Rejected

Facial fillers are minimally invasive aesthetic procedures performed for facial rejuvenation and contouring all over the world. Fillers even in the most experienced hands can lead to fatal complications such as vascular complications that need to be managed immediately with the help of hyaluronidase protocols mentioned in literature. In this case report, a patient was asymptomatic with no signs of vascular occlusion such as blanching or poor capillary refill for 48 h. He came after more than 48 h of the filler injection with complaints of pulsating pain in the right infraorbital and nasolabial area. We noticed necrosed microvesicles in the infraorbital artery territory with signs of impending skin necrosis extending from right infraorbital region up to the nasolabial fold (slightly medial to it). He was treated immediately with three pulsed doses of 500 units higher dilation of 10 ml each every hour (reconstitution carried out using 3mL normal saline). The skin color improved with decreased pain, and the next day (after 14 hours) we injected 500 units of hyaluronidase in higher dilution of 10mL as slight redness was still present. Skin redness, swelling, and pain disappeared the following day. Skin was completely healed and by 15 days we noticed slight post-inflammatory hyperpigmentation, which was easily managed with Q-switched laser and creams. We hereby report a case of delayed skin necrosis (>48 h) following filler injections in the cheek area, in the infraorbital artery vascular territory, which was successfully managed with pulsed dose of hyaluronidase.

Vitreoretinal surgery is associated with undesirable intraoperative and postoperative complications including pain, postoperative nausea and vomiting, and oculocardiac reflex (OCR). Systemic analgesics have side effects and are contraindicated in some cases. We hypothesized that the preoperative sub-Tenon's injection of levobupivacaine with general anesthesia would decrease postoperative pain and intraocular pressure as well as the incidence of complication.

Post-traumatic stress disorder (PTSD) is characterized by avoidance of trauma-associated stimuli and amygdala hyperreactivity, and is highly co-morbid with alcohol use disorder (AUD). Our lab uses a predator odor (bobcat urine) stress model that produces conditioned avoidance of an odor-paired context in a subset of rats, mirroring avoidance symptoms that manifest in some but not all humans exposed to trauma. We previously showed that after predator odor stress, Avoiders exhibit escalated operant alcohol self-administration (SA), higher aversion-resistant operant alcohol responding, hyperalgesia, and greater anxiety-like behavior compared to unstressed Controls. We also showed previously that systemic antagonism of corticotropin-releasing factor-1 receptors (CRFR1) reduced escalation of operant alcohol SA in rats not indexed for avoidance, that corticotropin-releasing factor (CRF) infusions into the central amygdala (CeA) produced conditioned place avoidance in stress-naïve rats, and that intra-CeA infusion of a CRFR1 antagonist reduced hyperalgesia in Avoiders. Here, we show that avoidance behavior is persistent after repeated predator odor exposure. In addition, Avoiders showed lower weight gain than Controls after predator odor re-exposure. In the brain, higher avoidance was correlated with higher number of c-Fos + cells and CRF immunoreactivity in the CeA. Finally, we show that intra-CeA CRFR1 antagonism reversed post-stress escalation of alcohol SA and reduced avoidance behavior in Avoiders. Collectively, these findings suggest that elucidation of the mechanisms by which CRFR1-gated CeA circuits regulate avoidance behavior and alcohol SA may lead to better understanding of the neural mechanisms underlying co-morbid PTSD and AUD.

To determine whether patients with cluster headache have more sickness absence and disability pension days compared to matched references and possible associations with sociodemographic characteristics.

Groin pain in active individuals and athletes without clinical evidence of hernia or hip pathologic findings is challenging for health care clinicians and aggravating for those experiencing pain. Frequently called sports hernia or athletic pubalgia, many surgeons continue to refute the diagnosis because there is a lack of consensus and clear comprehension of the basic pathophysiologic features of this groin pain syndrome.

A large number of patients have chronic back pain, producing disability. Consequently, there is a need to validate instruments for pain measurement. The aim of this study was to determine the validity and reliability of the Oswestry Disability Scale for Low Back Pain in the population with chronic back pain in Cienfuegos.

To evaluate the safety and efficacy of bermekimab, an interleukin-1⍺ inhibitor, in the treatment of hidradenitis suppurativa (HS).

The aim of this study was to determine whether postnatal women whose babies required neonatal intensive care unit (NICU) admission self-reported lower pain scores and required less analgesia than women whose babies remained with them. A prospective matched audit comparing pain scores and analgesia requirements where every woman with a baby admitted to the NICU was matched to 2 women whose babies remained on the ward was undertaken. Matches were based on age, number of previous births, type of birth, episiotomy, and epidural or spinal analgesia use. Data were collected on pain scores and analgesia administered in the first 72 hours postbirth. A total of 150 women were recruited and matched from November 2015 to May 2017. No statistically significant differences were found between the 2 groups for opiate analgesia use (P = .91) or pain scores (P = .89). Regardless of NICU admission, significantly higher pain scores were reported in participants who had episiotomies (P = .03). Birth via cesarean birth resulted in significantly higher pain scores (P < .01) and greater opiate administration (P < .01). This study found no statistically significant difference between pain scores or analgesia use of mothers whose babies required NICU admission and mothers whose babies remained with them.