Short-Term Changes in Algometry, Inclinometry, Stabilometry, and Urinary pH Analysis After a Thoracolumbar Junction Manipulation in Patients with Kidney Stones

Objectives: To determine the efficacy of a high-velocity low-amplitude manipulation of the thoracolumbar junction in different urologic and musculoskeletal parameters in subjects suffering from renal lithiasis. Design: Randomized, controlled blinded clinical study. Settings/Location: The Nephrology departments of two hospitals and one private consultancy of physiotherapy in Valencia (Spain). Subjects: Forty-six patients suffering from renal lithiasis. Interventions: The experimental group (EG, n¿=¿23) received a spinal manipulation of the thoracolumbar junction, and the control group (CG, n¿=¿23) received a sham procedure. Outcome measures: Pressure pain thresholds (PPTs) of both quadratus lumborum and spinous processes from T10 to L1, lumbar flexion range of motion, stabilometry, and urinary pH were measured before and immediately after the intervention. A comparison between pre- and postintervention phases was performed and an analysis of variance for repeated measures using time (pre- and postintervention) as intrasubject variable and group (CG or EG) as intersubject variable. Results: Intragroup comparison showed a significant improvement for the EG in the lumbar flexion range of motion (p¿<¿0.001) and in all the PPT (p¿<¿0.001 in all cases). Between-group comparison showed significant changes in PPT in quadratus lumborum (p¿<¿0.001), as well as in the spinous processes of all of the evaluated levels (p¿<¿0.05). No changes in urinary pH were observed (p¿=¿0.419). Conclusion: Spinal manipulation of the thoracolumbar junction seems to be effective in short term to improve pain sensitivity, as well as to increase the lumbar spine flexion

TMAO and Gut Microbial-Derived Metabolites TML and γBB Are Not Associated with Thrombotic Risk in Patients with Venous Thromboembolism

Background: The present work evaluates the association between circulating concentrations of Trimethylamine-N-oxide (TMAO), gamma butyrobetaine (gamma BB), and trimetyllisine (TML) in controls and patients with venous thromboembolism (VTE) with coagulation parameters. Methods: The study involved 54 VTE patients and 57 controls. Platelet function, platelet hyperreactivity, platelet adhesiveness, thrombosis-associated parameters, and thrombin generation parameters were studied. Plasma TMAO, gamma BB, and TML determination was performed using an ultra-high-performance liquid chromatography system coupled with mass spectrometry. Results: No differences were found for TMAO, gamma BB, or TML concentrations between controls and VTE patients. In thrombin generation tests, TMAO, gamma BB, and TML showed a positive correlation with lag time and time to peak. TMAO, gamma BB, and TML negatively correlated with peak height. No significant differences were observed regarding TMAO, gamma BB, and TML concentrations between the two blood withdrawals, nor when the control and VTE patients were analyzed separately. No correlation was observed between these gut metabolites and platelet function parameters. Conclusions: No differences were found regarding TMAO, gamma BB, and TML concentrations between the control and VTE groups. Some correlations were found; however, they were mild or went in the opposite direction of what would be expected if TMAO and its derivatives were related to VTE risk

Modelling the management of forest ecosystems: importance of wood decomposition

Scarce and uncertain data on woody debris decomposition rates are available for calibrating forest ecosystem models, owing to the difficulty of their empirical estimations. Using field data from three experimental sites which are part of the North American Long-Term Soil Productivity (LTSP) Study in south-eastern British Columbia (Canada), we developed probability distributions of standard wood stake mass loss of Populus tremuloides and Pinus contorta. Using a Monte Carlo approach, 50 synthetic decomposition rate values per debris type were used to calibrate the ecosystem-level forest model FORECAST. Significant effects of uncertainty of pine stake mass loss rates on estimated tree growth were found, especially in moderately managed forests, as estimations of available nitrogen were affected. Consequently, our work has shown that projections of tree growth under management conditions depend on accurate estimations of woody debris decomposition rates, and special effort should be done in create reliable databases of decomposition rates for their use in tree growth and yield modelling

