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NSAIDs inhibit bone healing through the downregulation of TGF-β3 expression during endochondral ossification.

Non Steroidal Anti-Inflammatory drugs (NSAIDs) are potent inhibitors of post-traumatic pain. Several studies have highlighted that NSAIDs could exert a negative effect on bone healing process possibly by down-regulating chondrogenesis and endochondral ossification. The aim of the study is to explore the potential mechanism though which NSAIDs can affect chondrogenesis. M&M: Trabecular bone from the fracture site was isolated from 10 patients suffering from long bone fractures. Mesenchymal Stem Cells (MSCs) were isolated following collagenase digestion and functional assays to assess the effect of diclofenac sodium on chondrogenesis were performed. Gene expression analysis of 84 key molecules was performed.

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Characterization of cannabis use by patients with myotonic dystrophy type 1: A pilot study.

The treatment of myotonic dystrophy type 1 (DM1) focuses on reducing symptom burden. However, since medication often fails to produce satisfying symptom relief, some patients seek alternatives, such as cannabis, to help reduce some of these symptoms. The aim of this study was to provide an accurate profile of cannabis use among DM1 patients. Phone interviews were conducted to identify current and former users, and to assess reasons for cannabis use. Characteristics of cannabis use were also investigated. Briefly, among the 72 study participants, 22.2% currently used cannabis and a majority of them (56.9%) reported using it to relieve symptoms associated with DM1. These users, classified as therapeutic users, reported poorer health status (EQ-5D index scores: 0.532±0.230 vs. 0.823±0.208, p = 0.020; EQ-VAS scale 50.56±10.74 vs. 75.57±21.50, p = 0.009) than non-therapeutic users. Finally, differences among sex were also highlighted. While the therapeutic effects of cannabis were not explored in our study, our results support the potential role of cannabis and cannabinoids in the treatment of DM1-associated symptoms which will need to be thoroughly investigated.

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Associations between Potentially Modifiable and Non-Modifiable Risk Factors and Gait Speed in Middle and Older-Aged Adults: Results from the Canadian Longitudinal Study on Aging.

Gait speed is a strong predictor of morbidity and mortality in older adults. Understanding the factors associated with gait speed and the associated adverse outcomes will inform mitigation strategies. We assessed the potentially modifiable and non-modifiable factors associated with gait speed in a large national cohort of middle and older-aged Canadian adults.

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[Rheumatic pain and chronic pain in children, adolescents and young adults].

Rheumatic diseases, such as juvenile idiopathic arthritis (JIA), are typically associated with acute pain mainly caused by inflammation. Chronic pain is described as pain lasting at least 3 months. In JIA patients chronic pain may occur despite successful treatment. Chronic pain and pain disorders frequently occur during the course of the disease despite successful control of inflammation.

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[Spirituality and health care. The perspective of patients with chronic pain].

Chronic pain affects all aspects of human life, which raises spiritual questions that should be included within the framework of multimodal care.

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High-dose midodrine is not effective for treatment of persistent hypotension in the intensive care unit.

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SMILE technique for Pilonidal Sinus destruction with a radial laser probe – video vignette.

The ideal treatment for pilonidal sinus disease is still not established. It is generally agreed that the treatment of choice for pilonidal disease should be characterized by a short time to healing with a low recurrence rate, a short hospital stay, easy postoperative care, minimal pain and a short time off work. In 2017 Densilly introduced sinus laser-assisted closure (SiLaC) – a new treatment option for pilonidal sinus disease by using a radial laser probe (1).

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Coconut Oil with Vitamins A and E as a New Topical Emollient Mixture for Pruritus in Children with Cholestatic Liver Disease.

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How I do it: Management of venous bleeding from the superior petrosal vein during endoscopic microvascular decompression.

A repair strategy for venous bleeding from the superior petrosal vein (SPV) is essential during endoscopic microvascular decompression.

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Bilateral severe heterotopic ossification following primary total knee arthroplasty: a case report in Pakistan.

The incidence of unilateral minor heterotopic ossification after primary total knee arthroplasty is still unknown, but bilateral severe heterotopic ossification is rare and has not been reported before. Presented in this report is a 60-year-old female patient who developed bilateral knee pain and stiffness 2 weeks after primary total knee arthroplasty. Her weight was 70 kg and body mass index was 32.2. Preoperatively, she had bilateral varus deformity of both knees. X-rays taken 3 months after surgery revealed bilateral severe heterotopic ossification. The patient had been on non-operative treatment (including anti-inflammatory drugs and physiotherapy). There was a marked improvement 6 months after surgery. This case report showed the non-operative treatment may produce acceptable results for patients with severe bilateral heterotopic ossification after primary total knee arthroplasty, and exerted no influence on the final clinical outcome.

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