Rejected

Desmopathy of the collateral ligaments of the equine interphalangeal joint is caused by a combination of factors, including hoof shape, excessive loading and ground surface. This complex problem poses a diagnostic challenge due to the non-specificity of perineural analgesia and the limitations associated with the most popular imaging methods such as radiography and ultrasonography. The aim of this study was to retrospectively determine the prevalence of desmopathy of the collateral ligaments of the equine distal interphalangeal joint in Poland between 2016 and 2019, and to establish the frequency and type of the associated pathologies. Desmopathy of the collateral ligaments of the distal interphalangeal joint was diagnosed in 14% of 152 horses examined by magnetic resonance imaging (MRI). In 64% of the cases, other changes were observed in the equine digit, and in 36% of the cases, desmopathy was the only diagnosed problem. Desmopathy of the collateral ligaments is not a frequently reported pathology in the distal part of the equine limb. The diagnostic difficulties described in this article suggest that considerable caution should be exercised when formulating the final diagnosis, prognosis and treatment options.

Schizencephaly is a very rare anatomical malformation of the cerebrum characterized by a cleft extending from the cortex to the ventricles. Usually, this disease is diagnosed at a very young age or in early adulthood. Symptoms may vary depending on the site and the size of the malformation. Here, we are describing the unique case of a 21-year-old female, with a past medical history of migraine-type headaches, who presented after the first-onset seizure and was found to have open-lip schizencephaly. She was started on levetiracetam with no complications. In this report, we are trying to describe the proposed etiology and discuss the typical clinical presentation of schizencephaly and compare it to our adult patient who survived childhood without significant cognitive or neurological impairment.

The Essex-Lopresti pattern of injury comprises radial head fracture, distal radioulnar joint (DRUJ) dislocation and disruption of the interosseus membrane (IOM). Diagnosis is often delayed, and reconstruction remains a management dilemma, with several proposed techniques addressing the radial head via either replacement or fixation; reconstruction of the DRUJ ligaments via anatomic or non-anatomic methods; and IOM reconstruction with synthetic grafts, allograft or autograft. We present a 26-year-old man with a chronic Essex-Lopresti injury who underwent revision ulnar shortening osteotomy (USO), IOM reconstruction using a brachioradialis graft and an Adams-Berger ligament reconstruction of the DRUJ ligaments following a three-year course of increasing pain and instability following radial head dislocation. This case demonstrates the feasibility of a single-stage reconstruction of a chronic Essex-Lopresti injury using a brachioradialis and a palmaris longus autograft. Level V (Therapeutic).

Shoulder injury related to vaccine administration (SIRVA) is a term given to describe shoulder pain and dysfunction arising within 48 hours after vaccine administration and lasting for more than one week. While SIRVA is most commonly seen after influenza and tetanus vaccines, there have been a few recent case reports describing SIRVA-like symptoms after COVID-19 vaccine administration. Two patients presented to the shoulder surgeon's practice center with complaints of shoulder stiffness and pain following the COVID-19 vaccine. The first patient was a 33-year-old man; he presented within 2 days of onset of the pain and 14 days from the vaccine date. He had a complete restriction of shoulder motion (0° flexion, and no external or internal rotation) at presentation. This patient was treated with non-steroidal anti-inflammatory drugs (NSAID) and rested in a sling for a week. The second patient was a 53-year-old woman; she presented with a 6-week duration of mild restriction of active shoulder motion and shoulder pain. Her magnetic resonance imaging (MRI) revealed the presence of subacromial-subdeltoid bursitis. She was treated with subacromial steroid injection and range of motion shoulder exercises. Both patients recovered a near-normal range of motion recovery within a month, and their pain improved significantly. The main lessons from this case report were: (1) patients presenting with a recent increase in pain and acute loss of shoulder movements after vaccination may be managed conservatively with rest and NSAID medications and (2) in case of a subacromial-subdeltoid bursitis in the MRI, subacromial injection of steroid may provide good pain relief.

Heterotopic pancreas is a congenital anomaly defined as the presence of the pancreatic tissue outside its normal location, which is usually discovered incidentally. We describe a rare case of heterotopic pancreatic tissue in the neck and the node surrounding the cystic duct of the gallbladder. A 33-year-old female presented with right upper quadrant abdominal pain aggravated after fat meals. The diagnosis was made as chronic cholecystitis. Laparoscopic cholecystectomy was performed. Pathologic examination showed a lobulated nodule connected to the cystic duct. Microscopically, this node consisted of all components of pancreatic tissue. Localization of heterotopic pancreatic tissue in the gallbladder is exceedingly rare. Less than 40 cases of heterotopic pancreas in the gallbladder have been reported worldwide. The ectopic pancreas is an extraordinary congenital entity. Although pancreatic tissue in the lymph node is an exceptional finding, pathologists should be aware of it because it may be confused with tumor or metastasis.

To determine the effectiveness of digital health technologies in the management of chronic pain.

Patients will continue to present to the otolaryngologist's office with "sinus headaches" as their primary complaint. Otolaryngologists should take particular care in establishing a precise diagnosis. A thorough clinical history, comprehensive head and neck examination, well-performed nasal endoscopy, and imaging as necessary are essential components for effective diagnosis and treatment plan implementation. It is fundamental to acknowledge the criteria for diagnosing the various headache disorders that may disguise themselves as sinonasal complaints. Moreover, this patient population accurately diagnosed and treated will be extremely grateful for someone pointing them in a direction to obtain the relief they truly need.

The aim of the study was to investigate the clinical variations of Systemic Inflammatory Response Index (SIRI), Systemic Inflammation Index (SII), and Alvarado Score during the COVID-19 pandemic period.

Moderate sedation and analgesia (MSA) can help patients experience less anxiety and discomfort, tolerate procedures that do not require general anesthesia, and maintain the ability to respond to verbal commands. Nurses administer MSA in a variety of clinical areas, and facility leaders may have difficulty creating a single standard of care for this task. Completion of a presedation assessment that includes the patient in the decision-making process is an important aspect of care. When administering MSA, nurses should have immediate unrestricted patient access and no competing responsibilities that could distract them from monitoring and assessing the patient. Nurses should complete education and competency verification activities before administering MSA. AORN recently revised the "Guideline for care of the patient receiving moderate sedation/analgesia," and this article addresses the standard of care, the presedation assessment, patient monitoring, and competency; it also includes scenarios describing specific concerns in two patient care areas.