A systematic review protocol on the effectiveness of therapeutic exercises utilised by physiotherapists to improve function in patients with burns.

BACKGROUND: Therapeutic exercises play a crucial role in the management of burn injuries. The broad objective of this review is to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. Population = adults and children/adolescents with burns of any aspect of their bodies. Interventions = any aerobic and/or strength exercises delivered as part of a rehabilitation programme by anyone (e.g. physiotherapists, occupational therapists, nurses, doctors, community workers and patients themselves). Comparators = any comparator. Outcomes = any measure of outcome (e.g. quality of life, pain, muscle strength, range of movement, fear or quality of movement). Settings = any setting in any country. METHODS/DESIGN: A systematic review will be conducted by two blinded independent reviewers who will search articles on PubMed, CiNAHL, Cochrane library, Medline, Pedro, OTseeker, EMBASE, PsychINFO and EBSCOhost using predefined criteria. Studies of human participants of any age suffering from burns will be eligible, and there will be no restrictions on total body surface area. Only randomised controlled trials will be considered for this review, and the methodological quality of studies meeting the selection criteria will be evaluated using the Cochrane Collaboration tool for assessing risk of bias. The PRISMA reporting standards will be used to write the review. A narrative analysis of the findings will be done, but if pooling is possible, meta-analysis will be considered. DISCUSSION: Burns may have a long-lasting impact on both psychological and physical functioning and thus it is important to identify and evaluate the effects of current and past aerobic and strength exercises on patients with burns. By identifying the characteristics of effective exercise programmes, guidelines can be suggested for developing intervention programmes aimed at improving the function of patients with burns. The safety and precautions of exercise regimes and the optimal frequency, duration, time and intensity will also be examined to inform further intervention. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CDR42016048370 .

Differential expression of heat shock protein 105 in melanoma and melanocytic naevi.

The objective of this study is to assess the expression of heat shock protein 105 (HSP105) in melanoma and benign melanocytic lesions. The expression of HSP105 in 62 human melanoma samples--46 primary and 16 metastatic lesions--and 42 melanocytic naevi samples, was assessed by immunohistochemistry. Western blotting was performed on melanoma cell lines, melanoma tissues with matched normal skin and melanocytic naevi. The Mann-Whitney test was used for statistical analysis and significance was considered to be P less than 0.05. Seventy-four per cent of the primary melanoma lesions and 88% of the metastatic lesions overexpressed HSP105 by immunohistochemistry. The majority of melanocytic lesions (95%) were negative (P<0.05). Western blotting detected high expression of HSP105 in melanoma cell lines and tissues. The expression of HSP105 was related to the invasiveness of the lesions. Melanocytic naevi expressed HSP105 at a level that was similar to that of normal skin. Our results show that high expression of HSP105 is associated with malignant melanoma especially advanced and metastatic lesions. The results suggest that HSP105 analysis may be a helpful tool as a poor prognostic indicator and as a diagnostic aid in problematic lesions; in addition, melanoma can be included in the growing list of tumours overexpressing HSP105 to be targeted for potential HSP105-based therapeutic strategies.