Chronic neck pain (CNP) is a worldwide health problem with several risk factors. One of the most widely used treatments for managing this condition is therapeutic exercise, which could generate a response called exercise-induced hypoalgesia (EIH). There is no consensus on the best exercise modality to induce hypoalgesia. Therefore, this review aims to analyze and synthesize the state-of-the-art about the hypoalgesic effect of exercise in subjects with CNP. We included articles on EIH and CNP in patients older than 18 years, with pain for more than three months, where the EIH response was measured. Articles that studied CNP associated with comorbidities or measured the response to treatments other than exercise were excluded. The studies reviewed reported variable results. Exercise in healthy subjects has been shown to reduce indicators of pain sensitivity; however, in people with chronic pain, the response is variable. Some investigations reported adverse effects with increased pain intensity and decreased pain sensitivity, others found no clinical response, and some even reported EIH with decreased pain and increased sensitivity. EIH is an identifiable, stimulable, and helpful therapeutic response in people with pain. More research is still needed on subjects with CNP to clarify the protocols and therapeutic variables that facilitate the EIH phenomenon. In addition, it is necessary to deepen the knowledge of the intrinsic and extrinsic factors that influence EIH in people with CNP.

Background: The anterior cerebral artery (ACA), a critical component of the cerebral arterial circle, exhibits substantial morphological variability. While previous studies have explored ACA morphology using cadaveric and imaging methods, a comprehensive meta-analysis incorporating the latest evidence is lacking. Methods: Following current guidelines, a systematic review and meta-analysis were performed across four major databases, supplemented by the gray literature and targeted journal searches. Ninety-nine studies, encompassing 85,316 patients, met the inclusion criteria. Statistical analyses were conducted using R, applying random effects models to estimate pooled prevalence and morphometric parameters. Results: The pooled prevalence of typical ACA morphology was 93.75%, whereas variants were noted in 6.25% of cases. The predominant variation identified was the accessory ACA (aACA) (1.99%), followed by unilateral absence of the A1 segment (1.78%), with the latter being more frequently recognized in imaging studies (p < 0.0001). Rare variants encompassed azygos ACA (azACA) (0.22%), fenestrated ACA (fACA) (0.02%), and bihemispheric ACA (bACA) (0.02%). The mean diameter and length of the A1 segment were measured at 2.10 mm and 14.24 mm, respectively. Hypoplasia of the A1 segment (<1 mm diameter) was recorded in 3.15% of cases. The influences of imaging modality, laterality, and population distribution on prevalence estimates were minimal. No significant publication bias was detected. Conclusions: Although infrequent, variants of the ACA possess significant clinical importance attributable to their correlation with aneurysm formation and the impairment of collateral circulation. The aACA and the absence of the A1 segment emerged as the most common variations. This meta-analysis presents an updated and high-quality synthesis of ACA morphology, serving as a valuable reference for clinicians and anatomists.

El dolor lumbar es un problema de salud global y su nivel de discapacidad depende, entre otras variables, de las creencias negativas de los pacientes respecto del dolor. Evidencia sostiene que dichas creencias están asociadas con las que poseen sus profesionales tratantes, por lo que es importante identificar cómo evolucionan durante la formación de pregrado de los profesionales sanitarios. El objetivo de este estudio transversal fue determinar la presencia de creencias negativas sobre dolor lumbar en estudiantes de fisioterapia y compararlas entre distintos cursos del ciclo formativo. Participaron estudiantes de segundo a quinto año de fisioterapia de una universidad chilena, quienes completaron una encuesta basada en los siete mitos sobre dolor lumbar de Deyo y respondieron según su grado de acuerdo con los enunciados. Los resultados fueron comparados entre los diferentes niveles. 127 estudiantes completaron la encuesta (57 hombres y 70 mujeres). Los mitos 1, 2, 4, 6 y 7 se presentaron con mayor frecuencia en segundo año y tendieron a disminuir progresivamente en los cursos superiores. Los mitos 3 y 5 presentaron un patrón distributivo menos claro. Los estudiantes de segundo nivel presentaron un mayor grado de acuerdo con los mitos, los de tercer nivel presentaron mayor inseguridad en las respuestas, mientras que los alumnos de cuarto y quinto nivel presentaron mayor desacuerdo con los mitos. En conclusión, las creencias negativas sobre dolor lumbar pueden encontrarse presentes en estudiantes de fisioterapia, pero éstas tienden a modificarse positivamente a lo largo de su proceso formativo. Palabras claves: Dolor; Dolor Lumbar; Creencias negativas sobre dolor lumbar; Mitos de Deyo; Estudiantes de fisioterapia. Low back pain is a global health problem, and its level of disability depends, among other variables, on patients' negative beliefs regarding pain. Evidence supports that these beliefs are associated with those held by their treating professionals, so it is important to identify how they evolve during the undergraduate training of health professionals. This cross-sectional study aimed to determine the presence of negative beliefs about low back pain in physical therapy students and compare them between different courses of the training cycle. Second, to fifth-year physiotherapy students from a Chilean university participated; they completed a survey based on Deyo's seven myths about low back pain and responded according to their degree of agreement with the statements. The results were compared between the different levels. 127 students completed the survey (57 males and 70 females). Myths 1, 2, 4, 6, and 7 were presented more frequently in the second year and tended to decrease progressively in higher grades. Myths 3 and 5 presented a less clear distributional pattern. Second-level students presented a higher degree of agreement with the myths, and third-level students presented greater insecurity in the answers. In contrast, fourth and fifth-level students presented greater disagreement with the myths. In conclusion, negative beliefs about low back pain may be present in physical therapy students, but these tend to modify positively throughout their formative process. Keywords: Pain; Low back pain; Negative beliefs about low back pain; Deyo’s myths; Physical therapy students.

Background/Objectives: The objective of this study was to describe the anatomical variants of the pancreaticobiliary junction and how its position or structural change could be associated with hepatic, duodenal, and pancreatic clinical complications. Methods: We searched MEDLINE, Scopus, Web of Science (WOS), Google Scholar, CINAHL, and EMBASE databases from their inception up to September 2024. Results: Two authors independently performed the search, study selection, data extraction, and assessed the methodological quality with an assurance tool for anatomical studies (AQUA). Finally, the pooled prevalence was estimated using a random effects model. A total of 59 studies with a total of 22,752 participants were included in this review. The overall prevalence of the anomalous pancreaticobiliary junction (APBJ) variant was 12% (95% CI = 6% to 18%). The prevalence of cancer associated with variants of APBJ was 29% (95% CI = 23% to 34%). Conclusions: In the present anatomical systematic review and meta-analysis, we found that a longer common channel correlated with a higher prevalence of bile duct or gallbladder malignancy, due to the backward flow of bile which occurs as a result of the position and distance of the bile ducts, as well as pancreatic failing. Hence, APBJs are of great interest for gastroduodenal surgeons.