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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.
The erector spinae plane block: a narrative review
Pablo Kot,Pablo Rodriguez,Manuel Granell,Beatriz Cano,Lucas Rovira,Javier Morales,Ana Broseta,Jose De Andrés 대한마취통증의학회 2019 Korean Journal of Anesthesiology Vol.72 No.3
Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.
Costanzo Pablo René,Suárez Sebastián Matías,Kozak Andrea Elina,Knoblovits Pablo 대한남성과학회 2022 The World Journal of Men's Health Vol.40 No.2
Purpose:Purpose: Vitamin D (VD) acts on sperm motility, capacitation and survival but its role in steroidogenesis is less clear. Aims: To analyze seasonal variations in sex steroids and VD in a healthy male population. Materials and Methods:Materials and Methods: Twenty-nine healthy males, 34.0±4.8 years were included. Blood collection in winter (W) and sum-mer (S) was performed to measure: 25OHD, total testosterone (TT), free testosterone (FT), estradiol (E2), luteinizing hormone (LH), and sex hormone binding globulin (SHBG). Testosterone/estradiol (T/E2) ratio was calculated. Results:Results: In W, lower levels of 25OHD: 18.8±7.2 ng/mL vs. 38.8±11.9 ng/mL (p<0.0001) and LH: 3.5±1.2 mU/mL vs. 3.9±1.5 mU/mL (p=0.05), and higher levels of TT: 501.9±157.7 ng/dL vs. 405.0±128.0 ng/dL (p=0.0003), FT: 11.8±4.1 ng/dL vs. 10.2±3.7 ng/dL (p=0.017), SHBG: 28.5±10.9 nmol/L vs. 23.6±7.9 nmol/L (p=0.002) and T/E2 ratio: 30.7±19.7 ng/dL/pg/mL vs. 17.3±3.6 ng/dL/pg/mL (p=0.0015) with no variation in E2 levels were observed. A positive correlation between 25OHD and E2 (r=0.28, p=0.04) and negative correlations between 25OHD and TT (r=-0.27, p=0.049), 25OHD and FT (r=-0.32, p=0.01), and 25OHD and T/E2 (r=-0.44, p=0.0008) were found. Conclusions:Conclusions: In healthy young male population, seasonal variations were observed in 25OHD and LH levels (higher in S) and in TT, FT, SHBG levels, and T/E2 (higher in W). Lower values of TT and FT in S are accompanied by higher levels of LH, which rules out a central mechanism for lowering testosterone. 25OHD negatively correlated with TT, FT, and T/E2 and posi-tively correlated with E2, suggesting a relationship between VD status and changes in gonadal steroids.
I Can Not Wear My Sunglasses: An Unusual Sarcoidosis Presentation
José Pablo Miramontes González,Virginia Velasco Tirado,Pablo González García,Marta Sánchez García,Ángeles Fidalgo Fernández 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.4
A 39-year-old Caucasian man was referred to University Hospital Salamanca from a primary care unit due to the presence of an erythematous violaceous nodule at the superior portion of his nose. Physical examination indicated that the firm, fixed erythematous violaceous nodule measured approximately 2 cm in diameter and was located in-ferior to a scar on the nasal bridge. Cutaneous involvement in sarcoidosis occurs in 25% of cases. A wide range of clinical presentations of cutaneous sarcoidosis is recognized. Skin lesions are classified as either non-specific, of which erythema nodosum is the most representative and specific, or as granulomatous, which includes maculo-papular nodules, plaques, infiltrated scars, lupus pernio, ulcerations, warty lesions and erythroderma. Scar sarcoid-osis is a type of cutaneous sarcoidosis.
Further Specialization of Clustered VLIW Processors: A MAP Decoder for Software Defined Radio
Pablo Ituero,Marisa López-Vallejo 한국전자통신연구원 2008 ETRI Journal Vol.30 No.1
Turbo codes are extensively used in current communications standards and have a promising outlook for future generations. The advantages of software defined radio, especially dynamic reconfiguration, make it very attractive in this multi-standard scenario. However, the complex and power consuming implementation of the maximum a posteriori (MAP) algorithm, employed by turbo decoders, sets hurdles to this goal. This work introduces an ASIP architecture for the MAP algorithm, based on a dual-clustered VLIW processor. It displays the good performance of application specific designs along with the versatility of processors, which makes it compliant with leading edge standards. The machine deals with multi-operand instructions in an innovative way, the fetching and assertion of data is serialized and the addressing is automatized and transparent for the programmer. The performance-area trade-off of the proposed architecture achieves a throughput of 8 cycles per symbol with very low power dissipation.
Correlation Between the Sinew Channels with the Myofascial System, Pathology, and Treatment
Pablo Nava Jaimes,Alejandro Martínez Reyes,Daniel García Lara,Abel Cristian Patiño Coyuca 사단법인약침학회 2022 Journal of Acupuncture & Meridian Studies Vol.15 No.4
The sinew channels are a tendon and muscle network, and their description is based on the observation presented on the Huangdi Neijing Ling Shu. However, the myofascial system is an uninterrupted series of connective tissue that is comprised of layers that run in different directions. The similarities on these pathways are compared, such as a brief description on the myofascial pain syndrome and its similitude with the Impediment disorder from the Traditional Chinese Medicine (TCM). Furthermore, we discuss the treatment of these conditions from a Traditional Chinese Medicine perspective.