Background and Objectives: Prolidase deficiency (PD) is a rare, life-threatening, genetically determined disease with an incidence of 1-2 cases per 1 million births. The disease inhibits collagen synthesis, which leads to organ and systems failure, including hepato- and splenomegaly, immune disorders, chronic ulcerative wounds, respiratory infections, and pulmonary fibrosis. The complexity of the problems associated with this disease necessitates a comprehensive approach and the involvement of an interdisciplinary team. The objective was to present the treatment and care plan, as well as complications of PD, in a young woman following admission to an intensive care unit (ICU). Materials and Methods: A retrospective observational single-case study. Results: A 26-year-old woman with PD was hospitalized in the ICU for acute respiratory failure. The presence of difficult-to-heal extensive leg ulcers and the patient\'s immunocompromised condition resulted in the development of sepsis with multiple organ failure (respiratory and circulatory, liver and kidney failure). Complex specialized treatment consisting of wound preparation, limb amputation, the minimization of neuropathic pain, mechanical ventilation, renal replacement therapy, circulatory stabilization, and the prevention of complications of the disease and of therapy were applied. On the 83rd day of hospitalization, the patient expired. Conclusions: Despite the use of complex treatment and care, due to the advanced nature of the disease and the lack of therapies with proven efficacy, treatment was unsuccessful. There is a need for evidence-based research to develop effective treatment guidelines for PD.

OBJECTIVE: Neck pain is commonly referred to an ENT specialist and can be caused by the little-known inflammatory condition of the lateral thyrohyoid ligament. The pathophysiology of this condition is believed to be inflammation subsequent to over-exertion or cervical trauma. Typically, patients present with chronic unilateral neck pain. Elicitation of localized tenderness over the axis of the lateral thyrohyoid ligament on palpation is a key finding for its diagnosis. We present an unusual case with an acute course and subcutaneous inflammation and discuss its management in an effort to raise awareness for this often-misdiagnosed syndrome.
METHODS: A systematic literature research on PubMed was performed selecting patients with a definitive diagnosis of thyrohyoid syndrome or lateral thyrohyoid ligament syndrome.
RESULTS: We collected 54 cases from three studies. This condition is an important differential diagnosis for acute or chronic antero-lateral or unilateral neck pain.
CONCLUSIONS: No specific radiological findings are defined and a CT scan is therefore not necessary for its diagnosis, but ultrasound is a useful tool to primarily assess any neck lesion. Once the diagnosis is made, a local infiltration of steroids is the most sustainable treatment option and relapse prevention.

BACKGROUND: Congenital lumbar facet joint defect is a rare congenital developmental disorder with only a few reported cases in the literature, primarily affecting the L5-S1 segments. This study reports the first case of a defect in the left L3 inferior articular process; and presents a review of the existing literature on the subject, proposes a classification system, and validates the inter-observer and intra-observer reliability of this classification system.
METHODS: A 14-year-old boy presented to our orthopedic clinic with persistent lower back pain for 1 month. Imaging analysis, including CT scans, 3D reconstruction, and MRI, revealed a congenital lumbar facet joint defect at the L3 level, which has not been reported. Conservative treatment resulted in a significant improvement in his symptoms, and he is currently under follow-up care.
CONCLUSIONS: Congenital defect of the lumbar facet joint is a rare spinal condition. This article reports the first patient with a defect in the left L3 inferior articular process and conducts a comprehensive literature review, proposing a classification of articular process defects into five types. The two most common types are Types B and C. We have demonstrated that this system is reliable and reproducible and have described the treatment of each type.

Introduction: Methadone is used to treat intractable cancer pain when other opioid analgesics are ineffective. Methadone tablets may be difficult to administer in cases of gastrointestinal passage obstruction. However, changing the route of methadone tablet administration is possible. Case Description: The patient, diagnosed with esophagogastric junction cancer with multiple metastases, continued to receive methadone tablets even after not being longer able to take oral medication. Method: Methadone tablets were administered using a simple suspension method via gastrostomy. We measured the respiratory rate during sleep daily. We also measured weekly QTc values using a 12-lead electrocardiogram and methadone blood concentration periodically. No side effects were observed. Conclusion: Using a simple suspension method to administer methadone is a safe pain management method when accompanied by careful monitoring. To date, no study has examined the tube administration safety of methadone tablets. Thus, this case report is of important clinical significance.

