Pain Sensation Research Articles

Subconjunctival trypsin injection for anterior chamber fibrin exudates in eyes with globe rupture following vitrectomy

AIM: To compare the safety and clinical outcomes of subconjunctival trypsin and dexamethasone (DEX) injections in the treatment of anterior chamber fibrin exudates in eyes with globe rupture following primary wound repair and vitrectomy. METHODS: A retrospective analysis included 42 males and 10 females (mean age 46.0±6.0y, range 34 to 58y) who underwent primary wound sutures and vitrectomy for globe rupture. Patients with pupil-covered fibrinous exudate or/and membrane in the anterior chamber were treated. On the first postoperative day, subconjunctival injections of either 5000 units (0.4 mL) of trypsin solution (n=25) or 0.5 mL (1 mg) DEX (n=27) were administered to accelerate exudate absorption. Efficacy was assessed by observing break time and partial absorption of the fibrin exudate membrane. Safety and comfort were evaluated by monitoring intraocular pressure (IOP), allergy, pain, and foreign body sensation. RESULTS: Both groups achieved 1/3 absorption of the anterior chamber fibrin exudate membrane, but the trypsin group exhibited shorter break time and partial absorption time compared to the DEX group (P<0.05). Trypsin treatment was also less irritating to patients. No adverse reactions were reported, and IOP remained stable. Visual acuity improved in both groups without statistical difference. CONCLUSION: Compared to DEX, trypsin demonstrates a shorter absorption time for the fibrin exudate membrane with a more comfortable process in treating pupil-covered fibrinous exudate or/and membrane after vitrectomy for globe rupture.

Postoperative Pain Level Following Surgery of the Hand and Wrist in the Ambulatory Setting

Surgical procedures of the hand are increasingly performed in an ambulatory setting. Postoperative analgesia is based empirically on the painfulness of individual surgical procedures without these having been examined systematically. The painfulness (visual analogue scale) of 722 surgical procedures of the hand and wrist (1 July 2021 to 30 June 2023) was assessed until day 5. Analgesia was conducted empirically in accordance with WHO principles. The primary endpoint was the pain sensation on the first postoperative day in bone and joint procedures compared with soft tissue or endoscopic procedures as well as hardware removals. Secondary endpoints were pain sensation in correlation with gender, age, duration of the procedure and preoperative analgesia. Bone and joint procedures were associated with significantly (p<0.001) more pain (5.42±2.8) compared with other procedures (3.47±2.6). Female (p=0.001) and younger patients (R>0.2) as well as longer procedure duration (R>0.2) showed a weak association with higher postoperative pain, whereas preoperative consumption of opioids was moderately associated with higher opioid intake (R=0.34). Overall, pain decreased continuously from the evening of the procedure (4.4±2.8) until day 5 (3.7±2.7; 2.8±2.4; 2.1±2.1; 1.6±1.9; 1.3±1.7) CONCLUSION: This data provides a scientific basis for pain medication supply following surgical procedures of the hand and wrist in an ambulatory setting. A broad range of pain perception must be considered, even in seemingly minor surgical procedures.

Ocular involvement of oak processionary caterpillar hairs: Clinical outcome up to one year.

