Rejected

Pelvic fractures and sacroiliac joint (SI) diastasis are debilitating injuries which can drastically decrease an individual's functional capacity, and lead to significant morbidity and mortality. In younger, healthier populations, pelvic fractures are usually the result of sudden traumatic forces, such as a motor vehicle collision. Atraumatic pelvic fractures can also occur, and are most commonly due to age related changes and osteoporosis. Even with prompt surgical management, pelvic fractures often result in a host of challenging complications such as disruption of the SI joint with subsequent limitations in mobility and chronic pain. In this case report, we present a novel treatment of SI diastasis, secondary to corticosteroid induced osteoporosis and pelvic fractures. We performed percutaneous bilateral poly-methyl-methacrylate (PMMA) SI joint fusions under CT-guidance. Here we describe a case of bilateral SI joint CT guided percutaneous arthroplasty for osteoporotic SI joint diastasis and pelvic fractures, resulting in a rapid resolution of SI joint pain and restoration of the ability to ambulate in a previously wheelchair-bound patient. This may be of particular benefit in patients who are poor surgical candidates who experience osteoporotic fractures and would be otherwise unable to receive definitive operative management of their pathologic fractures.

Pancreatic cancer (PC) is one of the most lethal cancers and is the eleventh most common cancer worldwide. This disease is characterized by an often-fatal evolution and a high burden of symptoms, particularly pain. Several studies have demonstrated that pancreatic cancer patients have a high prevalence of pain, with up to 82% of patients reporting pain, often requiring systemic strong opioids as mainstay treatment. This comprehensive review of pancreatic cancer related pain (PCRP), focuses on current mechanisms that lead to pain including regional invasion processes, as well as the local secretion of factors that sensitize nociceptive nerves.

cortex (LRC) has been used to regulate high blood pressure, body temperature, pain and bone disorders in East Asia. Glucocorticoids (GCs), also known as steroids, are potent immunity regulators widely used in the treatment of inflammatory diseases. However, despite their effectiveness, GC usage is strictly controlled due to severe side‑effects, such as osteoporosis. However, further research is required as to date, at least to the best of our knowledge, there is no appropriate model to overcome secondary osteoporosis as a side‑effect of GC use. Thus, the aim of the present study was to establish an experimental model of osteoporosis induced by GC. Furthermore, the present study aimed to establish the research methodology for medical evaluations of the effectiveness and side‑effects of GCs. A secondary osteoporosis animal model was established, and the animals were divided into two groups as follows: The allergic contact dermatitis (ACD)‑induced group and the non‑ACD‑induced group. In the ACD‑induced group, a GC topical application group was compared with a GC subcutaneous injection group. The results revealed that the presence of ACD affected the induction of GC‑mediated osteoporosis. Therefore, the group exhibiting induced ACD that was treated with a topical application of GC was selected for examining the side‑effects of GCs. The effects of LRC on secondary osteoporosis were confirmed and . The results indicated that LRC regulated dexamethasone‑induced osteoblast apoptotic markers, including caspase‑6, caspase‑9, X‑linked inhibitor of apoptosis, apoptosis inhibitor 1 and apoptosis inhibitor 2, and increased the expression of osteoblast differentiation‑related genes, such as Runt‑related transcription factor 2 and bone morphogenetic protein 2 in the MC3T3E‑1 cell line. LRC also significantly reduced GC‑induced osteoporosis and exerted anti‑inflammatory effects . In addition, LRC inhibited the reduction of calbindin‑D28k in the kidney. Overall, the results of the present study suggest that the use of LRC alleviates GC‑induced secondary osteoporosis.

Multimodal general anesthesia based on modified intercostal nerve block (MINB) has been found as a novel method to achieve an intraoperative opioid-sparing effect. However, there is little information about the effective method to inhibit visceral nociceptive stress during single-port thoracoscopic surgery.

There is a paucity of studies investigating relationship between psychological distress and effectiveness of epidural steroid injection in patients with chronic lower back pain (CLBP).

Quadratus lumborum (QL) block has shown promising analgesic efficacy in the adult population in previous meta-analyses. However, the response of the pediatric group to pain stimulation is stronger than that in the adult population, and the management of pediatric pain is constrained by limited available analgesia agents. All data analyzed during this study are collected from published articles.

With a national rate of 82.4%, France is currently one of the world's leading users of epidural analgesia (EA), which is promoted not just as a pain reliever but also as a technology that makes childbirth safer. Drawing on analytical tools from science and technology studies, reproductive studies and ignorance studies, I will show how this obstetric drug came to be widely used after significant knowledge/ignorance battles had been fought during heated public and medical controversy in the 1970s. Different visions of the 'knowns', the 'unknowns' and 'know-how' came into conflict in this context, supported by a series of moral, political and feminist justifications that were often at odds with one another. While the defenders of natural birth clashed with feminists, created ambiguities around conceptions of the maternal body, and struggled to produce large-scale clinical knowledge on the risks of EA, the defenders of EA put forward technological promises and biomedical modernization as a means to outstrip the knowledge wars. In the aftermath of this epistemic battle, EA was to gradually become an 'unlearner' technology; that is, a modern tool that radically silenced the maternal body and led to denial, disregard or unawareness of a whole range of shared and alternative knowledges and 'know-how' relating to female physiology and the birth process that are free of pharmaceutical products and medical interventions.

Overprescription of opioids has fueled an epidemic of addiction and overdose deaths. The FDA required manufacturers of extended-release/long-acting (ER/LA) opioids to fund continuing medical education (CME) on opioids as part of a Risk Evaluation and Mitigation Strategy (REMS).

In some settings, it may be difficult to differentiate between a confounder and a mediator. For instance, the observed association of self-reported childhood psychological abuse (CPA) with onset of chronic obstructive pulmonary disease (COPD) and migraine may be confounded by current mood/psychological state (e.g., the subjective evaluation of one's own affective state), as well as mediated by an individual's psychopathological symptoms. In this study, we propose the "independence hypothesis," which could prove meaningful to explore in data that lack prospective or objective indices of CPA. We used cross-sectional data from wave VI (2007-2008) of the Tromsø Study, Norway ( N = 12,981). The associations between CPA and COPD and migraine were assessed with Poisson regression models. CPA was associated with a 46% increased risk of COPD (relative risk [RR] = 1.46, 95% confidence interval [CI]: [1.02, 1.90]) and a 28% increased risk of migraine in adulthood (RR = 1.28, 95% CI: [1.04, 1.53]), independent of age, sex, parental history of psychiatric problems/asthma/dementia, smoking, respondent's mood/psychological state, and mental health. These findings suggest that the association between retrospectively reported CPA and COPD and migraine is not driven entirely by respondent's mood/psychological state and mental health. Assessing the independent effect of self-reported CPA on COPD and migraine in retrospective studies may prove more meaningful than exploring the mediating role of mental health. Here, we provide the analytical rationale for assessing the independent effect in settings where it is difficult to differentiate between a confounder and a mediator. Moreover, we provide a theoretical rationale for assessing the independent effect of retrospectively reported childhood adversity on health and well-being.

No long-term follow-up data exist in any treatment for chronic radicular pain occurring with disc pathology and after failed back surgery. A previous randomized controlled trial (RCT) has proven efficacy in short-term follow-up as an evidence-based effective therapeutic option.