Rejected

Exercise-induced laryngeal obstruction (EILO) is common in young people with exertional breathing difficulties. Psychological characteristics have been proposed as underlying contributors; however, the evidence for this is limited. Describe self-reported health, self-efficacy, and anxiety symptoms in adolescents with EILO, and address possible associations with EILO subtypes and severity. Cross-sectional study of 71/180 (39%) adolescents tested for EILO at Haukeland University Hospital during 2014-2016, age range 14-18 years. Validated questionnaires were used to assess general self-rated health, subjective health complaints (Health Behavior in School-aged Children-Symptom Check List; HBSC-SCL), general self-efficacy (GSE), and anxiety symptoms (SCARED). The outcomes were compared with normative data from comparable unselected populations. The HBSC-SCL items for somatic complaints revealed weekly or more often occurrence of headache in 42%, abdominal pain in 30%, backache in 31%, and dizziness in 32%. For psychological complaints, corresponding figures were 26% for feeling low, 43% for irritability or bad mood, 33% for feeling nervous, and 38% for sleep problems. Mean (range) GSE score was 3.13 (2.2-4.0), and reports suggesting anxiety symptoms were rare. The outcomes were in line with normative data from comparable unselected populations. Self-rated health, and scores obtained for HBSC-SCL, GSE, and SCARED were similarly distributed across EILO subtypes and severity. Self-reported health, self-efficacy, and level of anxiety symptoms in adolescents with laryngoscopically confirmed EILO were similar to data obtained in comparable unselected populations, irrespective of EILO subtype and severity. The findings challenge the notion that pediatric EILO is causally related to psychological problems.

To study the incidence of peptic ulcers accompanied by gastrointestinal bleeding after surgery for critical lower limb ischemia and their relationship with the factors predisposing to mucous membrane damage.

Despite the popularity of the ultrasound-guided transversus abdominis plane (TAP) block and the diversity of advancing approaches, the extent of injectate spread limits its clinical benefits. This study used three-dimensional computed tomography (3D-CT) imaging and a cold stimulus to evaluate the spread of a local anesthetic injected through the subcostal exterior semilunaris to transversus abdominis plane (SE-TAP) block in healthy volunteers.

We aimed to explore the role of enhanced recovery after surgery (ERAS) in patients who underwent percutaneous endoscopic lumbar interbody fusion (PELIF).

Tumor necrosis factor-α (TNF-α) is a pro-inflammatory cytokine and involves in a variety of pain conditions. Some findings suggest that TNF-α may act directly on primary afferent neurons to induce acute pain hypersensitivity through non-transcriptional regulation. This study investigated whether TNF-α had an effect on functional activity of P2X3 receptors in primary sensory neurons. Herein, we report that a brief (5 min) application of TNF-α rapidly enhanced the electrophysiological activity of P2X3 receptors in rat dorsal root ganglia (DRG) neurons.

While cluster headaches are classified and considered a primary headache disorder, secondary causes of cluster headaches have been reported and may provide insight into cluster headaches' potential pathophysiology. The mechanisms underlying this headache phenotype are poorly understood, and several theories have been proposed that range from the activation within the posterior hypothalamus to autonomic tone dysfunction. We provide a review of reported cases in the literature describing secondary causes after cardiac procedures. We will present a novel pediatric case report of a 16-year-old boy with an isolated innominate artery who presented with acute new-onset headaches 8 h following cardiac catheterization of the aortic arch with arteriography and left pulmonary artery stent placement. The headaches were characterized by attacks of excruciating pain behind the left eye and jaw associated with ipsilateral photophobia, conjunctival injection, rhinorrhea, with severe agitation and restlessness. These met the -3 criteria for episodic cluster headaches. The headaches failed to respond to non-steroidal anti-inflammatory medications, dopamine antagonists, and steroids. He showed an immediate response to treatment with oxygen. This unique case of cluster headaches following cardiac catheterization in a pediatric patient with an isolated innominate artery may provide new insight into cluster headaches' pathogenesis. We hypothesize that the cardiac catheterization induced cardiac autonomic changes that contributed to the development of his cluster headaches. The role of aortic arch anomalies and procedures in potential disruption of the autonomic tone and the causation of cluster headaches is an area requiring further study.

