Rejected

Sumatriptan succinate (SUT) is a potent drug used for relieving or ending migraine and cluster headaches. SUT bioavailability is low (15%) when it is taken orally owing to its gastric breakdown and bloodstream before reaching the target arteries.

: Some individuals with chronic pain do not seek care. This decision may be due to characteristics of the individual, pain, and/or their health professional(s). : This study aimed to identify and compare features of individuals with chronic pain, their pain and general health, and their health care professional between community-dwelling adults who did and did not seek care. : Randomly selected adults were mailed a study questionnaire that screened for chronic pain (pain persisting ≥3 months) and asked about their general well-being (Short Form [SF]-36), pain location (body diagram), pain intensity and characteristics (Leeds Assessment of Neuropathic Symptoms and Signs), experiences with health care professionals (Chronic Illness Resources Survey), and visits made to health professionals over the past year. Respondents were categorized as help-seeking (≥1 visit in the past year) and non-help-seeking (zero visits in the past year). : Six percent of respondents (44/696) were non-help-seeking. These respondents differed in individual, pain, and health care professional characteristics when compared to those who did seek care. Specifically, when other variables were controlled, non-help-seeking individuals were less likely to be male (relative risk [RR] = 0.39, 95% confidence interval [CI], 0.18-0.86), report comorbid conditions (RR = 0.46, 95% CI, 0.22-0.98), report being treated as an equal partner in decision making (RR = 0.40, 95% CI, 0.18-0.93), and rate their health care professional as important to their pain management (RR = 0.39, 95% CI, 0.18-0.85). They were more likely to use over-the-counter medication to manage their pain (RR = 2.52, 95% CI, 1.14-5.58). : Experiences with health professionals play a role in determining whether an individual manages his or her pain independently. Future research should explore the safety of those who do not seek care.

Arterial injury/entrapment is an uncommon sequelae of long bone fractures, particularly in closed injuries. The proximity of the anterior tibial artery to the distal tibia poses a risk of entrapment with a fracture at this level. To the best of our knowledge, this is the first case report of a partial nonunion due to entrapment of the anterior tibial artery in a healed tibia fracture in a pediatric patient.

Cannabis abuse has been an issue of major concern for the Albanian society in recent years, following the wide illegal planting of the species. Legal lacunas, weaknesses from the drug-controlling agencies, and the easiness of harvesting plants have contributed to the creation of a general negative opinion toward a potential use of its active principles for medical purposes. Professionals of the field and policymakers are largely focused on harm reduction activities, thus bypassing the option of legalizing cannabinoids for clinical conditions that might find relief in their use. The discussion of a case suffering from postherpetic neuralgia shows how this negative opinion is depriving Albanian patients from an otherwise helpful pharmacological option whose efficacy has been confirmed by an important bulk of research. Uncovering the roots of this misperception will help address the issue. Clinicians with expertise need to have their say in the debate, since for the majority of countries where medicinal cannabis is legalized, this was due to consumer-led initiatives. Ensuring patients' freedom as implied within the principle of autonomy is also a sound ethical support of such legalization.

Previous studies of patients with neck pain have reported a high variability in prevalence of MRI findings of disc degeneration, disc herniation etc. This is most likely due to small and heterogenous study populations. Reasons for only including small study samples could be the high cost and time-consuming procedures of having radiologists coding the MRIs. Other methods for extracting reliable imaging data should therefore be explored.The objectives of this study were 1) to examine inter-rater reliability among a group of chiropractic master students in extracting information about cervical MRI-findings from radiologists´ narrative reports, and 2) to describe the prevalence of MRI findings in the cervical spine among different age groups in patients above age 18 with neck pain.

Currently, intraoperative use of local anaesthetic is not routinely given in all laparoscopic appendicectomies. Although its use has been widely studied in laparoscopic hernia repairs, gynaecological laparoscopy and laparoscopic cholecystectomies, there are no published trials of the use of intraperitoneal local anaesthetic during laparoscopic appendicectomy in the Australasian setting. The aim of this study was to determine whether the use of intraperitoneal ropivacaine during laparoscopic appendicectomy will reduce the amount of post-operative opiate analgesia used, abdominal pain, post-operative nausea or vomiting, shoulder tip pain and length of hospital stay.

Intussusception after one anastomosis gastric bypass is a rare postoperative complication that occurs with bowel obstruction. The diagnosis may be challenging because of long-standing, intermittent, nonspecific symptoms. Our paper describes an unusual case of antegrade intussusception that occurred 28 months after laparoscopic one anastomosis gastric bypass surgery.

One of the main goals of novel, noninvasive imaging techniques like high-resolution nerve ultrasound (HRUS) and corneal confocal microscopy (CCM) is the prediction of treatment response for patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Peripheral neurotoxicity is a common adverse reaction in cancer patients undergoing chemotherapy. The neuropathologic changes were partly associated with mitochondrial dysfunction and autophagy. Tanshinone IIA, a compound extracted from the medicinal herb , has been shown to exhibit neuroprotective effects. The present study investigated the effects of tanshinone IIA on chemotherapy-induced neurotoxicity and to study the underlying mechanism. Neuroma cell line N2a and rats were treated with oxaliplatin and/or tanshinone IIA. The effects on neurotoxicity were evaluated using cell viability assay, flow cytometry detection of apoptosis, measurement of intracellular reactive oxygen species (ROS) and mitochondrial membrane potential (Ψm), autophagy detection, nerve function assessment, and behavior assessment. The results showed that tanshinone IIA prevented oxaliplatin-induced inhibition of cell viability and reduced apoptosis. Tanshinone IIA also prevented excessive oxidative stress, as demonstrated by decreased ROS levels and reduced Ψm loss. Lastly, treatment with tanshinone IIA promoted autophagy through the PI3K/Akt/mTOR signaling pathway. The experiment showed that tanshinone IIA ameliorated oxaliplatin-induced allodynia and sciatic nerve dysfunction. An increase in serum nerve growth factor level was observed. In conclusion, the results of the study suggested a protective role of tanshinone IIA in neurotoxicity induced by oxaliplatin via mitochondrial protection and autophagy promotion.