Rejected

Baastrup's disease is a rare condition of the vertebral column often misdiagnosed and wrongly treated due to poor knowledge, characterized by low back pain arising from the close approximation of adjacent posterior spinous processes and resultant degenerative changes. Diagnosis rests on clinical examination and detailed imaging studies. Proposed therapies include conservative treatment, percutaneous infiltrations or surgical therapies. We present the case of a 31-year-old man with persistent chronic lumbago for several years. In whom, the diagnosis of Baastrup's disease was high suspected clinically, with a final surgical treatment despite the absence of inflammation on imaging studies, which allowed the diagnostic confirmation and the return to a normal social and professional life. We wish through this case, to expose the different steps of interventional diagnostic/therapeutical procedures until the surgical management in a clinical suspicion of Baastrup's diseases with unclear radiological findings.

Se and selenoproteins play critical metabolic roles, as in glutathione peroxidase (antioxidant defense) and iodo-thyronine deiodinase 2 (thyroid hormone production). Other Se-dependent pathways can promote apoptosis and decrease oncogene expression. Se deficiency (SeD) is rare in the US, given its abundance in food and soil. SeD is linked to tobacco use, excessive ETOH consumption, birth control pills, and inflammatory bowel disease. SeD can increase the risk of prostate cancer and Burkitt's lymphoma. Severe SeD can cause skeletal muscle dysfunction and endemic cardiomyopathy (Keshan disease). We present herein a case of SeD 7 + years after heart transplantation, in whom prostate cancer and Burkitt's post transplant lymphoproliferative disorder (PTLD) developed.

Chronic pain has become a common problem within primary care and can negatively impact patients' lives.

Complementary therapies provide cancer survivors and clinicians with options for managing chronic pain. Recent published clinical guidelines and research findings support the use of relaxation therapy for managing chronic pain in cancer survivors. However, translating research findings into clinical practice remains a challenge. Using theory to guide implementation of a new practice can increase the likelihood of successful adoption. This article uses relaxation therapy for cancer survivors to describe how clinicians could use Rogers' Diffusion of Innovation Theory and the related Collaborative Research Utilization Model to implement a complementary therapy and ensure that it becomes standard practice.

Currently, no universally accepted methods exist to assess drug-related aberrant behaviors in emergency department (ED) patients. There are several screening tools to identify opioid misuse in patients with chronic pain, however, the validity of these screening tools to assess for misuse within the ED remains unclear.

We have reviewed the scientific literature related to four diseases in which to serotonin (5-HT) is involved in the etiology, herein named 5-HT-linked diseases, and whose prevalence is influenced by estrogenic status: depression, migraine, irritable bowel syndrome and eating disorders. These diseases all have in common a sex-dimorphic prevalence, with women more frequently affected than men. The co-occurrence between these 5-HT-linked diseases suggests that they have common physiopathological mechanisms. In most 5-HT-linked diseases (except for anorexia nervosa and irritable bowel syndrome), a decrease in the serotonergic tone is observed and estrogens are thought to contribute to the improvement of symptoms by stimulating the serotonergic system. Human pregnancy is characterized by a unique 5-HT and estrogen synthesis by the placenta. Pregnancy-specific disorders, such as hyperemesis gravidarum, gestational diabetes mellitus and pre-eclampsia, are associated with a hyperserotonergic state and decreased estrogen levels. Fetal programming of 5-HT-linked diseases is a complex phenomenon that involves notably fetal-sex differences, which suggest the implication of sex steroids. From a mechanistic point of view, we hypothesize that estrogens regulate the serotonergic system, resulting in a protective effect against 5-HT-linked diseases, but that, in turn, 5-HT affects estrogen synthesis in an attempt to retrieve homeostasis. These two processes (5-HT and estrogen biosynthesis) are crucial for successful pregnancy outcomes, and thus, a disruption of this 5-HT-estrogen relationship may explain pregnancy-specific pathologies or pregnancy complications associated with 5-HT-linked diseases.

Fogo Selvagem (FS) is a rare autoimmune disease characterized by acantholysis and inflammation of the epidermis. It was evidenced in this disease the increase of proinflammatory cytokines levels which can be influenced by physical activities. Kinesiotherapy, as physiotherapeutic interventions, was associated improvement levels of the quality of live, mainly the pain. Understanding the impact of such methodology in immunology of the FS, may constitute an alternative and effective approach. We compare the levels of serum cytokines and chemokines between nine patients with FS submitted to kinesiotherapy for 12 weeks and ten patients not submitted to kinesiotherapy. The kinesiotherapy was composed by self-stretching followed by a resistance training for upper and lower limbs. The protocol was carried out in three sections of eight to ten repetitions with 70% of the maximum load measured by test maximum of ten repetitions. After strengthening period patients performed a passive stretching. The training sessions lasted 50 min and were performed 3 times a week at least 12 weeks. Cytokines and chemokines were assessed in plasma using enzyme-linked immunosorbent assay and/or cytometric bead array. Patients with FS were being kinesiotherapy presented minors levels of interferon-γ, interleukin (IL)-17, IL-22, and IL-15 when compared to those not submitted to kinesiotherapy. No differences were observed for the detection of the chemokines chemokine ligand (CCL)-2, CCL-3, CCL-5, CCL-11, C-X-C motif chemokine 8 (CXCL-8), and CXCL-10. These results suggest that kinesiotherapy had a positive impact on inflammatory markers that are associated with disease worsening in FS.

To characterize the level of probability or perceived risk that will trigger patients, physicians, nurses, or therapists to initiate clinical activities to prevent late effects, including chronic physical impairments and adverse symptoms that often occur among breast cancer (BC) survivors.

The aim of this study was to investigate the opioid-sparing effect of a cooling brace after surgical correction of idiopathic surgery in children.