Search

PDF file - 44KB, Supplementary figure 6. Validation of the oligonucleotides pairs used to detect the expression of the different isoforms of NADPH oxidases.

PDF file - 112KB

PDF file - 28KB, Supplementary figure 7. Downregulation of multiple NADPH oxidases in K562 cells.

PDF file - 68KB, Supplementary Figure 1. Inhibitors of NADPH oxidases and BCR-ABL synergize to avoid the proliferation of two different CML cell lines.

Purpose: Cancer cells show higher levels of reactive oxygen species (ROS) than normal cells and increasing intracellular ROS levels are becoming a recognized strategy against tumor cells. Thus, diminishing ROS levels could be also detrimental to cancer cells. We surmise that avoiding ROS generation would be a better option than quenching ROS with antioxidants. Chronic myelogenous leukemia (CML) is triggered by the expression of BCR-ABL kinase, whose activity leads to increased ROS production, partly through NADPH oxidases. Here, we assessed NADPH oxidases as therapeutic targets in CML.Experimental Design: We have analyzed the effect of different NADPH oxidase inhibitors, either alone or in combination with BCR-ABL inhibitors, in CML cells and in two different animal models for CML.Results: NADPH oxidase inhibition dramatically impaired the proliferation and viability of BCR-ABL–expressing cells due to the attenuation of BCR-ABL signaling and a pronounced cell-cycle arrest. Moreover, the combination of NADPH oxidase inhibitors with BCR-ABL inhibitors was highly synergistic. Two different animal models underscore the effectiveness of NADPH oxidase inhibitors and their combination with BCR-ABL inhibitors for CML targeting in vivo.Conclusion: Our results offer further therapeutic opportunities for CML, by targeting NADPH oxidases. In the future, it would be worthwhile conducting further experiments to ascertain the feasibility of translating such therapies to clinical practice. Clin Cancer Res; 20(15); 4014–25. ©2014 AACR.

PDF file - 61KB, Supplementary figure 4. The activity of SHP1 protein tyrosine phosphatase increases after treatment with imatinib, DPI or a combination thereof.

PDF file - 108KB, Supplementary figure 2. Analysis of the interaction of NADPH oxidases inhibitors and BCR-ABL in bone marrow cells from healthy donors.

PDF file - 340KB, Supplementary figure 5. Combination of NADPH oxidases and BCR-ABL inhibitors progressively increases the proportion of sub-G1 phase cells.

PDF file - 87KB, Supplementary Figure 8. Inhibitors of NADPH oxidases and Flt3-ITD synergize to prevent the proliferation of two different AML cell lines.

PDF file - 44KB, Supplementary figure 3. Antioxidants and rotenone treatment hamper K562 cell proliferation. DPI treatment reduces BCR-ABL protein levels.

PDF file - 287KB

Background: The ageing process may lead to functional limitations, musculoskeletal pain, and worsened quality of life. The aim of this paper is to evaluate two physical therapy interventions for reducing musculoskeletal pain and improving quality of life in older adults. Methods: A cohort study was carried out with older people (60–75 years old). The Geriatric Physical Therapy group (n = 70) received massage therapy, therapeutic exercise, and therapeutic education program for 5 weeks; the Standardized Therapeutic Exercise group (n = 140) received a standardized therapeutic exercise and therapeutic education program for 3 weeks. Health-related quality of life (SF-36v2) and musculoskeletal pain intensity (VAS) were collected at baseline (A0), post-intervention (A1), and 12 weeks after baseline (A2). Results: There was pain intensity reduction in both groups (p < 0.05) and health-related quality of life improvement, except for Emotional Role (p = 0.34); Physical Function (p = 0.07), Bodily Pain (p = 0.02), and General Health (p = 0.09). At A2 there was a difference (p < 0.05) for neck pain in favor of the Geriatric Physical Therapy Group. Conclusions: Within the limitations of the study, it was possible to conclude that both physical therapy interventions showed a positive effect for reducing non-specific neck pain and low back pain in older adults, which may contribute to health-related quality of life improvement.

In this study, we aimed to investigate women’s experiences with compliance with prescribed pelvic floor muscle exercises (PFMEs) and lifestyle changes 6–12 months after completing an individual pelvic floor physiotherapy program. This study was targeted to understanding factors affecting adherence to PFMEs and lifestyle changes to deal with pelvic organ prolapse (POP) symptoms. We designed this research as a descriptive qualitative study. We conducted this study from December 2016 to September 2017 in Madrid, Spain. Twenty-six women with symptomatic POP selected using a purposive sampling method participated in six focus groups and three one-to-one semi-structured interviews. Three authors coded and inductively analyzed transcript contents with iterative theme development. A thematic analysis revealed three main themes: (1) symptoms change; (2) PFMEs and lifestyle changes performance; and (3) a health practitioner–patient relationship. Women identified as adherent reported improvement in physical symptoms and emotional and general state as a result of the new knowledge achieved. Fear also promoted compliance with performing PFMEs and adopting lifestyle changes. Likewise, PFMEs preference and routine, integration of PFMEs and lifestyle changes into activities of daily living, support guides, therapeutic alliance, individual supervision, follow-up, and feedback were also identified as adherence facilitators. One of the biggest barriers that we identified was responsibility. Compliance with prescribed PFMEs and lifestyle changes can be improved with effective individual, women-centered, and supervised physiotherapy programs reducing symptoms, including exercises aligned with women’s preferences that are easy to integrate in daily living, promoting knowledge and awareness of their condition, providing written or electronic guidelines, with routine follow-up visits offering both positive feedback and clear and consistent messages, and enhancing therapeutic alliance.

FRIDA is a diffraction-limited imager and integral-field spectrometer that is being built for the adaptive-optics focus of the Gran Telescopio Canarias. In imaging mode FRIDA will provide scales of 0.010, 0.020 and 0.040 arcsec/pixel and in IFS mode spectral resolutions of 1500, 4000 and 30,000. FRIDA is starting systems integration and is scheduled to complete fully integrated system tests at the laboratory by the end of 2017 and to be delivered to GTC shortly thereafter. In this contribution we present a summary of its design, fabrication, current status and potential scientific applications.

