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Abstract Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.

Abstract Urinary tract infections (UTIs) are the main complication associated with clean intermittent catheterization (CIC) and are facilitated by post-void residual urine and trauma to the mucosa during voiding. The risk of UTI may be diminished by reducing the residual volumes and preventing microtrauma caused by mucosal suction through the eyelets of conventional eyelet catheters (CEC). A new micro-hole zone catheter (MHZC) was developed and tested in an ex vivo porcine lower urinary tract model and in vivo, in pigs, against a CEC. It was shown that, irrespective of the micro-hole diameter, the new catheter ensured increased flowrates and significantly lower residual volumes at the first flow-stop. Furthermore, with a micro-hole diameter of 0.4 mm, mucosal suction was virtually eliminated, regardless of the insertion depth or simulated intra-abdominal pressure mimicking sitting or standing humans. Pressure profile experiments and endoscopy studies indicated that the bladder gradually folds against the drainage tip of the new catheter, without blocking the flow, and, unlike with the CEC, sharp pressure variations and flow-stops did not occur during voiding. The MHZC outperformed the CEC in all tested scenarios and decreased residual volumes, thus potentially decreasing the risk of UTIs.

BackgroundSmall clusters comprising hundreds to thousands of neurons are an important level of brain architecture that correlates single neuronal properties to fulfill brain function, but the specific mechanisms through which this scaling occurs are not well understood. In this study, we developed an in vitro experimental platform of small neuronal circuits (islands) to probe the importance of structural properties for their development, physiology, and response to microtrauma.MethodsPrimary cortical neurons were plated on a substrate patterned to promote attachment in clusters of hundreds of cells (islands), transduced with GCaMP6f, allowed to mature until 10–13 days in vitro (DIV), and monitored with Ca2+ as a non-invasive proxy for electrical activity. We adjusted two structural factors–island size and cellular density–to evaluate their role in guiding spontaneous activity and network formation in neuronal islands.ResultsWe found cellular density, but not island size, regulates of circuit activity and network function in this system. Low cellular density islands can achieve many states of activity, while high cellular density biases islands towards a limited regime characterized by low rates of activity and high synchronization, a property we summarized as “flexibility.” The injury severity required for an island to lose activity in 50% of its population was significantly higher in low-density, high flexibility islands.ConclusionTogether, these studies demonstrate flexible living cortical circuits are more resilient to microtrauma, providing the first evidence that initial circuit state may be a key factor to consider when evaluating the consequences of trauma to the cortex.

Abstract Purpose Sports injuries among youth and adolescent athletes are a growing concern, particularly at the knee. Based on our current understanding of microtrauma and anterior cruciate ligament (ACL) healing characteristics, this clinical commentary describes a comprehensive plan to better manage ACL microtrauma and mitigate the likelihood of progression to a non‐contact macrotraumatic ACL rupture. Methods Medical literature related to non‐contact ACL injuries among youth and adolescent athletes, collagen and ACL extracellular matrix metabolism, ACL microtrauma and sudden failure, and concerns related to current sports training were reviewed and synthesized into a comprehensive intervention plan. Results With consideration for biopsychosocial model health factors, proper nutrition and modified sports training with increased recovery time, a comprehensive primary ACL injury prevention plan is described for the purpose of better managing ACL microtrauma, thereby reducing the incidence of non‐contact macrotraumatic ACL rupture among youth and adolescent athletes. Conclusion Preventing non‐contact ACL injuries may require greater consideration for reducing accumulated ACL microtrauma. Proper nutrition including glycine‐rich collagen peptides, or gelatin‐vitamin C supplementation in combination with healthy sleep, and adjusted sports training periodization with increased recovery time may improve ACL extracellular matrix collagen deposition homeostasis, decreasing sudden non‐contact ACL rupture incidence likelihood in youth and adolescent athletes. Successful implementation will require compliance from athletes, parents, coaches, the sports medicine healthcare team, and event organizers. Studies are needed to confirm the efficacy of these concepts. Level of evidence V

The purpose of this article is to present the phenomenon of psychological microtrauma, a trauma that is cumulative in nature and results from prolonged exposure to many stressful situations in one area of suffering that are usually not so severe as those causing post-traumatic stress disorder and are included in criterion A in the Diagnostic and Statistical Manual of Mental Disorders. The introduction to the International Classification of Diseases 11th Revision of a new disorder named complex post-traumatic stress disorder, despite allowing a better understanding of people who experience chronically repeating traumas, does not explain the consequences of microtrauma which can be approached from psycho-dynamic, clinical and social perspectives. Taking into account the difficulties associated with identifying microtrauma, knowledge of this phenomenon could be useful for clinicians and their patients. The theory of microtrauma is a promising area of research and may finally bring the answer why there is a high prevalence of diagnosing post-traumatic disorder among people who experience not severe but chronic stressful events in one area in terms of content in their daily lives, e.g. discrimination. It shows how much is still ahead of us in understanding trauma and how rich and complex this phenomenon is. [ABSTRACT FROM AUTHOR]

The presence of brachial diplegia despite the normal muscular strength of the lower extremities is called the man-in-the-barrel syndrome (MIBS). Although this rare syndrome often occurs due to the bilateral supratentorial brain lesions, it may also rarely occur as a result of infratentorial causes. In this report, we describe a case presenting with MIBS of which etiological underlying cause was bilateral brachial plexopathy developed secondarily to recurrent microtrauma. A 51-year-old male patient presented to our clinic with complaints of pain and weakness on both arms. After electrodiagnostic examination, bilateral brachial plexopathy was identified. The findings of the patient improved following methylprednisolone therapy. It is very important to determine the treatable causes of this syndrome at an early stage.

