Rejected

Dorsal root ganglion stimulation (DRG-S) is a form of neuromodulation used to treat chronic pain. A spinal cord stimulation (SCS) method with paresthesia-free waveform used in the dorsal columns, burst-SCS, recently demonstrated efficacy using intermittent stimulation, where stimulation is cycled on and off for set durations. Tonic SCS is a paresthesia-based therapy that is ineffective at sub-perception levels and when delivered in a cycled manner. DRG-S also uses a tonic waveform, yet unlike tonic SCS, it is effective at sub-perception levels. This study aimed to determine whether the cycling of stimulation at the DRG could maintain DRG-S efficacy.

This study aimed to investigate the physicochemical stability of morphine-ropivacaine-ziconotide mixtures used in intrathecal analgesia.

This study aimed to determine the long-term effects of dorsal root ganglion (DRG) stimulation on pain, physical function, and quality of life in patients with chronic postsurgical pain. We hypothesized that the effects of DRG stimulation would be sustainable through two years of follow-up.

Increased mechanical sensitivity has been observed on the unaffected side in chronic pain conditions, suggesting generalized or widespread hypersensitivity. However, this cannot be considered as a universal response since this hypersensitivity is inconsistent across muscle pain pathologies. The aim of this study was to assess generalized hypersensitivity in chronic unilateral shoulder pain, using pressure pain threshold (PPT) mappings of the infraspinatus muscle. The proposed evaluation is based on the assessment of PPT on a limited subset of sites, reducing potential habituation or sensitization effects.

α9-containing nicotinic acetylcholine receptors (nAChRs) have been shown to play critical roles in neuropathic pain. The α-conotoxin (α-CTx) RgIA and its analog RgIA4 were identified as the most selective inhibitor of α9α10 nAChR. However, the mechanism of their selectivity toward α9α10 nAChR remains elusive. Here, we reported the co-crystal structure of RgIA and RgIA4 in complex with acetylcholine binding protein (-AChBP) at resolution of 2.6 Å, respectively. Based on the structure of the complexes, together with molecular dynamic simulation (MD-simulation), we suggested the key residues of α9α10 nAChR in determining its high affinity for RgIA/RgIA4. This is the first time the complex between pain-related conotoxins and -AChBP was reported and the complementary side of α9 subunit in binding of the antagonists shown. These results provide realistic template for the design of new therapeutic in neuropathic pain.

Morphologically and functionally identical to brain synapses, the nerve ending particles synaptosomes are biochemically derived membrane structures responsible for the transmission of neural information. Their surface and mechanical properties, measured in vitro, provide useful information about the functional activity of synapses in the brain in vivo. Glutamate and kainic acid are of particular interest because of their role in brain pathology (including causing seizure, migraine, ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hematoma, traumatic brain injury and stroke). The effects of the excitatory neurotransmitter L-glutamic acid and its agonist kainic acid are tested on Na, K-ATPase and Mg-ATPase activities in synaptic membranes prepared from the cerebral cortex of rat brain tissue. The surface parameters of synaptosome preparations from the cerebral cortex in the presence of L-glutamic and kainic acids are studied by microelectrophoresis for the first time. The studied neurotransmitters promote a significant increase in the electrophoretic mobility and surface electrical charge of synaptosomes at 1-4 h after isolation. The measured decrease in the bending modulus of model bimolecular membranes composed of monounsaturated lipid 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine provides evidence for softer membranes in the presence of L-glutamate. Kainic acid does not affect membrane mechanical stability even at ten-fold higher concentrations. Both the L-glutamic and kainic acids reduce acetylcholinesterase activity and deviation from the normal functions of neurotransmission in synapses is presumed. The presented results regarding the modulation of the enzyme activity of synaptic membranes and surface properties of synaptosomes are expected by biochemical and biophysical studies to contribute to the elucidation of the molecular mechanisms of neurotransmitters/agonists' action on membranes.

The study authors sought to compare outcomes in patients with severe mitral valve regurgitation (MR) undergoing urgent, as compared to elective, mitral valve repair employing MitraClip. They hypothesized that, compared to elective cases, MitraClip procedures performed for urgent indications would be associated with increased intraoperative and postoperative complications but have similar long-term outcomes.

Although the symptoms and radiographic signs may mimic rhinogenic sinusitis, odontogenic sinusitis (OS) with periapical lesions (PALs) is fundamentally an endodontic infection. It is considered to be one of the main causes of OS, especially when presented unilaterally. Despite this routine dental examination is not performed and periapical infection frequently remains undiagnosed by otolaryngologists and radiologists.

Trends in phototherapy utilization including its main clinical indications were last characterized by Luersen et al. for the time period of 1997-2010. In this study, we update data on the use of phototherapy in the United States from 2015-2018. We queried the National Ambulatory Medical Care Survey (NAMCS) data on number of phototherapy visits as well as demographics and associated dermatoses. There were an approximately 1.31 million outpatient phototherapy visits during the study period with a decreasing trend over time. Leading indications for phototherapy were dermatitis not otherwise specified (NOS), (25.7%) followed by atopic dermatitis (AD) (11.7%), and pruritus (9.7%). There is a downtrend in the use of phototherapy from 2015-2018. Psoriasis is no longer the main indication for phototherapy, which may be due to the advent of highly effective novel biologics.

Aquatic exercise is being increasingly recommended for healthy individuals as well as people with some special health conditions. A systematic review with meta-analysis was performed to synthesize and analyse data on the effects of water-based training (WT) programs on health status and physical fitness of healthy adults and adults with diseases to develop useful recommendations for health and sports professionals. We searched three databases (PubMed, Web of Science, and Scopus) up to June 2021 for randomized trials that examined WT in adults. A total of 62 studies were included, of which 26 involved only healthy individuals and 36 focused on adults with chronic diseases. In the healthy group, the effects of WT on strength, balance, and cardiorespiratory fitness were beneficial, indicating the usefulness of performing WT for at least 12 weeks (2-3x/week, 46-65 min/session). Among adults with diseases, improvements were observed in patients with fibromyalgia (in balance and cardiorespiratory fitness), bone diseases (pain, balance, flexibility and strength), coronary artery disease (strength and anthropometry), hypertension (quality of life), stroke (quality of life), diabetes (balance and quality of life), multiple sclerosis (quality of life and balance), and Parkinson's disease (pain, gait, cardiorespiratory fitness and quality of life). Research is required to determine the effects of WT on patients with heart disease, especially coronary artery disease. In adults with chronic disease, benefits in physical fitness and/or other health-related measures were mainly observed after 8-16 weeks of training. WT is an effective physical activity when the intention is to enhance health and physical fitness in healthy adults and adults with chronic diseases.