Conservative treatment of pelvic floor dysfunction (PFD) includes therapeutic exercise for pelvic floor muscle (PFM) training or other complementary exercise modalities, such as hypopressive exercises. However, the long-term effectiveness of the conservative treatment depends on a patient’s adherence to the exercises and the integration of professional health advice into their daily life. The objective of this study was to establish the adherence experience of women with diagnosed PFD in home-based exercises after an intensive face-to-face physiotherapy treatment. A qualitative study from an interpretive paradigm was developed. Semi-structured individual and group interviews were performed 6 months after finishing individual physiotherapy treatment. The interviews were recorded, fully transcribed and analyzed thematically by creating categories. Thirty-one women were interviewed. The women reported that their adherence to home PFM exercises depended on the exercise program itself, its efficacy, their personal experiences with the exercises, intrinsic factors such as self-awareness or beliefs, and extrinsic factors, such as professional or instrumental feedback. Thus, therapeutic adherence could be more likely with effective physiotherapy programs that include mutually agreed home exercises and simple movements women can build into their daily lives. Improving awareness and knowledge of the pelvic region and the importance of PFM treatment as well as consideration for potential worsening of PFD will also encourage women to adhere to the exercises.

Pelvic floor dysfunction (PFD) is a functional condition present most frequently in women. Despite pelvic floor muscle training being considered by the International Continence Society (ICS) as the first-line treatment in uncomplicated urinary incontinence, other more comprehensive postural methods as 5P® LOGSURF have emerged. This preliminary cross-sectional study explores the effects of a single 5P® LOGSURF session on pelvic floor muscle (PFM) tone and strength (MVC), resting anal tone, intrarectal pressure, and deep abdominal muscles activation. Thirty women were included (11 without PFD and 19 with PFD). Primary outcome measures were PFM tone, PFM MVC and resting anal tone and secondary measures outcomes were intrarectal pressure and deep abdominal activation. All outcome measures were collected before, throughout and after a single 30′ 5P® LOGSURF session. The findings from this study suggest that PFM tone (PFD group: p = 0.09, d = 0.72, non-PFD group: p = 0.003, d = 0.49) and PFM MVC (PFD group: p = 0.016, non-PFD group: p = 0.005) decreased in both groups after a single 5P® LOGSURF session, with a medium effect size for women with PFD. Contrarily, deep abdominal muscle MVC increased (PFD group: p &lt, 0.001, non-PFD group: p = 0.03). Intrarectal pressure and resting anal tone decreased in both groups throughout the session. These results suggest that 5P® LOGSURF method may be interesting if is performed by women with mild symptoms of PFD or healthy women to achieve a decrease in PFM tone in women who manifested pain to intracavitary techniques or practices. Further research with higher sample sizes and long-term are necessary for generalizing.

Therapeutic patient education programs must assess the competences that patients achieve. Evaluation in the pedagogical domain ensures that learning has taken place among patients. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a tool for assessing patient knowledge about urinary (UI) and pelvic organ prolapse (POP) conditions. The aim of this study was to translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Spanish and test its measurement properties, as well as propose real practical cases as a competence assessment tool. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Measurement properties analysis was performed by assessing the validity, reliability, responsiveness, and interpretability. A total of 275 women were recruited. The discriminant validity showed statistically significant differences in the PIKQ scores between patients and expert groups. Cronbach’s alpha revealed good internal consistency. The test–retest reliability showed excellent correlation with UI and POP scales. Regarding responsiveness, the effect size, and standardized response mean demonstrated excellent values. No floor or ceiling effects were shown. In addition, three “real practical cases” evaluating skills in identifying and analyzing, decision making, and problem-solving were developed and tested. The Spanish PIKQ is a comprehensible, valid, reliable, and responsive tool for the Spanish population. Real practical cases are useful competence assessment tools that are well accepted by women with pelvic floor disorders (PFD), improving their understanding and their decision-making regarding PFD.

We propose a point-mass biomechanical model to estimate the forces and moments supported by the upper extremity during Lofstrand crutch-assisted gait. This model is based on the Newtonian classical mechanics and the angular momentum theorem. The system arm-crutch is divided into three segments: 1) crutch, 2) wrist-elbow, and 3) elbow-shoulder. The theoretical model was experimentally validated with a disabled person with spinal cord injury. Two crutch-assisted gait patterns have been chosen to carry out the experimental validation: two-point reciprocal gait and swing-through gait. Six position markers (three placed on the arm and three placed on the crutch) and two force sensors (placed on the crutch) were used in experiments for testing the model. The results were compared with a distributed-mass model based on studies previously published, concluding that the relative mean difference between models is less than 3% Body Weight and 1% Body Weight times Height when forces and moments are estimated, respectively. Some advantages of using a point-mass model are summarized: simple formulation, easy to understand; require less numerical calculation reducing the computational cost; requires less position markers placed on the subject, increasing therefore the comfort of the subject.

Certain secondary effects derived from medical treatment in breast cancer can favor the development of alterations in shoulder biomechanics. To the best of our knowledge, persistent peripheral pain as a key factor for the development of neuromuscular activity impairments has not been analyzed. A cross-sectional descriptive study was carried out. A total of 90 women were included and allocated to three groups: (i) 30 women with persistent peripheral pain after breast cancer treatment, (ii) 30 women without pain after breast cancer treatment, and (iii) 30 healthy women. Surface electromyography was employed to measure the onset and amplitude of the muscle activity of three shoulder movements. Statistically significant differences were found in the neuromuscular activity for all the muscles and shoulder movements among women with persistent pain versus healthy women (i.e., amplitude muscle activity variable p &lt, 0.001). Statistically significant differences were also observed in the neuromuscular activity for certain muscles in shoulder movements among women with persistent pain versus women without pain, as well as between women without pain versus healthy women. Therefore, following breast cancer treatment, women showed alterations in their shoulder neuromuscular activity, which were more significant if persistent pain existed. These findings may contribute to developing a selective therapeutic exercise program that optimizes the shoulder neuromuscular activity in women after breast cancer treatment.

