Rejected

To conduct a systematic review of randomized controlled trials about the safety (number and severity of adverse events) and efficacy (pain reduction and functional improvement) of mesotherapy in musculoskeletal disorders, and to compare them with other therapeutic options, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.

Transcranial Doppler (TCD) ultrasonography is the only noninvasive bedside technology for the detection and monitoring of cerebral embolism. TCD may identify patients at risk of acute and chronic neurologic injury from gaseous or solid emboli. Importantly, a window of opportunity for intervention-to eliminate the source of the emboli and thereby prevent subsequent development of a clinical or subclinical stroke-may be identified using TCD. In this review, we discuss the application of TCD sonography in the perioperative and intensive care setting in adults and children known to be at increased risk of cerebral embolism. The major challenge for evaluation of emboli, especially in children, is the need to establish the ground truth and define true emboli identified by TCD. This requires the development and validation of a predictive TCD emboli monitoring technique so that appropriately designed clinical studies intended to identify specific modifiable factors and develop potential strategies to reduce pathologic cerebral embolic burden can be performed.

: To evaluate the prevalence of sleep bruxism, related factors, and quality of life of preschool children and their families. The sample was 475 children between 4 and 5 years old enrolled in schools in the city of Bauru-Brazil. Parents/legal guardians answered two questionnaires, one to assess the presence of bruxism and related factors and another that was the validated Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Intraoral clinical examination was performed by two trained examiners (Kappa = 0.82) within the school environment. The data were analyzed using statistics and the Mann-Whitney, Kruskal-Wallis, and Spearman correlation coefficient. The significance level was < 0.05.The prevalence of sleep bruxism was 47.4%. The highest prevalence was related to Class I canines and marked overjet, oral habits, such as nail biting, lip biting, chewing gum, and mouth breathing. Children with agitated sleep, reports of headache, and those considered aggressive, anxious, and/or shy were also more related. In the studied sample, sleep bruxism prevalence was high and related to important oral and general factors. Data also indicated SB as the main factor that interfered in the OHRQoL of children and their families.

Foreign body aspiration is a rare but life-threatening event. Most accidental aspiration events occur in children. In adults, it can represent up to 25% of cases. Bronchoscopy remains the gold standard for diagnosing and treating foreign body aspiration from the lower respiratory tract. A 63-year-old female smoker with a history of chronic alcoholism and exposure to pyrotechnic smoke presented a productive cough, with whitish expectoration, dyspnea and pleuritic chest pain on the right side. On chest X-ray, she presented opacity in 2/3 of the right hemithorax. Computed axial tomography revealed consolidation with an air bronchogram on the right hemithorax, cylindrical bronchiectasis, ground glass pattern and centrilobular nodules. Bronchoscopic examination revealed a foreign body covered with granulation tissue in the right segmental bronchus (B6). The granulation tissue was integrated into the foreign body. In a second attempt, the foreign body could be removed, which was of bone consistency, seemingly a bird bone, confirmed by pathological anatomy results. After further questioning, the patient reported that two years before, she had choked when eating chicken. She had a cough and an episode of hemoptysis, but she chose not to ask for medical advice.

A 78-year-old woman was diagnosed with herpes zoster in the first branch of the trigeminal nerve and was treated with amenamevir. Subsequently, she was hospitalized for postherpetic neuralgia. Fever and unconsciousness were observed, and a diagnosis of varicella-zoster virus meningoencephalitis and vasculitis was made. In addition to the antithrombotic therapy, she was treated with intravenous acyclovir and steroid pulse therapy; however, her unconsciousness persisted. Amenamevir was not transferrable to the spinal fluid and resulted in an incomplete treatment of herpes zoster in the cerebral nerve region, suggesting that this case may be related to the severe course of the disease.

Although mesh-related pain, termed "somatic pain," is a well-known pain syndrome following Lichtenstein repair, few reports are available on somatic pain following transabdominal preperitoneal repair (TAPP) and its pathogenesis remains unclear. We report on two patients with refractory somatic chronic pain following TAPP. In the present two cases, both mesh fixation with rigid permanent metal tackers and mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP. The lessons learned from these two cases are: (a) mesh shrinkage resulting in contractile forces on the groin musculature could be considered as potential mechanisms in the etiology of chronic somatic pain following TAPP; (b) partial mesh removal would be an effective alternative to total mesh removal in those patients for remedial surgery.

We report a case of a COVID-19 patient presenting fever, headache and dyspnea evolving with severe acute abdominal pain; contrasted computed tomography (CT) scan diagnosed splenic infarction. We emphasize the importance of seeking the identification of complications of SARS-CoV-2 infection, notably thromboembolic events, with the potential to reduce the morbidity and mortality of the disease. Studies on radiological aspects involving the spleen and splenic infarctions associated with COVID-19 are scarce.

People that experience a trauma, might also experience problems in their social relationships. However, how witnessing a terrorist attack influences social relationships, is still understudied. This is important, as currently there is more focus on the individual's mental health, and not on how this mental health can impact the individual's social relations. In this study, the impact of the experience of a terrorist attack on social relationships was studied.