Rejected

A thirty-year-old pregnant woman was admitted to hospital with headache and gastrointestinal discomfort. She developed peripheral oedema and had an emergency caesarean section following an episode of tonic-clonic seizures. Her delivery was further complicated by postpartum haemorrhage and she was admitted to the Intensive Care Unit (ICU) for further resuscitation and seizure control which required infusions of magnesium and multiple anticonvulsants. Despite haemodynamic optimisation she developed an acute kidney injury with evidence of liver damage, thrombocytopenia and haemolysis. Haemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome, a multisystem disease of advanced pregnancy which overlaps with pre-eclampsia, was diagnosed. HELLP syndrome is associated with a range of complications which may require critical care support, including placental abruption and foetal loss, acute kidney injury, microangiopathic haemolytic anaemia, acute liver failure and liver capsule rupture. Definitive treatment of HELLP is delivery of the fetus and in its most severe forms requires admission to the ICU for multiorgan support. Therapeutic strategies in ICU are mainly supportive and include blood pressure control, meticulous fluid balance and possibly escalation to renal replacement therapy, mechanical ventilation, neuroprotection, seizure control, and management of liver failure-related complications. Multidisciplinary input is essential for optimal treatment.

The human monkeypox infection has become the prevalent orthopoxviral disease in humans, and has developed challenging and threatening situations worldwide. This study is aimed at exploring the global epidemiological, biological and clinical characteristics of monkeypox from 1970 to July 1, 2022.

Primary herpetic gingivostomatitis (PHGS) represents the most observed clinical feature of primary herpes infection with the simplex virus (HSV). It is often caused by HSV-1 and affects children most of the time. Unlike, the majority of primary HSV infections that is asymptomatic. It may be preceded by some prodromal symptoms like fever, anorexia, irritability, malaise, and headache. After the resolution of the primary infection, the virus remains latent in a nervous ganglion. The aim of the present paper was to report a case of severe PHGS with herpetic whitlow in a 10-year-old child.

The objective of this study was to estimate the minimal important change (MIC) and responsiveness of core patient reported outcome measures for chronic low back pain (LBP) and Modic changes.

Premature cardiovascular events in systemic lupus erythematosus (SLE) contribute to morbidity and mortality, with no effective preventive strategies described to date. Immune dysregulation and metabolic disturbances appear to play prominent roles in the induction of vascular disease in SLE. The peroxisome proliferator activated receptor-gamma agonist pioglitazone (PGZ suppresses vascular damage and immune dysregulation in murine lupus and improves endothelial dysfunction in other inflammatory diseases. We hypothesised that PGZ could improve vascular dysfunction and cardiometabolic parameters in SLE.

Spinal cord stimulation (SCS) is an effective treatment for failed back surgery syndrome (FBSS). In patients with FBSS, opioids have often been initiated, even before SCS is trialed.

Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered in cases of short-lasting, hemifacial pain associated with autonomic dysfunction. Additionally, in the approach to this disease, secondary causes that facilitate its onset must be ruled out.

In 2017, a 72-year-old woman was seen in the gastroenterology department with a 2-month history of mild and intermittent abdominal pain without other accompanying symptoms. Her medical history was unremarkable, except for a previous visit due to facial photodermatitis 3 years earlier. Diazepam for a sleeping disorder was the only chronic medication recorded. Results of physical examination, blood count, and basic metabolic panels including assessment of renal and liver function were normal; only the ferritin level was slightly elevated (265 ng/mL [595 pmol/L]; normal range, 10-120 ng/mL [22-269 pmol/L]). Abdominal US was performed, followed by multiphasic contrast-enhanced CT and liver MRI due to the findings of the first study. A diagnosis was not established in that moment, and acetaminophen was prescribed for pain relief. As the symptoms continued, laboratory tests and imaging studies were repeated 2 years later, with similar findings and no notable changes.

Technological innovation has been closely intertwined with the growth of modern anesthesiology as a medical and scientific discipline. Anesthesia & Analgesia, the longest-running physician anesthesiology journal in the world, has documented key technological developments in the specialty over the past 100 years. What began as a focus on the fundamental tools needed for effective anesthetic delivery has evolved over the century into an increasing emphasis on automation, portability, and machine intelligence to improve the quality, safety, and efficiency of patient care.