Comparison of the effectiveness of an e-health program versus a home rehabilitation program in patients with chronic low back pain: A double blind randomized controlled trial

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Andalusian Health Service, Junta de Andalucia (grant number PC-0185-2017, PC-0253-2017 and PC-0536-2017, PI18/00562 Proyecto E-CEPEDOL). This study was funded by a research grant (PI18/00562 Proyecto E-CEPEDOL co-funded by FEDER -European Regional Development Fund/European Social Fund "A way to make Europe"/"Investing in your future") from the Carlos III Health Institute and 3 grants from the Andalusian Health Service, Junta de Andalucia (PC-0185-2017, PC-0253-2017 and PC-0536-2017). The funders did not take part in the design of the study, its implementation, analysis, data interpretation an/or the presentation of results.Objetive: We conducted a randomized double blind clinical trial, to compare the effectiveness of McKenzie exercises and electroanalgesia via an e-Health program versus a home rehabilitation program on functionality, pain, fear of movement and quality of life in patients with non-specific chronic low back pain. Methods: Seventy-four participants with non-specific chronic low back pain were randomized to either the e- Health program group (n=39) or the home rehabilitation program group (n=35). The interventions consisted of the e-Health program group performing McKenzie exercises and received transcutaneous electrical nerve stimulation, while the home rehabilitation group attended an information session to explain the exercises, which they then performed at home with printed instructions. Both groups performed 3 weekly sessions for 8 weeks. The following were analyzed main measures: pain, disability, fear of movement, quality of life, trunk muscle endurance and trunk anteflexion motion were assessed at baseline and at 2 months. Results: Independent samples Student’s t-tests showed that although the patients who followed the e-Health program showed significantly greater improvement than those who followed the home disability rehabilitation program in terms of intensity of pain, lumbar flexion mobility (P < 0.001), and the following dimensions of quality of life (P < 0.005), both groups improved significantly in the immediate post-treatment follow up compared with baseline scores. Conclusions: Patients with chronic low back pain who followed an unsupervised home intervention supported by an individualized video exercise program showed greater post-treatment improvement than those who followed the same program with printed instructions.Junta de Andalucia PC-0185-2017 PC-0253-2017 PC-0536-2017 PI18/00562 Proyecto E-CEPEDOLInstituto de Salud Carlos III PI18/00562 Proyecto E-CEPEDOLFEDER -European Regional Development Fund/European Social Fun

SENTISIM: A hybrid training platform for SLNB in local melanoma staging

Sentinel Lymph Node Biopsy (SLNB) has been established as an accurate procedure for regional melanoma staging. SNLB has a diagnostic significance as biopsy-based staging identifies patients with nodal metastases who may benefit from immediate complete lymphadenectomy and prolongs disease-free survival for all patients. This work presents a new training platform for SLNB in local melanoma staging, that solves the previous problemsmaintaining a realistic scenario, at the same time that measures a series of important parameters to determine the quality of the surgery.Peer ReviewedPostprint (published version

Identifying SARS-CoV-2 'memory' NK cells from COVID-19 convalescent donors for adoptive cell therapy

COVID-19 disease is the manifestation of syndrome coronavirus 2 (SARS-CoV-2) infection, which is causing a worldwide pandemic. This disease can lead to multiple and different symptoms, being lymphopenia associated with severity one of the most persistent. Natural killer cells (NK cells) are part of the innate immune system, being fighting against virus-infected cells one of their key roles. In this study, we determined the phenotype of NK cells after COVID-19 and the main characteristic of SARS-CoV-2-specific-like NK population in the blood of convalescent donors. CD57+ NKG2C+ phenotype in SARS-CoV-2 convalescent donors indicates the presence of 'memory'/activated NK cells as it has been shown for cytomegalovirus infections. Although the existence of this population is donor dependent, its expression may be crucial for the specific response against SARS-CoV-2, so that, it gives us a tool for selecting the best donors to produce off-the-shelf living drug for cell therapy to treat COVID-19 patients under the RELEASE clinical trial (NCT04578210)

SENTISIM: A hybrid training platform for SLNB in local melanoma staging

Sentinel Lymph Node Biopsy (SLNB) has been established as an accurate procedure for regional melanoma staging. SNLB has a diagnostic significance as biopsy-based staging identifies patients with nodal metastases who may benefit from immediate complete lymphadenectomy and prolongs disease-free survival for all patients. This work presents a new training platform for SLNB in local melanoma staging, that solves the previous problemsmaintaining a realistic scenario, at the same time that measures a series of important parameters to determine the quality of the surgery.Peer Reviewe

SENTISIM: A hybrid training platform for SLNB in local melanoma staging

Sentinel Lymph Node Biopsy (SLNB) has been established as an accurate procedure for regional melanoma staging. SNLB has a diagnostic significance as biopsy-based staging identifies patients with nodal metastases who may benefit from immediate complete lymphadenectomy and prolongs disease-free survival for all patients. This work presents a new training platform for SLNB in local melanoma staging, that solves the previous problemsmaintaining a realistic scenario, at the same time that measures a series of important parameters to determine the quality of the surgery.Peer Reviewe

Isolated Limb Perfusion for Malignant Melanoma: Systematic Review on Effectiveness and Safety

The present study describes the results of a systematic review conducted to objectively assess the clinical effectiveness and toxicity of isolated limb perfusion for the treatment of patients with locally advanced melanoma of the limbs. The technique was found to be safe and efficacious in these patients

Factors associated with sentinel lymph node status and prognostic role of completion lymph node dissection for thick melanoma.

Sentinel lymph node (SLN) biopsy is useful for the prognostic stratification of patients with thick melanoma. Identifying which variables are associated with SLN involvement and establishing risk in different subgroups of patients could be useful for guiding the indication of SLN biopsy. The value of complete lymph node dissection (CLND) in patients with a positive SLN biopsy is currently under debate. To identify factors associated with SLN involvement in thick melanoma we performed a multicentric retrospective cohort study involving 660 patients with thick melanoma who had undergone SLN biopsy. To analyze the role of CLND in thick melanoma patients with a positive SLN biopsy, we built a multivariate Cox proportional hazards model for melanoma-specific survival (MSS) and disease-free survival (DFS) and compared 217 patients who had undergone CLND with 44 who had not. The logistic regression analysis showed that age, histologic subtype, ulceration, microscopic satellitosis, and lymphovascular invasion were associated with nodal disease. The CHAID (Chi-squared Automatic Interaction Detection) decision tree showed ulceration to be the most important predictor of lymphatic involvement. For nonulcerated melanomas, the histologic subtype lentigo maligna melanoma was associated with a low rate of SLN involvement (4.3%). No significant differences were observed for DFS and MSS between the CLND performed and not-performed groups. Nodal status on CLND was associated with differences in DFS and MSS rates. We identified subgroups of thick melanoma patients with a low likelihood of SLN involvement. CLND does not offer survival benefit, but provides prognostic information