Long-term consistency of clinical sensory testing measures for pain assessment

Pablo Bellosta-López,Víctor Doménech-García,Thorvaldur Skuli Palsson,Pablo Herrero,Steffan Wittrup Mcphee Christensen 대한통증학회 2023 The Korean Journal of Pain Vol.36 No.2

Background: Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Methods: Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Results: Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96–0.99; MDC, 22–55 kPa) and from good to excellent at 6 months (ICC, 0.88–0.95; MDC, 47–91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91–0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57–0.74; MDC, 24%–35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). Conclusions: PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

Cr(VI) removal from synthetic and real wastewaters: The use of the invasive biomass Sargassum muticum in batch and column experiments

Marta Lopez-Garcıa,Roberto Herrero,Manuel E. Sastre de Vicente,Pablo Lodeiro 한국공업화학회 2012 Journal of Industrial and Engineering Chemistry Vol.18 No.4

The macroalgae Sargassum muticum was selected for the treatment of solutions containing Cr(VI). Very acidic pH values were established as optimal for Cr(VI) reduction. Algae chemical modification reduced equilibrium time to 4 h. First order kinetic model was used to describe the reduction kinetic of Cr(VI). A column experiment allowed to distinguish the processes occurring during Cr(VI) elimination: its reduction to Cr(III) and the subsequent adsorption of this species formed. Under the selected conditions the biomass was capable of reducing all the incoming Cr(VI) during 77 h. Industrial wastewaters from chrome plating industry were also tested for chromium removal.

A Clinical Trial Protocol to Compare the Effect of Dry Needling and Acupoint Dry Needling on Wrist Flexor Spasticity after Stroke

Najmeh Nazari,Noureddin Nakhostin Ansari,Soofia Naghdi,Pablo Herrero Gallego,Roshanak Honarpisheh 사단법인약침학회 2022 Journal of Acupuncture & Meridian Studies Vol.15 No.4

Background: Stroke is the leading cause of disability in adults worldwide, with spasticity after stroke being one of the more common complications. Dry needling (DN) has been demonstrated to decrease spasticity in stroke patients, although its effects on improving function remain unclear. The purpose of this study protocol is to compare the short-term effects of DN versus acupoint DN on wrist flexor spasticity and upper extremity function in patients with stroke. Methods: A double-blind, randomized clinical trial will be conducted to include patients with stroke and upper extremity spasticity and functional disability. Twenty-four patients with stroke will be randomly assigned to either the DN or acupoint DN (DNap) group. These groups will receive three DN sessions during a one-week period of the wrist flexor muscles or at the LI4 & TE5 acupoints, respectively. The primary outcome measure is the Modified Modified Ashworth Scale (MMAS) of spasticity. The secondary outcomes are the Fugl–Meyer Assessment of motor function (FMA) and the goniometry to assess the active and passive range of motion of the wrist. Data will be collected at baseline, immediately after the end of three sessions DN, and at a one-week follow-up visit. Discussion: The results of this comparative study will help to determine the more effective method for reducing spasticity and improving motor function in patients with stroke.

Not just sensitization: sympathetic mechanisms contribute to expand experimental referred pain

Víctor Doménech-García,Alberto Rubio Peirotén,Miren Lecea Imaz,Thorvaldur Skuli Palsson,Pablo Herrero,Pablo Bellosta-López 대한통증학회 2022 The Korean Journal of Pain Vol.35 No.3

Background: Widespread pain partially depends upon sensitization of central pain mechanisms. However, mechanisms controlling pain distribution are not completely known. The present study sought to assess skin temperature variations in the area of experimentally-induced pain and potential sex differences. Methods: Pressure-pain thresholds (PPTs) were measured on the right infraspinatus muscle. At the end of Day 0, all participants performed an eccentric exercise of the shoulder external rotators to induce muscle soreness 24 hours after. On Day 1, participants indicated on a body chart the area of pain induced by 60 seconds of suprathreshold pressure stimulation (STPS; PPT + 20%) on the right infraspinatus muscle. Skin temperature variations in the area of referred pain were recorded with an infrared thermography camera, immediately before and after the STPS. Results: Twenty healthy, pain-free individuals (10 females) participated. On Day 0, the pre-STPS temperature was higher than the post-STPS temperature on the arm (P = 0.001) and forearm (P = 0.003). On Day 1, the pre-STPS temperature was higher than the post-STPS temperature on the shoulder (P = 0.015), arm (P = 0.001), and forearm (P = 0.010). On Day 0, the temperature decrease after STPS in females was greater than in males on the forearm (P = 0.039). On Day 1, a greater temperature decrease was found amongst females compared with males at the shoulder (P = 0.018), arm (P = 0.046), and forearm (P = 0.005). Conclusions: These findings indicate that sympathetic vasomotor responses contribute to expand pressure-induced referred pain, especially among females.

