircrew.

From Donor to Recipient: Considerations for Blood Transfusion Outcomes Research

2017 ◽  
Vol 19 (5) ◽  
pp. 491-498
Author(s):  
Allison R. Jones ◽  
Michelle R. Brown ◽  
David E. Vance
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Outcomes Research ◽  
Current Evidence ◽  
Patient Specific ◽  
Blood Component ◽  
Blood Components ◽  
Packed Red Blood Cells ◽  
Blood Component Transfusion ◽  
Donor Characteristics

Donated blood can be broken down into blood components for use in patient care. This article focuses primarily on packed red blood cells (PRBCs), as they experience breakdown during storage that may adversely impact patient outcomes. Patients require PRBC transfusions for a number of clinical reasons. Although transfusions of PRBCs provide some clinical benefit, they are also associated with increased morbidity and mortality across multiple patient populations, albeit the mechanisms underlying this relationship remain unclear. With an aging, more acutely ill population requiring aggressive treatment and a lack of transfusion alternatives, research focused on PRBCs has gained momentum. Proper interpretation of research findings on the part of clinicians depends on accurate data collection that includes aspects of both the transfused blood components and the recipients. The purpose of this article is to examine stored PRBC factors, blood-donor characteristics, transfusion-specific factors, and patient-specific characteristics as they relate to patient outcomes research. Challenges associated with performing and interpreting outcomes of transfusion-related research are presented. Implications of current evidence for patient care, such as awareness of benefits as well as risks associated with blood component transfusion, are also provided.

Antithrombotic Therapy in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention: Where Are We Now?

2018 ◽  
Vol 52 (9) ◽  
pp. 884-897 ◽  
Author(s):  
Ryan G. D’Angelo ◽  
Thaddeus McGiness ◽  
Laura H. Waite
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Triple Therapy ◽  
Bleeding Risk ◽  
Coronary Intervention ◽  
Low Risk ◽  
Current Evidence ◽  
Patient Specific ◽  
Coronary Syndrome ◽  
Percutaneous Coronary

Objective: To synthesize the literature and provide guidance to practitioners regarding double therapy (DT) and triple therapy (TT) in patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI). Data Sources: PubMed and MEDLINE (January 2000 to February 2018) were searched using the following terms: atrial fibrillation, myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, anticoagulation, dual-antiplatelet therapy, clopidogrel, aspirin, ticagrelor, prasugrel, and triple therapy. Study Selection and Data Extraction: The results included randomized and nonrandomized clinical trials and meta-analyses. Each study was reported based on study design, population, intervention, comparator, and key cardiovascular (CV) and bleeding outcomes. Data Synthesis: A total of 15 studies were included in the review. The majority of studies evaluating DT and TT utilized clopidogrel and warfarin as components of the regimen, although there are emerging data with newer agents. Evidence purporting DT regimens to be equally effective in preventing CV events and improved safety profiles compared with TT regimens included populations with relatively low risk for recurrent CV events, and many of these studies were observational in nature. Overall, current evidence as well as American and European guidelines support the use of TT in patients with AF who require PCI for the least possible amount of time, depending on patient-specific factors involving bleeding and thrombosis. Conclusions: In the majority of patients with AF who require PCI, TT should be used for the shortest period of time possible. DT regimens may be used in patients requiring PCI who have low risk for thrombosis and/or high bleeding risk.

scholarly journals Stress as a potential moderator of ovarian hormone influences on binge eating in women

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 222 ◽  
Author(s):  
Natasha Fowler ◽  
Phuong T. Vo ◽  
Cheryl L. Sisk ◽  
Kelly L. Klump
Keyword(s):  
Binge Eating ◽  
High Stress ◽  
Ovarian Hormones ◽  
Current Evidence ◽  
Ovarian Hormone ◽  
Moderating Effects ◽  
Response To Stress ◽  
Increased Sensitivity ◽  
As Stress

Previous research has demonstrated significant associations between increased levels of ovarian hormones and increased rates of binge eating (BE) in women. However, whereas all women experience fluctuations in ovarian hormones across the menstrual cycle, not all women binge eat in response to these fluctuations, suggesting that other factors must contribute. Stress is one potential contributing factor. Specifically, it may be that hormone-BE associations are stronger in women who experience high levels of stress, particularly as stress has been shown to be a precipitant to BE episodes in women. To date, no studies have directly examined stress as a moderator of hormone-BE associations, but indirect data (that is, associations between BE and stress and between ovarian hormones and stress) could provide initial clues about moderating effects. Given the above, the purpose of this narrative review was to evaluate these indirect data and their promise for understanding the role of stress in hormone-BE associations. Studies examining associations between all three phenotypes (that is, ovarian hormones, stress, and BE) in animals and humans were reviewed to provide the most thorough and up-to-date review of the literature on the potential moderating effects of stress on ovarian hormone–BE associations. Overall, current evidence suggests that associations between hormones and BE may be stronger in women with high stress levels, possibly via altered hypothalamic–pituitary–adrenal axis response to stress and increased sensitivity to and altered effects of ovarian hormones during stress. Additional studies are necessary to directly examine stress as a moderator of ovarian hormone–BE associations and identify the mechanisms underlying these effects.

scholarly journals Computational modelling of the inflammatory response in trauma, sepsis and wound healing: implications for modelling resilience

2014 ◽  
Vol 4 (5) ◽  
pp. 20140004 ◽  
Author(s):  
Yoram Vodovotz
Keyword(s):  
Inflammatory Response ◽  
Acute Inflammation ◽  
Computational Modelling ◽  
Data Driven ◽  
Patient Specific ◽  
Cell Tissue ◽  
Organ Systems ◽  
Forward Process

Resilience refers to the ability to recover from illness or adversity. At the cell, tissue, organ and whole-organism levels, the response to perturbations such as infections and injury involves the acute inflammatory response, which in turn is connected to and controlled by changes in physiology across all organ systems. When coordinated properly, inflammation can lead to the clearance of infection and healing of damaged tissues. However, when either overly or insufficiently robust, inflammation can drive further cell stress, tissue damage, organ dysfunction and death through a feed-forward process of inflammation → damage → inflammation. To address this complexity, we have obtained extensive datasets regarding the dynamics of inflammation in cells, animals and patients, and created data-driven and mechanistic computational simulations of inflammation and its recursive effects on tissue, organ and whole-organism (patho)physiology. Through this approach, we have discerned key regulatory mechanisms, recapitulated in silico key features of clinical trials for acute inflammation and captured diverse, patient-specific outcomes. These insights may allow for the determination of individual-specific tolerances to illness and adversity, thereby defining the role of inflammation in resilience.

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