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Components of primary care multimodal rehabilitation and their association with changes in sick leave: An observational study.

To address the increase in sick leave for nonspecific chronic pain and mental illness, the Swedish government and the Swedish Association of Local Authorities and Regions entered into an agreement on a "Rehabilitation Guarantee" to carry out multimodal rehabilitation (MMR).

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A case report of secondary parathyroid adenomatous hyperplasia with carcinoma.

Secondary parathyroid hyperplasia canceration is very rare and thus easily be overlooked during parathyroid ultrasound examination. However, secondary parathyroid hyperplasia still has the possibility of canceration, and it is still important to be alert to its occurrence when performing ultrasound examinations and clinical treatment.

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A possibly new autoinflammatory disease due to compound heterozygous phosphomevalonate kinase gene mutation: does it open a new horizon?

Mevalonate kinase (MVK) plays a role in cholesterol and non-sterol isoprenoid biosynthesis and its deficiency-related diseases are caused by bi-allelic pathogenic mutations in the MVK gene, (MVK), which leads to rare hereditary autoinflammatory diseases. The disease may manifest different clinical phenotypes depending on the degree of the deficiency in the enzyme activity. The complete deficiency of the enzyme activity results in the severe metabolic disease called mevalonic aciduria, while a partial deficiency results in a broad spectrum of clinical presentations called hyper-immunoglobulin D syndrome (HIDS). Serum immunoglobulin (Ig) D and urine mevalonic acid levels may be increased during inflammatory attacks of HIDS.

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Women with lipoedema: a national survey on their health, health-related quality of life, and sense of coherence.

Lipoedema is a chronic disease in adipose tissue that almost exclusively affects women during periods of hormonal alterations. Its main symptoms include an abnormal accumulation of subcutaneous fat in the buttock, hips, and legs, which is associated with pain, swelling, and easy bruising. Herein, a grading in three stages is used to determine disease progression. Problematically, lipoedema manifestations are often confused with lifestyle-induced obesity, which is why the various health problems among affected women often remain unrecognized. Overall, research on lipoedema is scarce. As such, this study examined the health, health-related quality of life (HRQOL), and sense of coherence (SOC) among women with lipoedema.

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Quercetin Attenuates Nitroglycerin-Induced Migraine Headaches by Inhibiting Oxidative Stress and Inflammatory Mediators.

This study aimed to investigate the antimigraine potential of quercetin in migraine pain induced by nitroglycerin (NTG), 10 mg/kg, intraperitoneal injection in rats. Quercetin was administered orally for 1 week, and behavioral parameters associated with pain were assessed 30 min after NTG injection. At the end of the study, the rats were killed so that immunohistochemical examination of their brains could be performed. The time and frequency of rearing and sniffing in the category of exploratory behavior, walking in the category of locomotor behavior, and total time spent in the light chamber were reduced in the disease control group compared with the normal group during the assessment of behavioral parameters. Pathologic migraine criteria, such as increased levels of calcitonin gene-related peptide and increased release of c-fos cells, were more prominent in the caudal nucleus triceminalis of the NTG control group. In the treatment groups, behavioral and pathological measures were less severe after pretreatment with quercetin at doses of 250 and 500 mg/kg. Therefore, it was concluded that quercetin improved the pain behavior of migraine patients in the NTG-induced migraine rat model. Quercetin is thought to have antimigraine effects due to its antioxidant and anti-inflammatory potential. Quercetin may therefore be a novel agent that can treat or prevent migraine pain and associated avoidance behaviors.

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Sport and self-esteem in people living with HIV: a cross-sectional study.

In the general population, sport activity is associated with better health and better self-esteem. Among people living with HIV (PLHIV), sport activity could also be associated with better self-esteem. The main objective of our study was to assess the association between sport activity and self-esteem among people living with HIV. The secondary objectives were to evaluate the associations between sport activity with fatigue as well as with pain.

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Curcuma as an anti-inflammatory component in treating osteoarthritis.

