Rejected

To investigate the effectiveness of spinal manipulation combined with myofascial release compared with spinal manipulation alone, in individuals with chronic non-specific low back pain (CNLBP).

Migraine is a chronic disorder that negatively affects a patient's quality of life (QOL). As little is known about the QOL of migraine sufferers in Saudi Arabia, our aim was to investigate the QOL and the level of migraine-associated disability of migraine patients.

The aim of this study was to perform a meta-analysis on the effect of weight loss obtained by bariatric surgery or behavioral intervention on migraine frequency and indices of severity.

Thoracic endovascular aortic repair (TEVAR) with endograft coverage from the left subclavian (LSA) to celiac artery has been hypothesized to increase spinal cord ischemia. This study analyzes the impact of extended coverage upon adverse outcomes and aortic remodeling in patients with complicated acute Type B Aortic Dissection (aTBAD).

Skin ulcers represent a common complication of sickle cell disease, especially in homozygous forms, with multifactorial pathogenetic mechanisms and frequent location at lower extremities; more specifically perimalleolar areas are favourite location because of a chronic microvascular disturbance and capillary stasis in a district with low fatty tissue. Chronicization and recurrence of unhealable lesions significantly have a high impact on quality of life of these patients in terms of pain management and psycho-physical dysfuncRomation. When we deal with a chronic ulcer, as it often happens in patients affected by hemoglobinopathies, the key-point is to make the skin lesion healable and vital by reactivating blocked repair process. Although it's controversial topic, patterns of patients with higher HbF concentrations might be more protective in accordance with reduced HbS polymerization; indeed, clinical features of ulcer represent the best predictors suggesting the correct strategy to achieve a good final outcome. Hereafter we report the case of a young woman with skin complications secondary to drepanocytosis, in which an interlinked reparative model consisting of surgery and advanced medications in addition to an adequate transfusional support, especially in earlier phases, has allowed to achieve clinical success after several years of care failure.

The aim of this study is to understand the effect of ultrasound (US) guided erector spinae plane block (ESPB) in improving the intraoperative and postoperative analgesia in patients undergoing mastectomies, decreasing the use of opioids and in reducing postoperative nausea and vomiting.

OA is now well accepted as a low-grade inflammatory disease affecting the whole joint. In addition to mechanical loading, inflammation (particularly synovitis), contributes significantly to OA. Synovial macrophages act as immune cells and are of critical importance in the symptomology and structural progression of OA. Activated macrophages are regulated by mTOR, NF-κB, JNK, PI3K/Akt and other signaling pathways, and are polarized into either M1 or M2 subtypes in OA synovial tissues, synovial fluid, and peripheral blood. The activation state and the M1/M2 ratio is highly associated with OA severity. Aside from autocrine interactions, paracrine interactions between macrophages and chondrocytes play a vital role in the initiation and development of OA by secreting inflammatory cytokines, growth factors, matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases (TIMPs), which lead to subsequent cartilage degradation and destruction. Treatments targeting synovial macrophages relieve pain, and protect from synovitis, cartilage damage, and osteophyte formation during OA development. Macrophage reprogramming of transformation from the M1 to M2 subtype, more than a decrease in the quantity of activated macrophages, appears to be an effective treatment option for OA. This review provides a broad understanding of the contributions of polarized macrophages to joint health and disease. Multifunctional agents with immunomodulatory effects on macrophage reprogramming can skew the inflammatory microenvironment towards a pro-chondrogenic atmosphere, and are thus, potential therapeutic options for the treatment of OA and other immune diseases.

In this study, we constructed a structural equation model (SEM) for predicting the quality of life (QOL) in elderly Koreans with chronic musculoskeletal pain (CMP) and examined the differences between sexes. Data were earlier collected in a prior study of 307 participants (101 men and 206 women) with CMP, aged 65 years and above, who used geriatric welfare centers located in two cities. The effects of pain, functional limitation, perceived health status, pain coping, and social support on the QOL were estimated with a multigroup SEM. For both men and women, the results show sequential causality from pain to functional limitation, perceived health status, and QOL. However, the relationships among pain, pain coping, functional limitation, and QOL differ between men and women. The multigroup SEM provides a better understanding of the sex differences in the QOL of elderly with CMP. The results suggest that in order to improve QOL among the elderly with CMP, a customized strategy should be applied that takes into account differences between the sexes.

To investigate the burden of sleep problems within the Spinal Cord injured (SCI) community with respect to the general population (GP) in Switzerland. The study further explored potential predictors for receiving treatment for sleep problems after SCI. Cross-sectional study. SCI community in Switzerland. Individuals diagnosed with an SCI, aged 16 years or older that permanently reside in Switzerland ( = 1549). Not applicable. Perceived sleep problems within the SCI community and GP. For those with sleep problems and SCI, an indicator for having received treatment was measured. 58.8% of survey participants indicated having a sleep problem; 69.4% of those with a sleep problem did not indicate receiving treatment. Amongst people living with an SCI, individuals between the ages of 46-60 years (adjusted Odds Ratio, OR = 3.07; 95% CI 1.54-6.16), participants reporting severe financial hardship (OR = 2.90; 95% CI) 1.69-4.96, and those that indicated having pain (OR = 5.62; 95% CI 3.52-8.98) were more likely to have a chronic sleep problem. In comparison to the Swiss GP, the prevalence of having a sleep problem was 18% higher among persons with SCI, with the largest discrepancy for males with paraplegia between the ages of 46-60 years (Prevalence ratio, PR = 1.28; 95% CI, 1.21-1.36). Individuals with SCI experience more sleep problems compared to the Swiss GP. Findings from this study suggest that clinical screening for sleep issues targeting high risk groups is needed to reduce the large prevalence of non-treatment in individuals with SCI.