At the beginning of this century, the advent of a second generation of \'quantum technologies\' was announced together with its revolutionary potential to change existing information technologies. Despite the rapidly increasing paid to quantum technological development, there has been little attention paid to the specific characteristics or relationships within emerging quantum ecosystems. The aim of this study is to visualize the innovation structures and relationships that are emerging to shape these technological developments. As these structures typically depend on specific regional features, we have specifically focused on the Spanish case, as it is potentially indicative of the differences between European innovation models and other regional patterns. This objective was achieved by researching the funding network of the ecosystem, collected from a systematic review of various official sources and relevant previous literature. The resulting dataset was framed using the Innovation Ecosystem model and broken down through network analysis theory, as well as characterized through descriptive statistics. This framework identified the significant role that projects play in European scientific and technological innovation, which work as hubs to concentrate resources and incentive cooperation between actors. This is relevant because current work on quantum technologies neglects their importance, as their analysis focuses on the quantity of institutions rather than their relations. Moreover, this paper points out the prominence of public funding to drive quantum innovation, largely stemming from the European Commission. This is another key mechanism that is missed by the existing literature. Finally, it also sheds light on the recipients of this funding, who are mostly research centres. These results allow us to conceptualize the Spanish quantum ecosystem and offer the opportunity for comparative studies with other quantum technologies ecosystems.

BACKGROUND: Compartment syndrome is a well-known phenomenon that is most commonly reported in the extremities. However, paralumbar compartment syndrome is rarely described in available literature. The authors present a case of paralumbar compartment syndrome after high intensity deadlifting.
METHODS: 53-year-old male who presented with progressively worsening low back pain and paresthesias one day after high-intensity deadlifting. Laboratory testing found the patient to be in rhabdomyolysis; he was admitted for intravenous fluid resuscitation and pain control. Orthopedics was consulted, and Magnetic Resonance Imaging revealed significant paravertebral edema and loss of muscle striation. Given the patient\'s lack of improvement with intravenous and oral pain control, clinical and radiographic findings, there was significant concern for acute paralumbar compartment syndrome. The patient subsequently underwent urgent fasciotomy of bilateral paralumbar musculature with delayed closure.
CONCLUSIONS: Given the paucity of literature on paralumbar compartment syndrome, the authors\' goal is to promote awareness of the diagnosis, as it should be included in the differential diagnosis of intractable back pain after high exertional exercise. The current literature suggests that operative cases of paralumbar compartment syndromes have a higher rate of return to pre-operative function compared to those treated non-operatively. This case report further supports this notion. The authors recommend further study into this phenomenon, given its potential to result in persistent chronic exertional pain and irreversible tissue damage.

