Dolor musculoesquelético ligado a la interpretación musical en la Comunidad Valenciana / Playing-related musculoskeletal disorders in the Valencian Community

Objetivos Existe una relación entre la práctica habitual de un instrumento y la aparición de trastornos musculoesqueléticos. El síntoma más destacado de estos trastornos es el dolor, de manera que puede establecerse la existencia de dolor ligado a la interpretación musical como un problema ocupacional específico. La Comunidad Valenciana es una región con una tradición musical reconocida, en la que no se conoce suficientemente el impacto que tiene sobre la salud el desempeño musical. El objetivo de esta investigación ha sido definir la frecuencia del dolor de origen musculoesquelético en los estudiantes de música de nuestro medio y estudiar su localización regional en función del tipo de instrumento. Materiales y método Se han incluido en el estudio aquellos estudiantes de música que están cursando Grado Medio o Superior en conservatorios de la Comunidad Valenciana. Las variables se han recogido por medio de un cuestionario de salud que han cumplimentado los estudiantes. Para determinar la intensidad del dolor se han calculado las medias de la EVA y de las puntuaciones de dolor de los cuestionarios SRS-22 y CAVIDRA, validados para la población española. Se ha realizado un estudio de localización segmentaria del dolor en los diferentes grupos de instrumento. Resultados En el presente estudio se recogieron 268 encuestas, de las cuales 222 cumplían criterios de inclusión. El 68% de los encuestados declaraba haber desarrollado en algún momento molestias o dolor ligado a la interpretación musical. El sistema más frecuentemente afectado fue el musculoesquelético. Los síntomas relacionados con tocar más frecuentemente referidos fueron dolor, tensión muscular, contractura y fatiga. Conclusiones El 68% de los músicos presentan algún tipo de dolor ligado a la interpretación musical en algún momento de su carrera. El estudio de la topografía del dolor relacionada con el instrumento ofrece datos interesantes para definir estrategias de prevención (AU)

Objectives There is a relationship between routinely playing an instrument and musculoskeletal disorders. The most important of these disorders is pain. Therefore, playing-related musculoskeletal disorders can be established as a specific occupational problem. The Valencian Community is a region with a well-known musical tradition, in which the health impact of playing an instrument has not been sufficiently identified. The aim of this study was to define the frequency of musculoskeletal pain in music students in our environment and to identify its localization according to the instrument played. Materials and method This study included music students in the intermediate or advanced levels of the conservatoires of the Valencian Community. The variables were gathered through a health questionnaire completed by the students. To determine pain intensity, we calculated the mean VAS scores and the pain scores of the SRS-22 and CAVIDRA questionnaires, which have been validated for the Spanish population. Segmental pain localization was studied in the different groups of instruments. Results A total of 268 questionnaires were gathered, of which 222 met the inclusion criteria. Playing-related pain or discomfort was reported by 68% of respondents. The most frequently affected system was the musculoskeletal system. The most frequently-reported playing-related symptoms were pain, muscular tension, spasm and fatigue. Conclusions A total of 68% of the musicians in this study reported some type of playing-related pain at some time during their studies. Study of the topography of instrument-related pain provides useful data for the design of prevention strategies (AU)

[Playing-related musculoskeletal disorders in the Valencian Community]. / Dolor musculoesquelético ligado a la interpretación musical en la Comunidad Valenciana.

OBJECTIVES: There is a relationship between routinely playing an instrument and musculoskeletal disorders. The most important of these disorders is pain. Therefore, playing-related musculoskeletal disorders can be established as a specific occupational problem. The Valencian Community is a region with a well-known musical tradition, in which the health impact of playing an instrument has not been sufficiently identified. The aim of this study was to define the frequency of musculoskeletal pain in music students in our environment and to identify its localization according to the instrument played. MATERIALS AND METHOD: This study included music students in the intermediate or advanced levels of the conservatoires of the Valencian Community. The variables were gathered through a health questionnaire completed by the students. To determine pain intensity, we calculated the mean VAS scores and the pain scores of the SRS-22 and CAVIDRA questionnaires, which have been validated for the Spanish population. Segmental pain localization was studied in the different groups of instruments. RESULTS: A total of 268 questionnaires were gathered, of which 222 met the inclusion criteria. Playing-related pain or discomfort was reported by 68% of respondents. The most frequently affected system was the musculoskeletal system. The most frequently-reported playing-related symptoms were pain, muscular tension, spasm and fatigue. CONCLUSIONS: A total of 68% of the musicians in this study reported some type of playing-related pain at some time during their studies. Study of the topography of instrument-related pain provides useful data for the design of prevention strategies.

Satiety responsiveness and eating behavior among Chilean adolescents and the role of breastfeeding.

