Rejected

Keloids belong to the group of fibroproliferative diseases and clinically often present with functional and cosmetic impairment of the patient, as well as with pruritus and pain. The pathogenesis of keloids has not been definitively clarified and treatment is often protracted and less than satisfactory. A variety of therapeutic options are available for treatment of keloids; however, the evidence base is small due to studies with low case numbers. Use of multimodal treatment concepts seems to be promising and has shown good results, especially in the treatment of auricular keloids.

Repository corticotropin injection (RCI; Acthar Gel) is approved by the US Food and Drug Administration (FDA) for use in 19 indications, including for the treatment of selected patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), symptomatic sarcoidosis, uveitis, and keratitis. Despite treatment with disease-modifying antirheumatic drugs, many patients with RA, SLE, and other chronic inflammatory rheumatic diseases continue to be affected by severe pain and fatigue, indicating a need for other therapies. To examine the clinical data regarding the impact of RCI treatment on pain and fatigue in selected populations, this review included English-language peer-reviewed publications of clinical trials of any size and cohort studies with more than 10 patients that included pain and/or fatigue based on patient-reported outcomes (PROs) and/or physician-assessed measures in adults following treatment with RCI for RA, SLE, symptomatic sarcoidosis, uveitis, or keratitis. Literature searches identified eight studies that met these criteria. Four studies (reported in five publications) were in patients with RA or SLE, two in patients with sarcoidosis, one in patients with uveitis, and one in patients with noninfectious keratitis. Across the different types of studies assessed (clinical trials, chart reviews, real-world evidence), the results were consistent with respect to the impact of RCI treatment on improving pain and fatigue. As summarized in this review, data from patient- and physician-reported outcome measures in eight studies demonstrate that, in addition to improving more traditional efficacy measures, RCI may also improve pain and fatigue in patients with RA, SLE, symptomatic sarcoidosis, uveitis, and noninfectious keratitis.

Computed tomography angiographies are frequently performed in the emergency department (ED) for the assessment of cervical artery dissection (CeAD) due to the high risk of associated morbidity, but their diagnostic utility is not fully evaluated. We assessed the radiological outcomes and clinical correlates of CTAs performed for suspected CeAD.

Chiari I malformation is defined as caudal displacement of the cerebellar tonsils into the foramen magnum. The most commonly associated finding is cervical syringomyelia. The most common presenting symptom is occipital and upper cervical pain. The incidence of syringomyelia is between 30% and 70%. Surgery is recommended for symptomatic patients. The main purpose of the study is to present the data of children with Chiari type I malformation that were treated surgically in low-volume center and to describe some atypical presentations in children.

To describe experiences of clitoromegaly in women with congenital adrenal hyperplasia (CAH).

The microbiota-gut-brain axis has attracted significant attention with respect to studying the mechanisms of brain aging; however, the specific connection between gut microbiota and aging remains unclear. The abnormal expression and mutation of proteins belonging to the P4-ATPase family, including , results in a variety of neurological diseases. The results of our analysis demonstrate that there was a shift in the abundance of certain gut microbiota in -knockout (KO) mice. Specifically, there was an increase in pro-inflammatory bacteria that accelerate aging and a decrease in probiotics that delay aging. Consequently, an enhanced oxidative stress response was observed, which was characterized by a reduction in the superoxide dismutase (SOD) activity and an increase in malondialdehyde (MDA) and reactive oxygen species (ROS) levels. In addition, our data demonstrate that there was a decrease in the number of cells in the dentate gyrus (DG) region of the hippocampus, and aggravation of aging-related pathological features such as senescence β-galactosidase (SA-β-Gal), p-HistoneH2AX (Ser139), and p16. Moreover, KO mice show typical aging-associated behavior, such as memory impairment and slow pain perception. Taken together, we demonstrate a possible mechanism of aging induced by gut microbiota in -KO mice, which provides a novel perspective for the treatment of aging through the microbiota-gut-brain axis.

