Rejected

Work-related musculoskeletal disease (MSD) is the second leading cause of disability globally. Ophthalmologists widely report MSDs in the neck (70%) and back pain (40-80%). Our study intended to identify the prevalence of MSDs among pediatric ophthalmologists.

Lichenoid reaction (LR) is a relatively common mucocutaneous disease with an unknown etiology. Since the cause of the LRs is unknown, many drugs have been studied to palliate the symptoms. Previous studies reported that corticosteroids are often effective in the management of several oral inflammatory diseases. The aim of the present study was to compare the effect of Melissa gel and triamcinolone 0.1% paste on clinical indices of oral LRs.

Many studies already reported on the association between patient characteristics on the severity of COVID-19 disease outcome, but the relation with SARS-CoV-2 antibody levels is less clear. To investigate this in more detail, we performed a retrospective observational study in which we used the IgG antibody response from 11,118 longitudinal antibody measurements of 2,082 unique COVID convalescent plasma donors. COVID-19 symptoms and donor characteristics were obtained by a questionnaire. Antibody responses were modelled using a linear mixed-effects model. Our study confirms that the SARS-CoV-2 antibody response is associated with patient characteristics like body mass index and age. Antibody decay was faster in male than in female donors (average half-life of 62 versus 72 days). Most interestingly, we also found that three symptoms (headache, anosmia, nasal cold) were associated with lower peak IgG, while six other symptoms (dry cough, fatigue, diarrhoea, fever, dyspnoea, muscle weakness) were associated with higher IgG concentrations.

Chronic low back pain remains highly prevalent, costly, and the leading cause of disability worldwide. Symptoms are complex and treatment involves an interdisciplinary approach. Due to diverse anatomical etiologies, treatment outcomes with interventional options are highly variable. A novel approach to treating chronic axial low back pain entails the use of peripheral nerve stimulation to the lumbar medial branch nerve, and this review examines the clinical data of the two different, commercially available, non-spinal neuromodulation systems. This review provides the clinician a succinct narrative that presents up-to-date data objectively. Our review found ten clinical studies, including one report of two cases, six prospective studies, and three randomized clinical trials published to date. Currently, there are different proposed mechanisms of action to address chronic axial low back pain with different implantation techniques. Evidence suggests that peripheral nerve stimulation of the lumbar medial branch nerve may be effective in improving pain and function in patients with chronic axial low back pain symptoms at short and long term follow up, with good safety profiles. Further long-term data is needed to consider this intervention earlier in the pain treatment algorithm, but initial data are promising.

This study is aimed at determining the impact of work-related low back pain (LBP) on functional performance and physical capabilities.

Qingjie Fuzheng granules (QFG) exert an anticancer effect against colorectal cancers (CRC). However, the pharmacological molecular mechanisms are still unclear. This study was aimed to establish a simple method to predict targets of QFG against CRC by the network pharmacology strategy. 461 compounds and 1559 targets in QFG were enriched by BATMAN-TCM. 21 of the common targets were obtained by the groups of "Jun," "Chen," "Zuo," and "Shi" medicine in QFG. The enrichment analyses of GO functional terms, KEGG pathway, and OMIM/TTD diseases displayed the targets in the different and complementary effects of four functional medicines in QFG. Then, 613 differential targets for QFG in CRC were identified. GO functional terms and KEGG pathway analyses showed that QFG regulated the inflammatory function and lipid metabolic process. There were also targets that played a role in the binding to the receptors in membranes, in the activation of the transportation signal, and provided pain relief by regulation of the neural related pathways. Next, the protein-protein interaction network was analyzed, and the levels of the predicted targets in CRC primary tumor were explored, and 7 candidate targets of QFG against CRC were obtained. Furthermore, with real-time PCR and enzyme-linked immunosorbent assay (ELISA) analysis, downregulation of dopamine D2 receptor (DRD2) and interleukin-6 (IL-6), and upregulation of interleukin-10 (IL-10) were identified following the treatment of QFG. At last, the survival and prognosis of the potential targets of QFG in CRC patients were analyzed by GenomicScape, and IL-6 was suggested to be an index for the regulation of QFG in CRC. These results might elucidate the possible antitumor mechanism of QFG and highlight the candidate therapeutic targets and the application direction in clinical treatment for QFG.

