Rejected

The importance of chronic venous disease (CVD), as a cause of reduced quality of life and increased costs to healthcare systems, is expected to rise in parallel with population aging and the increasing prevalence of obesity. Venoactive drugs (VADs) are frequently used to treat the symptoms and signs of CVD. The most commonly used and widely studied VAD, micronised purified flavonoid fraction (MPFF), is effective at all stages of CVD, and has been shown to significantly reduce leg pain, leg heaviness and swelling, as well as ankle oedema and functional discomfort, in clinical trials. Recently, experiments employing animal models of CVD have demonstrated that MPFF has anti-inflammatory and venotonic effects at the microvalve level, and a pilot clinical study in patients with CVD has provided support for these findings. Collectively, these results suggest that early initiation of MPFF treatment may have the potential to favourably alter the clinical course of the disease, although further clinical data are required to confirm these findings. International guidelines on CVD management strongly recommend MPFF to reduce symptoms and improve quality of life. Studies are now needed to investigate the impact of long-term treatment on disease progression.

Data on safety and tolerability of the vaccines against severe acute respiratory virus coronavirus-2 (SARS-CoV-2, or coronavirus disease-2019 [COVID-19]) in patients with myasthenia gravis (MG) are currently limited. In this study we investigated the safety of mRNA-based two-dose vaccination in a cohort of patients with MG.

With advancement in human microbiome research, an increasing number of scientific evidences have endorsed the key role of both gut and skin microbiota in the pathogenesis of psoriasis. Microbiome dysbiosis, characterized by altered diversity and composition, as well as rise of pathobionts, have been identified as possible triggers for recurrent episodes of psoriasis. Mechanistically, gut dysbiosis leads to "leaky gut syndrome" via disruption of epithelial bilayer, thereby, resulting in translocation of bacteria and other endotoxins to systemic circulation, which in turn, results in inflammatory response. Similarly, skin dysbiosis disrupts the cutaneous homeostasis, leading to invasion of bacteria and other pathogens to deeper layers of skin or even systemic circulation further enhanced by injury caused by pruritus-induced scratching, and elicit innate and adaptive inflammation. The present review explores the correlation of both skin and gut microbiota dysbiosis with psoriasis. Also, the studies highlighting the potential of bacteriotherapeutic approaches including probiotics, prebiotics, metabiotics, and fecal microbiota transplantation for the management of psoriasis have been discussed.

New findings from migraine studies have indicated that this common headache disorder is associated with anomalies in attentional processing. In tandem with the previous explorations, this study will provide evidence to show that visual attention is impacted by migraine headache disorders. 43 individuals were initially recruited in the migraine group and 33 people with non-migraine headache disorders were in the control group. The event-related potentials (ERP) of the participants were calculated using data from a visual oddball paradigm task. By analyzing the N200 and P300 ERP components, migraineurs, as compared to controls, had an exaggerated oddball response showing increased amplitude in N200 and P300 difference scores for the oddball vs. standard, while the latencies of the two components remained the same in the migraine and control groups. We then looked at two classifications of migraine with and without aura compared to non-migraine controls. One-Way ANOVA analysis of the two migraine groups and the non-migraine control group showed that the different level of N200 and P300 amplitude mean scores was greater between migraineurs without aura and the control group while these components' latency remained the same relatively in the three groups. Our results give more neurophysiological support that people with migraine headaches have altered processing of visual attention.

The prevalence of headache disorders, migraine, chronic daily headache (CDH), and medication-overuse headache (MOH) among the elderly in Japan has not been sufficiently investigated. We performed a questionnaire-based survey and revealed 3-month headache prevalence and headaches' characteristics.

Labor arrest is estimated to account for approximately one-third of all primary cesarean deliveries and is associated with an increased risk of adverse maternal and perinatal outcomes. One of the main causes is represented by the mismatch between the size of the birth canal and that of the fetus, a condition usually referred to as cephalopelvic disproportion.

Neuropathic pruritus is a previously neglected symptom of a wide range of neurological diseases. Peripheral nerve or root compression syndromes, space-occupying lesions of the central nervous system, chronic inflammatory neurological diseases and polyneuropathy can cause neuropathic pruritus. Even when the identification of the underlying neurological disease is successful, a direct causal treatment is not always possible, hence an effective symptomatic treatment remains the only therapeutic option. The purpose of this review article is to present the current literature on various therapeutic agents and options in the treatment of neuropathic pruritus.

The aim of the study was to investigate whether the use of pre- and postoperative gabapentin can decrease postoperative pain, morphine consumption, anxiety and side effects, as well as improve patient satisfaction. A total of 56 patients, 9-17 years of age, undergoing a modified Ravitch procedure, were randomised (allocation ratio 1:1) to receive multiple perioperative doses of gabapentin (preoperatively 15 mg/kg, postoperatively 7.5 mg/kg, two times per day for three days) or a placebo. All the patients received intravenous infusion of morphine, paracetamol and non-steroidal anti-inflammatory drugs. Metamizole was given as a "rescue drug". The observation period included the day of surgery and three postoperative days. The primary outcomes were postoperative pain intensity (at rest, during deep breathing and coughing). Additional outcomes included the consumption of morphine, the total number of doses of metamizole, anxiety, postoperative side effects and patient satisfaction. Median average and maximal pain scores (on the day of surgery and on the second postoperative day) were significantly lower only in the gabapentin group at rest ( < 0.05). Compared to the placebo group, gabapentin treatment reduced the demand for morphine on the first postoperative day (median 0.016 vs. 0.019 mg/kg/h; = 0.03) and the total number of metamizole doses (median 1 vs. 2 = 0.04). Patient satisfaction was significantly greater in the gabapentin group (median 10 vs. 9; = 0.018). Anxiety and postoperative side effects were similar in both groups ( > 0.05). Pre- and postoperative gabapentin administration as part of a multimodal analgesic regimen may decrease postoperative pain, opioid consumption and demand for a "rescue drug", as well as improve patient satisfaction.

Intrahepatic cholestasis of pregnancy is associated with significant risk of stillbirth which contributes to variation in clinical management. Recent Society for Maternal-Fetal Medicine guidance recommends 36 week delivery for patients with serum bile acids >100 umol/L, consideration for delivery between 36-39 weeks stratified by bile acid level, and against preterm delivery for those with clinical features of cholestasis without bile acid elevation.

The effectiveness of tiletamine-zolazepam (1.7 mg/kg) plus medetomidine (0.07 mg/kg; TZM) as an immobilizing combination in raccoons (Procyon lotor; n=43) and striped skunks (Mephitis mephitis; n=7) was evaluated during October 2019. Mean induction time for raccoons was 15.0±6.6 min. First signs of recovery (head up) occurred 12.9±6.0 min after receiving atipamezole reversal (0.35 mg/kg) and animals were standing in 30.3±16.1 min. Mean induction time for skunks was 11.7±5.8 min. Following reversal, skunks first raised their heads in 6.7±4.3 min and stood in 17.1±12.9 min. Recovery in skunks and female raccoons was not related to length of time immobilized, but male raccoons that were immobilized for longer periods of time stood faster after reversal. Raccoon heart rate (HR) remained steady during immobilization, but respiration rate (RR) and rectal temperature (RT) declined. The HR and RR were similar among males and females, but RT of male raccoons were, on average, 0.5 C higher than those of females, and rate of temperature decline was slower for males. The HR, RR, and RT of skunks declined during immobilization. Although induction times for both raccoons and skunks were longer than expected, induction and recovery were smooth, side effects were few, analgesia was adequate for nonsurgical procedures, and reversal reduced time in captivity.