The potential of Pinus caribaea Morelet sawdust for the removal of nickel ions (Ni²⁺) and other metallic trace ions (Co²⁺, Cr³⁺, Mn²⁺) from aqueous solutions was investigated under batch conditions. Several parameters such as size of particles, contact time, pH, initial metal and biomass concentrations, desorption conditions and reusability were evaluated on natural biomass. Biosorption was fast, effective (73%) and biomaterial can be reused after five cycles. To enhance the removal capacity of nickel, pine sawdust was modified by acidic and oxidative treatments. Cellulosic residues from sawdust sequential extraction showed great biosorption capacity (96%). In the presence of a metal mixture, oxidized sawdust had better selectivity for Cr³⁺ ions than for Ni²⁺ . Pinus caribaea biomass could be an environmental, inexpensive and renewable material for the depollution of water laden with metallic trace elements.

Keywords: Biomass recycle; Modified sawdust; Nickel; Pinus caribaea Morelet; Water treatment.

Keywords: AHO, Albright hereditary osteodystrophy; Albright hereditary osteodystrophy; G protein; GNAS; GPCR; PHP, pseudohypoparathyroidism; PTH, parathyroid hormone; genodermatoses; pseudopseudohypoparathyroidism.

A successful case of crossover replantation of the left foot to the stump of the right leg was described. The lower extremities were amputated at different levels. On the left side, there was a complete amputation in the distal part of the lower leg with comminuted fracture of the distal tibia. On the right side, there was a complete amputation in the hindfoot with comminuted fracture of both the talus and calcaneus. Since anatomical replantation was impossible, we performed crossover replantation of the left foot to the right lower leg. At the latest follow-up examination, forty-six months after the accident, the patient walked independently with a prosthesis on the stump of the left leg. Crossover replantation should be considered in bilateral amputations for the salvage of at least one extremity.

Keywords: Replantation; Traumatic amputation.

Dislocation of the polyethylene insert is a rare complication of total knee arthroplasty (TKA), which has only been described in a handful of case reports. Here, we describe a report of a 55-year-old woman presenting 13 months after the primary TKA with signs of neurovascular compromise. A magnetic resonance image showed posterior extrusion of her polyethylene insert causing a mass effect on the gastrocnemius muscle and the popliteal neurovascular bundle. A multidisciplinary team including a joint reconstruction surgeon, vascular surgeon, and nerve specialist performed a revision TKA with peroneal nerve decompression. The polyethylene insert was noted to be dislocated, rotated 90 degrees, and incarcerated in the posterior knee.

Keywords: Complications; Neurovascular compromise; Polyethylene extrusion; Popliteal artery; Total knee arthroplasty.

Whiteflies are insect vectors that affect a variety of plants such as tomatoes, cabbages, sweet potatoes, eggplants, and cassava. In Uganda, whiteflies are a major contributor to the spread of Cassava Brown Streak Disease (CBSD). By suckling on infected cassava plants, whiteflies can potentially transfer the Cassava Brown Streak Virus that causes CBSD to uninfected clean plants nearby when they migrate. When they attack the cassava plants in large numbers, whiteflies can also cause significant physical damage through suckling. This eventually can lead to leaf loss or plant death. Whiteflies also excrete "honeydew", which harbors a fungus known as "sooty mold" that covers the leaves, limiting access to sunlight which in turn affects plant food production. As part of their work, the cassava breeders often conduct studies to assess the population of whiteflies in cassava fields through a manual process of visual inspection which can be arduous and time-consuming. This paper presents a cassava whitefly dataset that has been curated to enable researchers to build solutions for the automation of the count and detection of whiteflies. The dataset contains 3,000 images captured in a whitefly trial site in Uganda. It depicts different variations of whitefly infestation from low to high infestation. This data has already been used to provide a proof-of-concept solution for whitefly counting based on Machine Learning approaches.

Keywords: CBSD; Cassava; Whitefly; Whitefly count.

