Rejected

Pediatric migraine is common, and appropriate abortive treatment is important to limit impact on school performance and mental health. This review will describe the latest evidence for abortive treatment in the emergency department and inpatient settings.

Pain is a significant public health issue that may be particularly problematic among injured service members who are at high risk of chronic physical and mental health conditions. The goals of this study were to describe the prevalence and types of low back pain (acute vs. recurrent) among service members injured while on combat deployments, and to examine the differences in posttraumatic stress disorder (PTSD) and depression prevalence and severity, as well as quality of life, for individuals with low back pain compared with those without.

Modifications at the basic nitrogen of the benzomorphan scaffold allowed the development of compounds able to segregate physiological responses downstream of the receptor signaling, opening new possibilities in opioid drug development. Alkylation of the phenyl ring in the -substituent of the MOR-agonist/DOR-antagonist LP1 resulted in retention of MOR affinity. Moreover, derivatives , , and were biased MOR agonists toward ERK1,2 activity stimulation, whereas derivative was a low potency MOR agonist on adenylate cyclase inhibition. They were further screened in the mouse tail flick test and PGE2-induced hyperalgesia and drug-induced gastrointestinal transit.

Adhesions are a major cause of long-term postsurgical complications in abdominal and pelvic surgery. Existing adhesion scores primarily measure morphological characteristics of adhesions that do not necessarily correlate with morbidity. The aim of this study was to develop a clinical adhesion score (CLAS) measuring overall clinical morbidity of adhesion-related complications in abdominal and pelvic surgery.

Asking questions of our political candidates can help us understand where they stand on issues. To support that aim, American Geriatrics Society (AGS) leaders and public policy experts have developed a compendium of questions that AGS members and others can use to ascertain where candidates stand on issues important to achieving our vision for a world where we are all able to contribute to our communities and maintain our health, safety, and independence as we age, and where older people have access to high-quality person-centered care informed by geriatrics principles. This question guide will help hold officials accountable by encouraging those who run for any office, including and perhaps especially the presidency, to articulate a clear actionable vision to meet the needs of all older Americans by (1) ensuring access to geriatrics health professionals, (2) expanding Title VII geriatrics training programs, (3) ensuring our workforce is competent to care for older Americans, (4) reducing the toll and impact of chronic diseases, (5) ensuring access to adequate pain relief for older Americans living with advanced illness, (6) supporting American women, (7) supporting American families, and (8) addressing complexity in caring for older Americans.

Although doctor-led RAT has advantages, serial processing (triage – investigation – treatment) still predominates in UK EDs. We have designed a RAT decision-support app to assist ED nurses to select investigations and treatments at initial patient assessment and aid acuity scoring.

Inhibition of immune and inflammatory reaction induced by the expose of nucleus pulposus (NP) could effectively ameliorate neuropathic pain in the lumbar disc herniation. Maresin1 (MaR1), as a macrophage-derived mediator of inflammation resolution, displayed potent anti-inflammatory action. In the present study, we attempted to elucidate the impact of MaR1 on radicular pain and the interaction with NLRP3 inflammasome. We established a rat model of non-compressive lumbar disc herniation and different administration (MaR1 or Caspase-1 inhibitor) was given to them. The paw withdrawal latency (PWL) and paw withdrawal thresholds (PWTs) were observed to assess pain behaviors. The spinal cord horns were collected and the levels of IL-1β and IL-18 were measured by ELISA. The mRNA and protein expression levels of NLRP3 inflammasome components were tested by RT-PCR, western blot and immunohistochemistry. The endogenous MaR1 levels of the spinal cord were analyzed using LC-MS/MS. The application of NP in the models lead to mechanical and thermal hypersensitivity, increased IL-1β and IL-18 levels and expressions of NLRP3 inflammasome components, which were reversed markedly by administration of MaR1. Caspase-1 inhibition also improved mechanical hypersensitivity, decreased the expressions of inflammatory cytokines and restrained the activation of inflammasome. Meanwhile, Caspase-1 inhibitor promoted the endogenous MaR1 synthesis, which was hindered in the pain models. Altogether, our study indicated that the negative interaction between MaR1 and NLRP3 inflammasome mediated the inflammatory response in spinal dorsal horn, which involved in the pathogenesis of radicular pain.

Even before COVID-19 had a significant impact on public health in the UK, there were media reports that access to epidural analgesia for women during labour was being restricted in some NHS hospitals [1]. To determine whether the crisis management of COVID-19 in NHS hospitals was having an adverse effect on the availability of labour epidural analgesia, the Obstetric Anaesthetists' Association (OAA) surveyed consultant anaesthetists who are service leads for obstetric anaesthesia in their hospital. The link to an online survey was posted on a WhatsApp group, created for consultant service leads for obstetric anaesthesia to share information about COVID-19 disease, and was also emailed to all 209 consultants who the OAA believed to be service leads.

Anodal transspinal Direct Current Stimulation (tsDCS) has been suggested as a means to treat neuropathic pain by reducing pain signalling/processing and Laser Evoked Potentials (LEPs) likewise as a method to evaluate such reduction. However, results in previous studies are disagreeing. To evaluate these claims using rigorous methodology, LEPs were evoked from hands and feet in healthy volunteers. The N2 potential and three psychophysic parameters (general- and pinprick pain, warmth) were used to evaluate the signalling and appreciation of pain respectively. This was made at three time points; at baseline, directly- and 30 min after low thoracic tsDCS (20 min, 2.5 mA, cathode on shoulder). The study was randomized, cross over, double blinded and placebo controlled. At the group level, low thoracic anodal tsDCS produced reduced perceptions of all three tested pain qualities from the foot (p < 0.05 – p < 0.001). These reductions began during stimulation and became more pronounced during the 30 min after its cessation (p < 0.05 – p < 0.01). The LEP parameter alteration mirroring these changes was latency prolongation (p < 0.05 – p < 0.001) whereas amplitude reductions were in par with placebo stimulation. Similar but less pronounced and only transient (during stimulation, p < 0.05 – p < 0.001) changes, were seen for hand stimulation. The interindividual variation was large. The findings indicate that anodal tsDCS may become a technique to treat neuropathic pain by reducing pain signalling/processing and LEPs likewise a method to evaluate such reduction.

There is increasing interest in the use of purified cannabidiol (CBD) as a treatment for a wide range of conditions due to its reported anti-inflammatory, anxiolytic, antiemetic and anticonvulsant properties.