Rejected

Pepper is one of the most consumed spices in the world. Its main compound is capsaicin, a widely studied biomarker that has pharmacological activities due to its anti-inflammatory and analgesic capacity. Topical formulations such as patches based on capsaicin have been developed as an option in relieving pain and reducing swelling. In addition, capsaicin is used as an active ingredient in non-lethal weapon formulations such as pepper spray through the QuEChERS concept () technique. Used for food analysis, it allows the direct analysis of the biomarker by TLC-ESI-MS, which are previously separated by HPTLC () using an internal standard for determination of Rf and confirmation of capsaicin in different matrices.

Cutaneous lymphomas (CLs) are a group of rare, potentially disfiguring and disabling cancers that can have a significant impact on quality of life (QoL). While previous studies have shown that mycosis fungoides (MF) and Sézary syndrome (SS) impair QoL, the effect of other types of CL on QoL has not been evaluated.

Enhanced Recovery After Surgery (ERAS) has led to a paradigm shift in perioperative care through multimodal interventions. Still, ERAS remains a relatively new concept in neurosurgery, and there is no summary of evidence on ERAS applications in cranial neurosurgery.

Scalp avulsion is a rare trauma in the developed world but is a common injury in countries with poorly established infrastructure and safety regulations. This case reports the long-term sequelae of this injury, observed while conducting a humanitarian mission, and discusses immediate actions for management in an acute setting. We aim to increase awareness about this injury, its risk factors, and treatment options to better prepare clinicians in the developed world to provide care for this condition in the austere environment, which may include not only chronic pain, functional, and aesthetic concerns, but also a psychological impact that persists years after the initial injury.

The genetic modules that contribute to human evolution are poorly understood. Here we investigate positive selection in the Epidermal Differentiation Complex locus for skin barrier adaptation in diverse HapMap human populations (CEU, JPT/CHB, and YRI). Using Composite of Multiple Signals and iSAFE, we identify selective sweeps for LCE1A-SMCP and involucrin (IVL) haplotypes associated with human migration out-of-Africa, reaching near fixation in European populations. CEU-IVL is associated with increased IVL expression and a known epidermis-specific enhancer. CRISPR/Cas9 deletion of the orthologous mouse enhancer in vivo reveals a functional requirement for the enhancer to regulate Ivl expression in cis. Reporter assays confirm increased regulatory and additive enhancer effects of CEU-specific polymorphisms identified at predicted IRF1 and NFIC binding sites in the IVL enhancer (rs4845327) and its promoter (rs1854779). Together, our results identify a selective sweep for a cis regulatory module for CEU-IVL, highlighting human skin barrier evolution for increased IVL expression out-of-Africa.

Conventional nerve blocks utilize local anesthetic drugs to provide pain relief for hours or days following surgery or trauma. However, postoperative and trauma pain can last weeks or months. Ultrasound-guided percutaneous cryoneurolysis is an anesthetic modality that offers substantially longer pain relief compared to local anesthetic-based nerve blocks.

Chronic rhinosinusitis is a common condition characterised by inflammation of the nasal and sinus linings, rhinorrhoea, nasal blockage, facial pain and loss of sense of smell for longer than 12 weeks. CRS can occur with or without nasal polyps.Areas covered: First line treatment in chronic rhinosinusitis with nasal polyps is long-term intranasal corticosteroids, which have few adverse events associated with their use, as second-generation intranasal corticosteroids having a bioavailability of <0.5%. Systemic corticosteroids are used when intranasal steroids fail to achieve symptom control. However, the repeated use of oral corticosteroids is associated with numerous adverse events and the benefit from a course of oral corticosteroids is lost within three to six months.Expert opinion: Antibiotics are commonly prescribed in nasal polyposis although there is also very little evidence for their use outside of acute infection. Macrolide antibiotics are also associated with a transient increase in the risk of arrhythmias. Biologics offer a steroid-sparing alternative to the treatment of severe nasal polyposis. They have shown to be relatively well tolerated in studies to date, however studies suggest that there is no disease modifying effect and that any benefit is lost within weeks of finishing treatment.

Lemierre's syndrome is a rare and potentially life-threatening condition that follows an oropharyngeal infection, typically from and usually affects healthy adolescents or young adults. The characteristic features are septic thrombophlebitis of the internal jugular vein and septic embolism leading to multiorgan involvement, commonly the brain, lungs and bones. We report a man with presenting symptoms suggesting hemicrania continua, whose initial imaging showed no features of dural venous sinus or jugular thrombosis. Two weeks later, he had fever, sore throat, cervical lymphadenopathy and grew from peripheral blood cultures. Further imaging identified thrombosis of the internal jugular vein and cerebral venous sinuses, with multifocal cavitating lung lesions. Following antibiotics and anticoagulation, he recovered without residual deficits. Lemierre's syndrome when recognised and treated early has a good prognosis but delayed treatment may result in significant morbidity or mortality.

We would like to thank Dr. Russo and colleagues (Russo et al., 2021) for their interest in our publication (Pushparaj et al., 2021) and for their insightful comments. Dr. Russo and his colleagues are correct in stating our meta-analysis of 7 RCTs did not show analgesic benefit of pulsed radiofrequency [pRF] neuromodulation for chronic shoulder pain over conservative medical management [CMM]. As noted by Dr. Russo and colleagues, heterogeneity in "conventional medical management" in the included studies was considerable. Though a meta-analysis that does not include the data from Eyigor study (Eyigor et al., 2010) may yield different results, we recommend focusing on the qualitative analysis of the results as summarized in the letter by Dr. Russo et al.