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23 pages, 5089 KiB  
Review
Optimizing Airway Function Through Craniofacial and Cervical Manipulations and Emergency-Anesthesia Maneuvers: Applications in Airway Function Enhancement, Pneumonia, and Asthma—Narrative Review
by Jason Park, Luz Benitez, Amethyst Hamanaka, Ghulam Husain Abbas, Emmanuel Faluade, Sjaak Pouwels and Jamie Eller
J. Clin. Med. 2025, 14(13), 4494; https://doi.org/10.3390/jcm14134494 - 25 Jun 2025
Viewed by 629
Abstract
Background: Even with advanced management involving pharmacologic and ventilatory strategies, respiratory dysfunction increases morbidity and reduces the quality of life. This narrative review examines how craniofacial and cervical manipulative interventions—including nasomaxillary skeletal expansion, breathing re-education, and structural techniques—may holistically optimize airway function by [...] Read more.
Background: Even with advanced management involving pharmacologic and ventilatory strategies, respiratory dysfunction increases morbidity and reduces the quality of life. This narrative review examines how craniofacial and cervical manipulative interventions—including nasomaxillary skeletal expansion, breathing re-education, and structural techniques—may holistically optimize airway function by enhancing neurological and lymphatic dynamics, modulating vagal tone, reducing pharyngeal collapsibility, and supporting immune regulation across diverse clinical settings. Objectives: To explore manual techniques that influence respiratory and autonomic function and to evaluate their reported clinical efficacy and supporting evidence, particularly in the context of airway disorders such as asthma and pneumonia. Methods: A narrative review of the literature from PubMed and Google Scholar was conducted using search terms related to airway function and osteopathic manipulative techniques (OMTs). The inclusion criteria spanned 2010–2025 English-language peer-reviewed full-text articles on airway function, OMT, and emergency airway maneuvers. Clinical trials, observational studies, and reviews were included; non-peer-reviewed content and animal studies (unless mechanistically relevant) were excluded. Chapman’s reflexes related to respiratory function were incorporated to highlight somatic–visceral correlations. Key Findings: The techniques reviewed included frontal lift, vomer manipulation, maxillary and zygomatic balancing, and cervical adjustments. Thoracic OMT methods, such as diaphragm doming and lymphatic pump techniques, were also addressed. Emergency techniques, such as the BURP and Larson maneuvers, prone positioning, and high-frequency chest wall oscillation, were presented as comparative strategies to OMTs for acute airway management. Conclusions: Craniofacial and cervical manipulations can be a promising adjunct for enhancing airway function. However, the current literature displays heterogeneity and lack of large-scale randomized trials, which emphasize the necessity for standardized research and the establishment of clinical guidelines with the collected evidence. Full article
(This article belongs to the Section Respiratory Medicine)
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12 pages, 1918 KiB  
Case Report
Improvement in Chronic Low Back and Intermittent Chronic Neck Pain, Disability, and Improved Spine Parameters Using Chiropractic BioPhysics® Rehabilitation After 5 Years of Failed Chiropractic Manipulation: A Case Report and 1-Year Follow-Up
by Katally Sanchez, Jason W. Haas, Paul A. Oakley and Deed E. Harrison
Healthcare 2025, 13(7), 814; https://doi.org/10.3390/healthcare13070814 - 3 Apr 2025
Viewed by 1753
Abstract
Background/Objectives: We present a case documenting the successful treatment for a patient with chronic low back pain (CLBP), chronic neck pain (CNP), and decreased quality of life improving after conservative therapy. CLBP has been the leading cause of disability globally for the past [...] Read more.
