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Purpose: The aim of this study was 2-fold: (1) to examine the relationships between psychophysiological responses and locomotor demands with variations in technical performance during 2v2 and 4v4 conditioned games and (2) to compare psychophysiological and locomotor responses among players exhibiting higher and lower technical performance levels during the conditioned games. Methods: Twenty-four male youth soccer players (16.3 ± 0.8 y old) participating at the trained/developmental level underwent monitoring for psychophysiological responses (including heart rate, rating of perceived exertion, and visual analog scale), locomotor demands (such as distance covered), and technical performance variables (including successful and unsuccessful passes and shots, as well as lost balls) across 2v2 and 4v4 formats. These formats were applied 4 times within a single session and were replicated twice over 2 weeks. Results: Large correlations between the number of lost balls per minute and mean heart rate were found in both the 2v2 and 4v4 games (r =.586 and r =.665, respectively). Successful shots were inversely and largely correlated with mean heart rate (r = −.518) in 4v4 games. The number of interceptions per minute was inversely and significantly correlated with the visual analog scale in 2v2 and 4v4 games (r = −.455 and r = −.710, respectively). The frequency of lost balls was significantly higher among players who attained a higher mean heart rate (2v2: +42.9%, P =.031, d = −0.965; 4v4: +57.1%, P <.001, d = −2.072). Conclusions: Coaches should be aware that highly psychophysiologically demanding scenarios may significantly impair technical performance. Therefore, prioritizing technical performance by deliberately adjusting the intensity should be considered. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the impact of injectable plateletrich fibrin (iPRF) and concentrated growth factor on postoperative pain, edema, trismus, and quality of life in impacted mandibular third molar surgery. The primary aim of this study was to minimize common sequelae following third molar surgery by using iPRF and concentrated growth factor. The secondary objective was to compare the postoperative effects of these products. Method and materials: This study represents a single-center, randomized prospective clinical trial conducted at the Ordu University Faculty of Dentistry. It involved patients who underwent third molar surgery for various reasons between July and October 2022. The predictor variables were the use of concentrated growth factor and i-PRF. They were categorized as concentrated growth factor, i-PRF, and control groups. The outcome variables include pain levels and analgesic consumption measured on a visual analog scale, distances between predetermined anatomical points, maximum mouth opening capacity, and data from the postoperative symptom severity (PoSSe) scale. Some statistical tests were performed with a 95% confidence interval, which was considered significant. Results: Total analgesic use was notably lower in the concentrated growth factor group (P = .044). Concentrated growth factor and iPRF outperformed the control group in all edema measurements by postoperative day 7 (tragus–pogonion, lateral canthus–angulus, tragus–commissura; P < .05). Concentrated growth factor significantly reduced trismus on days 2 and 7. Quality of life was notably higher in the concentrated growth factor group than in the control group (P = .026), although iPRF group differences were not significant. Conclusion: The results indicate that concentrated growth factor has a limited impact on postoperative pain, but significantly reduces edema, trismus, and enhances quality of life. The iPRF group experienced positive effects on pain, edema, and trismus, although the statistically significant differences observed with concentrated growth factor highlight its potential for use instead of iPRF after third molar surgery. An increased sample size is essential for more comprehensive results [ABSTRACT FROM AUTHOR]

Gingival recession treatment is one of the major clinical challenges in periodontics, and various surgical techniques have been proposed to correct it. Most of these techniques are suitable for isolated recession sites and involve harvesting an autogenous tissue graft, which increases patient morbidity and might result in inferior esthetics due to incision design. This study assessed the benefit of adding platelet-rich fibrin (PRF) to the vestibular incision subperiosteal tunneling approach (VISTA) in treating multiple gingival recession compared to using VISTA alone. A total of 41 teeth with Miller Class I and II defects were randomized in a split-mouth design. Multiple clinical parameters were tested, including the change in gingival thickness over time, keratinized tissue width, and gingival phenotype (using the transparency of a periodontal probe). Patient-centered outcomes were also assessed via visual analog scale. Multiple Miller Class I and II recessions in the maxilla can be effectively treated with VISTA. However, when used in conjunction with PRF, no significant differences were detected in any parameter. VISTA has been shown to be associated with a low level of postsurgical pain for patients and can be used for patients with high esthetic demands. [ABSTRACT FROM AUTHOR]

This study assessed the effects of buccal contour augmentation for periodontally compromised teeth with horizontal bone loss. A total of 30 subjects were divided into Group A or Group B (n = 15 subjects per group). Group A received open-flap debridement (OFD) with buccal contour augmentation using deproteinized bovine bone mineral (DBBM), jointly referred to as contour augmentation for periodontal defects (CAPD; test group). Group B received only OFD (control group). Bleeding on probing (BOP), clinical attachment level (CAL), probing depth (PD), gingival recession (GR), keratinized mucosa width (WKM), keratinized mucosa thickness (TKM), and labial cortical plate thickness were compared at baseline and 1 year. BOP, CAL, PD, and GR did not show significant differences. TKM increased by 1.76 mm for Group A but decreased by 1 mm for Group B. WKM increased from 2.86 ± 0.4 mm to 3.6 ± 0.71 mm (P < .001) and from 2.93 ± 0.32 mm to 3 ± 0.7 mm (P = 0.5) for Groups A and B, respectively, which showed statistical significance. Labial cortical plate thickness increased from 0.94 ± 0.3 mm to 1.95 ± 0.54 mm (P < .001) for Group A but decreased from 0.87 ± 0.45 mm to 0.68 ± 0.31 mm for Group B. Visual analog scale scores for pain perception showed no difference between the two groups. CAPD for periodontally compromised teeth improves WKM and TKM. Long-term analyses are needed to determine its benefits in daily clinical practice. [ABSTRACT FROM AUTHOR]

Context: Wheelchair Power Soccer (WPS) is the only team sport that allows the participation of people with severe physical disabilities who require the daily use of motorized wheelchairs. These individuals may live with chronic pain due to the characteristics of the disabilities and treatments, interfering with their health and limiting their participation in sports. Objectives: To investigate the prevalence of musculoskeletal pain and its relationship with mood in WPS players and to analyze the incidence of traumatic injuries during a championship. Methods: A prospective, longitudinal study was carried out on 30 WPS athletes (93.33% male) with a mean (SD) (range) age of 22.37 (9.79) (47) years. Data collection was performed during a South American WPS Championship lasting 3 days, with: investigation of the presence of musculoskeletal pain and mood through a questionnaire; investigation of the occurrence of traumatic injuries through match observation; and confirmation of the occurrence of traumatic injuries through access to medical department records. Results: About 30% (n = 9/30) of the sample presented some pain on the day of evaluation, with an intensity of 5.67 (3.35) (10) points on the visual analog scale. The most common regions of pain were the lower back (13.3%, n = 4/30), thoracic (10%; n = 3/30), and cervical (10%; n = 3/30) areas of the spine. A total of 46.7% (n = 14/30) reported pain in the month before data collection but of less intensity (2.56 [4] [10] points), the most common regions being the lower limbs (20%; n = 6/30) and cervical spine (20%; n = 6/30). Among the between-group comparisons (ie, participants with pain vs without pain), no relationship was observed between mood state and pain. No traumatic injuries were identified during the competition. Conclusion: The presence of musculoskeletal pain was common in WPS players, but it was not related to mood. As no traumatic injuries were observed during the championship, this modality seems to be safe for people with physical disabilities in general. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the long-term predictability of simplifying mandibular overdenture treatment using single-stage surgery and immediate prosthetic loading of a single implant to provide a more affordable treatment option. Materials and Methods: A total of 29 patients with a mean age of 68 years with problematic mandibular dentures were treated. A single implant (Brånemark System Mklll TiUnite, Nobel Biocare) was placed into the mandibular midline for primary stability. A ball attachment was placed, and the retentive cap was incorporated into the existing denture. The patients were recalled at 3 and 12 months and at 3, 5, 10, and 15 years. Clinical assessments, radiographs, and resonance frequency analysis were recorded. All complications, failures, maintenance, and reasons for failure to follow-up were noted. Visual analog scale (VAS) questionnaires were used to record patient satisfaction (ANOVA; P < .05). Results: One implant did not achieve sufficient primary stability to be immediately loaded and was treated with a two-stage delayed loading protocol. Of the 28 patients receiving immediately loaded implants, 14 patients were available for follow-up at 15 years. Implant survival remained at 100% throughout the study. Patient satisfaction was high, with a significant increase in all comfort and functional parameters (P values ranged from < .001 to .07) throughout the 15-year period. Conclusions: These 15-year results indicate that immediate loading of a single oxidized surface implant used to retain a mucosa-borne overdenture is a safe, reliable, and cost-effective treatment with high levels of patient satisfaction long term. [ABSTRACT FROM AUTHOR]

Context: Soft tissue mobilization is frequently employed for delayed onset muscle soreness (DOMS) management. Foam roller and percussive massage are 2 popular soft tissue mobilization methods preferred by various professionals. However, their effects on DOMS symptoms are controversial and there are no studies comparing these 2 methods. The aim of the present study was to compare the acute effects of soft tissue mobilization with a foam roller or a percussive massage device on DOMS in young male recreational athletes. Design: A parallel, single-blinded, randomized controlled trial. Methods: Thirty-six participants (median [interquartile range 25/75]; age: 20.0 [19.3/21.0] y) were randomly allocated to percussive massage group (n = 12), foam roller group (n = 12), and control group (n = 12). First, a fatigue protocol targeting quadriceps femoris was performed. Then, participants received soft tissue mobilization with foam roller/percussive massage or rested for 10 minutes according to their groups. Pain and fatigue were evaluated by a visual analog scale, and the skin surface temperature of over the quadriceps femoris was measured with thermal camera imaging. Evaluations were performed at baseline, following fatigue protocol, at 24th hour, and at 48th hour. Changes from the baseline at 24th and 48th hours were compared between groups. Results: No significant between-group differences were observed at the assessments performed at 24th or 48th hour regarding the changes from baseline in pain (P value for 24th hour = .905, P value for 48th hour = .733), fatigue (P value for 24th hour = .895, P value for 48th hour = .606), or skin surface temperature measurements (P values for 24th hour = between .300 and .925, P values for 48th hour = between .311 and .750). Conclusions: Soft tissue mobilizations applied with foam roller or percussive massage device do not seem to be superior to passive resting in alleviating DOMS symptoms in recreational athletes. [ABSTRACT FROM AUTHOR]

