Rejected

The aim of this study was to review current literature regarding the epidemiology of vestibular migraine (VM), patient presentation, pathogenesis, and treatment.

Patient-controlled analgesia (PCA) appears to be the preferred modality for treatment of pain associated with vaso-occlusive crisis (VOC) and is the current standard of therapy at most institutions. With limited data available, this study analyzed the effectiveness of PCA vs intravenous push (IVP) hydromorphone for pain management of VOC. The primary objective was to determine whether PCA or IVP hydromorphone is more effective in controlling VOC pain determined by a reduction in mean absolute difference pain intensity (MPI) from baseline to discharge. This retrospective single-center study evaluated differences in outcomes between patients treated with PCA vs those treated with IVP hydromorphone for VOC during hospital admission. Those 18 years or older admitted with one of the following International Classification of Diseases, Tenth Revision codes were included: D57.0 (Hb-SS disease with crisis), D57.2 (sickle cell/Hb-C disease), and D57.4 (sickle cell thalassemia), and administered PCA or IVP hydromorphone. The observed difference in absolute pain scores were not statistically significant ( = 0.753). The use of IVP hydromorphone resulted in a significant reduction in length of stay (LOS) and morphine milligram equivalent (MME) use compared to PCA, but was associated with a numerical increase in treatment failures. This study was limited by its retrospective nature, uneven distribution of groups, and only reviewed use of IVP and PCA hydromorphone at one institution.

Pain control is among the most important healthcare services in patients affected by rheumatoid arthritis (RA), but the current therapeutic options (i.e., disease-modifying anti-rheumatic drugs) are limited by the risk of the side effects. In this context, we proposed an innovative approach based on the hybridization between carbonic anhydrase inhibitors (CAIs) and CO releasing molecules (CORMs). The resulting CAI-CORM hybrids were revealed to possess strong anti-inflammatory effects in in vitro models of diseases and to relieve ache symptoms in an in vivo RA rat model. In this work, we have deepened the study of these promising hybrids, designing a library of coumarin-based compounds, also including internal dicobalt hexacarbonyl systems. The results obtained from the CO releasing study, the CA inhibitory activity, and the in vivo pain-relief efficacy evaluation in the RA rat model confirmed the success of this strategy, allowing us to consider CAI-CORM hybrids promising anti-nociceptive agents against arthritis.

The purpose of this review is to discuss the current evidence for Cognitive Behavioral Therapy for Insomnia (CBT-I) for patients with migraine and comorbid insomnia. In this article, we provide a narrative review of the literature on CBT-I and migraine, highlighting recent advances in research into this topic. Finally, we propose a way for clinicians to integrate CBT-I into clinical practice.

Rheumatoid Meningitis (RM) is a rare complication of Rheumatoid Arthritis (RA) that can manifest as stroke-like episodes. We present the case of a 63-year-old woman with a past history of Overlap Syndrome (OS) and clinical manifestations suggestive of Amyopathic Dermatomyositis, Rheumatoid Arthritis, and Systemic Lupus Erythematosus. She presented to the emergency department with sudden onset right-sided clumsiness and numbness and a 2-week history of left hemicraneal headache. Laboratory workup revealed positive serum Antinuclear Antibodies (ANA), anti-Ro antibodies, Anti-Citrullinated Peptide Antibodies (ACPA), and elevated Rheumatoid Factor (RF). Lymphocytic pleocytosis, positive ACPA and anti-Ro antibodies with passive diffusion pattern, and negative microbiological studies were demonstrated in the CSF. Brain MRI showed predominant left fronto-parieto-occipital leptomeningeal and pachimeningeal enhancement. We diagnosed RM and started methylprednisolone IV mg/kg once daily. Stroke-like episodes in the setting of a patient with lymphocytic pleocytosis in CSF and meningeal enhancement should raise suspicion of RM. In this context, serum RF and ACPA levels should always be measured and ACPA should also be measured in CSF. To our knowledge, this is the first reported case of RM in the context of an OS. ACPA levels in CSF could be a relevant diagnostic clue in the setting of central nervous system (CNS) disturbance and overlapping autoimmune conditions that include RA. In our case, the presence of a suggestive clinical scenario of RM reinforces the probable pathogenic role of ACPA when it is present in the CNS, even without intrathecal synthesis evidence.

Asarum heterotropoides f. mandshuricum (Maxim.) Kitag. (AH) is widely used to treat influenza, COVID-19, allergic rhinitis, headache, toothache, rheumatoid arthritis, and peptic ulcer. However, its clinical use is controversial due to the concern of aristolochic acid nephropathy (AAN) caused by its component aristolochic acid analogs (AAs).

In a chronic pain-causing disease such as juvenile idiopathic arthritis, the quality of coping with pain is crucial. Parents have a substantial influence on their children's pain-coping strategies. This study aimed to develop scales for assessing parents' strategies for coping with their children's pain and a shorter improved scale for children usable in clinical practice.

Our meta-analysis aimed to compare the analgesic effectiveness of ultrasound-guided preoperative erector spinae plane block (ESPB) versus paravertebral nerve block (PVB) in breast surgery.

To systematically review the current evidence in the literature to compare the efficacy of different regional anesthesia interventions in the treatment of ACLR.

Long-term neurological health risks associated with oil spill cleanup exposures are largely unknown. We aimed to investigate risks of longer-term neurological conditions among U.S. Coast Guard (USCG) responders to the 2010 Deepwater Horizon (DWH) oil spill.