To evaluate a consecutive series of patients that presented with ocular findings after contact with the oak processionary caterpillar (OPC) during an epidemic reproduction of the OPC in Germany in 2019 and to assess the 1-year outcome of those eyes with persisting OPC hairs in the cornea. Retrospective analysis of 11 eyes (11 patients) that presented in June/July 2019 with acute ocular symptoms after outdoor activity or caterpillar nest removal. Evaluation of patients charts and slit-lamp images up to one year. Assessment of the incidence of patients with OPC-associated ocular complaints in the subsequent years (2020-2023). All patients had conjunctival injection, foreign body sensation, pain, itching and/or burning sensation. In 9/11 eyes, multiple caterpillar hairs could be detected in the superficial and deeper cornea. Hair removal was attempted in 8/9 eyes; in one eye hair removal was impossible due to its deep stromal location (lost-to-follow-up). Entire hair removal was successful in 2/9 eyes, hence, six eyes with persisting hairs within the cornea were followed. Stromal haze developed adjacent to the hairs in all eyes and individual hairs disappeared (n = 4) and/or showed migration within the cornea (n = 3). Until 2023, the number of patients with OPC-associated ocular complaints decreased continuously. Ophthalmologists should be aware of the possibility of caterpillar hairs in patients with acute eye symptoms after outdoor acitivities, especially in early summer; the incidence may fluctuate, though. Hair removal is recommended to avoid possible intraocular migration, still residing hairs did not cause any serious long-term complications in our cohort. What is known Within the late spring and early summer season, mass reproduction of the oak processionary carterpillar (OPC) can lead to an increased number of patients with OPC-related eye complaints (pain, itching and burning sensation) caused by OPC hairs within a very short period of time. Within that season, people should be (more) actively sensitized to avoid trees with OPC hairs, take precautions and avoid eye rubing when having complaints What is new Complete surgical removal of the hairs can be difficult and is often unsuccessful due to their tiny size and often stromal location most possibly resulting from eye rubbing In the longer-term, residing hairs have shown to develop haze adjacent to the hair, migrate within the cornea or disappear/resolve. Since this may go along with an inflammatory reaction, long-term follow-up and topical steroids may be useful.

Effects of GlideScope, Pentax Airway Scope, and Macintosh Blade on the incidence of postoperative sore throat: a cohort study of 9,881 patients.

Postoperative sore throat (POST) is a common complaint after general anesthesia. POST is defined by the presence of a self-reported foreign body sensation or a painful sensation in the throat after general anesthesia. This condition may affect recovery and patient satisfaction and is associated with many factors, including intubation tools. Previous studies have reported conflicting results on POST. This retrospective cohort study, with sample size of 9,881 patients, was conducted to confirm the hypothesis that the use of video laryngoscopy (VL) is associated with a lower incidence of POST compared with direct laryngoscopy (DL). Data were extracted from a prospectively maintained quality improvement database. A total of 9,881 patients were included in the study. Statistical analysis was conducted for comparisons of demographic characteristics and to determine the effect of intubation tools on the incidence of POST. The patients had similar baseline demographic characteristics. Compared with DL, VL was associated with a lower incidence of POST (12.98% vs. 17.49%, P < 0.001). In addition, the use of Pentax Airway Scope (AWS) was associated with a lower incidence of POST compared with the use of GlideScope (GVL, 8.14% vs. 16.25%, P < 0.001). To better adjust for possible confounding factors, mixed-effects generalized linear model analysis revealed that older age (odds ratio [OR]: 0.995, 95% confidence interval [CI]: 0.992-0.999, P = 0.006), AWS compared to DL (OR: 0.416, 95% CI: 0.350-0.494, P < 0.001), and male sex (OR: 0.836, 95% CI: 0.747-0.935, P = 0.002) are associated with reduced incidence of POST. Compared with DL, VL is associated with a lower incidence of POST. In addition, the use of AWS is associated with a lower incidence of POST compared with the use of GVL. Retrospectively registered, NCT06515808, date of registration: 23/07/2024.

ICF based comparison of musculoskeletal health in regions of Poland and Spain.

The International Classification of Functioning, Disability and Health (ICF) is the framework for describing disability. The aim of the study was to compare differences in health status between the populations of the Podkarpackie region of Poland and the Castilla y León region of Spain, using the ICF core set for post-acute musculoskeletal conditions. A total of 840 people were included in the study. The brief version of ICF core set for post-acute musculoskeletal conditions was used in the study. Information obtained from semi-structured interviews and a physiotherapy assessment was recoded into ICF qualifiers to obtain comparable data. Significant differences in functioning were found between the two samples, with a higher prevalence in all the ICF entities for the Spanish sample. Similarities were found in the ICF components 'Body Functions' and 'Environmental Factors', with the most prevalent ICF entities being 'b280 Sensation of pain' and 'e225 Climate' respectively. For 'Activities and Participation', differences were observed, with 'd430 Lifting and carrying objects' being the most common for the Spanish sample and 'd450 Walking' for the Polish sample. Significant differences were found between the two samples, indicating better musculoskeletal health in the Polish sample. Future research using the ICF Core Sets in practice should be expanded and carried out in other countries to improve the ability to make comparisons between populations and to develop policies for territorial equity in health.Trial registration: NCT06283407.