Purpose: To assess the pain, swelling, infection, and alteration in sensation following the flapless placement of zygomatic implants guided by dynamic navigation. Materials and Methods: A randomized controlled trial was conducted on 20 patients. In group 1, the placement of the zygomatic implants was carried out without reflecting a mucoperiosteal flap (flapless). In group 2, a mucoperiosteal flap was raised (flapped). Two zygomatic implants were placed in each patient (one on each side) under local anesthesia, guided by dynamic navigation. Postoperative evaluations included pain (using the visual analogue scale [VAS]), swelling (using standard measurements), maxillary sinus infection, and alteration of sensation (using mechanical stimuli, thermal threshold detection, and a two-point discrimination test). The assessments were carried out at 2 days, 1 week, and then 1, 2, and 3 months postoperatively. Results: In group 1, all implants except for one were successfully osseointegrated. Immediate postoperative pain and swelling were both significantly greater in group 2 (P < .01). No alteration in sensation was detected in any case in the two groups. There were a total of three cases of chronic sinusitis: one in group 1 and two in group 2. Conclusions: The flapless placement of zygomatic implants guided by dynamic navigation and under local anesthesia improves postoperative recovery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate two pharmacologic antibiotic prophylaxis regimens and a control group of immunocompetent patients undergoing two-stage dental implant placement in a triple-blind randomized controlled clinical trial. Materials and Methods: From a group of 61 immunocompetent patients, 21 were randomly allocated into group 1 (G1) without antibiotic prophylaxis (control), 20 in group 2 (G2) with preoperative antibiotic prophylaxis (1 g amoxicillin 1 hour before the procedure), and 20 in group 3 (G3) with preoperative (1 g amoxicillin) and postoperative (500 mg every 8 hours for 5 days) antibiotic prophylaxis. Pain was assessed with the visual analog scale (VAS) and by considering the number of painkillers patients used. Infection was identified via the presence of pus and fistula. Patients were evaluated after 7, 14, 30, and 120 days. Implant failure (defined as mobility upon the application of manual torque) was evaluated after 120 days during the second surgical stage. Results: At the 7-day follow-up, pain intensity was less severe in the patients who had received antibiotics, with the G3 patients experiencing the least pain (P < .05). Infection was present in groups G1 (2 cases) and G3 (2 cases), but there was no statistically significant intergroup difference. Two implants failed, one in G1 and the other in G3. Conclusions: Based on the results of the present study, although the use of antibiotics reduced pain in the immediate postoperative period, it did not reduce infection rates and implant failure in immunocompetent patients. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of menstrual-cycle (MC) phase on measures of recovery status, that is, resting heart rate, perceived sleep quality, and physical and mental readiness to train, among female endurance athletes. Methods: Daily data were recorded during 1 to 4 MCs (ie, duration ≥21 and ≤35 d, ovulatory, luteal phase ≥10 d) of 41 trained-to-elite-level female endurance athletes (mean [SD]: age 27 [8] y, weekly training: 9 [3] h). Resting heart rate was assessed daily using a standardized protocol, while perceived sleep quality and physical and mental readiness to train were assessed using a visual analog scale (1–10). Four MC phases (early follicular phase [EFP], late follicular phase, ovulatory phase, and midluteal phase [MLP]) were determined using the calendar-based counting method and urinary ovulation-prediction test. Data were analyzed using linear mixed-effects models. Results: Resting heart rate was significantly higher in MLP (1.7 beats·min−1, P =.006) compared with EFP without significant differences between the other MC phases. Perceived sleep quality was impaired in MLP compared with late follicular phase (−0.3, P =.035). Physical readiness to train was lower both in ovulatory phase (−0.6, P =.015) and MLP (−0.5, P =.026) compared with EFP. Mental readiness to train did not show any significant differences between MC phases (P >.05). Conclusions: Although significant, the findings had negligible to small effect sizes, indicating that MC phase is likely not the main determinant of changes in measures of recovery status but, rather, one of the many possible stressors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the alveolar sealing performance between free gingival graft (FGG) and porcine collagen membrane (MS) and qualitatively assess patient-centered outcomes via a visual analog scale. Method and materials: Eighteen patients were randomly divided into control (FGG) and test (MS) groups. After extraction, all the alveoli were filled with bovine bone grafts (small granules) and sealed. Follow-up was during the immediate postoperative period and after 3, 7, 15, 30, 60, 90, and 120 days. After 180 days, before implant placement, tissue samples were obtained for histologic analysis. The epithelial tissues were morphometrically measured for each sample. Qualitative information on the patient's perception of the treatment was collected after 7 days. Results: A faster healing was observed for the MS group. After 60 days, all the sites from the MS were partially healed, in contrast with only five from the FGG. The histologic results after 120 days showed for the FGG group a predominant acute inflammatory process, whereas chronic processes were observed for the MSgroup. The mean epithelial heights found for the FGG and MS were 535.69 pm and 495.33 pm, respectively (P = .54). The intragroup analysis showed significant variance among the data (P<.001) for both groups. The qualitative result showed statistically more significative comfort for the MS group (P < .05). Conclusion: Within the limitations of the study, both techniques effectively promote alveolar sealing. However, the visual analog scale result was superior and more signiffcant for the MS group, with faster wound healing and lower discomfort. [ABSTRACT FROM AUTHOR]

BackgroundChronic pain has long been a major health burden that has been addressed through numerous forms of pharmacological and nonpharmacological treatment. One of the tenets of modern medicine is to minimize risk while providing efficacy. Further, because of its noninvasive nature, virtual reality (VR) provides an attractive platform for potentially developing novel therapeutic modalities.ObjectiveThe purpose of this study was to determine the feasibility of a novel VR-based digital therapy for the treatment of chronic pain.MethodsAn open-label study assessed the feasibility of using virtual embodiment in VR to treat chronic pain. In total, 24 patients with chronic pain were recruited from local pain clinics and completed 8 sessions of a novel digital therapeutic that combines virtual embodiment with graded motor imagery to deliver functional rehabilitation exercises over the course of 4 weeks. Pain intensity as measured by a visual analog scale before and after each virtual embodiment training session was used as the primary outcome measure. Additionally, a battery of patient-reported pain questionnaires (Fear-Avoidance Beliefs Questionnaire, Oswestry Low Back Pain Disability Questionnaire, Pain Catastrophizing Scale, and Patient Health Questionnaire) were administered before and after 8 sessions of virtual embodiment training as exploratory outcome measures to assess if the measures are appropriate and warrant a larger randomized controlled trial.ResultsA 2-way ANOVA on session × pre- versus postvirtual embodiment training revealed that individual virtual embodiment training sessions significantly reduced the intensity of pain as measured by the visual analog scale (P