Soil is a naturally occurring non-renewable resource, and good soil quality is a prerequisite for the survival of plants, animals and humans. Soil quality depends on the content and distribution of trace elements. Gold mining in the Witwatersrand Basin in South Africa left behind enormous unrehabilitated mining waste tailings near the City of Johannesburg that are contaminated by trace elements. Heavy metals change the physical and chemical properties of the soil derived from the mining waste material, consequently disturbing the normal functions of the soil and posing a potential health risk to plants, animals, and humans. To assess soil quality from abandoned historical gold mine residues, three conglomerate samples were petrologically examined using hand specimen, polished thin sections viewed under a reflected light microscope, and X-ray diffraction, to determine the mineralogical composition. The minerals include quartz, mica, chlorite, calcite and sulphides. Geochemical data of major elements measured by weight percent (wt%) were generated using X-ray fluorescence (XRF) technique and are NiO < Cr₂O₃ < V₂O₅ < ZrO₂ < MnO < P₂O₅ < TiO₂ < Al₂O₃ < CaO < MgO < Na₂O < K₂O < Fe₂O₃ < SiO₂. The geochemistry of trace elements, pH, and electrical conductivity (EC), were determined from 21 soil samples. The samples were collected from 30 to 150 cm depths from nine sites and investigated using inductively coupled plasma optical emission spectroscopy (ICP-EOS) and XRF. ICP-EOS data (mg/kg): Fe > S > Cu > Mn > Cr > Zn > Ni > Co > Mo > P, and XRF data (mg/kg): S > F > Cl > V > Cr > Zn > Co > Cu > Ni > Mo. The trace elements data are variable in the tailing soil than in the crustal background soil. According to ICP-EOS data, the surveyed sites show increased Cu content, pH values of 1.9-5.3 and EC values of 43-679 mS/m, indicating soil contamination.

Keywords: Contamination factor; Geoaccumulation index; Land use type; Potential health risks; Trace elements enrichment.

Keywords: DIF, direct immunofluorescence; medication side-effects; vasculitis.

The IL-23/IL-17 axis plays an important role in the development of autoimmune diseases, but the mechanism regulating IL-23 production is mainly unknown. We investigated how TNFAIP3 and Sp1 affect IL-23 production by human macrophages after exposure to resiquimod, a TLR7/8 agonist. IL-23 production was significantly upregulated by resiquimod but only slightly by LPS (a TLR4 agonist). Interestingly, IL-23 levels were significantly attenuated after sequential stimulation with LPS and resiquimod, but IL-12p40 and IL-18 levels were not. TLR4-related factors induced by LPS may regulate IL-23 expression via TLR7/8 signaling. LPS significantly enhanced TNFAIP3 and IRAK-M levels but reduced Sp1 levels. After exposure to resiquimod, RNA interference of TNFAIP3 upregulated IL-23 significantly more than siRNA transfection of IRAK-M did. In contrast, knockdown of Sp1 by RNA interference significantly attenuated IL-23 production. Transfection with siRNA for TNFAIP3 enhanced IL-23 expression significantly. After stimulation with resiquimod, GW7647-an agonist for PPARα (an inducer of NADHP oxidase)-and siRNA for UCP2 (a negative regulator of mitochondrial ROS generation) enhanced TNFAIP3 and reduced IL-23. siRNA for p22phox and gp91phox slightly increased Sp1 levels. However, after exposure to resiquimod siRNA-mediated knockout of DUOX1/2 significantly enhanced Sp1 and IL-23 levels, and decreased TNFα-dependent COX-2 expression. Concomitantly, TNFAIP3 levels was attenuated by DUOX1/2 siRNA. TNFAIP3 and Sp1 levels are reciprocally regulated through ROS generation. In conclusion, after stimulation of the TLR7/8 signaling pathway IL-23 production in human macrophages is regulated negatively by TNFAIP3.

Keywords: Human macrophage; IL-23; IRAK-M; Specificity protein 1; TNFAIP3.

