Rejected

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was discovered in China in late 2019 and subsequently triggered a global pandemic. Dentists, like many other health professionals, are at an increased risk of contracting the virus as they work in close proximity to patients, especially when performing aerosol-generating procedures. Thus, in order for dentists to protect themselves and their patients, it is recommended that practitioners wear filtering facepiece 2 (FFP2) respirators. The prolonged use of these FFP2 respirators has been linked to several side effects. The aim of this paper is to assess the perceived experience associated with N95/FFP2 respirators based on the available literature and data collected through an online survey completed by Italian dental professionals. Articles were included up to May 2020 and literature searches were conducted through The National Library of Medicine, Cochrane Central Register of Controlled Trials, and Embase databases. The search terms included COVID-19, respirators, masks, and discomfort. An online survey was administered to 256 Italian dentists. The results from this survey were in agreement with the available literature. The findings concurred that the prolonged use of respirators was associated with headaches (47.5%), severe exertion and discomfort (50.8%), moderate concentration problems (54.3%), moderate breathing difficulties (63.5%), and consequently, an impaired work ability (85.5%). These findings were not influenced by the number of hours spent wearing the respirator. Despite several side effects, FFP2 respirators are fundamental in protecting dentists and their importance was acknowledged.

While many still consider food to be innocuous, ongoing research demonstrates food's role, both harmful and protective, in chronic pain […].

Familial Mediterranean Fever (FMF) is an autosomal recessive auto-inflammatory disease characterized by pathogenic variants in the gene, with allele frequencies greatly varying between countries, populations and ethnic groups. In order to analyze the spectrum of variants and genotypes among clinically diagnosed FMF patients from South Lebanon, data were collected from 332 participants and 23 variants were screened using a Real-Time PCR Kit. The mean age at symptom onset was 17.31 ± 13.82 years. The most prevalent symptoms were abdominal pain, fever and myalgia. molecular analysis showed that 111 patients (63.79%) were heterozygous, 16 (9.20%) were homozygous, and 47 (27.01%) carried two variants or more. E148Q was the most encountered variant among heterozygous subjects. E148Q/M694V was the most frequent in the compound heterozygous/complex genotype group, while M694I was the most common among homozygous patients. Regarding allele frequencies, M694V was the most common variant (20.7%), followed by E148Q (17.1%), V726A (15.7%) and M694I (13.2%). The high percentage of heterozygous patients clinically diagnosed as FMF highlights the pseudo-dominant transmission of the disease in Lebanon and emphasizes the importance of molecular testing for a more accurate diagnosis and better management and treatment of FMF.

Postoperatively, standardized clinical care pathways (SCCPs) help patients reach necessary milestones for discharge. The objective of this study was to achieve 90% compliance with a pectus specific SCCP within 9 months of implementation. We hypothesized that adherence to a pectus SCCP following the Nuss procedure would decrease postsurgical length of stay (LOS).

: Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). : A single-blinded, randomized clinical trial was carried out. A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group. The intervention consisted of two treatment sessions per week, for four weeks and eight sessions. Four measurement moments (at baseline, immediately, 1 month, and 3 months after intervention) were considered. Pain intensity, CPM, TS, functional and somatosensory outcomes were measured. : Statistically significant differences were revealed for time factor (F = 16.40, < 0.01, η = 0.28) and group*time interaction for kinesiophobia (F = 3.89, = 0.01, η = 0.08) showing post-hoc differences in favor of the VR group at 3 months ( < 0.05, d = 0.65). Significant effects were shown for time factor ( < 0.05) but not for the group*time interaction ( > 0.05) for pain intensity, rotation range of motion (ROM), Neck Disability Index, pain catastrophizing, fear-avoidance beliefs, left side pressure pain threshold (PPT) and anxiety. Statistically significant differences were not found for time factor ( > 0.05) and neither in group*time interaction ( > 0.05) for CPM, TS, right side PPT, flexo-extension and lateral-flexion ROM. : Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months. Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.

Ibuprofen, a non-steroidal anti-inflammatory pain reliever, is among pharmaceutical residues of environmental concern ubiquitously detected in wastewater effluents and receiving rivers. Thus, ibuprofen removal potentials and associated bacteria in the hyporheic zone sediments of an impacted river were investigated. Microbially mediated ibuprofen degradation was determined in oxic sediment microcosms amended with ibuprofen (5, 40, 200, and 400 µM), or ibuprofen and acetate, relative to an un-amended control. Ibuprofen was removed by the original sediment microbial community as well as in ibuprofen-enrichments obtained by re-feeding of ibuprofen. Here, 1-, 2-, 3-hydroxy- and carboxy-ibuprofen were the primary transformation products. Quantitative real-time PCR analysis revealed a significantly higher 16S rRNA abundance in ibuprofen-amended relative to un-amended incubations. Time-resolved microbial community dynamics evaluated by 16S rRNA gene and 16S rRNA analyses revealed many new ibuprofen responsive taxa of the Acidobacteria, Actinobacteria, Bacteroidetes, Gemmatimonadetes, Latescibacteria, and Proteobacteria. Two ibuprofen-degrading strains belonging to the genera and were isolated from the ibuprofen-enriched sediments, consuming 400 and 300 µM ibuprofen within three and eight days, respectively. The collective results indicated that the hyporheic zone sediments sustain an efficient biotic (micro-)pollutant degradation potential, and hitherto unknown microbial diversity associated with such (micro)pollutant removal.

