Rejected

We describe a case of an orthotopic heart transplant recipient who presented with chest pain related to blunt chest trauma 3 weeks post-transplantation. Electrocardiogram showed anterior ST-segment elevation. Coronary angiography revealed a dissection of the mid-distal left anterior descending artery with preserved antegrade flow. Conservative management of the coronary artery dissection was pursued. While the patient had a favorable long-term clinical outcome, the coronary dissection persisted on 1- and 2-year follow-up coronary angiography.

Chronic wounds, ie, non-healing ulcers, have a prevalence of ~1% in the general population. Chronic wounds strongly affect the quality of life and generate considerable medical costs. A fraction of chronic wounds will heal within months of appropriate treatment; however, a significant fraction of patients will develop therapy-refractory chronic wounds, leading to chronic pain, infection, and amputation. Given the paucity of therapeutic options for refractory wounds, cell therapy and in particular the use of adipose-derived stromal cells (ASC) has emerged as a promising concept. ASC can be used as autologous or allogeneic cells. They can be delivered in suspension or in 3D cultures within scaffolds. ASC can be used without further processing (stromal vascular fraction of the adipose tissue) or can be expanded in vitro. ASC-derived non-cellular components, such as conditioned media or exosomes, have also been investigated. Many in vitro and preclinical studies in animals have demonstrated the ASC efficacy on wounds. ASC efficiency appears to occurs mainly through their regenerative secretome. Hitherto, the majority of clinical trials focused mainly on safety issues. However more recently, a small number of randomized, well-controlled trials provided first convincing evidences for a clinical efficacy of ASC-based chronic wound therapies in humans. This brief review summarizes the current knowledge on the mechanism of action, delivery and efficacy of ASC in chronic wound therapy. It also discusses the scientific and pharmaceutical challenges to be solved before ASC-based wound therapy enters clinical reality.

Extreme angles in lower body joints may adversely increase the risk of injury to joints. These injuries are common in the workplace and cause persistent pain and significant financial losses to people and companies. The purpose of this study was to predict lower body joint angles from the ankle to the lumbosacral joint (L5S1) by measuring plantar pressures in shoes. Joint angle prediction was aided by a designed footwear sensor consisting of six force-sensing resistors (FSR) and a microcontroller fitted with Bluetooth LE sensors. An Xsens motion capture system was utilized as a ground truth validation measuring 3D joint angles. Thirty-seven human subjects were tested squatting in an IRB-approved study. The Gaussian Process Regression (GPR) linear regression algorithm was used to create a progressive model that predicted the angles of ankle, knee, hip, and L5S1. The footwear sensor showed a promising root mean square error (RMSE) for each joint. The L5S1 angle was predicted to be RMSE of 0.21° for the X-axis and 0.22° for the Y-axis, respectively. This result confirmed that the proposed plantar sensor system had the capability to predict and monitor lower body joint angles for potential injury prevention and training of occupational workers.

Chronic low back pain secondary to degenerative changes in the spine is a common cause of disability, and disc degeneration is one of the most frequent imaging findings. Intervertebral vacuum phenomenon (IVP) is usually observed in advanced degeneration. Recently, this phenomenon has gained interest due to a relatively new surgical technique called percutaneous discoplasty, aimed at treating low back pain secondary to degenerative disc disease in elderly patients.

