scholarly journals The comparison of MRN, electrophysiology and progression among typical CIDP and atypical CIDP subtypes

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yuan Feng ◽  
Yu Zhang ◽  
Xiaoyun Su ◽  
Chuansheng Zheng ◽  
Zuneng Lu

Abstract We aimed to compare the electrophysiology and magnetic resonance neurography (MRN) results of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) subtypes and to explore the progression from atypical CIDP to typical CIDP. We collected the medical records of 45 CIDP patients to analyse the rate of progression from atypical CIDP to typical CIDP subtypes. The cerebrospinal fluid (CSF) protein (p = 0.024) and overall disability sum score (ODSS) (p = 0.000) differed among patients with typical CIDP, distal acquired demyelinating symmetric neuropathy (DADS) and Lewis-Sumner syndrome (LSS). The compound motor action potential (CMAP) of typical CIDP was lower than that of the other subtypes (p = 0.016, p = 0.022 and p = 0.012). The cross-sectional area (CSA) of nerve roots in typical CIDP was significantly thicker than that of nerve roots in DADS and LSS. There were fewer DADS and LSS patients who progressed to typical CIDP than those who progressed to pure motor and pure sensory CIDP (p = 0.000), and the progression from pure motor to typical CIDP required a significantly longer time than the progression from pure sensory to typical CIDP (p = 0.007). Typical CIDP was more severe than the other subtypes not only in terms of clinical and electrophysiology factors but also in terms of MRN factors.

2021 ◽  
pp. 1-9
Author(s):  
Kyosuke Koide ◽  
Atsuhiko Sugiyama ◽  
Hajime Yokota ◽  
Hiroki Mukai ◽  
Jiaqi Wang ◽  
...  

<b><i>Introduction:</i></b> This study assessed the morphological changes and diffusion tensor imaging (DTI)-derived parameters of the brachial plexus using magnetic resonance neurography (MRN) in patients with anti-myelin-associated glycoprotein (anti-MAG) neuropathy. <b><i>Methods:</i></b> Eight patients with anti-MAG neuropathy underwent MRN of the brachial plexus with 3-dimensional (3D) short tau inversion recovery (STIR) and DTI sequences. Two neuroradiologists and a neurologist qualitatively assessed nerve hypertrophy on 3D STIR MRN. The cross-sectional area (CSA) of the nerve roots was measured. Quantitative analyses of fractional anisotropy (FA) and axial, radial, and mean diffusivity (AD, RD, and MD) were obtained after postprocessing on DTI and manual segmentation. <b><i>Results:</i></b> There was nerve hypertrophy in 37.5% of the patients with anti-MAG neuropathy. All patients with anti-MAG neuropathy with nerve hypertrophy were refractory to rituximab therapy. The CSA of the nerve roots was inversely correlated with FA and positively correlated with MD and RD. FA decreased in the nerve roots and inversely correlated with disease duration. <b><i>Conclusions:</i></b> Nerve hypertrophy appears in the proximal portion of peripheral nerves, such as the brachial plexus, in patients with anti-MAG neuropathy. Altered diffusion in the nerve roots might be associated with the loss of myelin integrity due to the demyelination process in anti-MAG neuropathy.


2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Jihyeung Kim ◽  
Young Eun Choi ◽  
Jeong Hwan Kim ◽  
Seung Hak Lee ◽  
Sohee Oh ◽  
...  

