Rejected

Diclofenac is commonly used as pain relief. Hypoglycemia has rarely been reported due to aspirin and indomethacin use but not of any other nonsteroidal anti-inflammatory drugs.

This study proposes machine learning to analyze the risk factors of the collapse in patients with non-traumatic hip osteonecrosis of the femoral head.

Management of patients who experience refractory chronic nasal pain (CNP) of no apparent cause can be unclear. To measure pain outcomes in managing patients with CNP after rhinoseptoplasty or nasal trauma. We retrospectively reviewed patients with CNP after rhinoseptoplasty or trauma, treated with a gabapentinoid drug, local nerve block with lidocaine plus dexamethasone, or both. The study included 28 patients, 12 men and 16 women, of mean age 39.1 years (range 22-66), experiencing CNP after rhinoseptoplasty ( = 22) and nasal bone fracture ( = 6). Pain was distributed at the nasal dorsum (53%), periorbital area (15%), septum (13%), nasal tip (13%), and cheek (6%). The most common types of pain pattern, onset time, and duration were pressing and stabbing pain (41%), immediately developed (43%), and lasting 3-6 months (39%), respectively. After treatment, pain was relieved completely in 12 (43%) patients and mild to moderate in 7 (25%), but 9 (32%) showed no response. Postoperative or traumatic CNP can be a complex manifestation with several atypical characteristics. The combination of a gabapentinoid drug and local nerve block with lidocaine plus dexamethasone improved CNP in 68% of patients.

, an intestinal parasite, is widely distributed in humans and various animals, such as pigs, cattle and cats. The clinical symptoms of giardiasis are characterized as including abdominal pain, acute or chronic diarrhea, and bloating and weight loss in humans and animals, leading to public and veterinary health problems worldwide. However, the prevalence and genotypes of in pigs in Fujian Province, southeastern China, have not been reported. In the present study, 725 fecal samples were collected from six cities (Fuqing, Putian, Nanping, Longyan, Sanming, Zhangzhou) in Fujian Province and analyzed for prevalence and genotypes using nested PCR targeting the beta-giardin (), glutamate dehydrogenase () and triosephosphate isomerase () genes. The results shown that total occurrence rate of was 26.9% (195/725) in pigs, with significant differences in the prevalence among different regions ( = 86.508, < 0.05) and groups ( = 12.748, < 0.05). 195, 11 and 6 samples were detected at the , and loci, respectively. Each one belonged to a subtype of assemblage E and was analyzed using sequences obtained in this study. Based on phylogenetic analyses of sequences from the three genetic loci, only one MLG E1 was found. The results indicated that pigs may present a potential zoonotic risk of spreading infection from animals to humans in this area. The findings of the present study also provide basic data for the prevention and control of infection in pigs and humans in China.

Periocular ecchymosis, or periocular bruising, is a common clinical finding. Periocular skin is thin with an extensive vascular network, making this anatomical region prone to bruising. The most common etiology is trauma, but rarely, patients can present with spontaneous periocular ecchymosis (SPE). The pathophysiology of SPE is complex and varied. In this literature review of 121 articles, we assessed the frequency and variety of causation of this infrequent entity. The main finding was that by far the most common diagnosis causing SPE is amyloidosis and neoplasm, most notably neuroblastoma. Amyloidosis accounted for 23% articles (28/121) and neuroblastoma for 17% articles (21/121). Overall, neoplastic processes accounted for 30% of the articles (36/121), raised intracranial pressure and vascular malformations for 19% of the articles (23/121), migraine and atypical headache for 7% of the articles (8/121), while iatrogenic accounted for 5% of the articles (6/121). Through exploration and appreciation of the pathophysiology, we hope to foster a greater understanding in the clinician to establish underlying etiology, from benign to life-threatening, when presented with SPE.

