Rejected

Mineral and bone diseases (MBD) are predominant in patients with chronic kidney disease (CKD) and leads to several bone manifestations, from pain to skeletal fractures. Cumulative traditional clinical risk factors, such as age and gender, in addition to those related to CKD, enhances the risk of comorbidity and mortality related to fractures. Despite great advances in understanding MBD in CKD, clinical and biological targets are lacking, which leads to under-management of fractures. Optimal PTH control results in a net improvement in defining the levels of bone remodeling. In addition, circulating biomarkers such as bone-specific alkaline phosphatase and cross-linked collagen type I peptide will also additional information about bone mineralization and evaluation of fracture risk. Imaging techniques will facilitate to characterize the patient at risk by the use of the measurement of bone mineral density by DEXA or by high peripheral computed tomography which allow the discrimination of trabecular and cortical bone. We here reviewed the literature related to the epidemiology and pathophysiological role of mineral and biochemical factors involved in CKD-MBD with a special focus in fracture risk. We also provide an algorithm that could be used for the management of bone diseases and the treatment decision. Finally, the combined expertise of clinicians from various disciplines is crucial for the best prevention of fractures.

The influence of aging on the clinical presentation of obstructive sleep apnea (OSA) is not well characterized in US veterans. Our aims were to (1) examine age and established predictors of sleepiness and insomnia symptoms in veterans with OSA and (2) determine if the relationship between predictors of the Epworth sleepiness scale (ESS) and insomnia severity index (ISI) depended on age.

Abnormal remodeling of subchondral bone (SB) induced by estrogen deficiency has been shown to be involved in osteoarthritis (OA). Raloxifene (RAL) is commonly used to treat postmenopausal osteoporosis (OP). However, little is known about its effects on OA combined with estrogen deficiency. This study was performed to evaluate the efficacy of RAL on patella baja-induced patellofemoral joint OA (PFJOA) in an ovariectomized rat model.

There has been a rise in urgent care centers throughout the country over the past 10 years, leading to an increase in patients accessing medical care in these locations. These centers advertise an alternative to the Emergency Department (ED) for the evaluation and treatment of urgent medical conditions. The goal of this analysis was to examine the use of urgent care visits for migraine within 2 urgent care centers within a large academic medical system in New York City. We examined the trends in management and treatment of migraine in these urgent care settings, as well as prescriptions and instructions given to this patient population upon discharge. We paid particular attention to whether the medications administered and prescribed on discharge were those recommended by American Headache Society migraine management guidelines.

To evaluate retrospectively safety and effectiveness of cervical vertebroplasty (cVP) based on a single-center large cohort.

Neuropathic pain (NPP) is an unfavorable pathological pain with the characteristics of hyperalgesia, allodynia, and spontaneous pain. This study aimed to study the influence of dexmedetomidine (Dex) on NPP. Chronic constriction injury (CCI) was operated to form the NPP rat model. The OX42 and anti-glial fibrillary acidic protein (GFAP), the nerve growth factors (NGFs), and the Janus kinase/signal transducers and activators of transcription (JAK/STAT) proteins were separately detected by quantitative reverse transcription-polymerase chain reaction or Western blot. Inflammatory factors were detected by enzyme-linked immunosorbent assay. The results demonstrated that Dex obviously alleviated CCI-stimulated mechanical allodynia and thermal hyperalgesia. Meanwhile, the expressions of interleukin-1β, tumor necrosis factor-α, chemokine c-X3-c-motif ligand 1, and C-C motif chemokine ligand 2 were greatly increased in CCI rats, but these effects were reversed by Dex. In addition, Dex promoted the expressions of NGF, brain-derived neurotrophic factor, neurotrophins-3 (NT-3), and NT-4 in CCI rats. Moreover, the RNA or protein expression levels of OX42 and GFAP were significantly increased in CCI rats, while Dex inhibited the expressions of OX42 and GFAP. Furthermore, Dex blocked JAK/STAT signaling pathway by decreasing p-JAK and p-STAT in CCI rats. Dex had the potential to alleviate NPP by regulating JAK/STAT pathway in CCI rat.

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that affects synovial joints, leading to inflammation, joint destruction, loss of function, and disability. Although recent pharmaceutical advances have improved treatment of RA, patients with RA often inquire about dietary interventions to improve RA symptoms, as they perceive rapid changes in their symptoms after consumption of certain foods. There is evidence that some ingredients have pro- or anti-inflammatory effects. In addition, recent literature has shown a link between diet and microbiome changes. Both diet and the gut microbiome are linked to circulating metabolites that may modulate inflammation. However, evidence of the effects of an anti-inflammatory and probiotic-rich diet in patients with RA is scarce. There is also a need for biological data to support its anti-inflammatory effects.

Chronic osteoarthritis (OA) pain leads to severe impairments in physical functioning and quality of life. Data of patients with severe chronic knee and/or hip OA pain were extracted from the database of a prospective, noninterventional trial to assess the benefits of tapentadol prolonged release (PR) in elderly patients (>65 years of age; n = 1162) compared with younger patients (≤65 years of age; n = 498). Tapentadol PR treatment (up to 3 months) significantly reduced pain intensity and pain-related restrictions on daily functioning and significantly improved physical and mental quality of life in both patient groups. The incidence of adverse drug reactions was low. Tapentadol PR is a useful strong analgesic to improve pain intensity, physical functioning and quality of life in elderly OA patients.

The purpose of this study was to investigate the subjective recovery from pregnancy-related pelvic girdle pain (PGP) during the first 6 weeks after delivery and to detect possible risk factors for a poor recovery.