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Development of the Cold Urticaria Activity Score.

Cold urticaria (ColdU) is a form of inducible urticaria where cold induces wheals and/or angioedema. The burden of disease is high and linked to trigger thresholds, exposure, and avoidance. There are presently no validated patient-reported outcome measures (PROMs) to assess and monitor disease activity. Our objective was to develop a disease-specific activity score for ColdU that is easy to administer and evaluate.

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Targeted muscle reinnervation for a recurrent traumatic neuroma of the sural nerve: illustrative case.

Traumatic neuromata often recur after resection. Recently, targeted muscle reinnervation (TMR) has been shown to be a promising alternative for the treatment of traumatic neuroma, also in nonamputees. This case shows that TMR can also be applied for this indication in recurrent traumatic neuroma.

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Utility of Gait Biofeedback Training to Improve Walking Biomechanics in Patients With Chronic Ankle Instability: A Critically Appraised Topic.

Chronic ankle instability (CAI) is a condition that involves feelings of the ankle "giving way," pain, and decreased self-reported function. Individuals with CAI often demonstrate persistent biomechanical impairments during gait that are associated with repetitive lateral ankle sprains (LAS) and the development of early onset ankle posttraumatic osteoarthritis (OA). Traditional rehabilitation strategies have not successfully improved these reported aberrant gait biomechanics; thus, traditional rehabilitation may not effectively reduce the risk of recurrent LAS and ankle OA among individuals with CAI. Conversely, targeted gait training with biofeedback may be effective at decreasing the risk of recurring LAS and ankle OA if these rehabilitation strategies can promote individuals with CAI to develop a gait strategy that protects against subsequent LAS and ankle OA.

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Response After Repeated Ketamine Injections in a Rat Model of Neuropathic Pain.

Ketamine, an N-methyl-D-aspartate antagonist, reduces pain by decreasing central sensitization and pain windup. However, chronic ketamine use can cause tolerance, dependency, impaired consciousness, urinary symptoms, and abdominal pain. This study aimed to investigate the effects of repeated ketamine injections and ketamine readministration after discontinuation in a rat model of neuropathic pain. To induce neuropathic pain, partial sciatic nerve ligation (PSNL) was performed in 15 male Wistar rats, and these animals were divided into three groups: PSNL (control), PSNL + ketamine 5 mg/kg (K5), and PSNL + ketamine 10 mg/kg (K10; n=5 each). Ketamine was injected intraperitoneally daily for 4 weeks, discontinued for 2 weeks, and then readministered for 1 week. Following PSNL, the mechanical withdrawal threshold was determined weekly using the Von Frey. The K10 group showed a significant increase in the mechanical withdrawal threshold, presented here as the target force (in g), at 21 and 28 days compared to the time point before ketamine injection (mean±SE, 276.0±24.0 vs. 21.6±2.7 and 300.0±0.0 vs. 21.6±2.7, respectively; P<0.01) and at 14, 21, and 28 days compared to the control group (108.2±51.2 vs. 2.7±1.3, 276.0±24.0 vs. 2.5±1.5, and 300.0±0.0 vs. 4.0±0.0, respectively; P<0.05). However, in the K10 group, the ketamine effects decreased significantly at 7 days after readministration compared to those after 28 days of repeated injections (P<0.05). In the K10 group, repeated ketamine injections showed a significant increase in antinociceptive effect for >2 weeks, but this ketamine effect decreased after drug readministration.

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Cervical cerebrospinal fluid venous fistula with syringomyelia treated with suboccipital decompression: illustrative case.

Cerebrospinal fluid (CSF) venous fistulas are a recently discovered and underdiagnosed cause of spontaneous spinal CSF leak, which may lead to spontaneous intracranial hypotension. Most cases occur in the thoracic spine, and only 2 cases were reported in the cervical spine. Treatments include the epidural blood patch, fibrin glue injection, and surgical ligation of the fistula.

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Vogt-Koyanagi-Harada Disease following mRNA-1273 (Moderna) COVID-19 Vaccination.

To report a case of Vogt-Koyanagi-Harada (VKH) disease following mRNA-1273 (Moderna) COVID-19 vaccination.

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Nonsteroid anti-inflammatory drugs and the risk of peptic ulcers after gastric bypass and sleeve gastrectomy.

Pharmacologic pain treatment is common among bariatric patients. Nonsteroid anti-inflammatory drugs (NSAID) are not recommended after Roux-en-Y gastric bypass (RYGB) because of the increased risk of marginal ulceration, but the connection with NSAID is not unambiguous.

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Clinical Manifestations and Treatment of Vogt-Koyanagi-Harada Disease during Pregnancy and after Birth: A Case Report.

To describe the clinical manifestations of Vogt-Koyanagi-Harada (VKH) disease during pregnancy and after birth and the therapeutic challenge of treating patients with this condition.

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Clinical and Laboratory Parameters of Autoinflammatory Disorders in Single Tertiary Care Center.

Autoinflammatory diseases (AIDs) are disorders with an inborn error of innate immunity, characterized by recurrent episodes of fever and inflammatory attacks. The spectrum of AIDs is expanding, but there are no standardized clinical criteria for the diagnosis of the patients. This study aims at establishing the first autoinflammatory registry of an Iranian population focusing on the clinical and laboratory features that may help clinicians for a better understanding and diagnosis of these disorders. Clinical and laboratory characteristics of patients who were clinically and or genetically diagnosed with AIDs were collected during 15 years. The updated version of classification criteria from the Eurofever Registry was used for the clinical diagnosis. Twenty-eight patients (16 males and 12 females) with the mean±SD age of 28.03±14.49 years (from 2 to 68 years) were entered this study. About 29% were genetically diagnosed. Familial Mediterranean fever (FMF) was the most common diagnosis of the patients. Fever duration episodes were between 1-10 days. Some of the clinical manifestations from the most to the least common were as follows: arthralgia and arthritis (80%), myalgia (76%), coughs and shortness of breath (68%), fatigue (60%), abdominal pain (56%), increased erythrocyte sedimentation rate(ESR) (48%), and splenomegaly (24%). Here, we presented the most common clinical manifestations of Iranian AIDs who have registered in our AID registry which would be a useful guide for managing the same patients and also designing the future studies.

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Popliteal Artery Occlusion in a Sole Sciatic Arterial System Requiring Complex Repair.

Persistence of the sciatic artery is a rare phenomenon in vascular surgery. It results from abnormal embryologic development, and where present in the absence of a femoral arterial system, it can have significant clinical implications for patients and can even be limb threatening. We present the case of a 69-year-old man with left-sided, short-distance claudication and rest pain, which caused concern for critical limb ischaemia. Computed tomography angiography revealed a persistent sciatic artery arising from the common iliac artery and resulting in an occluded popliteal artery. The patient underwent a double-bypass procedure to restore the arterial supply to the symptomatic limb. A left iliopopliteal Dacron graft bypass was performed, followed by a left iliopopliteal Dacron to posterior tibial bypass using the patient's great saphenous vein. The left sciatic artery was ligated proximally. This allowed for restoration of arterial supply to the patient's left lower limb, relieving his claudication and rest pain. The key finding was the aneurysmal nature of the sciatic artery, reflecting the likely thromboembolic nature of the distal popliteal disease. Thus, our patient required not only a bypass procedure but also ligation of the native sciatic artery. Timely management is critical due to severity of consequences.

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