Rejected

Optic neuritis is an inflammatory demyelinating disorder of the central nervous system. Anti-NMDA receptor (NMDAR) antibodies encephalitis is also mediated by the inappropriate immunological response. We report a girl who was readmitted because of unilateral eye pain and vision impairment in the remission period of anti-NMDAR encephalitis. Based on the limited available literature on the treatment of optic neuritis associated with anti-NMDA receptor antibody, she was treated with a combination of corticosteroids and intravenous immunoglobulin with clinical improvement. Optic neuritis in the remission phase of anti-N-methyl-D-aspartate receptor encephalitis remains relatively uncommon. It is important to document and follow these patients to understand the pathogenesis of optic neuritis in the setting of anti-NMDAR encephalitis and formulate effective therapeutic strategies.

Using narcotics for pain management is an integral part of orthopaedic surgery, especially after traumatic injuries such as ankle fractures. Although narcotics are often necessary for adequate pain control, prolonged duration of opioid treatment is becoming more common, and the detrimental effects of opioid use are well known. To treat this epidemic, we need to better understand the factors that put patients at risk for increased narcotic requirements and potential opioid misuse after orthopaedic injuries. The purpose of this study was to retrospectively compare opioid use among ankle fracture patients in smokers versus nonsmokers to better elucidate whether tobacco use is a risk factor for increased opioid consumption. A retrospective review was conducted for all patients who presented with an ankle fracture (Weber A to C) to any of 8 institutions in a large mid-Atlantic regional hospital system and subsequently underwent surgery between the November 2013 and January 2017. Exclusion criteria included patients age <18 years, a diagnosis of a pilon fracture, polytrauma, history of substance abuse, chronic pain syndromes, and osteoporosis. This yielded a total of 130 patients (96 nonsmokers and 34 smokers). A repeated-measures analysis of variance was conducted to compare opioid consumption between the 2 groups. Model analysis demonstrated no difference between the 2 groups (p = .782). There was no difference in opioid consumption at 1 month (p = .838), 2 months (p = .569), or 3 months (p = .656) between smokers and nonsmokers. Our study revealed no significant difference in opioid consumption among smokers compared with nonsmokers in patients treated for ankle fractures.

Hip arthroplasty is a widely used and successful orthopedic procedure for the treatment of degenerative, inflammatory, or traumatic joint disease. The procedure promotes significant pain relief, as well as recovery of limb function, reduction of disability, and better quality of life. However, there are related complications, which have characteristic imaging aspects. In the present study, we review the literature and exemplify such complications using images obtained at our facility, illustrating the main radiological aspects of complications such as heterotopic ossification, periprosthetic fractures, osteolysis, infection, wear, and dislocation.

Primary central nervous system lymphoma (PCNSL) is a rare tumor that accounts for <1%-4% of primary CNS tumor. PCNSLs are class of non-Hodgkin's lymphomas which are primarily of diffuse large B-cell origin (90%), with remaining being T-cell lymphoma (10%). Author report a rare case of PCNSL presenting as an intracranial mass involving the entire ventricular system, in an immunocompetent 36-year-old male with severe headache, decreased vision, and unsteady gait. The diagnosis was obtained by histopathological and subsequent immunohistochemistry.

Non-neoplastic cysts localized in salivary glands are quite rare and represent approximately 2-5% of all salivary gland lesions. Salivary duct cyst, also known as sialocyst is a true cyst with the epithelium lining the inner side of its walls. It is generally observed in minor salivary glands and it rarely involves the parotid. Patients are mostly affected between the ages of 30 and 40 and the lesion is rarely seen in children. The current case is a rare report, as the patient was a child. The diagnosis has been difficult to ascertain due to the presence of pain, symptom characteristic for inflammatory lesions.

Botulinum toxin (BTX) is a popular cosmetic therapy administered by both dentists and physicians. The ability of the toxin to locally paralyze muscles has led to the use of BTX as a potential therapy for a variety of medical conditions. This article will discuss the current head and neck applications of BTX. In addition, a brief review of other potential clinical benefits is provided.

We evaluated the prevalence of fibromyalgia syndrome (FMS) in peritoneal dialysis (PD) patients and whether this syndrome is associated with gender, age, duration of PD, or other laboratory parameters. A total of 60 chronic PD patients (26 women, 34 men) and 60 healthy controls (30 women, 30 men) were included. We recorded each participant's age, gender, cause of kidney failure, PD duration, laboratory parameters, education level, and symptoms related to FMS, diagnosed according to the 2010 American College of Rheumatology criteria. Eleven patients (18%) in the PD group and nine (15%) in the control group met the diagnostic criteria for FMS. There were no statistically significant differences in age; gender; education level; PD duration; laboratory parameters; or sleepdisturbance, fatigue, or cognitive symptoms between the FMS and non-FMS groups among the PD patients. We next compared control and PD patients with FMS. Both groups were of a similar age and gender and had similar sleep disturbance and cognitive symptoms, but more patients had fatigue in the control group. The prevalence of FMS among PD patients was similar to that in the general population, and FMS was not associated with gender, age, duration of PD, or other laboratory parameters.

The study aim was to explore the experience of doctors and nursing assistants in the management of physical restraint (PR) in critical care units.

In chronic renal failure, plasma 1,25-hydroxyvitamin D levels decrease due to the disturbance of the hydroxylation of 25-hydroxyvitamin D in the kidney, which results in decreased calcium absorption from the intestine. This induces hypocalcemia, which increases the secretion of parathyroid hormone. Parathyroid hormone can stimulate bone resorption which renders the bone susceptible to fractures even with trivial trauma.

Erector spinae plane (ESP) block is a promising technique in the field of pediatric postoperative analgesia considering its safety and simplicity.