Rejected

Fractional picosecond lasers is effective for the treatment of wrinkles or acne scars.

A 40-year-old woman presented with headache, bilateral optic disc edema, and visual loss. She had been diagnosed with COVID-19 (coronavirus disease 2019) 15 days ago. Her cerebrospinal fluid opening pressure was 410 mmHO, and cranial imaging was normal. She had obesity as a risk factor but had not experienced any ophthalmic complaints before. COVID-19 could be a causative or precipitating factor for intracranial hypertension especially in high-risk groups even in the late phases of the disease and has not been discussed in the literature as such. This should be studied further and kept in mind to prevent permanent loss of vision.

Neuropathic pain is a painful condition that arises after a lesion or an insult to the somatosensory nervous system, either in a central or peripheral location. The most common cause of neuropathic pain is diabetes. Controlled trials have been conducted on recent advancements in medicine to investigate the effect of vitamin C in the treatment of neuropathic pain. In this study, we aim to investigate the role of vitamin C in reducing pain associated with diabetic neuropathy.

Anaplastic large cell lymphomas (ALCL) are a rare type of primary breast lymphoma. The association between breast implants and ALCL was first described in 1997. Breast implant associated (BIA)-ALCL arises from the inflammatory T cells surrounding the fibrous capsule, and most tumors are . Here we present the case of a 60-year-old woman with ALCL following bilateral silicone breast prosthesis implantation for aesthetic reason. The patient presented at our observation 7 years following the first surgery reporting a sport trauma in the right thoracic region with breast enlargement and tenderness, complaining breast pain at the palpation of the right breast. Imaging study showed a right fluid collection surrounding the affected breast implant. For this reason, the patient underwent bilateral complete capsulectomy (surgical specimen histologically analyzed and resulted negative for ALCL) and implantation of new breast silicone prosthesis. In 10 months, a progressive relapse of the symptoms with a right peri-implant fluid collection restauration was documented and bilateral surgical removal of breast prostheses with right peri-implant capsular biopsy were performed. The histological analysis of the peri-implant capsule laid for ALCL cellules and a new radical surgical excision of bilateral periprothesic capsule was performed followed by adjuvant radiotherapy for a skin relapse of the disease with a subsequent complete remission. No further relapse was observed afterwards. This clinical case raised a series of diagnostic and therapeutic issues highlighting similarities with previous BIA-ALCL reports, but also some peculiarities that deserve to be further investigated and described in order to make an early recognition of the disease for the proper management and treatment of the patient. Due to the rarity of these tumors, rapidly diagnosing a BIA-ALCL case, not neglecting other associated symptoms or signs, is essential to ensure timely and safe treatment.

Since the inflammation and oxidative stress is the main pathophysiological pathway of neural damage in spinal cord injury (SCI), we tried to evaluate the role of ivermectin (IVM) combined with multi-walled carbon nanotube (MWCNT) in the treatment settings of SCI and its underlying mechanism. Wistar rats with T9 vertebra laminectomy in five groups of: sham-operated, vehicle, IVM (0.1 mg/kg), IVM-MWCNT (0.1 mg/kg), and minocycline (90 mg/kg) were used. We evaluated the locomotor scaling and other behavioral tests for neuropathic pain. Also, tissue samples were obtained to evaluate the expression of M1 and M2 macrophage marker, concentration of TNF-α, IL-1β, and IL-1, and oxidative stress level to assess neuroinflammatory changes. Both IVM and IVM-MWCNT after induction of SCI significantly enhanced the experimental tasks' outcomes, including locomotion and neuropathic tests. Also, decreasing in pro-inflammatory cytokines including TNF-α, IL-1β, and IL-1 in the spinal cord and dorsal root ganglion tissues was also notable in both IVM and IVM-MWCNT-treated groups 28 days after induction of SCI in compared to the vehicle-treated SCI group. Both IVM and IVM-MWCNT significantly decreased oxidative stress, induced by SCI, based on the results of ROS and NADPH activity. IVM-MWCNT-treated animals indicated better outcome in every previous experiment in comparison to IVM-treated animals. The effectiveness of IVM-MWCNT was similar to minocycline treatment in all experimental task (as positive control group). IVM-MWCNT might be a novel treatment in spinal cord injury, which could act through decreasing the oxidative stress and increase the polarization of M1 in comparison to M2 macrophages.

The number of international acromegaly-related registries is increasing; however, heterogeneity of acromegaly symptoms and signs across countries is not well described. We compared clinical disease manifestations at diagnosis between two large University referral centers from two continents.

Pancreatic pseudocyst is a widely recognised local complication following acute pancreatitis. Typically occurring more than four weeks after acute pancreatitis, a pseudocyst is a mature, encapsulated collection found within the peripancreatic tissues manifesting as abdominal pain, structural compression, gastroparesis, sepsis and organ dysfunction. Therapeutic interventions include endoscopic transpapillary or transmural drainage, percutaneous catheter drainage and open surgery. We present our management of idiopathic chronic pancreatitis complicated by a pancreatic pseudocyst extending to the splenic capsule in a 38-year-old man. A trial of conservative management was sought, but later escalated to percutaneous fluoroscopic drainage. Despite a period of volume reduction of the pseudocyst, reaccumulation occurred. We describe successful surgical treatment via means of a splenocystojejunostomy and subsequent pain reduction.

Tension pneumocephalus (TPC) is a rare but devastating intracranial condition where increased intracranial pressure due to entrapped air causes compression of the brain leading to headache, seizures, altered mental status (AMS), and death. The author presents the case of patient with a past medical history of eye-enucleation who subsequently developed TPC in the setting of occult trauma. The diagnosis was made via commuted tomography (CT) scan and the patient underwent needle and burr-hole decompression in the emergency department (ED). TPC is a rare cause of altered mental status, which occurs most often secondary to trauma, and should be considered in patients with AMS and trauma.

People with cancer are increasingly more likely to visit an emergency department for acute care than the general population. They often have long wait times and more exposure to infection and receive treatment from staff less experienced with cancer-related problems. Our objective was to examine emergency department (ED) visits among people with cancer to understand how often and why they seek care.