El objetivo del presente artículo es acercar la acción educativa, de los centros españoles en el exterior, desde el enfoque de la convivencia y la interculturalidad en sus aulas. A través de una aproximación al organismo que regula esta acción, se va a presentar una contextualización teórica en los diferentes tipos de centros que el Ministerio de Educación, Cultura y Deporte (MECD) dispone en el exterior y que suponen una apertura internacional de la lengua y la cultura española en contacto con otros sistemas educativos y en otros estados. En diferentes programas y tipos de centros se desarrolla la difusión de la lengua y la cultura española. Para ello, se entra en contacto con otras sociedades, momento en que la convivencia y el ámbito intercultural adquieren su protagonismo. Lo intercultural pretende establecer ese intercambio necesario. “nos permite analizar otras culturas desde sus propios patrones culturales; busca el encuentro y tiene una visión crítica de otras culturas” (Martínez, 2010,50). Como punto de partida se tomará como referencia la Ley Orgánica 2/2006, de 3 de mayo, de Educación que en su preámbulo establece “fomentar la convivencia democrática y el respeto a las diferencias individuales “como uno de sus fines . The objective of this article is to bring the educational action of Spanish centers abroad closer, from the approach of coexistence and interculturality in their classrooms. Through an approach to the body that regulates this action, it will present a theoretical contextualization in the different types of centers that the Ministry of Education, Culture and Sport (MECD) has abroad and that involve an international opening of the language and Spanish culture in contact with other educational systems and in other states. In different programs and types of centers the dissemination of the Spanish language and culture is developed. In order to do so, we come into contact with other societies, at which time coexistence and the intercultural sphere acquire their leading role. The intercultural aims to establish that necessary exchange. "It allows us to analyze other cultures from their own cultural patterns; seeks the encounter and has a critical vision of other cultures "(Martínez, 2010,50). As a starting point, reference will be made to Ley Orgánica 2/2006, de 3 de mayo, on Education, which in its preamble establishes "fostering democratic coexistence and respect for individual differences" as one of its purposes.

Hypopressive exercises have emerged as a conservative treatment option for pelvic floor dysfunction (PFD). The aim of this study was to compare the effects of an eight-week hypopressive exercise program to those of an individualized pelvic floor muscle (PFM) training (PFMT) program, and to a combination of both immediately after treatment and at follow-up assessments at 3, 6 and 12 months later. The study was a prospective, single-centre, assessor-blinded, randomised controlled trial. Ninety-four women with PFD were assigned to PFMT (n = 32), hypopressive exercises (n = 31) or both (n = 31). All programs included the same educational component, and instruction about lifestyle interventions and the knack manoeuvre. Primary outcomes were the Pelvic Floor Distress Inventory Short Form (PFDI-20), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), PFM strength (manometry and dynamometry) and pelvic floor basal tone (dynamometry). There were no statistically significant differences between groups at baseline, nor after the intervention. Overall, women reduced their symptoms (24.41&ndash, 30.5 on the PFDI-20), improved their quality of life (14.78&ndash, 21.49 on the PFIQ-7), improved their PFM strength (8.61&ndash, 9.32 cmH2O on manometry, 106.2&ndash, 247.7 g on dynamometry), and increased their pelvic floor basal tone (1.8&ndash, 22.9 g on dynamometry). These data suggest that individual PFMT, hypopressive exercises and a combination of both interventions significantly reduce PFD symptoms, enhance quality of life, and improve PFM strength and basal tone in women with PFD, both in the short and longer term.

The Prolapse Quality of Life Questionnaire (P-QoL) is a specific questionnaire created to assess the impact of pelvic organ prolapse on women&rsquo, s quality of life. The aim of the present study was to cross-culturally adapt and assess the psychometric properties of the P-QoL for Spanish women. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Psychometric analysis was performed by assessing the validity, reliability, responsiveness and feasibility. A total of 200 Spanish women were recruited and assigned to symptomatic and asymptomatic groups. The Spanish P-QoL version demonstrated good content validity. Convergent validity showed high intercorrelations with the Pelvic Floor Distress Inventory short form and the Pelvic Floor Impact Questionnaire short form. The discriminant validity showed statistically significant differences between the symptomatic and the asymptomatic groups. The internal consistency was high and of acceptable values. The test-retest reliability was shown to be high in all the cases. Regarding responsiveness, the effect size and standardized response mean demonstrated moderate values. The average time for administration was 10 (3) min. The Spanish P-QoL showed considerable support for the appropriate metric properties of validity, reliability, responsiveness and feasibility to evaluate the symptom severity and its impact on the quality of life in Spanish women with urogenital prolapse.

Myoelectric activity and range of motion during ULNT1 were recorded in 62 breast cancer (BC) survivors who had axillary lymph node dissection (n = 30) or sentinel lymph node biopsy (n = 32) within the previous 18 months, and 63 age-matched healthy women. BC survivors' symptoms were reproduced by ULNT1 and exhibited greater myoelectric activity in the biceps brachii than healthy women (MD (95% CI): 21,26 (10,83-31,70)). No differences between the axillary lymph node dissection and sentinel lymph node biopsy groups (MD (95% CI): 8,47 (−7,84-24,79)) were found. Myoelectric activity in the triceps brachii was greater in the sentinel lymph node biopsy group (MD (95% CI): 2,70 (−2,06–7,60)). BC survivors exhibited less shoulder and elbow range of motion during ULNT1 than healthy women. Increased upper limb nerve mechanosensitivity in BC survivors was associated with a greater protective muscle response during ULNT1.

