Case Report: Borrelia-DNA Revealed the Cause of Arthritis and Dermatitis During Treatment With Rituximab
Borrelia-specific antibodies in serum did not contribute to the diagnosis of Borrelia arthritis or Borrelia-associated dermatitis in a young woman with ongoing treatment with rituximab due to multiple sclerosis. The diagnosis was confirmed by the detection of Borrelia-DNA in a skin punch biopsy. The patient history did not reveal any tick exposure. She had suffered for several months from fluctuating pain and swelling of the right knee as well as skin involvement with redness and oedema around the ankle of the same leg. Monoarthritis was confirmed by a rheumatologist. Knee puncture was performed but the synovial fluid was only sufficient for microscopic examination of crystals. Neither monosodium urate crystals nor calcium pyrophosphate crystals were found. Borrelia serology in blood revealed borderline levels of immunoglobulin (Ig)M and IgG, respectively. Treatment with doxycycline resulted in resolution of the joint and skin manifestations within a month. This case highlights that Borrelia-specific antibody levels cannot be reliably interpreted in patients who have received B-cell depleting therapy. Under these circumstances, detection of the bacterial genome in different body fluids, such as in the skin, can be a useful complement to the diagnosis of Lyme disease. In this young female, the diagnosis would certainly have been further delayed without the detection of Borrelia-DNA in the skin.
CASES: Two patients presented with medial chest pain and deformity after high-speed motor vehicle accidents (MVAs) in which they were restrained drivers. Physical examination revealed retraction of the pectoralis major from the sternum on resisted adductio...
I'm taking care of an outpatient patient: 60y/o woman with chronic abdominal pain with prior history of gastric bypass, appendectomy, incisional hernia repair. Her pain had been previously controlled with oxycodone 10mg a couple times a day, but recently less effective due to emesis. GI is following now, has her on Zofran, Reglan, Promethazine but the nausea is still pretty severe. Patient is cachectic and having trouble with PO intake. Utox is appropriate. I'm considering a Fentanyl patch... Read more
NEW YORK (Reuters Health)—Lower doses of cannabidiol (CBD) failed to provide any meaningful reduction in pain when added to other analgesic therapy in patients with hand osteoarthritis (OA) or psoriatic arthritis (PsA) in a randomized, placebo-controlled study from Denmark.1 Writing in the journal, Pain, Jonathan Vela, MD, and colleagues of Aalborg University note that CBD... [Read More]
ConclusionsThese findings suggest that social disruption –induced stress pre-exposure may upregulate accumbal TRPV1 receptor expression and consequently aggravate acid-induced writhing. Group testing prevents such stress pre-exposure escalation of acid-induced writhing most likely by strengthening the GABAergic inhibition on local neural activity in the medial septum.
Do oral medical cannabis or cannabinoids work in chronic pain? Here's what the evidence says.Medscape Medical News
This study aims to systematically review and synthesize the evidence on the safety data from the published COVID-19 vaccine trials. This study followed PRISMA guidelines. We searched three major electronic databases (PubMed, Embase, and Google Scholar) for published studies between Dec 2019 and 2020. Eligible study designs were randomized trials and pre-and post-intervention evaluations. Descriptive findings of included studies were reported stratified by target population, setting, outcomes, and overall results. From PubMed, Embase, WHO database, and Google Scholar screened titles and abstracts, 11 studies were identified...
Soft Matter, 2021, Accepted Manuscript DOI: 10.1039/D1SM00517K, PaperAditi Chakrabarti, Salem Al-Mosleh, L. Mahadevan When a thin stream of aqueous sodium alginate is extruded into a reacting calcium chloride bath, it polymerizes into a soft elastic tube that spontaneously forms helical coils due to... The content of this RSS Feed (c) The Royal Society of Chemistry
Soft Matter, 2021, Advance Article DOI: 10.1039/D1SM00838B, PaperAshish Yadav, N. M. Anoop Krishnan Developed repulsive bump potential to simulate the steric repulsion conditions in C-S-H gels. To cite this article before page numbers are assigned, use the DOI form of citation above. The content of this RSS Feed (c) The Royal Society of Chemistry
CrystEngComm, 2021, Accepted Manuscript DOI: 10.1039/D1CE00763G, CommunicationLihong Zhou, Guanghui Wang, Jie Du, Qinjiang Zhao, Xiang Pei The system of organic solvent and ligand had been successfully applied to regulate the coordination of metal ions in organic chemistry. Inspired by previous works, we had conducted the study... The content of this RSS Feed (c) The Royal Society of Chemistry