BACKGROUND: Low back pain (LBP) is an understudied condition among runners, and it is unclear what biomechanical features could be targeted for gait retraining to mitigate pain.
OBJECTIVE: How do running biomechanics differ between healthy individuals and those with running-related LBP?
METHODS: This was a case-controlled, comparative study design of community runners: running-related LBP (n=52) and healthy controls (n=52). All runners completed running history forms and performed a 3-dimensional gait analysis. Kinematic data were collected using a motion capture system and normalized to a gait cycle, while participants ran on a level grade at self-selected speed on an instrumented treadmill. Current running volume, temporal-spatial, kinetic and kinematic features were compared between groups.
RESULTS: The LBP group had 39.5 % lower weekly distance and 15.4 % fewer were currently training for a race (all p<.05). Runners with LBP demonstrated lower cadence (166±10 step/min vs. 171±9 step/min; p=.05), greater center of gravity lateral displacement (1.4±0.5 cm vs. 1.2 ±.3 cm; p=.044) and greater stride width variability (1.3±0.4 cm versus 1.0 ± 0.04 cm; p=.008). Runners with LBP had a greater Vertical Average Loading Rate ([VALR] 67.7±22.2 bodyweights [BW]/s vs. 62.2±21.5 BW/s; p=.022), and higher joint moments (N*m/(kg*m)) at the knee in the sagittal plane (2.13±0.50 vs. 1.87±0.56; p <.001), frontal plane (1.44±0.39 vs. 1.29±0.29; p=.013), and at the hip in the frontal plane (2.04±0.51 vs. 1.84±0.41; p=.024). No differences were found between groups in the pelvis, hip, knee, and ankle joint excursions in any plane of motion during a typical gait cycle.
CONCLUSIONS: These collective motion signature may reflect challenges with control of motion and VALR in the presence of back pain. Cadence training to increase step rate, coupled with core/hip muscle activation, may be an important strategy to reduce motion variability, impact loading rate and pain symptoms while running.

UNASSIGNED: Rheumatoid arthritis (RA) is a chronic disease and may worsen over time. Today, nurse-led case management (NLCM) has been recommended to improve clinical outcomes for chronic disease patients, yet little is known regarding its impact on pain, fatigue, and C-reactive protein (CRP) among RA patients. We aimed to explore this issue among such groups via a two-group pre- and post-test approach.
UNASSIGNED: All subjects were recruited from one hospital in Taiwan from January 2017 to June 2018 and assigned to either a 6-month NLCM program in addition to usual care or to a control group that received usual care only. All of them were followed for 2 years. Outcomes of interests were compared at four time points: baseline, the third day after NLCM completion, and at 6 and 24 months after NLCM. Effects between them were tested using the generalized estimating equations (GEE) model after adjusting for differences at baseline.
UNASSIGNED: A total of 50 patients in the NLCM group and 46 in the control group were recruited for data analysis. Results from the GEE model indicated that integrating NLCM into conventional care benefited patients in decreasing levels of pain and fatigue, as well as CRP value. These improvements were still observed for 2 years after NLCM.
UNASSIGNED: NLCM was shown to be helpful in lowering pain, fatigue, and CRP, which implies that NLCM may be a reference in the provision of tailored care for those affected by rheumatism.

BACKGROUND: Several clinical trials have shown that nirsevimab, an antibody targeting the respiratory syncytial virus (RSV), reduces RSV bronchiolitis requiring admission. In 2023-2024, Catalonia and Andorra adopted immunization strategies for children <6 months and those born during the epidemic season. This study evaluates the effectiveness of nirsevimab in preventing hospitalizations from RSV bronchiolitis.
METHODS: In the epidemic season of 2023-2024, a test-negative case-control study was conducted in three hospitals from Catalonia and Andorra. Patients <12 months old admitted with bronchiolitis and tested for RSV using molecular microbiology tests were included. The effectiveness in preventing RSV bronchiolitis hospitalization and severe disease was estimated using multivariate models. Comparisons between immunized, non-immunized, and non-eligible patients were made in prospectively collected epidemiological, clinical, and microbiological variables.
RESULTS: Two hundred thirty-four patients were included. RSV was detected in 141/234 (60.2%), being less common in the immunized group (37% vs 75%, p < .001). The rate of immunized patients among those eligible was 59.7%. The estimated effectiveness for RSV-associated lower respiratory tract infection was 81.0% (95% confidence interval: 60.9-90.7), and for preventing severe disease (the need for NIV/CMV), 85.6% (41.7-96.4%). No significant differences by immunization status were observed in patients with RSV concerning viral coinfections, the need for NIV/CMV or length of hospital stay.
CONCLUSIONS: This study provides real-world evidence of the effectiveness of nirsevimab in preventing RSV-lower respiratory tract infection hospitalization and severe disease in infants during their first RSV season following a systematic immunization program. Immunized patients did not exhibit a higher rate of viral coinfections nor differences in clinical severity once admitted.

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