In Quebec, Canada, the public healthcare system offers free medical services. However, patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy coverage. In contrast, private clinics provide expedited care but are relatively scarce and entail out-of-pocket expenses. Once a patient with pain caused by a spinal disorder meets a pain medicine specialist, spinal intervention is quickly performed when indicated, and patients are provided lifestyle advice. Transforaminal epidural steroid injections are frequently administered to patients with radicular pain, and steroid injections are administered on a facet joint to control low back or neck pain. Additionally, medial branch blocks are performed prior to thermocoagulation. France's universal healthcare system ensures accessibility at controlled costs. It emphasizes physical activity and provides free physical therapy services. However, certain interventions, such as transforaminal and interlaminar epidural injections, are not routinely used in France owing to limited therapeutic efficacy and safety concerns. This underutilization may be a potential cause of chronic pain for many patients. By examining the differences, strengths, and weaknesses of these two systems, valuable insights can be gained for the enhancement of global spinal pain management strategies, ultimately leading to improved patient outcomes and satisfaction.
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http://dx.doi.org/10.12998/wjcc.v12.i15.2682 | DOI Listing |
J Surg Case Rep
January 2025
Department of Colorectal Surgery, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga, Sydney, New South Wales 2076, Australia.
An 84-year-old lady presented with 1 day history of sudden onset generalized abdominal pain, fevers, and peritonism. Computed tomography was suggestive of a mid-small bowel perforation associated with a distal ovoid soft tissue density structure without pneumobilia. An urgent laparotomy demonstrated two areas of jejunal diverticula necrosis and perforation associated with a 3 cm luminal mass in the proximal ileum, and proximal small bowel dilatation.
View Article and Find Full Text PDFEClinicalMedicine
February 2025
Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, Anhui, China.
Background: Brain stimulation therapy (BST) has significant potential in treating psychiatric, movement, and cognitive disorders. Given the high prevalence of comorbidities among these disorders, we conducted an umbrella review to comprehensively assess the efficacy of BSTs in treating the core symptoms across these three categories of disorders.
Methods: We systematically searched for meta-analyses and network meta-analyses of randomized controlled trials with sham controls up to September 25, 2024, from databases including PubMed, PsycINFO, Embase, and the Cochrane Library.
Front Med (Lausanne)
January 2025
Department of Hepatobiliary Surgery, Binzhou Medical University Hospital, Binzhou, China.
Primary hepatic carcinosarcoma (HCS) is an extremely rare malignant tumor with carcinomatous and sarcomatous elements. Few reported cases of HCS exist, especially with sufficient records to describe imaging and pathological features, making the diagnosis, treatment, and prognosis of HCS a significant challenge for physicians. Here, we report a case of HCS with spontaneous rupture as the initial symptom in a 77-year-old elderly male who was admitted with right upper abdominal pain for 8 days.
View Article and Find Full Text PDFFront Immunol
January 2025
Department of Pain Management, The State Key Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Background: The nod-like receptor family pyrin domain-containing 3 (NLRP3) has been implicated in various skin diseases. However, its role in mediating 2, 4-dinitrofluorobenzene (DNFB)-induced chronic itch remains unclear.
Methods: Widetype () and deletion ( )mice, the expression of transient receptor potential (TRP) ankyrin 1 (TRPA1) inhibitor or recombinant mice interleukin-18 (IL-18) were used to establish and evaluate the severity of DNFB-mediated chronic itch.
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