Aims The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments. Methods One hundred and fifty women with pelvic floor disorders participated on one occasion, and 20 women returned for the same investigations by two different raters on 3 different days. At each session, PFM strength was assessed using palpation (both the modified Oxford Grading Scale and the Levator ani testing), manometry, and dynamometry; and PFM activation was assessed using sEMG. Results The interrater reliability of manometry, dynamometry, and sEMG (both root-mean-square [RMS] and integral average) was high (Lin's Concordance Correlation Coefficient [CCC] = 0.95, 0.93, 0.91, 0.86, respectively), whereas the interrater reliability of both palpation grading scales was low (Cohen's Kappa [k] = 0.27-0.38). The intrarater reliability of manometry (CCC = 0.96), and dynamometry (CCC = 0.96) were high, whereas intrarater reliability of both palpation scales (k = 0.78 for both), and of sEMG (CCC = 0.79 vs 0.80 for RMS vs integral average) was moderate. The Bland-Altman plot showed good inter and intrarater agreement, with little random variability for all instruments. The correlations among palpation, manometry, and dynamometry were moderate (coefficient of determination [r2] ranged from 0.52 to 0.75), however, transperineal sEMG amplitude was only weakly correlated with all measures of strength (r2 = 0.23-0.30). Conclusions Manometry and dynamometry are more reliable tools than vaginal palpation for the assessment of PFM strength in women with pelvic floor disorders, especially when different raters are involved. The different PFM strength measures used clinically are moderately correlated; whereas, PFM activation recorded using transperineal sEMG is only weakly correlated with PFM strength. Results from perineal sEMG should not be interpreted in the context of reporting PFM strength.

Background: The Standardised Nordic Questionnaire (SNQ) is an instrument to analyse the musculoskeletal symptoms in an ergonomic or occupational health context. We aimed to cross-culturally adapt and evaluate the psychometric properties of the SNQ among Spanish musicians. Methods: Cross-cultural adaptation and psychometric validation (reliability, validity, and feasibility) was performed. Reliability was analysed by test-retest reliability (Cohen&rsquo, s Kappa) and internal consistency (Kuder&ndash, Richardson). Content and face validity were measured by the Expert Committee and the opinion of participants. Construct validity (Mann&ndash, Whitney U test) was measured by comparing with questionnaires used to assess pain and disability in neck, shoulders, upper back, and low back regions. Feasibility was calculated with the average response time. Results: A total of 312 Spanish musicians were included. The Spanish version of SNQ achieved good semantic, conceptual, idiomatic, and content equivalence. For most of the variables, test-retest reliability was good to very good (k = 0.60&ndash, 0.81). The internal consistency showed good to acceptable (Kuder&ndash, Richardson 20 (KR20) = 0.737&ndash, 0.873). Participants with versus without musculoskeletal problems in a related region showed significantly higher disability/pain, indicating a good construct validity. About the feasibility, the average response time of the questionnaire was 6 min (&plusmn, 2). Conclusions: The results show that the Spanish SNQ is reliable, valid, and feasible screening tool to assess musculoskeletal problems among musicians.

Aim To measure the neuromuscular activation of the pelvic floor and abdominal muscles concurrently with vaginal closure forces induced during a hypopressive exercise (HE) and to identify the contribution of the HEs sequences (posture and maneuver) in the muscle's activation. Methods A cross-sectional study design was employed. Sixty-six women who had participated in a physical therapy program focused on HEs were recruited. Pelvic floor muscle (PFM) activation was measured using surface electromyography (sEMG) in supine and in the orthostatic position, and vaginal closure force was measured through vaginal dynamometry in supine. Activation of the abdominal, gluteal, and hip adductor muscles was measured using sEMG. Maximum effort voluntary contractions (MVCs) of the PFMs and reference contractions of the abdominal and hip muscles were acquired for normalization purposes. A HE was then performed in a supine position with one leg raised, then in an orthostatic position. Results During the supine HE, the peak PFM sEMG amplitude was 74.4% to 86.5% (49.6%-109.6%) of MVC, the peak vaginal closure force was between 51.2% and 55.7% (95.5%-382.9%) of MVC, and the muscles of the lateral abdominal wall were activated between 25.4% and 35.3% of the reference contraction. During the orthostatic HE, PFM activation was 61.4% (40.1%-105.6%) of MVC, and the lateral abdominal wall muscles contracted at 22.8% of the reference activation level. Conclusions The PFMs, abdominal, gluteal, and adductor muscles are activated during the performance of a HE. The activation level of the PFMs and abdominal muscles is likely insufficient to result in strength gains; however, they could have an endurance effect.

Background . Chronic non-specific neck pain is a frequent complaint. It is a recognized medical and socioeconomic problem and a frequent cause of job absenteeism. In recent years, case reports about myofascial pain syndrome (MPS) are emerging among patients suffering from pain. MPS is a regional pain syndrome characterized by myofascial trigger points (MTrP) in palpable taut bands of skeletal muscle that refer pain to a distance, and that can cause distant motor and autonomic effects. Objective. To assess the prevalence of active and latent MTrPs in subjects suffering from chronic non-specific neck pain. Design . A population-based cross-sectional descriptive study was carried out from January 2012 to December 2014. Setting. Three primary healthcare centers in Alcala de Henares, Madrid (Spain). Subjects. Two hundred and twenty-four participants diagnosed by their family doctor with chronic non-specific neck pain. Methods. Participants were examined by a physical therapist to determine the presence of MPS. Pain descriptions from the subjects and pain body diagrams guided the physical examination. The subjects were not given any information concerning MPS or other muscle pain syndromes. Results . All participants presented with MPS. MTrPs of the trapezius muscles were the most prevalent, in 93.75% of the participants. The most prevalent active MTrPs were located right (82.1%) and left (79%) in the nearly-horizontal fibers of the upper trapezius muscle. Furthermore, active MTrPs in the levator scapulae, multifidi, and splenius cervicis muscles reached a prevalence of 82.14%, 77.68%, and 62.5%, respectively. Conclusions . MPS is a common source of pain in subjects presenting chronic non-specific neck pain.