Background/Objectives: We present a case documenting the successful treatment for a patient with chronic low back pain (CLBP), chronic neck pain (CNP), and decreased quality of life improving after conservative therapy. CLBP has been the leading cause of disability globally for the past few decades, resulting in decreased quality of life physically and emotionally. This case is important in the medical literature to add to studies reporting successful conservative treatment of CLBP and CNP. Triage, diagnosis, and understanding of economical and conservative therapeutics can benefit patients; providers as well as institutions and third party payors benefit from improved outcomes. Methods: A 39-year old male presented with severe CLBP who had experienced no long-term success with prior chiropractic spinal manipulative therapy (SMT). After symptoms began to worsen in spite of receiving SMT, the patient sought treatment for his pain, abnormal spine alignment, and poor sagittal alignment at a local spine facility. History and physical examination demonstrated altered spine and postural alignment including significant forward head posture and reduced cervical and lumbar lordosis and coronal plane abnormalities. Treatment consisted of a multi-modal regimen focused on strengthening postural muscles, specific spine manipulation directed toward abnormal full-spine alignment, and specific Mirror Image® traction aiming to improve spine integrity by realigning the spine toward a more normal position. The treatment consisted of 36 treatments over three months. All original tests and outcome measures were repeated following care. Results: Objective and subjective outcome measures, patient-reported outcomes, and radiographic mensuration demonstrated improvement at the conclusion of treatment and maintained at 1-year follow-up re-examination. Conclusions: This case demonstrates that the CBP® orthopedic chiropractic treatment approach may represent an effective method to treat abnormal spinal alignment and posture. This study adds to the literature regarding conservative methods of treating spine pain and spinal disorders. Full article
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16 pages, 1675 KiB  
Article
The Effects of Cervical Manipulation Compared with a Conventional Physiotherapy Program for Patients with Acute Whiplash Injury: A Randomized Controlled Trial
by Joan Parera-Turull, Maite Garolera, Jose-Blas Navarro, Dolors Esteve Bech-Decareda, Josep Gual-Beltran, Jose-Vicente Toledo-Marhuenda and Emilio-Jose Poveda-Pagan
Healthcare 2025, 13(7), 710; https://doi.org/10.3390/healthcare13070710 - 24 Mar 2025
Viewed by 1396
Abstract
Whiplash injuries (WLs) are the most frequent cause of emergency room visits after motor vehicle collisions. In clinical practice, massage, electrotherapy, mobilization, or therapeutic exercise are used. As part of manual therapy, high-velocity, low-amplitude manipulative techniques can also be used. Objectives: To [...] Read more.
Whiplash injuries (WLs) are the most frequent cause of emergency room visits after motor vehicle collisions. In clinical practice, massage, electrotherapy, mobilization, or therapeutic exercise are used. As part of manual therapy, high-velocity, low-amplitude manipulative techniques can also be used. Objectives: To evaluate the effect of the cervical Specific Adjustment Technique (SAT) in adults affected by whiplash on pain, functionality, cervical mobility, and radiological changes in cervical curvature through a prospective, single-blind, randomized clinical trial. Methods: One hundred and nineteen patients with grade II acute WL were randomly assigned to either the manipulation group (MAN group = 59) or the rehabilitation group (RHB group = 60) to receive 3 or 20 sessions of treatment, respectively. Both groups were measured at baseline and 15, 30, and 120 days after starting treatment. Results: Statistically significant differences were found in the MAN group in flexion (p = 0.041) and left-side bending (p = 0.022); similar statistical values were found in the other measures. According to the interaction treatment-time effect, statistical significance for the Cobb angle was obtained in the MAN group (p = 0.047). Conclusions: the effects of SAT were comparable in terms of pain, functionality, and mobility of the cervical spine. Although further research is needed on its effects in the acute phase, due to its effectiveness and lower associated cost, SAT could be considered a useful technique, at least during the first 3 months after a traffic collision. Full article
(This article belongs to the Special Issue Advances in Manual Therapy: Diagnostics, Prevention and Treatment)
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9 pages, 3341 KiB  
Case Report
A Closed Reduction of Cervical Spine Subluxation in an Arabian Foal with an External Neck Stabilizer
by Natalia Domańska-Kruppa, Elżbieta Stefanik, Małgorzata Wierzbicka and André Kleinpeter
Animals 2025, 15(3), 325; https://doi.org/10.3390/ani15030325 - 23 Jan 2025
Viewed by 1087
Abstract
Cervical spine injuries that impact young horses and foals can result in mild to severe neurological signs or even result in sudden death. There are only a few reports on conservative treatment options for this condition in the scientific literature. If the condition [...] Read more.
