Unraveling the Molecular Determinants of Manual Therapy: An Approach to Integrative Therapeutics for the Treatment of Fibromyalgia and Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Application of protocols without parameter standardization and appropriate controls has led manual therapy (MT) and other physiotherapy-based approaches to controversial outcomes. Thus, there is an urgency to carefully define standard protocols that elevate physiotherapy treatments to rigorous scientific demands. One way in which this can be achieved is by studying gene expression and physiological changes that associate to particular, parameter-controlled, treatments in animal models, and translating this knowledge to properly designed, objective, quantitatively-monitored clinical trials (CTs). Here, we propose a molecular physiotherapy approach (MPTA) requiring multidisciplinary teams, to uncover the scientific reasons behind the numerous reports that historically attribute health benefits to MT-treatments. The review focuses on the identification of MT-induced physiological and molecular responses that could be used for the treatment of fibromyalgia (FM) and chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). The systemic effects associated to mechanical-load responses are considered of particular relevance, as they suggest that defined, low-pain anatomic areas can be selected for MT treatment and yet yield overall benefits, an aspect that might result in it being essential to treat FM. Additionally, MT can provide muscle conditioning to sedentary patients without demanding strenuous physical effort, which is particularly detrimental for CFS/ME patients, placing MT as a real option for integrative medicine programs to improve FM and CFS/ME.This research was funded by the Fundación Universidad Católica de Valencia San Vicente Mártir (UCV) Research Grant Program grant number 2018-121-001.Fisioterapi

Estado actual de las metástasis óseas

Los tumores óseos primarios representan solo un pequeño porcentaje comparado con las metás - tasis óseas. Pero, mientras que los tratamientos neo-adyuvantes y las técnicas de reconstrucción han mejorado la supervivencia y la calidad de vida de los pacientes afectos de tumores óseos primarios, el tratamiento primario de las metástasis óseas sigue siendo paliativo. Siendo el objetivo del tratamiento de las metástasis óseas: evitar el dolor y restaurar al máximo la actividad funcional del paciente, hasta su muerte. Y todo ello con la ayuda del tratamiento médico, de la quimioterapia, los bifosfonatos, denosumab, la radioterapia y la cirugía. En la actuali - dad las recientes mejoras en nuestra comprensión de los mecanismos biológicos y moleculares implicados en la metástasis ósea pueden conducir a mejores y más precoces métodos de diagnóstico y tratamiento. Se intenta dar una pequeña pincelada sobre la fisiopatología actual de las metástasis óseasPrimary bone tumors represent only a small percentage compared to bone metastases. But while neo-adjuvants treatments and reconstruction techniques have improved survival and quality of life of patients with primary bone tumors, primary treatment of bone metastases remains palliative. The goals of treatment for bone metastases are pain relief and maximal functional restoration of the patient, until his death. And of all this, with the help of medical treatment with chemotherapy, bisphosphonates, denosumab, radiotherapy and surgery. At present the recent improvements in our understanding of the biological and molecular mechanisms involved in bone metastasis may lead to better and earlier diagnosis and treatment methods. We try to give a small sample of the current pathophysiology of bone metastases

Aproximación Actual a la Infección Protésica

La infección es la complicación más grave de la artroplastia. La infección periprotésica (IP) puede dar lugar a una significativa morbilidad y deterioro funcional. La incidencia de la IP es alrededor de 1-3% a pesar de una técnica quirúrgica correcta, medidas asépticas y profilaxis adecuada. La patogénesis de estas infecciones se relaciona con microorganismos que acceden a la prótesis directamente durante la cirugía o después de la cirugía por vía hematógena, formando biopelículas sobre su superficie. El diagnóstico y el tratamiento de estas infecciones es un desafío para el cirujano ortopédico. En este artículo realizamos una actualización en relación con la patogénesis, la microbiología, los factores predisponentes, la clasificación, la presentación clínica, el diagnóstico y tratamiento de la IPInfection is the most severe complication of arthroplasty. PJI (Periprosthetic Joint Infection) can result in significant morbidity and functional impairment. The incidence of PJI is about 1-3% in spite of correct surgical tecniques, aseptic measures and antibiotic prophylaxis. The pathogenesis of these infections is related to microorganism that reach the prosthesis directly during surgery or after surgery by the haematogenous route forming biofilms. The diagnosis and treatment of this infections is a challenge for the orthopedic surgeon. In this paper we do an update in pathogenesis, microbiology, the predisposing factors, classification, clinical presentation, diagnosis and treatment of the PJI

