Rejected

Freeze-drying methods not only enable the delivery of growth factors using platelets, but also extend the shelf-life of platelet concentrates. The present study shows the clinical results of treating knee osteoarthritis with freeze-dried platelet-derived factor concentrate (PFC). While it improved pain, activities of daily living, sports and recreational activities, and knee-related quality of life, it did not significantly improve symptoms other than pain, such as restricted range of motion and mechanical symptoms. As such, the treatment effect may be attributed to anti-inflammatory action rather than actual cartilage regeneration.

Adverse event reporting patterns vary between countries, reflecting differences in reporting culture, clinical practice and underlying patient populations. Japan collects about 60,000 domestic adverse event reports yearly and shares serious reports with the World Health Organization (WHO) Programme for International Drug Monitoring in VigiBase, the WHO global database of individual case safety reports. Understanding these reports in the global context can be helpful for regulators worldwide and can aid hypothesis-generation for Japanese-specific vulnerabilities to adverse drug reactions.

Chronic pelvic pain, which carries a high burden of disability and distress, is a common presentation to gynaecology clinics. While there is increasing acknowledgment of the complexity of chronic pelvic pain, and the benefits of providing management from a multidisciplinary team within a sociopsychobiomedical framework, the mainstay of management in gynaecology outpatient clinics remains within a single clinician biomedical-focused model. This model of care is only sufficient for women who present with minimal psychosocial complexity to their pain.

Breast milk is the optimum for all infants, but hospitalization in the neonatal intensive care unit can cause separation of mothers and infants, which often interferes with milk secretion. Some reports show that domperidone is effective in promoting milk secretion. However, the Food and Drug Administration in the United States cautioned to not use domperidone for increasing milk volume because domperidone carries some risk of cardiac events, including QT prolongation, cardiac arrest, and sudden death. In contrast, it is used in Canada, Australia, and the United Kingdom with safety. The pharmacodynamics and pharmacokinetics of drugs may vary by race or ethnic origin, and it is not known whether domperidone is effective or safe for Japanese. In this study we report the effects of domperidone for Japanese mothers with insufficient lactation. Ten mothers were enrolled in a pilot study. After confirming that there were no abnormal findings on the electrocardiogram, the mothers were administered domperidone. Seven of 10 who took domperidone increased their milking volume. Prolactin was increased in 9 of 10 mothers. Adverse events were observed in two mothers, one headache and one abdominal pain; all symptoms were mild and improved promptly; and there were no adverse cardiac events. These results are consistent with reports from other countries. Domperidone may tentatively be considered effective for increasing milk secretion in Japanese mothers as in other populations. Our preliminary study of 10 cases indicates the need for further studies with larger sample sizes to assess the efficacy and safety of domperidone.

In recent decades, diagnostic imaging became an important generator of large increases in medical spending. Inappropriate head CT referrals also increase population irradiation and unnecessarily burden and frighten patients.

Postlaminectomy syndrome diagnoses secondary to adjacent segment degeneration are a substantial and rising cause of morbidity in the United States. Emerging spinal cord neuromodulation technologies have produced successful outcomes for postlaminectomy neuropathic pain but are less effective in treating neurogenic claudication secondary to recurrent lumbar stenosis. Percutaneous interspinous process decompression systems can be used as a salvage treatment modality for persistent structural neurogenic claudication in postlaminectomy syndrome or after spinal cord stimulator implantation.

Neonates feel pain. There is a concern among practitioners that pain of injecting analgesics to neonates prior to circumcision could as well be the same as the pain of the procedure. This has made many reluctant to offer effective analgesia for circumcision. If eutectic mixture of local anesthetics (EMLA) provides analgesia comparable to dorsal penile nerve block (DPNB), it will obviate needle prick and encourage analgesia use in neonatal circumcision.

Observational studies comparing uniportal and multiportal video-assisted thoracoscopic surgery (VATS) in the treatment of lung cancer have produced conflicting results. We present a Canadian study comparing clinical outcomes of uniportal and multiportal VATS in the treatment of lung cancer.

Premature ejaculation (PE) is a common sexual dysfunction for which selective serotonin reuptake inhibitors (SSRIs) have been used effectively for treatment. However, compliance with therapy and predictors of long-term SSRI use in the treatment of PE are not well known.

There are no studies that have evaluated the correlation between self-rated pain, peri-implant clinical and radiographic parameters (plaque index [PI], bleeding on probing [BOP], probing depth [PD], and crestal bone loss [CBL]) and whole salivary interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) levels among patients with and without peri-implantitis.