Resumen Objetivo Conocer la percepcion de puerperas y profesionales sanitarios sobre el embarazo y el parto como factores de riesgo de disfunciones del suelo pelvico (DSP). Sujetos y metodos Estudio cualitativo con grupos focales, entrevistas semiestructuradas y analisis de documentos realizado entre marzo del 2014 y mayo del 2015 en el Hospital Universitario Principe de Asturias (HUPA) y en el centro de salud Juan de Austria, del distrito asistencial de Alcala de Henares (Madrid). Participaron 19 puerperas ingresadas en el HUPA y 9 profesionales sanitarios relacionados con el embarazo, parto y puerperio. Se formaron 4 grupos focales, se realizaron 13 entrevistas semiestructuradas y se recogieron 4 cuestionarios. Mediante un proceso iterativo de analisis se identificaron las categorias emergentes. El rigor de la investigacion se garantizo mediante diferentes procesos de triangulacion. Resultados Se identificaron 5 categorias: el embarazo, parto y puerperio; la informacion; el suelo pelvico (SP); la atencion profesional y la intervencion sanitaria. Las puerperas refirieron que precisaban mas informacion de calidad y supervisada sobre el SP, sus funciones, sus problemas y los factores que pueden desencadenarlos, su prevencion y su recuperacion. Los profesionales refrendaron la opinion de las puerperas anadiendo la necesidad de protocolos y de equipos multidisciplinares que incluyan al fisioterapeuta. Conclusiones Las puerperas desconocen los factores que desencadenan DSP. Son necesarios equipos multidisciplinares en Atencion Primaria y especializada que incluyan al fisioterapeuta y que actuen segun protocolos clinicos durante el embarazo, parto y puerperio.

Background: The Oslo Sports Trauma Research Center Questionnaires on Health Problems (OSTRC-H) and Overuse Injury (OSTRC-O) have shown a greater ability to identify athletes with health problems and to estimate the severity of those problems compared with traditional surveillance methods. Despite the numerous language adaptations of these questionnaires and their extended use, some of their measurement properties remain unknown. Moreover, these questionnaires are not available for Spanish-speaking athletes, and the validity and reliability of these questionnaires in youth athletes are unknown. Purpose: To cross-culturally adapt and investigate the measurement properties of the second version of the OSTRC-H (OSTRC-H2) and OSTRC-O (OSTRC-O2) questionnaires in Spanish youth athletes. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Following international guidelines, we developed Spanish cross-cultural adaptations of the questionnaires, including a comprehensibility analysis with 30 participants from the target population. In the second phase, 73 athletes (age range, 12-18 years) were invited to participate in an 11-week prospective study. The reliability (internal consistency and test-retest reliability) of both questionnaires was assessed through use of Consensus-Based Standards for the Selection of Health Measurement Instruments recommendations. The construct validity and responsiveness of the OSTRC-H2 were evaluated using the convergence of the OSTRC-H2 severity score and the number of days of time loss. The response rate after 11 weeks was calculated as a feasibility indicator. Results: Equivalent Spanish versions were developed. A total of 63 athletes (age range, 12-17 years) participated in the prospective study. The Cronbach alpha was 0.93 (95% CI, 0.92-0.94) for OSTRC-H2 and 0.88 (95% CI, 0.86-0.90) for OSTRC-O2. The intraclass correlation coefficient was 0.87 (95% CI, 0.79-0.92) and 0.85 (95% CI, 0.81-0.89), and the Cohen kappa was 0.80 (95% CI, 0.71-0.89) and 0.87 (95% CI, 0.78-0.96), respectively, for OSTRC-H2 and OSTRC-02. Correlations between the severity score and time loss (Spearman rho = 0.61) and between the changes in both scores over time (Spearman rho = 0.78) were within our expected range. The response rate was 95.5% for the OSTRC-O2 and 99.6% for the OSTRC-H2. Conclusion: These results present equivalent, reliable, and feasible Spanish versions of both questionnaires as well as evidence of the validity and responsiveness of the OSTRC-H2.

The authors wish to make the following correction to their paper published in the International Journal of Environmental Research and Public Health [...]

Background: Playing-related musculoskeletal disorders are the most frequent complaints among instrumental musicians. The aims of this study were: to assess the prevalence of musculoskeletal pain, to evaluate neck, shoulder, and lower back disability, and to determine the associated factors with the presence of musculoskeletal pain among musicians. Methods: A population-based, cross-sectional descriptive study was conducted. We selected Spaniard musicians over 16 years old who played a musical instrument for at least five hours per week. They answered the Spanish versions of the Standardised Nordic Questionnaire, the Oswestry Disability Index, Neck Disability Index and Shoulder Pain and Disability Index. Results: We found 94.8% of musicians presented at least one symptomatic region in the last 12 months, and 72.3% in the last seven days. Female musicians (OR 4.38, CI 2.11&minus, 9.12), musicians with overweight or obesity (OR 5.32, CI 2.18&minus, 12.97), and musicians who play more than 14 h per week (OR 3.86, CI 1.80&minus, 8.29)were shown to be a higher risk of suffering musculoskeletal pain. Conclusions: Musculoskeletal disorders symptoms are highly prevalent in musicians. The main risk factors related to musculoskeletal disorders symptoms were gender (being female), overweight, obesity, and spending playing more than 14 h a week practicing. This study highlights the need to provide strategies to prevent occupational disabilities among musicians. Further studies are needed to analyse the prevalence of pain in the musician using other sampling methods.

