Overview of CF lung pathophysiology

Defects of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) protein affect the homeostasis of chloride, bicarbonate, sodium, and water in the airway surface liquid, influencing the mucus composition and viscosity, which induces a severe condition of infection and inflammation along the whole life of CF patients. The introduction of CFTR modulators, novel drugs directly intervening to rescue the function of CFTR protein, opens a new era of experimental research. The review summarizes the most recent advancements to understand the characteristics of the infective and inflammatory pathology of CF lungs.     

The effect of motor imagery on quality of movement when performing reaching tasks in healthy subjects: A proof of concept

IntroductionThe use of motor imagery (MI) has been shown to offer significant improvements in movement performance in sports, and is now receiving a lot of attention as a relatively new therapeutic approach which can be applied in rehabilitation. However, the effects of MI on the quality of movement is still unclear. This study explored the immediate effect of MI on reaching tasks in healthy subjects.Methods17 healthy individuals (33 ± 8.2 years) participated in the study. Surface electromyography (sEMG) and inertial measurement units (IMU) were used to identify muscle activity and angular velocity in both upper limbs. Participants performed a reach task using their dominant and non-dominant arms at their most comfortable speed, they were then asked to imagine themselves performing the same reaching task, and finally they were asked to repeat the reaching task.ResultsSignificant decreases were seen in the muscle activity between pre and post MI for Biceps Brachii, Anterior Deltoid and Triceps Brachii. In addition, a significant increase was seen in extension angular velocity post MI.DiscussionThe results indicate that the use of MI just after physical practice appears to have an immediate effect on the muscle activity and kinematics during a reaching task, which may suggest an improved quality of movement.ConclusionThis proof of concept study shows the potential for MI to improve the quality of performing reaching task and offers a possible therapeutic option for Stroke survivors and other neuromuscular disorders.     

Focal hole versus screw stimulation to prevent false negative results in detecting pedicle breaches during spinal instrumentation

ObjectiveWe describe a stimulus-evoked EMG approach to minimize false negative results in detecting pedicle breaches during lumbosacral spinal instrumentation.MethodsIn 36 patients receiving 176 lumbosacral pedicle screws, EMG threshold to nerve root activation was determined using a focal probe inserted into the pilot hole at a depth, customized to the individual patients, suitable to position the stimulating tip at the point closest to the tested nerve root. Threshold to screw stimulation was also determined.ResultsMean EMG thresholds in 161 correctly fashioned pedicle instrumentations were 7.5 mA ± 2.46 after focal hole stimulation and 21.8 mA ± 6.8 after screw stimulation. Direct comparison between both thresholds in individual pedicles showed that screw stimulation was always biased by an unpredictable leakage of the stimulating current ranging from 10 to 90%. False negative results were never observed with hole stimulation but this was not true with screw stimulation.ConclusionsFocal hole stimulation, unlike screw stimulation, approaches absolute EMG threshold as shown by the lower normal limit (2.6 mA; p < 0.05) that borders the upper limit of threshold to direct activation of the exposed root.SignificanceThe technique provides an early warning of a possible pedicle breakthrough before insertion of the more harmful, larger and threaded screw.     

Symptom improvement in dry eye subjects following intranasal tear neurostimulation: Results of two studies utilizing a controlled adverse environment

PurposeTo evaluate the safety and effectiveness of the intranasal tear neurostimulator (ITN) in improving dry eye symptoms assessed in a controlled adverse environment (CAE®).MethodsStudy 1: Multicenter, subject-masked, randomized-sequence, crossover design. Single intranasal (active) and extranasal (control) ITN administration during CAE exposure. Study 2: Single-arm, open-label design. Intranasal ITN administration ≥2 times/day for 45 days, CAE assessment at days 0 and 45. In both studies, upon CAE entry, and every 5 min thereafter, subjects assessed eye dryness score (visual analog scale, 0–100 mm; EDS-VAS), and ocular discomfort score (ODS; Ora Calibra™, 0–4), for ≈2 h. Study 1: when ODS was ≥3 at 2 consecutive timepoints, subjects applied ITN intranasally or extranasally for ≈3 min, and again when achieving the same ODS criteria in randomized sequence. Study 2: days 0 and 45, ITN was applied for ≈3 min employing the same ODS criteria as Study 1.ResultsStudy 1: Significantly greater pre- to post-application reductions in mean [SEM] EDS (−16.5 [1.7] vs −3.1 [1.7], P < 0.0001) and ODS (−0.93 [0.08] vs −0.34 [0.08], P < 0.0001; n = 143) with intranasal vs extranasal stimulation. Study 2: On day 0 (n = 52) and day 45 (n = 48), significant pre- to post-application reductions in mean [SEM] EDS (−15.9 [2.7] and −15.2 [2.4]; P < 0.0001), and ODS (−1.3 [0.2] and −1.3 [0.1]; P < 0.0001). Few device-related adverse events were reported, none serious.ConclusionsAcute symptom relief is significant with the ITN and remains undiminished after daily use.     

Introduction and evaluation of a novel multi-camera surface topography system

BackgroundSurface topography can be used for the evaluation of spinal deformities without any radiation. However, so far this technique is limited to posterior trunk measurements due to the use of a single posterior camera.Research questionPurpose of this study was to introduce a new multi camera surface topography system and to test its reliability and validity.MethodsThe surface topograph uses a two-camera system for imaging and evaluating the subjects front and back simultaneously. Inter- and intra-rater reliability was tested on 40 human subjects by two observers. For validation human, subjects were scanned by MRI and surface-topography. For additional validation we used a phantom with an anthropomorphic body which was scanned by CT and surface topography.ResultsInter- (0.97−0.99) and intra-rater reliability (0.81−0.98) testing revealed good and excellent results in the detection of the body surface structures and measurement of areas and volumes. CT based validation revealed good correspondence between systems in the imaging and evaluation of the phantom model (0.61–10.52 %). Results on validation of human subjects revealed good to moderate results in the detection and measurements of almost all body surface structures (1.36–13.34 %). Only measurements using jugular notch as a reference showed moderate results in validity (0.62–27.5%) testing.SignificanceWe have introduced a novel and innovative surface topography system that allows for simultaneous anterior and posterior trunk measurements. The results of our reliability and validity tests are satisfactory. However, in particular around the jugular notch region further improvements in the surface topography reconstruction are needed.