Rejected

To compare the effects of intrathecal anaesthesia using procaine and xylazine, with and without sedation with I/V xylazine and butorphanol, on sedation and cardiorespiratory measures in calves undergoing umbilical surgery.

To describe the (1) prevalence and perceptions of cardiovascular disease and related health conditions in African Americans with osteoarthritis pain, (2) their knowledge of cardiovascular safety of commonly prescribed analgesics for OA, and (3) frequency of high-risk analgesic use.

Involvement of the pituitary gland by leukemic infiltration is exceedingly rare. Here, we describe a very late recurrence of B-cell acute lymphoblastic leukemia masquerading as a pituitary tumor and review the literature for previously reported cases. Our female patient presented 13 years after completion of therapy for B-ALL with headache, amenorrhea, galactorrhea and a pituitary mass. Subsequent studies revealed recurrence of her leukemia, and the pituitary lesion resolved after induction chemotherapy. Our case highlights the importance of considering leukemic infiltrate in the differential diagnosis of pituitary mass, particularly in a patient with a history of hematologic malignancy, sparing unnecessary surgical intervention and informing endocrine evaluation. In addition, the case also highlights difficulties with characterizing this recurrence as a very late relapse or clonal evolution of the original leukemia.

We herein report a patient who was diagnosed as having olfactory groove schwannoma (OGS) which was negative for CD57 (Leu7) but positive for Schwann/2E and Sox10. A 13-year-old female with a chief complaint of headache was referred to our department due to a tumor lesion in the anterior skull base identified by magnetic resonance imaging (MRI). At the first visit, she did not exhibit altered consciousness, motor palsy, anosmia, seizures, or café au lait spots. On contrast-enhanced computed tomography (CT), a heterogeneously enhanced tumor, 50 × 45 × 50 mm in size, was observed at the anterior skull base. The left cribriform plate was thinner on bone window CT. The tumor exhibited strong, heterogeneous gadolinium enhancement on MRI as well. Slight tumor staining was observed by angiography of the left internal carotid artery but not the left external carotid artery. The patient was preoperatively diagnosed as having meningioma and underwent gross tumor resection via the basal interhemispheric approach. The tumor was strongly positive for S-100 protein and negative for epithelial membrane antigen and CD57 by immunostaining. The tumor was positive for both Schwann/2E and Sox10, which aided in the differential diagnosis between OGSs and olfactory ensheathing cell (OEC) tumors, and the definitive diagnosis was OGS. The assessment of immunoreactivities for Schwann/2E and Sox10 might be necessary to differentiate CD57-negative Schwannomas from OEC tumors.

Inflammatory myopathies (IM) [1] and myasthenia gravis (MG) [2] are autoimmune disorders presenting with muscle weakness. Their coexistence is infrequent, and the myasthenia-myositis clinical spectrum has emerged as a novel concept [3]. A 66-year-old woman with postoperative hypothyroidism presented with acute onset muscle pain in limbs starting two weeks earlier.

Post-laminectomy syndrome (PLS) is characterized by chronic pain and complex pathological entity after back surgery. An epidural adhesiolysis is considered an effective treatment option for lumbar PLS. In this study, we retrospectively analyzed the outcome and evaluated the predictive factors of combined epidural adhesiolysis and balloon decompression using inflatable balloon catheters in lumbar PLS cases. One hundred and forty-seven subjects were retrospectively assessed and analyzed. The percentages of patients who exhibited treatment response were 32.0%, 24.5%, and 22.4% of the study population at 1, 3, and 6 months, respectively. In multivariate logistic regression analysis, the pain duration was independently associated with the treatment response six months after combined epidural adhesiolysis and balloon decompression (odds ratio = 0.985, 95% confidence interval = 0.971-0.999; = 0.038). In addition, the receiver operating characteristic curve analysis showed that the area under the curve of pain duration after lumbar surgery was 0.680 (95% confidence interval = 0.597-0.754, = 0.002), with an optimal cut-off value of ≤14 months, sensitivity of 51.5%, and specificity of 81.4% Our results suggest that an early intervention using combined epidural adhesiolysis and balloon decompression in lumbar PLS patients may be associated with a favorable outcome, even though it has limited effectiveness.

Novel coronavirus, SARS-CoV2, has caused pandemic of highly contagious disease called coronavirus disease 2019 (COVID-19), with epicenters in China, Italy, Spain, and the USA. Primarily affecting the human respiratory system, SARS-CoV2 has some impact on the human brain, but apparently minimal on the cerebellum, at least so far. Neurological involvement in the acute phase appears to manifest with confusion, dizziness, impaired consciousness, propensity to develop acute strokes, anosmia, hypogeusia, ataxia, epilepsy, and neuralgia. Cerebellar scholars are facing a time of uncertainty. Telemedicine has suddenly emerged as an alternative to follow patients. There is an urgent need to develop novel platforms to assess and follow ataxic patients remotely, especially because cerebellar patients often require ambulatory care to maintain their autonomy.

Type 2 diabetes mellitus (T2DM) is most demanding public health problem of 21 century. Uncontrolled diabetes may cause complications affecting any part of gut from mouth to rectum presenting as vomiting, nausea, bloating, abdominal pain, constipation and diarrhoea. The aim of this study was to compare levels of oxidative stress and inflammatory markers in small intestinal bacterial overgrowth (SIBO) positive and negative diabetic patients.

Zika virus (ZIKV) is an emergent arthropod-borne virus whose outbreak in Brazil has brought major public health problems. Infected individuals have different symptoms, including rash and pruritus, which can be relieved by the administration of antiallergics. In the case of pregnant women, ZIKV can cross the placenta and infect the fetus leading to congenital defects. We have identified that mast cells in the placentae of patients who had Zika during pregnancy can be infected. This led to our investigation on the possible role of mast cells during a ZIKV infection, using the HMC-1 cell line. We analyzed their permissiveness to infection, release of mediators and ultrastructural changes. Flow cytometry detection of ZIKV-NS1 expression 24 h post infection in 45.3% of cells showed that HMC-1 cells are permissive to ZIKV infection. Following infection, β-hexosaminidase was measured in the supernatant of the cells with a notable release at 30 min. In addition, an increase in TNF-α, IL-6, IL-10 and VEGF levels were measured at 6 h and 24 h post infection. Lastly, different intracellular changes were observed in an ultrastructural analysis of infected cells. Our findings suggest that mast cells may represent an important source of mediators that can activate other immune cell types during a ZIKV infection, which has the potential to be a major contributor in the spread of the virus in cases of vertical transmission.