Randomized trial comparing the effects of one set vs two sets of resistance exercises for outpatients with chronic low back pain and leg pain

AIM

Progressive resistance exercises (PRE) are prescribed to reverse the deconditioning associated with chronic back pain. The spine rehabilitation program has utilized 2 sets of progressive resistance exercises during each session, with increased resistance between sets, and with successive sessions. Exercise literature has challenged the need for multiple sets of resistance exercises, with a single set producing similar functional benefits. The authors studied whether completing 1 versus 2 sets of resistance exercises would affect strength, pain and disability outcomes in subjects with chronic low back pain (CLBP).

METHODS

The study randomly assigned subjects with CLBP to perform either 1 set or 2 sets of progressive resistance exercises during otherwise identical spine rehabilitation programs. The patient sample included 100 subjects (36 male patients, 64 female patients, mean age 46 years) with chronic back pain referred to spine rehabilitation. Primary outcomes were back strength and progressive isoinertial lifting evaluation (PILE) at discharge. Secondary outcomes were Oswestry disability (0-100) and pain scores (0-10). Exercises consisted of Cybex back extension, rotary torso, pull downs, and multi-hip; lifting of crates from floor-to-waist (lumbar) and waist-to-shoulder (cervical) heights. The maximum levels of exercises were determined using a four repetition to maximum protocol, and the PILE.

RESULTS

At discharge, there was no significant difference in strength, disability or pain measures between subjects completing 1 versus 2 sets of resistance exercises.

CONCLUSION

These findings suggest that there were no added benefits for completing a second set of resistance exercises during therapy sessions for patients with CLBP.

First Report of Alfalfa mosaic virus Infection in Viburnum tinus in Chile

Viburnum tinus L., commonly known as laurustinus, is an ornamental shrub that is widely used as a garden plant and flower crop. V. tinus is popular because of its desirable characteristics such as evergreen foliage, tolerance to pruning, winter blooms, and its adaptation to cold temperate zones. It is also relatively easy to grow and is commonly used as a windbreak. Infection of this ornamental species by Alfalfa mosaic virus (AMV) has been associated with yellow mottling or variegated leaf coloring, including light green and white, and has been referred to as the "Viburnum Calico" (1,4). In April 2011, at the onset of winter in the Southern Hemisphere, intense yellow spotting and mottling was observed on V. tinus leaves in the San Joaquin Campus at Pontificia Universidad Catolica de Chile. Presence of Aphis spiraecola Patch was observed on the shrubs, however, in the area it is also common to find other aphid species such as Toxoptera aurantii (Boyer de Fonscolombe) and A. fabae Scopoli. Leaf tissue samples from 10 asymptomatic and 10 symptomatic plants were examined for the presence of AMV by tissue-blot immunoassay with a commercially available polyclonal antibody (Agdia Inc., Elkhart, IN) along with the Goat affinity purified anti-rabbit IgG conjugated (Whole Molecule) (Molecular Probes, Invitrogen Corp., Carlsbad, CA). First-strand cDNA synthesis and PCR were performed with specific primers CP-AMV1 and CP-AMV2 (3). AMV was detected in all symptomatic leaves and also in two of the asymptomatic tissue analyzed by tissue blot assay. Reverse transcription (RT)-PCR produced 753-bp amplicons in all samples that were positive to AMV by tissue printing. No amplification product was observed when water control or seronegative samples were used as templates in the RT-PCR assays. Two amplicons were directly sequenced in both directions to confirm the identification of AMV in the leaf samples. The sequences obtained were homologous and BLASTN analysis of the submitted sequence (GenBank Accession No. JN040542) showed 99% nucleotide sequence identity to an AMV isolate described from Nicotiana tabacum L. (GenBank Accession No. FJ527749). These results demonstrate the presence of AMV in V. tinus in Chile. This pathogen has also been described to be affecting V. tinus in France (1) and V. lucidum Mill. in Spain (2). In Chile, V. tinum is increasingly grown as an ornamental plant. Therefore, care should be taken to ensure that the propagative materials of V. tinum are devoid of AMV infection to prevent further spread of this virus. References: (1) L. Cardin et al. Plant Dis. 90:1115, 2006. (2) M. Cebrián et al. Plant Dis. 92:1132, 2008. (3) M. Finetti-Sialer et al. J. Plant Pathol. 79:115, 1997. (4) H. E. Williams et al. Phytopathology 61:1305, 1971.

[Clinical experience in diabetes and pregnancy]

We followed patients with pregnancy and diabetes in an outpatient clinic. 240 had gestational diabetes, 16 had type II and 5 type I diabetes. 85% of 110 patients with gestational diabetes had normal glucose tolerance test post partum (AGT). Type I patients were younger (25 years old) than AGT (32) or type II (33) patients. Complications frequently observed among diabetics included hypertension, premature membrane rupture and polyhydroamnios (the latter only among AGT and type II patients). Insulin was required for diabetes control in 14% of cases. Cesarean section was more frequent in diabetics than in a control population (21%): AGT 45%, type II 45% and type I 60%. Larger newborns occurred in 21% of AGT and 22% of type II as compared to 6% in controls. Neonatal mortality was 2.1% in AGT patients (0.8% in controls). Hyperbilirrubinemia, polyglobulia and hypocalcemia were more frequent among newborns of diabetic patients.

