Rejected

To report the long-term outcome of horses treated with interspinous ligament desmotomy (ISLD) for pain associated with overriding dorsal spinous processes (ORDSP) and determine the influence of preoperative diagnostic analgesia on long-term outcome.

The pectoral nerve block type II (Pecs II block) combined with general anesthesia provides analgesia during breast and axillary surgery. This report describes the first use of the Pecs II block as the sole anesthetic for axillary surgery. A patient needed resection of axillary masses. She was not only very reluctant to have general anesthesia but also considered high risk because of multiple comorbidities. An ultrasound-guided Pecs II block was performed. Both masses were resected without additional sedation or analgesia. This case report suggests that, in selected cases, the Pecs II block can be used as the sole anesthetic for axillary surgery.

Calcineurin inhibitors are the backbone of lung transplant (LT) immunosuppression regimens. The aim of this observational review is to evaluate the use of tacrolimus XR (LCP-Tac, Envarsus®) in LT recipients at various clinical stages from cyclosporine or tacrolimus IR (Tac-IR). Due to the favorable pharmacokinetics and reported lower adverse effects, LCP-Tac became the tacrolimus preparation of choice at our transplant center for conversion in the setting of the Tac-IR national shortage.

Endometriosis is a disease of reproductive age women that is commonly characterized by symptoms that often negatively impact quality of life. The clinical management of endometriosis remains highly variable and mostly influenced by geographic location, practice patterns, and breadth of clinician experience. This variability in treatment has inspired a trend towards multidisciplinary and specialized care of patients suffering from this disease. Surgical sampling, followed by histologic confirmation of endometrial-like tissue, remains the standard for the definitive diagnosis of endometriosis. However, the high sensitivity and specificity of MRI and ultrasound has shed light on the path towards non-surgical diagnosis of deep infiltrating endometriosis. Molecular variability and intricacy of this disease has limited the development of biologic markers to target for non-invasive diagnosis and pharmacologic therapies. Surgical management of advanced-stage endometriosis can be difficult, mostly secondary to the invasive nature of the disease, and anatomical distortion requiring advanced surgical skills to manage. The high prevalence of chronic pelvic pain and other complex pain syndromes in patients with endometriosis also requires knowledge in the management of these types of issues in order to provide comprehensive care. Menopausal endometriosis, extrapelvic presentation, and potential malignant transformation of lesions are infrequent, requiring a high index of suspicion for timely diagnosis and treatment.

Bipolar I disorder frequently has an early onset, with an estimated prevalence rate of 1.8% in pediatric populations. Early onset is associated with a high degree of chronicity; however, limited data are available on the long-term efficacy of drug therapies in pediatric populations. The aim of the current study was to evaluate the long-term safety and efficacy of lurasidone in children and adolescents with bipolar depression.

A position statement published by the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care (SIAARTI) is fostering a vibrant debate, crossed by deep fears. These are recommendations addressed to ICU doctors who must decide whether to implement intensive treatments for patients who need them to survive. Specifically, the reference is to the patients to whom the CoViD-19 epidemic has compromised respiratory capacity. We still do not have clear what positive criteria can help make clinical decisions in contexts of insufficient resources that force us to make choices.

Adhesive capsulitis is a common problem in patients with chronic kidney disease. Patients suffer from joint stiffness and painful joint movement.Conservative treatments consist non-steroid antiinflamatory drugs, intraarticular injections and physical therapy. Newer approches such as platelet-rich plasma injections (PRP) also can be applied but there is little evidence for the effectiveness of PRP in patients with adhesive capsulitis. A 70 year-old woman, receives dialysis treatment admitted to our out-patient clinic with stiffness and pain in her right shoulder. Her diagnosis was confirmed with MRI as adhesive capsulitis., PRP injectionn began to be applied as planned; 3 times, 15 days between each injection. Visual analog scale (VAS), disabilities of the arm, shoulder and hand questionnare (DASH) and range of motion (ROM) of her right shoulder were evaluated before the procedure process. ROM, DASH and VAS were assessed every 2 weeks after each injection. At the last assesment average ROM increased on flexor, abductor and internal rotator sides. It was evaluated 90° for flexion, 90° for abduction and 30° for internal rotation. However, she didn't report any improvement for function and pain based on DASH and VAS.

To explore healthcare professionals' perceptions of challenges to chronic pain management.

Primary Central Nervous System Lymphoma (PCNSL) remains a diagnostic challenge due to the variable clinical manifestations. Liquid biopsies, particularly those involving cell-free DNA (cfDNA) from plasma, are rapidly emerging as important and minimally invasive adjuncts to traditional biopsies. However, conventional pathology may be still essential to obtain a diagnosis.