Left bundle branch block (LBBB) is associated with specific septal-to-lateral wall activation patterns which are strongly influenced by the intrinsic left ventricular (LV) contractility and myocardial scar localization. The objective of this study was to propose a computational-model-based interpretation of the different patterns of LV contraction observed in the case of LBBB and preserved contractility or myocardial scarring. Two-dimensional transthoracic echocardiography was used to obtain LV volumes and deformation patterns in three patients with LBBB: (1) a patient with non-ischemic dilated cardiomyopathy, (2) a patient with antero-septal myocardial scar, and (3) a patient with lateral myocardial scar. Scar was confirmed by the distribution of late gadolinium enhancement with cardiac magnetic resonance imaging (cMRI). Model parameters were evaluated manually to reproduce patient-derived data such as strain curves obtained from echocardiographic apical views. The model was able to reproduce the specific strain patterns observed in patients. A typical septal flash with pre-ejection shortening, rebound stretch, and delayed lateral wall activation was observed in the case of non-ischemic cardiomyopathy. In the case of lateral scar, the contractility of the lateral wall was significantly impaired and septal flash was absent. In the case of septal scar, septal flash and rebound stretch were also present as previously described in the literature. Interestingly, the model was also able to simulate the specific contractile properties of the myocardium, providing an excellent localization of LV scar in ischemic patients. The model was able to simulate the electromechanical delay and specific contractility patterns observed in patients with LBBB of ischemic and non-ischemic etiology. With further improvement and validation, this technique might be a useful tool for the diagnosis and treatment planning of heart failure patients needing CRT.

Keywords: cardiac resynchronization therapy; left bundle branch block; left ventricular deformation; myocardial scar; personalized computational model.

The aim of this qualitative systematic review is to summarize and analyze the different modalities of exercise training and its potential effects in patients on extracorporeal membrane oxygenation (ECMO) support. ECMO is an outbreaking, life-saving technology of the last decades which is being used as a gold standard treatment in patients with severe cardiac, respiratory or combined cardiorespiratory failure. Critically ill patients on ECMO very often present intensive care unit-acquired weakness (ICU-AW); thus, leading to decreased exercise capacity and increased mortality rates. Early mobilization and physical therapy have been proven to be safe and feasible in critically ill patients on ECMO, either as a bridge to lung/heart transplantation or as a bridge to recovery. Rehabilitation has beneficial effects from the early stages in the ICU, resulting in the prevention of ICU-AW, and a decrease in episodes of delirium, the duration of mechanical ventilation, ICU and hospital length of stay, and mortality rates. It also improves functional ability, exercise capacity, and quality of life. Rehabilitation requires a very careful, multi-disciplinary approach from a highly specialized team from different specialties. Initial risk assessment and screening, with appropriate physical therapy planning and exercise monitoring in patients receiving ECMO therapy are crucial factors for achieving treatment goals. However, more randomized controlled trials are required in order to establish more appropriate individualized exercise training protocols.

Keywords: assessment; early mobilization; exercise training; extracorporeal membrane oxygenation (ECMO); intensive care unit-acquired weakness (ICU-AW); rehabilitation.

Background: Previous animal studies reported an association of non-steroidal anti-inflammatory drugs (NSAIDs) with adverse outcomes in acute myocarditis, which is why these drugs are currently not recommended in affected patients. In this retrospective case-control study, we sought to investigate the effects of NSAID treatment in patients with acute myocarditis and myopericarditis to complement the available evidence. Method: A total of 114 patients with acute myocarditis were retrospectively enrolled. Demographical, clinical and laboratory data were extracted from hospital records. Patients who received NSAIDs (n = 39, 34.2%) were compared to controls. Follow-up on all-cause mortality was acquired for two years. Propensity score matching was additionally conducted to account for covariate imbalances between groups. Results: Treatment with NSAIDs was neither associated with a worse outcome (p = 0.115) nor with significant differences in left ventricular systolic function (p = 0.228) or in-hospital complications (p = 0.507). Conclusion: Treatment with NSAIDs was not associated with adverse outcomes in our study cohort. Together with the findings of previous studies, our results indicate that these drugs could be safely administered in patients with myocarditis and myopericarditis.

Keywords: NSAID; NSAR; acetylsalicylic acid; aspirin; cardiology; ibuprofen; inflammation; myocarditis.