Effect of weight loss on HDL-apoA-II kinetics in the metabolic syndrome

Reduced HDL (high-density lipoprotein) concentration in the MetS (metabolic syndrome) is associated with increased risk of cardiovascular disease and is related to defects in HDL-apoA-II (apolipoprotein A-II) kinetics. Dietary restriction is the most commonly used weight loss strategy. In the present study, we examined the effect of weight loss on HDL-apoA-II kinetics in men with the MetS at the start and end of a 16-week intervention trial of a hypocaloric low-fat diet (n=20) compared with a weight maintenance diet (n=15), using a stable isotope technique and compartmental modelling. The low-fat diet achieved a significant reduction (P<0.01) in BMI (body mass index), abdominal fat compartments and HOMA (homoeostasis model assessment) score compared with weight maintenance. Weight loss also significantly (P<0.05) decreased both the production rate (−23%) and FCR (fractional catabolic rate) (−12%) of HDL-apoA-II, accounting for a net decrease in apoA-II concentration (−9%). Reductions in the HDL-apoA-II production rate were significantly associated with changes in body weight (r=0.683, P<0.01), plasma triacylglycerols (triglycerides) (r=0.607, P<0.01) and, to a lesser extent, plasma insulin (r=0.440, P=0.059) and HOMA-IR (HOMA of insulin resistance) (r=0.425, P=0.069). Changes in the apoA-II FCR were also significantly associated with reductions in visceral adipose tissue mass (r=0.561, P=0.010). In conclusion, in obese men with the MetS, short-term weight loss with a low-fat low-caloric diet lowers plasma apoA-II concentrations by decreasing both the production and catabolism of HDL-apoA-II. The cardiometabolic significance of this effect on HDL metabolism remains to be investigated further

Short-term changes in median nerve neural tension after a suboccipital muscle inhibition technique in subjects with cervical whiplash: A randomised controlled trial.

Objectives To assess the immediate effect of a suboccipital muscle inhibition (SMI) technique on: (a) neck pain, (b) elbow extension rangeof motion during the upper limb neurodynamic test of the median nerve (ULNT-1), and (c) grip strength in subjects with cervical whiplash;and determine the relationships between key variables.Design Randomised, single-blind, controlled clinical trial.Setting Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Spain.Participants Forty subjects {mean age 34 years [standard deviation (SD) 3.6]} with Grade I or II cervical whiplash and a positive responseto the ULNT-1 were recruited and distributed into two study groups: intervention group (IG) (n = 20) and control group (CG) (n = 20).Interventions The IG underwent the SMI technique for 4 minutes and the CG received a sham (placebo) intervention. Measures were collectedimmediately after the intervention.Main outcome measures The primary outcome was elbow range of motion during the ULNT-1, measured with a goniometer. The secondaryoutcomes were self-perceived neck pain (visual analogue scale) and free-pain grip strength, measured with a digital dynamometer.Results The mean baseline elbow range of motion was 116.0◦(SD 10.2) for the CG and 130.1◦(SD 7.8) for the IG. The within-groupcomparison found a significant difference in elbow range of motion for the IG [mean difference −15.4◦, 95% confidence interval (CI) −20.1to −10.6; P = 0.01], but not for the CG (mean difference −4.9◦, 95% CI −11.8 to 2.0; P = 0.15). In the between-group comparison, thedifference in elbow range of motion was significant (mean difference −10.5◦, 95% CI −18.6 to −2.3; P = 0.013), but the differences in gripstrength (P = 0.06) and neck pain (P = 0.38) were not significant.Conclusion The SMI technique has an immediate positive effect on elbow extension in the ULNT-1. No immediate effects on self-perceivedcervical pain or grip strength were observed

Discovery of serum biomarkers for pancreatic adenocarcinoma using proteomic analysis

Background and aims:The serum/plasma proteome was explored for biomarkers to improve the diagnostic ability of CA19-9 in pancreatic adenocarcinoma (PC).Methods:A Training Set of serum samples from 20 resectable and 18 stage IV PC patients, 54 disease controls (DCs) and 68 healthy volunteers (HVs) were analysed by surface-enhanced laser desorption and ionisation time-of-flight mass spectrometry (SELDI-TOF MS). The resulting protein panel was validated on 40 resectable PC, 21 DC and 19 HV plasma samples (Validation-1 Set) and further by ELISA on 33 resectable PC, 28 DC and 18 HV serum samples (Validation-2 Set). Diagnostic panels were derived using binary logistic regression incorporating internal cross-validation followed by receiver operating characteristic (ROC) analysis.Results:A seven-protein panel from the training set PC vs DC and from PC vs HV samples gave the ROC area under the curve (AUC) of 0.90 and 0.90 compared with 0.87 and 0.91 for CA19-9. The AUC was greater (0.97 and 0.99, P0.05) when CA19-9 was added to the panels and confirmed on the validation-1 samples. A simplified panel of apolipoprotein C-I (ApoC-I), apolipoprotein A-II (ApoA-II) and CA19-9 was tested on the validation-2 set by ELISA, in which the ROC AUC was greater than that of CA19-9 alone for PC vs DC (0.90 vs 0.84) and for PC vs HV (0.96 vs 0.90).Conclusions:A simplified diagnostic panel of CA19-9, ApoC-I and ApoA-II improves the diagnostic ability of CA19-9 alone and may have clinical utility