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Analysis of short-term efficacy of radiofrequency thermocoagulation in the treatment of classic trigeminal neuralgia.

The objectives of the study were to explore the short-term efficacy of radiofrequency thermocoagulation for the treatment of classic trigeminal neuralgia (TGN). A retrospective analysis of 58 patients with classical TGN treated with radiofrequency thermocoagulation at our institution between 2016 and 2019, including 23 men and 35 women. The mean age of all patients was 62.1±10.9 years, the duration of the disease ranged from 2 months to 360 months, and the mean duration of the disease was 80.1±77.9 months. Patients were divided into three groups, V2, V3, and V2+V3, according to the site of symptom presenta-tion. Treatment effectiveness was evaluated by observing patients' before surgery, after surgery, and 1-year after surgery visual pain simulation (VAS) scores. The clinical efficacy was evaluated by calculating the percentage of patients whose net improve-ment in VAS scores of the three groups of patients V2, V3, and V2+V3 reached the minimal clinically important differences MCID value of TGN. Patients' after surgery VAS scores and 1-year after surgery VAS scores all showed meaningful improvement (p<0.001) compared with pre-operative VAS scores, and after surgery VAS scores showed meaningful change (p<0.05) com-pared with 1-year after surgery VAS scores. About 84.62%, 95.45%, and 86.96% of patients in V2, V3, and V2+V3 groups showed net improvement in after surgery VAS scores to MCID values, and 69.2%, 86.4%, and 74.0% of patients in 1-year after surgery VAS scores showed net improvement to MCID values, respectively. The early efficacy of radiofrequency thermocoagulation for classic TGN is significant, but patients have a tendency to have recurrence of pain symptoms 1 year after surgery.

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Psoriatic Spondylitis: A Disease Manifestation in Debate: Evidences to Know for the Clinical Rheumatologist.

With the advent of classification criteria for psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), patients with axial manifestations associated with psoriasis, initially described in the l950s as a specific entity termed psoriatic spondylitis (PS), are now categorized within PsA, ankylosing spondylitis (AS), and axSpA. Thus, different terms are used to describe axial disease in patients with PsA including PS, axial psoriatic arthritis (axPsA), and psoriatic spondyloarthritis. Patients with PS may present with inflammatory and/or mechanical back pain, but also may display axial disease on imaging despite not complaining of back pain. Cervical spondylitis has been reported in 35% to 75% of patients with PsA. Axial disease is silent in 20% and 25% of patients with axial PsA and PsA, respectively. The majority of axPsA patients have peripheral arthritis alongside the axial involvement, whereas only 2% to 5% of PsA patients have solely axial arthritis with no peripheral arthritis.A debate is currently underway as to whether inflammatory axial disease and psoriasis represent axSpA with psoriasis or a subset of PsA named axPsA. Studies have recognized that axial disease in PsA patients seems to be different demographically, genetically, clinically, and radiographically when compared with AS with or without psoriasis. This narrative review summarizes current knowledge regarding axial involvement of PsA in terms of history, terminology, classification, epidemiology, clinical presentation, imaging, diagnosis, and treatment, with the aim of providing advice for management of PS in clinical evidence-based practice. Data-driven studies are needed to develop clear, nonoverlapping classification criteria for spinal involvement in PsA.

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Diagnosis of comorbid migraine without aura in patients with idiopathic/genetic epilepsy based on the gray zone approach to the International Classification of Headache Disorders 3 criteria.

Migraine without aura (MwoA) is a very frequent and remarkable comorbidity in patients with idiopathic/genetic epilepsy (I/GE). Frequently in clinical practice, diagnosis of MwoA may be challenging despite the guidance of current diagnostic criteria of the International Classification of Headache Disorders 3 (ICHD-3). In this study, we aimed to disclose the diagnostic gaps in the diagnosis of comorbid MwoA, using a zone concept, in patients with I/GEs with headaches who were diagnosed by an experienced headache expert.

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Long-term effect of anesthesia choice on patients with hepatocellular carcinoma undergoing open liver resection.

