Rejected

The purpose of this study was to determine which nonsurgical treatments patients believe are most effective for managing pain secondary to hip and knee arthritis.

To compare postoperative pain control among men who received different quantities of narcotic prescriptions following scrotal surgery. We hypothesized that men receiving eight vs four pills of acetaminophen 300 mg/codeine 30 mg there would be no significant difference in mean pain following scrotal and inguinal surgery.

Scarring and volume reduction of the axillary space resulting in persistent lymphedema is a side effect of axillary treatment in breast cancer patients. The aim of this paper is to describe the reduction of lymphedema achieved with a turnover flap. Between October 2016 and May 2018, five patients with grade 2 lymphedema following breast cancer therapy underwent reconstructive surgery with a turnover flap. Complete excision of the symptomatic axillary scar tissue followed by re-augmentation using a turnover flap was performed. Subsequently, all patients underwent breast reconstruction using a distant flap reconnected to the thoracodorsal vessels. The circumference of both arms, quality of life and pain were measured before and after surgery. An average reduction in pain in the ipsilateral arm from 6 to 1 on the numerical scale as well as an improvement in quality of life (2.8 vs. 7.0) was observed. A decrease in lymphedema especially in the upper arm was identified. No complications such as secondary bleeding, infections or flap loss were observed. Complete removal of the axillary scar tissue after breast cancer treatment and re-augmentation of the axilla with a turnover flap results in a reduction in ipsilateral lymphedema and an improvement in pain and quality of life. We interpret these findings as a result of the physiological re-alignment of the lymphatic vessels combined with a lymph node-containing local transposition flap. Therefore, re-augmentation with a turnover flap could be an effective non-microsurgical alternative to lymph node transplantation.

Caesarean rates increased in different parts of the world, rising from 20% to 33% in the USA and from 40% to 55% in Brazil between 1996 and 2011; however, there was no reduction in morbimortality rates. Several factors have been suggested as responsible for this increase, such as health judicialisation, fear of the painful process on the patients' part and reduction of medical training in vaginal delivery and labour complications. It is urgent to reverse this process and, therefore, a model of actions was created with the intention of engaging the team in order to reduce caesarean rates in a Brazilian hospital.

Migraine is a recurrent, disabling neurovascular headache disorder. The patient's quality of life can be severely impaired by migraine attacks. Stellate ganglion block (SGB) can be used to relieve pain in the head, neck, and upper extremities. In the present cases, we performed SGB in 2 patients with migraine that responds poorly to drugs.

To investigate the postoperative analgesic effect of ultrasound-guided quadratus lumborum block (QLB) in patients undergoing arthroscopic hip surgery.

It has recently been shown that the 'triangle operation'1 may be associated with margin-free resection in selected patients with borderline resectable pancreatic cancer after neoadjuvant chemotherapy. Such a procedure consists of en bloc removal, following the adventitial plane of the whole mesopancreas from the triangular space delimited by the superior mesenteric artery, hepatic artery, and portal vein.2-11 In this video, we show how to safely perform this procedure by laparoscopy.

Emergence of the novel corona virus (severe acute respiratory syndrome (SARS)-CoV-2) in December 2019 has led to the covid-19 pandemic. The extent of covid-19 involvement in the central nervous system is not well established, and the presence or the absence of SARS-CoV-2 particles in the cerebrospinal fluid (CSF) is a topic of debate.

Acute traumatic avulsion or rupture of the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (TMP) joint is a frequent sports-related injury. If not diagnosed and treated early, it may lead to chronic instability, pain, and loss of pinch and grip strength and possibly osteoarthritis. UCL insufficiency may be treated by various techniques, such as bone anchors, transosseous sutures with or without a pull-out button, tendon grafts, or with TMP joint fusion in neglected cases with arthrosis. A simple technique of internal fixation of an avulsion fracture of the distal attachment of the UCL on the proximal phalanx of the thumb using transosseous sutures is described.