Rejected

The purpose of this study was to evaluate if dosing fentanyl, dexmedetomidine, and propofol based on ideal or adjusted vs actual weight in patients would decrease overall opioid and sedative use. This was a retrospective chart review comparing adjusted vs actual weight-based dosing protocol of mechanically ventilated (MV) intensive care unit (ICU) adult patients who required fentanyl and either propofol or dexmedetomidine. A total of 261 patients were included in which 101 patients were in the actual weight group and 160 patients were in the adjusted weight group. Total doses per MV day of fentanyl was 1042 ± 1060 µg in the actual weight group vs 901 ± 1025 µg in the adjusted weight group ( = .13). Total doses per MV day of midazolam was 20 ± 19 mg in the actual group vs 15 ± 19 mg adjusted group ( = .02). Average MV days was 8.2 vs 7.1 days, ICU length of stay was 10.6 vs 9.4 days, and self-extubation rates were 17.8% vs 4.4% in the actual group and adjusted group, respectively. Total midazolam doses per MV day were lower in the adjusted group. No significant change was seen in MV days, ICU length of stay, or self-extubation rates.

Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported.

This review aimed to evaluate the efficacy of intra-articular injections of bone marrow derived mesenchymal stem cells (BM-MSCs) for the treatment of knee osteoarthritis (KOA).

Bullous pemphigoid (BP) is the most common autoimmune blistering disease. Although pruritus is a leading symptom in BP, its specific characteristics have not been explored.

Pyoderma gangrenosum (PG) is a rare, ulcerative dermatosis that is part of a systemic auto-inflammatory process. The overall incidence of PG is 5.8 per 100 000 individuals and it is associated with an increased mortality rate compared with the general population. Due to the pathergy phenomenon-present in 20% to 30% of cases-traumatic events, such as debridement or surgery, are often avoided in these patients. This report is on the use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) combined with a reticulated open cell foam dressing with through holes (ROCF-CC) to achieve debridement and granulation in a lower extremity PG wound.

This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

Increased frequencies of physiological episodes have been a significant concern for Naval Aviation for the last several years. These include several aircraft platforms, but no previously documented E-2D Hawkeye events. This report documents an episode in an E-2D, with multiple aircrew affected at the same time. While deployed aboard a U.S. aircraft carrier, five E-2D Hawkeyes aircrew were simultaneously exposed to the same over-pressurization during a routine sortie. Out of the five aircrew, four immediately reported hypoxic-like neurocognitive symptoms of mental slowing, difficulty concentrating, and headache. They were evaluated and treated using standard protocol according to the Physiologic Event Clinical Practice Guidelines set by the Naval Safety Center. All aircrew were treated with 100% ground level oxygen with resolution of symptoms. Although rare, physiological events may occur in multipassenger platforms such as the E-2D Hawkeye. Utilizing and strictly adhering to standard clinical practice guidelines provided an efficient process of evaluation by different flight surgeons concurrently that avoided a possible delay in treatment. After, eliminating other potential etiology for the crews symptoms, a pressure-related mechanism of injury appears to be the most probable cause.

L. (Capparaceae) is grown worldwide. Caper has been used in traditional medicine to treat various diseases including rheumatism, kidney, liver, stomach, as well as headache and toothache.

We examined the relationship between loneliness and health among young adolescents. We also investigated the validity of a single-item measure of loneliness by comparing this to a composite score. The current data come from a nationally representative sample of 11- to 15-year-old adolescents (=3305; =52%) from Denmark collected in 2014 as part of the Health Behaviour in School-aged Children (HBSC) collaborative cross-national survey. A series of binary logistic regressions showed that higher loneliness among adolescents, whether measured using the single- or multi-item measurement, was associated with poorer self-rated health, higher frequency of headache, stomach ache, backache, difficulties sleeping, greater sleep disturbance and more instances of feeling tired in the morning. Those associations were relatively consistent across sex and age groups.

Even though uremic pruritus (UP) is very troublesome for haemodialysis (HD) patients, its underlying mechanism is not fully understood.