Rejected

Interventional pain management procedures provide significant improvement to patient quality of life and functionality. In-office procedures are becoming an increasingly more common site of pain management intervention for patients with minimal risk of harm.

Some people complain about the persistent pain after lumbar discectomy whose cause remains unclear, which may be related to the lumbar muscles of the trunk. We aimed to determine the relationship between the occurrence of lumbar L4-5 disc herniation (LDH) and the size of psoas muscles.

Psoriasis is an immune-mediated chronic inflammatory skin disease characterized by erythema, scales, and infiltration of the skin, which causes deleterious effects on patient quality of life. TRP channel played important roles in the generation and conductance of itch signal . According to our results, psoriasis induced itch was TRPV4 dependent, and TRPV4 expression in both epidermis and DRG were up-regulated in psoriasis. Thus, TRPV4 is an attractive candidate for treating psoriasis induced itch. Cimifugin is a common compound in antipruritic Chinese medicine. In our study, GSK1016790A, a TRPV4 channel specific agonist, induced acute itch was inhibited by cimifugin in a dose-dependent manner. Furthermore, cimifugin treatment reduced the scratching behavior and reversed the TRPV4 up-regulation induced by psoriasis. In particular, cimifugin decreased GSK1016790A induced calcium response both in HaCaT cells and DRG neurons. Importantly, in TRPV4 transfected HEK293 cells, GSK101 induced calcium response was also significantly inhibited by cimifugin pretreatment. Consistent with our calcium imaging result, cimifugin pretreatment also inhibited GSK101 induced inward currents. Our study delineated a new role of TRPV4 in psoriasis and emphasized the antipruritic effect of cimifugin, which opened a new avenue to itch management in psoriasis.

Osteomas of the paranasal sinuses are benign, slow-growing bone tumors that can cause a variety of clinical features depending on their size and location. Most osteomas are asymptomatic and located in the frontal sinus. In rare cases, they may grow to extend into the cranial or orbital cavities, resulting in atypical presentations. The authors presented an aggressive case of a frontoethmoidal sinus osteoma with intracranial extension of an inflammatory sinonasal polyp.

Transcutaneous auricular vagus nerve stimulation (t-VNS) has been proposed as an alternative method for the treatment of various neurological and psychiatric disorders. Contrary to the classic invasive vagus nerve stimulation (i-VNS), t-VNS does not require surgical intervention. The application of t-VNS for the treatment of epilepsy has been poorly studied. Hence, we performed a systematic review of the literature to elucidate efficacy, adverse effects and technical features of t-VNS in patients with epilepsy.

Malignant pheochromocytomas are rare endocrine tumors that develop within chromaffin tissue. The diagnosis of malignancy is based on neoplastic recurrence or the presence of metastasis in organs that lack chromaffin tissue. We report a series of four cases because of their diagnostic and therapeutic particularities.

Meloxicam (MLX) is a non-steroidal anti-inflammatory drug, extensively used for inflammatory diseases and pain treatments, which exhibits five known solids forms. Form IV of MLX, a zwitterionic monohydrate (MH), is an emblematic hydrate case with promissory dissolution properties in a poorly soluble drug. However, the lack of information about MH stability regarding the dehydration process and phase transition impedes the development of further stability studies. A multi-spectroscopic/chemometric approach was implemented coupling middle- (MIR), near-infrared (NIR) and Raman spectroscopies to monitor the heat-mediated dehydration process of MH. The application of multivariate curve resolution-alternating least squares (MCR-ALS) to multi-source spectra by data fusion allow a complete view of the phenomena, improving the selectivity and precision to establish the transition temperatures and to identify involved species. It was revealed a two-step mechanism, where MH changes to Form V at 90 °C obtaining its complete dehydration at 130 °C, Form V remains unchanged during the temperature range 130-190 °C and then the polymorphic conversion to Form I starts, which reaches 100 % at 230 °C before melting MLX (248 °C). The findings of this work allow set targets in the process control of products using MH. Additionally, MCR-ALS detected an event not evidenced by conventional thermal analysis, the transformation of Form V to Form I.

Background Severe traumatic injuries to the collateral ligaments of the metacarpophalangeal (MCP) joints of the fingers are rare and often missed. There is no consensus on how to treat neglected, chronic, and symptomatic ligament tears. The two main options are ligament reinsertion and ligament reconstruction, but no criteria exist to help surgeons choose between them. Hypothesis The structure and intraoperative appearance of the collateral ligament can be used to select between reattachment and ligament reconstruction; when the ligament is repairable, effective reattachment with a suture anchor is possible in chronic forms more than 3 months after the injury event. Patients and methods Thirteen patients (14 consecutive cases) who underwent surgical treatment for a traumatic complete symptomatic tear of an MCP joint collateral ligament that was at least 3 months old were included retrospectively. Six patients (7 fingers) had been treated by anchor reinsertion (Group A) and seven patients (7 fingers) by ligament reconstruction as described by Hsieh (Group B). Clinical and radiographic assessment consisted of the QuickDASH questionnaire, measurements of strength and active range of motion of the MCP compared to the other hand, and AP and lateral radiographs over the MCP joint. Results Twelve patients (13 fingers) were reviewed after a mean follow-up of 84 ± 49 months. The mean QuickDASH was 4.7 ± 5.4 for group A and 23.8 ± 16.0 for group B (p = 0.008). There was a significant decrease in the flexion/extension motion (64°/-6°) in group B relative to the healthy contralateral hand and group A fingers (p = 0.012 and p = 0.014). There were no visible degenerative joint lesions at the final assessment; however, three patients in group B had undergone revision surgery to address chronic pain. Two of them had a preoperative volar subluxation that was not corrected by the ligament reconstruction. Discussion When a ligament is determined to be repairable based on intraoperative findings, reinsertion on bone provides satisfactory and long-lasting stabilization of the MCP joint even if the procedure is not done immediately after the injury occurs. If it is not repairable and no preoperative volar subluxation is found, the ligament reconstruction technique described by Hsieh restores stability to the MCP joint in the medium term with no signs of degeneration. Level of evidence: IV; case series.

Evaluate physical activity (PA) and sedentary behavior and their associations with symptom and quality of life outcomes in adults with persistent post-concussive symptoms (PPCS) following mild traumatic brain injury (mTBI).

Aim of the study is to assess the clinical characteristics and treatment outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19.