Effects of a novel osteopathic visceral technique for the pancreas on pain and range of motion in a patient with neck pain: Case report.

INTRODUCTION: Neck pain is a leading cause of disability worldwide. Visceral referred pain is a common form of disease-induced pain, with visceral nociception being referred to somatic tissues. OBJECTIVE: The aim of this case report was to evaluate the immediate and long term effects of a novel osteopathic visceral technique (OVT) on pain and cervical range of motion (CROM) in a patient with nonspecific neck pain (NS-NP). METHOD: A case of a 47-year-old female suffering with NS-NP for four months. The patient had sought physiotherapy treatment several times, and occasionally used anti-inflammatory medication to relieve symptoms. The patient presented muscle cervical tenderness and hyperalgesia over the spinous processes of C3-C4 spinal segments with limited CROM. A novel osteopathic visceral manipulation (OVM) technique was applied in the epigastric region targeting the pancreas. Immediately after the treatment, the patient reported reduction in pain evaluated with the numerical evaluation scale (NRS), and a clinically significant increase in pressure pain threshold (PPT) in C3 spinous process. Improvement in CROM was also observed. The post-treatment improvements have been maintained at 1-month of follow-up assessment. CONCLUSION: A single OVT was effective in reducing cervical pain and increasing CROM in a patient with NS-NP caused by a viscerosomatic reflex. The results of this case study provides preliminary evidence that OVM can produce hypoalgesia in somatic tissues with segmentally related innervation. This finding encourages future research to gain a better understanding of the mechanisms of regional inhibitory interdependence involving the viscerosomatic reflexes of OVM.

A Shared Perspective on in Vitro and in Vivo Models to Assay Intestinal Transepithelial Transport of Food Compounds.

Assessing nutrient bioavailability is complex, as the process involves multiple digestion steps, several cellular environments, and regulatory-metabolic mechanisms. Several in vitro models of different physiological relevance are used to study nutrient absorption, providing significant challenges in data evaluation. However, such in vitro models are needed for mechanistic studies as well as to screen for biological functionality of the food structures designed. This collaborative work aims to put into perspective the wide-range of models to assay the permeability of food compounds considering the particular nature of the different molecules, and, where possible, in vivo data are provided for comparison.

Delphinidin-3-rutinoside from Blackcurrant Berries (Ribes nigrum): In Vitro Antiproliferative Activity and Interactions with Other Phenolic Compounds.

Blackcurrant berries (Rigrum L.) are of great interest for food scientists/technologists as a source of delphinidin-3-rutinoside (D3R). This is an uncommon phenolic compound in diets that unveils potent antiproliferative activity besides its colour. Other phenolic compounds, such as chlorogenic acid (CA) and epicatechin (EC), also known by their antiproliferative effects, are abundant in foods and beverages. To design smart food/supplements combinations containing blackcurrant and improved anticancer properties at the gastrointestinal level, there is the need for more data concerning the combined effects of those molecules. In this work, synergistic, additive, or antagonistic effects against gastric and intestinal cancers of D3R, CA, and EC were assessed in vitro. The antiproliferative activity of D3R, CA, and EC, alone and in binary combinations (D3R+CA, D3R+EC, and CA+EC) on NCI-N87 (gastric) and Caco-2 (intestinal) cells, was assessed following the Chou-Talalay theorem at equipotent contributions (i.e., (IC50)1/(IC50)2). D3R presented the strongest antiproliferative activity of the single molecules tested, with IC50 values of 24.9 µM and 102.5 µM on NCI-N87 and Caco-2 cells, respectively. The combinations D3R+CA and CA+EC were synergic against NCI-N87 until IC50 and IC75, respectively, while D3R+EC shifted from slight antagonism to synergism at higher doses. On Caco-2 cells, antagonism at low doses and synergism at high doses was observed. Therefore, the synergisms observed on the gastric cancer model at low doses occurred on the colon model only at high doses. Data herein described is vital to the targeted smart design of foods and supplements, as it is foreseen that the same combination of phenolic compounds causes different interactions/effects depending on the dose and gastrointestinal compartment.

Protein Hydrolysates from Brewing By-Products as Natural Alternatives to ACE-Inhibitory Drugs for Hypertension Management.

The treatment of hypertension is of major importance to reduce the risk of cardiovascular disease, the leading cause of death worldwide. Angiotensin-converting enzyme (ACE) inhibitors are anti-hypertensive drugs associated with several side effects. Natural products, namely bioactive peptides from brewing by-products, brewers' spent grain (BSG), and yeast (BSY), are promising alternatives since they can inhibit ACE in vitro. However, the oral intake of these peptides may modify their expected inhibitory effect owing to possible changes in active peptides' bioavailability, which have not been assessed so far. The goal of this study was to simulate oral administration to evaluate BSG/BSY peptides' effectiveness by submitting protein hydrolysates sequentially to simulated gastrointestinal digestion, intestinal absorption (Caco-2 cells), and liver metabolism (HepG2 cells). MTT assay was used to assess BSG/BSY protein hydrolysates safeness. The ACE-inhibitory potential of initial and final protein hydrolysates (BSY, BSG, and a new product, MIX) were tested using a fluorometric assay and compared with captopril (1 µM, an ACE-inhibitory drug). Simulation of oral administration greatly increased BSY and MIX protein hydrolysates' ACE-inhibitory capacity, though final MIX and BSG revealed greater ACE-inhibitory potential than captopril. Notwithstanding, all final protein hydrolysates presented ACE-inhibitory capacity, thus being promising compounds to manage hypertension.

