Prevalence of post-traumatic neuropathic pain after digital nerve repair and finger amputation

Introduction: Post-traumatic neuropathic pain is a major factor affecting the quality of life after finger trauma and is reported with considerable variance in the literature. This can partially be attributed to the different methods of determining neuropathic pain. The Douleur Neuropathique 4 (DN4) has been validated to be a reliable and non-invasive tool to assess the presence of neuropathic pain. This study investigated the prevalence of neuropathic pain after finger amputation or digital nerve repair using the DN4 questionnaire. Methods: Patients with finger amputation or digital nerve repair were identified between 2011 and 2018 at our institution. After a minimal follow-up of 12 months, the short form DN4 (S-DN4) was used to assess neuropathic pain. Results: A total of 120 patients were included: 50 patients with 91 digital amputations and 70 patients with 87 fingers with digital nerve repair. In the amputation group, 32% of the patients had pain, and 18% had neuropathic pain. In the digital nerve repair group, 38% of the patients had pain, and 14% had neuropathic pain. Secondly, of patient-, trauma-, and treatment-specific factors, only the time between trauma and surgery had a significant negative influence on the prevalence of neuropathic pain in patients with digital nerve repair. Conclusion: This study shows that persistent pain and neuropathic pain are common after finger trauma with nerve damage. One of the significant prognostic factors in developing neuropathic pain is treatment delay between trauma and time of digital nerve repair, which is of major clinical relevance for surgical planning of these injuries.</p

Small Angle Scattering and Zeta Potential of Liposomes Loaded with Octa(carboranyl)porphyrazine

In this work the physicochemical characterization of liposomes loaded with a newly synthesised carboranyl porphyrazine (H2HECASPz) is described. This molecule represents a potential drug for different anticancer therapies, such as Boron Neutron Capture Therapy, Photodynamic Therapy and Photothermal Therapy. Different loading methods and different lipid mixtures were tested. The corresponding loaded vectors were studied by Small Angle Scattering (SANS and SAXS), light scattering and zeta potential. The combined analysis of structural data at various length scales and the measurement of the surface charge allowed to obtain a detailed characterization of the investigated systems. The mechanisms underlying the onset of differences in relevant physicochemical parameters (size, polydispersity and charge) were also critically discussed

Fabrication Principles and Their Contribution to the Superior In Vivo Therapeutic Efficacy of Nano-Liposomes Remote Loaded with Glucocorticoids

We report here the design, development and performance of a novel formulation of liposome- encapsulated glucocorticoids (GCs). A highly efficient (>90%) and stable GC encapsulation was obtained based on a transmembrane calcium acetate gradient driving the active accumulation of an amphipathic weak acid GC pro-drug into the intraliposome aqueous compartment, where it forms a GC-calcium precipitate. We demonstrate fabrication principles that derive from the physicochemical properties of the GC and the liposomal lipids, which play a crucial role in GC release rate and kinetics. These principles allow fabrication of formulations that exhibit either a fast, second-order (t1/2 ∼1 h), or a slow, zero-order release rate (t1/2 ∼ 50 h) kinetics. A high therapeutic efficacy was found in murine models of experimental autoimmune encephalomyelitis (EAE) and hematological malignancies

Long-term disability arrangements : a comparative study of assessment and quality control

In order to promote individuals’ participation in society and to reduce individuals’ dependence on allowances, governments have developed and implemented policies containing elements of income support and reintegration as well as strategies for the prevention of disease and disability. An important element with regard to policies on disability is the evaluation of disability in a percentage or a category. These evaluations are the crossroads for people in the journey from work through sickness to disability or reintegration. Changes in policies on disability take place against a background of Europeanisation of social policies and of a growing contribution from private insurers in social security provision. Benchmarking of practices is an important topic in these changes. This study places similarities and differences in the practices of disability evaluation in a general public scheme in 15 countries (Belgium, Denmark, Finland, France, Germany, Hungary, Ireland, Italy, the Netherlands, Norway, the Russian Federation, Slovenia, Spain, the UK and the USA) with respect to the organisation of the evaluation process and quality control

Cybersecurity in the Agrifood sector

Every day new digital applications find their way into our lives. Digitization has brought our society many benefits and will do so for the coming years as key enabler for our economy. It is an important driver behind innovation and economic growth. However, to create sustainable innovation and frequent use, security is absolutely essential. Due to the increased frequency of high tech possibi¬lities, the chance of technical failure or severe misusage and abuse of vulnerabilities can become a realistic threat. This article deals with cybersecurity in the agrifood sector

Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation – A systematic review

Background: Pain after amputation can be known as residual limb pain (RLP) or phantom limb pain (PLP); however, both can be disabling in daily life with reported incidences of 8% for finger amputations and up to 85% for major limb amputations. The current treatment is focused on reducing the pain after neuropathic pain occurs. However, surgical techniques to prevent neuropathic pain after amputation are available and effective, but they are underutilized. The purpose of the review is to investigate the effects of techniques during amputation to prevent neuropathic pain. Methods: A systematic review was performed in multiple databases (Embase, Medline, Web of Science, Scopus, Cochrane, and Google Scholar) and following the PRISMA guidelines. Studies that reported surgical techniques to prevent neuropathic pain during limb amputation were included. Results: Of the 6188 selected studies, 13 eligible articles were selected. Five articles reported techniques for finger amputation: neurovascular island flap, centro-central union (CCU), and epineural ligatures, and flaps. For finger amputations, the use of prevention techniques resulted in a decrease of incidences from 8% to 0–3% with CCU being the most beneficial. For major limb amputations, the incidences for RLP were decreased to 0 to 55% with TMR and RPNI and compared to 64–91% for the control group. Eight articles reported techniques for amputations on major limbs: targeted muscle reinnervation (TMR), targeted nerve implantation, concomitant nerve coaptation, and regenerative peripheral nerve interface (RPNI). Conclusions: Based on the current literature, we state that during finger and major limb amputation, the techniques to prevent neuropathic pain and PLP should be performed

Gamma-Irradiated Liposome/Niosome And Lipogelosome/Niogelosome Formulations For The Treatment Of Rheumatoid Arthritis

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Liposome/DNA Systems: Correlation Between Hydrophobicity and DNA Conformational Changes

In a previous work, we found that liposome hydrophobicity could affect deoxyribonucleic acid (DNA) association efficiency. Now, we have focused on the possible correlation between liposome hydrophobicity and DNA conformation. DNA lyophilized with cationic vesicles with high hydrophobicity changes its conformation into a more condensed form, probably the C form. With noncharged vesicles, it changes its conformation from B to a partial A form. These results contribute to a better understanding of the interaction between DNA and lipids, suggesting there is direct relationship between hydrophobicity and DNA conformation changes: The higher the hydrophobicity factor, the more pronounced the changes in DNA form, to a more condensed form