Background: Small clusters comprising hundreds to thousands of neurons are an important level of brain architecture that correlates single neuronal properties to fulfill brain function, but the specific mechanisms through which this scaling occurs are not well understood. In this study, we developed an in vitro experimental platform of small neuronal circuits (islands) to probe the importance of structural properties for their development, physiology, and response to microtrauma., Methods: Primary cortical neurons were plated on a substrate patterned to promote attachment in clusters of hundreds of cells (islands), transduced with GCaMP6f, allowed to mature until 10-13 days in vitro (DIV), and monitored with Ca 2+ as a non-invasive proxy for electrical activity. We adjusted two structural factors-island size and cellular density-to evaluate their role in guiding spontaneous activity and network formation in neuronal islands., Results: We found cellular density, but not island size, regulates of circuit activity and network function in this system. Low cellular density islands can achieve many states of activity, while high cellular density biases islands towards a limited regime characterized by low rates of activity and high synchronization, a property we summarized as "flexibility." The injury severity required for an island to lose activity in 50% of its population was significantly higher in low-density, high flexibility islands., Conclusion: Together, these studies demonstrate flexible living cortical circuits are more resilient to microtrauma, providing the first evidence that initial circuit state may be a key factor to consider when evaluating the consequences of trauma to the cortex., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Adegoke, Teter and Meaney.)

Purpose: To study the role of corneal microtrauma in the development of complications, leading to bacterial ulcers. Performed clinical assessment, conservative therapy, and surgical interventions for 236 patients with the complication of microtrauma, mainly related to the prolonged presence of foreign bodies in the cornea (86.1% they had a metallic nature). Methods included ophthalmologic investigations and laboratory procedures, which revealed the presence of bacterial corneal ulcer in 97 cases (41.1%), recurrent erosion — 62 cases (26.3%), traumatic keratitis — 25 cases (10.6%) and deep cornea’s infiltrate — 52 cases (22.0%). The development of complications was due to the later removal of FB (in some cases more than 1 month after the trauma), incomplete removal of foreign bodies, non-compliance with aseptic and antiseptic rules during in the removal of FB’s without follow up of patients. Streptococcus, staphylococcus, pneumococcus, and isolated cases of Pseudomonas aeruginosa and Escherichia coli were mainly diagnosed. Conservative therapy included specific, pathogenetic, symptomatic and antiallergic medications. Nitric oxide (NO) in the gas stream was used to accelerate the reparative processes, weakening of the inflammatory exudation and cellular proliferation. Surgical interventions were performed for preserving of eyes, prophylactic and therapeutic purposes in the form autoconjunctiveal plast y, deep lamellar and penetrating keratoplast y (preserved and fresh corneas) and amniotic membrane transplantation. According to the results of treatment of 236 patients with the corneal erosion completed with elimination of inflammatory reaction, restoration of corneal transparency; 52 patients with corneal infiltrate -development of opacities in the stromal cornea layers; patients with keratitis –formation of corneal leucoma and 52% — keratoplast y were performed. In cases of corneal ulcer process ended with the formation of a rough leucoma in 30 patients (30.9%), surgical interventions with a partial improvement of visual function were observed in 62 patients (63.9%), the removal of the eye were done in 5 patients (5.2%).

Athletes with microtrauma or overuse injuries resulting from an accumulation of repeated small forces may differ from athletes with macrotrauma or acute injuries in their psychosocial responses because of the unique challenges presented by these insidious-onset and often chronic injuries. Our purpose was to use narrative inquiry to examine the psychosocial experiences and responses of 10 long-distance runners who had experienced microtrauma injuries. Qualitative data analysis of interview data led to a chronological timeline of the injury experience and an assessment of the meaning attributed to these injury experiences using a variation of Mishler’s core-narrative approach. Participants reported distinct thoughts, feelings, and behaviors during each phase of the injury—pre-injury, injury onset, and outcome. In the pre-injury period, participants indicated specific running-related goals and attributed their injuries to overtraining or a change in training. During the injury onset phase, participants consistently indicated two themes: self-diagnosis and treatment, and not taking time off. Within the outcome phase of injury, participants acknowledged changed training because of the injury, and lessons learned from their injury experiences. The narratives of microtrauma-injured runners revealed psychosocial distress and behavioral tendencies post-injury that have important implications for runners, coaches, and healthcare professionals.

Tissue microtrauma (TM) is one of the causes of impaired performance of cyclists of any category. Unlike macro-trauma, TM can be prevented through correct posture, which has been studied by different authors. This article presents a systematic review that focuses on three specific aspects: What are the principal causes of tissue microtrauma? Which technologies have been used to measure the flexion points of a cyclist? How many people have the experimental protocol included in the articles? For this, a review is carried out in four search engines using search strings related to the topic, including results in a range of 11 years and using a detailed methodological process. Finally, the article establishes that the main causes of microtrauma are incorrect posture, that in the measurement of flexion points, optical systems are the most used, but they are limited to laboratory studies and that inertial systems, although they are still consolidating, have greater potential. [ABSTRACT FROM AUTHOR]

A 26-year-old male was referred with sequel of Stevens-Johnson Syndrome (SJS) in form of bilateral severe keratinisation of lid margin and Symbhlepharon involving in particular forniceal region. At the time of presentation his visual acuity was 20/120. Indirect ophthalmoscopic examination revealed normal optic nerve head with attached retina. Superficial dissection was done between palpebral and bulbar conjunctiva so as to release symblepharon and further ocular surface reconstruction was carried out with labial Mucous Membrane Graft [MMG]. His best corrected final visual acuity was 20/40 with well accepted graft indicating that this technique definitely improves visual acuity and alleviates patient discomfort by improving ocular surface milieu and hence, possibly further avoids deterioration of ocular surface in SJS.