Context: Contralateral training in the early stages after surgery can improve the balance of the reconstructed knee, which is impaired following anterior cruciate ligament reconstruction (ACLR). However, little is known about the neuromuscular cross exercise after ACLR. Objective: To investigate the effects of an 8-week cross exercise on balance and function of the reconstructed knee following ACLR. Design: A single-blind randomized clinical trial. Participants: Thirty athletic males who underwent ACLR were randomly divided into intervention (n = 15) and control groups (n = 15). Intervention: The intervention and control groups received a routine physiotherapy program. In addition, the intervention group performed neuromuscular exercises on the nonoperated limb. Outcome Measures: Before and 9 weeks after ACLR, dynamic and static balance, function, and pain in the reconstructed knee were measured by Star Excursion Balance Test (SEBT), stork balance stand test, balance error scoring system (BESS), Lysholm questionnaire, and visual analog scale. Data were analyzed by SPSS using 2-independent sample t test, paired t test, and analysis of covariance. Results: Between-group comparison showed that, contralateral knee neuromuscular exercises significantly increased in the reaching distance in SEBT in the anterior (P <.001), posterior (P <.001), posteromedial (P =.010), and posterolateral directions (P =.007), decreased the number of errors in 4 stance positions of BESS including single stance on the firm (P ≤.001) and foam surface (P ≤.001), and tandem stance on the firm (P =.028) and foam surface (P ≤.001). It also increased the time of standing of the stork stand test (P =.044) and decreased the pain intensity (P =.014). Conclusion: Neuromuscular exercise of the nonsurgical knee could improve the dynamic and static balance, and pain in the early stages following ACLR in the surgical leg. These findings may be potentially valuable for current rehabilitation protocols. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the gain in peri-implant keratinized mucosa (KM) using a combination of a free gingival graft (FGG) strip with a xenogeneic collagen matrix (XCM) and compare it to that of an FGG alone. Materials and Methods: This randomized controlled clinical study included a total of 30 patients with a minimal amount of peri-implant KM (= 1 mm) in the maxillary and mandibular anterior regions (including the premolars). The study population was divided into two groups using a randomization protocol; group A (n = 15) received a combination of FGG strip and XCM, and group B (n = 15) received FGG only to augment the KM. Clinical parameters included width of KM (WKM) measured at baseline, 1 month, and 6 months; a customized pink esthetic score (PES) measured at baseline and 6 months; and patient morbidity using visual analog scale (VAS) at days 1, 7, and 14 postoperatively. Results: After 1 month, both groups showed statistically significant gain in KM that reduced slightly by the 6-month follow-up but remained statistically significant when compared to baseline. When the gain was compared between the two groups, the difference was not statistically significant. Better esthetic outcomes and lower morbidity were reported in group A compared to group B, and this difference was statistically significant. Conclusions: Within the limitations of the study, it can be concluded that the combination of FGG strip with XCM is a viable alternative to the use of FGG in augmenting peri-implant KM. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of split-thickness labial eversion periosteoplasty (EPP) for soft tissue closure in horizontal ridge augmentation of posterior mandibular regions using a bone shell onlay grafting technique. Materials and Methods: Sixteen patients (12 female and 4 male; mean age: 46.2 ± 8.7 years) with 18 horizontal bone defects in posterior mandibular regions were included for lateral onlay bone grafting using the bone shell technique. After lateral bone augmentation, the EPP was used for soft tissue closure and was prospectively followed up for wound healing efficacy using a modified scoring index. The scoring index included dichotomous (yes: 0 / no: 1) evaluation of the following items: (1) bleeding on palpation or spontaneously, (2) tissue color difference, (3) presence of hematoma, (4) presence of granulation tissue, (5) incomplete incision margin closure, (6) dehiscence with visible augmentation material, (7) presence of exudation, and (8) presence of suppuration. In addition, a visual analog scale (VAS) was used to quantify and record the amount of pain and swelling (0 = no pain/swelling and 5 = severe pain/swelling); VAS scores of 0, 1, and 2 were rated as 1 in the dichotomous scoring index, and VAS scores of 3, 4, and 5 were rated as 0. A summarized wound healing score consisting of all 10 items was assessed at days 2, 7, and 14 and at months 1 and 4 postoperatively, including a comparison of the follow-up evaluations. Results: The summarized healing score increased significantly (P < .01) between day 2 (score: 6.6 ± 1.1) and day 7 (score: 8.9 ± 1.0) but showed little difference between day 14 (score: 9.6 ± 0.6) and the 1- and 4-month follow-ups (score: 10.0 ± 0). There was no wound dehiscence and no incomplete incision margin adaptation. For the individual parameters evaluated, bleeding on palpation, hematoma, and exudation were the most frequent side effects at day 2 at 50%, 100%, and 22.2%, respectively, and at day 7 at 16.7%, 55.6%, and 22.2%, respectively. The average pain score and the swelling/edema score were initially 4.0 ± 0 and 3.0 ± 0.77 on day 2, with a significant decrease (P < .001) by day 7 (pain: 2.0 ± 0; edema/swelling: 2.0 ± 0.59) and day 14 (pain: 1.0 ± 0.42; edema/swelling: 2.0 ± 0.79) and complete absence (score: 0) at months 1 and 4. Conclusions: Labial split-thickness EPP facilitates flap advancement and enables tight soft tissue coverage in large horizontal posterior mandibular bone augmentations as a result of offset double-layer wound closure. Although this procedure is shown to be surgically demanding, the postoperative complication rate may be reduced significantly. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effects of mental fatigue (MF) induced by an incongruent Stroop task (ST) and by using social media (SM) compared to watching a documentary (control) on dynamic resistance training. Twenty-one resistance-trained males attended three identical experimental sessions with the only difference of the randomized cognitive task (ST, SM, or control). Each session consisted of (a) baseline MF and motivation visual analogue scale responses, (b) cognitive task, (c) postvisual analogue scale responses, (d) warm-up, and (e) resistance training based on three sets of bench press at 65% of one-repetition maximum till concentric failure. Number of repetitions, ratings of perceived exertion, mean velocity of repetitions, and three repetitions in reserve estimated by subjects were recorded for each set. Both ST (p <.001) and SM (p =.010) effectively induced MF, but only ST impaired the number of repetitions performed in Set 2 (p =.036) and generated higher-than-normal levels of ratings of perceived exertion even reaching significant differences compared to SM in Set 1 (p =.005). However, SM also affected neuromuscular performance by impairing movement velocity in Set 1 (p =.003). The ability of estimating three repetitions in reserve or motivation was not affected by any condition (p range =.362–.979). MF induced by ST impaired the number of repetitions performed, what seems to be mediated by higher-than-normal levels of ratings of perceived exertion. Besides, SM also impaired the ability to apply force against 65% of one-repetition maximum measured by movement velocity. [ABSTRACT FROM AUTHOR]

Study Design. Meta-analysis. Objective. This meta-analysis investigates the outcomes of laminoplasty (LP) and laminectomy with fusion (LF) to guide effective patient selection for these 2 procedures. Background. Although LF traditionally offers the ability for excellent posterior decompression, it may alter cervical spine bio-mechanics and increase the risk of adjacent segment degeneration. LP aims to preserve the natural kinematics of the spine but has not been universally accepted, and may be associated with inadequate decompression, neck pain, and recurrent stenosis. Materials and Methods. PubMed, Cochrane, and Google Scholar (pages 1-20) were searched up until March 2024. The outcomes studied were surgery-related outcomes [operative time (OR) time, estimated blood loss (EBL), and length of stay], adverse events (overall complications, C5 palsy, and reoperations), radiographic outcomes (cervical lordosis, cervical sagittal vertical axis, and T1 slope angle), and patient-reported outcome measures (Neck Disability Index, Visual Analog Scale for neck pain, and Japanese Orthopaedic Association). Results. Twenty-two studies were included in this meta-analysis, of which 19 were retrospective studies, 2 were prospective non-randomized studies, and 1 was a randomized controlled trial. A total of 2128 patients were included, with 1025 undergoing LP and 1103 undergoing LF. Patients undergoing LP experienced significantly shorter operative time (P = 0.009), less EBL (P = 0.02), a lower rate of overall complications (P < 0.00001) and C5 palsy (P = 0.003), a lower T1 slope angle (P = 0.02), and a lower Neck Disability Index (P = 0.0004). No significant difference was observed in the remaining outcomes. Conclusion. This meta-analysis demonstrates that for cervical myelopathy, LP has the benefits of shorter operative time time, less EBL, and reduced incidence of C5 palsy as well as overall complication rate. Given these findings, LP remains an important surgical option with a favorable complication profile in patients with cervical myelopathy, although careful patient selection is still paramount in choosing the right procedure for individual patients. Level of Evidence. 4. [ABSTRACT FROM AUTHOR]

Study design. Retrospective review of prospectively collected data. Objective. To determine the impact of preoperative symptom duration on postoperative functional outcomes after cervical disc replacement (CDR) for radiculopathy. Summary of Background Data. CDR has emerged as a reliable and efficacious treatment option for degenerative cervical spine pathologies. The relationship between preoperative symptom duration and outcomes after CDR is not well established. Methods. patients with radiculopathy without myelopathy who underwent primary 1- or 2-level CDRs were included and divided into shorter (< 6 mo) and prolonged (≥ 6 mo) cohorts based on preoperative symptom duration. patient-reported outcome measures (pROMs) included neck disability index (NDi), visual analog scale (VAS) neck and arm. Changes in PROM scores and minimal clinically important difference (MCID) rates were calculated. Analyses were conducted on the early (within 3 mo) and late (6 mo-2 y) postoperative periods. Results. A total of 201 patients (43.6 ± 8.7 y, 33.3% female) were included. In both early and late postoperative periods, the shorter preoperative symptom duration cohort experienced significantly greater change from preoperative PROM scores compared with the prolonged symptom duration cohort for NDI, VAS-Neck, and VAS-Arm. The shorter symptom duration cohort achieved MCID in the early postoperative period at a significantly higher rate for NDI (78.9% vs. 54.9%, P = 0.001), VAS-Neck (87.0% vs. 56.0%, P < 0.001), and VAS-Arm (90.5% vs. 70.7%, P = 0.002). Prolonged preoperative symptom duration ( ≥ 6 mo) was identified as an independent risk factor for failure to achieve MCID at the latest timepoint for NDI (OR: 2.9, 95% CI: 1.2-6.9, P = 0.016), VAS-Neck (OR: 9.8, 95% CI: 3.7-26.0, P < 0.001), and VAS-Arm (OR: 7.5, 95% CI: 2.5-22.5, P< 0.001). Conclusions. Our study demonstrates improved patient-reported outcomes for those with shorter preoperative symptom duration undergoing CDR for radiculopathy, suggesting delayed surgical intervention may result in poorer outcomes and greater postoperative disability. Level of Evidence. Level III. [ABSTRACT FROM AUTHOR]

The use of virtual reality (VR)-based biofeedback (BF), a relatively new intervention, is a non-pharmacological treatment of depressive and anxiety symptoms. However, studies on VR-based BF are lacking and inconclusive. A total of 131 adults were recruited from the community. Participants who scored ≥10 on the Patient Health Questionnaire-9 (PHQ-9) or ≥9 on the Panic Disorder Severity Scale (PDSS) were included in the group with depressive or anxiety symptoms (DAS group), and others as the healthy control group (HC group). Participants from the DAS group were randomly assigned to VR-based or conventional BF intervention. All individuals visited at three times (weeks 0, 2, and 4), and completed the Montgomery-Asberg Depression Rating Scale (MADRS), the State-Trait Anxiety Inventory (STAI), and a visual analog scale (VAS) before and after the intervention, and PHQ-9 at the beginning and final visit. The analysis included a total of 118 participants (DAS/VR: 40, DAS/BF: 38, HC/VR: 40). There was no significant difference in demographic variables among the three groups. After the intervention, the DAS/VR group exhibited significant decreases in MADRS (70.0 %), PHQ-9 (64.1 %), STAI (29.5 %), and VAS (61.7 %) scores compared to the baseline (p <0.001). There were no significant differences between the effects of VR-based BF and conventional BF with a therapist. The HC group also showed significant decreases in the measures of depression and anxiety after receiving VR-based BF. VR-based BF was effective in reducing depressive and anxiety symptoms, even for subthreshold depression and anxiety symptoms in the HC group. • Our study revealed that VR-based Biofeedback (BF) was effective in adults with depressive and anxiety symptoms. • Depression and anxiety symptoms decreased after the intervention of VR-based BF compared to before. • Healthy subjects also demonstrated significant decreases in depression and anxiety measures after receiving VR-based BF. • This finding suggests that VR-based BF seems to be a promising intervention for treating depression and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Overall symptom severity (OSS) and patient‐reported chronic rhinosinusitis (CRS) control are global measures of CRS identified as consensus, essential criteria for CRS disease control assessment. We sought to determine the functional relationship between these two metrics.Using an international multicenter mixed‐methods design, 260 CRS patients were recruited. OSS score was measured using a visual analog scale. Patient‐reported CRS control was measured as “controlled,” “partly controlled,” and “uncontrolled.” Twelve participants underwent semi‐structured interviews to discuss OSS and patient‐reported CRS control.The majority of interviewed participants felt OSS and patient‐reported CRS control measured different constructs—while OSS only measured symptoms, patient‐reported CRS control was more global, including not only symptom severity but also concepts such as medication usage, activity impairment, and exacerbations. Nevertheless, OSS score was strongly correlated with (ρ = 0.67, p < 0.001) and highly predictive of patient‐reported CRS control. OSS score of >4 (95% confidence interval [CI]: 1.8–4.2) had 74.7% sensitivity and 93.2% specificity in identifying patients reporting their CRS as not controlled. OSS score of >6.6 (95% CI: 4.1–7.1) had 77.0% sensitivity and 75.9% specificity in identifying patients reporting their CRS as uncontrolled. The 22‐item Sinonasal Outcome Test score was also predictive of patient‐reported CRS disease control but OSS was significantly more predictive.Patients conceptually view patient‐reported CRS control as a more global measure that subsumes OSS. Quantitatively, however, OSS is highly correlated with patient‐reported CRS control, possibly reflecting their redundancy. For ease of use, we recommend patient‐reported CRS control be reflected by OSS <4 for controlled, 4 ≤ OSS < 7 for partly controlled, and OSS ≥7 for uncontrolled CRS. [ABSTRACT FROM AUTHOR]