Palmitoylation by ZDHHC4 inhibits TRPV1-mediated nociception.

Transient receptor potential vanilloid 1 (TRPV1) is a capsaicin-sensitive ion channel implicated in pain sensation. While TRPV1 potentiation in hyperalgesia development has been extensively investigated, its functional decline during pain relief remains largely unexplored. Here, by molecular, electrophysiological and in vivo evidence, we reveal that S-palmitoylation fine-tunes TRPV1 function by promoting its degradation via the lysosome pathway thereby facilitating inflammatory pain relief. The palmitoyl acyltransferase ZDHHC4 is identified to physically interact with TRPV1 and to catalyze S-palmitoylation at the cysteine residues C157, C362, C390, and C715 of the channel. Furthermore, we show that TRPV1 palmitoylation is counterbalanced by the depalmitoylase acyl-protein thioesterase 1 (APT1), thereby reinstating pain sensation. These findings provide important mechanistic insights into the relief phase of inflammatory pain.

Dermal macrophages control tactile perception under physiological conditions via NGF signaling

We demonstrated previously that sorting nexin 25 (SNX25) in nerve-associated macrophages plays critical roles in pain sensation by regulating tissue NGF content under both physiological and neuropathic conditions. In the present study, we apply the SNX25–NGF paradigm to tactile perception by showing that Snx25+/- mice or macrophage-specific Snx25 conditional knock-out (mcKO) mice had weaker responses to tactile stimuli in normal conditions. Snx25 mcKO mice responded poorly to transcutaneous electrical stimuli at a frequency of 5 Hz (C fiber responses), but normally to stimuli at a frequency of 250 Hz (Aδ fiber responses) or of 2000 Hz (Aβ fiber responses). CX3CR1-positive dermal macrophages were frequently found near calcitonin gene–related peptide (CGRP)- positive nerves and, less frequently, tyrosine hydroxylase (TH)-positive nerves. We confirmed that the tissue content of NGF was lower in Snx25 mcKO mice than in wild-type mice, and in turn, dermal NGF injection restored tactile sensitivity in Snx25+/- mice and Snx25 mcKO mice to normal levels. These results indicate that CGRP-positive C-nociceptors (possibly also TH-positive C-LTMRs) associated dermal macrophages control tactile perception by producing NGF and secreting it into the dermis.

Brainstem hemorrhage associated with venous hypertensive myelopathy without dural arteriovenous fistula: illustrative case.

Venous hypertensive myelopathy (VHM), formerly known as "Foix-Alajouanine syndrome," is a spinal cord dysfunction caused by impaired perfusion of the spinal cord. Most cases are attributed to spinal dural arteriovenous fistulas (dAVFs), but there are scattered reports of VHM without concomitant dAVF. Furthermore, no cases of VHM associated with intracranial hemorrhage exist. A 68-year-old man with a history of hypertension presented with a sudden headache, proximal paresis of the left upper extremity, impaired pain and temperature sensation in the right upper extremity, dysphagia, and dysarthria. Computed tomography scans showed intraparenchymal hemorrhage in the left medulla oblongata and a linear, continuous high-density area extending from the medulla oblongata to the cervical spinal cord. Magnetic resonance images showed cervical spondylosis at the C5-6 and C6-7 levels, with high signal intensity changes from the medulla oblongata to the lower cervical cord on T2-weighted images. Cerebral angiography showed no abnormal vessels. Conservative treatment gradually improved symptoms and the high signal intensity areas. This case highlights intracranial hemorrhage occurring from extracranial causes and the possibility of VHM due to cervical spondylosis. When hemorrhagic lesions of the craniovertebral junction or spinal parenchymal lesions are encountered, the underlying pathology should be investigated thoroughly and systematically. https://thejns.org/doi/10.3171/CASE24441.