Lysophosphatidic acid (LPA) signaling is known to play key roles in the initiation and maintenance of various chronic pain models. Here we examined whether LPA signaling is also involved in diabetes-induced abnormal pain behaviors. The high-fat diet (HFD) showing elevation of blood glucose levels and body weight caused thermal, mechanical hyperalgesia, hypersensitivity to 2000 or 250 Hz electrical-stimulation and hyposensitivity to 5 Hz stimulation to the paw in wild-type (WT) mice. These HFD-induced abnormal pain behaviors and body weight increase, but not elevated glucose levels were abolished in LPA and LPA mice. Repeated daily intrathecal (i.t.) treatments with LPA antagonist AM966 reversed these abnormal pain behaviors. Similar abnormal pain behaviors and their blockade by daily AM966 (i.t.) or twice daily Ki16425, another LPA antagonist was also observed in db/db mice which show high glucose levels and body weight. Furthermore, streptozotocin-induced similar abnormal pain behaviors, but not elevated glucose levels or body weight loss were abolished in LPA and LPA mice. These results suggest that LPA and LPA play key roles in the development of both type I and type II diabetic neuropathic pain.

The practice of recreational urethral sounding involves insertion of foreign body in the urethra usually for sexual gratification. We present a case of a 62-year-old male with longstanding recurrent urinary tract infections complicated with Staphylococcus epidermidis bacteremia, discitis, and osteomyelitis at T12-L1 vertebral level associated with left psoas abscess secondary to a retained foreign body inserted into his urethra and urinary bladder. He had extraction of foreign body, cystoscopy, and open cystolithotripsy. He received long-term antibiotics and back surgery resulting in residual chronic back pain. This case illustrates important chronic infectious complications associated with the high-risk sexual practice of urethral sounding.

Introduction The opioid epidemic has been linked to several other health problems, but its impact on headache disorders has not been well studied. We performed a population-based study looking at the prevalence of opioid use in headache disorders and its impact on outcomes compared to non-abusers with headaches. Methodology We performed a cross-sectional analysis of the Nationwide Inpatient Sample (years 2008-2014) in adults hospitalized for primary headache disorders (migraine, tension-type headache [TTH], and cluster headache [CH]) using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We performed weighted analyses using the chi-square test, Student's t-test, and Cochran-Armitage trend test. Multivariate survey logistic regression analysis with weighted algorithm modelling was performed to evaluate morbidity, disability, and discharge disposition. Among US hospitalizations during 2013-2014, regression analysis was performed to evaluate the odds of having opioid abuse among headache disorders. Results A total of 5,627,936 headache hospitalizations were present between 2008 and 2014 of which 3,098,542 (55.06%), 113,332 (2.01%), 26,572 (0.47%) were related to migraine, TTH, and CH, respectively. Of these headache hospitalizations, 128,383 (2.28%) patients had abused opioids. There was a significant increase in the prevalence trend of opioid abuse among patients with headache disorders from 2008 to 2014. The prevalence of migraine (63.54% vs. 54.86%), TTH (2.29% vs. 2.01%), and CH (0.59% vs. 0.47%) was also higher among opioid abusers than non-abusers (p<0.0001). Opioid abusers with headaches were more likely to be younger (43 years old vs. 50 years old), men (30.17% vs. 24.78%), white (80.83% vs. 73.29%), Medicaid recipients (30.15% vs. 17.03%), and emergency admissions (85.4% vs. 78.51%) as compared to opioid non-abusers with headaches (p<0.0001). Opioid abusers with headaches had higher prevalence and odds of morbidity (4.06% vs. 3.70%; adjusted odds ratio [aOR]: 1.48; 95% CI: 1.39-1.59), severe disability (28.14% vs. 22.43%; aOR: 1.58; 95% CI: 1.53-1.63), and discharge to non-home location (17.13% vs. 18.41%; aOR: 1.35; 95% CI: 1.30-1.40) as compared to non-abusers. US hospitalizations in years 2013-2014 showed the migraine (OR: 1.61; 95% CI: 1.57-1.66), TTH (OR: 1.43; 95% CI: 1.22-1.66), and CH (OR: 1.34; 95% CI: 1.01-1.78) were linked with opioid abuse. Conclusion Through this study, we found that the prevalence of migraine, TTH, and CH was higher in opioid abusers than non-abusers. Opioid abusers with primary headache disorders had higher odds of morbidity, severe disability, and discharge to non-home location as compared to non-abusers.

Vertebral compression fractures are often found in the elderly population with known risk factors. Less commonly, they may occur in otherwise healthy patients following traumatic falls and can cause significant pain requiring opioid therapy. This case emphasizes the use of percutaneous balloon kyphoplasty as an effective treatment strategy in a young opioid-dependent patient as a means to support the return to baseline functionality.