Trigeminal neuralgia (TN) is a common facial neuropathic pain that is mainly characterized by spontaneous or induced needling or electric shock pain in the innervation area of the trigeminal nerve. It is also referred to as "the cancer that never dies". The olfactory ensheathing cell (OEC) is a special glial cell in the nervous system that has a strong supportive function in nerve regeneration. Cell transplantation therapy is a useful treatment modality that we believe can be applied in TN management. In this study, OECs were transplanted into the ligation site of the infraorbital nerve of rats. We found that after the OEC transplantation, mechanical pain threshold in the face of the rats was significantly increased. Western blotting, immunofluorescence assay, and reverse transcription-quantitative polymerase chain reaction were performed on the trigeminal ganglia (TG) of model rats. The results revealed a decrease in the expression of P2X7 receptor (P2X7R) in the trigeminal ganglia. Our findings show that OEC transplantation has a good therapeutic effect on TN in rats, and that can reduce the expression of P2X7R in trigeminal ganglia. Therefore, we think that OEC transplantation may be a suitable treatment for TN.

Facing the rising cases of with higher fatalities COVID-19, some countries decided to give the third dose of vaccine as a booster. As of 9 January 2022, 90.31% of health workers in Indonesia have received the third dose vaccine. This study aims to provide an evaluation of adverse events following immunization (AEFI) in a single center in Indonesia to form a basis for ensuring safety for booster administration nationally. A retrospective, cross-sectional study was conducted using an online survey. Demographic data, AEFI complaints, and factors influencing AEFIs were evaluated. In this study, there were a total of 311 subjects were gathered. The most common AEFI symptoms found at onset <24 h to 28 days were pain at the injection site, fever, shoulder pain, and headache. Most of the AEFI severity of <24 h to 28 days post-vaccination was grade 1 (reduced or uninterrupted daily activities). There was a significant correlation between AEFI and several factors, such as the history of drug allergy, exercise after vaccination, age, BMI < 25, history of symptoms after the first and second vaccinations, and history of COVID-19. There was no anaphylactic reaction in this study. Several AEFI should be considered for the third dose of COVID-19 vaccine administration.

Primary intraosseous cavernous hemangioma (PICH) is a rare, benign tumor of vascular origin, typically arising in the vertebral body. Its presence in the skull is exceedingly rare, with only a few cases being reported worldwide. We carried out the first systematic review of the literature, covering the epidemiology, clinical and imaging features, management, and prognosis of cranial PICH. The literature search revealed 51 studies with 77 patients; the mean age of the patients was 32.7 years with a female predominance of 1.4:1. The majority of cranial PICHs were located in the calvarium, primarly in the frontal and parietal regions, with only a few located in the skull base. The most common initial clinical manifestation was local growth or swelling, followed by a headache. Radiographically, PICHs represented osteolytic, intradiploic masses, which in many cases displayed trabeculations, leading to the so-called "honeycomb" or "starburst" pattern. After contrast administration, PICH typically enhance. Tumor removal, with craniectomy or en-bloc resection and subsequent skull reconstruction, was selected for calvarial PICHs, whereas a transsphenoidal approach, with only partial resection, was applied for clival/sella PICHs. Preoperative embolization, aiming to minimize intraoperative blood loss, was performed in the case of large tumors. At a mean follow-up of 39. months, no patient experienced tumor recurrence, even after subtotal resection (STR). Owing to the benign nature of the tumor, maximal safe resection is recommended as the treatment of choice for patients with cranial PICH.

Bidirectional interaction between the brain and the peripheral organs plays a key role in homeostasis in the body. Abnormalities in brain-body communication potentially leads to a number of brain diseases, including psychiatric and neurodegenerative disorders. For example, dysbiosis of gut microbiota and altered levels of microbes-derived compounds plays an important role in the pathophysiology of a number of psychiatric disorders and neurodegenerative disorders. Furthermore, depression is the most common psychiatric symptom in patients with physical disorders, including pain and cardiovascular diseases. This special issue brings together current information on the brain-body communication in health and diseases.