Articles: peripheral-nerve-injuries.
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Although most severe peripheral nerve injuries result from high-speed mechanisms, there is no laboratory model to replicate this clinical condition. ⋯ Nerve architecture is injured in a graded fashion during stretch injury, which likely reflects tissue biomechanics. This study suggests new considerations in the theoretical framework of nerve stretch trauma.
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Lesions of peripheral nerves substantially influence the long-term prognosis and functional outcome. Approximately 70% of peripheral nerval lesions are associated with vascular injuries and occur more frequently with certain fractures and osteosynthesis types. The prognosis and treatment depend on the severity of the injury and the presence of axonal lesions, in particular, determines the further procedure. ⋯ Iatrogenic vascular lesions occur particularly in percutaneous interventions and are reported in up to 8% of cases after operations involving the musculoskeletal system. Iatrogenic nerve lesions are almost exclusively the result of surgical procedures and represent up to 17.5% of traumatic nerve injuries. For all lesions the general principles of surgical treatment are valid and the rapid involvement of professional expertise is decisive.
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The main aim of this retrospective computed tomography (CT) study was to examine the morphometric development of the geniculate ganglion (GG) in children aged between 1 and 18 years for surgical approaches. ⋯ Our data suggested that the area and width of GG were progressively increasing with age in the childhood period. The calculated formula representing the growth dynamic of GG in children and the incidence of the presence of the dehiscent GG can be useful for radiologists and otologists to estimate its size and to avoid iatrogenic injury during early childhood surgeries.
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The incidence of peripheral neuropathy development and chronic pain is strongly associated with the arrival of senescence. The gradual physiological decline that begins after the mature stage produces myelin dysregulation and pathological changes in peripheral nervous system, attributed to reduction in myelin proteins expression and thinner myelin sheath. Moreover in elder subjects, when nerve damage occurs, the regenerative processes are seriously compromised and neuropathic pain (NeP) is maintained. ⋯ Differently from adults, it does not affect fibres myelination. In light of a continuous growth in elderly population and correlated health problems, including metabolic disorders, the prevalence of neuropathy is enhancing, generating a significant public cost and social concern. In this context energy depletion by dietary restriction can be a therapeutic option in NeP.
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Electrical muscle stimulation has been demonstrated to facilitate nerve regeneration and functional recovery, but the underlying mechanism remains only partially understood. In this study, we investigated the positive effect of electrical muscle stimulation following nerve injury and its molecular mechanisms of autophagy regulation. The sciatic nerves of Sprague-Dawley rats were transected and immediately repaired. ⋯ The number of autophagosomes and the expression of autophagy marker LC3-Ⅱ in distal nerve stump were increased while the level of autophagy substrate protein P62 was decreased following electrical muscle stimulation. Blockage of the autophagy flux by chloroquine (CQ) diminished the positive effect of electrical muscle stimulation on nerve injury. These results illustrated that electrical muscle stimulation accelerates axon regeneration and functional recovery through promoting autophagy flux in distal nerve segments following nerve injury and immediate repair (IR) by a so far unknown mechanism.