Background: Opioid-reduced multimodal analgesia has been used clinically for many years to decrease the perioperative complications associated with opioid drugs. We aimed to assess the clinical effects of opioid-reduced anesthesia during thoracoscopic sympathectomy. Methods: Surgical patients (n = 151) with palmar hyperhidrosis were randomly divided into control (Group C, 73 patients) and test (Group T, 78 patients) groups. All patients were administered general anesthesia using a laryngeal mask. In Group C, patients received propofol, fentanyl, and cisatracurium for anesthesia induction, and maintenance was achieved with propofol and remifentanil, along with mechanical ventilation during the operation. In Group T, anesthesia was induced with propofol, dezocine, and dexmedetomidine (DEX) and maintained with propofol, DEX, and an intercostal nerve block, along with spontaneous breathing throughout the operation. Perioperative complications related to opioid use include hypotension, bradycardia, hypertension, tachycardia, hypoxemia, nausea, vomiting, urine retention, itching, and dizziness were observed. To assess the impact of these complications, we recorded and compared vital signs, blood gas indices, visual analogue scale (VAS) scores, adverse events, and patient satisfaction between the two groups. Results: Perioperative complications related to opioid use were similar between groups. There were no significant differences in the type of perioperative sedation, analgesia index, respiratory and circulatory indicators, blood gas analysis, postoperative VAS scores, adverse reactions, propofol dosage, postoperative recovery time, and patient satisfaction. Conclusions: In minimally invasive surgeries such as thoracoscopic sympathectomy, opioid-reduced anesthesia was found to be safe and effective; however, this method did not demonstrate clinical advantages. Trial registration: Chinese Clinical Trial Register: ChiCTR2100055005, on December 30, 2021. [ABSTRACT FROM AUTHOR]

Background: Pulsed radiofrequency (PRF) treatment targeting the greater occipital nerve (GON) has shown efficacy in treating various conditions. This double-blind, randomized controlled study aimed to evaluate the effects of combining PRF therapy with GON block (GONB) therapy in patients with chronic migraine. Methods: The study consisted of two groups: GONB and GONB + PRF, each comprising 16 patients with chronic migraine. Using 0.5-Hz sensorial stimulation, a 5-cm-long radiofrequency needle was inserted under ultrasound guidance in both groups. Subsequently, all patients received a GONB by administering 2 mL of 0.25% bupivacaine. In the GONB + PRF group, patients underwent 4 min of PRF at 42℃, whereas the GONB group did not receive any PRF treatment. Follow-up examinations were performed at 1, 2, 3 and 6 months after the procedure to evaluate the frequency and severity of migraine attacks, number of headache days, and analgesic consumption. Results: In the GONB + PRF group, the visual analog scale (VAS) score, number of migraine attacks, number of headache days, and analgesic consumption were significantly lower compared to the GONB group (P < 0.05). Significant decreases (60%) in mean VAS scores, number of migraine attacks, number of headache days, and consumption of analgesic medications were observed in the GONB + PRF group at the 1-, 2-, 3-, and 6-month follow-ups compared with the pre-treatment period (P < 0.05). Conclusions: The combination of GONB and PRF presents a promising new treatment option for patients with chronic migraine. This approach has demonstrated efficacy in minimizing analgesic use, decreasing the frequency of migraine attacks, reducing the number of headache days and decreasing the severity of migraine attacks. Trial Registration: NCT05464212. [ABSTRACT FROM AUTHOR]

Objective: Foot massage is known to be effective on the emotional state (anxiety, depression, etc.) in the postoperative period. However, studies on its effect on functional level are insufficient. Aim: The study aimed to investigate the impact of foot plantar massage on functional recovery in older adults undergoing general surgery, employing a randomized clinical trial design. Methods: A total of 70 older adults aged 65 years and above who underwent abdominal surgery were included. Various assessments were conducted, including pain levels (Visual Analogue Scale), fear of mobility (Tampa Scale for Kinesiophobia), functional independence (Functional Independence Measure), balance (Berg Balance Scale), basic mobility (Rivermead Mobility Index), mental function status (Standardized Mini-Mental State Examination), and delirium (Nu-DESC). Results: Statistically significant differences were observed in some assessment parameters within the groups during the 2nd and 3rd measurement times, with the intervention group demonstrating significant mean differences. Discussions: The literature underscores the increase in kinesiophobia scores post-general/abdominal surgery in older adults, emphasizing the importance of evaluating functional level and kinesiophobia to expedite discharge processes and potentially plan early post-discharge rehabilitation to mitigate readmissions for functional reasons. Conclusions: Ultimately, foot massage was found to be effective in reducing kinesiophobia, improving balance, mobility, daily living skills, and mental status in older adults post-abdominal surgery, thereby advocating for the facilitation of post-discharge rehabilitation programs or the reduction of readmission rates. The clinical trials number: NCT05534490. [ABSTRACT FROM AUTHOR]

Background: Studies have found that in healthy individuals without nasal disease, changes in posture cause an increase in nasal resistance, especially in the prone posture. Many patients with obstructive sleep apnea syndrome (OSAS) sleep in a prone posture, but no studies have examined the effect of this change in posture on nasal resistance in patients with OSAS. Therefore, we conducted this study to investigate this posture-related physical phenomenon in individuals with OSAS. Methods: We evaluated the nasal patency of 29 patients diagnosed with OSAS using the visual analog scale (VAS), acoustic rhinometry, and video-endoscopy in the sitting, supine, and prone postures. Results: In the OSAS group, both supine and prone postures significantly influenced subjective nasal blockage and led to a notable reduction in the minimal cross-sectional area (mCSA) as determined by acoustic rhinometry, compared to the sitting posture. The prone posture exhibited a more pronounced effect than the supine posture. Endoscopic evaluations further revealed increased hypertrophy of the inferior turbinate in the supine posture for the right nasal passage and the prone posture for the left. However, no significant differences were observed between the prone and supine postures. Conclusion: In OSAS patients, nasal resistance significantly increased in supine and prone postures compared to sitting, with the prone posture showing a greater effect. Clinicians should consider a patient's habitual sleep posture and the effects of postural changes when assessing OSAS severity and devising treatment plans. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]

Background: Migraine is an episodic disorder and a frequent form of headache. An impaired balance between free radical production and an impaired antioxidant defense system leading to oxidative damage may play a major role in migraine etiology. We sought to investigate whether dietary antioxidant quality score (DAQS) is associated with migraine intensity and frequency among women suffering from migraine. Methods: This cross-sectional study was conducted on 265 women. The data related to anthropometric measures and dietary intake were collected. DAQS score was calculated based on FFQ (food frequency questionnaire) vs. the reference daily intake (RDI) quantity. To measure migraine intensity, the migraine disability assessment questionnaire (MIDAS) and visual analog scale (VAS) were used. The frequency of headaches was defined as the days the participants had headaches in the last month and a 30-day headache diary was used. Results: The results of the study demonstrated that VAS, MIDAS, and frequency of headaches were reduced significantly from the low DAQS (poor quality of antioxidants) to high DAQS (high quality of antioxidants) after adjusting covariates. Also, multinomial regression showed there was an inverse association between higher DAQS and the frequency of headaches. In the adjusted model, subjects with the higher DAQS were 69% less likely to have moderate migraine disability, compared with those with the lower DAQS. Linear regression showed, there was an inverse association between vitamin C intake and the grades of pain severity.َAlso in a crude model, a negative association was found between vitamin E and the frequency of headaches. Conclusion: In conclusion, Participants with higher DAQS had lower migraine intensity and headache frequency. In addition, the consumption of vitamin C may potentially associate with decreasing the severity of headaches. Dietary antioxidants should be monitored closely in individuals suffering from migraine. [ABSTRACT FROM AUTHOR]

Study Design: A technical note and retrospective case series. Objective: Highly upward-migrated lumbar disc herniation (LDH) is challenging due to its problematic access and incomplete removal. The most used interlaminar approach may cause extensive bony destruction. We developed a novel translaminar approach using the unilateral portal endoscopic (UBE) technique, emphasizing effective neural decompression, and preserving the facet joint's integrity. Methods: This retrospective study included six patients receiving UBE translaminar discectomy for highly upward-migrated LDHs from May 2019 to June 2021. The migrated disc was removed through a small keyhole on the lamina of the cranial vertebra. The treatment results were evaluated by operation time, hospital stays, complications, visual analog scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) score, and modified MacNab criteria. Results: The mean pre-operative VAS for back pain (5.0 ± 4.9), VAS for leg pain (9.2 ± 1.0), JOA score (10.7 ± 6.6), and ODI (75.7 ± 25.3) were significantly improved to 0.3 ± 0.5, 1.2 ± 1.5, 27.3 ± 1.8, 5.0 ± 11.3 respectively at the final follow-up. Five patients had excellent, and one patient had good outcomes according to the Modified MacNab criteria. The hospital stay was 2.7 ± 0.5 days. No complication was recorded. The MRI follow-up showed complete disc removal, except for one patient with an asymptomatic residual disc. Conclusions: UBE translaminar discectomy is a safe and effective minimally invasive procedure for highly upward-migrated LDH with satisfactory treatment outcomes and nearly 100% facet joint preservation. [ABSTRACT FROM AUTHOR]