(1) Background: In cardiomyopathies, identification of genetic variants is important for the correct diagnosis and impacts family cascade screening. A classification system was published by the American College of Medical Genetics and Genomics (ACMG) in 2015 to standardize variants' classification. The aim of the study was to determine the rate of reclassification of previously identified variants in patients with childhood-onset cardiomyopathies. (2) Methods: Medical records of patients and their relatives were screened for clinical and genetic information at the Department of Congenital Heart Defects and Pediatric Cardiology, German Heart Center Munich. Patients without an identified genetic variant were excluded from further analyses. Previously reported variants were reevaluated by the ACMG criteria in November 2021. (3) Results: Data from 167 patients or relatives of patients with childhood-onset cardiomyopathy from 137 families were analyzed. In total, 45 different genetic variants were identified in 71 individuals. Classification changed in 29% (13/45) with the greatest shift in "variants of unknown significance" to "(likely) benign" (9/13). (4) Conclusions: In patients with childhood-onset cardiomyopathies, nearly a third of reported genetic variants change mostly to more benign classes upon reclassification. Given the impact on patient management and cascade screening, this finding underlines the importance of continuous genetic counseling and variant.

Keywords: cardiomyopathy; childhood; genetic; molecular genetic diagnosis; pediatric; variant.

Environmental microbes living in communities engage in complex interspecies interactions that are challenging to decipher. Nevertheless, the interactions provide the basis for shaping community structure and functioning, which is crucial for ecosystem service. In addition, microbial interactions facilitate specific adaptation and ecological evolution processes particularly essential for microbial communities dwelling in resource-limiting habitats, such as the deep oceans. Recent technological and knowledge advancements provide an opportunity for the study of interactions within complex microbial communities, such as those inhabiting deep-sea waters and sediments. The microbial interaction studies provide insights into developing new strategies for biotechnical applications. For example, cooperative microbial interactions drive the degradation of complex organic matter such as chitins and celluloses. Such microbiologically-driven biogeochemical processes stimulate creative designs in many applied sciences. Understanding the interaction processes and mechanisms provides the basis for the development of synthetic communities and consequently the achievement of specific community functions. Microbial community engineering has many application potentials, including the production of novel antibiotics, biofuels, and other valuable chemicals and biomaterials. It can also be developed into biotechniques for waste processing and environmental contaminant bioremediation. This review summarizes our current understanding of the microbial interaction mechanisms and emerging techniques for inferring interactions in deep-sea microbial communities, aiding in future biotechnological and therapeutic applications.

Keywords: community function; correlation network analysis; deep sea; microbial community; microbial interactions.

Human coronaviruses (HCoV) are causative agents of mild to severe intestinal and respiratory infections in humans. In the last 15 years, we have witnessed the emergence of three zoonotic, highly pathogenic HCoVs. Thus, early and accurate detection of these viral pathogens is essential for preventing transmission and providing timely treatment and monitoring of drug resistance. Herein, we applied enhanced darkfield hyperspectral microscopy (EDHM), a novel non-invasive, label-free diagnostic tool, to rapidly and accurately identify two strains of HCoVs, i.e., OC43 and 229E. The EDHM technology allows collecting the optical image with spectral and spatial details in a single measurement without direct contact between the specimen and the sensor. Thus, it can directly map spectral signatures specific for a given viral strain in a complex biological milieu. Our study demonstrated distinct spectral patterns for HCoV-OC43 and HCoV-229E virions in the solution, serving as distinguishable parameters for their differentiation. Furthermore, spectral signatures obtained for both HCoV strains in the infected cells displayed a considerable peak wavelength shift compared to the uninfected cell, indicating that the EDHM is applicable to detect HCoV infection in mammalian cells.

Keywords: enhanced darkfield hyperspectral microscopy (EDHM); human coronavirus (HCoV); plaque assay.

Background: The effect of PPM in mechanical prostheses on long-term survival is not well-established.

Methods: Patients who received a 21 mm or smaller aortic valve between 2000 and 2011 were retrospectively analyzed (n = 416). Propensity matching was used in order to account for baseline differences in patient subgroups (PPM vs. no PPM; severe PPM vs. no severe PPM).