Cervical spine injuries that impact young horses and foals can result in mild to severe neurological signs or even result in sudden death. There are only a few reports on conservative treatment options for this condition in the scientific literature. If the condition is left untreated, it can lead to the development of degenerative joint disease, resulting in chronic neurological symptoms and discomfort. We present the case of a two-day-old Arabian foal that showed signs of ataxia following a neck injury, being the result of cervical spine subluxation. Radiological examination revealed a dislocation between the second and third cervical vertebrae. At admission to the clinic on the seventh day of life, the foal’s clinical examination parameters were within physiological ranges. The head posture at the presentation was consistently low, the foal could not lift its head above the shoulder joint throughout the whole examination, the neck muscles were spastically tensed and clinical signs of ataxia were present. The foal underwent a closed reduction in the subluxation under general anesthesia and a fiberglass semicircular gutter was created to stabilize the neck in the desired position. The ataxia symptoms began to improve around day 12 post manipulation, and the fiberglass stabilizer was removed after 16 days post manipulation, followed by radiographs. The dislocation of C2/C3 was no longer visible on the radiographs, and the foal was able to assume a normal neck posture after the removal of the fixator. Full article
(This article belongs to the Section Equids)
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11 pages, 1253 KiB  
Article
Three-Dimensional Posture Analysis-Based Modifications After Manual Therapy: A Preliminary Study
by Fabio Scoppa, Andrea Graffitti, Alessio Pirino, Jacopo Piermaria, Federica Tamburella and Marco Tramontano
J. Clin. Med. 2025, 14(2), 634; https://doi.org/10.3390/jcm14020634 - 19 Jan 2025
Viewed by 1419
Abstract
Background/Objectives: Manual therapies like Osteopathic Manipulative Treatment (OMT) and Gentle Touch Intervention (GTI) are widely employed for improving posture and spinal alignment, but their effects as measured using advanced technologies remain underexplored. This study aims to evaluate the short-term postural effects of these [...] Read more.
Background/Objectives: Manual therapies like Osteopathic Manipulative Treatment (OMT) and Gentle Touch Intervention (GTI) are widely employed for improving posture and spinal alignment, but their effects as measured using advanced technologies remain underexplored. This study aims to evaluate the short-term postural effects of these interventions using a non-invasive three-dimensional rasterstereography-based approach, focusing on the cervical arrow, lumbar arrow, kyphotic angle, and lordotic angle parameters. Methods: A three-armed randomized controlled trial was conducted with 165 healthy participants. The subjects were divided into control (CTRL), OMT, and GTI groups. Their postural parameters were assessed pre- and post-intervention using the Spine3D system by Sensor Medica (Guidonia Montecelio, Italy). The statistical analyses included paired t-tests and an ANOVA, with the significance set at p < 0.05. Results: Significant reductions in the cervical arrow were observed in both the OMT (p < 0.005) and GTI (p < 0.05) groups, while the kyphotic angle significantly improved only in the GTI group (p < 0.05). No significant changes were found in the lumbar arrow or the lordotic angle across the groups. The control group showed no postural variations, reinforcing the specificity of the interventions. Conclusions: Both OMT and GTI influence spinal posture, particularly in the cervical and thoracic regions. GTI, with its gentle approach, demonstrated unique effects on the thoracic curvature, suggesting neurophysiological mechanisms. These findings highlight the potential of manual therapies for posture modulation and suggest future research should explore their long-term benefits and applications in clinical populations. Full article
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13 pages, 1156 KiB  
Article
The Effect of Audible Joint Manipulation Sounds in the Upper Cervical Spine on Brain Wave and Autonomic Nervous System Activity
by Dalton Whitman, Rob Sillevis and Matthew Frommelt
Life 2025, 15(1), 103; https://doi.org/10.3390/life15010103 - 15 Jan 2025
Viewed by 2368
Abstract
Background: High-velocity, low-amplitude (HVLA) manipulation is a common manual therapy technique used for treating pain and musculoskeletal dysfunction. An audible manipulation sound is commonly experienced by patients who undergo HVLA manipulation; however, there is little known about the effects and clinical relevance of [...] Read more.
