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Traumatic peripheral neuropathic pain is a complex syndrome caused by a primary lesion or dysfunction of the peripheral nervous system. Secondary to the lesion, resident or infiltrating macrophages proliferate and initiate a cross-talk with the sensory neurons, at the level of peripheral nerves and sensory ganglia. The neuron–macrophage interaction, which starts very early after the lesion, is very important for promoting pain development and for initiating changes that will facilitate the chronicization of pain, but it also has the potential to facilitate the resolution of injury-induced changes and, consequently, promote the reduction of pain. This review is an overview of the unique characteristics of nerve-associated macrophages in the peripheral nerves and sensory ganglia and of the molecules and signaling pathways involved in the neuro-immune cross-talk after a traumatic lesion, with the final aim of better understanding how the balance between pro- and anti-nociceptive dialogue between neurons and macrophages may be modulated for new therapeutic approaches.

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Pregnancy associated with chronic kidney disease (CKD) have a significant fetal and maternal risk, including developing preeclampsia, prematurity and progress of renal function. Is CKD a barrier in conception? The aim of the study was to monitor the maternal and fetal evolution and complications occurring during pregnant patients with different degrees of CKD. Our study used a descriptive and prospective plan for analyzing pregnancies of women with CKD and the fetal and maternal impact of it. A total of 23 patients were included in the study and were followed for three years. Results: Of total number of 104 patients with renal pathology included in studied group, 23 had chronic kidney disease (22%) and the rest of it had acute renal insufficiency or infectious renal pathology. Depending on the evolution of CKD there were 8 cases with acute deterioration of renal function and 15 cases in which the renal function remained stationary. The underlying renal disease was represented by autosomal dominant polycystic kidney disease, diabetic nephropathy, chronic pyelonephritis, glomerular nephropathies, and women who have already been on hemodialysis therapy. Urinary tract infections, nephrotic syndrome and preeclampsia were the main causes of acute on CKD. Complications were represented by spontaneous abortions, prematurity, septic shock and, in some cases, followed by progression of CKD stage. Conclusions: Pregnancy associated with CKD represents a challenge for physicians, even in early stages, and it is necessary to be monitored in a multidisciplinary team, for reducing fetal and maternal risks.

Background: Antibiotics represent one of the most used classes of medications since the discovery of penicillin by Alexander Fleming in 1928. A significant percentage of antibiotics and their metabolites are excreted in the urine, leading to a high concentration in the kidney that may often cause renal impairment. Medication-induced nephrotoxicity represents one of the most common causes of acute kidney injury (AKI) in hospitalized patients. Clinical manifestations are variable, ranging from mild to severe forms, requiring renal replacement therapy. Methods: We conducted a retrospective study on 122 patients admitted for antibiotics' associated acute kidney injury in our county clinical emergency hospital for the interval of time of one year. We have collected patients' demographic data, history of past and current medications and diseases, biological parameters and imagistic data. Drug-induced AKI was defined considering AKIN classification. Results: From the 122 admitted patients (42 men and 80 women). Aminoglycosides (gentamicin and amikacin), vancomycin, beta-lactam antibiotics (ceftriaxone and cefuroxime), usually monotherapy and rarely in combination therapy were the constant causes of AKI. The most frequent co-morbidities in our study group were: diabetes mellitus (35.2%), renal lithiasis (32%) and arterial hypertension (20.5%). Presence of diabetes mellitus as comorbidity (OR=2.8; CI=1.5-5.9, P=0.01), administration of nephrotoxic combinations, (OR=1.9; CI=1.1-3.8, P=0.04) and moderate-to-severe dehydration syndrome on admission (OR=3.8; CI=2.1 -6.8, P less than 0.001), were discovered to be independent risk factors for AKI due to antibiotic administration in our study group. Renal replacement therapy was needed in 17.2% of our patients, and 11.4% died in spite of intensive therapy. Conclusions: By living in the era of highly resistant pathogens and patients with multiple comorbidities, antibiotics represent important allies to healthcare workers, with the condition of optimal prescription and use. Also, several strategies may help prevent medication-induced acute kidney injury, especially in patients that are highly susceptible: dosage adjustment to the renal dysfunction, adequate hydration during the therapy, avoidance of concomitant use of other nephrotoxic drugs such as non-steroidal anti-inflammatory drugs, reninangiotensin-aldosterone inhibitors or contrast media.