Etiology, Diagnosis And Therapy Of Burning Mouth Syndrome In Denture Wearers - Review

Background: The Burning Month Syndrome (BMS) is an oral mucosa pain - with or without inflammatory signs - without any specific lesion. Burning mouth syndrome (BMS) is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity. The cause of BMS is not known, therefore a complex association of biological, psychological and neurophatic factors has been identified. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The aim of this study was to understand the etiological factors (local, systemic, and psychosocial) which may be responsible for oral burning associated with BMS, and to offer the prosthodontic practitioners possibilities for treatment generally at all patients, especially at denture wearers in solving this problem. Matherials and methods: Review of literature was used to analyze the etiological factors for BMS, pain characteristics, diagnostic criteria and treatment possibilities for BMS condition at patients with dentures. Results: BMS can be divided into three types depending on the intensity of pain. There are also few possible theories behind the cause of BMS. Local oral factors are: denture acrylic allergies, poorly fitting dentures, para functional activities, salivary gland dysfunction, taste dysfunction, infectious agents, periodontal diseases, peripheral nerve damage. Systemic factors are: nutritional deficiency/anemia, central nervous system disorders, psychological disorders, hormonal changes and diabetes mellitus, xerostomia and Sjogren's syndrome. Discussion: Problems with dentures are important factors in the burning symptoms. Inadequate denture retention and stability can induce abnormal tongue activity and become a habit to retain the denture extensions and in adequate freeway space increase load on the denture bearing areas which results of burning mouth sensation. It is clinically helpful if patients find that removal of the denture reliefs their symptoms. Although the short‐term follow‐up studies may show potential symptomatic improvement with treatment in patients with BMS, the long‐ term outcomes for BMS remain unclear. In perspective, complete understanding of the etiology and pathogenesis is imperative to the development of novel and efficacious therapeutic strategies and will guide overall prognosis of the disease in the future. Conclusion: Although different etiological theories have been proposed to explain primary burning mouth syndrome, none have received universal acceptance to date. BMS is a difficult and challenging problem for the dental practitioner. It is a clinical diagnosis made via the exclusion of all other causes. No universally accepted diagnostic criteria, laboratory tests, imaging studies or other modalities definitively diagnose or exclude BMS. The key to successful management is a good diagnostic work-up and coordination between the prosthodontic practitioners and appropriate physicians and psychologists. All this together will help prosthodontics practitioners to better diagnose and treat the BMS.

Separate anterior paraventricular thalamus projections differentially regulate sensory and affective aspects of pain

The experience of pain is complex, involving both sensory and affective components, yet the underlying neural mechanisms remain elusive. Here, we show that formalin-induced pain behaviors coincide with increased responses in glutamatergic neurons within the anterior paraventricular nucleus of the thalamus (PVA). Furthermore, we describe non-overlapping subpopulations of PVAVgluT2 neurons involved in sensory and affective pain processing, whose activity varies across different pain states. Activating PVA glutamatergic neurons is sufficient to induce mechanical hypersensitivity and aversion behaviors, whereas suppression ameliorates formalin-induced pain. Furthermore, we identify the segregation of PVAVgluT2 projections to the bed nucleus of the stria terminalis (BNST) and nucleus accumbens (NAc), each influencing specific aspects of pain-like behavior. This finding provides an important insight into the mechanism of distinct components of pain, highlighting the pivotal role of PVA in mediating different aspects of pain-like behavior with distinct circuits.

Low-dose sufentanil does not affect tolerance to LBNP-induced central hypovolemia or blood pressure responses during a cold pressor test.

Hemorrhage is a leading cause of death in the prehospital setting. Since trauma-induced pain often accompanies a hemorrhagic insult, the administered pain medication must not interfere with critical autonomic regulation of arterial blood pressure and vital organ perfusion. The purpose of this study was to test two unrelated hypotheses: 1) sublingual sufentanil (Dsuvia) impairs tolerance to progressive central hypovolemia and 2) sublingual sufentanil attenuates pain sensation and the accompanying cardiovascular responses to a noxious stimulus. Twenty-nine adults participated in this double-blinded, randomized, crossover, placebo-controlled trial. After sublingual administration of sufentanil (30 μg) or placebo, participants completed a progressive lower-body negative pressure (LBNP) challenge to tolerance (aim 1). After a recovery period, participants completed a cold pressor test (CPT; aim 2). Addressing the first aim, tolerance to LBNP was not different between trials (P = 0.495). Decreases in systolic blood pressure from baseline to the end of LBNP also did not differ between trials (time P < 0.001, trial P = 0.477, interaction P = 0.587). Finally, increases in heart rate from baseline to the end of LBNP did not differ between trials (time P < 0.001, trial P = 0.626, interaction P = 0.424). Addressing the second aim, sufentanil attenuated perceived pain (P < 0.001) in response to the CPT, though the magnitude of the change in mean blood pressure during the CPT (P = 0.078) was not different between trials. These data demonstrate that sublingual sufentanil does not impair tolerance to progressive central hypovolemia. Additionally, sublingual sufentanil attenuates perceived pain, but not the accompanying mean blood pressure responses to the CPT.NEW & NOTEWORTHY Addressing two unique aims, we observed that sublingual sufentanil administration does not impair tolerance or cardiovascular responses to lower-body negative pressure (LBNP)-induced progressive central hypovolemia. Second, despite pain perception being reduced, sublingual sufentanil did not attenuate mean blood pressure responses to a cold pressor test (CPT).