Background: High-velocity, low-amplitude (HVLA) manipulation is a common manual therapy technique used for treating pain and musculoskeletal dysfunction. An audible manipulation sound is commonly experienced by patients who undergo HVLA manipulation; however, there is little known about the effects and clinical relevance of the audible manipulation sound on cortical output and the autonomic nervous system. This study aimed to identify the immediate impact of the audible manipulation sound on brainwave activity and pupil diameter in asymptomatic subjects following an HVLA cervical manipulation. Methods: 40 subjects completed this quasi-experimental repeated measure study design. Subjects were connected to electroencephalography and pupillometry simultaneously, and an HVLA cervical distraction manipulation was performed. The testing environment was controlled to optimize brainwave and pupillometry data acquisition. Pre-manipulation, immediately after manipulation, and post-manipulation data were collected. The presence of an audible manipulation sound was noted. Results: Twenty subjects experienced an audible manipulation sound. Brainwave activity changes were significant (p < 0.05) in both the audible manipulation sound and non-manipulation sound groups. Pupil diameter changes (p < 0.05) occurred in both eyes of the non-manipulation sound group and in the left eye of the audible-manipulation sound group. Brainwave activity patterns were similar in both groups. Conclusions: The presence of an audible manipulation sound is not required to produce central nervous system changes following an HVLA cervical manipulation; however, the audible manipulation sound does prolong the effects of brainwave activity, indicating a prolonged relaxation effect. Full article
(This article belongs to the Special Issue Advances in Non-Invasive Brain Stimulation)
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13 pages, 973 KiB  
Article
Nerve-Sparing Laparoscopic Radical Hysterectomy (nsLRH) without Adjuvant Therapy in FIGO Stage IB3 Cervical Cancer Patients: Surgical Technique and Survival Outcomes
by Roberto Tozzi, Sofia Bigardi, Giulia Spagnol, Federico Ferrari, Carlo Saccardi, Marco Noventa and Matteo Marchetti
Cancers 2024, 16(19), 3355; https://doi.org/10.3390/cancers16193355 - 30 Sep 2024
Viewed by 1789
Abstract
(1) Background: In 2018 FIGO reclassified tumors confined to the cervix larger than 4 cm as stage IB3. Although concurrent CTRT has been the standard of care and surgery the alternative, optimal management remains controversial due to the lack of direct comparison between [...] Read more.
(1) Background: In 2018 FIGO reclassified tumors confined to the cervix larger than 4 cm as stage IB3. Although concurrent CTRT has been the standard of care and surgery the alternative, optimal management remains controversial due to the lack of direct comparison between surgery and CTRT. (2) Methods: This prospective observational study investigated the efficacy, safety and oncologic outcomes of nerve-sparing laparoscopic radical hysterectomy (nsLRH) for FIGO stage IB3 cervical cancer patients (IB3). From 2009 to 2023, IB3 patients underwent laparoscopic pelvic lymphadenectomies with frozen section analysis, followed by a nsLRH if the lymph nodes were tumor-free. No uterine manipulator was used and the vaginal cuff was sealed before retrieving the specimen. Intermediate-risk patients were under close observation without adjuvant therapy. Outcomes were monitored until 2023. (3) Results: During the study period, 74 IB3 patients were treated. Sixty-eight (91.9%) underwent a nsLRH. A complete resection with negative margins was achieved in all cases. At a median of 68 months of follow-up, the disease-free survival (DFS) rate was 89.7% and the overall survival (OS) rate was 93.1%. The overall complication rate was 23.5% and there were no grade 4–5 complications. (4) Conclusions: In patients with IB3 cervical cancer, a nsLRH is safe and effective. While awaiting the results from ongoing randomized trials, these findings support nsLRH as a viable treatment. Full article
(This article belongs to the Special Issue Cervical Cancer: Clinical Feature, Trial and Management)
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21 pages, 1365 KiB  
Review
Recent Advances and Mechanisms of Phage-Based Therapies in Cancer Treatment
by Vivian Y. Ooi and Ting-Yu Yeh
Int. J. Mol. Sci. 2024, 25(18), 9938; https://doi.org/10.3390/ijms25189938 - 14 Sep 2024
Cited by 9 | Viewed by 5892
Abstract
The increasing interest in bacteriophage technology has prompted its novel applications to treat different medical conditions, most interestingly cancer. Due to their high specificity, manipulability, nontoxicity, and nanosize nature, phages are promising carriers in targeted therapy and cancer immunotherapy. This approach is particularly [...] Read more.
