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Treatment with ozone therapy is of interest in many fields of medicine. In the field of angiology, ozone is used to treat infected wounds that are difficult to heal. In this case report, the authors report the introduction of innovative therapeutic equipment into clinical practice to accelerate the healing process of clinical wounds by the external application of ozone in various forms. They present positive results of the comprehensive treatment of a 52-year-old woman with an ulcer on her right lower leg, which formed after a previous orthopedic surgery. In addition to pharmacotherapy and compression therapy, local ozone therapy was applied. After 30 ozone therapy procedures, the ulcer healed completely, and the patient's pain was significantly alleviated, as assessed by a visual analog scale (9.0 points before therapy vs 0.5 point after therapy). As a result, the patient's quality of life improved, as assessed by the EuroQol scale (10 points before therapy vs 90 points after therapy).The use of local ozone therapy can be an appropriate complement in the comprehensive treatment of chronic wounds. In the presented case, ozone therapy helped complete healing of the ulcer and significantly reduced the intensity of pain experienced, thus improving the patient's quality of life.

Epidural anesthesia has been an established procedure in anesthesia for many years. Possibly due to its invasiveness, the associated fear of serious complications and the proliferation of alternative methods, an overall decline in its use can be observed. Several alternative procedures have been developed, especially the introduction of ultrasound into anesthesia, which are increasingly being used in clinical practice. The aim of this continuing medical education (CME) article is to shed light on the remaining range of indications for epidural anesthesia, to present the approaches and possible clinical benefits as well as to evaluate the effects that go beyond pure analgesia, according to the current evidence. In addition, potential complications and preventive approaches are discussed. This article is based on a literature search in PubMed and Google Scholar.

Osteoarthritis is a common chronic degenerative disease that causes pain and disability with increasing incidence worldwide. The osteochondral junction is a dynamic region of the joint that is associated with the early development and progression of osteoarthritis. Despite the substantial advances achieved in the imaging of cartilage and application to osteoarthritis in recent years, the osteochondral junction has received limited attention. This is primarily related to technical limitations encountered with conventional MR sequences that are relatively insensitive to short T2 tissues and the rapid signal decay that characterizes these tissues. MR sequences with ultra-short echo time (UTE) are of great interest since they can provide images of high resolution and contrast in this region. Here we briefly review the anatomy and function of cartilage, focusing on the osteochondral junction. We also review basic concepts and recent applications of UTE MR sequences focusing on the osteochondral junction.

Acetaminophen is routinely used for perioperative analgesia in children undergoing major surgical procedures. There are few estimates of acetaminophen pharmacokinetic parameters in children with congenital heart disease, especially those with cyanotic heart disease.

The use of virtual interventions is of interest to patients with chronic disease and healthcare professionals. This study aimed to determine the effect of virtual child disease management programme on burden and social adjustment of caregivers of children with coagulation factor deficiencies. Moreover, the effect of this intervention on children's acute pain and bleeds was assessed.

Strongyloidiasis, an intestinal parasitic infection caused by Strongyloides stercoralis, rarely occurs in Japan. When treated with immunosuppressive drugs, two potentially lethal conditions, hyperinfection and dissemination, may develop in asymptomatic carriers of this parasite. We report development of strongyloidiasis during treatment of polymyositis with glucocorticoids plus rituximab. A 44 year-old woman had been diagnosed with anti-signal recognition particle antibody-positive polymyositis with interstitial pneumonia 6 years previously, for which she had recently been receiving prednisolone at 5 mg/day and rituximab at 375 mg/m2 twice every 3 months. Her condition appeared to be well controlled. She was admitted to our hospital with a one-month history of chronic diarrhoea and epigastric pain. Standard microscopic examination of a sample of feces revealed the presence of S. stercoralis; however, serologic testing for parasites was negative. Treatment with ivermectin alleviated her inflammatory diarrhea and eradicated the fecal parasites. We believe that our patient had an exacerbation of S. stercoralis infection (hyperinfection syndrome) that was exacerbated by low-dose glucocorticoids plus rituximab. Strongyloidiasis should be considered in immunocompromised individuals with unexplained diarrhea, even in non-endemic areas.

This study assessed the safety and effectiveness of vonoprazan for prevention of duodenal and gastric ulcer recurrence in patients on long-term nonsteroidal anti-inflammatory drugs (NSAIDs) in routine clinical practice.

Sinonasal inverted papilloma (SNIP) is one of the most common benign tumors of the nasal cavity and sinuses and is at risk for recurrence and malignant transformation. It is crucial to precisely predict SNIP before surgery to determine the optimal surgical technique and prevent SNIP recurrence. This study aimed to evaluate the diagnostic value of computed tomography (CT) features and SNIP clinical characteristics and to develop and validate a clinically effective nomogram. Here, 267 patients with SNIP and 273 with unilateral chronic rhinosinusitis with/without nasal polyps were included. Patient's demographic and clinical characteristics (i.e., gender, age, nasal symptoms, history of sinus surgery, smoking, and alcohol dependence) and CT features (i.e., lobulated/wavy edge, air sign, focal hyperostosis, diffuse hyperostosis, focal osseous erosion, and CT values) were recorded. Independent risk factors were screened using logistic regression analysis. A nomogram model was developed and validated. Logistic regression analysis showed that age, facial pain/headache, history of sinus surgery, lobulated/wavy edge, air sign, focal hyperostosis, focal osseous erosion, and CT values were independent predictors of SNIP. A nomogram comprising these 8 independent risk factors was established. The area under the curve (AUC) for the training set was .960 (95% CI, .942-.978) and the AUC for the validation set was .951 (95% CI, .929-.971). The obtained results suggested that the nomogram based on age, facial pain/headache symptoms, history of sinus surgery, and CT characteristics had an excellent diagnostic value for SNIP.

Implementing tools that identify cost-saving opportunities for ambulatory orthopaedic surgeries can improve access to value-based care. We developed and internally validated a machine learning (ML) algorithm to predict cost drivers of total charges after ambulatory unicompartmental knee arthroplasty (UKA).

To determine the effectiveness of laser therapy for managing patients with orofacial pain (OFP). In addition, to determine which parameters provide the best treatment effects to reduce pain, improve function, and quality of life in adults with OFP.