Background: Thoracoscopic-guided thoracic paravertebral nerve block (TG-TPVB) and thoracoscopic-guided intercostal nerve block (TG-INB) are two postoperative analgesia technology for thoracic surgery. This study aims to compared the analgesic effect of TG-TPVB and TG-INB after uniportal video-asssited thoracic surgery (UniVATS). Methods: Fifty-eight patients were randomly allocated to the TG-TPVB group and the TG-INB group. The surgical time of nerve block, the visual analog scale (VAS) scores, the consumption of sufentanil and the number of patient-controlled intravenous analgesic (PCIA) presses within 24 h after surgery, the incidence of adverse reactions were compared between the two groups. Results: The VAS scores were significantly lower during rest and coughing at 2, 6, 12, and 24 h in the TG-TPVB group than in the TG-INB group (P < 0.05). The consumption of sufentanil and the number of PCIA presses within 24 h after surgery were significantly lower in the TG-TPVB group than in the TG-INB group (P < 0.001).The surgical time of nerve block was significantly shorter in the TG-TPVB group than in the TG-INB group (P < 0.001). The incidence of bleeding at the puncture point was lower in the TG-TPVB group than that in the TG-INB group (P < 0.05). Conclusion: TG-TPVB demonstrated superior acute pain relieve after uniVATS, shorter surgical time and non-inferior adverse effects than TG-INB. [ABSTRACT FROM AUTHOR]

Background: Over the past three decades, our understanding of sleep apnea in women has advanced, revealing disparities in pathophysiology, diagnosis, and treatment compared to men. However, no real-life study to date has explored the relationship between mask-related side effects (MRSEs) and gender in the context of long-term CPAP. Methods: The InterfaceVent-CPAP study is a prospective real-life cross-sectional study conducted in an apneic adult cohort undergoing at least 3 months of CPAP with unrestricted mask-access (34 different masks, no gender specific mask series). MRSE were assessed by the patient using visual analog scales (VAS). CPAP-non-adherence was defined as a mean CPAP-usage of less than 4 h per day. The primary objective of this ancillary study was to investigate the impact of gender on the prevalence of MRSEs reported by the patient. Secondary analyses assessed the impact of MRSEs on CPAP-usage and CPAP-non-adherence depending on the gender. Results: A total of 1484 patients treated for a median duration of 4.4 years (IQ25–75: 2.0–9.7) were included in the cohort, with women accounting for 27.8%. The prevalence of patient-reported mask injury, defined as a VAS score ≥ 5 (p = 0.021), was higher in women than in men (9.6% versus 5.3%). For nasal pillow masks, the median MRSE VAS score for dry mouth was higher in women (p = 0.039). For oronasal masks, the median MRSE VAS score for runny nose was higher in men (p = 0.039). Multivariable regression analyses revealed that, for both women and men, dry mouth was independently and negatively associated with CPAP-usage, and positively associated with CPAP-non-adherence. Conclusion: In real-life patients treated with long-term CPAP, there are gender differences in patient reported MRSEs. In the context of personalized medicine, these results suggest that the design of future masks should consider these gender differences if masks specifically for women are developed. However, only dry mouth, a side effect not related to mask design, impacts CPAP-usage and non-adherence. Trial Registration: InterfaceVent is registered with ClinicalTrials.gov (NCT03013283).First registration date is 2016–12-23. [ABSTRACT FROM AUTHOR]

Object: Evaluation of the impact of patients' participation on postoperative recovery and satisfaction who underwent the Percutaneous Endoscopic Interlaminar Discectomy(PEID). Methods: We collected data from sixty-nine patients who underwent PEID surgery at Chuzhou Chinese and Western Medicine Hospital between January 2020 and December 2022. All patients had L5/S1 lumbar disc herniation and met the inclusion and exclusion criteria. The patients were divided into two groups: non-communication group (n = 33) and communication group (n = 36). The division was made based on whether the patients had preoperative surgical video viewing and intraoperative communication. We compared the baseline data, surgical time, VAS score, lumbar JOA score, surgical complications, and patient satisfaction between the two groups. Result: The communication group showed better pain control and functional recovery in the early postoperative period. The communication group had better VAS scores on the first day and month after surgery, as well as JOA scores on the first week and month after surgery, with statistically significant differences (P < 0.05). There was no significant difference in hospital stay, VAS score, JOA score, and postoperative complications between the two groups of patients at 3 and 6 months after surgery. The communication group had higher patient satisfaction (P < 0.05). Conclusion: Preoperative surgical video viewing and intraoperative communication by PEID patients can alleviate pain, accelerate functional recovery, improve symptoms, and increase patients' satisfaction. We need to do more work to develop this new model. [ABSTRACT FROM AUTHOR]

Introduction: This study clarified the expression changes and clinical significance of CD44+CD62L− Treg and CD44−CD62L+ Treg subsets in the peripheral blood of patients with allergic rhinitis (AR). Methods: The peripheral blood of 39 patients with AR and 42 healthy controls was collected. Clinical data, such as sex, age, IgE titer, allergen screening information and visual analogue scale (VAS) score, were recorded. Changes in serum IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ were detected using the cytometric bead array method. Flow cytometry was used to detect the proportions of Th1, Th2, Th17, TFH, and Th9 cells and the proportions of CD44+CD62L− Treg and CD44−CD62L+ Treg subsets. Correlation analysis was performed between the CD44+CD62L− Treg subsets and the CD44−CD62L+ Treg subsets with clinical indicators (VAS score, total IgE titer), cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ), and Th1/Th2/Th17/TFH/Th9 cell proportions. Results: Compared to the control group, the proportion of total Treg cells and CD44+CD62L− Treg cells in the AR group decreased, and the proportion of CD44−CD62L+ Treg cells increased (p < 0.05). The proportions of CD44+CD62L− Treg cells significantly negatively correlated with Th2 cells (R = −0.5270, p < 0.05) and positively correlated with Treg cytokine IL-10 (R = 0.6447, p < 0.05). In addition, CD44+CD62L− Treg cells negatively correlated with the VAS score (R = −0.4956, p < 0.05), total IgE level (R = −0.4177, p < 0.05) and Th2 cytokine IL-6 level (R = −0.3034, p < 0.05) but positively correlated with the Th1 cytokine IL-2 (R = 0.4331, p < 0.05). In contrast, the proportion of CD44+CD62L− Treg cells significantly positively correlated with the Th2 cells (R = 0.6187, p < 0.05). Moreover, the proportion of CD44−CD62L+ Treg cells positively correlated with the VAS score (R = 0.4060, p < 0.05), total IgE level (R = 0.5224, p < 0.05) and Th2 cytokine IL-4 (R = 0.2647, p < 0.05) and IL-6 levels (R = 0.3824, p < 0.05) but negatively correlated with Th1 cytokine IL-2 (R = −0.3451, p < 0.05) and IL-10 (R = −0.3277, p < 0.05). Conclusion: A greater proportion of CD44+CD62L− Tregs correlated with better reversal of the Th1/Th2 imbalance and milder clinical symptoms in AR patients. The presence of more CD44−CD62L+ Tregs correlated with a weaker immunosuppressive effect on Th2 cells and more severe clinical symptoms in AR patients. These findings provide new perspectives for the treatment and disease monitoring of AR. [ABSTRACT FROM AUTHOR]

Effective regulation of emotions is essential in coping with everyday stressors. Although cognitive reappraisal and acceptance are both commonly employed to downregulate negative emotions, they differ in many aspects. Their effectiveness in real‐life situations can also be influenced by prior stress or a person's trait preferences for certain emotion regulation (ER) strategies. In the present study, we compared the effectiveness of both ER strategies in a laboratory setting, while focussing on the effect of stress and trait moderators. Ninety‐eight healthy participants aged 18–40 were randomly divided into three groups with instructions to use reappraisal, acceptance, or nothing while viewing distressing pictures from the IAPS database. Half of the participants in each group underwent a laboratory stressor (socially evaluated cold pressor test) 20–30 min before the ER task. The effectiveness of ER was measured subjectively on the visual analog scale, and by measuring heart rate, skin conductance, and pupil responses. The data show that cognitive reappraisal lowered subjectively experienced negative emotion, while acceptance did not. These group differences were however not supported by psychophysiological indicators. Secondly, although the laboratory stressor elicited cortisol stress responses in our participants, we did not find any effect on ER. Furthermore, the data has not supported the moderation effect by trait reappraisal and acceptance. The present findings show that deliberate usage of ER strategies when viewing emotionally charged pictures leads to a decrease in experienced emotion. On the other hand, the effects of stress and trait moderators were not supported, therefore they may be smaller and more variable than expected. [ABSTRACT FROM AUTHOR]

