Rejected

Gamma Knife surgery (GKS) is an established treatment option for trigeminal neuralgia (TN). However, the long-term efficacy of GKS for patients with TN has not been well-studied. The aim of the study is to evaluate the sequential course of pain control after GKS and analyze the factors associated with the long-term analgesic effect, focusing on radiation dosimetry and neurovascular conflict (NVC) factors.

We aimed to compare the clinical efficacy and safety of arthroscopy-guided continuous suprascapular nerve block (AS-SSNB) and ultrasound-guided continuous interscalene block (US-ISB) in postoperative analgesia in patients undergoing arthroscopic rotator cuff repair (ARCR).

Accumulating research indicates robust associations between sense of control and salutary health and well-being outcomes. However, whether change in sense of control is associated with subsequent outcomes has been under-evaluated. Participants (N = 12,998) were from the Health and Retirement Study-a diverse, nationally representative, and longitudinal sample of U.S. adults aged >50 years. We examined how increase in sense of control (from t:2006/2008 to t: 2010/2012) was associated with better outcomes on 35 indicators of: physical-, behavioral-, and psychosocial-health (t:2014/2016). We used multiple logistic-, linear-, and generalized-linear regression models and controlled for sociodemographic characteristics, personality traits, sense of control, and all outcomes in the pre-baseline wave (t:2006/2008). During the 4-year follow-up, people in the highest (vs. lowest) quartile of sense of control, conditional on prior sense of control, had reduced risk of mortality and improved physical-health outcomes (lower risk of: stroke, lung disease, physical limitations, cognitive impairment, chronic pain and higher self-rated health). Sense of control was related to better health-behaviors (increased physical activity, reduced sleep problems), higher psychological well-being (positive affect, life satisfaction, optimism, purpose, personal-, health-, financial-mastery), lower psychological distress (depression, hopelessness, negative affect, perceived constraints), decreased loneliness, and increased contact with friends. Sense of control was unrelated to other physical health indicators (diabetes, hypertension, heart disease, cancer, arthritis, overweight/obesity), health behaviors (binge drinking, smoking), and social factors (living with spouse/partner, frequency of contact with children and other family). These findings underscore the importance of sense of control as a potential intervention target for fostering physical-, behavioral-, and psychosocial-health.

Low-intensity shockwave therapy (LiST) has emerged as an effective treatment for pain in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and it has been postulated that LiST may also be effective in patients with lower urinary tract symptoms (LUTS).

Headache affects and disables at least 1 billion people worldwide. Patients and providers seek new therapies to relieve headache without the side effects and financial burden of current treatments. This narrative review highlights recent treatment advances in integrative headache medicine: nutraceuticals and behavioral therapies.

Pyogenic (unspecific) spondylodiscitis and implant-associated vertebral osteomyelitis (IAVO) are important diseases with the risk of neurological and septic complications. An early diagnosis is essential in which magnetic resonance imaging (MRI), histopathology and microbiological identification of the pathogen play key roles. The goals of conservative treatment in uncomplicated spondylodiscitis are antibiotic infection control and pain management. In the case of sepsis, neurological deficits, segmental instability or epidural abscesses surgical treatment of the infection with stabilization of the spine should be considered. In IAVO the formation of a mature biofilm represents the transition from acute to chronic infection. Acute infections can be treated by extensive debridement in combination with biofilm-active antibiotic treatment while retaining the implant. In chronic infections implant removal or exchange in combination with several weeks of antibiotic treatment is often necessary.

G protein-coupled angiotensin II receptors, ATR and ATR, are integral components of the renin-angiotensin system (RAS) that regulates blood pressure and fluid balance in humans. While ATR is a well-established target of angiotensin receptor blockers (ARBs) for managing hypertension and a prime system for studying biased signaling, ATR has been recognized as a promising target against neuropathic pain and lung fibrosis. In this review, we discuss how recent structural advances illuminate ligand-binding modes and subtype selectivity, shared and distinct features of the receptors, their transducer-coupling patterns, and downstream signaling responses. We also underscore the key ATR aspects that require further studies to fully appreciate the mechanistic framework that fine-tunes their cellular and physiological functions, providing untapped potential for drug discovery.

The therapeutic potential of medical cannabis to treat a variety of conditions is becoming increasingly recognised. Globally, a large number of countries have now legalised cannabis for medical uses and a substantial number of patients are able to access their medications. Yet in the UK, where medical cannabis was legalised in November 2018, only a handful of NHS prescriptions have been written, meaning that most patients are unable to access the medicine. Reasons for this are manyfold and include the perceived lack of clinical evidence due to the challenges of studying medical cannabis through randomised controlled trials. In order to develop the current evidence base, the importance of incorporating real-world data (RWD) to assess the effectiveness and efficacy of medical cannabis has gradually become recognised. The current paper provides a detailed outline of Project Twenty21 (T21), the UK's first medical cannabis registry, launched in August 2020. We provide the rationale for T21 and describe the methodology before reporting the characteristics of the 'first patients' enrolled in the registry. We describe the health status of all patients enrolled into the project during its first 7 months of operation and the sociodemographic characteristics and primary presenting conditions for these patients, as well as details of the medical cannabis prescribed to these individuals. By 12th March 2021, 678 people had been enrolled into T21; the majority (64%) were male and their average age was 38.7 years (range = 18-80). The most commonly reported primary conditions were chronic pain (55.6%) and anxiety disorders (32.0%) and they reported high levels of multi-morbidity, including high rates of insomnia and depression. We also present preliminary evidence from 75 patients followed up after 3 months indicating that receipt of legal, prescribed cannabis was associated with a significant increase in self-reported health, assessed using the visual analogue scale of the EQ-5D-5L (Cohen's d = .77, 95% CI = .51-1.03). Our initial findings complement reports from other large-scale databases globally, indicating that the current RWD is building up a pattern of evidence. With many clinicians demanding better and faster evidence to inform their decisions around prescribing medical cannabis, the current and future results of T21 will expand the existing evidence base on the effectiveness of cannabis-based medical products (CBMPs).