Osteoarthritis (OA) is nowadays the most common musculoskeletal progressive condition. In recent decades, incidence and prevalence of OA have increased significantly. It is estimated that the prevalence of OA among adults older than 60 is 12%, affecting about 240 million people globally. The cause has not been fully elucidated, and therefore, there is no cure at the moment. It is a multifactorial degenerative disease with an inflammatory component mediated by numerous proinflammatory and anti-inflammatory cytokines, chemokines, and growth factors. OA is not yet fully understood; therefore, therapeutic interventions are aimed primarily at reducing symptoms and slowing the progression of joint destruction. Of the therapeutic options available, the most often prescribed are nonsteroidal antirheumatic drugs, which have numerous side effects. Therefore, a need for a safe, effective substance is differentiated, which will be used in adjuvant treatment, but also in disease prevention, and which will comparatively have no or fewer side effects. One such substance is curcumin, a hydrophobic polyphenol that forms the active component of the rhizome of the Curcuma longa plant. Several studies have shown its potent antioxidant and anti-inflammatory effect, non-toxicity, and safety at high daily doses. In addition to blocking chondrocyte apoptosis, curcumin also blocks the expression of cyclooxygenase, prostaglandin E-2 and proinflammatory cytokines in chondrocytes, potentially alleviating symptomatic diseases. Although there are significant variations in quality, methodology, and research results conducted on curcumin efficiency in OA treatment, curcumin is primarily recommended as systematic short-term and medium-term adjuvant therapy that reduces inflammatory biochemical factors. Reducing inflammation leads to better pain regulation and improved joint function, significantly reducing standard prescribed doses of drugs. The most researched daily doses of curcumin intake are 1000-2000 mg/day, which would also be the doses that most of the authors recommend. Further research is needed to determine the preventive role of curcumin in the pathogenesis of OA, the effects of long-term usage of curcumin in preventive purposes and treatment of osteoarthritis, as well as to determine optimal therapeutic dosages.

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Callus Culture of as a New, Highly Productive and Stable Source of Caffeoylquinic Acids.

During our ongoing efforts to investigate biotechnological sources of caffeoylquinic acid (CQA) metabolites, we discovered the plant Fisch. (Asteraceae), which is able to produce callus cultures with high yield and extremely high stability. An actively growing callus line, designated as Sr-L1, retained the ability to produce 11 CQAs during long-term cultivation (more than 20 years). A total of 29 polyphenolic compounds were identified in the leaves and Sr-L1 callus culture of , including CQAs, lignol derivatives, flavonoids, and dihydrostilbenes. The composition of CQAs in the Sr-L1 culture was identical to that in the leaves. Sr-L1 calli did not produce flavonoids and dihydrostilbenes, but produced lignol derivatives, which were absent in leaves. The HPLC-UV-HRMS determination showed the presence of monoacyl derivatives of CQAs such as 5-CQA, 4-CQA, -5-CQA, and 5—coumaroylquinic acid in the Sr-L1 culture. Among diacyl derivatives, 3,4-diCQA, 3,5-diCQA, -3,5-diCQA, 4,5-diCQA, 3—coumaroyl-5–CQA, and 3–caffeoyl-5–p-coumaroylquinic acid were found. The content of 5-CQA reached 7.54 mg/g dry weight and the content of 3,5-diCQA was as high as 18.52 mg/g dry weight. 3,5-diCQA has been reported to be of high nutritional and pharmacological value, as it alleviates inflammatory pain, reverses memory impairment by preventing neuronal apoptosis, and counteracts excessive adipose tissue expansion, serving as an attractive treatment option for obesity. The high content of 3,5-diCQA and the exceptional stability of biosynthesis make callus cultures of a promising source for the development of drugs and nutraceuticals.

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Evidence-Based Interventions to Improve Opioid Prescribing in Primary Care: a Qualitative Assessment of Implementation in Two Studies.

The TOPCARE and TEACH randomized controlled trials demonstrated the efficacy of a multi-faceted intervention to promote guideline-adherent long-term opioid therapy (LTOT) in primary care settings. Intervention components included a full-time Nurse Care Manager (NCM), an electronic registry, and academic detailing sessions.

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EEG changes during left- and right-sided weakness in patient with sporadic hemiplegic migraine.

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