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Access to opioid analgesics for medical use at hospital level in the Democratic Republic of Congo: an exploratory mixed-method study.

To investigate the availability of and access to opioid analgesics at hospital level in the Democratic Republic of Congo.

Applying symptom dynamics to accurately predict influenza virus infection: An international multicenter influenza-like illness surveillance study.

Public health organizations have recommended various definitions of influenza-like illnesses under the assumption that the symptoms do not change during influenza virus infection. To explore the relationship between symptoms and influenza over time, we analyzed a dataset from an international multicenter prospective emergency department (ED)-based influenza-like illness cohort study.

Comparison of cytokine production in mice inoculated with mRNA vaccines BNT162b2 and mRNA-1273.

Two mRNA vaccines of BNT162b2 and mRNA-1273 were licensed. The most common adverse event is regional pain at the injection site in 80%. As systemic reactions, fatigue and headache were noted in 40-60% and febrile illness in 10-40% of the recipients. To investigate the mechanism of adverse events, cytokine profiles were investigated in mice. Muscle tissue and serum samples were obtained on days 0, 1, 3, 5, and 7, and at 2 and 4 weeks after the first dose. The second dose was given 4 weeks after the first dose and samples were obtained. After inoculation with 0.1 mL of mRNA-1273, IFN-γ and IL-2 were detected in muscle tissues and serum samples on day 1 of the second doses, and similar profiles were observed for IL-4, IL-5, and IL-12 production. mRNA-1273 induced higher levels of Th1 and Th2 cytokines. TNF-α was induced in muscle tissues on day 1 of the first dose and enhanced on day 1 of the second dose after inoculation with BNT162b2 and mRNA-1273. IL-6 was also detected in muscle tissue on day 1 of the first dose, but it decreased after day 3, and enhanced production was demonstrated on day 1 of the second dose. G-CSF in muscle tissues showed a similar profile. The induction of inflammatory cytokines in the mouse model is related to the cause of adverse events in humans, with a higher incidence of adverse events after the second dose. This article is protected by copyright. All rights reserved.

Seeing Blue Dots After COVID-19 Infection.

Blockade of orexin receptor type-1 by SB-334867 and activation of orexin receptor type-2 attenuate morphine tolerance in rats.

The interaction of orexinergic neurons with the opioidergic system and their effects on morphine analgesia and tolerance have not been fully elucidated. The purpose of the study was to evaluate the effects of the orexin-1 and orexin-2 receptor (OX1R and OX2R) agonist and antagonist on morphine analgesia and tolerance in rats.

Safety and Effectiveness of Etanercept Biosimilar SB4 for Rheumatic Diseases in South Korea: Real-World Post-marketing Surveillance Data.

SB4 is the first approved biosimilar of etanercept, a biologic tumor necrosis factor inhibitor, to treat various autoimmune diseases including axial spondylarthritis (axSpA), rheumatoid arthritis (RA), psoriatic arthritis (PsA), and plaque psoriasis (PsO). This post-marketing surveillance (PMS) study of SB4 investigated safety and effectiveness in routine clinical practice and is part of the drug approval process in Korea.

The role of a simple questionnaire predicting treatment success in children with ACNES.

Some children with chronic abdominal wall pain or groin pain do not have an inguinal hernia but suffer from anterior cutaneous nerve entrapment syndrome (ACNES). Diagnosing ACNES is challenging, especially in children as a diagnostic gold standard is lacking. A paediatric questionnaire containing 17 simple items was earlier found to discriminate between abdominal pain due or ACNES or IBS. Scores range from 0 points (ACNES very unlikely) to 17 points (ACNES very likely). The present study investigates whether this 17-item questionnaire predicted treatment success in children receiving therapy for ACNES.

Long-Term Safety and Effectiveness of Erenumab in Patients with Migraine: A Systematic Review and Single-Arm Meta-analysis.

Several studies on use of erenumab for migraine treatment have been published over recent years. However, its long-term safety and effectiveness have not been consistently established in the literature yet. We aimed to perform a qualitative and quantitative analysis of the long-term safety and effectiveness of erenumab for the treatment of migraine headaches.

Effects of Transcranial Direct Current Stimulation (t-DCS) of the Cerebellum on Pain Perception and Endogenous Pain Modulation: a Randomized, Monocentric, Double-Blind, Sham-Controlled Crossover Study.

Accumulating evidence demonstrates a role of the cerebellum in nociception. Some studies suggest that this is mediated via endogenous pain modulation. Here, we used t-DCS to test the effects of modulation of cerebellar function on nociception and endogenous pain modulation. Anodal, cathodal, and sham cerebellar t-DCS were investigated in a cross-over design in 21 healthy subjects. The nociceptive flexor (RIII) reflex, conditioning pain modulation (CPM), and offset analgesia (OA) paradigms were used to assess endogenous pain modulation. Somatosensory evoked potentials (SEPs) and pain ratings were used to assess supraspinal nociception and pain perception, respectively. No significant t-DCS effects were detected when including all t-DCS types and time points (baseline, 0, 30, 60 min post t-DCS) in the analysis. Exploratory analysis revealed an increased RIII reflex size immediately after cathodal t-DCS (compared to sham, P = 0.046, η = 0.184), in parallel with a trend for a decrease in electrical pain thresholds (P = 0.094, η = 0.134), and increased N120 SEP amplitudes 30 min after cathodal compared to anodal t-DCS (P = 0.007, η = 0.374). OA was increased after anodal compared to sham stimulation (P = 0.023, η = 0.232). Exploratory results suggested that cathodal (inhibitory) cerebellar t-DCS increased pain perception and reduced endogenous pain inhibition while anodal (excitatory) t-DCS increased endogenous pain inhibition. Results are principally compatible with activation of endogenous pain inhibition by cerebellar excitation. However, maybe due to limited t-DCS skull penetration, effects were small and unlikely to be clinically significant.

A Comparative Review of the Outcome following MVD and PBC in Patients with Trigeminal Neuralgia.

Objective This study is aimed to systematically review the treatment outcomes between percutaneous balloon compression (PBC) and microvascular decompression (MVD) in patients with trigeminal neuralgia. Methods A systematic review in accordance with the PRISMA guideline was performed using PubMed, Embase and Cochrane CENTRAL databases. Only those articles with more than 5 years' follow-up length were included in this investigation. In order to uniformly assess the postoperative outcome, we defined pain relief for those totally pain free, while the postoperative hospitalization and last follow-up period as early and long-term, respectively. The facial numbness was quantified with BNI score. Results After database searching and screening, 7797 cases were enrolled finally according the criteria. The early pain relief rates were 94.1% (1551/1649) and 89.9% (4962/5482) following PBC and MVD (OR=0.603, p<0.05), while the long-term 58.1% (921/1566) and 74.9% (4549/6074) (OR=2.089, p<0.05), respectively. Although a significant higher facial numbness occurred in PBC group in the early stage, it was mostly diminished 5 years later compared with MVD group. At long-term follow-up, hypoacousia and facial palsy occurred more often in MVD group (p<0.05). Conclusions Both MVD and PBC provide a satisfactory outcome for the patients in long-term. As a simple, safe and reliable technique, PBC should not be shrugged off by neurosurgeons.

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