The increasing interest in bacteriophage technology has prompted its novel applications to treat different medical conditions, most interestingly cancer. Due to their high specificity, manipulability, nontoxicity, and nanosize nature, phages are promising carriers in targeted therapy and cancer immunotherapy. This approach is particularly timely, as current challenges in cancer research include damage to healthy cells, inefficiency in targeting, obstruction by biological barriers, and drug resistance. Some cancers are being kept at the forefront of phage research, such as colorectal cancer and HCC, while others like lymphoma, cervical cancer, and myeloma have not been retouched in a decade. Common mechanisms are immunogenic antigen display on phage coats and the use of phage as transporters to carry drugs, genes, and other molecules. To date, popular phage treatments being tested are gene therapy and phage-based vaccines using M13 and λ phage, with some vaccines having advanced to human clinical trials. The results from most of these studies have been promising, but limitations in phage-based therapies such as reticuloendothelial system clearance or diffusion inefficiency must be addressed. Before phage-based therapies for cancer can be successfully used in oncology practice, more in-depth research and support from local governments are required. Full article
(This article belongs to the Special Issue Bacteriophages Biology and Bacteriophage-Derived Technologies)
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11 pages, 604 KiB  
Article
Associations of Treatment Outcome Expectations and Pain Sensitivity after Cervical Spine Manipulation in Patients with Chronic Non-Specific Neck Pain: A Cohort Study
by Danai Paleta, Stefanos Karanasios, Nikolaos Diamantopoulos, Nektarios Martzoukos, Nikolaos Zampetakis, Maria Moutzouri and George Gioftsos
Healthcare 2024, 12(17), 1702; https://doi.org/10.3390/healthcare12171702 - 26 Aug 2024
Viewed by 2439
Abstract
(1) Background: This cohort study aimed to evaluate the effect of patients’ treatment expectations on pain perception changes following manual therapy cervical manipulations in individuals with chronic mechanical neck pain. (2) Methods: Demographic data were collected by 56 subjects who were asked to [...] Read more.
(1) Background: This cohort study aimed to evaluate the effect of patients’ treatment expectations on pain perception changes following manual therapy cervical manipulations in individuals with chronic mechanical neck pain. (2) Methods: Demographic data were collected by 56 subjects who were asked to fill out the Neck Disability Index (NDI) and the Expectations for Treatment Scale (ETS). All patients received one single cervical manipulation, and pressure pain thresholds (PPTs) were measured before and immediately after the manipulation with a digital algometer. (3) Results: A total of 56 patients participated. Most subjects (62.5%) had high treatment expectations according to the ETS scale. Statistically significant increases in PPTs were noted both locally and in remote areas (p < 0.05), with 37.5–48.2% of participants showing clinically significant changes in pain perception. However, no statistically significant correlation was found between high treatment expectations and increased PPTs (p > 0.05). (4) Conclusions: Although a significant reduction in pain perception was observed, it did not correlate with patients’ treatment expectations. Future research for further investigation of this hypothesis by comparing real versus sham treatment and exploring additional mechanisms affecting changes in PPTs after cervical manipulations in this population will contribute to a better understanding of the research question. Full article
(This article belongs to the Special Issue Rehabilitation and Care of Musculoskeletal Disorders)
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8 pages, 783 KiB  
Article
Safety and Preliminary Efficacy of Cervical Paraspinal Interfascial Plane Block for Postoperative Pain after Pediatric Chiari Decompression
by Jared M. Pisapia, Tara M. Doherty, Liana Grosinger, Audrey Huang, Carrie R. Muh, Apolonia E. Abramowicz and Jeff L. Xu
Healthcare 2024, 12(14), 1426; https://doi.org/10.3390/healthcare12141426 - 17 Jul 2024
Cited by 1 | Viewed by 1941
Abstract
Background: Surgery for lesions of the posterior fossa is associated with significant postoperative pain in pediatric patients related to extensive manipulation of the suboccipital musculature and bone. In this study, we assess the preliminary safety, effect on neuromonitoring, and analgesic efficacy of applying [...] Read more.