Results: Five- and ten-year survival was 78 ± 3.52% and 64.51 ± 4.51% in patients with PPM, versus 83.3 ± 3.12% and 69.37 ± 4.36% in patients without (p = 0.28) when analyzed at 10.39 ± 5.25 years after the primary procedure. Independent risk factors for impaired survival, after matching, were age, serum creatinine, and severe pulmonary hypertension. Five- and ten-year survival in patients with severe PPM was 73.34 ± 6.01% and 61.76 ± 8.17%, respectively, versus 74.72 ± 5.68% and 67.50 ± 7.09% in those without (p = 0.49), at 8.82 ± 5.17 years after SAVR. Age was the only independent variable that influenced long-term survival when severe PPM was added to the model.

Conclusions: PPM or severe PPM does not impact long-term survival up to 10 years in mechanical valve recipients when matching for preoperative variables.

Keywords: aortic valve; mechanical valve; patient–prosthesis mismatch; propensity matching.

Enzymatic hydrolysates from Oysters (OAH) display multiple biological activities. Previously, a 3~5 KDa oyster ultrafiltration component (OUP) showed a high property of preventing skin oxidation. Subsequently, we identified specific peptides with such activity. OUP was fractionated stepwise by Sephadex-G25 and RP-HPLC, and active fractions were screened using UV-irradiated HaCaT cells. The most active fractions (OP5-3) were analyzed by LC-MS/MS and a total of 17 peptides were identified. Results from mass spectrometry showed that OP5-3 consisted of peptides with a molecular weight range of 841.51-1786.92 Da. Six of these peptides were synthesized for validating the activity of resisting skin oxidation in the same cell model. All six peptides showed varying degrees of antioxidant activity, while pretreatment of HaCaT cells with AIVAEVNEAAK alleviated UV cytotoxicity, inhibited metalloproteinase 1 (MMP-1) expression, and showed the highest activity to resist UV-induced skin photo-oxidation among these peptides. In addition, results from molecular docking analysis of MMP-1 with AIVAEVNEAAK showed that AIVAEVNEAAK suppresses its enzymatic activity by directly interacting with MMP-1 and thus exhibit anti-photoaging activity.

Keywords: HaCaT cells; oyster; peptides; photo-oxidation.

Switchable and reversible optical elements have potential applications in self-adaptive optics. Shape-memory polymer devices with adaptive properties could be easily switched under environment or field stimuli. Here, the laser beam interference technique was used to realize the periodic grating structures of the shape-memory polymer, and memory and recovery of the grating structures were performed. A one-dimensional grating structure was fabricated from dual-beam interference lithography of a nanosecond laser and underwent pressure in a condition of 195°C. The vertical height of the grating was reduced, and the diffraction light was weakened. When the sample was cooled down to room temperature, the morphology of the grating could be kept. After raising the ambient temperature of the sample to 120°C, the morphology of the grating was recovered to the original state, which realized the shape-memory function.

Aims: To identify the prevalence of major and minor electrocardiographic abnormalities and their association with the main risk factors for cardiovascular disease in a population in the province of Bengo, northern Angola.

Methods: A cross-sectional community-based study was conducted and a representative random sample stratified by sex and age was selected. In total, 2379 black individuals were included in the final analysis. A standard 12-lead ECG were recorded from all participants, analyzed and processed by the University of Glasgow software and coding by the Minnesota code.

Results: 22.3% of participants had minor electrocardiographic abnormalities and 4.58% major ECG abnormalities. The most common minor ECG abnormalities were abnormal T wave inversion, minor isolated ST abnormalities and premature beats. The most common major ECG abnormalities were Left ventricular hypertrophy with major ST-T abnormalities, Ventricular conduction defects and major Q-wave abnormalities. Hypertension, diabetes mellitus, hypercholesterolemia, alcohol consumption and smoking, were significantly associated with major and minor electrocardiographic abnormalities.

Conclusions: In this study several participants had minor and major electrocardiographic abnormalities. Minor electrocardiographic abnormalities were more prevalent in men and major abnormalities in women. The electrocardiographic abnormalities had significant associations with the main cardiovascular risk factors.