Idiopathic intracranial hypertension (IIH) is a clinical syndrome characterised by headache and papilloedema that can lead to significant visual morbidity. There are few studies in the literature about the visual outcome of IIH. We have reviewed the record of 76 patients with IIH according to the modified Dandy criteria. There was a significant improvement in the Humphrey 24-2 mean deviation (MD) in the study eyes (worse affected eye at presentation) in both the medically treated group (+2.0 dB; from -5.60 dB at baseline to -3.60 dB at final follow-up, < .01) and in the fellow eyes in the medically treated group (+1.70 dB, from -4.40 dB at baseline to -2.74 dB at final follow-up, < .01). Higher papilloedema grade (beta -0.66, < .001) and age ( < .02) were inversely correlated with the final visual field MD in the study eye. The visual outcome for the IIH patients in our study was predominantly favourable, but patients with high-grade papilloedema had a worse visual prognosis and required more aggressive treatment.

Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key factors in the etiology and pathophysiology of anxiety- and stress-related psychosomatic disorders. In these overlapping conditions, avoidance can increase the risk of mental comorbidities and interfere with the efficacy of cognitive behavioral treatment approaches built on fear extinction. Despite resurging interest in avoidance research also in the context of psychosomatic medicine, especially in conditions associated with pain, disturbed interoception, and disorders of the gut-brain axis, current study designs and their translation into the clinical context face significant challenges limiting both, the investigation of mechanisms involved in avoidance and the development of novel targeted treatment options. We herein selectively review the conceptual framework of learning and memory processes, emphasizing how classical and operant conditioning, fear extinction, and return of fear shape avoidance behaviors. We further discuss pathological avoidance and safety behaviors as hallmark features in psychosomatic diseases, with a focus on anxiety- and stress-related disorders. Aiming to emphasize chances of improved translational knowledge across clinical conditions, we further point out limitations in current experimental avoidance research. Based on these considerations, we propose means to improve existing avoidance paradigms to broaden our understanding of underlying mechanisms, moderators and mediators of avoidance, and to inspire tailored treatments for patients suffering from psychosomatic disorders.

During recent years, the detection of osteoarticular infections has increased, thanks to improvement and wide availability of diagnostic tools. Despite that, surgeons and patients still have to deal with long-term sequelae, including osteoarthritis, chronic osteomyelitis, and premature physeal arrest. Subsequent joint reconstruction is the most difficult challenge when the hip or knee has been affected. Most surgical procedures described to manage these devastating consequences are only palliative, with the goal focused on improving stability and pain control, but seldom ending with a highly functional joint. Premature physeal arrest has an unpredictable course after an osteoarticular infection. The prognosis depends on the age of the child, the type of injury (partial or total bony bar), the proportion of the physeal surface affected, and the bone compromised. Peripheral injuries lead to angular limb deformities, whereas central bars lead to limb-length discrepancies. Surgical treatment should be oriented to preserve physeal function and allow normal growth to resume. In those cases where preserving physeal function is not possible, the orthopaedic surgeon must deal with the sequelae of limb-length discrepancies and/or bone deformities.

Upper limb ischemia in patients with chronic kidney disease treated by haemodialysis is a known complication, but fortunately its progression into gangrene is not frequent. Ischemia occurs in 3.7-5% of dialysis patients, in dependence on the type of vascular access. The main cause behind the risk of digital upper limb ischemia in dialysis patients is the presence of an arteriovenous fistula. The higher the location of arteriovenous fistula, the higher the risk of onset of ischemia. In case of brachiocephalic and brachiobasilic fistulas, the risk for developing symptomatic ischemia is faced by 10-25% of patients, in case of radiocephalic fistula only by 1-1.8% of patients. In making the diagnosis we rely on the history of symptoms and physical examinations of both upper limbs. The patient may describe subjective symptoms as pain, having cold fingers, cramps during and outside dialysis, altered sensation and impaired finger movement. The therapy includes radiological intervention, removal of high-flow arteriovenous fistula, its closure, and amputation. The treatment aims to provide the patients with maximum possible multidisciplinary care and to prevent amputation. In this respect the orthopaedic examination is critical for further diagnosis and therapy of the patient at risk of upper limb impairment or for upper limb salvage.