Background: Surgery for lesions of the posterior fossa is associated with significant postoperative pain in pediatric patients related to extensive manipulation of the suboccipital musculature and bone. In this study, we assess the preliminary safety, effect on neuromonitoring, and analgesic efficacy of applying a cervical paraspinal interfascial plane block in pediatric patients undergoing posterior fossa surgery. Methods: In this prospective case series, we enrolled five patients aged 2–18 years undergoing surgery for symptomatic Chiari type I malformation. An ultrasound-guided cervical cervicis plane (CCeP) block was performed prior to the incision. A local anesthetic agent (bupivacaine) and a steroid adjuvant (dexamethasone) were injected into the fascial planes between the cervical semispinalis capitis and cervical semispinalis cervicis muscles at the level of the planned suboccipital decompression and C1 laminectomy. Motor-evoked and somatosensory-evoked potentials were monitored before and after the block. Patients were assessed for complications from the local injection in the intraoperative period and for pain in the postoperative period. Results: No adverse events were noted intraoperatively, and there were no changes in neuromonitoring signals. Pain scores were low in the immediate postoperative period, and rescue medications were minimal. No complaints of incisional pain or need for narcotics were noted at the time of the 3-month postsurgical follow-up. Conclusions: In this study, we demonstrate the preliminary safety and analgesic efficacy of a novel application of a CCeP block to pediatric patients undergoing suboccipital surgery. Larger studies are needed to further validate the use of this block in children. Full article
(This article belongs to the Special Issue Pain Management Practice and Research)
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12 pages, 1355 KiB  
Article
Comparison of Short-Term Effects of Different Spinal Manipulations in Patients with Chronic Non-Specific Neck Pain: A Randomized Controlled Trial
by Jessica García-González, Raúl Romero-del Rey, Virginia Martínez-Martín, Mar Requena-Mullor and Raquel Alarcón-Rodríguez
Healthcare 2024, 12(13), 1348; https://doi.org/10.3390/healthcare12131348 - 5 Jul 2024
Cited by 2 | Viewed by 3875
Abstract
Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations. This study aimed to compare the short-term effects of UCS manipulation versus a combination of CCT spine manipulations [...] Read more.
Spinal manipulations for chronic non-specific neck pain (CNNP) include cervical, cervicothoracic junction, and thoracic spine (CCT) manipulations as well as upper cervical spine (UCS) manipulations. This study aimed to compare the short-term effects of UCS manipulation versus a combination of CCT spine manipulations on pain intensity, disability, and cervical range of motion (CROM) in CNNP patients. In a private physiotherapy clinic, 186 participants with CNNP were randomly assigned to either the UCS (n = 93) or CCT (n = 93) manipulation groups. Neck pain, disability, and CROM were measured before and one week after the intervention. No significant differences were found between the groups regarding pain intensity and CROM. However, there was a statistically significant difference in neck disability, with the CCT group showing a slightly greater decrease (CCT: 16.9 ± 3.8 vs. UCS: 19.5 ± 6.8; p = 0.01). The findings suggest that a combination of manipulations in the CCT spine results in a slightly more pronounced decrease in self-perceived disability compared to UCS manipulation in patients with CNNP after one week. However, no statistically significant differences were observed between the groups in terms of pain intensity or CROM. Full article
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18 pages, 7033 KiB  
Article
Dicerandrol C Suppresses Proliferation and Induces Apoptosis of HepG2 and Hela Cancer Cells by Inhibiting Wnt/β-Catenin Signaling Pathway
by Dongdong Zhou, Dandan Chen, Jingwan Wu, Ting Feng, Pinghuai Liu and Jing Xu
Mar. Drugs 2024, 22(6), 278; https://doi.org/10.3390/md22060278 - 14 Jun 2024
Cited by 7 | Viewed by 2338
Abstract
Overwhelming evidence points to an aberrant Wnt/β-catenin signaling as a critical factor in hepatocellular carcinoma (HCC) and cervical cancer (CC) pathogenesis. Dicerandrol C (DD-9), a dimeric tetrahydroxanthenone isolated from the endophytic fungus Phomopsis asparagi DHS-48 obtained from mangrove plant Rhizophora mangle via chemical [...] Read more.
