Rejected

Medical robot is a promising surgical tool, but no specific one has been designed for interventional treatment of chronic pain. We developed a computed tomography-image based navigation robot using a new registration method with binocular vision. This kind of robot is appropriate for minimal invasive interventional procedures and easy to operate. The feasibility, accuracy and stability of this new robot need to be tested.

A rare case of extensive streptococcal myositis is reported. A 46-year-old man was admitted following acute swollen right elbow joint associated with localised pain, erythema and hypoaesthesia. Multiple tense blisters subsequently developed around the affected elbow joint extending to the axilla. He was treated for suspected soft tissue infection and septic arthritis. Blood test investigations demonstrated raised creatine kinase (894 U/L) and inflammatory markers (white cell count 21.1×10/L; C reactive protein 370 mg/L). Emergency CT scan reported extensive myositis affecting the triceps, latissimus dorsi and pectoralis major muscle with no fascial involvement. He was escalated to intensive care unit and treated for infectious myositis. Further investigation revealed positive streptococcal antibody (anti-streptodornase B titre >1600 U/mL). He was managed conservatively with microbiologist specialist input and supportive care. The patient made good recovery after receiving 10 days of intravenous antibiotics and subsequently switched to oral antibiotics. He was discharged on day 30 of admission after receiving intensive inpatient physiotherapy.

To demonstrate the importance of planning all steps of laparoscopic myomectomy including incision, techniques to reduce the blood loss and suturing.

Mild to moderate road traffic injury (RTI) in people of working age is associated with limited recovery. Less is known about RTI recovery in older age. This study explored the perspectives and factors associated with recovery and health-related quality of life following mild to moderate RTI in older age in New South Wales, Australia.

The aim of this study was to evaluate the efficacy of oral transmucosal (OTM) cannabidiol (CBD), in addition to a multimodal pharmacological treatment for chronic osteoarthritis-related pain in dogs. Twenty-one dogs were randomly divided into two groups: in group CBD ( = 9), OTM CBD (2 mg kg every 12 h) was included in the therapeutic protocol (anti-inflammatory drug, gabapentin, amitriptyline), while in group C ( = 12), CBD was not administered. Dogs were evaluated by owners based on the Canine Brief Pain Inventory scoring system before treatment initiation (T0), and one (T1), two (T2), four (T3) and twelve (T4) weeks thereafter. Pain Severity Score was significantly lower in CBD than in C group at T1 ( = 0.0002), T2 ( = 0.0043) and T3 ( = 0.016). Pain Interference Score was significantly lower in CBD than in C group at T1 ( = 0.0002), T2 ( = 0.0007) and T4 ( = 0.004). Quality of Life Index was significantly higher in CBD group at T1 ( = 0.003). The addition of OTM CBD showed promising results. Further pharmacokinetics and long-term studies in larger populations are needed to encourage its inclusion into a multimodal pharmacological approach for canine osteoarthritis-related pain.

Sympathetic activity and insulin resistance have recently been linked with chronic tendon and musculoskeletal pain. Polycystic ovarian syndrome is linked with insulin resistance and increased sympathetic drive and was therefore an appropriate condition to study the effects of modulating sympathetic activity on Achilles tendon and musculoskeletal symptoms.

Zerumbone, a monocyclic sesquiterpene from the wild ginger plant (L.) Smith, attenuates allodynia and hyperalgesia. Currently, its mechanisms of action in neuropathic pain conditions remain unclear. This study examines the involvement of potassium channels and opioid receptors in zerumbone-induced analgesia in a chronic constriction injury (CCI) neuropathic pain mice model. Male Institute of Cancer Research (ICR) mice were subjected to CCI and behavioral responses were tested on day 14. Responses toward mechanical allodynia and thermal hyperalgesia were tested with von Frey's filament and Hargreaves' tests, respectively. Symptoms of neuropathic pain were significantly alleviated following treatment with zerumbone (10 mg/kg; intraperitoneal, i.p.). However, when the voltage-dependent K channel blocker tetraethylammonium (TEA, 4 mg/kg; i.p.), ATP-sensitive K channel blocker, glibenclamide (GLIB, 10 mg/kg; i.p.); small-conductance Ca-activated K channel inhibitor apamin (APA, 0.04 mg/kg; i.p.), or large-conductance Ca-activated K channel inhibitor charybdotoxin (CHAR, 0.02 mg/kg; i.p.) was administered prior to zerumbone (10 mg/kg; i.p.), the antiallodynic and antihyperalgesic effects of zerumbone were significantly reversed. Additionally, non-specific opioid receptors antagonist, naloxone (NAL, 10 mg/kg; i.p.), selective µ-, δ- and κ-opioid receptor antagonists; β-funaltrexamine (β-FN, 40 mg/kg; i.p.), naltrindole (20 mg/kg; s.c.), nor-binaltorphamine (10 mg/kg; s.c.) respectively attenuated the antiallodynic and antihyperalgesic effects of zerumbone. This outcome clearly demonstrates the participation of potassium channels and opioid receptors in the antineuropathic properties of zerumbone. As various clinically used neuropathic pain drugs also share this similar mechanism, this compound is, therefore, a highly potential substitute to these therapeutic options.

Acute neck pain (ANP) has recently been demonstrated to be a predictor of persistent posttraumatic complaints after mild traumatic brain injury (mTBI). The aim of this study was to determine specific characteristics of patients with ANP following mTBI, their posttraumatic complaints and relationship with functional outcome.

Postdural puncture headache after accidental dural puncture during labour may lead to chronic sequalae.

Shivering is a common side effect in women having cesarean delivery (CD) under spinal anesthesia, which can be bothersome to the patient, and it can also interfere with perioperative monitoring. In several studies, the intrathecal (IT) addition of a lipophilic opioid to local anesthetics has been shown to decrease the incidence of shivering.