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Predictors of persistent post-surgical pain intensity and interference at 1 year after breast cancer surgery: assessing central sensitization, central sensitivity symptoms, and psychological factors.

Persistent post-surgical pain (PPSP) is associated with upper limb dysfunction and decreased quality of life and causes long-term suffering for breast cancer survivors after surgery. However, the predictors of PPSP remain unclear. The purpose of this study was to examine predictors of PPSP intensity and interference at 1 year postoperatively, focusing on treatment-related factors, pre- and postoperative central sensitization (CS), CS-related symptoms (e.g., muscle stiffness, fatigue, sleep disturbances), and psychological factors.

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Osteoporotic fracture admissions compared to other major medical admissions in Irish public hospitals.

Multinational reports suggest Ireland has one of the greatest illness burdens related to osteoporosis. Hospital care represents the costliest portion of health services. We found public hospital bed days for fragility fractures in Ireland increased by 43% between 2008 and 2017 which exceeded those for other common diseases.

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Poorer surgical outcomes at 2 years postoperatively in patients with lumbar spinal stenosis with long-term preoperative leg numbness: a single-center retrospective study.

The purpose of this study was to assess whether differences in duration of preoperative leg numbness lead to different surgical outcomes.

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Mechanistic and thermal characterization of acupuncture for chemotherapy-induced peripheral neuropathy as measured by quantitative sensory testing.

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of chemotherapy. Acupuncture is a promising non-pharmacological intervention for CIPN. However, the physiological effects of acupuncture treatment remain poorly understood. We examined the effects of acupuncture on CIPN using semi-objective quantitative sensory testing (QST).

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A multidisciplinary care pathway improves quality of life and reduces pain in patients with fibrous dysplasia/McCune-Albright syndrome: a multicenter prospective observational study.

Fibrous dysplasia/McCune-Albright syndrome (FD/MAS) may cause pain, impaired ambulation and decreased quality of life (QoL). International guidelines advocate management of FD/MAS in a tertiary multidisciplinary care pathway, but no longitudinal data are available to support this recommendation. This multicenter prospective observational study aimed to evaluate effects of 1 year of treatment in the FD/MAS care pathway in 2 tertiary clinics on QoL and pain, assessed by change in Short Form 36 and Brief Pain Inventory between baseline and follow-up. Patients completing baseline questionnaires < 1 year after intake were classified as new referrals, others as under chronic care.

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Visible Apical Blebs on CXR: Are Plain Radiographs Under-Utilized in Primary Spontaneous Pneumothorax?

A primary spontaneous pneumothorax (PSP) is caused by rupture of subpleural emphysematous blebs, without inciting event or pre-existing co-morbidity. A previously healthy 16-year-old male presented with upper chest pain. As expected, chest radiographs (CXR) demonstrated a 13 mm pneumothorax. Additionally, a 4.7 cm apical bleb was identified. After six-hours of observation and non-rebreather oxygen mask therapy, follow-up CXR confirmed stable findings. The patient was subsequently discharged home after symptoms improved. Follow-up CXR at 2-weeks confirmed persistent visible apical bleb. After lengthy discussion addressing patient and parental concerns, elective surgical management was pursued. Current literature suggests blebs are not routinely identified on CXR. While there is no universally accepted management algorithm for PSP in children, visible apical blebs on CXR may influence the decision to pursue surgical intervention. Shared decision making should involve counseling regarding the recurrence risk following surgery, and consideration of patient-specific factors including patient and parental anxiety.

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An Anterior Cingulate Cortex-to-Midbrain Projection Controls Chronic Itch in Mice.

Itch is an unpleasant sensation that provokes the desire to scratch. While acute itch serves as a protective system to warn the body of external irritating agents, chronic itch is a debilitating but poorly-treated clinical disease leading to repetitive scratching and skin lesions. However, the neural mechanisms underlying the pathophysiology of chronic itch remain mysterious. Here, we identified a cell type-dependent role of the anterior cingulate cortex (ACC) in controlling chronic itch-related excessive scratching behaviors in mice. Moreover, we delineated a neural circuit originating from excitatory neurons of the ACC to the ventral tegmental area (VTA) that was critically involved in chronic itch. Furthermore, we demonstrate that the ACC→VTA circuit also selectively modulated histaminergic acute itch. Finally, the ACC neurons were shown to predominantly innervate the non-dopaminergic neurons of the VTA. Taken together, our findings uncover a cortex-midbrain circuit for chronic itch-evoked scratching behaviors and shed novel insights on therapeutic intervention.

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Spesolimab improves patient-reported outcomes in patients with generalized pustular psoriasis: results from the Effisayil 1 study.

Generalized pustular psoriasis (GPP) is a rare inflammatory skin disease with a considerable clinical burden. In the Effisayil 1 study, spesolimab, an anti-interleukin-36 receptor monoclonal antibody, demonstrated efficacy in treating GPP flares.

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Progestins in the symptomatic management of endometriosis: a meta-analysis on their effectiveness and safety.

Endometriosis is a complex chronic disease that affects approximately 10% of women of reproductive age worldwide and commonly presents with pelvic pain and infertility.

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Emraclidine, a novel positive allosteric modulator of cholinergic M4 receptors, for the treatment of schizophrenia: a two-part, randomised, double-blind, placebo-controlled, phase 1b trial.

Emraclidine is a novel, brain-penetrant, highly selective M4 receptor positive allosteric modulator in development for the treatment of schizophrenia. We aimed to evaluate the safety and tolerability of multiple ascending doses of emraclidine in patients with schizophrenia.

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