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Identification of a new orthonairovirus associated with human febrile illness in China.

The genus Orthonairovirus, which is part of the family Nairoviridae, includes the important tick-transmitted pathogens Crimean-Congo hemorrhagic fever virus and Nairobi sheep disease virus, as well as many other poorly characterized viruses found in ticks, birds and mammals. In this study, we identified a new orthonairovirus, Songling virus (SGLV), from patients who reported being bitten by ticks in Heilongjiang Province in northeastern China. SGLV shared similar genomic and morphological features with orthonairoviruses and phylogenetically formed a unique clade in Tamdy orthonairovirus of the Nairoviridae family. The isolated SGLV induced cytopathic effects in human hepatoma cells in vitro. SGLV infection was confirmed in 42 hospitalized patients analyzed between 2017 and 2018, with the main clinical manifestations being headache, fever, depression, fatigue and dizziness. More than two-thirds (69%) of patients generated virus-specific antibody responses in the acute phase. Taken together, these results suggest that this newly discovered orthonairovirus is associated with human febrile illness in China.

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Long-Term Prevalence of Food Addiction Among Bariatric Surgery Patients: Influence on Metabolic and Psychological Outcomes.

We wanted to assess the prevalence of individuals with food addiction (FA) among bariatric surgery (BS) patients at long term and to determine if there was any relationship between FA and both clinical and psychological outcomes at the time of the evaluation. Participants were evaluated for the presence of FA with the Yale Food Addiction Scale 2.0. Of 134 subjects, 32 (23.9%) included met criteria for FA. The frequency of patients with depression at the time of the evaluation was greater among subjects with FA (34.4% vs. 11.8%;  = 0.006). The score obtained with the Beck Depression Inventory at the time of the evaluation was greater among subjects with FA (14.8 ± 11.5 vs. 6 ± 6.5;  < 0.0001). The frequency of subjects with FA who had criteria for binge eating disorder at the time of the evaluation was significantly greater (56.3% vs. 20.5%;  < 0.001). Patients with FA scored higher in the Lattinen index for chronic pain at the time of the evaluation (8.7 ± 5.9 vs. 5.8 ± 5.4;  = 0.014). However, clinical outcomes were similar between the two groups. Routine screening for FA at long term postoperatively should be recommended to improve psychological outcomes of BS.

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Thoracic epidural analgesia in a lung transplant patient with an activated partial thromboplastin time falsely elevated by C-reactive protein.

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Postoperative breakthrough pain in paediatric cardiac surgery not reduced by increased morphine concentrations.

Morphine is commonly used for postoperative analgesia in children. Here we studied the pharmacodynamics of morphine in children after cardiac surgery receiving protocolized morphine.

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Local infiltration analgesia does not have benefits in fast-track hip arthroplasty programmes: a double-blind, randomised, placebo-controlled, clinical trial.

Multimodal analgesia regimes including local infiltration analgesia (LIA) have been successfully applied in fast-track hip arthroplasty programmes. LIA's contribution to the analgesic effect in hip arthroplasty has been questioned. Our study sought to determine the analgesic efficacy of LIA in THA surgery in a fast-track programme.

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The effect of continuity of care on medical costs in patients with chronic shoulder pain.

Unnecessary surgery could be prevented through continuity of care (COC). The present study aimed to investigate the relationships between COC, surgery and cost associated with chronic shoulder pain. We used the Health Insurance Review and Assessment Service national patient sample (HIRA-NPS) in 2017. A total of 1717 patients were included. Bice-Boxerman Continuity of Care Index was used as the indicator for measuring the COC. Occurrence of surgery, associated costs, and direct medical costs were analysed. Logistic regression, a two-part model with recycled predictions and generalized linear model with gamma distribution were used. The majority of patients were 40-65 years old (high COC: 68.4%; low COC: 64.4%). The odds ratio (OR) for surgery was 0.41 in the high-COC group compared to the low COC group (95% CI, 0.20 to 0.84). Direct medical cost was 14.09% (95% CI, 8.12% to 19.66%) and 58.00% lower in surgery cost (95% CI, 57.95 to 58.05) in the high-COC group. Interaction with COC and shoulder impingement syndrome was significant lower in direct medical cost (15.05% [95% CI, 1.81% to 26.51%]). High COC was associated with low medical cost in patients diagnosed with chronic shoulder pain.

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Rural, Suburban, and Urban Differences in Chronic Pain and Coping Among Adults in North Carolina: 2018 Behavioral Risk Factor Surveillance System.

Our study aimed to examine the prevalence of chronic pain, its severity, its causes, and coping mechanisms that are used by North Carolina adults in rural, suburban, and urban areas.

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Development of a Structured Regional Analgesia Program for Postoperative Pain Management.

We pursued the use of regional analgesia (RA) to minimize the use of postoperative opioids. Our aim was to increase the use of postoperative RA for eligible surgical procedures in the NICU from 0% to 80% by June 30, 2019.

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If I stop, then what am I supposed to do? The experiences of sexual intimacy of women who live with provoked vestibulodynia.

We explored the experiences of sexual intimacy in women living with provoked vestibulodynia (PVD), a chronic pain condition where pain at the vaginal opening is triggered by touch. We conducted in-depth interviews with nine women who had suffered from PVD. Our findings reveal that their ability to trust and accept themselves is essential to how they cope when pain disrupts their freedom to have sexual intercourse. The tendency to endure painful intercourse and not tell the partner is driven by fear of rejection and conflict. Those who are able to overcome their fear, experience deeper intimacy and more sexual pleasure.

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En bloc resection of cervical adenocarcinoma with late recurrence to the iliopsoas.

This is a case of a 50-year-old woman diagnosed with recurrent cervical adenocarcinoma presenting with chronic and persistent low back pain. She underwent myomectomy for myoma uteri 8 years prior. Histopathology report revealed cervical cancer. She underwent chemotherapy, brachytherapy and external beam radiotherapy. All surveillance work-up, over the years, were negative until she was found to have a solitary recurrent lesion in the right iliopsoas muscle on CT scan. A multidisciplinary team of surgeons collaborated to perform wide excision of pelvic recurrence en bloc right internal hemipelvectomy, right hemicolectomy en bloc resection of external iliac artery and vein, external ilio-iliac artery interposition graft and external iliac vein-common femoral vein bypass. Final histopathologic results showed adenocarcinoma with endometrioid features with associated poorly differentiated high-grade carcinoma involving the iliopsoas, cecum and terminal ileum. Two months postoperatively, the patient is ambulating with minimal assistance.

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