Rejected

Chronic postsurgical pain (CPSP) is a relatively common complication after cardio-thoracic operations with well-known consequences in terms of return to normal activities and quality of life. Little is known about the prevalence and severity of CPSP after minimally invasive cardiac surgery. The aim of this study was to measure the rate of CPSP in patients undergoing right minithoracotomy mitral valve (MV) surgery and to compare the effectiveness of different approaches to pain control.

There is currently no pooled data in the literature to support whether additional facet joint block results in better clinical analgesia after percutaneous kyphoplasty. We assessed the existing evidence on the safety and efficacy of facet joint block in the treatment of patients with thoracolumbar compression fractures undergoing percutaneous kyphoplasty based on qualified trials.

Image guidance requires placement of a dynamic reference frame (DRF), often either onto local spinous process or by freehand intraosseous DRF placement into the ilium via the posterior superior iliac spine (PSIS). There is a paucity of studies in the literature that describe the complications of intraosseous DRF placement. The aim of this study was to describe the radiographic location, prevalence and nature of complications, and long-term clinical outcomes of attempted DRF placement into the PSIS.

D-0316 is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) developed for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR T790M mutation that progressed after prior treatment with the first- or second-generation EGFR-TKI.

This study evaluated the efficacy and feasibility of long-term use of levonorgestrel releasing intrauterine system (LNG-IUS) in endometriosis patients after using LNG-IUS for >5 years as their postoperative maintenance therapy.Data were obtained retrospectively from patients who maintained medical therapy for >5 years after surgical treatment of endometriosis from January 2008 to April 2015. Patients were divided into study group and control group according to the type of medication; the study group consisted of patients who received LNG-IUS as maintenance therapy, and patients in the control group received combined oral contraceptives (ethinyl estradiol 20 μg and drospirenone 3 mg) or dienogest 2 mg.A total of 263 patients (94 patients in the study group, 169 in the control group) were included in the study. 91.5% (86/94) of the patients in the study group maintained the treatment for >5 years, whereas only 21.9% (37/169) of patients in the control group maintained the treatment for >5 years.LNG-IUS significantly decreased the pain score for non-cyclic pelvic/back pain (from 4.0 ± 1.6 to 0.6 ± 1.3, P < .001), dysmenorrhea (from 6.5 ± 1.7 to 6.5 ± 1.7, P < .001), and dyspareunia/dyschezia (from 6.5 ± 1.7 to 1.3 ± 1.4, P = .006) after 1 year, and the effect was persistent for 10 years (P < .01). When compared with control group, the effect on pain reduction was comparable to the oral contraceptives or dienogest, with less systemic side effects such as mood change or nausea.LNG-IUS for >5 years as a postoperative maintenance therapy for endometriosis patients is an effective and feasible treatment that shows significant effect on pain reduction with less systemic side effect compared with other types of treatment. Therefore, LNG-IUS can be recommended as a long-term postoperative therapy for endometriosis patients who do not plan to become pregnant for several years.

The present study aimed at determining the contributions of background disorders responsible for participation restriction as indexed by a structured interview for the modified Rankin scale (mRS-SI).

Reddit is an online social media website where users set up individual discussion forums (subreddits) on various topics. To gauge public perceptions of the opioid epidemic in the United States we analyzed discussions on the subreddits r/ChronicPain, r/Opiates, r/Politics, r/Health, r/News, and r/Science that were identified with the search terms "opioid", "opioid crisis", and "opioid epidemic". We identified categories in each subreddit and used IBM Watson Natural Language Understanding to analyze emotional tones and themes in comments from individual discussion posts. There were similar categories across subreddits including Health and Fitness, Addiction, Drugs, Disease, and Chronic Pain. Some categories and concepts were subreddit-specific such as the category "Law, Government, Politics" in r/News and the concept "analgesic" in r/Health. Across these subreddits and categories, there was an overall negative sentiment, with little difference in emotional tones. Themes were also similar across subreddits and categories and were limited to specific drugs: opioid, heroin, and morphine. Tone and theme analysis of public perceptions of the opioid epidemic on Reddit documented the negative sentiments associated with specific opioids among people from many different perspectives.

Many studies using diffusion tensor tractography (DTT) have reported trigeminal neuropathy in various neurological diseases. However, no study on traumatic trigeminal neuropathy following whiplash has been reported.

Lichen sclerosus (LS) is a chronic inflammatory dermatosis that mostly affects the genital and anal skin areas. Symptoms may vary from pruritis and pain to sexual dysfunction, however, LS can also be asymptomatic. LS occurs at all ages and in both sexes. Approximately 5% of all women affected by vulvar LS will develop vulvar squamous cell carcinoma. Topical treatment is safe but less effective resulting in chronic course in most patients, who suffer from persistent itching and pain. In severe cases of therapy-resistant LS, there is no adequate treatment. Fat grafting is a novel regenerative therapy to reduce dermal fibrosis. The therapeutic effect of adipose tissue grafts for LS is already investigated in various pioneering studies. This review provides an overview of these studies and the putative mechanisms-of-action of fat grafting to treat LS.

This case report presents a novel approach for minimally invasive fully guided apicoectomy of the palatal root of a maxillary first molar using a custom-made 3D-printed template. To date, the development of diagnostic radiographic tools such as high-resolution CBCT devices, as well as of CAD planning software and CAM technologies, like 3D printing, allow for increased application in endodontics. The patient (a 38-year-old woman) suffered from pain on the right side of the face since 4 weeks and was diagnosed with chronic apical periodontitis of the palatal root of the maxillary right first molar. The root treatment of this tooth was followed up recently and the buccal roots showed no pathologic findings. A guided apicoectomy with access from the palate was chosen as elective therapy. 3D radiographic and intraoral surface datasets were imported into an implant planning software and superimposed, and minimally invasive access to the palatal root apex was planned. Subsequently, a tooth-supported drilling template was designed and created by additive manufacturing. A flapless approach was adapted using a punch-drill and the access to the root apex as well as the apical resection were performed with a trephine drill. The connective tissue punch was finally replaced and sutured. No postoperative complication was reported and a complete remission of symptoms was reported after 2 weeks. The follow-up after 21 months showed clinically stable wound conditions and radiologically a slight reossification in the area of the palatal root tip. The presented technique may lead to novel minimally invasive approaches for the preservation of infected maxillary molars.