Myofascial trigger points (MTrPs) are defined as very small and hypersensitive points in skeletal muscle that are palpable, and produce localized pain on compression. The aim of this study was to explore the feasibility of combining T2 mapping with diffusion tensor imaging (DTI) for assessing MTrPs in a rat model and to investigate properties of the pathophysiological mechanisms.

Chronic non-cancer pain (CNCP) is one of the most prevalent indications for medical cannabis (MC) treatment globally. In this study, we investigated CNCP parameters in patients during prolonged MC treatment, and assessed the interrelation between CNCP parameters and the chemical composition of MC chemovar used. A cross-sectional questionnaire-based study was performed in one-month intervals for the duration of six months. Subjects were adult patients licensed for MC treatment who also reported a diagnosis of CNCP by a physician. Data included self-reported questionnaires. MC treatment features included administration route, cultivator, cultivar name and monthly dose. Comparison statistics were used to evaluate differences between the abovementioned parameters and the monthly MC chemovar doses at each time point. 429, 150, 98, 71, 77 and 82 patients reported fully on their MC treatment regimens at six one-month intervals, respectively. Although pain intensities did not change during the study period, analgesic medication consumption rates decreased from 46 to 28% ( < 0.005) and good Quality of Life (QoL) rates increased from 49 to 62% ( < 0.05). These changes overlapped with increase in rates of (-)-Δ–tetrahydrocannabinol (THC) and -pinene high dose consumption. Even though we observed that pain intensities did not improve during the study, QoL did improve and the rate of analgesic medication consumption decreased alongside with increasing rates of high dose THC and -pinene consumption. Understanding MC treatment composition may shed light on its long-term effects.

Methylene blue (MB) is a cationic thiazine dye, widely used as a biological stain and chemical indicator. Growing evidence have revealed that MB functions to restore abnormal vasodilation and notably it is implicated even in pain relief. Physicians began to inject MB into degenerated disks to relieve pain in patients with chronic discogenic low back pain (CDLBP), and some of them achieved remarkable outcomes. For osteoarthritis and colitis, MB abates inflammation by suppressing nitric oxide production, and ultimately relieves pain. However, despite this clinical efficacy, MB has not attracted much public attention in terms of pain relief. Accordingly, this review focuses on how MB lessens pain, noting three major actions of this dye: anti-inflammation, sodium current reduction, and denervation. Moreover, we showed controversies over the efficacy of MB on CDLBP and raised also toxicity issues to look into the limitation of MB application. This analysis is the first attempt to illustrate its analgesic effects, which may offer a novel insight into MB as a pain-relief dye.

Triple pelvic osteotomy (TPO) is a prophylactic surgical procedure performed on dogs with canine hip dysplasia. The procedure is indicated in skeletally immature dogs without secondary osteoarthritis (OA). It has been suggested that 60° of rotation is excessive and is associated with poor outcome. The objective of the study was to assess the medium term outcome in dogs having undergone triple pelvic osteotomy (TPO) using 60° dedicated plates. Nine TPOs were performed in seven dogs with hip dysplasia. Eight of nine hips had 72-100% osseous union at the time of revisit. The mean time to final radiographic recheck was 200 days (range, 185-229 days). The mean time to follow-up was 11.5 months (range 11-12 months). All 7 dogs had regained full function and did not require supplemental analgesia. Pelvic canal narrowing was noted in the two dogs with bilateral surgeries, but no clinical consequences were noted according to owner's statement.If more than 40 degrees reduction angles at Ortolani test, 60° of rotation of the acetabulum can be used successfully in dogs with hip dysplasia. At the time of mid-term follow-up, all dogs in this case series had full function.