Clinical and experimental evidence suggested that anesthesia choice can influence cancer progression and patients' outcomes by modulating tumor microenvironment and tumorigenic pathways. Curative resection is the mainstay of therapy for hepatocellular carcinoma (HCC), which is an intractable disease due to high recurrence and poor prognosis. However, different anesthetics may play different roles in alleviating surgery-induced stress response and inflammatory cytokines release that are considered to be closely associated with proliferation, invasion and metastasis of tumor cells. Propofol, sevoflurane, non-steroidal anti-inflammatory drugs and local anesthetics have shown to exert anti-tumor effect on HCC mainly through regulating microRNAs or signaling pathways, while other inhalational agents, dexmedetomidine and opioids have the potential to promote tumor growth. In terms of anesthetic methods and analgesia strategies, propofol based total intravenous anesthesia and thoracic epidural analgesia could be preferred for HCC patients undergoing open liver resection rather than inhalational anesthesia. Local anesthesia techniques have great potential to attenuate perioperative stress response, hence they may contribute to more favorable outcomes. This review summarized the relations between different anesthesia choices and HCC patients' long-term outcomes as well as their underlying mechanisms. Due to the complexity of molecules interactions and signaling pathways, further studies are warranted to confirm these results so as to optimize anesthesia strategy for HCC patients.

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Pancreatic enzyme supplementation versus placebo for improvement of gastrointestinal symptoms in non-responsive celiac disease: A cross-over randomized controlled trial.

Pancreatic Exocrine Insufficiency (PEI) is a possible cause of recurrent/persistent symptoms in celiac disease. Although pancreatic enzyme supplementation may be used to treat non-responsive celiac disease (NRCD) in clinical practice, clinical outcomes are variable and there is limited and low quality evidence to support this practice. The aim of this study was to assess the efficacy of pancreatic enzyme supplements (PES) for improvement of gastrointestinal symptoms in NRCD.

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Human monkeypox – After 40 years, an unintended consequence of smallpox eradication.

Monkeypox is one of the many zoonotic viruses that belong to the genus of the Poxviridae family with a similar clinical appearance to smallpox. The symptoms of monkeypox include fever, headache, muscle aches, and lymphadenopathy. The transmission of monkeypox occurs from infected animals to humans or through direct contact (sexual or skin-to-skin), respiratory droplets, and clothing such as towels. The incidence of monkeypox is rising drastically over the world. This short communication discusses the causes of the rising monkeypox cases and emphasizes strategies to prevent the spread of the virus.

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A Case of Calcaneal Intraosseous Lipoma along with Haglund Deformity and Chronic Tendoachilles Tear Managed using Double Row Suture Anchor Repair Augmented with FHL Graft and Curettage of Lipoma with Filling the Cavity Using Hydroxyapatite Bone Substitute

Achilles' tendon is the largest tendon in the body, Tendon is an anatomical structure with inherent less blood supply and so more prone to injury and notorious healing outcomes. The management options for tendoachilles injury depend on the location of the tear, degree of retraction of the torn ends, and patient-related factors. Intraosseous lipoma is very rare benign tumor of bone accounting for 0.1% of all bone tumors. Most common site being proximal femur involvement of calcaneum is very rare presentation. Symptomatic patients with significant heel pain need operative intervention in the form of curettage alone or in combination with filling cavity with bone graft or bone graft substitutes. Many people use PMMA bone cement to fill the void.

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polymorphism’s influence on the clinical features and therapeutic effects in patients with migraine: An observational study.

Our study aimed to evaluate the influence of methylenetetrahydrofolate reductase () polymorphism on the clinical features and therapeutic effects in patients with migraine.

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Positioning the Catheter Tip Anterior or Posterior to the Saphenous Nerve in Continuous Adductor Canal Block: A Mono-Centric Retrospective Comparative Study.

Ultrasound-guided continuous adductor canal block (cACB) is a conventional choice in patients undergoing total knee arthroplasty (TKA) for the management of the postoperative pain. This study aims to compare different catheter tip locations for cACB relative to the saphenous nerve (anteriorly vs posteriorly) in terms of efficacy and complications.

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ASSESSMENT OF THE EFFICIENCY OF ANALGETIC ACTION OF ULTRASOUND-GUIDED FICB AS A COMPONENT OF PERIOPERATIVE MULTIMODAL ANALGESIA IN ERAS- STRUCTURE IN OBESE PATIENTS UNDERGOING TOTAL HIP REPLACEMENT.

The aim: To compare the efficiency of analgetic action of Ultrasound-guided FICB and prolonged EA as the components of perioperative multimodal analgesia in ERAS-structure in obese patients undergoing THR.

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