Rejected

I am as deeply inspired and humbled to receive this prestigious award, as I am profoundly indebted to the Bonica Award selection committee and the American Society of Regional Anesthesia and Pain Medicine Board of Directors for recognizing my contributions to the development, teaching, and practice of pain medicine in the tradition of Dr John J Bonica. I would also like to recognize my parents, Aura and Tito for providing me with the support and the environment to fulfill my professional goals. Moreover, the support that I have gotten from my team at the hospital, and the Chair of my Department, Dr Mark Lema needs to be underscored.

Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disease. Patients with NIID may present with heterogeneous clinical symptoms, including episodic encephalopathy, dementia, limb weakness, cerebellar ataxia, and autonomic dysfunction. Among the NIID cases reported in China, patients often have complicated and severe manifestations. Therefore, many clinicians do not consider the disease when the patient presents with relatively minor complaints.

We present the long-time survival of 2997 primary metacarpophalangeal (MCP) joint implants from the Norwegian Arthroplasty Register from 1994 to 2019. Six different implants were compared in terms of survival and risk of revision. The majority of implants were inserted in patients diagnosed with inflammatory diseases and in women. The overall survival was found to be 94%, 89%, 85% and 84% after 5, 10, 15 and 20 years. The most prevalent reason for revision was a fractured prosthetic component, and the second was pain. Implants inserted in the right hand and in younger patients had a higher risk for revision. Sex, type of implant, finger treated, one- or two-component prosthesis, and inflammatory or non-inflammatory conditions did not influence the survival. The frequency of MCP joint implantations decreased during the observation period. Our data show satisfactory long-term survival of the MCP implants, with no difference found between implant types or concepts. II.

Anti-N-methyl-D-aspartate receptor encephalitis is a form of autoimmune encephalitis with acute or subacute neuropsychiatric symptoms. Despite this fact, due to a couple of factors, this condition remains insufficiently acknowledged and is an under-recognised clinical scenario. We describe a case of a patient presenting with fever, headache and altered sensorium along with a history of disorientation, episodes of abnormal body movements and loss of consciousness in the later phase. She was initially thought to have Status epilepticus with tuberculous meningoencephalitis but her cognitive functions did not improve despite appropriate treatment. She displayed features away from the usual course of disease leading to suspicions of Autoimmune Encephalitis and Anti-N-methyl- D-aspartate receptor reports later confirmed the diagnosis. Methylprednisolone and Intravenous Immunoglobulin was started empirically and she was discharged in stable health with stabilised emotional and cognitive function with Azathioprine and Levetiracetam continued. Our findings suggested early diagnosis and prompt immunotherapy treatment beneficial for the outcome.

Metronidazole belongs to the nitroimidazole group of antibiotics. It is used for the treatment of anaerobic and protozoal organisms. Its common side effects are nausea, vomiting, headache, and abdominal pain. Urine discolouration is one of the rare side effects of metronidazole. We report a case of 4-years-old male, a known case of Steroid resistant nephrotic syndrome; Focal Segmental Glomerulosclerosis type who developed reddish discolouration of urine following the introduction of oral metronidazole which reverted back to its usual colour within 24 hours of discontinuing metronidazole. With no evidence of other possible causes, urine discolouration was linked with the use of metronidazole. Urine discoloration as a side effect of metronidazole is rarely reported in the literature. This case report of the rare adverse effects of the commonly used drug can be of importance in the scientific community. Urine discolouration could be considered a side effect of metronidazole when there is no other obvious cause.

The LIVIFY trial investigated the safety, tolerability, and efficacy, of Vonafexor, a second-generation, non-bile acid farnesoid X receptor agonist in patients with suspected fibrotic non-alcoholic steatohepatitis (NASH).

Smith-Magenis syndrome (SMS, OMIM# 182290) is a rare congenital disorder which characterized by multiple abnormalities involving in craniofacial, skeletal, otorhinolaryngolocial, neurological, behavioral and others. 17p11.2 microdeletion and RAI1 mutations have been proven to be genetic lesions of this disease. However, the relationship between RAI1 variants and different phenotypes is still unclear. The discoveries of more RAI1 mutations in patients with different phenotypes will help to elucidate the pathogenesis of the RAI1 gene. Here, we describe a young patient with schizophrenia and headache as the main clinical presentation, with SMS-like features including depression, sleep disturbance and pain-free status. Whole exome sequencing and Sanger sequencing suggested that a de novo mutation (NM_030665.3: c.4256C>T/p.S1419F) of RAI1 may be the genetic lesion of the patient. The bioinformatic program predicted that the new mutation (p.S1419F), located in an evolutionarily conserved site of RAI1, was deleterious. Further, western blot analysis suggested that the novel mutation may decrease the protein levels of RAI1 in the patient. Hence, we reported a novel mutation of RAI1 in a patient with SMS, schizophrenia and headache. Our study may expand the spectrum of RAI1 mutations which may further contribute to the mechanisms underlying SMS, schizophrenia and headache.

Trigeminal neuralgia (TN) is a common cranial nerve disease.

Objectives Numerous people have died from coronavirus disease 2019 (COVID-19) infection. Identifying crucial predictive biomarkers of disease mortality is critical to support decision-making and logistic planning in healthcare systems. This study investigated the association between mortality and medical factors and prescription records in 2020 in Japan, where COVID-19 prevalence and mortality remain relatively low. Methods This retrospective cohort study analyzed anonymous administrative data from the Diagnosis Procedure Combination (DPC) database in Japan. Results A total of 22,795 patients were treated in DPC hospitals in 2020 in Japan, and of these, 5,980 patients over 50 years old were hospitalized, with 299 (5.0%) dying. There were 2,399 severe patients among 11,440 total hospitalized patients (all ages). The results of a logistic model analysis revealed that an older age, male sex, Parkinson's disease, cerebrovascular diseases, and chronic kidney diseases were risk factors for mortality. A machine learning analysis identified an older age, male sex (mortality), pneumonia, drugs for acid-related disorders, analgesics, anesthesia, upper respiratory tract disease, drugs for functional gastrointestinal disorders, drugs for obstructive airway diseases, topical products for joint and muscular pain, diabetes, lipid-modifying agents, calcium channel blockers, drugs for diabetes, and agents acting on the renin-angiotensin system as risk factors for a severe status. Conclusions This COVID-19 mortality risk tool is a well-calibrated and accurate model for predicting mortality risk among hospitalized patients with COVID-19 in Japan, which is characterized by a relatively low COVID-19 prevalence, aging society, and high population density. This COVID-19 mortality prediction model can assist in resource utilization and patient and caregiver education and be useful as a risk stratification instrument for future research trials.