Rejected

The aim of this retrospective study is to evaluate the clinical-functional and radiographic results in pediatric patients with painful and disabling Flexible Flat Foot (FFF) refractory to conservative treatment who underwent percutaneous subtalar arthroereisis with a Maxwell Brancheau Arthroereisis® (MBA) implant. Patients aged 8-14 years old with a minimum follow-up of 24 months were included. A pre and postoperative radiographic evaluation was carried out analyzing Meary's angle, internal Moreau-Costa-Bartani´s angle, Talar declination angle, Calcaneal Pitch, Kite's angle, Talar-1st metatarsal angle, and Talonavicular coverage angle. In those patients with more than 5 years of follow-up, the development of subtalar osteoarthritis was evaluated. A clinical-functional evaluation was carried out using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot rating scale. Pre and postoperative pain was evaluated using the visual analog scale (VAS). Postoperative complications were described. Fourteen patients (19 feet) met the inclusion criteria. The mean age at surgery was 12 years old with a mean follow-up of 68.26 months. All radiographic angles improved significantly. No signs of subtalar osteoarthritis were identified. The mean pre and postoperative pain according to VAS was 7.05 and 0.77 respectively. The mean pre and postoperative AOFAS was 75.42 and 97.05 respectively. One female patient had persistent pain in both feet (VAS = 4). However, she was able to do sports and daily life activities without restrictions. None of the implants needed to be removed due to intolerance or pain. Subtalar arthroereisis seems to be effective to improve the clinical-functional and radiographic parameters in moderate pediatric FFF.

Non-healing wounds are among the main causes of morbidity and mortality. We recently described a novel, serum-free ex vivo expansion system, the quantity and quality culture system (QQc), which uses peripheral blood mononuclear cells (PBMNCs) for effective and noninvasive regeneration of tissue and vasculature in murine and porcine models. In this prospective clinical study, we investigated the safety and efficacy of QQ-cultured peripheral blood mononuclear cell (MNC-QQ) therapy for chronic non-healing ischemic extremity wounds. Peripheral blood was collected from 9 patients with 10 chronic (>1 month) non-healing wounds (8 males, 1 female; 64-74 years) corresponding to ischemic extremity ulcers. PBMNCs were isolated and cultured using QQc. Within a 20-cm area surrounding the ulcer, 2 × 107 cells were injected under local anesthesia. Wound healing was monitored photometrically every 2 weeks. The primary endpoint was safety, whereas the secondary endpoint was efficacy at 12-week post-injection. All patients remained ambulant, and no deaths, other serious adverse events, or major amputations were observed for 12 weeks after cell transplantation. Six of the 10 cases showed complete wound closure with an average wound closure rate of 73.2% ± 40.1% at 12 weeks. MNC-QQ therapy increased vascular perfusion, skin perfusion pressure, and decreased pain intensity in all patients. These results indicate the feasibility and safety of MNC-QQ therapy in patients with chronic non-healing ischemic extremity wounds. As the therapy involves transplanting highly vasculogenic cells obtained from a small blood sample, it may be an effective and highly vasculogenic strategy for limb salvage.

Non-infectious inflammation has been proposed as a major contributor to epidural-related maternal fever. We hypothesized that maternal serum C-reactive protein (CRP) and white blood cell (WBC) count at hospital admission predict intrapartum maternal fever.

Bone metastases are difficult to treat surgically, necessitating a multidisciplinary approach that must be applied to each patient depending on the specifics of their case. The main indications for surgical treatment are a lack of response to chemotherapy, radiation therapy, hormone therapy, immunotherapy, and bisphosphonates which is defined by persistent pain or tumor progression; the risk of imminent pathological bone fracture; and surgical treatment for single bone metastases. An important aspect of choosing the right treatment for these patients is accurately estimating life expectancy. Improved chemotherapy, postoperative radiation therapy, and sustainable reconstructive modalities will increase the patient's life expectancy. The surgeon should select the best surgical strategy based on the primary tumor and its characteristics, the presence of single or multiple metastases, age, anatomical location, and the functional resources of the patient. Preventive osteosynthesis, osteosynthesis to stabilize a fracture, resections, and reconstructions are the main surgical options for bone metastases. Resection and reconstruction with a modular prosthesis remain the generally approved surgical option to restore functionality, increase the quality of life, and increase life expectancy. Preoperative embolization is necessary, especially in the case of metastases of renal or thyroid origin. This procedure is extremely important to avoid complications, with a major impact on survival rates.

Diagnostic analgesia and lunging are parts of the equine lameness examination, aiding veterinarians in localizing the anatomical region(s) causing pain-related movement deficits. Expectation bias of visual assessment and complex movement asymmetry changes in lame horses on the lunge highlight the need to investigate data-driven approaches for optimally integrating quantitative gait data into veterinary decision-making to remove bias. A retrospective analysis was conducted with inertial sensor movement symmetry data before/after diagnostic analgesia relative to subjective judgement of efficacy of diagnostic analgesia in 53 horses. Horses were trotted on the straight and on the lunge. Linear discriminant analysis (LDA) applied to ten movement asymmetry features quantified the accuracy of classifying negative, partial and complete responses to diagnostic analgesia and investigated the influence of movement direction and surface type on the quality of the data-driven separation between diagnostic analgesia categories. The contribution of movement asymmetry features to decision-making was also studied. Leave-one-out classification accuracy varied considerably (38.3-57.4% for forelimb and 36.1-56.1% for hindlimb diagnostic analgesia). The highest inter-category distances (best separation) were found with the blocked limb on the inside of the circle, on hard ground for forelimb diagnostic analgesia and on soft ground for hindlimb diagnostic analgesia. These exercises deserve special attention when consulting quantitative gait data in lame horses. Head and pelvic upward movement and withers minimum differences were the features with the highest weighting within the first canonical LDA function across exercises and forelimb and hindlimb diagnostic analgesia. This highlights that movement changes after diagnostic analgesia affect the whole upper body. Classification accuracies based on quantitative movement asymmetry changes indicate considerable overlap between subjective diagnostic analgesia categories.

Family communication about pain is an important therapeutic target when a parent lives with chronic pain. Occupational therapy literature about communication in families affected by parental chronic pain is currently lacking.

To investigate the efficacy of percutaneous balloon compression of the Gasserian Ganglion (PCGG) in the treatment of trigeminal neuralgia(TN)and the influencing factors of recurrence after PCGG.

In animal, epidemiological, and human challenge studies, a pre-existing T-cell response to internal proteins of influenza A has been associated with improved virological and disease outcomes. The aim of this study was to assess whether inducing additional responses to conserved CD4 and CD8 T-cell antigens provides added benefit to standard influenza vaccination.

The miR-21 has been implicated in the process of neuroinflammation as well as neuropathic pain.

Patients with haemophilia (PwH) often suffer from joint pain due to repetitive haemarthroses and resulting arthropathy. Literature focuses so far on pain causes, diagnosis or treatment. A summary of prevalence rates, providing facts on the absolute occurrence of pain, is not sufficiently described so far. This review aimed to explore and systematically review different pain conditions, focussing on prevalence rates of pain in adult PwH.