Rejected

Chronic dermatoses, including atopic dermatitis, psoriasis, prurigo nodularis, chronic spontaneous urticaria and hidradenitis suppurativa, as well as accompanying subjective symptoms (itch and pain), have a great impact on patients' well-being. Skin plays an important role in the physiological sleep process. This review attempts to analyze the association between chronic dermatoses in adults and sleep quality in recent studies. Polysomnography and actigraphy are performed for the objective assessment of sleep quality. Questionnaire-based subjective evaluations of sleep quality, including the Pittsburgh Sleep Quality Index and Medical Outcomes Study Sleep Scale, are useful in clinical studies and clinical practice. Subjective symptoms such as itch and pain have an essential influence on sleep quality and general quality of life in patients with chronic skin diseases.

Oxaliplatin and fluoropyrimidine chemotherapy administered over 6 months is the standard adjuvant regimen for patients with high-risk stage II or III colorectal cancer. However, the regimen is associated with cumulative toxicity, characterised by chronic and often irreversible neuropathy.

Fractures, especially if articular and periarticular, are frequently associated to functional and clinical disabling outcomes and chronic pain. In particular, the injuries with loss of bone, ligament, and/or tendon tissue in which the full recovery of the wound area is not obtained are the worst anatomical/pathological conditions to heal. In this study, three different biological materials were used as regenerative approaches to rebuild the medial malleolus fracture of the ankle in which loss of bone, ligament, and tendon tissue occur. In particular, the morselized human bone tissue was combined with the human dermis decellularized, both augmented with homologous platelet-rich plasma. The magnetic resonance imaging study with contrast at the follow-up showed a signal compatible with vascularization of the tissue without sign of degeneration. Our new regenerative approach in which different biological materials were combined together showed a good choice of treatment for the reconstruction of not repairable outcome of a fracture.

The labor pain is probably the most severe pain a mother experiences in her lifetime and is usually severe and prolonged in women with pregnancy.

This study aimed to compare the efficacy and safety of very early preemptive meloxicam, early preemptive meloxicam, and postoperative meloxicam administration for postoperative pain relief in patients undergoing arthroscopic knee surgery (AKS). Three hundred and six patients about to receive AKS were consecutively enrolled in this randomized, controlled study and randomly allocated into three groups: very early analgesia (VEA) group, early analgesia (EA) group, and postoperative analgesia (PA) group. Pain visual analog scale (VAS) score at rest and at flexion, patient global assessment (PGA) score, consumption of rescue pethidine, and adverse events (AEs) were assessed. Pain VAS score and severity at rest/flexion were all decreased in the VEA group compared with EA group and PA group at 4 h post-operation and were also reduced in the VEA and EA groups compared with the PA group at 8 h and 12 h post-operation. PGA score was lower in the VEA group compared with the EA group and PA group at 4 h post-operation, and was attenuated in the VEA group and the EA group compared with the PA group at 8 h, 12 h, and 24 h post-operation as well. Consumption of rescue pethidine was less in the VEA group than that in the PA group. In addition, no difference in the incidence of AEs was found among the VEA, EA, and PA groups. In conclusion, preemptive meloxicam is more effective in postoperative pain control and equally tolerated compared with postoperative meloxicam in patients receiving AKS.

Hemophagocytic lymphohistiocytosis is a cytokine-driven inflammatory syndrome that is associated with substantial morbidity and mortality. Overall survival in adult patients with secondary haemophagocytic lymphohistiocytosis remains suboptimal, and novel therapeutic strategies are needed. The phosphorylation-dependent activation of the Janus family kinases JAK1 and JAK2 are hallmarks of the final common pathway in this disease. We therefore aimed to determine the activity and safety of ruxolitinib, a JAK inhibitor, in adults with secondary haemophagocytic lymphohistiocytosis.

Testicular torsion is a pathological condition which leads to sever scrotal pain and ischemia. After surgical reperfusion, oxidative stress factors cause to germ cell apoptosis. Thus, adjuvant therapy to surgery should be useful to decrease of ischemia/reperfusion (I/R) injury of testis. Modafinil, a drug to treat sleepiness, has been indicated to have anti-inflammatory effects. The aim was to evaluate the efficiency of modafinil administration after reperfusion surgery in a rat model of testicular torsion/detorsion (T/D). Male wistar rats were divided into three groups and each group contained 10 animals. To induce torsion right testis was rotated 720° clockwise and was left for 1 h. Modafinil group received modafinil (10 mg/kg) once daily intraperitoneally for 7 days after the surgery and the control group received physiologic saline once daily intraperitoneally for 7 days after the surgery. Thereafter, MDA, IL-1β and TNF-α levels and histopathological changes were investigated. MDA, IL-1β and TNF-α levels significantly increased in T/D group compared to the control group (P < .01 and P < .001, respectively). Moreover, modafinil administration significantly reduced these values compared to T/D group (P < .05 and P < .01, respectively). Histopathological changes such as degeneration in germinal cells were detected in testis T/D group of rats whereas modafinil administration prevented degeneration in germinal cells, edema and hemorrhage compared with T/D group. In conclusion, administration of modafinil after reperfusion surgery had protective role on testicular torsion in rat and reduced ischemia/reperfusion cellular injury via anti-inflammatory and decrease of oxidative stress.

In Germany, the numbers of patients with spondylarthritides (SpA) and rheumatoid arthritis (RA) have increased. This rise was possibly promoted by the introduction of new classification criteria (CC) that enable an earlier recognition and the inclusion of less severe cases. The study explores how the new CC for axial SpA (axSpA) are incorporated into the clinical practice, compared with the CC for RA and systemic lupus erythematosus (SLE). In addition, the study investigated whether the new entity of non-radiographic axSpA (nr-axSpA) is accepted and used in Germany.

A 10-year-old boy presented with chronic ulnohumeral subluxation 6 months after an open reduction of a Milch type II lateral condyle fracture subluxation performed at another hospital. The patient had persistent elbow pain and limited range of motion (ROM) between 20° and 50°. After the open reduction for chronic ulnohumeral subluxation and corrective osteotomy for articular surface reconstruction, he had an uneventful recovery with improved ROM of the affected elbow and no pain.