Background: Migraine is a primary headache defined as moderate-to-severe pain lasting 4 to 72 h, ranking 2nd among the disabling conditions for both genders regardless of the age and the greater occipital nerve (GON) block has been reported as an efficient treatment method for migraine. The present study aims to evaluate and compare the efficiency of the two methods of GON block, i.e., the ultrasound (US)-guided technique and the landmark-based technique. Method: Having a prospective and randomized design, the study assigned the patients with chronic migraine into two groups after which a neurologist performed landmark-based GON block in the first group while an algologist performed US-guided GON block in the second group. During the 3-month follow-up period, the number of days with pain, the duration of pain, the number of analgesic drugs taken in a month, and Visual Analogue Scale (VAS) scores were compared with the values ​​before treatment and at the 1st week, 1st month, and 3rd month after treatment. Results: US-guided GON block group included 34 patients while there were 32 patients in the landmark-based GON block group. US-guided GON block group showed significantly reduced VAS scores and frequency of attacks compared to the landmark-based GON block group at Month 1 after the procedure. After a 3-month follow-up period of the two groups, the frequency of attacks, analgesic intake and the duration of attacks were lower in both groups compared to the baseline. At 3-month follow-up, the mean of VAS scores decreased from 9,47 ± 2,69 to 4,67 ± 1,9 in US-guided GON block group and from 9,46 ± 0,98 to 7 ± 2,5 in the landmark-based GON block group. Conclusion: It was determined that both US-guided and landmark-based GON block were efficient techniques in patients with chronic migraine. US-guided GON block technique resulted in lower VAS scores, shorter durations of pain, lower frequencies of attack, and lower intake of analgesics compared to the landmark-based GON block technique. [ABSTRACT FROM AUTHOR]

Background: This study retrospectively compared short-term clinical outcomes and complications of minimally invasive surgery transforaminal lumbar interbody fusion(MIS-TLIF)and endoscopic lumbar interbody fusion(Endo-LIF))for two-segmental lumbar degenerative disease, aiming to guide spine surgeons in selecting surgical approaches. Methods: From January 2019 to December 2023, 30 patients were enrolled,15 in the MIS-TLIF group and 15 in the Endo-LIF group. All patients were followed up for more than 3 months after surgery and the following information was recorded: (1)surgery time, difference in hemoglobin between preoperative and postoperative, surgical costs, first time out of bed after operation, postoperative hospitalization time, postoperative complication; (2) ODI score (The Oswestry Disability Index), leg and back VAS score (Visual Analogue Scale), and lumbar vertebra JOA score (Japanese Orthopaedic Association Scores); (3) MacNab score at final follow-up to assess clinical outcome, CT to evaluate lumbar fusion. Results: There were significant differences between the two groups regarding operation time and cost, with the MIS-TLIF group performing significantly better. Intraoperative bleeding was considerably less in the Endo-LIF group compared to the MIS-TLIF group. However, there were no significant differences in the time of the first postoperative ambulation, postoperative hospitalization time, and postoperative complications. There was no significant difference in preoperative VAS, ODI, and JOA between the two surgical groups There were no significant differences in VAS(leg), ODI, and JOA scores between the two groups before and at 1 day,7 days, 1 month, 3 months and final follow-up. However, at 1 day postoperatively, the VAS(back)score in the Endo-LIF group was lower than that in the MIS-TLIF group, and the difference was statistically significant. At the final follow-up, all patients achieved grade III and above according to the Bridwell criteria, and there was no significant difference between the two surgical groups compared to each other. According to the MacNab score at the final follow-up, the excellent rate was 80.00% in the Endo-LIF group and 73.33% in the MIS-TLIF group, with no significant difference between the two groups. Conclusion: There was no significant difference in short-term efficacy and safety between Endo-LIF and MIS-TLIF for two-segment degenerative lumbar diseases. MIS-TLIF has a shorter operative time and lower costs, while Endo-LIF causes less tissue damage, blood loss, and early postoperative pain, aiding long-term recovery. Both MIS-TLIF and Endo-LIF are promising for treating two-segment lumbar degenerative disease. The choice of a surgical procedure depends on the patient's financial situation, their ability to tolerate surgery, and the surgeon's expertise. [ABSTRACT FROM AUTHOR]

Background: Nonspecific neck pain (NSNP) is a well-established global burden affecting. It is also a common problem in Pakistan. The burden of neck pain is also increasing day by day due to poor work ergonomics, and increased use of computers and mobiles after the pandemic. An individual's poor posture is often associated with forward head posture (FHP). Limited evidence is available about the effects of neck stabilization (NSE) and dynamic exercises (NDE) for nonspecific neck pain particularly in patients with FHP. This aimed to compare the effects of NSE versus NDE among patients having NSNP with FHP in reducing pain, disability, forward head posture and improving neck range of motion. Methods: It is a single-blinded randomized clinical trial with 60 patients aged 18–40 years, with moderate intensity NSNP for > 3 weeks and < 6 months along with FHP with a moderate disability on neck disability index (NDI) randomly assigned to the treatment groups. Group 1 was doing NSE and group 2 was doing NDE. Transcutaneous Electical Nerve Stimulation, cold packs, and stretching exercises were given to both groups. A total of 9 sessions (3 sessions/ week) were given to participants. NDI questionnaire, Visual analogue scale (VAS), goniometry, and plumb line measurement tool were used as baseline and assessment at the end of 3rd week. The data was analyzed on SPSS version 21. Descriptive analysis was performed. Independent t-test was used for between group comparison and paired t-test used for within group comparison. A p-value less than 0.05 was considered statistically significant. Results: After treatment within-group analysis of both NSE and NDE showed significant (p < 0.001) improvement in pain on VAS, all ROMs of the neck including flexion, extension, left and right lateral flexion and left rotation, plumb line and NDI score with very large effect size. However, between-group analysis showed non-significant differences (p > 0.05) for post-treatment mean VAS, neck ROM, NDI and plumb line measurement. Conclusion: Between NSE and NDE, no one is more beneficial than another. Both are equally effective in alleviating pain, increasing ROM, decreasing functional disability, and improving forward head posture in patients with NSNP. Trial Registration: Registered trial at ClinicalTrials.gov Identifier: NCT05298631, 28/03/2022, prospectively registered. [ABSTRACT FROM AUTHOR]

Objective Background Methods Results Conclusions This study was conducted to assess the efficacy of daily 2000 mg eicosapentaenoic acid (EPA) supplementation in individuals with chronic migraine.Chronic migraine is characterized by a minimum of 15 headache days/month, necessitating a focus on preventive treatment strategies. EPA, a polyunsaturated fatty acid recognized for its anti‐inflammatory properties, is examined for its potential effectiveness in chronic migraine management.A randomized, blinded, placebo‐controlled trial of eligible participants with a confirmed diagnosis of chronic migraine were enrolled. The intervention group received 1000 mg of EPA twice daily for 8 weeks, while the control group received two placebo softgels. Symptoms were recorded at 4 and 8 weeks. The primary outcome was assessed using the Headache Impact Test‐6 to evaluate changes in patients. Secondary outcomes encompassed migraine headache days, headache severity measured via a visual analog scale, and the number of consumed painkillers. Descriptive analyses were reported in mean (± standard deviation [SD]).A total of 60 patients were included in the study and finally, 56 patients completed the study according to the protocol, including 47 (84%) females. The data comparison at baseline did not show any significant difference between the two groups except in the number of patients using valproic acid as prophylaxis (21 patients in the EPA group, and 13 in the placebo group; p = 0.037). The results showed after 8 weeks, a mean (SD) difference of Headache Impact Test‐6 in the EPA and placebo groups was −6.96 (3.34) and −4.43 (5.24), respectively (p = 0.084). Regarding migraine headache days, participants reported a mean (SD) −9.76 (4.15) and −4.60 (4.87) decline in days with headache, respectively (p < 0.001). The number of attacks per month after 8 weeks was 3.0 (95% confidence interval [CI] 2.0–4.0) and 4.0 (95% CI 3.0–6.0), respectively (p < 0.001). Regarding severity, there was no significant difference between the two groups (mean [SD] difference: −0.76 [1.13] and –0.73 [1.04], respectively; p = 0.906). In terms of adverse events, two patients in the EPA group reported intolerable nausea and vomiting, and one patient in the placebo group reported dizziness.This study's findings support the potential of a daily 2000 mg EPA as a prophylactic pharmacotherapy in chronic migraine management, specifically in mitigating migraine attacks, migraine headache days, and overall quality of life. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Equinovarus deformity correction was performed by soft tissue release and bone deformity correction, and tendon transfer to maintain deformity correction. Because of the high complication rate of tendon fixation methods, partial or total anterior tibial tendon or posterior tibial tendon transfer to the peroneus tertius tendon was reported. The purpose of this study was (i) to review the results of this tendon transfer technique after release and correction of talipes equinovarus, and (ii) to analyze the complication of this technique.Between February 2017 and May 2022, 176 patients (210 feet) with equinus and/or varus foot and ankle deformities underwent anterior or posterior tibial tendon transfer to the peroneus tertius in our institute. Preoperative and postoperative foot and ankle range of motion (passive and active) were checked. The postoperative radiographic assessment included antero‐posterior (AP), lateral, and hindfoot alignment radiographs. Preoperative and postoperative lateral tibio‐talar, talo‐calcaneal, talo‐first metatarsal, tibial‐sole angles, hindfoot alignment, and anterior subluxation of the talus were checked. The American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot scale, and visual analog scale (VAS) were used to assess pain. Paired Student's t‐test was used to compare the clinical scores and radiographic angles before the operation and at the last follow‐up.The mean age of the patients was 23.27 ± 13.44 years (range, 3–69 years). The mean follow‐up time was 25.56 ± 16.37 months (range, 12–68 months). There were significant differences between the preoperative and postoperative measurements of the lateral tibio‐talar angle, lateral talo‐calcaneal angle, lateral talo‐first metatarsal angle, lateral tibial‐sole angle, and hindfoot alignment (p < 0.001). There was significant difference between the preoperative and postoperative AOFAS and VAS scores (p < 0.001). The early complications included infection in one patient, skin necrosis in two patients, and plantar numbness in three patients. The late complications included pin infection in three patients, tibio‐talar joint compression in four patients, forefoot pain in two patients, toe flexion in two patients, and plantar numbness in one patient. There were three cases of complications (1.43%) related to the transferred tendons.Tibialis anterior or posterior tendon transfer to the peroneus tertius is a safe and effective method for equinovarus deformity correction. It yielded excellent outcomes that produced high patient satisfaction and few complications. [ABSTRACT FROM AUTHOR]

