Rejected

To evaluate the use of mesenchymal stem cells (MSCs) in the attenuation of canine atopic dermatitis (AD).

Lumbar facet joints are a clinically important source of chronic low back pain. There have been extensive diagnostic accuracy studies, along with studies of influence on the diagnostic process, but most of them have utilized the acute pain model. One group of investigators have emphasized the importance of the chronic pain model and longer lasting relief with diagnostic blocks.

We present the case of a 61-year-old male patient with a known medical history of morbid obesity, chronic obstructive pulmonary disease and atrial fibrillation, who was receiving anticoagulation therapy with enoxaparin natrium prescribed by his family physician. The patient presented himself to the emergency department of our hospital with a complaint of severe pain in the right hemithorax, dyspnea, and diffuse cutaneous and subcutaneous haematoma in the inferior part of the right hemithoracic region. The patient underwent right-side video-assisted thoracic surgery on the second day to evacuate the haematothorax. Thoracic wall repair was achieved using a sandwich technique with a sublay reinforced with pericostal sutures and onlay insertion of bovine pericardium mesh.

Yoga interventions can improve function and reduce pain in persons with chronic low back pain (cLBP).

In the present study, the ability of baicalin to relieve neuropathic pain due to spinal nerve ligation in rats was explored, and the relationship between baicalin and α-adrenoceptors (α-AR) was determined. The neuropathic pain model was established by ligating the L5-L6 spinal nerves in Sprague-Dawley rats. Several α-AR antagonists were injected into the intramedullary sheath to evaluate the role of baicalin in neuropathic pain. The antagonists included nonselective α-AR antagonist idazoxan, α-AR antagonist BRL 44408, α-AR antagonist ARC 239 and α-AR antagonist JP 1302. The rats were divided into an untreated control group, saline group, baicalin group and baicalin + α-AR antagonist groups. Paw withdrawal threshold (PWT) was tested to assess the level of pain felt by the rats. The levels of α-AR mRNA were tested by reverse transcription-quantitative PCR. Inflammatory factors, including tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-17 and IL-1β, were analyzed by ELISA. The histopathological changes were assessed by hematoxylin and eosin staining. Flow cytometry was used to examine the percentage of CD4 peripheral blood mononuclear cells (PBMCs). Compared with the saline group, the PWT value increased after treating with baicalin. However, intrathecal injection of α-AR antagonist reversed the antinociceptive effects of baicalin. Compared with the saline group, the expression of α-AR and α-AR mRNA was upregulated significantly in the baicalin group (P<0.05). Levels of α-AR mRNA were also decreased in the baicalin + idazoxan group compared with the baicalin group (P<0.05). The levels of TNF-α, IL-6, IL-17 and IL-1β were raised after treatment with baicalin. In addition, baicalin treatment ameliorated the histological damage in the spinal cord. The percentage of CD4 PBMCs was increased in the saline group compared with the control group (P<0.05). Compared with the baicalin group, the percentage of CD4+ PBMCs was raised after treatment with the α-AR antagonists. In conclusion, intrathecal injection of baicalin produced an antiallodynic effect in a spinal nerve ligation-induced neuropathic pain model. The mechanism may be related to the regulation of a-AR expression.

Botulinum toxin (BTX) is widely used for pain control in various musculoskeletal disorders.

Chronic nonunion cervical fracture leading to cervical dystonia (CD) is very rare. This study reports a 72-year-old man who presented with 9-month history of progressively worsening neck tilting, neck tightness, neck pain, headache, and difficulty with swallowing. The patient was referred to speech therapy and confirmed to have dysphagia on modified barium swallow study. A cervical spine radiograph showed a chronic C2 nonunion fracture. Subsequent cervical spine magnetic resonance imaging confirmed chronic C2 nonunion fracture with kyphotic deformity of the cervical canal with associated cord compression at C1-C2 and severe central canal stenosis. Needle electromyography revealed dystonic or spasmodic neck muscles, consistent with diagnosis of CD. Botulinum toxin injection resulted in marked clinical improvement. The patient finally underwent occipital to C4 posterior segmental fusion. No recurrence of CD had occurred 12 months after botulinum toxin injection and surgery, which supports the conclusion that chronic C2 nonunion fracture is most likely responsible for CD in this case. The authors suggest that all patients with CD receive dysphagia evaluation and more importantly cervical spine imaging to rule out chronic C2 nonunion fracture.

Total knee arthroplasty (TKA), a common elective surgical procedure, is indicated in patients with knee pain that becomes refractory to nonsurgical interventions, such as weight loss, physical activity, physical therapy, and pharmacologic treatment. However, postoperative chronic pain is frequently reported and may lead to opioid use and dependence. Due to the increasing concern of the overuse of opioids in medical treatments, a search for other viable options is recognized. As a consequence, alternative therapies, such as transcutaneous electrical nerve stimulation (TENS), pulsed radiofrequency (PRF), and spinal cord stimulation (SCS) are being tried to potentially replace traditional opioid use in treating persistent postsurgical pain (PPSP), thus reducing opioid dependence across the nation. Here, we provide a brief overview of persistent pain following TKA procedures, with a particular emphasis on the role of promising therapies, such as TENS, PRF, and SCS for the treatment of post-TKA pain.

Chronic pelvic pain (CPP) is defined as recurrent or continuous pain in the lower abdomen or pelvis, non-menstrual or non-cyclic, lasting at least 6 months. There is strong evidence that up to 85% of patients with CPP have serious dysfunction of the musculoskeletal system, including abdominal myofascial syndrome (AMPS). AMPS is characterized as deep abdominal pain, originating from hyperirritable trigger points, usually located within a musculoskeletal range or its fascia of coating. In the literature, there are few studies that address AMPS.

Mastectomies can be complicated by difficult-to-treat postmastectomy pain syndrome (PMPS) and axillary web syndrome (AWS). We present a case of PMPS and AWS successfully treated with Pecs I and II blocks and trigger point injections. At follow-up after 4 months, our patient reported 70% improvement in pain, movement, function, and discontinuation of opioids. This case presents the utility of a multimodal approach for a patient with pain after mastectomy. This case report is the first-time demonstration of Pecs blocks to treat chronic PMPS.