Hot-iron branding is still commonly performed in cattle farming in tropical countries, and possibly has negative consequences for animal welfare and weight gain. This study examined the behavioural and weight gain responses of pure and crossbred Nellore heifer calves subjected to hot-iron branding on the cheek, without and with use of anaesthesia and analgesia. Ninety-two heifer calves, around 120 days old, were studied prospectively when subjected to hot-iron branding on the cheek (a statutory procedure in Brazil following brucellosis vaccination). Four randomly selected groups of calves were allocated to four treatments: no pain control (CO); subcutaneous anaesthetic local block (LA); intramuscular analgesia (meloxicam) (LT); and local anaesthesia plus meloxicam (LL). Behaviour, flight speed and body weight were evaluated before, during, and five (5-d) and 60 days (60-d) after branding. For these parameters, the only difference observed was higher tension in the CO group 5-d post-branding, suggesting a short-term negative effect of branding without pain control. The limited effects of the pain control treatments suggest interference in pain assessment by other factors, such as expression of fear and stress. Despite the lack of differences observed in behaviour and production parameters, facial hot-iron branding is an obvious welfare issue and, due to the additional handling involved, adoption of a simple pain relief protocol is not sufficient to minimise the welfare impact.

Surgical abnormalities of the adnexa in children and adolescents include a variety of ovarian and paraovarian lesions ranging from benign functional cysts to malignant tumors, torsion of the ovary and/or the fallopian tube, and adnexal infectious lesions ranging from salpingitis to tubo-ovarian abscesses. Presentations vary from asymptomatic pelvic masses to acute abdomen, while some ovarian tumors might present with precocious puberty or virilization. Acute pain might be caused by hemorrhage or rupture of ovarian or paraovarian cysts, adnexal torsion or adnexal infection. Differential diagnosis of adnexal masses should include periappendiceal abscess in all age groups, and endometriomas and ectopic pregnancy in adolescents. This review provides guidance on the differentiation between adnexal abnormalities, based on important clues from clinical assessment and diagnostic work-up, and ultimately on the decision making about the need for surgery, its level of urgency and the type of surgery to clinicians of all specialties involved in the care of young females.

Pain in dairy cattle is gaining attention globally. This study investigated the current attitudes of Chinese dairy practitioners to pain and its management in intensively raised dairy cattle. A total of 465 valid questionnaires with 26 painful conditions scored on numerical rating scales were collected from dairy practitioners. Data were analysed by descriptive statistics, analysis of variance, principal component analysis, and multivariate regression models. Dystocia was perceived as the most painful, while mild mastitis with milk changes only was perceived as the least painful. Respondents who agreed with the statement "pain management is worthwhile" tended to give a higher pain score. Young respondents (≤23 years old) and those from farms with ≤1000 cattle had lower pain scores for conditions with severe pain and low variability but higher pain scores for conditions with less severe pain and high variability, whereas highly educated respondents had consistently lower pain scores. As for pain management, older respondents (≥24 years old) tended to choose non-steroidal anti-inflammatory drugs, and farms with >1000 cattle were more likely to use analgesics. Training in pain perception and management should be emphasised with the hope of promoting animal welfare and reducing unnecessary production losses.

Chronic discogenic low back pain (CD-LBP) is caused by degeneration of the disc due to trauma to the annulus or by unprovoked degeneration, resulting in chronic pain. Spinal cord stimulation (SCS) employing the BurstDR waveform has been shown to be an effective treatment in a variety of chronic pain conditions. The aim of this prospective case study was to determine the effect of BurstDR SCS on pain relief, disability, and patient satisfaction in a population with CD-LBP.

The purpose of the present study was to test whether the addition of cisatracurium in combination with propofol and sevoflurane would result in a change in doses of used anesthetic drugs. Ten dogs (Group A) undergoing elective unilateral mastectomy surgery were included in the study. To induce and maintain anesthesia, subjects received propofol and sevoflurane at varying doses; analgesia was performed with remifentanil. After three months, the same subjects (Group B) underwent contralateral mastectomy and received the same anesthetic protocol with the addition of cisatracurium at a dosage of 0.2 mg/kg. The following parameters were monitored during anesthesia: heart rate, systolic blood pressure, end-tidal CO, oxygen saturation, halogenate requirement, and rectal temperature at baseline (T), induction (T), 5 (T), 10 (T), 15 (T), 20 (T), 25 (T), 30 (T), and 35 (T) time points. In Group A, halogenate requirement was reduced at all the time points other than T1 ( < 0.001); in Group B, the percentage of halogenate requirement was already reduced at T and remained constant during the experimental period, showing no significant intragroup differences. The dose requirements of sevoflurane and propofol varied significantly between the two groups, with significantly lower dosages in the Group B (the cisatracurium-treated group). Moreover, patients treated with cisatracurium showed a stable anesthetic plan. The nondepolarizing-muscle-relaxant cisatracurium besylate could be considered a useful adjunct to anesthetic protocols.