Keywords: Angola; Cardiovascular risk factors; ECG; Major and minor electrocardiographic abnormalities.

Globalization and climate change facilitate the spread and establishment of invasive species throughout the world via multiple pathways. These spread mechanisms can be effectively represented as diffusion processes on multi-scale, spatial networks. Such network-based modeling and simulation approaches are being increasingly applied in this domain. However, these works tend to be largely domain-specific, lacking any graph theoretic formalisms, and do not take advantage of more recent developments in network science. This work is aimed toward filling some of these gaps. We develop a generic multi-scale spatial network framework that is applicable to a wide range of models developed in the literature on biological invasions. A key question we address is the following: how do individual pathways and their combinations influence the rate and pattern of spread? The analytical complexity arises more from the multi-scale nature and complex functional components of the networks rather than from the sizes of the networks. We present theoretical bounds on the spectral radius and the diameter of multi-scale networks. These two structural graph parameters have established connections to diffusion processes. Specifically, we study how network properties, such as spectral radius and diameter are influenced by model parameters. Further, we analyze a multi-pathway diffusion model from the literature by conducting simulations on synthetic and real-world networks and then use regression tree analysis to identify the important network and diffusion model parameters that influence the dynamics.

Keywords: diffusion processes; invasive species; multi-scale networks; network models; simulation analytics; spatial networks.

Here, we report a rare case of lung adenocarcinoma with intrapulmonary metastases that have "spread through air spaces" (STAS) by means of the alveoli and bronchioles. The peripheral intrapulmonary metastases were exhibiting pure ground-glass nodules along the bronchioles on computed tomography. The primary pathologic diagnosis was micropapillary adenocarcinoma with prominent tumor STAS. Histopathologic examination revealed that the cancer cells in the bronchioles around the primary tumor revealed micropapillary clusters on the mucosal surface or in the air spaces and reached peripheral intrapulmonary metastatic nodules. Notably, no vascular and stromal invasion was observed. The pathologic findings suggest that cancer cells are viable in the airspace of the bronchioles and alveoli and may support the significance of STAS as a pattern of airborne metastasis.

Keywords: Case report; Lung adenocarcinoma; Micropapillary adenocarcinoma; Tumor-spread through air spaces (STAS).

Hundreds of different fast-growing Salix hybrids have been developed mainly for energy crops. In this paper, we studied water extracts from the bark of 15 willow hybrids and species as potential antimicrobial additives. Treatment of ground bark in water under mild conditions extracted 12-25% of the dry material. Preparative high-performance liquid chromatography is proven here as a fast and highly efficient tool in the small-scale recovery of raffinose from Salix bark crude extracts for structural elucidation. Less than half of the dissolved material was assigned by chromatographic (gas chromatography and liquid chromatography) and spectroscopic (mass spectrometry and nuclear magnetic resonance spectroscopy) techniques for low-molecular-weight compounds, including mono- and oligosaccharides (sucrose, raffinose, and stachyose) and aromatic phytochemicals (triandrin, catechin, salicin, and picein). The composition of the extracts varied greatly depending on the hybrid or species and the harvesting season. This information generated new scientific knowledge on the variation in the content and composition of the extracts between Salix hybrids and harvesting season depending on the desired molecule. The extracts showed high antibacterial activity on Staphylococcus aureus with a minimal inhibitory concentration (MIC) of 0.6-0.8 mg/mL; however, no inhibition was observed against Escherichia coli, Enterococcus faecalis, and Salmonella typhimurium. MIC of triandrin (i.e., 1.25 mg/mL) is reported for the first time. Although antibacterial triandrin and (+)-catechin were present in extracts, clear correlation between the antibacterial effect and the chemical composition was not established, which indicates that antibacterial activity of the extracts mainly originates from some not yet elucidated substances. Aquatic toxicity and mutagenicity assessments showed the safe usage of Salix water extracts as possible antibacterial additives.

Keywords: antimicrobial activity; mutagenicity; raffinose; toxicity; triandrin; water extract; willow bark.

Background: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge.

