Medical hypotheses
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White blood cells (WBC) are important parts of our immune system and they protect our body against infections by eliminating viruses, bacteria, parasites and fungi. There are five types of WBC. These are called Lymphocytes, Monocytes, Eosinophils, Basophils and Neutrophils. ⋯ At the end of the study, the system has showed 100% success in determining WBC cells. ResNet50, one of the CNN architectures, has showed the best performance with transfer learning. Cell types of Lymphocyte were determined with 99.52% accuracy rate, Monocyte with 98.40% accuracy rate, Basophil with 98.48% accuracy rate, Eosinophil with 96.16% accuracy rate and Neutrophil with 95.04% accuracy rate.
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Postherpetic neuralgia (PHN) is the most common complication of shingles caused by reactivation of varicella zoster virus (VZV). Management of PHN is often suboptimal while using current conventional treatments. Antiviral therapy was used to reduce PHN-associated pain in two small trials which showed conflicting results. ⋯ Accordingly, PHN patient may have a high prevalence of vitamin D deficiency which negatively affects the antiviral efficacy. Vitamin D supplementation may improve the antiviral efficacy on PHN. Future trials regarding antiviral therapy on PHN should consider patient characteristics and should be conducted among different subgroups of PHN patients.
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Tarlov cysts (TCs) consist of dilated nerve root sheaths filled with cerebrospinal fluid (CSF) and are most frequently found in the sacrum. It is estimated that 25% of detected TCs cause chronic pain and intestinal and urogenital symptoms due to compression of the sacral nerve root fibers inside the TC. Unfortunately, symptomatic TCs are frequently overlooked. ⋯ While increased intracranial pressure causes dilation of the ventricles, the associated increased spinal pressure may cause dilation of multiple spinal nerve root sheaths to form TCs. Furthermore, while the increased volume of the ventricles gradually compresses the neurons and axons of the brain against the bony skull, simultaneously, the increased pressure inside the nerve sheaths may also gradually compress the neurons and axons located inside the dorsal root ganglia and spinal nerves, resulting in neuropathic pain, sensory abnormalities, and neurogenic bladder and bowel symptoms. Hydrocephalus patients reporting neuropathic pain should be screened for the presence of TCs.
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Pain is reported to affect over 70% of individuals with inflammatory bowel diseases (IBD), with abdominal and musculoskeletal (MSK) pain representing the most common complaints. MSK pain is typically considered within the narrow framework of inflammatory extraintestinal manifestations of IBD, resulting in a limited scope for the nature and underlying mechanisms participating in MSK pain experiences in this population. Symptoms related to central sensitization have recently demonstrated association with active IBD and worse MSK pain experiences, suggesting a potential roll for central mechanisms in MSK-related pain. ⋯ Consequently, this paper proposes a broader theoretical model whereby central mechanisms, such as central sensitization and grey matter changes, as well as psychological and disease factors are suggested to modulate pain experiences in this population. Exploration of relationships within the proposed framework may provide not only a deeper understanding of the generation and maintenance of persistent MSK pain in IBD, but also highlight the need for new targeted management pathways in this population. This paper hypothesizes that exploration of central sensitization in IBD patients will demonstrate altered somatosensory functioning in patients with MSK pain, and that IBD activity and psychological factors will be associated with altered somatosensory functioning and worse pain experiences.
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Randomized Controlled Trial
A single preoperative pain neuroscience education: Is it an effective strategy for patients with carpal tunnel syndrome?
Patients undergoing carpal tunnel release surgery may continue to experience pain despite the intervention. This symptom may be modulated by psychosocial factors including depression, catastrophic thinking, and kinesiophobia. ⋯ The findings of this study indicate that a single preoperative PNE session in combination with therapeutic exercise does not provide added benefits in comparison to standard preoperative care plus therapeutic exercise. Future studies should evaluate if patients with carpal tunnel release are additionally benefited by the incorporation and consequent behavioural changes of more PNE sessions to multimodal treatment.