Rejected

Aging adults are impacted by pain. Technology can assist older adults with pain self-management while allowing for independence. The current usability study explored the use of voice assistant reminders for two pain self-management tasks in aging adults. Fifteen community-dwelling older adults with chronic pain and an average age of 65 years used the voice assistant for 4 weeks. Participants had moderate scores for pain severity (mean = 4.6 [SD = 2.3]) and pain interference (mean = 4 [SD = 2.6]). Voice assistant usability was above average (78 of 100). Median time to set up the Google Home Assistant profile was 5 minutes (SD = 7.5), with a median of asking for help two times. Pain self-management task reminders from the voice assistant were perceived as consistent, easy to set up, and helpful for accountability. Voice assistant reminders may be an option to help encourage a variety of pain self-management tasks in aging adults. [Journal of Gerontological Nursing, xx(x), xx-xx.].

Flavonoids are secondary metabolites that are widely distributed in plants. These phenolic compounds are classified into various subgroups based on their structures: flavones, flavonols, isoflavones, flavanones and anthocyanins. They are known to perform various pharmacological actions like antioxidant, anti-inflammatory, anticancer, antimicrobial, antidiabetic and antiallergic, etc. Diabetes is a chronic progressive metabolic disorder that affects several biochemical pathway and leads to secondary complications such as neuropathy, retinopathy, nephropathy and cardiomyopathy. Among them, management of diabetic neuropathy is one of the major challenges for physicians as the well pharmaceutical industries. Naturally occurring flavonoids are extensively used for the treatment of diabetes and its complications due to their antioxidant properties. Moreover, flavonoids inhibit various pathways that are involved in the progression of diabetic neuropathy like reduction of oxidative stress, decrease in glycogenolysis, increase glucose utilization, decrease in the formation of advanced glycation end products and inhibition of the the α-glucosidase enzyme. This review entails current updates on therapeutic perspectives of flavonoids in the treatment of neuropathic pain. This manuscript explains pathological aspects of neuropathic pain, the chemistry of flavonoids, and their application in amelioration of neuropathic pain through preclinical studies either alone or in combination with other therapeutic agents. Keywords: Flavonoids, diabetic neuropathy, oxidative stress, glycogenolysis, α-glucosidase .

Migraine is an exclusively human chronic disorder with ictal manifestations characterized by a multifaceted clinical complexity pointing to a cerebral cortical involvement. The present review is aimed to cover the clinical, neuroimaging, and neurophysiological literature on the role of the cerebral cortex in migraine pathophysiology.

The publication of explant rates has established risk factors and a definitive objective outcome of failure for spinal cord stimulation (SCS) treating neuropathic pain. We present a UK study analyzing explants of electrical neuromodulation devices for different conditions over 11 years in a single center specializing in neuromodulation.

The COVID-19 pandemic has prompted obstetric anesthesiologists to reconsider the ways in which basic anesthesia care is provided on the Labor and Delivery Unit. Suggested modifications include an added emphasis on avoiding general anesthesia, a strong encouragement to infected individuals to opt for early neuraxial analgesia, and the prevention of emergent cesarean delivery, whenever possible. Through team efforts, adopting these measures can have real effects on reducing the transmission of the viral illness and maintaining patient and caregiver safety in the labor room.

Chronic postsurgical pain and opioid use is a problem among patients undergoing many types of surgical procedures. A multidisciplinary approach to perioperative pain management known as a transitional pain service (TPS) may lower these risks.

Spine-related pain is oftentimes not managed satisfactorily by analgesic medications and physiotherapy. Pulsed radiofrequency targeting on dorsal root ganglion (DRG-PRF) is able to precisely relieve pain without permanent damage to nervous tissue. In this article, we provide a short-term result of DRG-PRF for spine-related pain.

The present study aims to determine the potential prophylactic effect of clopidogrel for migraine with patent foramen ovale (PFO) in patients who are poor responders to two or more common preventive medications. Migraineurs underwent contrast-enhanced transcranial doppler examination to confirm the presence of PFO and determine the right-to-left shunt degree. Clopidogrel 75 mg/day was added to the existing prophylactic regimen for 3 months and 6 months. The presence of PFO was found in 56.8% (151/266) of all patients with migraine and 70.2% (59/84) of migraine with aura (MHA), and among MHA a large shunt was observed in 36 patients. Twenty-six patients with drug-refractory migraine took clopidogrel 75 mg/day for 3 months. Compared with those at baseline, headache frequencies and attack durations were significantly lower (6.17±3.93/month (M) vs 3.28±2.67/M, p=0.003; 13.62±13.98/hour (H) vs 7.36±7.33/H, p=0.0049, respectively); visual analog scale scores and migraine disability assessment scores were also obviously decreased (6.32±1.97 vs 4.71±1.20, p<0.001; 22.14±7.13 vs 16.00±5.92, p=0.001, respectively). These improvements were maintained for 6 months in 12 patients. We concluded that PFO was closely correlated with migraine, especially in MHA. Clopidogrel could act as an effective complementary prophylactic for migraine with PFO in patients with poor response to routine prophylactics.

Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas. In addition, residual wounds, scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas, which may affect patients' appearance, movements, and mental health. However, inadequate attention has been paid to this issue which can result in problems, such as difficulty in healing, possibility of carcinoma, chronic pain and a heavy mental burden.

A previously healthy 42-year-old man had sudden-onset severe headache resolving within days. Two weeks later, he noted acute right-sided hemiparesis. Brain CT, MRI and digital subtraction angiography showed acute left hemispheric ischemic stroke, bilateral middle cerebral artery vasospasms and intracerebral aneurysms (Figure 1 A-E). The following day, cerebrospinal fluid (CSF) was obtained and appeared crystal-clear and without xanthochromia (Figure 2A). CSF cytology proved past subarachnoid hemorrhage (SAH) by demonstrating macrophages with ingested erythrocytes, hemosiderin and hematoidin crystals (Figure 2B). CSF may be clear, but CSF cytology can prove SAH two weeks after aneurysm rupture leading to vasospasm and stroke..