Background Chronic non-specific neck pain is related to limited cervical mobility, impaired function, neck muscles myofascial pain syndrome, and stress at work. The aforementioned factors are strongly related and may lead to a negative impact on health-related quality of life. There are some effective conservative Physical therapy interventions for treating chronic non-specific neck pain. Currently, Deep Dry Needling is emerging as an alternative for improving symptoms and consequently, the quality of life in patients with chronic non-specific neck pain. The purpose of the study was to examine the effectiveness of Deep Dry Needling of myofascial trigger points on health-related quality of life improvement, as a secondary analysis, in people with chronic non-specific neck pain. Methods A randomized parallel-group blinded controlled clinical trial was conducted at a public Primary Health Care Centre in Madrid, Spain, from January 2011 to September 2014. One hundred thirty subjects with chronic non-specific neck pain and active myofascial trigger points in neck muscles were randomly allocated into two groups. Subjects in the intervention group (n = 65) were treated with Deep Dry Needling in active myofascial trigger points plus stretching in neck muscles; Control group (n = 65) received only stretching. Both interventions lasted 2 weeks, 2 sessions per week. Health-related quality of life was measured with Short Form-36 (SF-36), in 5 assessments: at baseline, after intervention period; and at 1, 3 and 6 months after intervention. Results For both groups, SF-36 mean values increased in all dimensions in every assessment. Significant differences (p

To evaluate the responsiveness of the Spanish versions of Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7), in order to assess symptoms and quality of life in Spanish women with pelvic floor disorders.Prospective observational study to assess the responsiveness in 85 women with pelvic floor disorders. PFDI-20 and PFIQ-7 were completed before and after Physiotherapy intervention. The responsiveness was assessed with the p values using the Wilcoxon signed-rank test, the standardized response means of the change (SRM) and the effect size (ES).The Spanish PFDI-20 and PFIQ-7 and the subscales demonstrated small to good responsiveness. The responsiveness was higher for PFDI-20 than for PFIQ-7. The statistic for PFDI-20 was moderate to good (ES 0.68 and SRM 0.84; p0.0001), and small to moderate for PFIQ-7 (ES 0.48 and SRM 0.57; p0.0001). Regarding the subscales, the responsiveness was better for Pelvic Organ Prolapse Distress Inventory (POPDI) than Pelvic Organ Prolapse Impact Questionnaire (POPIQ) (ES 0.70 and SRM 0.78; ES 0.42 and SRM 0.47 respectively; p0.0001). Moderate responsiveness was found for Urinary Distress Inventory (UDI) and Urinary Impact Questionnaire (UIQ) (ES 0.54 and SRM 0.67; ES 0.52 and SRM 0.61 respectively; p0.0001). Colo-Rectal-Anal Distress Inventory (CRADI) and Colo-Rectal-Anal Impact Questionnaire (CRAIQ) showed poor responsiveness, small in both (ES 0.42, SRM 0.50 and p0.0001; ES 0.34, SRM 0.39 respectively; p0.001). All responsiveness was significant.PFDI-20 and PFIQ-7 Spanish versions showed good responsiveness to evaluate the symptoms and the quality of life in Spanish women with PFD undergoing Physiotherapy treatment.

Objective: To determine the effectiveness of an early physiotherapy intervention for the prevention of secondary lymphoedema on health-related quality of life in women who also received an education program after breast cancer surgery. Methods: One hundred and fifty three women diagnosed with unilateral breast cancer (stage IeII) treated with breast surgery, which included axillary lymph-node dissection, from Hospital Principe de Asturias, Alcal� a de Henares, Madrid (Spain) were randomly assigned into two groups. Subjects in early physiotherapy group (n ¼ 76) received a physiotherapy intervention combined with a therapeutic education program; women in the control group (n ¼ 77) received only the therapeutic education program. Both interventions were delivered by two different physiotherapists of Physiotherapy in Women's Health Research Group at Physiotherapy Department of Alcala University. Health related quality of life was measured with EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires in 5 assessments: after surgery just before group interventions started (A 1 ), after the 3-week group interventions finished (A2); and a followup period in 3 (A3), 6 (A4) and 12 (A5) months after surgical intervention. Results: Greater change in quality of life was observed for early physiotherapy group arm compared to control group, although no strong statistical evidence was found (p > .05) for most of the dimensions except for physical function and social function areas (p < .003). Conclusions: The control group with therapeutic education program reported a clear improvement in the perception of quality of life. Adding early physiotherapy to the therapeutic education program did not show statistically significant changes in the global score or in most of the dimensions, but showed an improvement in the physical and social dimensions.

Background: The evaluation of sexual function is an important outcome in women who suffer some pelvic floor disorders (PFD). The Female Sexual Function Index (FSFI) is the most widely used questionnaire to evaluate the sexual health in female population. This study presents the adaptation and psychometric validation of the FSFI for Spanish women with PFD. Methods: The Spanish version of the FSFI was developed through the forward and backward translation process. The psychometric properties of reliability, validity, responsiveness, and feasibility were conducted in Spanish women with PFD who were assigned to the case or control group (with or without sexual dysfunction respectively). Results: A total of 323 Spanish women with PFD were recruited. The cross-cultural adaptation of the Spanish FSFI achieved a good semantic, conceptual, idiomatic, and content equivalence. The test-retest reliability was shown to be high in all of the cases. The convergent validity showed high results in the domain intercorrelations between each domain and total FSFI. The discriminant validity showed statistically significant differences between sexual dysfunction and control groups. The responsiveness was shown to be moderate to good in the dimensions and excellent in the total FSFI. Conclusions: Spanish FSFI can be used as a reliable, valid, responsive, and feasible instrument for assessing sexual function in women.

