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Acute care diagnostics in children for general radiologists – not alone in the hospital at night.

 Radiologic care for children and adolescents during night and weekend shifts is challenging. This is especially true when a dedicated pediatric radiology front or background service is not available.

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Immune challenges upregulate the expression of cannabinoid receptors in cultured human odontoblasts and gingival fibroblasts.

Odontoblasts and gingival fibroblasts play essential roles in the physiological and pathological processes of dental tissue. Cannabinoid receptors (CB1 and CB2) are involved in analgesia by modulating the función of calcium channels that inhibit the synthesis of some neurotransmitters. A better understanding of the physiology of these receptors would provide the possibility of using them as therapeutic targets in controlling dental pain. The aim of this study was to evaluate the presence and activity of cannabinoid receptors in human odontoblast-like cells (OLC) and human gingival fibroblasts (HGF). CB1 and CB2 transcription was analyzed by real-time PCR, proteins were detected by immunofluorescence, and functional cannabinoid receptors were evaluated by measuring intracellular calcium concentration after stimulation with cannabidiol (CBD) and pre-treatment with a CB1 antagonist, a CB2 inverse agonist and a TRPV1 antagonist. Transcripts for CB1 and CB2 were found in both odontoblasts and gingival fibroblasts. Cannabidiol induced an increase in [Ca2+]i in both cells types, but surprisingly, pre-treatment with selective cannabinoid antagonists attenuated this effect, suggesting a functional communication between specific cannabinoid receptors and other CBD target receptors. In conclusion, human odontoblasts and gingival fibroblasts express functional CB1 and CB2 cannabinoid receptors, which could be modulated to improve the treatment of pain or dental sensitivity.

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Efficacy and Safety of Ketamine vs Electroconvulsive Therapy Among Patients With Major Depressive Episode: A Systematic Review and Meta-analysis.

Whether ketamine is as effective as electroconvulsive therapy (ECT) among patients with major depressive episode remains unknown.

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Efficacy and Safety of Methylprednisolone for Lung Surgery: a Systematic Review and Meta-analysis of Randomized Controlled Trials.

The administration of methylprednisolone (MP) is a component of perioperative multimodal analgesia that mitigates the potentially deleterious effects of postoperative pain and opioid consumption. However, a systematic evaluation of the efficacy and safety of MP is lacking. The present systematic review and meta-analysis was performed to quantify the potential clinical benefits and risks of perioperative MP in lung surgery.

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Effect of multiple analgesic pathways including local infiltration analgesia, peripheral nerve blocks, and intrathecal morphine for controlling pain after total knee arthroplasty.

We questioned whether the triple analgesic pathways procedure via local infiltration analgesia (LIA), peripheral nerve blocks, and intrathecal morphine (ITM) is superior to LIA only for controlling pain after Total Knee Arthroplasty (TKA).

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The relationship between substance use and physical activity among people living with HIV, chronic pain, and symptoms of depression: a cross-sectional analysis.

Chronic pain, depression, and substance use are common among people living with HIV (PLWH). Physical activity can improve pain and mental health. Some substances such as cannabis may alleviate pain, which may allow PLWH to participate in more physical activity. However, risks of substance use include poorer mental health and HIV clinical outcomes. This cross-sectional analysis examined the relationships of self-reported substance use (alcohol, cannabis, and nicotine use), gender, and age with self-reports of walking, moderate physical activity, and vigorous physical activity, converted to Metabolic Equivalent of Task Units (METs), among 187 adults living with HIV, chronic pain, and depressive symptoms in the United States. Women reported less walking, vigorous activity, and total physical activity compared to men. Individuals who used cannabis reported more vigorous physical activity relative to those who did not use cannabis. These findings were partially accounted for by substance use*gender interactions: men using cannabis reported more vigorous activity than all other groups, and women with alcohol use reported less walking than men with and without alcohol use. Research is needed to increase physical activity among women who use substances and to evaluate reasons for the relationship between substance use and physical activity among men.

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Pneumorrhachis: A rare cause of headache in a patient with a traumatic spinal cord injury due to gunshot wound.

A pneumorrhachis (PR) is a rare phenomenon in which air is found in the spinal canal. There are multiple etiologies, including iatrogenic, nontraumatic, and traumatic. Most traumatic PR are asymptomatic and resolve on their own, but a subset are symptomatic and require urgent surgical intervention. This case describes a traumatic PR in which a headache was the primary symptom.

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Multimodal Analgesia in Paving the Way for Enhanced Recovery After Cardiac Surgery.

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Antiphospholipid syndrome & lupus anticoagulant-hypoprothrombinemia.

Lupus anticoagulant-hypoprothrombinemia syndrome is a rare cause of hemorrhage. In this syndrome, antiphospholipid antibodies bind to the FII epitope in its carboxy-terminal portion and form antigen-antibody complexes that are rapidly cleared by the reticuloendothelial system, conditioning hypoprothrombinemia and thus a bleeding tendency. Lupus anticoagulant-hypoprothrombinemia syndrome is associated with autoimmune diseases, mainly systemic lupus erythematosus, and less frequently with primary antiphospholipid syndrome, discoid lupus, drugs, celiac disease, and haemato-oncological diseases. Immunosuppressants, mainly steroids, are the mainstay treatment, nevertheless, there is still a concern about the right treatment for this entity since there have been described less than 200 cases around the world. We describe the case of a male patient with a history of primary antiphospholipid syndrome that comes to our hospital with a severe headache due to intracranial hemorrhage, secondary to Lupus anticoagulant-hypoprothrombinemia.

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A retrospective case series of electroconvulsive therapy in the management of depression and suicidal symptoms in adolescents.

Major depressive disorder (MDD) with suicidal symptoms is common in adolescents. Electroconvulsive therapy (ECT) is highly effective in the treatment of MDD. We have described its use and outcome in a case series of adolescents with depression and suicidal symptoms receiving ECT.

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