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Low back pain represents the leading cause of disability since 1990. In 90% of cases, it is classified as non-specific low back pain, being chronic in 10% of subjects. Ultrasound has proven to be an effective measurement tool to observe changes in the activity and morphology of the abdominal muscles. This article reviews which core synergies are studied with ultrasound in healthy subjects and with chronic non-specific low back pain. A systematic review was conducted on studies analyzing synergies between two or more core muscles. Publications from 2005 until July 2021 were identified by performing structured searched in Pubmed/MEDLINE, PEDro and WOS. Fifteen studies were eligible for the final systematic review. A total of 56% of the studies established synergies between the core muscles and 44% between the homo and contralateral sides of the core muscles. The most studied core synergies were transversus abdominis, internal oblique and external oblique followed by the rectus abdominis and the lumbar multifidus. No studies establishing synergies with diaphragm and pelvic floor were found. Eight studies were conducted in healthy subjects, five studies in subjects with chronic non-specific low back pain compared to healthy subjects and two studies in subjects with chronic non-specific low back pain.

Mexico is an endemic region for dengue virus (DENV). The increase in this disease coincides with outbreaks of COVID-19, both of which are single-stranded positive RNA viruses. These characteristics make it difficult to distinguish each disease because they share clinical and laboratory features, which can consequently result in misdiagnoses. This is why the use of precision confirmatory tests (qRT-PCR) are crucial for early diagnosis. We herein report a pediatric patient who presented a coinfection for DENV and COVID-19, "SARS-CoV-2/Dengue". This patient initially presented a fever, cough, and headache and, three days later, developed generalized pain and epistaxis. Blood studies revealed thrombocytopenia and leukopenia, and the patient was admitted to the hospital for a probable DENV infection. Within 48 h, qRT-PCR tests specific for SARS-CoV-2 and DENV were performed and resulted as positive. The patient immediately received pharmacological treatment with azithromycin, oseltamivir, and metamizole. During hospitalization (9 days), the patient had no signs of respiratory distress and maintained normal body temperature and normal blood oxygen saturation. This case warns of the need for early diagnosis and adequate clinical and pharmacological management in the face of a "SARS-CoV-2/Dengue" coinfection. Early molecular detection of both viruses and timely treatment helped the patient to achieve a favorable recovery.

Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiveness of abobotulinumtoxinA (aboBoNT-A) in patients with shoulder pain who have set reduced pain as a treatment goal is understudied. In addition, some patients encounter delays in accessing treatment programs; therefore, the suitability of aboBoNT-A for pain reduction in this population requires investigation. These factors were assessed in aboBoNT-A-naive Brazilian patients in a post hoc analysis of data from BCause, an observational, multicenter, prospective study (NCT02390206). Patients (N = 49, = 25 female; mean (standard deviation) age of 60.3 (9.1) years; median (range) time since onset of spasticity of 16.1 (0-193) months) received aboBoNT-A injections to shoulder muscles in one or two treatment cycles ( = 47). Using goal attainment scaling (GAS), most patients achieved their goal of shoulder pain reduction after one treatment cycle (72.1%; 95% confidence interval: 57.2-83.4%). Improvements in GAS T-score from baseline, clinically meaningful reductions in pain score at movement, and clinically meaningful increases in passive shoulder abduction angle further improved with repeated treatment more than 4 months later, despite treatment starting at a median of 16.1 months after the onset of spasticity. These findings support the further investigation of aboBoNT-A injections in chronic post-stroke shoulder pain.

