Rejected

This observational study aimed to monitor the 5-year trends of kidney function in patients with peripheral artery disease (PAD) and concomitant chronic kidney disease (CKD) enrolled or not enrolled into a rehabilitative exercise program. Sixty-six patients (aged 72 ± 10, males n = 52) at KDOQI stages III-IV and PAD at Rutherford's stage I-III were included in the study, with a group (Exercise, EX; n = 32) receiving a 6-month structured pain-free home-based walking program and a group (Control, CO; n = 34) receiving walking advice and optimal nephrological care. Outcomes included kidney function measured through serum creatinine (sCr) and clinical outcomes, including the rate of advance of CKD stages and admission to dialysis, revascularizations, and hospitalizations. At baseline, the two groups were comparable for age, nephropathy, medications, comorbidities, and PAD severity. Patients in the EX group safely completed the exercise program. SCr values were slightly increased in EX (baseline: 2.35 ± 0.32; 5-year: 2.71 ± 0.39 mg/dL) and progressively worsened in CO (baseline: 2.30 ± 0.31; 5-year 4.22 ± 0.42 mg/dL), with a significant between-group difference ( = 0.002). The control group also showed a higher number of dialysis admissions (5 vs. 0, = 0.025) and advancing CKD stage as well a higher risks for lower limb revascularization (hazard ratio: 2.59; 95%CI: 1.11-6.02; = 0.027) and for all-cause hospitalization (hazard ratio: 1.77; 95%CI: 1.05-2.97; = 0.031). PAD-CKD patients enrolled in a low-moderate intensity home-exercise program showed more favorable long-term trends in kidney function and clinical outcomes than patients with usual care. These preliminary observations need to be confirmed in randomized trials.

Glutamate levels and lifetime in the brain extracellular space are dinamically regulated by a family of Na- and K-dependent glutamate transporters, which thereby control numerous brain functions and play a role in numerous neurological and psychiatric diseases. Migraine is a neurological disorder characterized by recurrent attacks of typically throbbing and unilateral headache and by a global dysfunction in multisensory processing. Familial hemiplegic migraine type 2 (FHM2) is a rare monogenic form of migraine with aura caused by loss-of-function mutations in the α2 Na/K ATPase (α2NKA). In the adult brain, this pump is expressed almost exclusively in astrocytes where it is colocalized with glutamate transporters. Knockin mouse models of FHM2 (FHM2 mice) show a reduced density of glutamate transporters in perisynaptic astrocytic processes (mirroring the reduced expression of α2NKA) and a reduced rate of glutamate clearance at cortical synapses during neuronal activity and sensory stimulation. Here we review the migraine-relevant alterations produced by the astrocytic glutamate transport dysfunction in FHM2 mice and their underlying mechanisms, in particular regarding the enhanced brain susceptibility to cortical spreading depression (the phenomenon that underlies migraine aura and can also initiate the headache mechanisms) and the enhanced algesic response to a migraine trigger.

Neck disability and pain are frequently encountered problems in patients with chronic migraine (CM). The long-term stimuli of neurons in the trigeminocervical junction may explain this situation. OnabotulinumtoxinA (ONA) treatment is one of the proven treatments for CM; however, there is no study data on the efficacy of ONA treatment on neck disability and pain in CM patients. Therefore, we aimed to investigate the effect of ONA treatment on disability, neck pain and headache intensity in CM patients. One hundred thirty-four patients who met the inclusion criteria were included in the study. ONA treatment was administered at a dose of 195 U to 39 sites in total as per Follow-the-Pain PREEMPT protocol. The disability was evaluated with the Neck Disability Index and the Migraine Disability Assessment; pain intensity was evaluated with the Visual Analogue Scale; the monthly number of headache days were recorded; quality of life was evaluated with the Headache Impact Test. All assessments were recorded at baseline and 3 months after treatment. After the treatment, neck-migraine disabilities decreased from severe to mild for neck and moderate for migraine ( < 0.001). Neck pain and headache intensities decreased by almost half ( < 0.001). The median number of monthly headache days decreased from 20 days to 6 days ( < 0.000). The quality-of-life level decreased significantly from severe to substantial level ( < 0.001). According to our results, ONA treatment was effective in reducing neck-related problems in CM patients. Long-term follow-up results may provide researchers with more comprehensive results in terms of the treatment of chronic migraine-neck-related problems.