Stereoselective Synthesis of (-)-Spicigerolide

(-)-Spicigerolide was enantioselectively synthesized from a protected (S)-lactaldehyde. The synthesis of the polyacetylated framework relied on two Zn-mediated stereoselective additions of alkynes to aldehydes as well as a regiocontrolled [3,3]-sigmatropic rearrangement of an allylic acetate. The pyranone moiety was constructed via ring-closing metathesis

Interacción entre clima y ocupación humana en la configuración del paisaje vegetal del Parque Nacional de Aigüestortes i Estany de Sant Maurici a lo largo de los últimos 15.000 años

The vegetation of the National Park of Aigüestortes i Estany de St Maurici is the result of an interaction between climate, plant community dynamics and the human occupation of the territory. The OCUPAproject aimed to reconstruct this interaction across the last millennia combining methods from palaeoecology and archaeology. The study focused primarily on the Sant Nicolau valley and built on the multidisciplinary analysis of the sedimentary archive of two lakes (Llebreta and Redó) and a number of archaeological sites located in shelters and outdoors. There is archaeological evidence of human presencesince 9000 yr cal BP, and a continuous record since 7500 yr cal BP. At early stages, humans transformed the surroundings of the shelters occupied and lithic tools indicate contacts with locations far away (i.e.,the Ebro plains). Since more than 3000 years ago, there has been human impact on the vegetation withoutinterruption until present. Initially, the impacts were mostly related to livestock: use of fire to open grazing lands, soil erosion and, during the medieval period, forestry and eutrophication of lakes. The agriculture impact in the lower part of the valley (e.g., Llebreta) occurred about 2100 yr ago, although some cereal grains and tools for harvesting have been found for the Neolithic. In the medieval period, the impact was higher than during the last centuries. In general, the changes in the human land use approximately follow the major changes in climate, but the specific causal link is likely related to the social and cultural dynamics of a broader territory since the Neolithic

Reduction of exposure of cyclists to urban air pollution

This book collects the main outcomes that were generated during the implementation of the LIFE+RESPIRA project (LIFE13 ENV/ES/000417), carried out in the city of Pamplona, Navarra, Spain. The research was conducted by a cross-functional team made up of more than 30 researchers belonging to three entities: The University of Navarra, the Centre for Energy, Environmental and Technological Research (CIEMAT) and Environmental Management of Navarra (GAN-NIK)

Medidas para reducir la exposición de los ciclistas a los principales contaminantes atmosféricos urbanos

Recoge los principales resultados generados durante la realización del proyecto LIFE+RESPIRA, llevado a cabo en la ciudad de Pamplona (Navarra, España) por un equipo interdisciplinar constituido por más de 30 investigadores pertenecientes a la Universidad de Navarra, el Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) y Gestión Ambiental de Navarra (GAN-NIK). El libro, que se ha publicado en castellano y en inglés, se ha dividido en 7 capítulos: 1. ¿Ciudades sostenibles? 2. Exposición de los ciudadanos a la contaminación atmosférica 3. Papel de la vegetación urbana en la calidad del aire 4. Modelos de alta resolución para evaluar la calidad del aire 5. Impactos de la contaminación urbana 6. Movilidad y sostenibilidad urbanas 7. Comunicación y educación ambiental. Este libro pretende ser una guía de utilidad para científicos, gestores y ciudadanos, aportando un conjunto de herramientas que permitan mejorar la calidad de vida de nuestras ciudades. Además, quiere rendir un homenaje a todos los voluntarios ciclistas que han participado en dicho proyecto y que son los verdaderos artífices del mismo, ya que gracias a su dedicación incondicional durante más de dos años, han proporcionado una cantidad ingente de datos sobre la calidad del aire de la ciudad de Pamplona

Resultados clínicos y funcionales del desbridamiento artroscópico en las lesiones osteocondrales de astràgalo