[Purpose]: Cancer cells show higher levels of reactive oxygen species (ROS) than normal cells and increasing intracellular ROS levels are becoming a recognized strategy against tumor cells. Thus, diminishing ROS levels could be also detrimental to cancer cells. We surmise that avoiding ROS generation would be a better option than quenching ROS with antioxidants. Chronic myelogenous leukemia (CML) is triggered by the expression of BCR-ABL kinase, whose activity leads to increased ROS production, partly through NADPH oxidases. Here, we assessed NADPH oxidases as therapeutic targets in CML. [Experimental Design]: We have analyzed the effect of different NADPH oxidase inhibitors, either alone or in combination with BCR-ABL inhibitors, in CML cells and in two different animal models for CML. [Results]: NADPH oxidase inhibition dramatically impaired the proliferation and viability of BCR-ABL-expressing cells due to the attenuation of BCR-ABL signaling and a pronounced cell-cycle arrest. Moreover, the combination of NADPH oxidase inhibitors with BCR-ABL inhibitors was highly synergistic. Two different animal models underscore the effectiveness of NADPH oxidase inhibitors and their combination with BCR-ABL inhibitors for CML targeting in vivo. [Conclusion]: Our results offer further therapeutic opportunities for CML, by targeting NADPH oxidases. In the future, it would be worthwhile conducting further experiments to ascertain the feasibility of translating such therapies to clinical practice., This work was supported by the Spanish Government's Ministry of Economy and Competitiveness (BFU2006-10362, BFU2009-10568, CSD2007-00015, BFU2011-28467), the Regional Government of Government of Castile & León (SA010A10-2, SA126A07, BIO/SA59/13) and the SAMUEL SOLORZANO BARRUSO Foundation (FS/7-2012). G.L.P. had a predoctoral fellowship from the Regional Government of Castilla y León, Spain.

Resumen Antecedentes y objetivo La fisioterapia compleja descongestiva, compuesta por drenaje linfatico manual, ejercicios, educacion terapeutica y vendaje compresivo, es el primer tratamiento de eleccion en pacientes con linfedema secundario a cancer de mama. La literatura indica que la efectividad del tratamiento depende en gran medida de la tecnica de vendaje. Asi, existen distintos tipos de vendajes que pueden emplearse. El objetivo es evaluar la eficacia de diferentes vendajes en funcion del grado y el estadio del linfedema. Descripcion de los casos Tres mujeres con linfedema secundario a cancer de mama. Dos de ellas fueron diagnosticadas de linfedema grado leve y una tercera de linfedema severo. Intervencion Se les aplico el mismo tratamiento conservador, excepto el tipo de vendaje, que vario en relacion con el grado de linfedema; en ambos linfedemas leves se aplicaron el vendaje neuromuscular y el vendaje multicapa, respectivamente; en el caso del linfedema severo, una combinacion de ambos. Resultados y discusion Todas las pacientes disminuyeron el volumen del miembro afectado. Los mejores resultados se obtuvieron en el caso de linfedema leve, en el que se empleo un vendaje multicapa, con una reduccion del volumen del edema de un 80,2% y la total eliminacion de los sintomas. El metodo de contencion en el tratamiento del linfedema podria aplicarse en funcion del grado y el estadio del mismo para optimizar resultados. Son necesarios ensayos clinicos con un tamano muestral apropiado que comparen los distintos tipos de vendaje en el mismo tipo de pacientes con el mismo grado de linfedema.

[ES]El objetivo general de este trabajo fue analizar el potencial de la familia NADPH oxidasa como diana terapéutica en leucemia mieloide crónica. Para desarrollar nuestro estudio utilizamos dos líneas celulares distintas de LMC, denominadas K562 y Boff210. Además utilizamos células mononucleadas (CMNs) de médula ósea de pacientes en fase crónica de la enfermedad y recién diagnosticados, de las cuales seleccionamos también las células hematopoyéticas progenitoras CD34+. La metodología requerida para llevar a cabo la investigación englobó diversas técnicas Bioquímicas y de Biología Molecular, tales como ensayos de proliferación por MTT, ensayos de formación y contaje de colonias, citometría de flujo, transferencia de western, RT-qPCR, ARN de interferencia, etc. Los resultados fueron los siguientes: todos los inhibidores de NADPH oxidasa utilizados (DPI, Apocinina e inhibidor de RAC1) fueron capaces de reducir significativamente la proliferación de las células K562, Boff210 y de las células monucleadas y CD34+ de médula ósea de pacientes, y la combinación de estos inhibidores con Imatinib o Nilotinib mostraba un efecto significativamente mayor, sugiriendo que la actividad NADPH oxidasas es necesaria para el crecimiento de estas células leucémicas. Al analizar la relación entre los agentes, el índice de combinación obtenido en la gran mayoría de los casos indicaba una fuerte sinergia entre ellos, es decir, la inhibición de las NADPH oxidasas era capaz de potenciar el efecto del Imatinib o del Nilotinib (fármacos actualmente utilizados como tratamiento de la Leucemia Mieloide Crónica en los pacientes). Se confirmó también el efecto antiproliferativo de la inhibición de NADPH oxidasas in vivo, utilizando dos modelos animales de LMC diferentes: un modelo de ratón xenoinjerto, en el que se generó un tumor sólido mediante la inoculación de células K562, y un modelo de ratón transgénico p210BCR-ABL, de manera que el DPI (inhibidor de NADPH oxidasas), fue capaz de reducir significativamente el crecimiento del tumor sólido en el modelo xenoinjerto, y de reducir el porcentaje de granulocitos presentes en sangre periférica en los ratones transgénicos, siendo superior el efecto antiproliferativo del tratamiento combinado DPI + Imatinib en ambos casos. Los niveles de ROS disminuían significativamente al tratar las células con DPI ó Imatinib, pero la reducción era significativamente mayor con el doble tratamiento, indicando que los efectos de los tratamientos sobre proliferación están directamente relacionados con una disminución de los niveles de ROS en las células. La activación de las rutas de señalización en K562 dependía de las especies reactivas del oxígeno generadas por las NADPH oxidasas, ya que cuando se inhibían estas enzimas, individualmente o en combinación con el inhibidor de BCR-ABL, los niveles de fosforilación de las proteínas estudiadas (BCR-ABL, CRKL, ERK y STAT5) se veían áltamente disminuidos. Además, el tratamiento con DPI y con la combinación DPI + Imatinib provocaba un fuerte bloqueo del ciclo celular en la fase de mitosis, lo que explicaría, junto con la disminución de la activación de la señalización, los efectos de los tratamientos observados en proliferación. Los estudios de viabilidad reflejaban como la inhibición de las NADPH oxidasas en K562 provocaba una reducción en el porcentaje de células vivas, y la entrada de la células en apoptosis. Cuando la tyr-fosfatasa SHP1 fue silenciada mediante RNAi, los niveles de fosforilación de BCR-ABL se veían incrementados, y cuando se trataron las células leucémicas con DPI o su combinación con Imatinib, la actividad fosfatásica específica de SHP1 aumentó también significativamente. Esto sugiere que la producción de ROS por las NADPH oxidasas mantiene activas las rutas de señalización dirigidas por BCR-ABL mediante la oxidación, y por tanto inhibición, de SHP1, que sería, una de las fosfatasas encargadas de desfosforilar, y por tanto inactivar a BCR-ABL. El estudio por RT-qPCR nos permitió determinar el patrón de expresión de NADPH oxidasas en las células K562 y en CMNs de 4 pacientes diferentes. En ningún caso se expresaron las isoformas NOX1, NOX3 y NOX4. En las células K562, las isoformas presentes fueron NOX2, NOX5 y DUOX2, siendo NOX2 la isoforma predominante. Así, silenciamos estos complejos enzimáticos mediante RNA de interferencia (RNAi) utilizando un sistema de infección lentiviral, y comprobamos como la inhibición de cualquiera de ellos conllevaba una disminución significativa tanto de la proliferación, como de la activación de la señalización, siendo el efecto mayor cuando se producía el silenciamiento simultáneo de las 3 isoformas. Esto sugería una función conjunta de todas las isoformas expresadas en estas células leucémicas, y señalaba como mejor estrategia en la terapia de la Leucemia Mieloide Crónica la utilización de inhibidores globales de NADPH oxidasas frente a inhibidores específicos de una única isoforma. Por tanto, nuestros resultados muestran que el uso de inhibidores específicos para la familia NADPH oxidasa, tanto de manera independiente, como en combinación con inhibidores de la oncoquinasa BCR-ABL, es una estrategia terapéutica efectiva y novedosa para combatir la leucemia mieloide crónica que podría mejorar en el futuro los resultados que se consiguen en los pacientes con la terapia tradicional.

