Rejected

Choriocarcinoma is a highly aggressive germ cell tumor and can metastasize to the brain. Although brain metastasis has a poor prognosis, the optimal treatment strategy remains unclear due to its low incidence. A 33-year-old man presenting with multiple lung nodules on chest radiography was referred to our hospital. Computed tomography revealed bilateral lung nodules and a large pelvic mass, and brain magnetic resonance imaging (MRI) demonstrated multiple brain lesions. He developed progressive headache and nausea and underwent two craniotomies because of rapid tumor growth and intratumoral hemorrhage. Metastasis of choriocarcinoma was strongly suspected because of histological findings and detection of urine human chorionic gonadotropin (hCG). He immediately received chemotherapy with bleomycin, etoposide, and cisplatin (BEP). Although the pelvic mass and pulmonary lesions reduced in size and the β-hCG level decreased after one cycle of BEP, brain MRI displayed an increase in the size and number of brain metastases. He underwent whole-brain radiotherapy (WBRT) concurrently with 2 cycles of BEP, leading to successful reduction of brain metastases. After 4 cycles of BEP, the β-hCG level was still higher than the normal range, and the pelvic and pulmonary lesions remained. He continued chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP) and etoposide, ifosfamide, and cisplatin (VIP). The β-hCG level normalized, and the residual pelvic mass was resected, revealing no viable cancer cells. Multimodal treatment, including two craniotomies and chemotherapy concurrent with WBRT, can achieve good control of lesions of the brain and other sites.

To evaluate the predictive validity of the Assessment of SpondyloArthritis international Society (ASAS) axial spondyloarthritis (axSpA), Amor, European Spondylarthropathy Study Group (ESSG) and modified New York (mNY) classification criteria.

We compared the outcome of robotic hysterectomy (RH) with laparoscopic hysterectomy (LH) for large uteri (≥16 weeks).

This article describes two common hypnotic communication techniques that can be used in anesthesiology and more generally for a variety of medical applications. First, the LAURS (listening, acceptance, utilization, reframing, suggestion) hypnotic communication structure is detailed. This technique allows clinicians to rapidly build patient rapport and maximize the chance of a suggestion being realized. Second, the "Lived in Imagination technique can be used to supplement a less than perfect local anesthesia technique or help provide analgesia or sedation to support a patient undergoing minor or even major surgical procedures. These techniques may allow for an adjunctive, seamless integration during standard clinical care.

A 2-year-old polytraumatized male cat was admitted to a teaching hospital for correction of a defective inguinal herniorrhaphy. Upon arrival, the cat showed signs of neuropathic pain, including allodynia and hyperalgesia. Analgesic therapy was initiated with methadone and metamizole; however, 24 h later, the signs of pain continued. Reparative surgery was performed, and a multimodal analgesic regimen was administered (methadone, ketamine, wound catheter and epidural anesthesia). Postoperatively, the cat showed signs of severe pain, assessed using the UNESP-Botucatu multidimensional composite pain scale. Rescue analgesia was initiated, which included methadone, bupivacaine (subcutaneous wound-diffusion catheter) and transversus abdominis plane block. Because the response was incomplete, co-adjuvant therapy (pregabalin and electroacupuncture) was then implemented. Fourteen days after admission, the patient was discharged with oral tramadol and pregabalin for at-home treatment.

Abdominoplasty is a very common surgery nowadays and mainly performed as an office-based procedure. Spinal anesthesia is assumed to be safer than general anesthesia in such operations. The aim of this study is to compare between spinal and general anesthesia for abdominoplasty.

Opioid-induced respiratory depression (OIRD) is a serious adverse reaction associated with opioid administration.

Chronic pain patients frequently report having sleep disturbances and many tend to stay up during the night and then sleep into the day.

This special issue comprised 14 articles from leaders in the field, that provide opinions and reviews of concepts that are central to the next generation of pain imaging studies. Topics include cutting-edge technologies and approaches that are at the forefront of such studies, as well as developments toward biomarkers of pain and clinical applications that bring us closer to harnessing understanding of pains and its modulation to offer better options to those suffering from pain.

Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory disease of gallbladder (GB) and can mimic GB cancer in extensive form. This study aims to assess the predictability of XGC on the basis of clinical presentation, laboratory tests, and radiological or intraoperative findings on frozen section analysis.