Rejected

COVID-19 has affected millions of children and, while it was previously considered as a respiratory disease, neurologic involvement has also been documented. The objective of this study was to identify the neurological manifestations (NMs) and the outcomes of children with COVID-19 who attended the National Medical Center "20 de Noviembre".

Foreign bodies that enter the pancreas and cause chronic complications cannot be removed by endoscopy. Surgical removal is necessary but also challenging. The development of augmented reality navigation has made it possible to accurate intraoperative navigation in laparoscopic surgery.

Stroke-like migraine attacks after radiation therapy (SMART) syndrome, is a late complication of brain radiotherapy (1). Symptoms are commonly subacute in onset and involve migraine type of headache, seizures, focal neurologic deficits (2). Magnetic resonance imaging (MRI) findings are usually unilateral and posterior predominant cortical-subcortical hyperintensity, swelling and prominent gyriform (cortical and leptomeningeal) gadolinium enhancement in the areas of the brain that underwent irradiation with or without diffusion restriction (1). There is no standard treatment protocol for SMART syndrome. Antiepileptics and corticosteroids are commonly used drugs.

Atopic dermatitis (AD), characterized by rashes, itching, and pruritus, is a chronic inflammatory condition of the skin with a marked infiltration of inflammatory cells into the lesion. It usually commences in early childhood and coexists with other atopic diseases such as allergic rhinitis, bronchial asthma, allergic conjunctivitis, etc. With a prevalence rate of 1-20% in adults and children worldwide, AD is gradually becoming a major health concern. Immunological aspects have been frequently focused on in the pathogenesis of AD, including the role of the epidermal barrier and the consequent abnormal cytokine expressions. Disrupted epidermal barriers, as well as allergic triggers (food allergy), contact allergens, irritants, microbes, aggravating factors, and ultraviolet light directly initiate the inflammatory response by inducing epidermal keratinocytes, resulting in the abnormal release of various pro-inflammatory mediators, inflammatory cytokines, and chemokines from keratinocytes. In addition, abnormal proteinases, gene mutations, or single nucleotide polymorphisms (SNP) affecting the function of the epidermal barrier can also contribute towards disease pathophysiology. Apart from this, imbalances in cholinergic or adrenergic responses in the epidermis or the role played by immune cells in the epidermis such as Langerhans cells or antigen-presenting cells can also aggravate pathophysiology. The dearth of specific biomarkers for proper diagnosis and the lack of a permanent cure for AD necessitate investigation in this area. In this context, the widespread role played by keratinocytes in the pathogenesis of AD will be reviewed in this article to facilitate the opening up of new avenues of treatment for AD.

Percutaneous nephrolithotomy (PCNL) is a minimally invasive procedure for removing renal calculi, while a large number of patients experience acute moderate-to-severe pain despite the analgesia provided. This study aimed to explore the risk factors for postoperative pain after PCNL, which may provide a novel perspective to refine the enhanced recovery after surgery (ERAS) program and to improve clinical outcomes. The clinical data of 331 patients who underwent PCNL in our hospital from September 2020 to February 2021 were retrospectively analyzed. The pain intensity was assessed every 4 h until 24 h post-surgery. According to the visual analog scale (VAS) score, patients were divided into two groups: mild or no pain group (VAS score, 0-3) and moderate-to-severe pain group (VAS score, 4-10). The pre-, peri-, and post-operative data were collected and analyzed. The indicators with statistically significant differences were selected, and multivariate logistic regression analysis was employed to determine the risk factors for postoperative pain after PCNL. Among 331 patients, 221 patients had moderate-to-severe pain and the incidence rate was 66.77%. Multivariate logistic regression analysis showed that the independent risk factors for moderate-to-severe pain after PCNL were the diameter of the renal calculus (odds ratio (OR) = 6.23, 95% confidence interval (CI) 2.50-15.56, P = 0.001), the number of renal calculi (OR = 15.892, 95% CI 7.721-32.711, P < 0.01), the presence of residual calculi (OR = 1.780, 95% CI 0.897-3.533, P = 0.01), and operation time (OR = 1.033, 95% CI 1.020-1.046, P < 0.01). The diameter of the renal calculus, the number of renal calculi, the presence of residual calculi, and operation time were significant predictors of postoperative pain after PCNL.

Gliomas infiltrating the corpus callosum (G-I-CC) majorly impact patient quality-of-life, but maximally safe tumor resection is challenging. We systematically reviewed the literature on G-I-CC.

The treatment of scaphoid nonunion can be challenging with increasing defect size. We evaluated the outcome of scaphoid nonunion with a substantial bone defect treated with a multidirectional locking plate combined with cancellous bone grafting only. Thirteen patients with significant osseous defects measuring 6 mm or more suffering from primary nonunion without treatment (n = 6) or recalcitrant nonunion following Herbert screw osteosynthesis (n = 7) were treated and reviewed retrospectively. The stabilization was performed after debridement, autologous cancellous bone grafting and volar locking plate osteosynthesis. After a mean follow-up period of 12 months, 12 of the 13 patients achieved successful unions with a free range of motion and complete remittance of pain in everyday activity. The mean scapholunate angle decreased from 59.7° ± 11 to 43.9° ± 5 (effect strength d:1.7, p < 0.00001), scaphoid humpback deformity angle from 58.9° ± 8 to 45.1° ± 8 (d:1.8, p < 0.0001), whereas strength of the injured hand increased from 36.4 kg ± 10 to 42.4 kg ± 9 (d:1.4, p < 0.0001). One nonunion persisted without fragment dislocation receiving revision after 1 year. Thus, locking plate osteosynthesis with cancellous bone grafting is a valid alternative in scaphoid nonunions with extensive bone defects. Additionally, stable retention of the fragments prevents dislocation even in delayed or persistent nonunion. Further prospective studies are required to confirm these findings.

Oclacitinib maleate (Apoquel®, Zoetis Inc.) is commonly used around the world for the control/treatment of pruritus associated with allergic dermatitis and the control/treatment of atopic dermatitis in dogs at least 12 months of age. A new flavored chewable formulation of oclacitinib has been developed where more than 90% of doses offered to dogs were freely accepted when tested in clinical trials. The objective of this study was to determine whether the new chewable formulation of oclacitinib has a similar onset of anti-pruritic activity as the original oclacitinib film-coated tablets (FCT). Twenty-one laboratory beagle dogs were randomized to treatment and received placebo, 0.4-0.6 mg/kg oclacitinib FCT or 0.4-0.6 mg/kg flavored chewable oclacitinib tablet (n = 7/group). Efficacy was measured by assessing reduction in pruritus 1-3 h post-administration of treatments. Pruritus was induced by injecting canine IL-31, intravenously (2.5 μg/kg), approximately 15 min prior to the pruritus observation window. Results from this study demonstrated both oclacitinib FCT and the flavored chewable oclacitinib tablet significantly reduced IL-31-induced pruritus within 1-3 h post-dosing compared to placebo (p = .0069 and .0113, respectively), suggesting the new formulation of oclacitinib chewable tablets works as quickly to reduce pruritus in dogs as the oclacitinib FCT.

Aims: To determine if the use of intravenous patient-controlled analgesia (IVPCA) in a fast-track joint replacement program is associated with increased use of perioperative opioid consumption and increased length of hospital stay.