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Comments on the Efficacy and Safety of Opioid Analgesics for the Management of Chronic Low Back Pain.

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Survey Data of COVID-19 Vaccine Side Effects among Hospital Staff in a National Referral Hospital in Indonesia.

In response to the current global challenge due to COVID-19, a dataset in this paper presented survey data of COVID-19 vaccine side effects among hospital staff in a national referral hospital in Indonesia. This survey data included the hospital staff of Dr. M. Djamil Hospital Padang, a national referral hospital in Indonesia, through a survey distributed via an online questionnaire, assessing COVID-19 vaccine side effects from 9 February to 13 February 2021. The items of the side effects included swelling, redness, itching, fever, headache, muscle pain, fatigue, coughing, diarrhea, nausea and vomiting, breathlessness, joint pain, fainted, anaphylactic reaction, itch, and swollen lymph nodes. In this survey data, we collected a total of 840 responses. The survey data were analyzed using univariate and bivariate analysis. Data analysis was performed using IBM version 25.0.

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Effectiveness of peloid therapy in patients with chronic low back pain: a single-blind controlled study.

The aim of this study was to compare peloid therapy in addition to home exercise with home exercise alone in terms of pain, function, quality of life, and depression in patients with chronic low back pain (cLBP). A total of 106 cLBP patients were divided into two equal groups as treatment and control. The peloid therapy group had peloid therapy (with a total of 15 sessions on 5 days per week for 3 weeks duration with 45 °C temperature lasting 30 min/day) + home exercise program. The control group was only given a home exercise program. Patients completed the visual analog scale-pain (VAS-pain), patient and physician global assessments (VAS-PGA and VAS-PhGA), revised Oswestry disability index (rODI) for functional status, the short form-36 (SF-36) for quality of life, and Beck Depression Inventory (BDI) for depression three times as before treatment, after treatment (3rd week), and 1 month after the end of treatment. Assessments in the 3rd week at the end of treatment revealed statistically significant improvements for rODI (p = 0.013), VAS-pain (p = 0.039), and VAS-PhGA (p = 0.002) parameters in the peloid therapy group compared to the control group. Assessments in the 1st month after the end of treatment revealed statistically significant improvements in rODI (p < 0.001), VAS-pain (p < 0.001), VAS-PGA (p = 0.002), VAS-PhGA (p < 0.001), and SF-36VE (p = 0.022) parameters in the peloid therapy group compared to the control group. Peloid therapy + home exercise was statistically significantly superior to home exercise alone in improving pain and function in patients with cLBP. Peloid therapy may be recommended as a non-pharmacological treatment for cLBP patients. There is a need for randomized studies with longer follow-up including biochemical parameters to verify the beneficial effects observed in this study and elaborate the mechanisms of action.

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A Rare Case of Human Herpesvirus 6 Meningitis in an Immunocompetent Asian Male Presented With a Severe Intractable Headache.

Human herpesvirus 6 (HHV-6) manifesting as a central nervous system (CNS) infection (especially meningoencephalitis) is reported as a primary infection in children and from reactivation in immunocompromised patients; however, it has rarely been reported in immunocompetent adults. Latent infections of the CNS can cause a myriad of clinical presentations ranging from a benign, febrile, self-resolving illness to limbic encephalitis, temporal lobe seizures, and neuropsychiatric symptoms such as behavioral disturbances and psychosis. No standard diagnostic criteria or management guidelines exist for this condition. Possible neuroimaging findings include abnormalities in the medial temporal lobe involving the hippocampus and amygdala. We hereby present a case of HHV-6 meningitis in a 48-year-old immunocompetent male presenting without encephalopathic symptoms and normal neuroimaging findings.

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The role of pre-season health characteristics as injury risk factors in female adolescent soccer players.

[Purpose] Determine if female adolescent soccer players with a history of concussion, impaired K-D scores, and pre-season subjective complaints of neck pain, dizziness, and headache were predisposed to additional risk of musculoskeletal or concussive injury during 10-weeks of competitive play. [Participants and Methods] Twenty-three female high school soccer athletes provided concussion history and reported pre-season subjective complaints. K-D testing was performed pre and postseason. During the 10-week season, all injuries, preventing participation in practice or game, were recorded. [Results] Six reported a history of concussion. Of those six, three injuries were reported, including two concussions and a hamstring strain. Baseline K-D scores were worse in athletes that had two or more pre-season subjective factors compared to those that did not have any. Moderate positive correlations were found between a history of concussion and the number of injuries and a history of concussion and K-D post-test scores. [Conclusion] Findings indicate that pre-season subjective factors of neck pain, dizziness and headache, history of concussion, and K-D potentially increased injury risk. Combining pre-season metrics both at baseline and during the course of the season may assist in better injury risk screening in-season or indicate suboptimal function due to cumulative effects.