Is Long COVID-19 under-diagnosed? The definition of this new condition has received many contributions, and it is still under development as a great variety of symptoms have been associated to it. This study explores the possibility that there are non-diagnosed cases among individuals who have been infected by SARS-CoV-2 and have not been vaccinated. The long-term symptoms identified among a sample 255 individuals have been associated to Long COVID-19 by recent literature. The study relates these symptoms to risk factors and health-related quality of life (HRQoL) negative impacts. The individuals were screened 1 year after discharge to explore its potential relation to Long COVID-19. Patients diagnosed with COVID-19 and discharged from designated hospitals in a Chinese province between January and April 2020 were included in this study. They received computed tomography (CT) scans one month after discharge. One year after discharge, patients were invited to physical examination and interviewed with questionnaire on health-related quality of life (HRQoL) and post-COVID-19 symptoms. Tobit regression and Logistic regression were applied to evaluate the risk factors for health utility value and pain/discomfort and anxiety/depression. One year after discharge, 39.61% patients complained of several of the symptoms associated to Long COVID-19. More than half had abnormal chest CT. Previous studies focused on the post-COVID-19 symptoms and chest CT findings of patients, but few studies have assessed the COVID-19-associated risk factors for health-related quality of life.

COVID-19 has significantly affected public health, social life, and economies worldwide. The only effective way to combat the pandemic is through vaccines. Although the vaccines have been in use for some time, safety concerns have still been raised. The most typical adverse effects of receiving a COVID-19 vaccine are localized reactions near the injection site, followed by general physical symptoms such as headaches, fatigue, muscle pain, and fever. Additionally, some people may experience VITT (vaccine-induced immune thrombotic thrombocytopenia), a rare side effect after vaccination. We present the case of a 60-year-old female patient that developed VITT-like symptoms with spleno-portal thrombosis and intestinal ischemia two weeks after the administration of the Ad26.COV2-S vaccine. Surgical treatment consisted of extensive bowel resection with end jejunostomy and feeding ileostomy. Two weeks after the first operation, a duodenal-ileal anastomosis was performed. The patient was discharged five weeks after the onset of the symptoms. Although some rare adverse effects are associated with the SARS-CoV-2 vaccines, the risk of hospitalization from these harmful effects is lower than the risk of hospitalization from COVID-19. Therefore, recognizing VITT is significant for ensuring the early treatment of clots and proper follow-up.

The aim of this study was to compare the clinical outcomes and hospital costs associated with two different meshes in robotic transabdominal preperitoneal inguinal hernia repair (IHR). Patients who underwent IHR were assigned to either the polyester self-gripping (PSG) or the polypropylene (PP) group depending on the mesh used. A propensity score matching analysis was performed to obtain balanced populations. Postoperative variables included complications such as surgical site events and recurrences. Hospital costs included all possible expenses generated by the surgery during the hospitalization period. From a database of IHR performed between February 2012 and July 2022, 131 PSG patients were matched to 131 PP repairs. Median operative time was shorter in the PSG group [55 (40-78) vs. 80 (60-116) minutes, p < 0.001]. No intraoperative complications were recorded. Patients who received the PSG mesh experience reduced immediate postoperative pain compared to the PP group. Average follow-up time was 35.2 months in the PSG group vs. 12.5 months in the PP group (p < 0.001). Median Comprehensive Complication Index was comparable in both groups (p = 0.489), with no surgical site infections logged. No cases of chronic pain were noted. Only two recurrences were recorded in the cohort, both of them in the PSG repairs. Hospital costs were USD $232 higher in the PP group but did not statistically differ (p = 0.523). There were no differences between the polyester self-gripping and the polypropylene mesh in terms of postoperative complications, clinical outcomes and hospital costs. Surgeons may opt for either meshes depending on their preferences and familiarity with each of the products.

Low back pain contributes to an increasing global health burden exacerbated by unsustained improvements from current treatments. There is a need to develop, and test interventions to maintain initial improvements from low back pain treatments. One option is to implement a booster intervention. This study aimed to develop and test the feasibility of implementing a booster intervention delivered remotely to supplement the benefits from a complex intervention for chronic low back pain.

Raynaud's disease is a vasospastic phenomenon affecting acral areas, which manifests itself in characteristic color changes. Symptoms are affected by mundane things like stress or temperature. There are also differences in the presence and progression of the disease in terms of gender, age, health-damaging behaviors (e.g., smoking) and occupation.

Sleep disorders are a common occurrence in the general population. Yet today, it is clearly agreed that sleep disorders represent both a cancer risk factor and a biological consequence of the of the activation of the immuno-inflammatory system induced by cancer itself.