Rejected

Random pattern skin flaps are applicable for reconstructing any defect in plastic surgery. However, they are difficult to apply because of necrosis. Sumatriptan, a selective 5-hydroxytryptamine 1b/1d agonist, is routinely used to offset acute migraine attacks. Recent studies have suggested that sumatriptan may induce vasodilation at lower concentrations. The authors' aim is to investigate the effect of sumatriptan on skin flap survival and the role of nitric oxide in this phenomenon.

As diffusion tensor imaging (DTI) is able to assess tissue integrity, authors used diffusion to detect abnormalities in trigeminal nerves (TGN) in patients with trigeminal neuralgia (TN) caused by neurovascular compression (NVC) who had undergone microvascular decompression (MVD). The authors also studied anatomical TGN parameters (cross-sectional area [CSA] and volume [V]). The study compared pre- and postoperative findings.

NSAID in knee OA impose many related adverse effects. Kinesio taping was recently suggested as a novel conservative treatment for reducing pain in OA, without adverse effects. This study aimed to compare kinesio taping and NSAID therapy for kn.ee OA. There were 37 participants in the first group (mean age, 53.72 ± 8.91 years), 29 participants in the second group (mean age, 50.24 ± 8.63 years), and 18 participants in the third group (mean age, 53.33 ± 8.50 years). These groups were treated with NSAID therapy and kinesio taping, kinesio taping only, and sham taping with NSAID therapy, respectively. Taping was repeated three times a week at 1-day intervals. Participants reported pain each week, using visual analog scale scores. The main effect of group and the pain-group interaction were not statistically significant (P = 0.88 and 0.15, respectively). Pain reduction in different weeks was statistically significant (P < .001). Cohen's effect size values for pain reduction in the first to third groups were 0.70, 0.55, and 0.48, respectively. Pain reduction was observed in the three groups, but there was no significant difference among the various treatments. Kinesio taping as a pain relief method may reduce pharmacotherapy demands or at least delay NSAID prescriptions in patients with early OA.

infection among humans (psittacosis) and pet birds (avian chlamydiosis), also known as parrot disease, parrot fever, and ornithosis, is a zoonotic bacterial disease. Humans most often become infected by inhaling the organism when urine, respiratory secretions, or dried feces of infected birds are dispersed in the air as very fine droplets or dust particles. infection of humans can cause influenza-like symptoms, such as fever of abrupt onset, pronounced headache, and dry cough, and can lead to severe pneumonia and non-respiratory health problems. Infection can also be asymptomatic. There is no vaccine for this infection. The disease is treatable with a tetracycline antibiotic, usually doxycycline, or a second-line therapy such as erythromycin or azithromycin. With appropriate treatment, the infection is rarely fatal. This report describes a case of severe, community-acquired pneumonia possibly due to in a resident of Colorado and examines significant clinical and epidemiological characteristics of psittacosis that affect confirming the diagnosis and managing the risks of exposure to psittacine (parrot-type) birds.

Pain is one of the problems that seriously affect people's quality of life for thousands of years. The causes of pain are complex and varied,and long-term pain can also lead to depression. It has become a research hotspot to develop analgesic preparations with significant drug effects and small side effects. Recent studies have shown that certain alkaloid monomers have analgesic targets such as γ-aminobutyric acid,cannabinoids,and capsaicin. If their preparation is applied to the analgesic field,they can make up for the defects such as strong addiction and side effects of traditional opioid and non-steroidal analgesic drugs,but there is no relevant literature to summarize the research results in this field. This article first introduces the mechanism of pain production and the target of analgesia. Based on this,the application status of alkaloid monomer analgesic preparations approved by China Food and Drug Administration( CFDA)( number varieties,type of dosage form,drug description,analgesic mechanism and advantages) was analyzed,and the research dynamics of alkaloid monomer analgesic preparations( new formulation and new technology) were reviewed. Finally,some problems in this field were pointed out,such as imperfect medication information,inadequate transformation of research results,and too few kinds of analgesic components in developed alkaloids. The development direction was also pointed out for the above problems,with a view to provide reference for further development and in-depth research.

Neuraxial analgesia is preferred over general anesthesia for cesarean delivery (CD), particularly in the presence of a labor epidural catheter. We hypothesize that care by a non-obstetric anesthesiologist as compared to care by an obstetric anesthesiologist is associated with a higher risk for use of general anesthesia for CD for patients with a preexisting labor epidural catheter.

The main clinical manifestations of Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) are migraine with aura, ischemic strokes, and progressive cognitive decline. Intracerebral hemorrhage (ICH) has been described in CADASIL, but is not widely recognized. Here we report a case with CADASIL that presented with fatal ICH. A 57-year-old right-handed man of Pakistani descent with history of genetically confirmed CADASIL, hypertension, and mood disorder presented to the emergency department via Emergency Medical Services (EMSs) after he was found down. Initial neurological examination showed a Glasgow Coma Scale (GCS) of 7 (E2, V1, M4), left gaze deviation, pinpoint pupils, and left hemiplegia. His medications included antihypertensive agents and aspirin. He was intubated in the emergency department due to inability to protect his airway. Computed tomographic scan of the head revealed acute hemorrhage in the right pons (ICH score 2) with extension into the right cerebral peduncle, as well as enlargement of the third and lateral ventricles suggesting early obstructive hydrocephalus that required an external ventricular drain placement. He had no improvement of his clinical status, and eventually extubation and comfort care were pursued. He died 6 days after presentation. CADASIL vasculopathy, cerebral microbleeds, hypertension, and antithrombotic agents are factors that could be related to ICH in patients with CADASIL. This case highlights the importance of adequate blood pressure control, magnetic resonance imaging assessment of cerebral microbleed, and careful discussion of the risk and benefits of antiplatelet agents when evaluating and treating patients with CADASIL.

Granulomatous mastitis (GM) is an inflammatory breast disease of unknown aetiology. It poses diagnostic and therapeutic challenges with myriad forms of clinical presentation, varying results to treatments and propensity to recur. This study aims to look at clinical and treatment factors that predispose to recurrence of GM.