Complex Regional Pain Syndrome (CRPS) is a chronic pain disorder with several sensory, autonomic, motor, and trophic symptoms. Diagnosis is based on clinical criteria like the Budapest Criteria, but there are limitations to those criteria, especially for pediatric cases and different clinical presentations. Technical testing—including laboratory tests, electrophysiological studies, sensory and autonomic function tests, and more advanced imaging—provides supportive, but not definitive, evidence. Biomarkers such as certain microRNAs, inflammatory mediators, and autoantibodies may offer the potential for improved diagnostic accuracy, although they have not yet been adequately validated. New imaging techniques, including ultrasound elastography and neuroimaging, have identified both peripheral and central pathophysiological changes in CRPS. We can improve our diagnosis of CRPS by integrating standardized clinical criteria with technical evaluations and biomarker improvements; this should serve to make diagnosis earlier, reduce diagnostic delay, and promote individualized treatment.

Background: The coronavirus disease 2019 (COVID-19) has a high prevalence and mortality worldwide. Thousands of patients with acute respiratory failure caused by COVID-19 are daily hospitalized in intensive care units (ICUs) around the world. Many of these patients require full mechanical respiratory support and long-term ventilator use. Using different ventilators and calculating important variables can be helpful in meeting therapeutic needs of patients. Objectives: The aim of present study was to investigate the effect of expiratory time constant (RCEXP) on the course of treatment and duration of mechanical ventilation in patients with acute respiratory failure hospitalized in ICU. Methods: The present cross-sectional study was conducted on 60 patients with acute respiratory failure who were hospitalized in the ICU and underwent mechanical ventilation due to COVID-19 in the first six months of 2020. The variables of RCEXP, lung compliance and lung resistance in all patients were recorded daily and analyzed. Then, based on clinical outcome, the patients were divided into two groups: the patients with wean outcome (N = 40) and those with death outcome (N = 20). Results: The mean ± SD of lung compliance in patients who were separated from ventilator and patients with death outcome were 74.73 (18.58) mL/cm H2O and 36.92 (10.56) mL/cm H2O, respectively, which was statistically significant (P = 0.001). The mean ± SD of lung resistance in patients who were separated from ventilator and patients with death outcome were calculated at 9.25 (4.62) and 14 (6.5), respectively, which was statistically significant (P = 0.015). Also, there was a statistically significant difference between the two groups in terms of mean ± SD of RCEXP (0.67 (0.23) vs. 0.49 (0.19), P = 0.010). Conclusions: According to the results of this study, there was a significant difference between high resistance, low compliance, RCEXP, and weaning success of intubation in patients hospitalized in the ICU.

Background: Chronic pain poses a significant challenge to the general population, especially in older adults. As a result, there is a growing emphasis on developing novel treatment options and expanding the use of emerging technologies. Objective: This comprehensive review aims to guide practitioners in chronic pain management by extending the current application of vagus nerve stimulation (VNS). The review examined peer-reviewed studies, including multicenter cohort studies and clinical trials, published within the past 25 years. VNS has shown the most promising results in pain reduction for headache and migraine, with less relief in inflammatory and neuropathic pain as compared to current first-line treatment options. Conclusion: Overall, this review seeks to compile and critically analyze the effect and efficacy of VNS on different forms of chronic pain using the most current studies and research applicable.

Background: Mesothelioma, a cancer primarily caused by asbestos exposure, has been increasing in the Middle East and North Africa (MENA), raising concerns about the region’s occupational and environmental health landscape. With varying Sociodemographic Index (SDI) and differing asbestos regulations across MENA, understanding mesothelioma trends over time is crucial. Methods: Using data from the Global Burden of Disease (GBD) Study 2021, we analyzed mesothelioma incidence, mortality, and disability-adjusted life years (DALYs) in MENA from 1990 to 2021. Age-standardized incidence rate (ASIR), mortality rate (ASMR), and disability rate (ASDR) were assessed by age, sex, and country. Trend analyses were conducted using joinpoint regression to identify significant shifts in disease burden over the study period. Results: Between 1990 and 2021, mesothelioma cases rose from 597 to 1365, with ASIR declining at an average annual percent change (AAPC) of −0.49% (P < 0.001). Countries like Oman and Saudi Arabia exhibited rising burdens, while the United Arab Emirates and Turkey saw declines. Males and older age groups had higher ASIR, ASMR, and ASDR rates, indicating gender- and age-based disparities. Conclusion: While the mesothelioma burden in MENA has declined overall, significant increases in certain countries highlight the need for uniform asbestos regulations and targeted health interventions, especially among high-risk demographics. Further research on occupational exposure and Sociodemographic Index (SDI) improvements could help reduce mesothelioma rates across the region.

Background: Weaning of ventilated COVID-19 patients from ventilators has been a major problem in some of these patients. We performed hemoperfusion in a selective group of COVID-19 patients to facilitate weaning from the mechanical ventilation (MV). Methodology: The present study was a retrospective case series of 30 consecutive COVID-19 patients, who showed difficulty with weaning off the ventilator. Hemoperfusion was performed by the HA330 disposable hemoperfusion cartridge (Jafron, China). Before and after hemoperfusion, changes in patients' hemodynamics, improvement in consciousness level, oxygen saturation, hypercapnia, initiating spontaneous breathing, and changes in lung involvement were assessed. Results: The patients average age was 48.38 ± 15.04 years, with 17 (56.7%) females. The post-hemoperfusion values of SpO2 (P < 0.001), mean arterial pressure (P = 0.003), positive end-expiratory pressure (P < 0.001), heart rate (P < 0.001), and ratio of arterial oxygen partial pressure to fractional inspired oxygen (P < 0.001) were significantly different compared to their pre-hemoperfusion values. The outcome of patients showed a significant relationship with age (P = 0.017) and spontaneous ventilation (P = 0.001). Conclusions: The findings endorse the implementation of hemoperfusion for ICU-hospitalized COVID-19 patients experiencing difficulty in weaning from mechanical ventilation. Hemoperfusion demonstrated significant improvements in vital signs for the majority of patients and was associated with a successful weaning and survival rate of 63.3%. While these results are promising, further evidence is needed to consider hemoperfusion as an accepted clinical approach.