Rejected

Thyroid storm is a rare, life-threatening condition characterized by severe or exaggerated clinical manifestations of thyrotoxicosis, commonly occurring in patients with longstanding, untreated hyperthyroidism such as Graves' disease and toxic nodular goiter. Subacute painful thyroiditis, also known as de Quervain thyroiditis, is a self-limited inflammatory disease of the thyroid gland that is characterized by neck pain, a tender diffuse thyroid goiter, elevated inflammatory markers, and a predictable course of thyroid function evolution. Rarely, it can cause thyroid storm. Herein, we report a rare case of a 25-year-old woman who was admitted for sepsis and acute painful thyroiditis who then developed thyroid storm. The patient was treated in the intensive care unit (ICU) and responded very well to steroids, propranolol, a seven-day trial of propylthiouracil, and ultimately achieved a euthyroid state on discharge.

Soft tissue tumors of Schwann cells in either the peripheral or cranial nerves are known as schwannomas or also as neurilemmomas. Limited data exists regarding psoas muscle schwannoma in the literature. Therefore, we have done an extensive literature review and found a total number of 46 cases of intra-psoas schwannoma including our case, which are summarized in this article along with reporting our new case.

The present study aimed to investigate the effects of Solanum nigrum Linne (SNL) in a model of 1‑chloro‑2,4‑dinitrobenzene (DNCB)‑induced atopic dermatitis (AD) and in TNF‑α/IFN‑γ‑stimulated HaCaT cells. AD is a chronic inflammatory skin disease and is characterized by erythema, edema, increased pruritus and eczema. Steroids are most commonly used for anti‑inflammatory therapy; however, their long‑term use is limited due to side‑effects, such as osteoporosis, brittle skin, muscle weaknesses and diabetes. Therefore, patients with AD require alternative treatment strategies. In previous studies, SNL has been reported to be effective against oxidants and cancer. However, to the best of our knowledge, the effects of SNL on AD have not yet been investigated. The present study examined the effects of SNL ethanol extract on a model of DNCB induced AD and on TNF‑α/IFN‑γ‑stimulated HaCaT cells. The skin tissue was sectioned to measure the thicknesses of the epidermis and dermis, as well as the numbers of eosinophils, mast cells and CD8 infiltration by H&E, toluidine blue, Masson's trichrome and IHC staining. ELISA was performed using serum to measure IgE levels. The present study also examined the expression of various inflammatory cytokines, MAPK and NF‑κB in TNF‑α/IFN‑γ‑stimulated HaCaT cells. SNL significantly reduced the levels of cytokines released from HaCaT cells stimulated with TNF‑α/IFN‑γ. SNL also significantly reduced the levels of p‑p38 at 30 min and significantly reduced the activation of NF‑κB in a time course experiment. In addition, SNL significantly reduced the level of serum IgE and dermal thickness and the infiltration of mast cells and CD8 in the BALB/c mouse model of DNCB‑induced AD. The results of the current study suggest that SNL exerts a suppressive effect on pro‑inflammatory cytokines in vitro and in vivo through the regulation of the immune system.

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections.

Few cases of arterial thromboembolisms have been reported after 2019 coronavirus disease (COVID-19), in case of severe infection or elderly patients. We report a case of femoral arterial thrombosis in a young patient following non-severe infection.

The inflammatory markers sST2, HSP27 and hsCRP have already been identified as prognostic markers in chronic heart failure (HF). Though individual biomarkers have proven their value in mortality risk prediction, the role of a multimarker strategy needs further evaluation.

Background Increasing numbers of neonates are undergoing painful procedures in low-income and middle-income countries, with adequate analgesia seldom used. In collaboration with a multi-disciplinary team in Kenya, we aimed to establish the first evidence-based guidelines for the management of routine procedure-related neonatal pain that consider low-resource hospital settings.

The COVID-19 outbreak, designated a "pandemic" by the World Health Organization (WHO) on 11 March 2020, has spread worldwide rapidly. Each country implemented prevention and control strategies, mainly classified as SARS LCS (SARS-like containment strategy) or PAIN LMS (pandemic influenza-like mitigation strategy). The reasons for variation in each strategy's efficacy in controlling COVID-19 epidemics were unclear and are investigated in this paper. On the basis of the daily number of confirmed local (imported) cases and onset-to-confirmation distributions for local cases, we initially estimated the daily number of local (imported) illness onsets by a deconvolution method for mainland China, South Korea, Japan and Spain, and then estimated the effective reproduction numbers by using a Bayesian method for each of the four countries. China and South Korea adopted a strict SARS LCS, to completely block the spread via lockdown, strict travel restrictions and by detection and isolation of patients, which led to persistent declines in effective reproduction numbers. In contrast, Japan and Spain adopted a typical PAIN LMS to mitigate the spread via maintaining social distance, self-quarantine and isolation etc., which reduced the values but with oscillations around 1. The finding suggests that governments may need to consider multiple factors such as quantities of medical resources, the likely extent of the public's compliance to different intensities of intervention measures, and the economic situation to design the most appropriate policies to fight COVID-19 epidemics.

National guidelines recommend early palliative care for patients with advanced heart failure, which disproportionately affects rural and minority populations.

Gastric volvulus is defined as twisting of the stomach along its long or short axis, a rare clinical entity that can lead to gastric outlet obstruction. Symptoms are typically acute and include retching, abdominal pain, and vomiting. Chronic intermittent manifestations of this entity present a diagnostic challenge as conclusive imaging findings are only apparent during symptomatic periods. Given the disorder's intermittent nature, a volvulus may resolve before imaging studies can be conducted. We present a rare case of an intermittent organo-axial gastric volvulus that responded to conservative measures.