Purpose. Although many surgeons have anecdotally described reversing the polarity of the autograft with the intent of improving regeneration, the optimal orientation of the autogenous nerve graft remains controversial. The aim of this study was to compare (1) the outcomes of orthodromic and antidromic nerve grafts to clarify the effect of nerve graft polarity and (2) the outcome of either form of nerve grafts with that of nerve repair. Methods. In 14 of the 26 rabbits used in this study, a 1 cm defect was made in the tibial nerve. An orthodromic nerve graft on one side and an antidromic nerve graft on the other were performed using a 1.2 cm long segment of the peroneal nerve. In the remaining 12 rabbits, the tibial nerve was transected completely and then repaired microscopically on one side but left untreated on the other. Electrophysiologic studies were performed in all animals at 8 weeks after surgery, and the sciatic nerves were harvested. Results. Compound motor action potential was visible in all rabbits treated by nerve repair but in only half of the rabbits treated by nerve graft. There was no significant difference in the compound motor action potential, nerve conduction velocity, or total number of axons between the orthodromic and antidromic nerve graft groups. However, in both groups, the outcome was significantly poorer than that of the nerve repair group. Conclusion. There was no significant difference by electromyographic or histologic evaluation between orthodromic and antidromic nerve grafts. Direct nerve repair with moderate tension may be a more effective treatment than nerve grafting.


Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 164
Author(s):  
Min Cheol Chang ◽  
Donghwi Park

Purpose: The purpose of this study was to investigate the findings of electrodiagnostic studies (nerve conduction study (NCS) and electromyography (EMG)) in patients with moderate and severe lumbar central spinal stenosis (LCSS). Methods: We retrospectively reviewed the medical records of Ulsan University Hospital and identified 32 consecutive patients (mean age = 66.9 ± 7.4 years; male:female = 8:24) with LCSS. Based on the results of T2 axial magnetic resonance imaging at the level of L4–5, patients were categorized as having severe (n = 14) or moderate LCSS (n = 18). Results from NCS and EMG were retrieved. Additionally, we included 15 age- and sex-matched volunteers without LCSS (mean age = 65.2 ± 8.0 years; male:female = 4:11) to serve as a control group. Results of NCS and EMG were compared between the three groups. Results: We found that, compared to normal subjects, patients with moderate or severe LCSS presented significantly lower distal amplitudes of the compound motor action potential of both peroneal and tibial nerves. Regarding EMG, positive sharp waves and fibrillation potentials were exclusively observed in patients with severe LCSS group (28.6%). Conclusion: Electrodiagnostic studies were significantly altered in patients with moderate and severe LCSS. Our results may be helpful to diagnose LCSS-induced radiculopathy and to differentiate it from other causes of peripheral nerve pathologies.


2019 ◽  
Vol 7 (2) ◽  
pp. 31813
Author(s):  
Rodrigo Santiago ◽  
Ana Karina Silva da Rocha Tanaka ◽  
Patrícia Treviso ◽  
Daisy Zanchi de Abreu Botene ◽  
Claudine Lamanna Schirmer

OBJECTIVE: To evaluate the sociodemographic, clinical characteristics and prevalence of medications used by elderly patients with cardiovascular diseases, addressing the difference between users of the single health care system (SUS) and private/covenant during hospitalization. Methods: A retrospective cross-sectional study was carried out in a large hospital in Porto Alegre, by reviewing medical records of patients hospitalized at the coronary care units in the period from January to December 2015. The sample consisted of the evaluation of 152 medical records, the collection was performed through a specific semi-structured instrument. RESULTS: A total of 68 elderly patients belonged to the SUS user group. The other 84 medical records were users of several Covenants / Individuals groups. Regarding lifestyle, it was shown that smoking was representative. The presence of a significant association Regarding the clinical profile, all patients in both groups were hospitalized in coronary care units. CONCLUSIONS: It is concluded that the patients in the private / covenants group use a greater number of drugs outside the National Essential Medicines report than those in the SUS group. The SUS group stands out for being more hypertensive and smokers and as a result, they perform more hospitalizations with more severe pathologies when compared to the other group. These comparative data highlight the importance of actions that aim to balance the differences between the modalities of health plans served in Brazil.


