Rejected

Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients.

Despite remission or low disease activity non-inflammatory complaints like exhaustion, fatigue, and pain persist in a significant proportion of patients with systemic lupus erythematosus (SLE) and have a considerable impact on health-related quality of life. This study evaluated the effects of balneotherapy on non-inflammatory complaints, quality of life, and work productivity of patients with SLE.

We describe the presentation of five adults with erythrasma, misdiagnosed as tinea and prescribed antifungal treatment which resulted in incomplete clearance. The lesions were restricted to axillary and/or inguinal folds. They were dry, brown macules with fine scaling. Except for one with moderate pruritus, they were asymptomatic. No fungal elements could be demonstrated in any of the patients in 10% KOH preparation. Gram stain revealed short gram-positive rods in varying proportions. All the patients showed a pink fluorescence on Wood's lamp examination. After treatment with topical clindamycin singly or in combination with oral azithromycin, there was complete clearance of the lesions leaving normal-appearing skin in three and residual hyperpigmentation in one. The overdiagnosis of tinea in the ongoing epidemic of dermatophytosis is a potential concern. Wood's lamp examination is very useful to confirm or exclude erythrasma.

Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects.

Carnitine plays a significant role in fatty acid transportation in mitochondria and has been shown to have a prophylactic effect on adult migraine. The aim of this randomized controlled trial was to compare and evaluate the effects of L-carnitine supplementation versus propranolol in the prevention of pediatric migraine.

Low back pain affects the lives of millions of people in the United States and the world. Not only does low back pain affect the quality of life for the individual patient, but it also accounts for many emergency department and health care visits. For a subset of patients, conservative measures such as medications and physical therapy, nonsurgical interventions, and surgery are not effective. Peripheral nerve stimulation is an emerging treatment option for patients with chronic low back pain. This case series assesses 6 patients' experiences with lumbar level peripheral nerve stimulation. Three male and 3 female patients underwent lumbar level peripheral nerve stimulation as a treatment for chronic low back pain. The average age of the patients was 63.5 years, and they demonstrated an average pain reduction of 64.8%. This series provides evidence that lumbar level peripheral nerve stimulation may be an efficacious treatment for chronic low back pain that is refractory to conservative measures. Large studies are needed to assess the outcomes and durations of improvement associated with this treatment.

Nonsteroidal anti-inflammatory drugs are an effective nonopiate option for pain control. However, the antiplatelet aggregation of cyclooxygenase-1 (COX-1) inhibitors presents a concern in that they may exacerbate bleeding in patients with solid organ injuries.

The purpose of this study was to investigate the impact of a family caregiver training program on care provision to burn patients. A quasi-experimental study was conducted with 96 family caregivers of burn patients admitted to a burn hospital in Iran. The caregivers' knowledge and training needs were measured at baseline. Four training sessions were provided for the experimental group and caregivers' practices were measured 6 weeks after discharge. Comparing the scores of knowledge and total care with its subdomains (i.e., diet and medication, wound care, itch decrease, wound scar healing, pain management, use of mobility assistive devices, and follow-up considerations) revealed a significant difference between the two groups of caregivers after the intervention (p < 0.01). The caregivers' practices regarding provision of care to burn patients were improved after attending the training program. Receiving sufficient and continuous information from admission to discharge can empower family members.

Hoffa's disease is anterior knee pain presumably stemming from inflammatory fibrous hyperplasia of the infrapatellar fat pad (Hoffa's pad). The etiology and pathogenesis are unclear, however, and no genetic information about the disease has been published. We report the genetic findings in cells from the fat pad of a patient with Hoffa's disease.

Ketamine is unique among anesthetics and analgesics. The drug is a rapid-acting general anesthetic that produces an anesthetic state characterized by profound analgesia, preserved pharyngeal-laryngeal reflexes, normal or slightly enhanced skeletal muscle tone, cardiovascular and respiratory stimulation, and occasionally a transient and minimal respiratory depression. Research has demonstrated the efficacy of its use on anesthesia, pain, palliative care, and intensive care. Recently, it has been used for postoperative and chronic pain, as an adjunct in psychotherapy, as a treatment for depression and posttraumatic stress disorder, as a procedural sedative, and as a treatment for respiratory and/or neurologic clinical conditions. Despite being a safe and widely used drug, many physicians, such as intensivists and those practicing in emergency care, are not aware of the current clinical applications of ketamine. The objective of this narrative literature review is to present the theoretical and practical aspects of clinical applications of ketamine in intensive care unit and emergency department settings.