Rejected

Thanks to their anti-inflammatory, anti-oedema, and anti-allergy properties, glucocorticoids are among the most widely prescribed drugs in patients with cancer. The indications for glucocorticoid use are very wide and varied in the context of cancer and include the symptomatic management of cancer-related symptoms (compression, pain, oedema, altered general state) but also prevention or treatment of common side effects of anti-cancer therapies (nausea, allergies, etc.) or immune-related adverse events (irAE). In this review, we first give an overview of the different clinical situations where glucocorticoids are used in oncology. Next, we describe the current state of knowledge regarding the effects of these molecules on immune response, in particular anti-tumour response, and we summarize available data evaluating how these effects may interfere with the efficacy of immunotherapy using immune checkpoint inhibitors.

Mobile-bearing unicompartmental knee arthroplasty (UKA) provides a durable option for the surgical treatment of monocompartmental knee arthritis. Despite its availability in the US since 2004, there is only one published North American series reporting on the minimum 10-year results of mobile-bearing UKA. The purpose of this study was to determine the survivorship, reasons for failure and patient-reported outcomes of the oxford mobile-bearing UKA at minimum 10-year follow-up.

The present study aimed to compare the sedative and analgesic effects of caudal epidural administration of lidocaine alone or in combination with four different α-adrenergic agonists in Mediterranean miniature donkeys. A total of ten clinically healthy (5 males and 5 females) Mediterranean miniature donkeys with an age of 5 ± 1 years, a weight of 100 ± 2 kg and a height at the withers of 0.8 ± 0.06 m (mean ± standard deviation) were used in experimental, crossover (Latin square), randomized and blinded study. Animals were assigned to five treatment groups including lidocaine alone (0.22 mg kg), or associated with one among xylazine (0.17 mg kg), detomidine (30 μg kg), medetomidine (15 μg kg), dexmedetomidine (5 μg kg) with a minimum washout period of 8 days between treatments. The degree of sedation was investigated using a simple descriptive scale of 0-3. Sedation scores were compared at each time using nonparametric (Kruskal-Wallis and Mann-Whitney U) tests. Analgesia was assessed by pinprick test. Sedation was greater in lidocaine/α-adrenergic agonist groups than in lidocaine group at 45-75 minutes after drug administration (p < 0.05). There were no significant differences among groups in time to onset of analgesia and ataxia and also in number of animals with complete perineal analgesia and ataxia. Duration of analgesia and ataxia were longer in lidocaine/α-adrenergic agonist groups than in lidocaine (p < 0.05). There were no significant differences among lidocaine/α-adrenergic agonist groups in sedation score and duration of analgesia and ataxia. No significant differences were observed in heart and respiratory rate and also rectal temperature at any time points between groups and within groups. Caudal epidural administration of α- adrenergic agonists associated with lidocaine resulted in sedative effects on Mediterranean miniature donkeys, while lidocaine alone did not induce sedation. These drugs associations should be considered when superior analgesia is advocated.

Studies of palliative care (PC) in hospitalized patients with cirrhosis have been retrospective, with limited evaluation of patient-reported measures and outcomes.

Evidence of detachment of the levator ani muscle system is seen more frequently in patients with pelvic floor disorders. It has been suggested that passive descent of the fetus prior to pushing could be used to decrease operative vaginal delivery and levator ani muscle injury. The objective of this planned analysis was to determine whether immediate or delayed pushing was associated with an increased proportion of injury to the levator ani muscle system after a first delivery among nulliparous women.

We aimed to systematically identify novel susceptible factors related to the occurrence and development of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)-like symptoms that were not limited to lifestyles or dietary habits in Chinese population.

Opioid use after surgery or trauma has been implicated as a contributing factor to opioid dependence. The Acute Care Surgery (ACS) service at our community-based trauma center instituted an opioid-minimizing, multi-modal pain control (MMPC) protocol. The classes of pain medication included a non-opioid analgesic, a non-steroidal anti-inflammatory drug, a gabapentinoid, a skeletal muscle relaxant, and a topical anesthetic. We hypothesize that the MMPC will result in lower opioid consumption compared with the prior STP as evidenced by lower morphine milligram equivalents (MME) per day.

Microvascular decompression (MVD) surgery is the treatment of choice for trigeminal neuralgia (TGN). However, decompression becomes difficult when the offending vessel penetrates the trigeminal nerve root.

Treatment guidelines identify cognitive behavioral therapy (CBT) as a treatment of choice for irritable bowel syndrome (IBS). As a learning-based treatment, homework assignments are regarded as important for optimizing outcomes for CBT-treated patients. However, their actual benefit for IBS is unknown. This study examined whether homework completion corresponds with immediate and sustained treatment response in IBS patients enrolled in CBT treatment. Subjects were 358 IBS patients receiving clinic-based CBT (10 session), home-based CBT (4 session), or a 4 session, non-specific IBS education comparator as part of a large NIH trial. Homework completion was rated by clinician at each session. IBS symptom improvement was measured with the Clinician Global Improvement Scale at treatment week 5, post-treatment (week 12), and at follow-ups (weeks 22, 34, 46, 62). Homework completion rates over the 10-week acute phase corresponded with greater IBS symptom improvement and patient satisfaction at post-treatment. Early treatment homework completion did not predict early treatment response. Contrary to expectations, homework compliance rates were not greater among in-clinic session patients than home-based patients. Data lend empirical support to the clinical value of homework in teaching patients how to self-manage painful GI symptoms refractory to conventional medical and dietary therapies.