A Protocol for the Validation of Novel Sham Acupuncture in Patients Who Have Had a Stroke

Background: A sham control group enhances the quality of clinical trials by controlling for the placebo effect. To ensure rigorous blinding to enhance the quality of clinical trials on acupuncture treatment it is important to develop a more sophisticated sham needle. Discrepancies in perceived needling sensation and treatment expectations between patients and healthy volunteers may affect study outcomes. Thus, it may be inappropriate to generalize the findings of a sham needle validation study in healthy adults to patients who have had a stroke. Therefore, this is a protocol for a clinical trial in patients who have had a stroke to validate a newly developed sham needle to be used in double-blind trials.Methods: Sixty-six patients who have had a stroke will be randomly assigned to the verum or sham needle group using a 1:1 ratio. As the verum and sham needles are identical in appearance, both participants and practitioners will be unaware of the needle type used for acupuncture treatment. After the acupuncture procedure, the participants will be asked whether they believe they received the verum or sham acupuncture treatment and indicate penetration, pain, and de qi sensation for each acupuncture point. A between-group comparison of needle-related adverse events will be performed.Discussion: This double-blind randomized controlled trial will be the first study to validate a newly developed sham acupuncture needle for patients who have had a stroke. The results of this study may inform clinical trial study design for acupuncture treatment of patients who have had a stroke.

Desenvolvimento de um dispositivo de fixação para aplicações de injeção com seringa em pacientes diabéticos

Hypodermic needles are widely used in both medicine and dentistry, which makes their study crucial. Understanding the pain perception caused by the insertion of these needles is particularly important for patients who fear or are phobic about seeing or feeling that they penetrate their skin. Our previous research focused on the impact of various needle characteristics on pain sensation during hypodermic injections and identified ways to reduce discomfort and injection-related phobia. We hypothesized that reducing the force required for needle penetration could minimize tissue trauma, and therefore, the pain experienced. That previous study investigated how factors such as cannula diameter, surface roughness, penetration depth, lubrication, and angle of the needle's bevel tip influence pain perception during injections, employing an artificial tissue model to gauge the effort needed for penetration. The findings indicated that needles with larger bevel angles required more penetration force, which correlated with increased pain perception among patients. In the presente study we further examined the wear and burr formation on repeatedly used needles using a profile projector and Scanning Electron Microscopy (SEM), which can hinder penetration and cause tissue damage. Additionally, we explored mechanical methods to prevent needles intended for subcutaneous injections from inadvertently penetrating muscle tissue. We developed a device to simplify the process of administering and self-administering injections, enhancing safety, comfort, and reducing the pain experienced by patients. This approach not only addresses the technical aspects of needle design but also considers the psychological impacts on patients, potentially improving therapeutic outcomes

Measuring functioning and disability in Korea: comparing general and dedicated surveys using the ICF