Efectos de la técnica de liberación por presión del punto gatillo miofascial latente del musculo trapecio superior: ensayo clínico aleatorio controlado / No disponible

Introducción: Los puntos gatillo miofasciales latentes (PGML) son responsables de dolor intenso y espontáneo. La cervicalgia mecánica no traumática se caracteriza por la presencia de hiperalgesia a la presión en la columna cervical, la cual afecta de igual manera a los músculos cervicales, como trapecios superiores, puesto que estos músculos reciben su inervación de los niveles C2-C4. Objetivo: Conocer los efectos inmediatos de la técnica de liberación por presión del PGML del trapecio superior en el umbral de dolor a la presión (UDP) de este músculo, así como del músculo angular del omoplato, del nervio occipital mayor (NOM), del nervio supra-orbitario (V1) y de las apófisis articulares de C3-C4 bilateralmente, y en la amplitud del movimiento activo cervical (AMAC). Material y métodos: Sesenta sujetos diagnosticados de PGML en las fibras más antero-superiores del músculo trapecio superior fueron incluidos en el estudio. Los valores del UDP se midieron bilateralmente en trapecio superior angular del omoplato, NOM, V1 y apófisis articulares de C3-C4 mediante un algómetro digital. La AMAC en flexión, extensión, latero-flexión homolateral, latero-flexión contralateral, rotación homolateral y rotación contralateral se midieron con un inclinómetro de burbuja. Al grupo intervención se le aplicó la técnica de liberación del PGM, y al grupo control se le aplicó una técnica placebo con ultra-sonidos sin intensidad. Resultados: Los resultados obtenidos demuestran que la técnica de liberación por presión del PGML del trapecio superior es efectiva en el aumento del UDP en este músculo inmediatamente después de su aplicación (p<0,01). Se verificó, además, que el aumento del UDP en el trapecio superior, tras la liberación del PGML, fue acompañado de un aumento simultáneo del UDP en el trapecio superior contralateral, así como en el músculo angular del omoplato bilateralmente, NOM bilateralmente, apófisis articulares de C3-C4 bilateralmente y V1 homolateral. En ambos grupos se verificó un incremento significativo de la AMAC (p<0,01). Sin embargo, en el grupo de intervención este aumento fue significativamente superior, lo que del punto de vista clínico puede ser bastante relevante. Conclusiones: La técnica de liberación por presión en el PGML del trapecio superior es una técnica útil en osteopatía, siendo efectiva en el aumento del UDP y de la AMAC inmediatamente después de su aplicación

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Puntos gatillo miofasciales: de la teoría a la práctica osteopática / Myofascial trigger points: from theory to practice

Introducción: Travell define el punto gatillo miofascial (PGM) como un punto hiperirritable en el músculo esquelético asociado a un nódulo palpable hipersensible dentro de una banda tensa. El punto es doloroso a la palpación y puede desencadenar un patrón característico de dolor referido, disfunción motora y fenómenos autonómicos. Objetivo: Valorar la importancia que los PGM pueden tener en osteopatía como posibles generadores de dolor, describir sus características clínicas para su correcto diagnóstico, y realzar la importancia de su tratamiento dentro de un protocolo osteopático. Material y métodos: Se ha realizado una revisión bibliográfica y posterior discusión sobre el tema. Resultados: Los PGM, a pesar de presentar alta prevalencia, son comúnmente olvidados o pobremente tratados debido al hecho de que la formación inicial de los profesionales pocas veces incluye la instrucción adecuada para identificarlos y tratarlos. Existe buena concordancia inter-observador para valorar la presencia o ausencia del PGM, ya sea latente o activo. Esto hace más fiable su diagnóstico. La literatura muestra que las características clínicas del PGM se identifican con una fiabilidad mayor o menor dependiendo de la característica específica y del músculo específico examinando. La experiencia clínica es esencial para lograr buenos resultados. Conclusiones: Siendo los PGM posibles generadores de dolor y de aferencias nociceptivas, el osteópata debe ser capaz de diagnosticar e inactivar correctamente un PGM cuanto antes, para evitar que se desarrolle un proceso de sensibilización central del sistema nervioso. El entrenamiento del terapeuta es esencial para la correcta identificación de un PGM. La banda tensa (BT) y la sensibilidad local son los signos clínicos más fiables para el diagnóstico de un PGM. La falta de un consenso general en cuanto a los criterios de diagnóstico más apropiados para el examen de los PGM es, cada vez más, el gran impedimento para su valoración

Introduction: travell defines the myofascial trigger point (MTrP) as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is painful on compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction and autonomic phenomena. Objective: to assess the role that MTrPs can play in osteopathy as potential sources of pain, to describe their clinical characteristics in order to correctly diagnose them and to underline the importance of treating them within an osteopathic treatment protocol. Materials and Methods: we carried out a literary review, followed by a discussion of the topic. Results: MTrPs, despite having a high prevalence, are often forgotten or poorly treated due to the fact that the early training given to medical professionals rarely includes sufficient information to identify and treat MTrPs. There is good inter-rater concordance in detecting the presence or absence of either latent or active MTrPs. This makes diagnosis more reliable. The literature shows that the reliability of the identification of the clinical characteristics of MTrPs depends on the specific characteristic and muscle being studied. Clinical experience is essential for obtaining good results. Conclusions: as MTrPs are potential sources of pain and noxious afferents, osteopaths should be able to correctly diagnose and deactivate them as soon as possible to avoid the central sensitisation of the nervous system. It is essential that osteopaths are trained to correctly identify MTrPs. A taut band (TB) and local sensitivity are the most reliable clinical signs for diagnosing MTrPs. The biggest obstacle preventing reliable diagnosis of MTrPs is the general lack of consensus surrounding the best diagnosis criteria to use