Background: The analgesia after lower third molar alveolectomy is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) that have significant risks, and are contraindicated in the third trimester of pregnancy. Aiming to reduce NSAIDs use after this surgery, we quantified analgesic effects of ultrasound (US)-guided extraoral mandibular nerve block. Methods: Thirty-six patients were equally allocated to the experimental or control group, based on their willingness to receive experimental US-guided extraoral mandibular nerve block for postoperative analgesia. The experimental block applied prior to lower third molar alveolectomy, was followed by standard intraoral inferior alveolar nerve block. In the control group, patients received only intraoral block of inferior alveolar nerve. All patients reported pain level (visual analogue scale, VAS) right after the application of blocks. The next day, patients reported duration of pain-free time and the use of analgesic. Results: The US-guided extraoral mandibular nerve block prolonged the pain-free time to 8 h (vs. 4 in control group, P < 0.001) and reduced NSAIDs use (12 patients needed analgesic in experimental vs. 17 patients in control group, P = 0.038). The application of experimental block was less painful (VAS = 2) than the application of intraoral inferior alveolar nerve block (VAS = 4, P = 0.011). In 8/18 patients in the experimental group US-guided extraoral mandibular nerve block solely achieved adequate surgical anesthesia. Conclusion: US-guided extraoral mandibular nerve block prolonged pain-free period and reduced the use of NSAIDs after lower third molar alveolectomy, thus proving to be successful analgesia method for this dental surgery. Clinical trial registration: https://classic.clinicaltrials.gov/ct2/show/NCT06009302, identification number: NCT06009302, date of registration: 18/08/2023. [ABSTRACT FROM AUTHOR]

Background: The bronchial suction has been applied in speeding lung collapse. Low suction pressure may not speed lung collapse, but high pressure causes occult lung injury. The aim of the study was to explore efficacy and safety of different suction pressure for speeding lung collapse. Methods: Eighty-four subjects undergoing uniport video-assisted thoracoscopic surgery (VATS) were randomly assigned for non-suction (Group 0), -10 cmH2O suction pressure (Group − 10), and − 30 cmH2O suction pressure (Group − 30). The primary outcome were the lung collapse scores (LCS) at 0 min (T0) after the visualization of the lung using a 10-point visual analogue scale and area under the curve (AUC) of LCS over time. The secondary outcomes included disconnection from the ventilator, the assessment of occult lung injury using NOS-3 expression, histologic scores of lung injury, and lung W/D weight ratio, intraoperative hypoxemia, the incidence of perioperative pulmonary complications. Results: Both the LCS at T0 and AUC analysis showed that compared with Group 0, Group − 10 and Group − 30 significantly achieved good lung collapse (P < 0.05), but no difference between Group − 10 and Group − 30. Four patients in Group 0 were treated with disconnection maneuver. The assessment of occult lung injury showed no differences. Conclusions: Applying − 10 cmH2O suction pressure for 1 min when pleural incision is a relatively safe method to promote lung collapse without the occurrence of occult lung injury. Trial registration: Chinese Clinical Trial Registry number, ChiCTR2200062991. Registered on 26/08/2022. [ABSTRACT FROM AUTHOR]

Background: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. Objectives: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. Methods: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. Results: The PFP group exhibited less trunk flexion (SLS, p =.006; SD, p =.016) and greater forward knee displacement (SLS, p =.001; SD, p =.004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p =.074; SD, p =.278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = −0.439, p =.000; SD, r = −0.365, p =.004) and ankle dorsiflexion (SLS, r = −0.339, p =.008; SD, r = −0.356, p =.005). Conclusion: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to evaluate the possible benefits of using video consent in the preoperative ureteroscopy (URS) consent process. Material and Methods: Prospective randomized trials took place at two Italian tertiary-care centers from March 2022 to September 2022. Patients were randomly assigned to two groups: Group A (standard verbal/written informed consent) and Group B (informed consent supported by video). We investigated the impact of both types of informed consent on patient anxiety levels using the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire both pre- and post-consent. In addition, using the Visual Analogue Scale, analysis of the effect of informed consent on postoperative pain and the number of calls for assistance during hospitalization as secondary outcomes was done. To assess the satisfaction level related to the whole process, patients were asked to rate their experience on a scale of 1–10, with 1 indicating "not satisfied" and 10 indicating "completely satisfied." Results: Overall, 166 patients were randomized 1:1 in each group. The multivariable regression model demonstrated that video-assisted informed consent significantly increased the difference between post- and pre-consent STAI with a reduced level of anxiety. The video-assisted informed consent significantly predicted the number of assistance calls during hospitalization. Conclusions: Video consent for ureteroscopies is a valid tool to improve procedure awareness and satisfaction. Video consent is able to reduce procedure-related patient anxiety and postoperative assistance calls, thus proving to be useful in obtaining better-informed consent for endourological procedures. [ABSTRACT FROM AUTHOR]

Background: Chronic low back pain (CLBP) is a prevalent condition that significantly impacts quality of life. Conventional treatments often provide limited relief, prompting exploration of alternative therapies such as yoga. This study aimed to evaluate the effectiveness of yoga practice in the management of CLBP in a sample population from Ranchi. Materials and Methods: A prospective, randomized trial was conducted over a period of one month. A total of 50 participants diagnosed with CLBP were randomly assigned to either a yoga intervention group or a control group receiving standard care. The yoga group participated in guided yoga sessions three times a week, each lasting 60 minutes. Pain levels were measured using the Visual Analog Scale (VAS) at baseline and after the intervention. Functional disability was assessed using the Oswestry Disability Index (ODI). Results: At the end of the study, participants in the yoga group showed a significant reduction in pain scores, with mean VAS scores decreasing from 7.5 ± 1.2 to 3.4 ± 0.9 (p < 0.001). The control group exhibited a marginal decrease in pain, with mean VAS scores reducing from 7.3 ± 1.3 to 6.8 ± 1.1 (p > 0.05). Additionally, the yoga group demonstrated an improvement in functional disability, with ODI scores decreasing from 45.7% to 22.3%, compared to the control group, which showed no significant change in ODI scores (p < 0.001). Conclusion: The findings suggest that yoga is an effective intervention for reducing pain and improving functional outcomes in individuals with chronic low back pain. Incorporating yoga into treatment plans for CLBP may offer significant benefits, particularly for patients seeking non-pharmacological options. [ABSTRACT FROM AUTHOR]

Introduction: Subarachnoid block is the most commonly used anaesthetic technique for caesarean sections. Post-dural puncture headache (PDPH) is an iatrogenic complication of spinal anaesthesia. Reported risk factors for PDPH include sex, age, pregnancy, needle tip shape and size, bevel orientation, approach and others. The aim of this study is to assess the incidence of postdural puncture headache in the median and paramedian approach using 25G Whitacre spinal needle in pregnant females undergoing caesarean section. Materials and methods: After obtaining institutional ethical committee approval,100 patients of ASA I and ASAII of pregnant women undergoing caesarean section belonging to age group of 18-35 years randomized by computer generated numbers into two groups (50 each) after fulfilling inclusion criteria. The patients were randomized to receive spinal anaesthesia by either a median (n=50) approach or paramedian approach (n=50). After informed written consent, all patients were premedicated with Inj.Metoclopromide 10mg and all patients received 500ml of Normal saline intravenously over 30minutes before the procedure. Each patient received 9-12mg of hyperbaric bupivacaine with 25G Whitacre spinal needle either through median approach(group M, n=50) or paramedian approach(group PM, n=50).The patients were followed for 48 hours for PDPH, presence of PDPH was assessed by visual numerical analogue scale. Results: Out of total 100 caesarean section patients, six patients developed PDPH. 4/50(8%) had PDPH in median approach and 2/50(4%) had PDPH in paramedian approach. However the difference in incidence of PDPH in both median and paramedian approaches is not statistically significant (p value=0.4000) and the severity of PDPH in both groups was of mild degree. Conclusion: Even though we noticed the incidence of PDPH is less with 25G Whitacre spinal needle in paramedian approach compared to median approach, but there was no significant statistical difference on incidence of PDPH using 25 G Whitacre spinal needle between median and paramedian approach in caesarean section patients. [ABSTRACT FROM AUTHOR]

Background: Modified radical mastectomy (MRM) with axillary lymph node clearance causes acute postoperative pain (40%) and chronic postoperative pain (60%). Aim and objective: post operative analgesia in MRM surgery through surgical drains. Methods: This study was conducted on patients undergoing elective surgery of MRM under general anesthesia in Pacific Medical College & Hospital, Udaipur. Patients were divided into two groups, 30 in each. Group B –Group B patients receive 40ml of 0.25% injection bupivacaine. Group C –Group C patients receive no drug. Duration of analgesia was recorded in hours when the the patient was shifted after surgery in the post anesthesia care unit until the patient feel pain and discomfort of more than 4 scores according to the visual analog pain scale chart . Results: All the demographic data were comparable (p value >0.05). The mean period of time during which analgesia was observed was significantly higher in Group B as compared to Group C (9.83±1.71 vs 4.03±1.25 hours, p=0.005). Conclusion: We hereby concluded that postoperative pain analgesia is improved on instillation of bupivacaine through surgical drain on wound bed in MRM patients. [ABSTRACT FROM AUTHOR]

