Rejected

This paper is part of the international consensus guidelines on chronic pancreatitis, presenting for interventional endoscopy.

Susceptibility to severe motion sickness has not been well described in the pediatric population, particularly in very young children. This study aimed to describe and evaluate risk factors and treatment responses in a group of children with severe motion sickness, including infants and toddlers.

We present a case of chronic non-communicating hydrocephalus (NCH) in a US military recruit. Non-communicating hydrocephalus is a pathologic obstruction of cerebrospinal fluid (CSF) resulting in enlargement of the ventricles and elevated intracranial pressure. The patient is an 18-year-old male recruit who was evaluated in the Naval Medical Center emergency room for left hip pain and incidentally was found to have profound ventriculomegaly on head imaging. The diagnosis and evaluation of hydrocephalus is greatly dependent on clinical history and supported by radiographic imaging. Based on these factors, one can determine if the hydrocephalus is either acute or chronic and communicating or non-communicating.

Mastocytosis is a spectrum of neoplastic, clonal cell disorders that are characterized by mast cell hyperplasia and accumulation. Disease and clinical presentation can vary depending on the extent of spread, ranging from skin-limited cutaneous mastocytosis to systemic mastocytosis that can mimic other disease processes. Symptoms may include pruritus, flushing, hypotension, headaches, abdominal pain, nausea, vomiting, and diarrhea. Although gastrointestinal (GI) symptoms are present in a majority of patients with systemic disease, the actual percentage of gut mast cell infiltration remains unknown. Here we describe a case of diarrhea secondary to GI involvement of systemic mastocytosis. A 55-year-old woman with a known history of systemic mastocytosis and medical noncompliance complained of persistent chronic diarrhea for one year. She was evaluated for other causes of diarrhea but all additional testing was unrevealing. She ultimately underwent upper endoscopy and colonoscopy in which biopsy and histologic analysis confirmed the presence of mastocyte infiltration. She was restarted on her medical therapy and her symptoms resolved. In conclusion, systemic mastocytosis is an uncommon cause of chronic diarrhea. However, in select patients, it is important to obtain a thorough medical history and exclude other potential causes.

The posterior communicating arteries (PCoA) are important component of collateral circulation between the anterior and posterior part of circle of Willis (CW). The hypoplasia or aplasia of PCoA will reflect on prognosis of the neurological diseases. Precise studies of the incidence of hypoplastic PCoA in Andhra Pradesh population of India are hitherto unreported, since the present study was undertaken. Two hundred and thirty one magnetic resonance angiography (MRA) images were analyzed to identify the hypoplasia of PCoA and presence of fetal type of posterior cerebral artery (f-PCA) in patients with different neurological symptoms. All the patients underwent 3.0T MRI exposure. The results were statistically analysed. A total of 63 (27.3%) PCoA hypoplasia and 13 cases with f-PCA (5.6%) cases were identified. The hypoplastic PCoA was noted more in males than females (<0.05) and right side hypoplasia was common than the left (<0.04); bilateral hypoplasia of PCoA was seen in 37 cases out of 63 and is significant. The hypoplastic cases of the present study also were associated with variations of anterior cerebral arteries and one case was having vertebral artery hypoplasia. Incidence of PCoA as unilateral or bilateral with other associated anomalies of CW is more prone to develop stroke, migraine and cognitive dysfunction. Knowledge of these variations in the PCoA plays a pivotal role in diagnoses of neurological disorders and in neurovascular surgeries and angiographic point of view.

Exercise programs in the treatment of chronic lumbar pain are quite diverse, but it has been proven that stabilization exercises are the most effective.

Cilostazol, a phosphodiesterase 3' inhibitor, is used in Asia-Pacific countries for stroke prevention, but rarely used elsewhere. In addition to weak antiplatelet effects, it stabilizes endothelium, aids myelin repair and astrocyte-neuron energy transfer in laboratory models, effects that may be beneficial in preventing small vessel disease progression.

To explore the surgical efficacy of microvascular decompression(MVD) when the recent magnetic resonance tomography angiography(MRA) is unable to determine the relationship between blood vessels and nerves in patients with trigeminal neuralgia(TN).

There are few reports on the comparison between teriparatide (PTH) and bisphosphonate (BP) in terms of osteoporosis pain-related behavior and immunohistochemical findings. The aims of this study were to evaluate skeletal pain associated with osteoporosis and to examine the inhibitory effect of PTH and BP on pain and bone loss in hind limb-unloaded (HU) mice. The mechanism of osteoporotic pain in HU mice was evaluated by examining pain-related behavior and immunohistochemical findings. The effects of PTH and alendronate (ALN), a potent osteoclast inhibitor, on these parameters were also assessed.