Rejected

Patellar tendinopathy is a common inflammatory condition in athletes who undergo large volumes of running and jumping. Kinesio-tape® (KT) is proposed to provide pain relief; however, its effect has not been examined on patellar tendinopathy.

Sjogren's syndrome (SS) is a chronic autoimmune disorder that causes the inflammation of the lacrimal and salivary glands, resulting in dryness of the eyes and mouth. In addition, fatigue and musculoskeletal pain, often described as aching, are very common. Treatment directed towards alleviating the fatigue and pain associated with SS is currently very limited. In March of 2019, the first peer reviewed case report showing clinical improvement using low-dose naltrexone (LDN) in a patient with suspected SS was published in Cureus. This report describes two additional patients with SS whose conditions responded favorably to a treatment with LDN therapy. The first case is a 24-year-old female with documented SS. Her diagnosis was based on a history of dry eyes, dry mouth, joint pain, fatigue, and headache. In addition, she had very high measures of inflammation and a positive anti SS-A antibody. She improved clinically with LDN therapy. The second case is a 66-year-old female with documented SS based on a history of dry eyes and dry mouth, joint pain, and elevated anti-SSA and anti-SSB antibodies whose joint symptoms responded to treatment with LDN.

Sarcoidosis is a systemic disorder characterized by development of granulomas within various organs in the body. It commonly affects people of African American and Scandinavian heritage between the ages of 20 and 40. The lungs are involved in 90% of patients. We report a case of sarcoidosis of the spleen and liver with minimal pulmonary involvement.

The production of pro-inflammatory cytokines and chemokines is increased during inflammatory bowel disease (IBD). Previously, it was demonstrated that brain derived neurotrophic factor (BDNF) expression is increased in experimental models of colitis. BDNF is partially responsible for the structural and functional changes that take place during IBD. However, the exact mechanisms underlying the upregulation of BDNF during gut inflammation are unknown. The aim of the present study was to determine the effects of direct treatment of smooth muscle cells with inflammatory cytokines on the synthesis and secretion of BDNF. BDNF expression and secretion levels were measured using ELISA kits on tissue lysates and on incubation media used to culture the rat colon smooth muscle tissues treated for 24 h with either tumor necrosis factor (TNF)-α or interleukin (IL)-1β. Compared with the control tissue samples, treatment with TNF-α and IL-1β resulted in a significant increase in the protein expression levels of BDNF in the incubated smooth muscle tissue. TNF-α and IL-1β also stimulated the secretion of BDNF. Chelation of intracellular Ca with BABTA-AM prevented the TNF-α and IL-1β-induced increase in BDNF protein expression and secretion levels. Furthermore, inhibition of protein kinase A (PKA) significantly reduced BDNF expression levels when treated with cytokines but not secretion. In conclusion, proinflammatory cytokines that are upregulated during IBD, directly stimulated BDNF expression and secretion in a Ca dependent manner. Considering the ability of BDNF to enhance smooth muscle contraction and pain sensation, this autocrine loop may partially explain the characteristic hypercontractility and hypersensitivity associated with IBD.

Snakebites caused by the genus Bothrops are often associated with severe and complex local manifestations such as edema, pain, hemorrhage, and myonecrosis. Conventional treatment minimizes the systemic effects of venom; however, their local action is not neutralized. The purpose of this study was to evaluate the effect of photobiomodulation (PBM) on C2C12 muscle cells exposed to B. jararaca, B. jararacussu, and B. moojeni venoms on events involved in cell death and the release of inflammatory mediators. Cells were exposed to venoms and immediately irradiated with low-level laser (LLL) application in continuous wave at the wavelength of 660 nm, energy density of 4.4 J/cm, power of 10 mW, area of 0.045 cm, and time of 20 s. Cell integrity was analyzed by phase contrast microscope and cell death was performed by flow cytometry. In addition, interleukin IL1-β, IL-6, and IL-10 levels were measured in the supernatant. Our results showed that the application of PBM increases cell viability and decreases cell death by apoptosis and necrosis. Moreover, the release of pro-inflammatory interleukins was also reduced. The data reported here indicate that PBM resulted in cytoprotection on myoblast C2C12 cells after venom exposure. This protection involves the modulation of cell death mechanism and decreased pro-inflammatory cytokine release.

Although renal cell carcinoma (RCC) is known for its propensity to metastasize widely throughout the body, cutaneous metastases are uncommon and seen in less than 3% of RCCs. A 56-year-old man presented with a painful red lesion with satellite nodules on his abdomen at a laparoscopic port site from a partial nephrectomy for a pT1a clear cell RCC that was performed 28 months prior. The lesion was excised; however, after excision the lesion recurred with continued pain and drainage from the surgical site. This was treated with multiple courses of antibiotics. Due to the persistent nature of the lesion, it was re-biopsied, and an atypical, keratin-positive, spindle-cell proliferation was identified within the dermis. The patient's previous skin excision was reexamined, and the same atypical cells were identified within large areas of necrosis, granulation tissue, and fibrosis. Further workup was performed on the initial excision, and the atypical cells showed expression of CD10, CAIX, PAX8, EMA, and vimentin, consistent with cutaneous involvement by RCC. Due to the rarity of skin metastases in RCC and the location at a previous laparoscopic port site, this lesion is presumed to have resulted from direct extension of tumor at the time of surgery. This article is protected by copyright. All rights reserved.

The purpose of the study was to investigate the effect of dexmedetomidine hydrochloride (Dex) on the recovery of cognitive function, hemodynamics, and postoperative analgesia in patients undergoing intracranial aneurysm craniotomy.

Sacroiliac joint dysfunction (SIJD) is a prominent source of pain in low back pain (LBP) patients. Tenderness inferior to the posterior superior iliac spine (PSIS) is an important sign presented in SIJD. Techniques including muscle energy technique (MET) and mechanical diagnosis and therapy (MDT) have shown benefits in SIJD. However, the effects of these treatments on tenderness and pain around the PSIS are yet to be determined.

White lesions of the vulva are a common vulvar disease of unclear etiology. Although a variety of treatments have been used to treat the disease in clinical practice, there is currently a lack of effective radical therapies. This study aimed to compare the feasibility and effectiveness of fractional ultrapulsed CO2 laser with that of high-intensity focused ultrasound in the treatment of white lesions of the vulva.