Clinical and radiological assessment of the cervical extensor muscles in people with neck pain. A narrative review

Background: Clinical and radiological investigations of the function and structure of the cervical extensor muscles are increasingly being used in physiotherapy practice.

Objectives: The aim of this review is to investigate the reliability and clinical utility of these tests, to report on normative data and to evaluate the association between the results of these investigations and neck pain.

Major Findings: A range of clinical and radiological tests have been described to assess the function and structure of the cervical extensor muscles. Clinical tests that evaluate cervical muscle strength and endurance can be performed reliably and there is some evidence that performance of these tests is impaired in people with neck pain. There is however, a need for better understanding of what constitutes normal strength and endurance in these muscles and whether abnormal function is a cause or effect of neck pain. Clinical tests of extensor motor control have not been extensively studied. Of the radiological investigations commonly used for evaluation of cervical extensor muscle structure, ultrasound cross-sectional measures have demonstrated acceptable reliability and correlate reasonably well with higher resolution MRI images.

Conclusions: The clinical and radiological tests commonly used to assess cervical extensor muscles generally have acceptable reliability and are mostly well suited within the physiotherapy clinic. Both clinical and radiological tests need further investigation through case-controlled longitudinal studies that explore the relationship between these tests and neck pain.     

Biallelic Pathogenic GFRA1 Variants Cause Autosomal Recessive Bilateral Renal Agenesis

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Caveolin-1 expression in lung carcinoma varies according to tumour histotype and is acquired de novo in brain metastases

Aims:  To study caveolin-1 (Cav-1) expression in metastatic lung carcinomas.
Methods and results:  Cav-1 expression was investigated in a series of 121 lung carcinomas and it was shown that 18/121 tumours (14.9%) were Cav-1+. None of the pure bronchioloalveolar carcinomas proved to be positive, vs. 42.8% of the large cell carcinomas (neuroendocrine subtype excluded). Adenocarcinomas (8.5%), large cell neuroendocrine carcinomas (20%) and squamous cell carcinomas (29.6%) displayed an intermediate percentage of positive cases, suggesting a gradient of Cav-1 expression according to tumour histotype-related aggressiveness. Moreover, the percentage of Cav-1+ tumours with distant metastases was almost double that of non-metastatic tumours (17.8% vs. 8.1%), irrespective of the histotype. In 34 tumours metastatic to the brain, primary and secondary lesions were compared and 53% of brain metastases were Cav-1+ vs. 20.6% of primaries, indicating a de novo acquisition of Cav-1 expression. This pattern was exclusive to the brain, as it was not acquired in adrenal metastases. In our series, the presence of epidermal growth factor receptor amplification, determined by fluorescence in situ hybridization, was not related to Cav-1 reactivity.
Conclusions:  Cav-1 immunoreactivity in lung carcinoma is histotype-dependent and acquired de novo in brain metastases, suggesting a site-specific phenotypic shift in secondary lesions.     

Changes with ageing in several leukocyte functions of male and female rats

The impairment of the immune system with aging, or immunosenescence, appears to contribute to the increased morbidity and mortality of aged subjects. T cell functions and Natural Killer activity seem to be the immune responses most affected by ageing. Since the immune system works more efficiently in females than in males, we have studied the changes of several immune functions with age in rats of both sexes. In addition, we have investigated if ovariectomy, a model of menopause in rats, produces a loss of this gender-related advantage. In the present work, the changes with age (2, 6, 12, 14, 18, 22 and 24 months old) in lymphocyte chemotaxis, T lymphoproliferative response to the mitogen ConA, IL-2 release and Natural Killer activity of cells from axillary nodes and spleen of male and female rats as well as of females ovariectomized at 12 months of age have been studied. An age-related decrease was found in all investigated functions, with a slightly different evolution depending on the immune organ and gender considered. In general, the data obtained show that a certain degree of immunosenescence takes place with age in rats, with males being less immunocompetent than intact age-matched females, but showing an immune response similar to that of ovariectomized animals.