Rejected

SPN-812 (extended-release viloxazine) is a structurally distinct, bicyclic, Serotonin Norepinephrine Modulating Agent (SNMA) in development as a treatment for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. This Phase 3, randomized, double-blind study (P302) evaluated the efficacy and safety of once-daily SPN-812 at doses of 200 and 400 mg compared to placebo in adolescents ages 12-17yrs with ADHD.

Vedolizumab (VDZ) is a humanized monoclonal IgG1 antibody which inhibits leukocyte vascular adhesion and migration into the gastrointestinal tract through α4β7 integrin blockade.

Subacromial impingement/pain syndrome is a common cause of shoulder pain that encompasses a spectrum of pathology of the subacromial bursa and rotator cuff tendons. Pathology of the rotator cuff tendons can range from inflammation to fibrotic changes to partial- and full-thickness tears. Biomechanical dysfunction of the rotator cuff and glenohumeral complex contributes to the pathophysiology and progression of subacromial impingement/pain syndrome. The most common risk factor for subacromial pain and rotator cuff tendinopathy is repetitive overhead activity. Rotator cuff conditions typically manifest with an insidious onset of pain but also can be the result of acute injury. Magnetic resonance imaging study and ultrasonography may be useful to evaluate for soft tissue pathology, depending on the level of clinical concern regarding rotator cuff tear. Management of rotator cuff conditions depends on multiple factors, including chronicity, underlying anatomic and biomechanical factors, age, and the presence and degree of tendon tears. Management typically starts with conservative care such as physical therapy, anti-inflammatory drugs, and injection therapies but eventually may include surgical repair.

Up to two-thirds of adolescent girls report painful periods but few seek medical care for their dysmenorrhea. Dysmenorrhea is associated with multiple physical and psychological symptoms, and the delayed evaluation and treatment of dysmenorrhea contributes to a poor quality of life and can result in lifelong health problems, including chronic pelvic pain and infertility. It is recommended that an assessment of patients' menstrual cycles be performed regularly, as identification of abnormally painful menstrual cycles may reveal potential health problems, including pelvic diseases such as endometriosis and adenomyosis. Visits to primary care providers offer an opportunity to assess and educate adolescents and their families on normal menstrual physiology. The purpose of this article is to review the evaluation and management of dysmenorrhea. [Pediatr Ann. 2020;49(4):e176-e182.].

Rheumatoid arthritis (RA) is a systemic, inflammatory disease of the joints and surrounding tissues. RA manifests itself with severe joint pain, articular inflammation, and oxidative stress. RA is associated with certain types of cancer. We have assumed that RA patients' increased susceptibility to cancer may be linked with genomic instability induced by impaired DNA repair and sensitivity to DNA damaging agents. The aim of this work was to analyze the sensitivity of peripheral blood mononuclear cells (PBMCs) isolated from RA patients to DNA damaging agents: tert-butyl hydroperoxide (TBH), bleomycin, ultraviolet (UV) radiation, and methyl methanesulfonate (MMS) and calculate the repair efficiency. TBH induce oxidative DNA lesions repaired mainly by base excision repair (BER). Bleomycin induced mainly DNA double-strand breaks repaired by non-homologous end joining (NHEJ) and homologous recombination repair (HRR). We included 20 rheumatoid arthritis patients and 20 healthy controls and used an alkaline version of the comet assay with modification to measure sensitivity to DNA damaging agents and DNA repair efficiency. We found an increased number of DNA breaks and alkali-labile sites in the RA patients compared to those in the controls. Exposure to DNA damaging agents evoked the same increased damage in both groups, but we observed statistically higher PMBC sensitivity to TBH, MMS, bleomycin as well as UV. Examination of the repair kinetics of both groups revealed that the DNA lesions induced by TBH and bleomycin were more efficiently repaired in the controls than in the patients. These data suggest impaired DNA repair in RA patients, which may accelerate PBMC aging and/or lead to higher cancer incidence among RA patients.

Cannabis has been used for thousands of years in many cultures for the treatment of several ailments including pain. The benefits of cannabis are mediated largely by cannabinoids, the most prominent of which are tetrahydrocannabinol (THC) and cannabidiol (CBD). As such, THC and/or CBD have been investigated in clinical studies for the treatment of many conditions including neuropathic pain and acute or chronic inflammation. While a plethora of studies have examined the biochemical effects of purified THC and/or CBD, only a few have focused on the effects of full-spectrum cannabis plant extract. Accordingly, studies using purified THC or CBD may not accurately reflect the potential health benefits of full-spectrum cannabis extracts. Indeed, the cannabis plant produces a wide range of cannabinoids, terpenes, flavonoids, and other bioactive molecules which are likely to contribute to the different biological effects. The presence of all these bioactive molecules in cannabis extracts has garnered much attention of late especially with regard to their potential role in the treatment of neuropathic pain associated with multiple sclerosis.

Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence.

Recognition and treatment of maternal hypotension during epidural anesthesia administration for intrapartum cesarean delivery preserves maternal-fetal perfusion. A case that required quality assurance review uncovered lapses in maternal hemodynamic monitoring during the transition to intrapartum cesarean delivery anesthesia. To address this, a practice outline was designed for trainee's education describing intrapartum epidural dosing for cesarean delivery and adequate blood pressure monitoring. The time-lapse between epidural dosing and subsequent blood pressure was evaluated before and after the introduction of our educational tool. The time-lapse between blood pressure measures decreased to <10 minutes (10.78-13.92 vs 8.8-9.76 minutes).

Acute mountain sickness (AMS) is a syndrome of non-specific symptoms (i.e. headache, anorexia, nausea, vomiting, dizziness, and fatigue) that may develop in non-acclimatized individuals after rapid exposure to altitudes ≥2500 m. In field studies, mean AMS scores usually peak after the first night at a new altitude. Analyses of the individual time courses of AMS in 4 studies performed at 3450 m and 4559 m revealed that 3 different patterns are hidden in the above described overall picture. In 41% of those who developed AMS (i.e. AMS-C score >0.70) symptoms peaked on day 1, in 39% symptoms were most prominent on day 2, and in 20 % symptoms were most prominent on day 3. We suggest to name the different time courses of AMS type I, type II, and type III, respectively. Here we hypothesize that the variation of time courses of AMS are caused by different pathophysiologic mechanisms. This assumption could explain why no consistent correlations between an overall assessment of AMS and single pathophysiologic factors have been found in a large number of studies over the last 50 years. In this paper we will briefly review the fundamental mechanisms implicated in the pathophysiology of AMS and discuss how they might contribute to the three different AMS time courses.

PRF stimulation has been safely and effectively applied for controlling various types of pain.