Rejected

Immunotherapy with the chimeric 14.18 anti-GD2 antibody (ch14.18) is associated with severe neuropathic pain. Different analgesic modalities have been employed, but pain management remains challenging and side effects such as desaturation, bradycardia, and hypotension have been reported. We retrospectively analyzed the efficacy of a multimodal regimen based on gabapentin, ketamine, and morphine in controlling pain during ch14.18 chemotherapy. In our cohort, the pain was low, desaturation and hypotension were infrequent, and no episode of bradycardia was reported. Morphine consumption was similar to other studies. Our results suggest that this regimen may be a valid analgesic option in children undergoing ch14.18 infusion.

Inflammatory pseudotumor (IPT) of the liver is a rare, tumor-like lesion that is considered to be biologically benign but often mimics malignancy.

To verify the prevalence of sleep disorders in temporomandibular disorders (TMD) subjects in a Brazilian population-based, cross-sectional survey (N = 1,643).

To calculate the monthly incidence of opioid-related adverse events in the opioid-naïve patients who contin-ue to use opioids in the post-operative period.

Spontaneous intracranial hypotension caused by cerebrospinal fluid (CSF) leak is a rarely encountered cause of persistent postural headaches in the absence of trauma or dural puncture. It presents with postural headache and is characterized by radiological findings of spinal CSF leak. The mainstay of management is an epidural patch with the patient's own blood (epidural blood patch [EBP]) and/or a fibrin glue product. We report here a case of spontaneous intracranial hemorrhage presenting with persistent headaches and bilateral subdural hematomas secondary to CSF leaks at multiple levels along the spinal cord, which was successfully managed with a single lumbar EBP.

Priapism refers to prolonged erection unrelated to sexual stimulation, with severe sequelae unless treated. In humans, it is a rare complication associated with epidural or spinal opioid administration. Its pathophysiology is unclear. This is the first report of priapism following neuraxial anesthesia in dog.

A 43-year-old male using valproic acid (VA) for 2 years for seizure disorder presented with right-sided moderate pleural effusion. Pleural fluid analysis revealed exudative effusion with 42% eosinophils. There was no evidence of haemothorax, pneumothorax, malignancy, and parasitic infections. Suspecting a drug-related event, VA was discontinued. The patient showed clinical improvement with resolution of pleural effusion on chest radiograph three weeks later. VA is a popular drug used for variety of disorders like seizures, migraines, and schizophrenia. There is a paucity of literature on VA-induced pleural effusion. Though a rare phenomenon, clinicians should be aware of such a possibility to avoid erroneous diagnosis.

It is recognized that multimodal management of chronic pain is necessary. This management requires the use of both drug and non-drug approaches. Acupuncture is a non-medicinal approach that has been shown to be effective in treating chronic musculoskeletal and arthritic pain. It has few side effects and contraindications. Its use should be developed in geriatrics as a complement to usual analgesics and other non-drug approaches.

Breakthrough infections in fully vaccinated persons pose a major challenge to the ongoing vaccine campaign against SARS-CoV-2 globally.