A Study on the Effects of Dry Needling in Multiple Sclerosis Patients with Spasticity: Protocol of a Randomized Waitlist-Controlled Trial

Omid Motamedzadeh,Noureddin Nakhostin Ansari,Soofia Naghdi,Amirreza Azimi,Ashraf Mahmoudzadeh,Sandra Calvo,Pablo Herrero 사단법인약침학회 2021 Journal of Acupuncture & Meridian Studies Vol.14 No.2

Background: Spasticity is a common symptom in multiple sclerosis (MS). Dry needling (DN) has been considered a useful method for the treatment of spasticity; however, there are no studies on the effects of DN on spasticity in patients with MS. We propose a study protocol aiming to investigate the effects of DN on spasticity in patients with MS. Methods: MS patients with plantar flexor spasticity will be recruited. Participants will be randomly assigned to the DN group, where they will be receiving a single session of DN, one minute for each head of gastrocnemius muscle, or to the waiting list control group with no intervention. Primary outcome measures are the Modified Ashworth Scale (MAS) for gastrocnemius spasticity, passive resistive torque, and podography for foot pressure distribution. The ankle active and passive range of dorsiflexion and Timed Up and Go tests are the secondary outcome measures. All outcomes will be measured at baseline, immediately after the intervention, and one week later. A mixed-model, general linear model, and two-way repeated-measures ANOVA will be used to compare the quantitative variables between groups and within groups at the measurement time points. The MAS ordinal measure of spasticity will be compared between groups using the Kruskal-Wallis test, and both the Friedman test and Wilcoxon test will be used for within-group changes. Discussion: This study will provide primary evidence on the effects of DN on gastrocnemius muscle spasticity and gait in patients with MS. Trial registration: Iranian Registry of Clinical Trials (IRCT): IRCT20190617043918N1.

Therapeutic effect of the immunomodulatory drug lenalidomide, but not pomalidomide, in experimental models of rheumatoid arthritis and inflammatory bowel disease

Belen Lopez-Millan,Rafael Diaz de la Guardia,Heleia Roca-Ho,Carmen M García-Herrero,Jessie R Lavoie,Michael Rosu-Myles,Elena Gonzalez-Rey,Francisco O’Valle,Gabriel Criado,Mario Delgado,Pablo Menendez 생화학분자생물학회 2017 Experimental and molecular medicine Vol.49 No.-

Thalidomide is an immunomodulatory drug (IMiD) with proven therapeutic action in several autoimmune/inflammatory diseases; however, its inherent high toxicity has led to the development of more powerful and safer thalidomide analogs, including lenalidomide and pomalidomide. These are new generation IMiDs that exhibit direct antitumor activity as well as anti-inflammatory/immunomodulatory properties, and are FDA-approved for the treatment of several hematological malignances. Here we investigated the potential therapeutic effects of lenalidomide and pomalidomide in several experimental murine models of autoimmune/inflammatory diseases: 2,4,6-trinitrobenzene sulfonic acid- and dextran sulfate sodium-induced inflammatory bowel disease and type II collagen-induced arthritis. Lenalidomide displayed a strong therapeutic effect in all these models of autoimmune/inflammatory diseases, while the effect of pomalidomide was less pronounced. In vitro experiments confirmed the immunosuppressive effect of both IMiDs on the proliferative response of stimulated human lymphocytes and on the balance of secreted cytokines toward an anti-inflammatory profile. We conclude that lenalidomide may offer a therapeutic opportunity against autoimmune/inflammatory diseases.