Background The Oxford Shoulder Score (OSS) and the Shoulder Pain and Disability Index (SPADI) are patient-based outcome scores with valid psychometric properties which are widely used for shoulder interventions. Objective The purpose of the study is to adapt both questionnaires cross-culturally to Spanish, and to test their reliability, validity, responsiveness, and feasibility. Design Cultural adaptation and psychometric validation study. Methods Consecutive patients who had undergone breast cancer surgery referred to an outpatient clinic at the University of Alcalá de Henares, Spain. One hundred and twenty women who had undergone breast cancer surgery, with pain and shoulder dysfunction. Cross-cultural adaptation was performed according to the international guidelines. Reliability was analysed by test-retest reliability and internal consistency. Content and convergent construct validity were measured by the Expert Committee’s and Spearman coefficient respectively. Responsiveness, feasibility, floor and ceiling effects were also tested. Results One hundred and twenty women aged 54.2 (±11) years took part in the study. The reliability was excellent; test-retest reliability was 0.974 (p

To analyze the effect of age in both B and T cell compartments of the immune system, we have studied the anti-dextran (Dx) B512 humoral immune response in aged C57BL/6 mice. We have used Dx in its native form, which induces a thymus-independent (TI) response, or conjugated to chicken serum albumin (CSA), which induces a thymus-dependent (TD) response. We have also analyzed the adjuvant effect of cholera toxin (CT) in both types of responses. Our results show that the B cell compartment is not greatly affected by age as demonstrated in the TI responses and that CT is a powerful adjuvant despite the age of the animals. However, we found a severe age-associated impairment of TD responses. We conclude that the first antigenic challenge deeply influences further antigenic responses in a positive or negative manner. Priming in early life with native Dx (TI) inhibited late TD responses in aged mice, even when the primary immunization had occurred a long time ago. This negative memory affects posterior TD responses both in the quantity and in the affinity of the response. However, immunization at an early age with TD priming (CSA-Dx) provoked a long-lasting immune memory that abolished in part the age-associated impairment of the response. Our results suggest that protocols of vaccination with TI antigens may not be a convenient strategy, because the development of further optimal immune responses to the same antigen can be impaired.

To develop a linguistically adapted and psychometrically validated Spanish version of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire Short Forms (PFDI-20 and PFIQ-7) to assess symptoms and quality of life in Spanish women with pelvic floor disorders.Cross-cultural linguistic adaptation was performed following the translation-backtranslation method in 30 native Spanish-speaking women with pelvic floor disorders to obtain PFDI-20 and PFIQ-7 Spanish versions. The psychometric properties were evaluated in 114 women with pelvic floor disorders. We calculated the reliability with the intraclass correlation coefficient and Cronbach's alpha coefficient, the validity with Spearman coefficient, the feasibility with the response rate and the filling time, and the ceiling and floor effects.Spanish versions of the PFDI-20 and PFIQ-7 achieved good semantic, conceptual, idiomatic and content equivalence. Concerning the psychometric validation, internal consistency was high with Cronbach's alpha coefficient of 0.837 (p0.001) for PFDI-20 and 0.967 (p0.001) for PFIQ-7. The test-retest reliability was 0.644 (p0.001) for the PFDI-20 and 0.786 (p0.001) for the PFIQ-7. Good construct validity was found with questionnaires: SF-12, EPIQ and ICIQ-SF. The average administration time was 10.1 (5.8)min for the PFDI-20, and 7.5 (4.7)min for the PFIQ-7. A ceiling effect was detected in the PFIQ-7 (25.4%).The PFDI-20 and PFIQ-7 Spanish versions showed semantic, conceptual, idiomatic and content equivalence with the original versions. Both instruments are reliable, valid and feasible to evaluate symptoms and quality of life in Spanish women with pelvic floor disorders.