Overwhelming evidence points to an aberrant Wnt/β-catenin signaling as a critical factor in hepatocellular carcinoma (HCC) and cervical cancer (CC) pathogenesis. Dicerandrol C (DD-9), a dimeric tetrahydroxanthenone isolated from the endophytic fungus Phomopsis asparagi DHS-48 obtained from mangrove plant Rhizophora mangle via chemical epigenetic manipulation of the culture, has demonstrated effective anti-tumor properties, with an obscure action mechanism. The objective of the current study was to explore the efficacy of DD-9 on HepG2 and HeLa cancer cells and its functional mechanism amid the Wnt/β catenin signaling cascade. Isolation of DD-9 was carried out using various column chromatographic methods, and its structure was elucidated with 1D NMR. The cytotoxicity of DD-9 on HepG2 and HeLa cells was observed with respect to the proliferation, clonality, migration, invasion, apoptosis, cell cycle, and Wnt/β-catenin signaling cascade. We found that DD-9 treatment significantly reduced tumor cell proliferation in dose- and time-dependent manners in HepG2 and HeLa cells. The subsequent experiments in vitro implied that DD-63 could significantly suppress the tumor clonality, metastases, and induced apoptosis, and that it arrested the cell cycle at the G0/G1 phase of HepG2 and HeLa cells. Dual luciferase assay, Western blot, and immunofluorescence assay showed that DD-9 could dose-dependently attenuate the Wnt/β-catenin signaling by inhibiting β-catenin transcriptional activity and abrogating β-catenin translocated to the nucleus; down-regulating the transcription level of β-catenin-stimulated Wnt target gene and the expression of related proteins including p-GSK3-β, β-catenin, LEF1, Axin1, c-Myc, and CyclinD1; and up-regulating GSK3-β expression, which indicates that DD-9 stabilized the β-catenin degradation complex, thereby inducing β-catenin degradation and inactivation of the Wnt/β-catenin pathway. The possible interaction between DD-9 and β-catenin and GSK3-β protein was further confirmed by molecular docking studies. Collectively, DD-9 may suppress proliferation and induce apoptosis of liver and cervical cancer cells, possibly at least in part via GSK3-β-mediated crosstalk with the Wnt/β-catenin signaling axis, providing insights into the mechanism for the potency of DD-9 on hepatocellular and cervical cancer. Full article
(This article belongs to the Special Issue Marine Bioactive Compound Discovery through OSMAC Approach)
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8 pages, 1664 KiB  
Case Report
Manual Therapy of Dysphagia in a Patient with Amyotrophic Lateral Sclerosis: A Case Report
by Ilaria De Marchi, Francesca Buffone, Alessandro Mauro, Irene Bruini and Luca Vismara
Medicina 2024, 60(6), 845; https://doi.org/10.3390/medicina60060845 - 22 May 2024
Cited by 1 | Viewed by 3034
Abstract
Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. [...] Read more.
Amyotrophic lateral sclerosis (ALS) is an incurable rare neurodegenerative condition, with 45% of cases showing the symptom of dysphagia; its clinical signs are atrophy, weakness, and fasciculations of the facial muscles, tongue, and pharynx. Furthermore, dysphagia is the main cause of aspiration pneumonia. The traditional treatment for dysphagia varies based on the patient’s difficulty of swallowing. The initial phase consists of dietary consistency adjustments, progressing to alternatives like nasogastric tubes or percutaneous endoscopic gastrostomy (PEG) in advanced stages. Osteopathic manipulative treatment (OMT) is a complementary ‘hands-on’ approach that has already shown positive results as an add-on therapy in various health conditions. This study is a case report of a man diagnosed with ALS with initial dysphagia, managed with a protocol that extraordinarily included OMT. The patient showed somatic dysfunctions in the mediastinal region, upper cervical region, and occipital area which are all anatomically related to the nervous system, especially the glossopharyngeal reflex. At the end of the rehabilitation protocol, there was a reduction in the swallowing problems measured with Strand Scale and swallowing tests, and the patient reported an improved psycho-physical well-being assessed with the Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-40). Instead, the neurological function measured with ALSFRS-S remained stable. Although the nature of this study design prevents any causal assumption, the positive results should lead to future randomized controlled trials to assess the effectiveness of OMT as an adjunctive therapeutic proposal to improve the health of ALS patients. Full article
(This article belongs to the Special Issue Neuromuscular Disorders: Diagnostical Approaches and Treatments)
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20 pages, 5997 KiB  
Case Report
Effects of Cervical Spinal Manipulation on Saccadic Eye Movements
by Adam Klotzek, Monem Jemni, Shad James Groves and Frederick Robert Carrick
Brain Sci. 2024, 14(3), 292; https://doi.org/10.3390/brainsci14030292 - 20 Mar 2024
Cited by 1 | Viewed by 6157
Abstract
Quantifying saccadic eye movements can assist in identifying dysfunctional brain networks in both healthy and diseased people. Infrared Oculography is a simple and non-invasive approach to capturing and quantifying saccades, providing information that might aid in diagnosis and outcome assessments. The effect of [...] Read more.
