Rejected

An acute migraine attack is a very painful condition and can be difficult to treat. Pharmacological treatments are limited by significant side effects and limited efficacy. There are anecdotal reports suggesting that acute migraine attacks could be treated using pressure point stimulation between the thumb and index fingers. There are no scientific published data to evaluate the effectiveness of this trigger point. Using rhythmic pressure applied to the trigger point between the index finger and thumb, we report the effectiveness of this method in 6 of 7 cases. This technique can effectively break acute migraine attacks in a matter of minutes. The pressure must be applied in a rhythmic cycle without causing significant pain. A detailed description of this technique in successfully treated cases is described in this manuscript.

Increasing evidence suggests a close association between chronic pain and executive function, a set of cognitive processes necessary for goal-directed behaviors. However, there is a dearth of longitudinal studies examining the predictive effect of executive function on the development of chronic pain. Drawing on the cyclical model of executive function and health, we sought to examine how executive function, measured at baseline, may predict chronic pain etiology approximately 9 years later. Using a large-scale dataset of midlife adults (N = 1553) from the MIDUS 2 and 3 (Midlife Development in the United States) studies, we employed multivariate logistic regression to examine the etiology of new chronic pain for individuals who did not have chronic pain at baseline. Further, we also tested whether executive function predicted the degree of pain interference, among individuals with chronic pain. Our results revealed that lower baseline executive function was associated with a significant likelihood of developing chronic pain 9 years later (OR = 0.812, p = .001), even after adjusting for demographics, health, and psychosocial confounds (OR = 0.827, p = .014). However, executive function failed to robustly predict the etiology and degree of chronic pain interference. Our findings underscore the critical role of executive function on the development of chronic pain.

Major depressive disorder (MDD) is one of the most common mental disorders. We designed a fast-onset antidepressant that works by disrupting the interaction between the serotonin transporter (SERT) and neuronal nitric oxide synthase (nNOS) in the dorsal raphe nucleus (DRN). Chronic unpredictable mild stress (CMS) selectively increased the SERT-nNOS complex in the DRN in mice. Augmentation of SERT-nNOS interactions in the DRN caused a depression-like phenotype and accounted for the CMS-induced depressive behaviors. Disrupting the SERT-nNOS interaction produced a fast-onset antidepressant effect by enhancing serotonin signaling in forebrain circuits. We discovered a small-molecule compound, ZZL-7, that elicited an antidepressant effect 2 hours after treatment without undesirable side effects. This compound, or analogous reagents, may serve as a new, rapidly acting treatment for MDD.

Prevalence of intracranial aneurysms in children with Apert syndrome has not been described, and development of an aneurysm as a complication secondary to craniofacial surgery has never been reported.

Epilepsy with eyelid myoclonia (EEM) has been associated with marked clinical heterogeneity. Early epilepsy onset has been recently linked to lower chances of achieving sustained remission and to a less favorable neuropsychiatric outcome. However, much work is still needed to better delineate this epilepsy syndrome.

Modified thoracoabdominal nerve block through the perichondrial approach (M-TAPA) is a new technique that provides effective analgesia of the anterior and lateral thoracoabdominal walls by administering local anesthesia only to the underside of the perichondral surface. The primary purpose of the present study was to investigate the postoperative analgesic efficacy of M-TAPA block performed before surgery in patients undergoing laparoscopic cholecystectomy (LC).

Transverse myelitis and cerebral venous thrombosis represent some of the described neurological complications of coronavirus disease. A woman in her early 30s presented with headache, left-sided sensory symptoms and voiding difficulty. The patient also reported dry cough, fever, nasal congestion, anosmia and ageusia 2 weeks before presentation. The clinical examination showed sensory disturbances on the left side of the body, starting from the lower abdomen and extending to the left leg, which was consistent with transverse myelitis. The laboratory assessment confirmed a previous infection with coronavirus disease and excluded autoimmune entities. Radiological investigations revealed left transverse sinus thrombosis with no spinal cord abnormalities. The treatment was started with therapeutic anticoagulation and intravenous high-dose steroids. The patient showed significant improvement, and the neurological deficits resolved after 3 months. This is the first documented case of imaging-negative myelitis associated with cerebral venous thrombosis after coronavirus disease.

Neck pain, headache, and/or orofacial symptoms are potentially the first (non-ischaemic) symptoms of an underlying vascular pathology or blood flow limitation. If an underlying vascular pathology or blood flow limitation is not recognized by the musculoskeletal rehabilitation clinician, it can subsequently be aggravated by treatment, raising the risk of serious adverse events. We argue that clinicians can make an important, and potentially lifesaving difference, by providing specific information and advice. This is especially the case in patients with an intermediate level of concern for example in patients who only show a few concerning features regarding a possible underlying serious condition, and for whom an initial vasculogenic hypothesis was rejected during the clinical reasoning process. We present background information to help the reader understand the context of the problem, and suggestions for how clinicians can provide appropriate information and advice to patients who present with neck pain, headache, and/or orofacial symptoms.

: To investigate the effect of progressive resistance exercise compared with low intensity home-based exercises on knee-muscle strength and joint function in people with anterior cruciate ligament (ACL) reconstruction and persistent hamstring strength deficits at 12-24 months after surgery. : Randomized controlled superiority trial with parallel groups, balanced randomization (1:1) and blinded outcome assessment. : We searched the databases PubMed, CINAHL, Scopus, SPORTDiscus, and the Cochrane Library from inception to January 6, 2022. : People with ACL reconstruction (hamstring autograft) and persistent hamstring muscle strength asymmetry were recruited one to two years post-surgery and randomised to either twelve weeks of supervised progressive strength training (SNG), or twelve weeks of home-based, low-intensity exercises (CON). The primary outcome was between-group difference in change in maximal isometric knee flexor muscle strength at twelve-week follow-up. : Fifty-one participants (45% women, 27 ± 6 years) were randomized to SNG (n=25) or CON (n=26), with 88% follow-up rate at twelve weeks. People in the SNG group improved their knee flexor muscle strength (0.18 Nm/kg, 95% CI 0.07 to 0.29; p = 0.002) more than the CON group, from baseline to twelve weeks. The SNG group also had superior Knee injury and Osteoarthritis Outcome Scores (KOOS) for Pain (4.6, 95% CI 0.4 to 8.7; p = 0.031) and Daily Living Function (4.7, 95% CI 1.2 to 8.2; p = 0.010) compared to the CON group. : In people with persistent hamstrings muscle strength deficits after ACL reconstruction, 12 weeks of supervised progressive strength training was superior to low intensity home based exercises for improving maximal knee flexor muscle strength and some patient reported outcomes.

Reversible cerebral vasoconstriction syndrome may be underdiagnosed. It can be accompanied by various complications, mainly intracerebral hemorrhage and ischemic stroke. The clinical presentation of this condition varies according to its localization. The aims of this review are to raise awareness of the disease, especially in the presence of corresponding risk factors; to connect its precipitating factors, pathophysiology, and complications; and to compare various differential diagnoses of vasoconstriction.