Rejected

Trigeminal neuralgia is an exemplary neuropathic pain condition characterized by paroxysmal electric-shock-like pain. However, up to 50% of patients also experiences concomitant continuous pain. In this neuroimaging study, we aimed to identify the specific anatomical features of trigeminal nerve root in patients with concomitant continuous pain.

The aim of this study was to compare the postoperative analgesic effectiveness of the 2 block types. We also aimed to evaluate the effect of these block types on the postoperative complications and parental satisfaction.

Trigeminal neuralgia (TN) is the most common cause of facial pain, leading to significant disability and impacting a patient´s quality of life. Percutaneous procedures like continuous radiofrequency (CRF), pulsed radiofrequency (PRF) and combined continuous and pulsed (CCPRF) have been studied in past years comparing different voltages in order to find more effective therapies with fewer complications, i.e. numbness and masseter muscle weakness. With regards to young patients, there is still insufficient evidence on the most appropriate procedure in this patient population. PRF does not cause thermal damage. The mechanism of action involves delivering an electrical field to targeted nerves or tissues, modulating pain. We propose that bipolar pulsed radiofrequency (2 parallel cannulas) in the trigeminal ganglion produce a denser and larger field resulting in more effective controlled pain. We present two cases of 40- and 48 year-old males with severe V2-3 TN who underwent bipolar PRF. We performed bipolar PRF on trigeminal ganglion through foramen ovale using two 22 G 100 mm cannula with 10 mm active tip. Parameters used were voltage 85 V, pulse width 20 ms and total duration time of 6 minutes. Both patients reported complete relief of pain after procedure and at 2 year up were pain free and experienced a better quality of life. There were no complications reported. CONCLUSIONS: Bipolar pulsed radiofrequency could be a non-neurodestructive option for young people with TN and deserves further investigation as a treatment option.

Approximately 30% of adults undergoing non-cardiac surgery suffer from preoperative anaemia. Preoperative anaemia is a risk factor for mortality and adverse outcomes in different surgical specialties and is frequently the reason for blood transfusion. The most common causes are renal, chronic diseases, and iron deficiency. International guidelines recommend that the cause of anaemia guide preoperative anaemia treatment. Recombinant human erythropoietin (rHuEPO) with iron supplementation has frequently been used to increase preoperative haemoglobin concentrations in patients in order to avoid the need for perioperative allogeneic red blood cell (RBC) transfusion.

Headache was described up to one third of the hospitalized patients, yet the clinical characteristics of headache associated with COVID-19 have not been defined. This observational case study included patients who were consulted to headache unit due to headache and had COVID-19 illness. Headache features in 13 PCR-confirmed COVID-19 patients with mild symptoms were reported. Headache was the isolated symptom of the COVID-19 in 3 patients, and emerged as an early symptom during the disease course in all patients. Patients specified severe, rapid onset, unrelenting headache with migraine-like features, as well as unusual sensory symptoms such as anosmia, and gastrointestinal symptoms such as diarrhea and loss of appetite and weight. Headache lasted up to 3 days in 70% of the patients and resolved in all patients within 2 weeks. Despite the fact that most of patients were female and headache characteristics were suggestive of migraine, majority of patients were not suffering from primary headaches. It was concluded that headache could be an isolated symptom of COVID-19, which might possibly be ignored in asymptomatic patients. Headaches associated with COVID-19 included features resembling migraine and/or atypical symptoms including anosmia and diarrhea.

We read with interest the narrative review by Arca et al. [1] on the use of headache medicines, specifically non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, amid novel coronavirus disease 2019 (COVID-19) pandemic. Arca et al. [1] have comprehensively summarized current understanding of the risks and benefits of NSAIDs and corticosteroids to facilitate decision-making by the clinicians. Nevertheless, we feel that headache medicines including the tricyclic antidepressant amitriptyline and the anticonvulsant valproate that possess the potential for weight gain are also worthy of discussion.

Respiratory symptoms are the predominant symptoms in COVID-19. However, 6.5 to 71% of patients with this disease have headaches (in most studies, between 11 and 14%). Despite this, little is known about the characteristics of this headache, its repercussions, or its temporal evolution. We describe here a case of persistent headache associated with COVID-19.

The value of intravenous oxycodone compared to morphine remains controversial. The purpose of this trial was to compare opioid-related adverse events (ORAES) of intravenous oxycodone and morphine after total hip arthroplasty.

Depression is very prevalent in rheumatoid arthritis (RA) compared with the general population and may be associated with poor clinical outcomes. Identifying factors associated with depression could improve outcomes for this at risk group. However, few studies have comprehensively examined the association of contextual and disease-related factors as well as pro inflammatory cytokines interleukin 6 (IL-6) and interleukin 17 (IL-17) with depression in RA. Therefore, we aimed to identify the factors significantly associated with depression and severe depression in RA, thus providing a reference for applying clinical care interventions for patients with RA.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic pain condition that requires multimodal management. The American Urologic Association includes sacral neuromodulation in the treatment algorithm for refractory IC/BPS. We sought to determine the rate of overall symptom improvement of IC/BPS symptoms, using validated measures, after treatment with percutaneous tibial nerve stimulation (PTNS), a form of peripheral neuromodulation.