Chiropractic Management of a Patient With Chronic Pain in a Federally Qualified Health Center: A Case Report.

OBJECTIVE: The aim of this case report is to describe the response of a patient with chronic pain who received chiropractic care in a federally qualified health center. CLINICAL FEATURES: A 61-year-old female patient with neck and back pain after a traumatic motor vehicle accident 3 years prior was referred for chiropractic care. She had neck pain, low back pain, knee pain, and pain associated with over 20 surgeries, as well as depression, opioid dependence, and low quality of life. INTERVENTIONS AND OUTCOMES: The patient was treated with chiropractic manipulation for her low back and neck pain and was counseled on nutrition and exercise. After 6 months, she reported improvements in pain, improved quality of life, and discontinuation of opioid pain medication. CONCLUSION: This patient improved after a course of chiropractic care that was integrated into a federally qualified health center.

Post-traumatic Scapholunate Advanced Collapse of the Wrist: A Case Report.

OBJECTIVE: The purpose of this report is to describe a patient with scapholunate advanced collapse (SLAC) of the wrist. CLINICAL FEATURES: A 38-year-old man presented to a chiropractic teaching clinic with right wrist pain after falling off of the tailgate of a truck 7 years prior. The mechanism of injury was a fall on an outstretched hand. Ultrasonography and radiography were performed, which demonstrated abnormal lunate kinematics and scapholunate interval diastasis associated with a clenched-fist maneuver. These findings were consistent with SLAC. INTERVENTION AND OUTCOME: Following the diagnosis of SLAC, the wrist was splinted. Conservative care consisting of physical therapy included paraffin dips, therapeutic ultrasound, and stretching. The patient received only minimal alleviation of pain, and a surgical consultation was obtained. The patient elected surgical intervention, utilizing the proximal row carpectomy procedure. CONCLUSION: This case demonstrates a patient with chronic wrist pain, with progression to carpal instability, which ultimately manifested as SLAC. We demonstrate, utilizing multiple imaging modalities, both preoperative and postoperative findings. To our knowledge, this is the first case to describe the use of diagnostic ultrasonography in the evaluation of the proximal row carpectomy procedure.

High-throughput analysis of meiotic crossover frequency and interference via flow cytometry of fluorescent pollen in Arabidopsis thaliana.

During meiosis, reciprocal exchange between homologous chromosomes occurs as a result of crossovers (COs). CO frequency varies within genomes and is subject to genetic, epigenetic and environmental control. As robust measurement of COs is limited by their low numbers, typically 1-2 per chromosome, we adapted flow cytometry for use with Arabidopsis transgenic fluorescent protein-tagged lines (FTLs) that express eCFP, dsRed or eYFP fluorescent proteins in pollen. Segregation of genetically linked transgenes encoding fluorescent proteins of distinct colors can be used to detect COs. The fluorescence of up to 80,000 pollen grains per individual plant can be measured in 10-15 min using this protocol. A key element of CO control is interference, which inhibits closely spaced COs. We describe a three-color assay for the measurement of CO frequency in adjacent intervals and calculation of CO interference. We show that this protocol can be used to detect changes in CO frequency and interference in the fancm zip4 double mutant. By enabling high-throughput measurement of CO frequency and interference, these methods will facilitate genetic dissection of meiotic recombination control.

Pityriasis rubra pilaris sensitive to narrow band-ultraviolet B light therapy.

Pityriasis rubra pilaris (PRP) is a rare skin condition which typically presents in adults as red-orange plaques with islands of sparing, perifollicular keratotic papules, waxy palmoplantar keratoderma, and erythema with fine, diffuse scale. Currently, there are no well-established treatment guidelines for this condition. This is party due to a lack of universally effective treatments for PRP, with some cases being resistant to multiple topical and systemic therapies. Systemic retinoids have been used with some success. Several phototherapy regimens have lead to variable results. The authors present a case of PRP, unresponsive to 6 month treatment of isotretinoin, that was subsequently treated with narrow-band ultraviolet B (NB-UVB) light therapy with complete resolution after four months of light treatment. The observed clinical benefit may encourage future phototesting and consideration of NB-UVB light therapy in recalcitrant PRP cases.