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Bio-Inspired Multi-Mode Pain-Perceptual System (MMPPS) with Noxious Stimuli Warning, Damage Localization, and Enhanced Damage Protection.

The multi-mode pain-perceptual system (MMPPS) is essential for the human body to perceive noxious stimuli in all circumstances and make an appropriate reaction. Based on the central sensitization mechanism, the MMPPS can switch between different working modes and thus offers a smarter protection mechanism to human body. Accordingly, before injury MMPPS can offer warning of excessive pressure with normal pressure threshold. After injury, extra care on the periphery of damage will be activated by decreasing the pressure threshold. Furthermore, the MMPPS will gradually recover back to a normal state as damage heals. Although current devices can realize basic functions like damage localization and nociceptor signal imitating, the development of a human-like MMPPS is still a great challenge. Here, a bio-inspired MMPPS is developed for prosthetics protection, in which all working modes is realized and controlled by mimicking the central sensitization mechanism. Accordingly, the system warns one of a potential injury, identifies the damaged area, and subsequently offers extra care. The proposed system can open new avenues for designing next-generation prosthetics, especially make other smart sensing systems operate under complete protection against injuries.

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Feasibility of Ultrasound-Guided Peritoneal Perfusion with Ozone in the Treatment of Chronic Pelvic Pain: A Bicenter Retrospective Analysis.

Numerous therapies have been developed for the treatment of chronic pelvic pain (CPP). Oxygen-ozone therapy is a new method for the treatment of CPP.

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Pseudomonas aeruginosa-induced nociceptor activation increases susceptibility to infection.

We report a rapid reduction in blink reflexes during in vivo ocular Pseudomonas aeruginosa infection, which is commonly attributed and indicative of functional neuronal damage. Sensory neurons derived in vitro from trigeminal ganglia (TG) were able to directly respond to P. aeruginosa but reacted significantly less to strains of P. aeruginosa that lacked virulence factors such as pili, flagella, or a type III secretion system. These observations led us to explore the impact of neurons on the host's susceptibility to P. aeruginosa keratitis. Mice were treated with Resiniferatoxin (RTX), a potent activator of Transient Receptor Potential Vanilloid 1 (TRPV1) channels, which significantly ablated corneal sensory neurons, exhibited delayed disease progression that was exemplified with decreased bacterial corneal burdens and altered neutrophil trafficking. Sensitization to disease was due to the increased frequencies of CGRP-induced ICAM-1+ neutrophils in the infected corneas and reduced neutrophil bactericidal activities. These data showed that sensory neurons regulate corneal neutrophil responses in a tissue-specific matter affecting disease progression during P. aeruginosa keratitis. Hence, therapeutic modalities that control nociception could beneficially impact anti-infective therapy.

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Scalp Swelling and Headache in a 12-year-old Boy.

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Isolated Sixth Nerve Palsy: A Case of Pseudotumor Cerebri and an Overview of the Evolutionary Dynamic Geometry of Dorello’s Canal.

The dynamics of increased intracranial pressure (ICP) and sixth cranial nerve palsy has undergone a paradigm shift, with emphasis shifting from a length hypothesis to a theory based on novel anatomic findings pertaining to the geometry of Dorello's canal. In particular, the sixth cranial nerve resides in a transfixed coaxial cylinder within the canal. The cisternal portion of the nerve is intradural and the rest of the nerve is extradural; therefore, with increased ICP, the former is stretched, thereby pulling on the rest of the nerve, which is anchored in Dorello's canal. We present a case of pseudotumor cerebri secondary to minocycline presenting with an isolated sixth nerve palsy. This case is used as a platform to segue into the recent findings outlined above, in particular, the evolutionary transformation of Dorello's canal from a circular outline with a bony roof to an elliptic profile with a fibro-osseus roof during hominid basocranial expansion. The fibro-osseus roof, being elastic, is particularly susceptible to the influence of raised ICP, thereby narrowing the canal and injuring the sixth cranial nerve.

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