Abstract Background Functioning is the third health indicator besides mortality and morbidity. Although Korea periodically collects functioning information, the functioning indicator has not been generated yet. This study aimed to evaluate how functioning information is currently collected in Korea’s health and disability surveys, especially in terms of comparability and comprehensiveness, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. Methods Data sources included three health and disability surveys in Korea (Population and Housing Census, Korean National Health and Nutrition Examination Survey, Survey on the Living condition of Persons with Disabilities) and two international ICF-based surveys (International Spinal Cord Injury Survey, Model Disability Survey). Functioning information was linked by category to the ICF Generic-30 Set utilizing the ICF linking rules. Results Three ICF categories (walking, washing oneself, dressing) were covered by all the data sources. Excluding the Census, which inherently differs from the other data sources, all the surveys addressed six ICF categories-b152 emotional functions; b280 sensation of pain; d240 handling stress and other psychological demands; d450 walking; d510 washing oneself; d540 dressing. Despite of the common ICF categories, important differences in the operationalization of questions and response options were found. Conclusions The overlap of content of health and disability surveys in Korea enables interoperability with other data sources. Available functioning data can be used for estimating the functioning indicator and metric, as recommended by WHO, which can serve as a valuable epidemiological indicator for complementing mortality and morbidity indicators and for estimating and monitoring rehabilitation or long-term care needs of the Korean population. Key messages • Korea’s health and disability surveys periodically collect functioning information at the national level, and the level of overlap across surveys enables interoperability with other data sources. • This study can contribute to generate a Korean common health metric based on functioning that can serve as a valuable epidemiological indicator by utilizing the international standard ICF.

Research progress of acupuncture in improving pain emotion by regulating functions of anterior cingulate cortex

Pain emotion is a negative emotion caused by pain, which seriously affects the patients' physical and psychological health. The anterior cingulate cortex (ACC) is a key brain region in the occurrence and regulation of pain and painful emotion. In this paper, we summed up the relevant progress of researches on acupuncture improvement of pain emotion from neurotransmitters and receptors, cellular signaling pathways and neural circuits of ACC, in order to provide a basis for further research. 1) Acupuncture can regulate the long-term potentiation of ACC synaptic transmission by down-regulating the expression of N-methyl-D-aspartic acid receptor (NMDAR)； and up-regulating the expression of μ-, delta- and κ-opioid receptors, neuropeptide S (NPS)/ NPS receptor, and the number of parvalbumin-expressing interneurons to reduce neuronal excitability, relieving pain emotion； 2) Acupuncture can regulate synaptic transmission of ACC neurons by inhibiting protein kinase Mζ (PKMζ)-GluR1 and cAMP/PKA-ERK-CREB signaling pathways, and modulate synaptic plasticity to ameliorate pain emotion； 3) Acupuncture intervention induced inhibition of rostral ACCGlu-thalamic circuit may result in relief of pain emotion but not pain sensation, whereas inhibition of the rostral ACCGlu-ventrolateral periaqueductal gray matter(vlPAG) circuit may relieve pain sensation but not pain emotion. In addition, our team found that in the treatment of painful diseases by acupuncture, the addition of "spirit-regulating" acupoints can not only improve patients' negative emotion, but also significantly relive patients' pain sensation.

Decoding the brain: EEG applications in sensory processing, emotion recognition, and pain assessment

This work explores the diverse applications of electroencephalography (EEG) across sensory processing, emotion recognition, and pain assessment. It analyzes recent studies employing EEG to investigate auditory perception, visual processing, emotional states, and pain experiences, highlighting common methodological approaches such as preprocessing techniques, feature extraction methods, and classification algorithms. Key findings reveal EEG’s potential in decoding complex brain states, from identifying neural correlates of music perception to detecting pain signals, and discuss the advancement of machine learning techniques, particularly deep learning, in enhancing the accuracy and real-time capabilities of EEG-based systems. The paper also addresses challenges in EEG research, such as limited spatial resolution and the need for larger, more diverse datasets, and proposes future directions emphasizing multimodal integration, standardization of protocols, and the development of user-friendly tools for clinical applications. This paper underscores EEG’s significant role in advancing our understanding of brain function and its potential to revolutionize neurological diagnostics and treatments.

Study on transient electric shock characteristics between human body and metal clothes hanger on residential platform near UHV AC transmission lines

AbstractWith the development of ultra‐high‐voltage (UHV) and extra‐high‐voltage transmission lines in China, the transmission lines are gradually approaching the residential areas. The phenomenon of induced electric shock caused by electrostatic induction effect can cause dissatisfaction and complaints from nearby residents. In this paper, a full‐size steel‐framed residential test platform was constructed near a 1000‐kV UHV alternating current (AC) transmission line, the transient shock characteristics of human bodies and metal hangers in different scenarios was investigated, then the relationship between transient shock energy and subjective perception of the human body was discussed. In addition, the shielding effect of shielding wires for transient electric shock situations is analyzed. It was found that the worst‐case scenario occurred when the grounded human body came into contact with the insulated metal clothes hanger, even eliciting a noticeable sensation of pain. In addition, increasing metal shielding wire number has a significant effect on weakening induced electric shocks.

