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Extracorporeal Shockwave Therapy for Mid-portion and Insertional Achilles Tendinopathy: A Systematic Review of Randomized Controlled Trials.

Extracorporeal shockwave therapy (ESWT) is used commonly to treat pain and function in Achilles tendinopathy (AT). The aim of this study was to synthesize the evidence from (non-) randomized controlled trials, to determine the clinical effectiveness of ESWT for mid-portion Achilles tendinopathy (mid-AT) and insertional Achilles tendinopathy (ins-AT) separately.

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Migraine-associated common genetic variants confer greater risk of posterior vs. anterior circulation ischemic stroke☆.

To examine potential genetic relationships between migraine and the two distinct phenotypes posterior circulation ischemic stroke (PCiS) and anterior circulation ischemic stroke (ACiS), we generated migraine polygenic risk scores (PRSs) and compared these between PCiS and ACiS, and separately vs. non-stroke control subjects.

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Measurement of Cumulative Preterm Neonatal and Maternal Stressors During Neonatal Intensive Care Unit Admission.

By nature, the neonatal intensive care unit (NICU) environment is stressful for both infants and mothers. This study aimed to explore and quantify the severity of early life stressors in premature infants admitted to the NICU and evaluate the effect of cumulative neonatal stressors on maternal mental health.

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Safety and Efficacy of Postoperative Nonsteroidal Anti-inflammatory Drugs in Sports Medicine.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for multimodal pain control after surgery. These medications work by selective or nonselective inhibition of cyclooxygenase, which has downstream effects on thromboxanes, prostaglandins, and prostacyclins. Clinical studies have shown beneficial effects for alleviating pain and reducing opioid consumption after surgery. Within hip arthroscopy, there is evidence that postoperative NSAIDs can also reduce the risk of symptomatic heterotopic bone formation. However, preclinical and animal studies have raised concern over the effect of NSAIDs on bone and soft-tissue healing. In addition, selective and nonselective cyclooxygenase 2 inhibitors may have different safety profiles regarding postoperative soft-tissue healing. The purpose of this review was to outline the mechanisms of action, efficacy, and effect on soft-tissue healing of postoperative NSAIDs and to provide evidence-based recommendations for appropriate use.

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The Association between Migraine and Fetal-Type Posterior Cerebral Artery in Patients with Ischemic Stroke.

The aim of the study was to determine if migraine is associated with fetal-type posterior cerebral artery (PCA) in patients with ischemic stroke.

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Thoracic spinal anaesthesia for abdominal surgery in a humanitarian military field hospital: a prospective observational study.

Providing safe and effective anaesthesia in the context of humanitarian medicine is always a challenging situation. Spinal anaesthesia, and in particular its thoracic approach, represents a promising technique for such a limited-resource environment. This prospective observational study investigated the feasibility of thoracic spinal anaesthesia (TSA) for abdominal surgery in a field-deployed military hospital.

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Immunogenicity of COVID-19 Vaccines in Patients with Diverse Health Conditions: a Comprehensive Systematic Review.

It remains unclear how effective COVID-19 vaccinations will be in patients with weakened immunity due to diseases, transplantation, and dialysis. We conducted a systematic review comparing the efficacy of COVID-19 vaccination in patients with solid tumor, hematologic malignancy, autoimmune disease, inflammatory bowel disease, and patients who received transplantation or dialysis. A literature search was conducted twice using the Medline/PubMed database. As a result, 21 papers were included in the review, and seropositivity rate was summarized by specific type of disease, transplantation, and dialysis. When different papers studied the same type of patient group, a study with a higher number of participants was selected. Most of the solid tumor patients showed a seropositivity rate of more than 80% after the second inoculation, but a low seropositivity was found in certain tumors such as breast cancer. Research in patients with certain types of hematological malignancy and autoimmune diseases has also reported low seropositivity, and this may have been affected by the immunosuppressive treatment these patients receive. Research in patients receiving dialysis or transplantation has reported lower seropositivity rates than the general population, while all patients with inflammatory bowel disease have converted to be seropositive. Meta-analysis validating these results will be needed, and studies will also be needed on methods to protect patients with reduced immunity from COVID-19. This article is protected by copyright. All rights reserved.

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Rash morphology as a predictor of COVID-19 severity: A systematic review of the cutaneous manifestations of COVID-19.

Approximately 6% of those with COVID-19 will experience cutaneous manifestations. Examining data from this cohort could provide useful information to help with the management of COVID-19. To that end, we conducted a systematic review primarily to assess rash morphologies associated with COVID-19 and their relationship with disease severity. Secondary outcomes include demographics, distribution, dermatological symptoms, timeline, diagnostic method and medication history. The literature was searched for all patients with skin manifestations thought to be related to suspected or confirmed COVID-19. Patients with a history of dermatological, rheumatological or occupational skin disorders were excluded. Of the 2056 patients selected, the most common morphologies were chilblain-like lesions (54.2%), maculopapular (13.6%) and urticaria (8.3%). Chilblain-like lesions were more frequent in the younger population (mean age 21.5, standard deviation ± 10.8) and were strongly linked with milder disease, not requiring an admission (odds ratio [OR] 35.36 [95% confidence interval {CI} 23.58, 53.03]). Conversely, acro-ischaemia and livedo reticularis were associated with worse outcomes, including a need for ICU (OR 34.01 [95% CI 16.62, 69.57] and OR 5.57 [95% CI 3.02, 10.30], respectively) and mortality (OR 25.66 [95% CI 10.83, 60.79] and OR 10.71 [95% CI 4.76, 24.13], respectively). Acral lesions were the most common site (83.5%). 35.1% experienced pruritus, 16.4% had pain and 4.7% reported a burning sensation. 34.1% had asymptomatic lesions. Rash was the only symptom in 20.9% and occurred before or alongside systemic symptoms in 12.4%. 28.3% had a positive polymerase chain reaction nasopharyngeal swab and 5.4% had positive antibodies, while 21.9% tested negative and 45.1% were not tested. In conclusion, COVID-19 causes a variety of rashes, which may cause symptoms and add to morbidity. Rash type could be helpful in determining COVID-19 prognosis.

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Acute tryptophan depletion alters affective touch perception.

Affiliative tactile interactions help regulate physiological arousal and confer resilience to acute and chronic stress. C-tactile afferents (CTs) are a population of unmyelinated, low threshold mechanosensitive cutaneous nerve fibres which respond optimally to a low force stimulus, moving at between 1 and 10 cm/s. As CT firing frequencies correlate positively with subjective ratings of touch pleasantness, they are hypothesised to form the first stage of encoding affiliative tactile interactions. Serotonin is a key modulator of social responses with known effects on bonding.

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Punicalagin Targets Atherosclerosis: Gene Expression Profiling of THP-1 Macrophages Treated with Punicalagin and Molecular Docking.

Atherosclerosis is an important cause of cardiovascular disorders worldwide. Natural botanical drugs have attracted attention due to their antioxidant, anti-inflammatory, and antiatherogenic properties in the treatment of atherosclerosis. Punicalagin is the major bioactive component of pomegranate peel, and has been shown to have antioxidant, anti-inflammatory, antiviral, anti proliferation, and anticancer properties. To explore its antiatherogenic properties at a molecular level, we investigated the genome-wide expression changes that occur in differentiated THP1 cells following treatment with a non-toxic dose of punicalagin. We also conducted a molecular docking simulation study to identify the molecular targets of punicalagin.

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