Rejected

Chronic pain and insomnia symptoms are prevalent in adolescents. This study examined the prospective associations between pain and insomnia symptoms in a large sample of adolescents.

There is heterogeneity among the outcomes used in regional anesthesia research.

The present study evaluated the mental health (MH) of athletes according to a range of variables, including SARS-CoV-2 infection status and sport-specific factors. An online survey was sent to 1636 Turkish professional athletes incorporating standardized scales assessing athlete-specific stress, depression, and anxiety. A total of 579 professional athletes (29% SARS-CoV-2 positive) participated in the study. While female athletes reported higher anxiety scores than males (p < 0.01), the depression scores of the athletes who had been infected with SARS-CoV-2 were significantly higher than athletes who were not infected (p = 0.03). Higher athlete-specific stress, depression, and anxiety scores were associated with participating in an individual sport, experiencing chronic pain, severe sports injury history, and performance concerns (all p < 0.01). MH symptoms in athletes were associated with being infected with SARS-CoV-2, female gender, participating in an individual sport, and performance concerns. MH assessments should be undertaken with athletes to detect vulnerabilities and enable appropriate and timely MH interventions.

Dedicated venous stents have not been utilized in the management of symptomatic chronic iliofemoral venous obstruction (CIVO) until recently. The Bard Venovo stent is one such stent noted to have increased chronic outward force and radial resistive force compared to the Wallstent. This study evaluates outcomes following the use of the Bard Venovo stent compared to a matched cohort of limbs that underwent stenting with the Wallstent-Z stent (composite) configuration.

Erector spinae plane block has been proposed to reduce opioid use and improve pain relief with controversial results. This randomized clinical study aimed to assess the efficacy of erector spinae plane block in major spine surgery including multimodal and 'Enhance Recovery After Surgery' programs.

This report summarises Australian spontaneous surveillance data for adverse events following immunisation (AEFI) for 2020, reported to the Therapeutic Goods Administration (TGA), and describes reporting trends over the 21-year period from 1 January 2000 to 31 December 2020. There were 3,827 AEFI records for vaccines administered in 2020, an annual AEFI reporting rate of 14.9 per 100,000 population. There was a slight (3.8%) decrease in the overall AEFI reporting rate in 2020 compared with 2019 (15.5 per 100,000 population). This decrease in the AEFI reporting rate in 2020 is potentially due to the impact of coronavirus disease 2019 (COVID-19) and was mainly from a decline in reported adverse events related to HPV, dTpa, and seasonal influenza vaccines. AEFI reporting rates for most individual vaccines in 2020 were similar to 2019. The most commonly reported adverse events were injection site reaction (37.1%); pyrexia (18.1%); rash (15.8%); vomiting (7.6%); pain (7.4%); headache (5.7%); and urticaria (5.1%). There were six deaths reported to the TGA. In one of the reports, the timing and clinical findings were consistent with a causal association with vaccination. In the remaining five reports, no clear causal relationship with vaccination was found.

Spinal cord stimulators (SCS) allow spine surgeons to provide relief for patients who suffer from chronic pain due to several disorders such as failed back surgery syndrome, complex regional pain syndrome, and neuropathy. Despite this, there remains a paucity of data regarding the utilization and reimbursement of SCS. Therefore, the purpose of this study is to evaluate the monetary and procedural trends of spinal cord stimulators among the Medicare database from 2000-2019.

Ketamine and its enantiomer S-ketamine (esketamine) are known to produce rapid-onset antidepressant effects in major depression. Intranasal esketamine has recently come into the market as an antidepressant. Besides experience from short-term use in anesthesia and analgesia, the experience with ketamine as long-term medication is rather low. The use of ketamine and esketamine is limited due to potential neurotoxicity, psychocomimetic side effects, potential abuse and interindividual variability in treatment response including cessation of therapy. Therefore, taking a look at individual patient risks and potential underlying variability in pharmacokinetics may improve safety and dosing of these new antidepressant drugs in clinical practice. Differential drug metabolism due to polymorphic cytochrome P450 (CYP) enzymes and gene-drug interactions are known to influence the efficacy and safety of many drugs. Ketamine and esketamine are metabolized by polymorphic CYP enzymes including CYP2B6, CYP3A4, CYP2C9 and CYP2A6. In antidepressant drug therapy, usually multiple drugs are administered which are substrates of CYP enzymes, increasing the risk for drug-drug interactions (DDIs). We reviewed the potential impact of polymorphic CYP variants and common DDIs in antidepressant drug therapy affecting ketamine pharmacokinetics, and the role for dose optimization. The use of ketamine or intranasal esketamine as antidepressants demands a better understanding of the factors that may impact its metabolism and efficacy in long-term use. In addition to other clinical and environmental confounders, prior information on the pharmacodynamic and pharmacokinetic determinants of response variability to ketamine and esketamine may inform on dose optimization and identification of individuals at risk of adverse drug reactions.

Inflammatory fibroid polyp (IFP) is a rare clinically benign mesenchymal tumor originating in the submucosa of the gastrointestinal tract. It has been generally considered to bear no malignant or metastatic potential and can be cured after resection. Herein, we present an unusual case of an IFP in the ileum showing extension to the muscularis propria and recurring in 3 years after endoscopic submucosal dissection (ESD) and surgical resection. A 41-year-old woman was admitted to the emergency department due to abdominal pain, abdominal distention, and vomit for 4 days. She had an ESD 3 years ago as a result of IFPs in the middle esophagus and gastric horn. She also had a small bowel resection for intussusception resulting from IFP 2 years previously. She had no family history of IFP. An intussusception was found 1 m away from the ileocecal valve and a red tumor about 5 cm in diameter was revealed after manipulation reduction, with several small polypoid protuberant masses in the adjacent intestine. The diseased bowel was excised and a primary side-to-side anastomosis was performed. The morphological and immunoprofile features were typical of IFP. The patient was required to fast after operation until she farted, and she was discharged 1 week later, asymptomatic. Therefore, IFP might show its aggressively neoplastic potential with infiltrative growth patterns and recur locally after inadequate resection. A sufficient surgical resection is recommended when the lesion has been found definitely to invade the muscularis and even the subserosa. However, more studies are required to seek for the exact etiology and mechanism of its invasiveness and recurrence due to the scarcity of current reports.