species, including willow trees, are distributed in the temperate regions of Asian countries, including South Korea. Willow trees are used to treat pain and inflammatory diseases. Due to the medicinal properties of willow trees, pharmacological studies of other spp. have gained attention; however, only a few studies have investigated the phytochemicals of these species. As part of our ongoing natural product research to identify bioactive phytochemicals and elucidate their chemical structures from natural resources, we investigated the marker compounds from indigenous Korean species, namely, , , , , , , , and . The ethanolic extract of each sp. was investigated using high-performance liquid chromatography combined with thin-layer chromatography and liquid chromatography-mass spectrometry-based analysis, and marker compounds of each sp. were isolated. The chemical structures of the marker compounds (), 3-(4-hydroxyphenyl)propyl β-D-glucopyranoside (), 2–acetylsalicin (), 1—coumaroyl glucoside (), picein (), isograndidentatin B (), 2'–acetylsalicortin (), dihydromyricetin (), and salicin () were elucidated via nuclear magnetic resonance spectroscopy and high-resolution liquid chromatography-mass spectrometry using ultrahigh-performance liquid chromatography coupled with a G6545B Q-TOF MS system with a dual electrospray ionization source. The identified marker compounds were examined for their antimicrobial effects against plant pathogenic fungi and bacteria. Dihydromyricetin () exhibited antibacterial activity against , inducing 32.4% inhibition at a final concentration of 125 μg/mL with an MIC value of 250 μg/mL. Overall, this study isolated the marker compounds of , , , , , , , and and identified the anti- bacterial compound dihydromyricetin.

Structural cardiac injury after blunt trauma is uncommon but usually life-threatening. While tricuspid injury is very rare and potentially lethal, the right heart can accommodate larger volumes and higher pressures in acute tricuspid insufficiency and facilitate initial stabilization prior to definitive valvular repair. ECMO may be used to ameliorate resulting right heart failure. The traumatic force required to cause cardiac structural injury is also associated with pulmonary complications related to pneumothorax, hemothorax, effusion, acute pain secondary to rib fractures, and pulmonary contusions causing hypoxia. We present an unusual case of hypoxia in a trauma patient caused by acute tricuspid regurgitation with pre-existing patent foramen ovale.

Traditional epidural test dose is somewhat unsuited in obstetrics because of potential risk of severe adverse effects when it is accidentally injected into the subarachnoid space. Some hospitals use a proportion of the total dose of epidural labor analgesia as a test dose. The aim of our study was to assess the effectiveness and safety of ropivacaine 5 mg with sufentanil 2.5 μg to detect intrathecal injection.

The objective was to investigate if age and gender affect the importance of domains of functioning when grading disability related to neck pain. Multi-group confirmatory factor analysis of register-based data on 392 patients undergoing cervical surgery was applied. The main outcome was item loadings on a common factor. The mean age was 55 years and 52% were women. The factor structure was different for both gender and age groups, P < 0.0001. Reading, driving, pain intensity, and recreational activity had the highest loadings while headaches, lifting, and sleep placed the lowest. Reading and pain intensity had bigger weight among men than women, while recreational activity and driving had higher loadings in women. Reading and work were more important for the younger than for the older respondents, while recreational activity was more important for the older respondents. The importance of factors determining disability caused by neck pain may vary by gender and age.

Fibromyalgic Syndrome is an important public health burden and affects up to 5% of the world population. It requires a complex treatment plan, possibly including antidepressants, anticonvulsants and benzodiazepines, which may in turn affect the patients' quality of life: hence the need to find additional therapies. The current pilot randomized-controlled study analyzes the effect of electromagnetic field locally administered as add-on therapy in the treatment of cervico-facial pain in patients with fibromyalgic syndrome. 17 patients were selected and low-frequency electromagnetic field was applied via small patches worn in the neck area, between vertebrae C3-C4. Patients were divided into 2 groups, Treated, receiving the therapy, and Placebo, receiving an identical device which was not working,, with respectively 8 and 9 patients. The whole follow up period was 12 months and facial/cervical pain levels were rated using VAS scale. Significant differences were found between patients who received placebo and those treated. Treated patients showed statistically significant improvements in facial/cervical pain at each time-point, both with respect to the previous one and if compared to placebo. In conclusion, low frequency electromagnetic field emerged as beneficial in treating cervico-facial pain in patients with Fibromyalgic syndrome, with no side effects.

Personality traits are one of the major factors influencing the behavior and functioning of an individual, and they play a crucial role in the development of psychosomatic disorders and diseases. This paper aimed to evaluate the importance of personality traits in temporomandibular disorder (TMDs) development using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five). Moreover, the relationship between personality type and the intensity of dysfunctional changes in the stomatognathic system was assessed using the NEO-FFI Personality Inventory by Paul Costa and Robert McCrae (the Five-Factor Model of Personality, known as the Big Five).