Rejected

Reversible cerebral vasoconstriction syndrome(RCVS)is a clinical and radiological syndrome that is characterized by recurrent severe thunderclap headaches with or without other neurological symptoms and diffuse segmental constriction of cerebral arteries that usually resolves spontaneously within three months. Posterior reversible encephalopathy syndrome(PRES)is also a clinical and radiological syndrome characterized by headache, seizures, altered consciousness, cortical blindness, other focal neurological signs, and a diagnostic imaging picture of brain vasogenic edema. Both syndromes can occur in similar clinical contexts such as hypertension, pre-eclampsia/eclampsia, drug neurotoxicity, uremia, and some autoimmune diseases, and are frequently associated. Although the syndromes are usually fully reversible with early diagnosis and prompt treatment, some cases can develop hemorrhagic or ischemic brain lesions, often resulting in permanent disability. We need to be aware of the typical and atypical imaging manifestations of the syndromes to make an accurate diagnosis.

Chronic pain, especially low back pain and hip pain, has been a growing public health concern that affects over 100 million Americans annually. Radiofrequency ablation (RFA) has distinct advantages over other chronic pain management modalities and its use has been increasing over the past decade. Among the growing population with comorbid conduction disorders and persistent pain, RFA and its potential interference with implantable cardiac devices is of concern.RFA is becoming a foundational element of persistent pain management and has been shown to be effective in a multitude of chronic pain syndromes. Cardiac implantable electronic devices (CIED), such as cardiac pacemakers or implantable cardioverter defibrillators, have been used in the treatment of cardiac conduction diseases for a number of decades. With our aging population, these diseases have increased in both incidence and prevalence. Chronic pain and cardiac conduction diseases are both common in our increasingly aging population.

Back pain is a common condition in horses, yet despite this, quantitative assessments of the efficacy of treatment are scarce. Mechanical nociceptive thresholds (MNTs) and acoustic myography (AMG) recordings were obtained, both preinterventionand postintervention, from the left and right epaxial muscles in eight healthy general riding horses (mean age 17 ± 6 yrs). Using an algometer, MNT readings were taken at each of the 6 preselected points along the thoracolumbar M. longissimus and M. gluteus medius region. AMG recordings of the M. longissimus and M. gluteus medius were taken while walking, trotting, and cantering on a left or right hand 20m circle on a longe, on a waxed sand surface in an indoor arena. Horses were then treated using a class 1 laser. Therapy was applied for 1 minute at 1000 Hz to the same preselected points from which MNT measurements had previously been taken. Measurements were subsequently taken 1 hour and 24 hours post-treatment for MNT reading, and only 24 hours after for AMG measurements. No significant effect of treatment was noted for the MNTs. The AMG results were analyzed in terms of their temporal summation (T-score), where statistically significant improvements in the T-scores for M. longissimus and M. gluteus medius were noted for the different gaits. It is concluded that cold laser therapy has a positive effect on horse muscles that reveals a change in their firing frequency that is commensurate with changes seen with analgesia in subjects experiencing pain.

Incidence of pulmonary infection is increasing and diagnosis and treatment are challenging. We surveyed the clinical features, risk factors, diagnosis, and management in 20 patients from northeastern Iran diagnosed by line probe assay and confirmed by sequencing the () region and carried out a literature review using the keywords "pulmonary infection" and "." The mean age of patients was 55.1 years, with 80% female and 90% diagnosed by sputum. Clinical symptoms included severe cough (90%), sputum production (70%), haemoptysis (50%), and chest pain (35%). Comorbidities included a history of tuberculosis (60%), smoking (40%), or chronic obstructive pulmonary disease (20%). Patients were treated with levofloxacin, clarithromycin, and co-trimoxazole. Except for two patients, the clinical symptoms improved. pulmonary infection is increasing in people with underlying diseases. Although choosing the most appropriate treatment remains a challenge, combining successful treatments could be useful in treating these patients.

The aim of this study was to compare the analgesic effects of pregabalin and ketamine on reducing pain after abdominal hysterectomy.

In recent years, arthroscopic anterior talofibular ligament (ATFL) repair techniques have been increasingly used for chronic ankle instability. Besides permitting the treatment of several comorbidities, arthroscopic techniques are applied to minimize the need for aggressive surgery and improve the assessment of anatomic structures. We describe our surgical technique for all-arthroscopic anatomic ATFL repair using a knotless anchor, which can adjust suture tension under direct visualization using a self-locking mechanism. Thus, this technique diminishes the chance of repaired ligament separation from its attachment by obtaining the desired tension. Moreover, its knotless property allows the avoidance of some complications such as neuritis and pain related to bulky knots.

The erector spinae plane block (ESPB) is gaining popularity in lumbar fusion for postoperative pain management.

In this controlled, blinded, randomized block pilot study, the main objective was to evaluate the effectiveness of intravenous flunixin meglumine, phenylbutazone, and acupuncture on ocular pain relief using a multifactorial pain scale in the horse. Four experimental horses underwent corneal epithelial debridement in four sessions, when a randomly selected treatment or a control was used. All horses were pain scored before corneal wounding, then at 18 time points, when 11 parameters were allocated. Differences in the area under the curve of pain scores between the treatment groups were analyzed using a paired t-test. Corneal pain was significantly reduced by the third postoperative day (P = .03) when all 11 parameters were considered. Five ocular signs showed significant differences between treatments and proved to be good indicators of ocular pain. The other parameters (heart rate, corneal touch threshold, respond to palpation, and three behavioral parameters) were determined to be irrelevant when evaluating the degree of pain. When considering the five ocular signs, the lowest pain score was attributed to the flunixin meglumine group (1114), followed by the electroacupuncture group (1356), the phenylbutazone group (1397), and the control group (1580). There were significantly lower pain scores (P = .01) in the flunixin meglumine group when compared with those recorded in the control group during the first 46 hours. Flunixin meglumine was the most effective treatment at reducing ocular pain in the horse. In the future, a reduction in the number of pain score parameters and more precisely defined image evaluation criteria could be used.

Checkpoint inhibitors show impressive and durable responses in various cancer types and provide new avenues for cancer immunotherapy. However, these drugs have a variety of adverse events. Common autoimmune-related adverse effects include fatigue, hepatitis, skin rash, endocrine deficiencies, and colitis. Neurotoxicity has been reported, but its incidence and course remain unclear.

Obstructive sleep apnea (OSA) is characterized by the cessation of air flow during sleep due to an obstruction in the nasopharyngeal/oropharyngeal region. The consequences that untreated obstructive sleep apnoea might have on patient's health include symptoms like sudden awakening with a sensation of suffocation, morning headache, daytime sleepiness and fatigue, lack of concentration, and it is commonly connected to hypertension, coronary artery disease, depression, obesity and other medical conditions.