Rejected

The amount of opioid prescribed following cesarean delivery is commonly in excess of patients' needs. An additional concern in a breastfeeding mother is neonatal opioid exposure. A maximum daily dose of 30 mg of oxycodone is recommended in breastfeeding women. Inadequate pain control can inhibit breastfeeding and other negative consequences. We aimed to evaluate the effect of reducing the as-needed opioid ordered following cesarean delivery on inpatient opioid consumption and analgesia.

Kundur, Boswellia serrata Roxb. ex Colebr., is prescribed by Unani (Greco-Arab) scholars clinically under conditions similar to vulvovaginal candidiasis (VVC) and has been supported by recent pharmacological studies, but scientific evidence is scarce.

To analyze outcomes and postoperative complications in patients undergoing robot-assisted isthmocele repair.

In previous clinical trials, patients with active rheumatoid arthritis (RA) treated with upadacitinib (UPA) have improved patient-reported outcomes (PROs). This post hoc analysis of SELECT-CHOICE, a phase 3 clinical trial, evaluated the impact of UPA vs abatacept (ABA) with background conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) on PROs in patients with RA with inadequate response or intolerance to biologic disease-modifying antirheumatic drugs (bDMARD-IR).

We aimed to prospectively assess the role of needle length in improving the tolerability/safety profile of OnabotulinumtoxinA (BoNTA) for chronic migraine (CM) prophylaxis, with a specific focus on neck pain, based on patients' body habitus and other variables.

Very few data are available on predictors of minimal disease activity (MDA) in patients with recent-onset psoriatic arthritis (PsA). Such data are crucial, since the therapeutic measures used to change the adverse course of PsA are more likely to succeed if we intervene early. In the present study, we used predictive models based on machine learning to detect variables associated with achieving MDA in patients with recent-onset PsA.

Trigeminal autonomic cephalalgia (TAC) is a type of one-sided cerebral painful headache, with attacks regularly accompanied by autonomic responses, such as tearing, runny nose, panic, nausea and vomiting on the affected side. Currently, the most common treatment strategies are drugs, nerve grafts and surgery. Clinical understanding of TACs is limited. Here, we report the case of thermocoagulation treatment of the pterygopalatine ganglion in an uncommon TAC under local anesthesia.

Painful castration of male piglets to avoid boar taint can potentially be replaced by three more ethical alternatives: entire male production in combination with a detection method, immunocastration (an active vaccination against the gonadotrophin-releasing factor, GnRF), and castration with pain relief (anesthesia and/or analgesia). With the aim of abandoning piglet castration and facilitating internal trade, the European Union (EU) was initially in favor of a single alternative. Immunocastration was proposed as a potential solution, but it has not yet been sufficiently assessed regarding its market potential. To address this point, this paper uses scenario analysis to examine whether and under what conditions immunocastration could be the general solution sought by the EU. The study constructs two extreme scenarios: one in which all uncertain elements negatively influence the growth of immunocastration; another in which all uncertain elements have positive influences. These scenarios provide insights into the variance in possible futures for the implementation of immunocastration. The results show that it is unlikely that immunocastration will become a single solution for all producers in the EU, because it is not the optimal solution for all types of EU pork production systems (i.e., cost-efficiency oriented, quality oriented, animal-friendly oriented, import dependent). Rather than debating and looking for evidence about which single method is the best for the entire EU, EU authorities are advised to allow the co-existence of all alternatives and to develop protocols for applying them in the pork industry.

The present case contributes to the limited literature on central nervous system involvement of blastic plasmacytoid dendritic cell neoplasm (BPDCN).  CASE PRESENTATION : A 63-year-old male presented to the department of neurology with a three-day history of rapidly progressing headache, fatigue, and confusion. Physical examination revealed multiple bruise-like skin lesions. Initial laboratory workup raised suspicion of acute leukemia, and a brain computer tomography identified several hyperdense processes. A bone marrow biopsy gave the diagnosis BPDCN, a rare and aggressive hematologic malignancy derived from plasmacytoid dendritic cells with a poor prognosis. Lumbar puncture showed not only signs of BPDCN, but also cerebral toxoplasmosis, thus providing a differential diagnosis. Despite intensive systemic and intrathecal chemotherapy, the patient died 25 days later due to multi-organ failure.