Quantifying saccadic eye movements can assist in identifying dysfunctional brain networks in both healthy and diseased people. Infrared Oculography is a simple and non-invasive approach to capturing and quantifying saccades, providing information that might aid in diagnosis and outcome assessments. The effect of spinal manipulation on quantified saccadic performance parameters has not been fully studied despite known post-manipulative effects on the brain and brainstem regions controlling them. This case study investigates spinal manipulation’s immediate and long-term effects on saccadic eye movements by quantifying the saccades of a male patient diagnosed with post-concussion syndrome. The patient performed horizontal saccades that were quantified before and immediately following cervical spinal manipulation both at the case study’s start and following a 2-week interim, during which the subject received six manipulative treatments. Immediate and long-term post-manipulative effects were observed, and the results revealed various post-manipulative effects across all quantified parameters in addition to between right and leftward saccades. The immediate post-manipulative effect was greatest at the case study’s onset, while the long-term right and leftward saccadic symmetry were most affected. The observations in this case study demonstrate that cervical spinal manipulation influences saccadic eye movements, providing new insights into its central neurological effects and therapeutic applications beyond its most commonly known use in pain management. More importantly, it encourages scientists to undertake further clinical investigations on wider scales. Full article
(This article belongs to the Section Neurorehabilitation)
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14 pages, 1561 KiB  
Article
Effectiveness of Deep Cervical Fascial Manipulation® and Sequential Yoga Poses on Pain and Function in Individuals with Mechanical Neck Pain: A Randomised Controlled Trial
by Prabu Raja G, Shyamasunder Bhat, Ranganath Gangavelli, Anupama Prabhu, Antonio Stecco, Carmelo Pirri, Vennila Jaganathan and César Fernández-de-Las-Peñas
Life 2023, 13(11), 2173; https://doi.org/10.3390/life13112173 - 6 Nov 2023
Cited by 6 | Viewed by 3771
Abstract
Background: This study aimed to investigate the effect of fascial manipulation (FM) of the deep cervical fascia (DCF) and sequential yoga poses (SYP) on pain and function in individuals with mechanical neck pain (MNP). Method: Following the predefined criteria, ninety-nine individuals with MNP [...] Read more.
Background: This study aimed to investigate the effect of fascial manipulation (FM) of the deep cervical fascia (DCF) and sequential yoga poses (SYP) on pain and function in individuals with mechanical neck pain (MNP). Method: Following the predefined criteria, ninety-nine individuals with MNP were recruited, randomised, and assigned to either the intervention group (IG) (n = 51) or the control group (CG) (n = 48). Individuals in the IG received FM (4 sessions in 4 weeks) and the home-based SYP (4 weeks). The CG participants received their usual care (cervical mobilisation and thoracic manipulation (4 sessions in 4 weeks) along with unsupervised therapeutic exercises (4 weeks). The participants underwent baseline and weekly follow-up measurements of pain using a numerical pain rating scale (NPRS) and elbow extension range of motion (EEROM) during the upper limb neurodynamic test 1 (ULNT1). The baseline and the fourth session follow-up measurements of the patient-specific functional scale (PSFS) and fear-avoidance behavior Questionnaire (FABQ) were also taken. Results: A repeated-measures ANOVA was performed. There were statistically significant differences between the IG and CG on the NPRS third and fourth sessions, with mean differences (MD) of −1.009 (p < 0.05) and −1.701 (p < 0.001), respectively. Regarding EEROM, there was a 20.120° difference (p < 0.001) in the fourth session between the groups. The MD in FABQ was −5.036 (p < 0.001), but there were no significant differences in PSFS between the groups during the follow-up. Conclusion: FM and SYP can aid in reducing pain and fear-avoidance behaviour and improve the function and extensibility of the upper quarter region. Full article
(This article belongs to the Special Issue Clinical Implications of the Fascial System)
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