A Novel Pathogenic Mutation in WNK1 Gene Causing HSAN Type II in Three Siblings.

Hereditary sensory and autonomic neuropathy (HSAN) is a rare genetic disorder that primarily affects the peripheral nervous system, leading to a progressive loss of the ability to perceive pain, temperature, and touch. This condition can result in severe complications, including injuries and infections due to the inability to feel pain. HSAN is classified into nine types, with types I and VII exhibiting autosomal dominant inheritance, while the others follow an autosomal recessive pattern. In this study, we examined three affected brothers of Turkish Azeri descent, aged 20, 23, and 25 years. They presented symptoms such as a lack of temperature and pain sensation, frequent wounds and infections, self-harm, and hyperkeratosis. To identify the genetic cause of their condition, whole-exome sequencing (WES) was performed, followed by Sanger sequencing to confirm the findings. The results revealed a homozygous likely pathogenic nonsense mutation, c.2971C > T (p.Arg991Ter), in exon 9 of the WNK1 gene. This mutation results in the truncation of three isoforms of the WNK1 protein, which are essential for pain perception. This discovery enhances our understanding of HSAN and highlights the importance of genetic testing for accurate diagnosis and future screening.

Use of the international classification of functioning, disability and health in a group of older persons with osteoarticular disorders

Objective: to describe the main structural and functional impairments, activity limitations, and social participation restrictions in elderly individuals with myoarticular dysfunctions using the International Classification of Functioning, Disability, and Health (ICF). Methods: a descriptive, cross-sectional, and retrospective study based on the analysis of clinical and functional data of elderly individuals with osteomyoarticular dysfunctions. A questionnaire including components of Functionality and Disability (ICF, 2004), mobility and stability (Timed Up and Go), lower limb muscle strength (Sit-To-Stand Test), and pain (visual analog scale) was used. Results: a total of 11 elderly individuals (70±1.4 years) with at least two comorbidities (100%) were included, with the majority reporting episodes of falls (54.5%). Pain was the primary complaint in "Body functions," reported by all participants. In "Body structures," the lower limbs (45.4%) and upper limbs (18.1%) had the highest prevalence of complaints. In "Activities and Participation," the most frequently mentioned items were performing housework tasks (31.8%), moving around (31.8%), and recreation and leisure (27.3%). Conclusion: among the ICF components, pain sensation was the most common finding in elderly individuals, especially affecting the lower limbs. Regarding activity limitations and social participation restrictions, performing housework tasks, moving around, and recreation/leisure were prevalent.

Health Effects of Methylmercury in Coastal Areas of the Yatsushiro Sea, Far from Minamata.

Minamata disease, caused by ingesting seafood contaminated with methylmercury dumped by corporations, was discovered in 1956; however, there has been no continued investigation to determine the full extent of the damage. Since 2004, it has been discovered that affected patients can be found in areas further away from Minamata than previously known. In the present study, we investigated various symptoms and somatosensory disturbances in western Miyanokawachi District, northern Himedo District, southwestern Nagashima District, and the uncontaminated Amami district and calculated the proportion of patients with sensory disturbances as a percentage of the population in each area. Both touch and pain sensations, with a predominance of the peripheral extremities, were observed in 58.6% of patients in Miyanokawachi, 53.9% in Himedo, 37.8% in Nagashima, and 1.4% in Amami. The lowest estimates of attributable fractions of the exposed group for four-limb-predominant sensory disturbance in the population of the contaminated districts were 94.1% in Miyanokawachi, 94.6% in Himedo, and 91.4% in Nagashima, and general and perioral sensory disturbances were also high. This suggests that the presence or absence of these sensory disturbances is useful in the diagnosis of Minamata disease, even in more distant parts of the Yatsushiro Sea area.