Rejected

Irritable bowel syndrome (IBS) is a multifactorial condition without any specific investigation. Faecal calprotectin (FC) may be elevated in IBS without any explanation. In addition, some patients with IBS have symptoms related to lactose intolerance.

Acne vulgaris is common dermatologic condition with an estimated prevalence of 80%. Acne has been shown to have a significant impact on patient quality of life and mental health, especially as inflammatory lesions typically occur on cosmetically sensitive areas with the potential for permanent scarring. There have been numerous advances in the treatment of inflammatory acne with light-based and laser devices. This technology permits effective treatment of active acne and scarring, with a short recovery and a decreased side effect profile as compared to medicinal standard-of-care and photodynamic therapies.

Wheelchair users with chronic shoulder pain have few options after conservative treatments fail. This pilot study's purpose was to establish safety and treatment effects of micro-fragmented adipose tissue (MFAT) injections under ultrasound guidance for treatment of refractory shoulder pain caused by rotator cuff disease in wheelchair users with spinal cord injury (SCI) to prepare for a larger trial.

Postoperative pain is a significant source of morbidity in patients undergoing living donor nephrectomy (LDN) and a deterrent for candidates. We implemented a standardized multimodal analgesic regimen, which consists of pharmacist-led pre-procedure pain management education, a combination transversus abdominis plane and rectus sheath block performed by the regional anesthesia team, scheduled acetaminophen and gabapentin, and as-needed opioids. This single-center retrospective study evaluated outcomes between patients undergoing LDN who received a multimodal analgesic regimen and a historical cohort. The multimodal cohort had a significantly shorter length of stay (LOS) (days, mean±SD: 1.8±0.7 vs 2.6±0.8; p<0.001) and a greater proportion who were discharged on postoperative day (POD) 1 (38.6% vs 1.5%; p<0.001). The total morphine milligram equivalents (MME) that patients received during hospitalization were significantly less in the multimodal cohort on POD 0-2. The outpatient MME prescribed through POD 60 was also significantly less in the multimodal cohort (median [IQR]; 180 [150-188] vs 225 [150-300]; p<0.001). The mean patient-reported pain score (PRPS) was significantly lower in the multimodal cohort on POD 0-2. The maximum PRPS was significantly lower on POD 0 (mean±SD: 7±2 vs 8±1, respectively; p=0.02). This study suggests that our multimodal regimen significantly reduces LOS, PRPS, and opioid requirements and has the potential to improve the donation experience.

Atopic dermatitis (AD) is a chronic and relapsing, inflammatory skin disease characterized by impaired skin barrier function and immune system dysregulation that results in dryness, skin microbiome dysbiosis, and intense pruritus. It is highly heterogeneous and its management is demanding. Patients with AD are at greater risk of comorbidities such as attention-deficit hyperactivity disorder as well as other atopic diseases. Early-onset AD cases typically improve or resolve in late childhood, however it is proposed that the prevalence of persistent or adult-onset AD is higher than previously thought. Basic therapy consists of emollient application and trigger avoidance, and when insufficient, topical corticosteroids (TCS) are the first-line treatment. However, corticophobia/steroid aversion and TCS side effects, particularly on sensitive skin areas, lead to low compliance and insufficient disease control. Several long- and short-term randomized controlled and daily practice studies have demonstrated that topical calcineurin inhibitors, such as pimecrolimus, have similar anti-inflammatory effects to low-to-medium strength TCS, reduce pruritus, and improve the quality of life of patients. In addition, pimecrolimus does not cause skin atrophy, is steroid-sparing, and has a good safety profile, with no evidence for an increased risk of malignancies or skin infections. In general, pimecrolimus cream is well accepted and well tolerated, encouraging patient adherence and leading to its use by many physicians as a preferred therapy for children and sensitive skin areas.

Ketamine is the recommended analgesic on the battlefield for Soldiers with hemorrhage, despite a lack of supportive evidence from laboratory or clinical studies. Hence, this study determined the effects of ketamine analgesia on cardiorespiratory responses and survival to moderate (37% blood volume; n=8/group) or severe hemorrhage (50% blood volume; n=10/group) after trauma in rats. We used a conscious hemorrhage model with extremity trauma (fibular fracture + soft tissue injury) while measuring mean arterial pressure (MAP), heart rate (HR), and body temperature (T) by telemetry, and respiration rate (RR), minute volume (MV), and tidal volume (TV) via whole body plethysmography . Male rats received saline (S) or 5.0 mg/kg ketamine (K) (100 µl/100 gram body weight) intra-arterially after trauma and hemorrhage. All rats survived 37% hemorrhage. For 50% hemorrhage, neither survival times (180 min (SD 78) vs 209 min (SD 66) nor percent survival (60% vs 80%) differed between S and K-treated rats. After 37% hemorrhage, K (compared with S) increased MAP, and decreased T and MV. After 50% hemorrhage, K (compared with S) increased MAP but decreased HR and MV. K effects on cardiorespiratory function were time-dependent, significant but modest, and transient at the analgesic dose given. K effects on T were also significant but modest, and more prolonged. Using this rat model, our data support the use of K as an analgesic in injured, hypovolemic patients.

To compare the clinical and paraclinical features and outcomes of pregnant and nonpregnant women with COVID-19.

Baricitinib is an oral, selective, reversible Janus kinase 1/2 inhibitor approved in the European Union and Japan and under investigation in the United States for treatment of atopic dermatitis (AD).

To identify profiles of patients who are at risk of dropping out from biopsychosocial approaches to chronic pain management.