OBJECTIVE: To determine patterns of satiety responsiveness and its relationship to eating in the absence of hunger (EAH), in a cohort of adolescents. We also assessed whether sex, body mass index and duration of breastfeeding, during infancy, predicted satiety responsiveness and eating behavior at 16 years. METHODS: Adolescents (n=576) from a longitudinal cohort, which began as an iron deficiency anemia preventive trial, participated in an unlimited breakfast after an overnight fast, and reported satiety response on a visual analog scale after the meal, followed by an EAH procedure. Height, weight and body composition were measured before breakfast. Latent profile analysis generated profiles that captured individual differences in satiety responsiveness. Multivariable regressions, adjusted for potential confounders, evaluated the association between: (1) satiety responsiveness and EAH, and (2) breastfeeding in infancy, satiety responsiveness and EAH in adolescence. RESULTS: Participants were on average 16.7-year old, 48% female, 37% overweight/obese and 76% were breastfed as the sole source of milk for <6 months. We found three latent profiles of satiety responsiveness: 1: 'responsive' (49%); 2: 'not responsive' (41%); 3: 'still hungry' (10%). Participants in the 'not responsive' or 'still hungry' profile were more likely to eat during the EAH procedure (odds ratio (OR)=2.5, 95% confidence interval (CI)=1.8-3.6). Being breastfed for <6 months was related to higher odds of being in the 'not responsive' or 'still hungry' profile (OR=1.8, 95% CI=1.2-2.6) and EAH (OR=2.2, 95% CI=1.4-3.3). Satiety responsiveness was not influenced by sex and overweight/obesity. CONCLUSION: After an ad libitum meal, we found varied satiety responses, which related to EAH. Furthermore, shorter breastfeeding duration was associated with poorer satiety response and higher consumption during an EAH procedure. Understanding if breastfeeding influences the development of satiety responsiveness and eating behavior may be important in an era characterized by abundant calorie-dense foods and a plethora of environmental cues promoting consumption.

Engineering CD19-specific T lymphocytes with interleukin-15 and a suicide gene to enhance their anti-lymphoma/leukemia effects and safety.

T lymphocytes expressing a chimeric antigen receptor (CAR) targeting the CD19 antigen (CAR.19) may be of value for the therapy of B-cell malignancies. Because the in vivo survival, expansion and anti-lymphoma activity of CAR.19(+) T cells remain suboptimal even when the CAR contains a CD28 costimulatory endodomain, we generated a novel construct that also incorporates the interleukin-15 (IL-15) gene and an inducible caspase-9-based suicide gene (iC9/CAR.19/IL-15). We found that compared with CAR.19(+) T cells, iC9/CAR.19/IL-15(+) T cells had: (1) greater numeric expansion upon antigen stimulation (10-fold greater expansion in vitro, and 3- to 15-fold greater expansion in vivo) and reduced cell death rate (Annexin-V(+)/7-AAD(+) cells 10+/-6% for iC9/CAR.19/IL-15(+) T cells and 32+/-19% for CAR.19(+) T cells); (2) reduced expression of the programmed death 1 (PD-1) receptor upon antigen stimulation (PD-1(+) cells <15% for iC9/CAR.19/IL-15(+) T cells versus >40% for CAR.19(+) T cells); and (3) improved antitumor effects in vivo (from 4.7- to 5.4-fold reduced tumor growth). In addition, iC9/CAR.19/IL-15(+) T cells were efficiently eliminated upon pharmacologic activation of the suicide gene. In summary, this strategy safely increases the anti-lymphoma/leukemia effects of CAR.19-redirected T lymphocytes and may be a useful approach for treatment of patients with B-cell malignancies.

Estudio comparativo de dos técnicas de infiltración miofascial en puntos gatillo: punción seca e inyección de anestésico local / A comparative study of two myofascial infiltration techniques in trigger points: dry needling and local anaesthetic injections

Introducción. En el tratamiento del dolor miofascial (DMF) se han recomendado diversos tipos de infiltración de puntos gatillo (PG). El propósito de este trabajo es comparar la eficacia y los efectos evolutivos de dos modalidades: punción seca (PS) e infiltración de anestésico local (IAL). Material y método. Se presenta un estudio observacional de casos y controles, en el que se incluyeron de forma consecutiva 24 pacientes con DMF, 15 tratados con PS y 9 con IAL. Se estudiaron las siguientes variables: dolor, mediante la escala analógica visual (EAV), en reposo y en esfuerzo, y el umbral doloroso mediante el algómetro de presión. Se valoró también la EAV durante la técnica y a los 20 minutos. Resultados. Se estudiaron 22 mujeres y dos varones con una edad media de 48 años. Todos los pacientes tratados mejoraron sus parámetros de dolor en reposo y al esfuerzo (p < 0,01). No hubo diferencias significativas entre ambas técnicas en cuanto a la mejora de la EAV. La EAV en reposo mejoró un porcentaje medio del 35 %, y un 33 % el de esfuerzo. La mejora del umbral de dolor fue mayor en los pacientes tratados con PS (p = 0,04). No hubo diferencia en las molestias sentidas durante la terapia, ni en el efecto inmediato del tratamiento. Discusión. Tanto la PS como la IAL son efectivas en la inactivación del PG, con efecto analgésico semejante. Sin embargo hay una cierta tendencia de la PS a mejorar más el umbral doloroso, hecho que sugiere mayor capacidad de inactivación del PG. Se concluye así que ambas técnicas pueden utilizarse para el alivio del dolor en aquellos pacientes diagnosticados de DMF

Introduction. Several kinds of trigger point injection have been recommended for myofascial pain syndrome. The aim of this study is to compare the efficacy and evolutive effects of two types of myofascial treatment: dry needling and local anaesthetic injection (LAI). Patients and methods. We included 24 myofascial pain patients, 15 treated by dry needling and 9 treated by anaesthetic local injection. The following variables were studied: resting and active pain by Visual Analogical Scale (VAS); pain threshold was measured by pressure algometer; discomfort during technique and immediate effect, at 20 minutes (VAS). Results. Twenty two females and 2 males with a mean age of 48 years, were treated. Patients improved resting and active pain level (p < 0.01). Pain threshold improved more in dry needling group (p = 0.04). Percentage transformed VAS improved 35 % resting and 33 % in activities. No differences were observed between groups in discomfort during therapy or in immediate effect of the treatment. Discussion. Dry needling and anaesthetic injection were effective for trigger point release. We observed more improvement on pain threshold in dry needling group, which suggests that technique is better to release trigger point. We concluded both techniques were useful to alleviate pain in myofascial syndrome patients