Visual snow syndrome (VSS) is a recently recognized chronic neurologic condition characterized by the constant perceiving of tiny flickering dots throughout the entire visual field. Metabolic overactivity and grey matter volume increase in the lingual gyrus has been reported. We investigated this by F-FDG PET/MR in comparison to healthy controls. Aside from voxel-based characterization, the classification accuracy of volume-of-interest (VOI)-based multimodal assessment was evaluated, also in comparison with visual analysis.

Persistent sciatic artery (PSA) is a rare congenital peripheral artery disorder that is usually detected incidentally on computed tomographic examination. PSA can also cause iliac aneurysm and acute thromboembolism, which are potentially associated with rest pain, claudication, and limb-threatening ischemia. Patients with PSA and leg ischemia should be treated with revascularization and appropriate management of PSA aneurysm. The authors often choose emergent bypass surgery or endovascular intervention for aneurysmal rupture and acute lower-extremity arterial occlusion. This report describes an emergency procedure using catheter-based thrombolysis for acute limb ischemia in a patient with PSA.

To assess safety of COVID-19 vaccination in pediatric patients with immune-mediated inflammatory disease (IMID) METHODS: Subjects 5-21 years of age with IMID who received at least one COVID-19 vaccine completed electronic surveys after each vaccine to assess side effects within one week of vaccination, current medications, and COVID-19 testing after vaccination. Charts were reviewed for COVID-19 polymerase chain reaction and IgG response to SARS-CoV-2 spike protein results, and for disease flare during the study period.

Erdong Gao (EDG), consisting equally of roots of Asparagi Radix and Ophiopogonis Radix, is a well-known traditional Chinese formulation that has been used to treat cough and throat pain for centuries. However, the bioactive components in EDG remain to be elucidated. In this study, a rapid and effective method involving live cell bio-specific extraction and HPLC-Q-TOF-MS/MS was established to rapidly screen and identify the anti-inflammatory compounds of an EDG extract. One hundred and twenty-four components were identified in EDG extract using HPLC-Q-TOF-MS/MS analysis. After co-incubation with 16HBE, HPAEpiCs and HUVECs, which have been validated as the key target cells for pulmonary diseases, sixteen components were demonstrated to exhibit an affinity for binding to them. Furthermore, fifteen components were subsequently verified to exert anti-inflammatory effects on lipopolysaccharide (LPS)-induced 16HBE, HPAEpiCs and HUVECs via inhibiting the release of TNF-α and IL-6, indicating that nine steroidal saponins may possess potential for the treatment of lung-related diseases. Taken together, our study provides evidence that live cell biospecific extraction combined with the HPLC-Q-TOF-MS/MS technique was an efficient method for rapid screening potential bioactive components in traditional Chinese medicines and the structure activity relationship of steroidal saponins in EDG was summarized for the first time.

This case series aims to characterize the demographics, complications, and spectrum of clinical manifestations of emerging human monkeypox (HMPX) cases.

Negative consequences and medical complications of COVID-19 can persist for up to several months after initial recovery. These consequences can include stroke, diabetes, decreased lung diffusing capacity, sleep apnea, pulmonary fibrosis, arrhythmia, myocarditis, fatigue, headaches, muscle aches, heart rate fluctuations, sleep problems, memory problems, nervousness, anxiety, and other neurological disorders. Thirty-one patients who reported symptoms related to previous COVID-19 disease of both sexes were enrolled in the initial program. The patients underwent compression sessions in a multiplace hyperbaric chamber. Each patient underwent a cycle of 15 compressions. Before the first session, each participant completed a venous blood gas test, a Fullerton test, and two spirometry tests (one before the Fullerton test and one after the test). Patients completed psychotechnical tests, a questionnaire on quality of life (Polish version of EQ-5D-5L), and a questionnaire on specific symptoms accompanying the disease and post-infection symptoms. The results showed significant improvements in areas such as quality of life, endurance and strength, some spirometric parameters, the anion gap and lactate levels, working memory, and attention in the group of treated patients. In contrast, there were no changes in pH, pO2, pCO2, glucose, and excess alkaline values. A follow-up interview confirmed that the beneficial effects were maintained over time. Considering the results obtained, including the apparent improvement in the patient's clinical condition, it can be concluded that the use of 15 compression sessions was temporarily associated with a noticeable improvement in health and performance parameters as well as improvement in certain blood gas parameters.

Modelling acute postoperative pain trajectories may improve the prediction of persistent pain after breast cancer surgery (PPBCS). This study aimed to investigate the predictive accuracy of early postoperative pain (EPOP) trajectories in the development of PPBCS.