Rejected

Thrombosis or thrombophlebitis of the superficial dorsal vein of the penis is called penile Mondor's disease. Although many factors are suggested as the etiology, but it has not been clarified yet. Hypersensitivity reactions may predispose to this complication in some patients; and it results from the formation of antigen-antibody immune complexes in the circulation as a consequence of the penetration of antigenic debris into the circulation due to pruritus-related excoriations caused by parasitic infestations like scabies. Herein, we present a case of isolated superficial dorsal penile vein thrombosis developing due to scabies infestation without any additional thrombogenic factors. Conservative approach and medical treatment were sufficient in the successful treatment of scabietic penile Mondor's disease.

The feet constitute an important sensory structure in the mechanisms of postural control. As a direct and often only interface between the body and the ground, the feet allow us to sense and interact with our environment. Sensory information provided by muscle and cutaneous afferents in the foot contribute to our ability to stand upright, and postural sway is necessary to detect both position and motion of the body in space. A decline in foot sole skin sensitivity occurs naturally with aging and as a result of neurological disorders, including different peripheral neuropathies, the commonest etiologies of which are diabetes mellitus or effects of chemotherapy. This decline in sensitivity is frequently associated with poorer postural control and increased risk of falls in these populations. The purpose of this comprehensive review is to summarize the evidence that supports a functional role of foot sole sensory tactile and muscular feedback in standing balance, and the postural consequences when this feedback is impaired with aging or disease. This brings new clinical perspectives on the development of intervention strategies to improve the quality of foot sole cutaneous feedback. It also seems to be a promising approach in the management of patients with balance disorders, with specific chronic pain syndromes, with neurologic diseases or those at risk of falling.

The ICA is the most common site of cervical artery dissection. Prompt and reliable identification of the mural hematoma is warranted when a dissection is clinically suspected. The purpose of this study was to assess to capacity of a standard DWI sequence acquired routinely on the brain to detect dissecting hematoma related to cervical ICA dissections.

Use of illicit opioids and misuse of prescription opioids are the main causes of drug-related deaths across the world, and the continuing rise in opioid-related mortality, especially affecting North America, Australia and Europe, is a public health challenge. Strategies that may help to decrease the high levels of opioid-related mortality and morbidity and improve care across Europe include risk assessment and interventions to improve the use of opioid analgesics, e.g. prescription drug-monitoring programmes, education on pain management to reduce opioid prescribing, and the implementation of evidence-based primary prevention programmes to reduce the demand for opioids. For patients who develop opioid use disorder (a chronic and relapsing problematic use of opioids that causes clinical impairment or distress), treatment combining opiate receptor full or partial agonist medications for opioid-use disorder (MOUD) with psychosocial interventions is essential. However, in Europe a substantial proportion of the 1.3 million high-risk opioid users (defined as injecting drug use or regular use of opioids, mainly heroin) remain outside of dedicated treatment programmes. More widespread and easier access to MOUD could reduce mortality levels; via approaches such as primary care-led treatment models, and efforts to improve patient retention and adherence to treatment programmes. Other harm-reduction strategies, such as the use of MOUD at optimal doses, the provision of take-home naloxone, the introduction of supervised drug-consumption facilities, and patient education to reduce the risk of overdose may also be beneficial.

Celiac disease (CD) is a systemic condition of autoimmune origin, affecting genetically predisposed individuals who at some point lose tolerance towards dietary gluten. Prevalence in the general population is 0.5 – 1%, with a higher frequency in women. The most important environmental factor for CD is ingestion of specific gluten peptides. It triggers a sequence of molecular events, involving the intestinal permeability and the immune system, which ends in damage of the intestinal mucosa. A number of studies have demonstrated the correlation between the intestinal microbiota and celiac disease. MicroRNAs through their regulatory role on gene expression have been implicated in the pathogenesis of CD and suggested as potential biomarkers. In the pediatric and adult population, CD displays different clusters of clinical symptoms. Persistent diarrhea, abdominal pain and involuntary weight loss are the classic symptoms of CD. In the majority of cases diagnosis relies on the combination of serum autoantibodies (anti-transglutaminase and anti-endomisium IgA) and duodenal biopsy showing villous atrophy, crypt hyperplasia and intraepithelial lymphocytes. Observance of a lifelong gluten-free diet, which interrupts the immune response to gluten peptides, is the only effective treatment of CD.

To investigate the value of macrophage migration inhibitor factor (MIF) in early severe acute pancreatitis (SAP).

New approaches to bariatric surgery aim to achieve stress-free anaesthesia with sympathetic stability to protect organs and provide sufficient tissue perfusion, analgesia and rapid emergence. Opioid-free and multimodal approaches to anaesthesia provide intra- and post-operative sedation and analgesia, particularly advantageous in morbidly obese patients, but their feasibility and efficacy are still disputed. We describe the case of a female patient proposed for laparoscopic bariatric surgery, conducted under an opioid-free anaesthesia protocol, the haemodynamic, ventilatory and analgesic control, and intra- and post-operative monitoring and complications.

Chronic neck pain is a common musculoskeletal disorder that is associated with functional disability and decreased of quality of life. Electrophysical agents are commonly used to relieve pain, however the effects of combined use of these agents are little studied. The objective is to investigate the efficacy of photobiomodulation and electrical stimulation to relieve pain, both in isolation and combined.

To test the hypothesis that patient-controlled analgesia (PCA) contributes to improvement of hemorheology in patients undergoing hip arthroplasty.