Soil response in a Mediterranean forest ecosystem of Southeast Spain following early prescribed burning

The escalation of global warming, high temperatures, and wildfire frequency in dry ecosystems, including semi-arid landscapes, has resulted in increased wildfire regimes, compromising ecosystem resistance and resilience. To mitigate these risks, prescribed burning (PB) is being employed as a preventive measure to modify fuel loads in forest ecosystems. However, fire can also impact soil structure and microbiota, which play critical roles in nutrient cycling, biodiversity conservation, and overall ecosystem functioning. Therefore, understanding post-fire processes is essential for sustainable forest management. However, while previous studies have explored the effects of prescribed fire management on semi-arid soil properties in Mediterranean forest ecosystems, gaps remain in our understanding of its specific impact on the physical structure, chemical composition, and biological activities of soils. In this study, we conducted early spring PB in SE Spain in 2021 and assessed the ecological and temporal effects of PB on semi-arid soils. Soil respiration (SR) measurements using automatic CO2 flow chambers were employed to evaluate microbiota recovery. To examine impacts on soil structure we evaluated physicochemical characteristics, soil hydraulic conductivity (SHC), and soil water repellency (SWR). No significant differences were observed in any of the variables studied after one year. However, immediate effects were detected shortly after the PB. Our research specifically targeted soil structure and microbiota in a semi-arid landscape with poor soils, characterized by slower recovery and potentially fragile ecosystems. These results provide valuable insights for forest management practices, indicating that prescribed fire management strategies in similar ecosystems are unlikely to cause adverse effects on soil health. However, further research is warranted to explore the potential effects of prescribed fire intensity and seasonality. Future studies can focus on investigating these factors to provide more targeted recommendations for effective forest management strategies and wildfire prevention efforts.

[Idiopathic chronic pancreatitis (with diffuse stenosis of Wirsung's duct) in ulcerative colitis]

We describe a case of chronic idiopathic pancreatitis associated with ulcerative colitis. Pancreatitis is a rare extra-intestinal manifestations of inflammatory bowel disease. Chronic idiopathic pancreatitis associated with ulcerative colitis are usually painless, without calcification, with stricture of the main pancreatic duct and with severe exocrine pancreatic insufficiency.

[Epidemiologic and nutritional characteristics of the elderly]

A sample of 1365 elders of both sexes from rural and urban populations was studied. Thirty four percent of the subjects were older that 80 years. 21.6% lived alone, 25% were illiterate and 50% did not finish elementary school. Mental impairment was found in 5.6% and body mass index was normal in 41.4% of subjects. Eighty seven percent did not smoke and 80% were teetotalers. Medical services were requested at least every one year by 15.4% and twice a year by 11.9% of subjects. These numbers will help to design preventive and interventional policies directed to this segment of the population.

[Collagenous colitis: an entity with diverse therapeutic options]

Collagenous colitis is a disorder which has been diagnosed with increasing frequency in the last few years, probably due to the routine obtention of colon biopsy specimens in the study of patients with chronic diarrhoea. Good responses have been reported with a number of therapies, although only a scarce number of clinical trials have been performed, partly because of the small number of patients studied. Two cases of collagenous colitis with different therapeutic approaches are here reported. All medical therapy options for this interesting disorder are reviewed.

Short-term recovery of soil and pine tree canopy after late prescribed burning in a semi-arid landscape

Climate change worsening due to global warming and progressive abandonment in rural areas mean that wildfires are increasing in extent and severity terms, and are one of the major disturbances in the Mediterranean Basin. To mitigate these disturbances, preventive management tools need to be used. Fire employment is being implemented, known as prescribed burnings, as forestry actions to change vegetation lines both vertically and horizontally to eliminate forest fuel load continuity. This study aimed to know the ecological effects of late prescribed burning treatments under mixed trees. Prescribed burns were carried out in October 2019 in the municipality of Ayna, Albacete (SE Spain). To assess the short-term (12-month) fire impact on soil, we measured soil respiration with a CO₂ flow chamber and analyzed soil physico-chemical properties. We also used minidisc infiltrometers to analyze soil repellency and soil hydraulic conductivity over a 1-year monitoring period. In addition, we evaluated the effects on tree strata by performing chemical nature analyses of fallen needles in Pinus pinaster after prescribed burning. According to our initial hypotheses, the results did not show significant changes in any parameter evaluated during the study period. However, some variables were affected in the first 3 months, needlefall and in microbiological activity, such as variations in soil physico-chemical properties, which can be due to long dry seasons combined with prescribed burning. This study attempts to observe and make known the effects that low-intensity prescribed burning has on soil and needlefall, which are relevant for updating forest management tools.

Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease

BACKGROUND AND AIMS

Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs.

METHODS

Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period.

RESULTS

We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs.

CONCLUSIONS

We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.