ObjetivosRevisión retrospectiva de los resultados clínicos, funcionales y el grado de satisfacción de los pacientes con lesiones osteocondrales de astrágalo (LOC) tratados mediante desbridamiento artroscópico, curetaje y microfracturas en nuestro centro.Material y métodoEntre enero de 2008 y diciembre de 2011 fueron revisados un total de 30 pacientes con LOC en los que el tratamiento conservador había fracasado, y se practicó desbridamiento artroscópico, curetaje y microfracturas. Se analizaron datos como etiología, localización, tamaño de la lesión y grado de la lesión según la clasificación de Berndt y Harty. Para la valoración clínica funcional se usó la escala de la American Orthopaedic Foot and Ankle Society (AOFAS) y la escala visual analógica (EVA). Se valoró también el grado de satisfacción mediante una encuesta simple. Se registraron lesiones asociadas, complicaciones y reintervenciones.ResultadosEl tiempo medio de seguimiento fue de 12 meses. La edad media de los pacientes era 43 años. Etiología traumática de la lesión en 10 de 30 pacientes. Tamaño medio de la lesión: 0,86 cm2. El valor medio de la escala AOFAS al final del seguimiento fue de 92 y la EVA disminuyó de 7 a 1. Todos los pacientes estuvieron satisfechos con el tratamiento recibido. No se registraron complicaciones ni reintervenciones.ConclusionesLas LOC en pacientes mayores de 40 años tienen unas características concretas, y reproducen resultados del tratamiento artroscópico similares a los de la población más joven.PurposeThis retrospective study assessed the clinical, functional results and degree of satisfaction of patients with osteochondral lesion of the talus (OCL) treated by arthroscopic debridement, curetagge and microfractures.Materials and methodsFrom January 2008 to December 2011, thirty patients with OCL, in whom conservative treatment had failed, were assessed. We analyzed data like etiology, location, size and degree of the lesion (according to Bernd & Harty classification). The AOFAS ankle score was used for clinical and functional evaluation. The degree of satisfaction was assessed by a simple questionnaire. Complications, associated lesions and reoperations were recorded.ResultsThe average follow-up 12 months (range 6 to 48). The average age of the patients was 43 years. We found traumatic etiology in 10 patients. The average size of the lesion was 0,86 cm2. The average AOFAS score on the last visit was over 90 points and the visual analog scale decreased from 7 to 1 point as well. All the patients were satisfied with the treatment. No reoperations or complications were found.ConclusionsOCL in patients over 40 years old have their own properties. We found that arthroscopic debridement curetagge and microfractures is successful in this population as in the younger one

Interacción entre clima y ocupación humana en la configuración del paisaje vegetal del Parque Nacional de Aigüestortes i Estany de Sant Maurici a lo largo de los últimos 15.000 años

The vegetation of the National Park of Aigüestortes i Estany de St Maurici is the result of an interaction between climate, plant community dynamics and the human occupation of the territory. The OCUPA project aimed to reconstruct this interaction across the last millennia combining methods from palaeoecology and archaeology. The study focused primarily on the Sant Nicolau valley and built on the multidisciplinary analysis of the sedimentary archive of two lakes (Llebreta and Redó) and a number of archaeological sites located in shelters and outdoors. There is archaeological evidence of human presence since 9000 yr cal BP, and a continuous record since 7500 yr cal BP. At early stages, humans transformed the surroundings of the shelters occupied and lithic tools indicate contacts with locations far away (i.e., the Ebro plains). Since more than 3000 years ago, there has been human impact on the vegetation without interruption until present. Initially, the impacts were mostly related to livestock: use of fire to open grazing lands, soil erosion and, during the medieval period, forestry and eutrophication of lakes. The agriculture impact in the lower part of the valley (e.g., Llebreta) occurred about 2100 yr ago, although some cereal grains and tools for harvesting have been found for the Neolithic. In the medieval period, the impact was higher than during the last centuries. In general, the changes in the human land use approximately follow the major changes in climate, but the specific causal link is likely related to the social and cultural dynamics of a broader territory since the Neolithic.Para el sondeo y estudio mineralógico se ha contado con la colaboración de financiación adicional a través del proyecto «Multidisciplinary research consortium on gradual and abrupt climate changes, and their impacts on the environment (GRACCIE), CSD2007-00067, Programa Consolider 2007»Peer Reviewe