Postoperative pain is acute with complex physiological responses to tissue injury. Epidural technique using opioids has been found to provide better pain relief than systemic opioids and also decreased incidence of postoperative complications. AIMS AND OBJECTIVES The aim of this study was to compare the onset, duration, quality of analgesia, cardio-respiratory effects and side effects of epidural butorphanol with epidural fentanyl for the relief of postoperative pain. METHODOLOGY 60 patients of either sex, age group of 18- 60 years, belonging to ASA grade Ι and ΙΙ, posted for elective lower abdominal surgeries were selected. They were randomly divided into 2 groups of 30 each. All surgeries were done under lumbar epidural anaesthesia. Postoperatively, when patient complained of pain, intensity of pain was assessed using Linear Visual analog scale (VAS) and when VAS score was >5, patients received either epidural butorphanol 2mg or epidural fentanyl 100µg diluted to 10ml with normal saline. Onset of analgesia, which is the time interval from administration of study drug till VAS score came down to < 5 was noted in both groups. Duration of analgesia, which is the time interval between start of analgesia (VAS score < 5) till patient complaints of pain (VAS score >5) was noted in both groups. Quality of analgesia was assessed using pain score in both the groups. Cardio-respiratory effects, heart rate, blood pressure and respiratory rate were monitored at regular intervals and were compared between the 2 groups. Side effects like sedation, pruritus, nausea, vomiting, hypotension and respiratory depression were noted. RESULTS Demographic profile (age, sex) was comparable in both groups. The onset of analgesia was clinically and statistically significantly late (6minutes) in butorphanol group when compared to fentanyl group (3minutes). Duration of analgesia was longer in butorphanol group (350 minutes) in comparison to fentanyl group (230 minutes) which was clinically and statistically significant. Quality of analgesia was better in butorphanol group. Sedation was the main side effect in butorphanol group. Incidence of pruritus, vomiting, hypotension and respiratory depression was more in fentanyl group. CONCLUSION Epidural butorphanol provides delayed onset but longer duration and better quality of analgesia than fentanyl with paucity of clinically significant side effects with both groups. [ABSTRACT FROM AUTHOR]

Background: Chronic urticaria (CU) is a persistent condition characterized by recurrent hives and itching, often resistant to standard treatments. Subcutaneous Histaglobulin, an immunomodulatory agent, has emerged as a potential therapeutic option for refractory CU. This study aims to evaluate the efficacy and safety of SC Histaglobulin in managing patients with refractory chronic urticaria. Methods: A clinical evaluation was conducted with 50 patients diagnosed with refractory CU. Participants received SC Histaglobulin (2 mL weekly) for 8 weeks. Outcomes were assessed using the Urticaria Activity Score (UAS7), Dermatology Life Quality Index (DLQI), and visual analog scale (VAS) for pruritus. Data were collected at baseline, during treatment, and at 4 weeks post-treatment. Statistical analyses included paired t-tests and Wilcoxon signed-rank tests. Results: The mean UAS7 score decreased significantly from 31.4 ± 6.2 at baseline to 12.1 ± 5.4 at the end of the treatment (p < 0.001), with 40% of patients achieving complete symptom resolution. DLQI scores improved from 15.8 ± 4.3 to 6.4 ± 3.1 (p < 0.001), and VAS scores for pruritus reduced from 7.6 ± 1.4 to 2.5 ± 1.1 (p < 0.001). SC Histaglobulin was well-tolerated, with mild adverse events reported. Conclusion: SC Histaglobulin is an effective and well-tolerated treatment for refractory chronic urticaria, significantly improving symptoms and quality of life. The study supports the use of SC Histaglobulin as a viable therapeutic option in this challenging patient population, although further research is needed to confirm these findings and explore long-term outcomes. [ABSTRACT FROM AUTHOR]

Although ubiquitous in numerous nightlife cultures, poker-machines present a high risk for problematic use and addiction. Previous research has demonstrated that gambling cues (e.g., flashing lights) can activate gambling urges in poker-machine gamblers. However, the processes that contribute to the maintenance of cue-reactive urges to gamble remain unclear. Consequently, the present study explored whether positive schizotypy predicted gambling urge, and whether cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. Seventy adults aged between 19 and 68 (M = 48.86, SD = 12.82) participated in an online cue-reactivity experiment. Participants first completed the Problem Gambling Severity Index and the Unusual Experiences subscale of the Short Oxford-Liverpool Inventory of Feelings and Experiences. Subsequently, at three time points (i.e., baseline, directly after a neutral cue, and directly after a gambling cue) participants completed the Altered State of Awareness, Altered Time Sense, and Absorption subscales of the Phenomenology of Consciousness Inventory and a visual analogue scale measuring cue-reactive urge to gamble. It was found that positive schizotypy was significantly positively correlated with cue-reactive urge to gamble. Additionally, cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. The theoretical, clinical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the contributors to self-rated health in people with late-stage Parkinson's disease (PD) and cognitive impairment. Methods: A secondary analysis of baseline data from the international Care of Late-Stage Parkinsonism (CLaSP) cohort study was conducted. Participants with PD and either dementia or mild cognitive impairment or MMSE < 24/30 in the absence of major depression were included if they had completed the EQ-5D-3L assessment (n = 277). Factors associated with self-rated health (EQ-5D-3L Index and Visual Analogue Scale) were investigated through multivariable linear regression. Results: More severe PD (motor and non-motor) was associated with worse self-rated health. The EQ-5D-3L dimensions of Mobility, Self-Care and Usual Activities were almost universally affected; the latter two particularly severely. Being unable to perform usual activities or having moderate to extreme anxiety or depression were significantly associated with EQ-5D-3L Visual Analogue Scale, suggesting these are particularly valued. Worse motor impairment and function and the non-motor symptom domains of mood, perception, sexual function, and miscellaneous (e.g., pain) were associated with worse self-rated health, whereas greater burden of gastrointestinal symptoms was associated with better self-rated health in multivariate analysis. Better self-rated health was associated with recent PD nurse consultation, and higher doses of dopaminergic medication. Conclusion: Improvement of activities of daily living, mood and anxiety should be prioritised in clinical practice, with consideration of perception and sexual function in this population. Recent nurse consultations and higher antiparkinsonian doses are associated with better self-rated health, suggesting there is no room for a therapeutic nihilism in this population of people within a complex phase of PD. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia (FM) is a chronic disorder characterized by widespread pain associated with fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depression. The role of Vitamin D in the pathophysiology of FM is poorly known. Studies available to establish the association between Vitamin D and FM have inconsistent results. Some of the studies reported a positive association and others found no relation. It is not clear whether the pain is due to and/or associated with low levels of Vitamin D. Aims and Objectives: The objective of the current study is to estimate Vitamin D levels in FM patients and to find the association between Vitamin D levels and severity of FM. Materials and Methods: In this cross-sectional study, seventy patients who fulfilled the inclusion (American College of Rheumatology 2016 criteria) and exclusion criteria as has been considered for the study were enrolled and their serum 25 hydroxy-vitamin D level has been measured by enzyme-linked immunosorbent assay reader. Pre-designed questionnaires were prepared to measure FM severity. Pain intensity was measured by the Visual Analog Scale (VAS). Results: A total of 70 patients who were diagnosed with FM were included in our study. The majority of them (80%) were female and the rest (20%) were male. The mean age is 48.2±9.2 years. Their mean body mass index (BMI) is 23.7±3.82. The mean Vitamin D serum level was 22.4±9.2 ng/dL. Vitamin D deficiency (VDD) was defined as patients with a serum level of 20 ng/mL and below. In our study, 62.8% (44) of the study population had VDD. According to VAS (0-10) pain scale, 15 (21.4%) subjects suffered from moderate pain and 55 (78.6%) subjects suffered from severe pain. The severity of FM was measured by the Fibromyalgia Severity Scale (FSS). The mean score of FSS was 22.7. To find the association between VDD and severity of FM, several covariates were identified and a multivariable logistic regression was done. Conclusion: VDD increases with an increase in age, BMI, VAS, and FSS, all of which are predicators of FM syndrome. [ABSTRACT FROM AUTHOR]

Background and objective: There is a need for simple functional test to assess treatment response in chronic pulmonary aspergillosis (CPA) in resource-constrained settings. The one-minute-sit-to-stand test (1-min-STS) is one such test. However, the minimal important difference (MID) for 1-min-STS in subjects with CPA remains unknown. Herein, we estimate the MID for 1-min-STS for CPA subjects. Materials and Methods: We retrospectively reviewed the clinical details of CPA subjects treated with oral azoles for 6 months. We included only subjects who completed the 1-min-STS test at baseline and 6 months. We used the change in VAS (visual analogue scale, for overall improvement) as an external anchor. We used the anchor and the distribution (standard deviation-based) methods to determine the MID estimates. We used the anchor-based method only if there was correlation of 0.3 with the 1-min-STS test. Results: One hundred-eight subjects completed the 1-min-STS test at baseline and 6 months. We did not find significant correlation between the change in VAS for overall improvement (r² = 0.024, P value = 0.809) and the 1-min-STS test. The MID for the 1-min-STS test was 2 repetitions (range, 1.5--2.8 repetitions). Conclusion: The MID for the 1-min-STS test in subjects with CPA was 2 repetitions. Future studies using a global rating of change scale as an anchor must confirm our findings. [ABSTRACT FROM AUTHOR]

To investigate the association between resilience and outcomes of pain and neck-related disability after single- and double-level anterior cervical discectomy and fusion (ACDF). Patients who underwent single- or double-level ACDF were sent a survey between 6 months and 2 years after surgery. The survey included the Brief Resilience Scale (BRS), visual analogue scale (VAS) for pain, Neck Disability Index (NDI), and Pain Self-Efficacy Questionnaire (PSEQ-2). Patients completed the VAS and NDI twice, once describing preoperative pain and disability and once describing current pain and disability. Respondents were classified as high resilience (HR), medium resilience (MR), or low resilience (LR). Demographics, PSEQ-2 scores, pre- and postoperative VAS and NDI scores, and change in VAS (ΔVAS) and NDI (ΔNDI) scores were compared between groups. Thirty-three patients comprised the HR group, 273 patients comprised the MR group, and 47 patients comprised the LR group. All groups demonstrated postoperative improvement in VAS and NDI scores that exceeded previously established MCID values. The HR group demonstrated greater improvement in pain compared with the LR group (ΔVAS: –5.8 for HR vs. –4.4 for LR, P = 0.05). Compared with the MR group, the LR group demonstrated greater postoperative pain (VAS: 3.2 for LR vs. 2.5 for MR, P = 0.02) and disability (NDI: 11.9 for LR vs. 8.6 for MR, P = 0.02). Patients demonstrated improvement in pain and neck-related disability after single- and double-level ACDF, regardless of resilience score. Patients with greater resilience may be expected to demonstrate more improvement in pain after ACDF. [ABSTRACT FROM AUTHOR]