Rejected

Pregnant individuals with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease, prematurity, and stillbirth. In March 2021, vaccination for at risk pregnant women was recommended in Switzerland, expanding this to all pregnant women in May 2021. Our aim was to assess the safety of mRNA COVID-19 vaccines in pregnancy.

Adhesive capsulitis of shoulder is a commoner condition in middle aged population and is classified into primary and secondary types based on etiology. Treatment options depend on stages of disease which ranges from physical therapy, non-steroidal anti-inflammatory medications, intra-articular steroid injection, hydro-dilatation therapy, manipulation under anesthesia, and arthroscopic capsular release. However, the condition is generally mismanaged by untrained professionals in the periphery center leading to complications. We report one such case, which was then managed arthroscopically.

Exoskeletons for the low-back have great potential as tools to both prevent low-back pain for healthy subjects and limit its impact for chronic patients. Here, we show a proof-of-concept evaluation of our low-back exoskeleton. Its peculiar feature is the backbone-tracking kinematic structure that allows tracking the motion of the human spine while bending the trunk. This mechanism is implemented with a rigid-yet-elongating structure that does not hinder nor constrain the motion of the wearer while providing assistance. In this work, we show the first prototype we manufactured. It is equipped with a traction spring to assist the wearer during trunk flexion/extension. Then, we report the results of a preliminary test with healthy subjects. We measured a reduction of the mean absolute value for some target muscles – including the erector spinae – when using the exoskeleton for payload manipulation tasks. This was achieved without affecting task performance, measured as task time and joints range of motion. We believe these preliminary results are encouraging, paving the way for a broader experimental campaign to evaluate our exoskeleton.

A 17-year-old adolescent boy complained of plantar pain at the first metatarsal 2 months after a catfish spine injury. Imaging was consistent with a retained foreign body, and surrounding osteolysis was concerning for osteomyelitis. He underwent surgical debridement and was found to have inflammation and necrosis, apparently caused by catfish spine venom.

A pheochromocytoma is a rare catecholamine-secreting tumor with an incidence of 0.8 per 100,000 person-years. Classic clinical manifestations include episodic headache, sweating, and tachycardia. This case report shares a unique presentation in which a patient with a history of atrial fibrillation status post-ablation procedure was admitted for chest pain and found to have imaging and laboratory findings consistent with pheochromocytoma. This case illustrates the importance of a high clinical index of suspicion for a pheochromocytoma since it can have a variety of clinical presentations and can result in unnecessary procedures.

Babesiosis is an infectious disease that is typically known to present with fevers, chills, and myalgias; and less commonly with anorexia, headache, nausea, and vomiting. The least common are shortness of breath, sore throat, neck stiffness, emotional lability, photophobia, and dark urine. Even more unusual are severe neurologic manifestations like altered mental status, motor deficits, and ataxia. We present two cases of patients, both in their seventies, with multiple comorbidities, who were admitted with similar symptoms of confusion/cognitive impairment, slurred speech, ataxia, fever, myalgias and chills, urinary frequency, and urgency, with no previous history of travel outside the country or tick bites. Both patients had extensive workup, which raised suspicion of hemolytic infections, especially babesiosis and malaria. Considering our patients had not traveled out of the country, we leaned more toward babesiosis. The patients were treated appropriately for babesiosis and were also empirically treated for Lyme's, anaplasmosis, along with Mycoplasma in the second patient. Following two days of treatment, cognition, as well as speech, improved dramatically. On outpatient follow-up, both patients had entirely resolved hemolysis, parasitic load, and neurological manifestations. During the literature review, neurologic manifestations, being associated with babesiosis, were found to be exceedingly rare but could be fatal if left undiagnosed. It is an infection that is associated with complete recovery on prompt diagnosis and treatment. It is pertinent to have a high suspicion of this disease, especially in endemic areas, such as the Northeast United States, even more so when seen with hematologic and neurologic manifestations.

Fitz-Hughs-Curtis syndrome is a manifestation of pelvic inflammatory disease (PID) which begins with sexually transmitted organisms such as () and, less commonly . The infection is hypothesized to disseminate into the peritoneum via lymphatic, hematogenous, or ascending spread of the organisms. Progression of the disease can result in liver capsule inflammation (perihepatitis) and adhesion formation between organs. This case presentation illustrates a female who presented with symptomology consistent with small bowel obstruction (SBO) and acute appendicitis. The patient was incidentally found to have Fitz-Hugh-Curtis syndrome during laparoscopic surgery, as noted by adhesions on peritoneal organs. These findings prompted a sexually transmitted infection (STI) screening which confirmed a infection, completing the clinical picture for Fitz-Hugh-Curtis syndrome. This case report highlights the need for an increased index of suspicion for Fitz-Hugh-Curtis syndrome in a young female who presents with right upper quadrant (RUQ) pain in order to prevent future complications of PID, including infertility.

School children are a means to reach and sensitize the community on the prevention of seasonal diseases such as malaria and dengue. The current study aims to determine the impact of school-based educational interventions on the knowledge of students toward the prevention and control of malaria and dengue in higher secondary schools.

We present an original technique for reconstruction of the right forefoot after Chopart's amputation. The case report was of a 20-year-old man who was a nonsmoker without comorbidities. He was referred to our department because of equinus deformity, pain, and prominence of the cuboid under the skin, leading to chronic ulceration at the stump. We performed flow through free latissimus dorsi flap including the eighth and tenth ribs to reconstruct the stump. Results were assessed at 18 months after operation, showing good stability and normal functional outcome of the foot. The patient is satisfied with the results achieved.

Physiological changes that occur during ageing can affect the incidence, experience and treatment of pain in older adults. This article reviews these physiological changes and how they can affect the best approach to management.