Rejected

Vulvar Lichen sclerosus (LS) is a chronic inflammatory disease in which architectural changes and symptoms like itching, soreness, pain and dyspareunia can affect quality of life and sexual activity. Perineoplasty has been shown to be effective as a supportive surgical treatment in women with refractory dyspareunia in addition to the standard topical immunosuppressive treatment. The aim of this study was to evaluate retrospectively general complaints, patient satisfaction concerning sexual activity, reduction of dyspareunia/apareunia, orgasm ability and recurrence of LS after perineoplasty.

Changes in fraction size of external beam radiotherapy (EBRT) exert non-linear impacts on subsequent toxicity. Commonly described by the linear-quadratic model, fraction size sensitivity of normal tissues is expressed by the α/β ratio. Here we study individual α/β ratios for different late rectal side effects after prostate EBRT.

To determine whether a post-operative prescription for opioids affects parental assessment of pain control following pediatric circumcision.

Coronavirus disease 2019 (COVID-19) is a newly found infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first observed in Wuhan, China, in December 2019. An otherwise healthy 13-month-old male presented with persistent fever and cheilitis as his initial findings of COVID-19 in April 2020 prior to the discovery and classification of the multisystem inflammatory syndrome in children (MIS-C). Clinical symptoms of COVID-19 are still evolving in the pediatric population, ranging from being asymptomatic to varied symptoms, such as fever, abdominal pain, and myocarditis. Other manifestations such as conjunctivitis and cheilitis can offer clues. We speculate that cheilitis can be a sign of the hyperinflammatory state, as seen in MIS-C.

This study aims to evaluate the analgesic efficacy of dexmedetomidine added to levobupivacaine following anterior cruciate ligament (ACL) surgery. Fifty patients undergoing ACL reconstruction were included. Group DL (dexmedetomidin-levobupivacaine) received 20 mL 0.5% levobupivacaine plus 1 mL (100 μg) dexmedetomidine. Group L (levobupivacaine) patients received 20 mL 0.5% levobupivacaine plus 1 mL saline 10 minutes before tourniquet release. A patient-controlled analgesia (PCA) pump was then connected, delivering 0.5 mg at every 10 minutes and 1-mg morphine and 75-mg diclofenac sodium was used as a rescue analgesic. Postoperative pain was evaluated 0, 2, 4, 6, 12, and 24 hours after extubation at rest and during movement. A rehabilitation program was started after surgery. Postoperative continuous passive motion (CPM) starting time, postoperative leg flexion angle, and straight leg lifting time were evaluated for each group. There were no significant differences between the groups in terms of demographic data and operation time. Morphine consumption, analgesic requirements, and visual analogue scale (VAS) assessments were significantly lower in group DL during the 24-hour period after surgery. The time to start CPM in the postoperative period was significantly shorter in group DL. Passive joint flexion angle was significantly higher in group DL. Postoperative straight leg lifting time was significantly shorter in group DL. Adding dexmedetomidine to the intra-articular levobupivacaine provided better postoperative pain control and improved rehabilitation period after ACL surgery.

Dorsal root ganglia (DRG) sensory neurons can transmit information about noxious stimulus to cerebral cortex via spinal cord, and play an important role in the pain pathway. Alterations of the pain pathway lead to CIPA (congenital insensitivity to pain with anhidrosis) or chronic pain. Accumulating evidence demonstrates that nerve damage leads to the regeneration of neurons in DRG, which may contribute to pain modulation in feedback. Therefore, exploring the regeneration process of DRG neurons would provide a new understanding to the persistent pathological stimulation and contribute to reshape the somatosensory function. It has been reported that a subpopulation of satellite glial cells (SGCs) express Nestin and p75, and could differentiate into glial cells and neurons, suggesting that SGCs may have differentiation plasticity. Our results in the present study show that DRG-derived SGCs (DRG-SGCs) highly express neural crest cell markers Nestin, Sox2, Sox10, and p75, and differentiate into nociceptive sensory neurons in the presence of histone deacetylase inhibitor VPA, Wnt pathway activator CHIR99021, Notch pathway inhibitor RO4929097, and FGF pathway inhibitor SU5402. The nociceptive sensory neurons express multiple functionally-related genes (SCN9A, SCN10A, SP, Trpv1, and TrpA1) and are able to generate action potentials and voltage-gated Na currents. Moreover, we found that these cells exhibited rapid calcium transients in response to capsaicin through binding to the Trpv1 vanilloid receptor, confirming that the DRG-SGC-derived cells are nociceptive sensory neurons. Further, we show that Wnt signaling promotes the differentiation of DRG-SGCs into nociceptive sensory neurons by regulating the expression of specific transcription factor Runx1, while Notch and FGF signaling pathways are involved in the expression of SCN9A. These results demonstrate that DRG-SGCs have stem cell characteristics and can efficiently differentiate into functional nociceptive sensory neurons, shedding light on the clinical treatment of sensory neuron-related diseases.

The efficacy of sphenopalatine ganglion (SPG) block for pain control after endoscopic sinus surgery remains controversial. We conduct a systematic review and meta-analysis to explore the influence of SPG block on pain intensity after endoscopic sinus surgery.

The greatest challenge the world is facing today is to win the battle against COVID-19 pandemic as soon as possible. Until a vaccine is available, personal protection, social distancing, and disinfection are the main tools against SARS-CoV-2. Although it is quite infectious, the SARS-CoV-2 virus itself is an enveloped virus that is relatively fragile because its protective fatty layer is sensitive to heat, ultraviolet radiation, and certain chemicals. However, heat and liquid treatments can damage some materials, and ultraviolet light is not efficient in shaded areas, so other disinfection alternatives are required to allow safe re-utilization of materials and spaces. As of this writing, evidences are still accumulating for the use of ozone gas as a disinfectant for sanitary materials and ambient disinfection in indoor areas. This paper reviews the most relevant results of virus disinfection by the application of gaseous ozone. The review covers disinfection treatments of both air and surfaces carried out in different volumes, which varies from small boxes and controlled chambers to larger rooms, as a base to develop future ozone protocols against COVID-19. Published papers have been critically analyzed to evaluate trends in the required ozone dosages, as a function of relative humidity (RH), contact time, and viral strains. The data have been classified depending on the disinfection objective and the volume and type of the experimental set-up. Based on these data, conservative dosages and times to inactivate the SARS-CoV-2 are estimated. In small chambers, 10-20 mg ozone/m over 10 to 50 min can be sufficient to significantly reduce the virus load of personal protection equipment. In large rooms, 30 to 50 mg ozone/m would be required for treatments of 20-30 min. Maximum antiviral activity of ozone is achieved at high humidity, while the same ozone concentrations under low RH could result inefficient. At these ozone levels, safety protocols must be strictly followed. These data can be used for reducing significantly the viral load although for assuring a safe disinfection, the effective dosages under different conditions need to be confirmed with experimental data.

PURPOSE: Although many studies have investigated the relationship between transient global amnesia (TGA) and migraine, to date, no meta-analysis has confirmed the existence and size of their association.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy that is strongly associated with chronic liver disease. Isolated hepatic tuberculosis is an uncommon type of tuberculosis. Concomitant occurrence of both conditions is extremely rare.