Structural Lesions in Periodic Lateralized Epileptiform Discharges (PLEDs)

In this study we investigated the structural lesions of patients with periodic lateralized epileptiform discharges (PLEDs) to determine the possible relationship of lesions to PLEDs' localization on EEG and to metabolic abnormality. Clinical findings and electroencephalography (EEG), computerized tomography (CT) and magnetic resonance imaging (MRI) of the 71 adult patients with PLEDs were evaluated

AB1491 ACUTE EFFECTS OF AN INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE ON CHRONIC NECK PAIN: A DOUBLE-BLIND, RANDOMIZED CONTROLLED TRIAL

BackgroundIndividuals with chronic neck pain, proprioceptive afferent information from the cervical spine may be impaired due to the presence of pain. Instrument-assisted soft-tissue mobilization (IASTM) is used to reduce pain and improve range of motion (ROM) and function.Cervical sensorimotor control includes the central integration and processing of all afferent information and the execution of the motor program through the cervical muscles and contributes to the maintenance of head posture and balance(1). In individuals with chronic neck pain, proprioceptive afferent information from the cervical spine may be impaired due to the presence of this pain(2). Many treatment modalities such as instrument-assisted soft-tissue mobilization (IASTM) have been used to reduce pain and increase proprioception(3).IASTM is used to reduce pain, increase soft-tissue mobility, and improve range of motion (ROM) and function. These instruments cause microtrauma to restore normal elasticity and function in soft-tissue(4). Kivlan has shown that significant and rapid changes in muscle function can occur with only a single IASTM application and have suggested the following mechanisms of action: an increased fascial motility, a proliferation of extracellular matrix fibroblasts, and an increased blood flow to the area close to the injured tissue, with decreased cellular matrix adhesion and localized ischemia(5).ObjectivesAim of this study, to determine the acute effects of single-session, IASTM on cervical joint position error (JPE) and pain in individuals with chronic neck pain.MethodsA total of 39 individuals (mean age=40.18±11.10 years) with chronic neck pain were included in this study. We divided the participants into IASTM, sham, and control groups of 13 members each. In the IASTM group, intervention was applied to the sternocleidomastoid and trapezius muscles with an application time of 45 seconds and a frequency of 60 beats/min. In the sham group, IASTM was applied at a 90° angle without pressure. The control group received no intervention. The pain severity and joint position error were evaluated before and after the intervention, by using the visual analog scale (VAS) and a cervical range of motion device.ResultsThe effects of time and treatment group on VAS score were statistically significant. The effect of time and treatment for VAS score was statistically significant (p=0.001). When the post-test was examined according to application, a statistically significant difference found in VAS scores (p=0.001), with the lowest pain score in the IASTM group and the highest pain score in the control group. The significant improvements found in JPE in all aspects of the cervical region in the IASTM group (p&lt;0.05). In the sham group, significant improvements observed in cervical extension, left rotation, and left lateral flexion movements in JPE (p&lt;0.05).ConclusionSingle-session IASTM is effective for improving the acute pain and JPE in individuals with chronic neck pain.References[1]Michiels S, De Hertogh W, Truijen S, November D, Wuyts F, Van de Heyning P. The assessment of cervical sensory motor control: A systematic review focusing on measuring methods and their clinimetric characteristics. Gait Posture. 2013;38(1):1–7.[2]Uremović M, Cvijetić S, Pasić MB, Serić V, Vidrih B, Demarin V. Impairment of proprioception after whiplash injury. Coll Antropol. 2007;31(3):823–7.[3]Damgaard P, Bartels EM, Ris I, Christensen R, Juul-Kristensen B. Evidence of Physiotherapy Interventions for Patients with Chronic Neck Pain: A Systematic Review of Randomised Controlled Trials. ISRN Pain. 2013;1–23.[4.]Baker RT, Nasypany A, Seegmiller JG, Baker JG. Instrument-Assisted Soft Tissue Mobilization Treatment for Tissue Extensibility Dysfunction. Int J Athl Ther Train. 2013;18(5):16–21.[5]Kivlan BR, Carcia CR, Clemente FR, Phelps AL, Martin RL. The effect of Astym Therapy on muscle strength: a blinded, randomized, clinically controlled trial. BMC Musculoskelet Disord. 2015;16(1):325.Disclosure of InterestsNone declared</jats:sec

Statin potentiates human platelet eNOS activity without enhancing eNOS mRNA and protein levels

Background/Aims: Experimental studies suggest an enhanced endothelial and platelet nitric oxide (NO) generation after statin treatment, possibly due to increased endothelial NO synthase (eNOS) activity and protein levels. In parallel with experimental research, statins were shown to increase the forearm blood flow independently of serum cholesterol in humans. However, it was not possible to correlate blood flow changes with eNOS levels in these studies due to limitations in obtaining arterial samples. Hence, we investigated changes in eNOS activity, mRNA and protein levels after statin treatment in human platelets, which are readily accessible unlike arteries. Methods: In vitro bleeding times were measured in 22 patients by stimulating platelets with collagen-epinephrine or collagen-ADP. To assess platelet eNOS activity, the bleeding times were also determined after incubating platelets with L-arginine. The measurements were repeated following 14 days of pravastatin (40 mg/day) treatment. Platelet-rich plasma was collected before and after statin treatment to evaluate eNOS mRNA (semiquantitative RT-PCR) and protein levels (Western blotting). Results: The basal bleeding time was prolonged by 24 +/- 3% (mean +/- SE) when the samples were incubated with 500 mu M of L-arginine. The NOS inhibitor L-N-5-(I-iminoethyl) ornithine reversed this effect, suggesting that it was mediated by NO. After statin treatment, the NO-mediated prolongation of the bleeding time with 500 mu M of L-arginine was significantly potentiated (to 44 +/- 10%). Despite enhanced eNOS activity, there was no significant change in platelet eNOS mRNA and protein levels after statin treatment. Conclusion: These data demonstrate that platelet eNOS activity is potentiated after statin treatment in humans in parallel with experimental studies. Copyright (C) 2008 S. Karger AG, Basel