Rejected

This study evaluated the effectiveness and safety of botulinum toxin type A (BoNT-A) and pulsed radiofrequency (RF) in the clinical treatment of postherpetic neuralgia (PHN). A total of 100 patients with PHN were randomly divided into two groups ( = 50 per group): RF group and BoNT-A group. Based on conventional drug treatment, patients were treated with either a single nerve root pulsed radiofrequency therapy or a single local subcutaneous injection of BoNT-A in the lesion area. All the patients were followed up for 24 weeks on pain scores, sleep quality, anxiety, and depression scores, etc. In the last follow-up at the end of 24 weeks postoperation, the pain scores of patients in both groups were significantly lower than those before the operation ( < 0.05), indicating that both treatments were effective against PHN; however, there was no significant difference between these two groups ( > 0.05). It is noteworthy that the subcutaneous injection of BoNT-A is relatively easy to administer and less expensive compared to RF. Therefore, we believe that the subcutaneous injection of BoNT-A is an effective and safe method for the treatment of PHN.

The single patient (n-of-1) trial can be used to resolve therapeutic uncertainty for the individual patient. Treatment alternatives are systematically tested against each other, generating patient-specific data used to inform an individualized treatment plan. We hypothesize that clinical decisions informed by n-of-1 trials improve patient outcomes compared to usual care. Our objective was to provide an overview of the clinical trial evidence on the effect of n-of-1 trials on clinical outcomes.

Neck and back pain afflicts millions of people. Magnetotherapy has shown to have anti-inflammatory effects that could act on pain generation, but the literature lacks provide a precise therapeutic protocol.

To investigate the association of pain with plasma C5a levels and other related inflammatory cytokines in neuromyelitis optica spectrum disorders (NMOSD) patients during remission.

Tenosynovial giant cell tumors (TGCT) are rare and locally aggressive neoplasms in synovium, bursae, and tendon sheaths, which cause pain, joint dysfunction, and damage to the affected joints. To evaluate the surgical patterns and economic burden among patients with TGCT who underwent joint surgery in the United States. Patients newly diagnosed with TGCT, aged 18-64 years, who underwent joint surgery post-TGCT diagnosis were identified from the OptumHealth Care Solutions, Inc database (Q1/1999-Q1/2017). Patients were required to be continuously enrolled for ≥1 year before and ≥3 years after the first TGCT diagnosis (index date). Surgical patterns were assessed post-index. Healthcare resource utilization and associated healthcare costs, and indirect costs related to work loss in year 1, year 2, and year 3 post-index, were compared with those at baseline. Of 835 eligible TGCT patients, 462 (55%) patients who had ≥1 joint surgery post-index were included. During a median follow-up of 5.7 years, 78% of patients underwent their first joint surgery in year 1 and 41% had ≥1 repeat surgery. Magnetic resonance imaging utilization was highest during baseline (46%) and declined afterward (28%, 17%, and 19% in years 1, 2, and 3, respectively). Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy, occupational therapy, and rehabilitation services, were commonly used during baseline (45%, 40%, and 30%, respectively). More patients used opioids in year 1 vs baseline (78% vs 45%; <0.0001), while its utilization return to baseline levels in year 2 (41%) and year 3 (42%). A similar pattern was observed for NSAIDs and physical/occupational therapy/rehabilitation services. Healthcare resource utilization and associated healthcare costs surged in year 1 and returned to baseline or lower in years 2 and 3. A similar pattern was observed for indirect costs associated with work loss. The high proportion of patients undergoing repeat surgeries and prevalent use of opioids, NSAIDs, and physical/occupational therapy/rehabilitation services suggests an unmet medical need after surgical treatment. Surgical resection alone might be inadequate to control TGCT. New treatment options may complement surgery and alleviate the clinical and economic burden experienced by patients with TGCT who had received prior surgery.

Moyamoya is a rare progressive cerebral arteriopathy, occurring as an isolated phenomenon (moyamoya disease, MMD) or associated with other conditions (moyamoya syndrome, MMS), responsible for 6-10% of all childhood strokes and transient ischemic attacks (TIAs).

The aim of this study was to explore the association between sagittal spinopelvic alignment and persistent low back pain (PLBP) following posterior decompression and instrumented fusion for mild L5-S1 spondylolisthesis.

Complete relief of pain due to irreversible pulpitis is challenging to obtain with analgesic medications. The high incidence of an inferior alveolar nerve block (IANB) failure makes it difficult for practitioners to perform endodontic treatment without implementing other anesthetic techniques, especially mandibular molars. The aim of this study was to compare efficacies of two different quantities of paraformaldehyde based pulpal medicaments to relieve the pain and control hyperemic pulp post-failure of IANB and supplementary technique in patients experiencing this symptomatic irreversible pulpitis in the permanent mandibular tooth.

Chronic neck pain is a prevalent condition adversely impacting patients' wellbeing in both life and work experience. Electro-thumbtack needle (ETN) therapy, combining acupuncture with transcutaneous stimulation, might be one of the effective complementary and alternative medicine (CAM) therapies in treating chronic neck pain, although the evidence is scarce. This study aims to estimate the efficacy and safety of ETN therapy for chronic neck pain.

The problem of painful and disabling work-related musculoskeletal disorders (MSDs) is increasing in many employment sectors of Latvia. Official statistics may underestimate the proportion of affected employees, causing delays in preventive interventions, ineffective rehabilitation, and a reduction of the workforce. This study investigated the prevalence of painful health conditions among Latvian workers by analyzing survey data and comparing these to official statistics on registered occupational diseases (ODs). A total of 2,446 workers participated in the state-level "Work conditions and risks in Latvia, 2017-2018" survey that included questions about pain lasting longer than 3 days during the previous year. The frequency of subjective reports on the presence, severity, and location of pain and related behaviors was assessed in relation to sex, age, education, and job position. Descriptive statistics and cross tabulation with the chi-squared test as well as multinomial logistic regression were applied to the data. Overall, 27.7% of respondents ( = 678) reported experiencing pain, predominantly in the lower back (14.3%) and mostly moderate (47.1%) or severe (45.1%). Only one-fifth of respondents (20.5%) took sick leave from work and one-third (29.0%) did not take action to alleviate their pain. Participants aged 55-74 years had a significantly higher odds ratio (OR) for pain in at least one body region-including hands and legs-than those aged 18-24 years. Women had significantly higher odds of headache (OR = 2.55) and neck pain (OR = 1.85) than men. Respondents with a primary or elementary education level had higher odds of pain in at least one body region (OR = 1.60) and in the lower back (OR = 1.86), while those with secondary education had higher odds of pain in hands (OR = 1.51) than employees with higher education. Unskilled workers had significantly higher odds of pain in hands (OR = 2.42) and legs (OR = 2.12) than directors. Official data revealed a dramatic increase in the proportion of MSDs and related disabilities in the last decade, reaching 75.5% of all first registered ODs in 2019. These results demonstrate a high prevalence of painful conditions among Latvian employees; urgent attention to diagnostics, treatment, and prevention is needed to ensure the musculoskeletal health and productivity of this population.