Methods: A randomized, non-inferiority clinical trial (385 patients) evaluated every hour immediate postoperative pain during 24 h, using a verbal rating 11-point scale for patient self-reporting of pain (VRS11). All patients received subarachnoid anesthesia and were randomly allocated in 4 groups: single shots femoral (FNB) or adductor canal blocks (ACB), both with dexamethasone (dex) and buprenorphine (bup). Patients received intravenous analgesia (metamizole magnesium, dexketoprofen) and rescue analgesia when needed: intravenous (paracetamol and morphine) and/or regional (femoral and sciatic nerve blocks). Demographics and adverse effects were also recorded.

Results: A 45.7% of patients had pain: bupACB 56.3%, bupFNB 50.0%, dexACB 40.6% and dexFNB 36.1% (p=0.022). Rescue analgesia was needed in 37.7% of patients (p=0.128). There were statistical differences in percentage of timepoints without pain (95.0±7.9%, p=0.014) and mean VRS11 (0.18±0.3, p=0.012) but no differences in distribution of intensity periods of pain. There were no significant differences in the need of rescue analgesia excepting the use of intravenous morphine (p=0.025).

Conclusions: buprenorphine is in the present trial inferior to dexamethasone by less than the established non-inferiority limit when used as perineural adjuvant in femoral nerve or adductor canal blocks in total knee arthroplasty analgesia. So, it could be considered an alternative in patients where dexamethasone is contraindicated, such as diabetics.

Objectives: The aim of this study was to evaluate the prevalence and severity of overactive bladder syndrome (OAB) and sexual dysfunction in fibromyalgia (FM) patients, as well as their relationship with disease severity.

Methods: Consecutive adult female patients with FM were enrolled. Patients filled in a comprehensive questionnaire package including demographic variables, disease severity assessment (revised Fibromyalgia Impact Questionnaire [FIQR]), neuropathic pain features (PainDetect Questionnaire [PDQ]), severity of OAB symptoms (Overactive Bladder Symptom Score [OABSS]), and determining sexual functioning (Female Sexual Function Index [FSFI]).

Results: The study included 481 patients, 116 (24.11%) had mild OAB, 82 patients (17.04%) had moderate OAB, and 34 patients had serious OAB (7.06%). In 14.17% of patients the bladder condition was causing them major issues in terms of discomfort. In 7.87% of patients the bladder condition was causing them significant problems. Sexual dysfunctions were found in 91 patients (18.91%). Using the FSFI as dependent variable, multivariate analysis revealed a positive relationship between sexual dysfunction and variables of disease burden (FIQR, p<0.0001; PDQ, p<0.0001, widespread pain index [WPI], p=0.0037). Using OABSS as the dependent variable, multivariate regression revealed a substantial contribution from FIQR (p<0.0001), PDQ (p=0.0037), and WPI (p=0.0030).

Conclusions: FM has the potential to affect both psychological and physiological processes in women with OAB and sexual dysfunction. These results emphasize the importance of a multidisciplinary approach to treat patients with overactive bladder syndrome and sexual dysfunction in FM.

Background: Root exit zone (REZ) compression by a fusiform vertebral artery (VA) aneurysm is a rare cause of hemifacial spasm (HFS). We report a case of successful microvascular decompression (MVD) for the treatment of HFS caused by a fusiform VA aneurysm. We also review the relevant literature and demonstrate the effectiveness of surgical treatment.

Case description: A 64-year-old man presented with a 2-year and 4-month history of progressive involuntary facial twitching on the right side. Radiological examination revealed a fusiform right VA aneurysm. The REZ that was compressed by the aneurysm and the underlying anterior inferior cerebellar artery (AICA) was surgically decompressed by transposing the VA and AICA and wrapping the aneurysm. Immediately post-operation, the patient's symptoms disappeared. For 7 years and 4 months postoperatively, there was no symptom recurrence or increase in aneurysm size.

Conclusion: MVD is an effective treatment for HFS caused by a fusiform VA aneurysm because symptoms are likely to improve immediately after treatment.

Keywords: Fusiform aneurysm; hemifacial spasm; microvascular decompression; vertebral artery aneurysm.