2018 ◽  
Vol 8 (4) ◽  
pp. 65-69
Author(s):  
Mao Nguyen Van ◽  
Dong Tran Nam

Background: Pigmented tumour of the skin is one of the common tumour in human including the benign pigmented tumours (more common) called Nevi tumours and the malignant one called melanoma which was less frequent but the most poor in prognosis. In addition, the others not belonging to these group had the same clinical appearance, so the application of histopathology and immunohistochemistry for the definitive diagnosis was indespensible. Objectives: 1. To describe the macroscopic features of the pigmented tumoral-like lesions; 2. To classify the histopathologic types of the pigmented cell tumours and the other pigmented tumours of the skin. Materials and Method: Cross-sectional research on 55 patients diagnosed as pigmented tumoral lesions by clinician, then all definitively diagnosed by histopathology combining the immunohistochemistry in difficult cases. Results: There was no difference in gender, the disease was discovered most common in adult, especially with the age over 51 years old (58.1%). the most region located was in the face accounting for 60%, following the trunk and limbs (14.6%, 12.8% respectively). All 3 malignant melanomas happened in foot. The most common color of the lesions was black (65.4%), the other ones were rose, grey and blue. Histopathology and immunohisthochemistry showed that the true pigmented cell tumours were 52.6% encompassing benign ones (Nevi tumour) (41.8%), melanoma (5.4%) and lentigo (5.4%). 47.4% was not the true pigmented cell tumour including pigmented basocellular carcinoma (36.4%) and the others less common as histiofibromas, acanthoma and papilloma. Conclusion: the pigmented tumoral-like lesions of the skin could be the true pigmented cell tumours and the others, so the application of the histopathology and the immunohistochemistry after the clinical discovery helps to determine and classify the disease definitely and for the best orientation of treatment as well. Key words: skin tumour, benign pigmented tumour (Nevi), malignant pigmented tumour (melanoma), pigmented basocellular carcinoma


2018 ◽  
Vol 8 (4) ◽  
pp. 28-33
Author(s):  
Mao Nguyen Van ◽  
Thao Le Thi Thu

Background: In practice it was difficult or impossible to have a correct diagnosis for the lymphoid proliferation lesions based on only H.E standard histopathology. In addition to histopathology, the application of immunohistochemistry was indispensable for the definitive diagnosis of the malignant or benign tumours and the origin of the tumour cells as well. Objectives: 1. To describe the gross and microscopic features of the suspected lesions of lymphoma; 2. To asses the expression of some immunologic markers for the diagnosis and classification of the suspected lesions of lymphoma. Materials and Method: Cross-sectional research on 81 patients diagnosed by histopathology as lymphomas or suspected lesions of lymphoma, following with immunohistopathology staining of 6 main markers including LCA, CD3, CD20, Bcl2, CD30 and AE1/3. Results: The most site was lymph node 58.1% which appeared at cervical region 72.3%, then the stomach 14.9% and small intestine 12.4%. The other sites in the body were met with lower frequency. Histopathologically, the most type of the lesions was atypical hyperplasia of the lymphoid tissue suspecting the lymphomas 49.4%, lymphomas 34.5%, the other diagnoses were lower including inflammation, poor differentiation carcinoam not excluding the lymphomas, lymphomas differentiating with poor differentiation carcinomas. Immunohistochemistry showed that, LCA, CD3, CD20, Bcl2, CD30 and AE1/3 were all positive depending on such type of tumours. The real lymphomas were 48/81 cases (59.3%), benign ones 35.8% and poor differentiated carcinomas 4.9%. Conclusion: Immunohistochemistry with 6 markers could help to diagnose correctly as benign or malignant lesions, classify and determine the origin of the tumour cells as lymphocytes or epithelial cells diagnosed by histopathology as lymphomas or suspected lesions of lymphomas. Key words: histopathology, immunohistochemistry, lymphomas, poor differentiated carcinomas, hyperplasia, atypicality


Author(s):  
Y. Widyastuti Y. Widyastuti

  ABSTRACT [In advanced countries the number of permanent contraception option ( kontap ) approximately 10 % of all national family planning methods , while in Indonesia reached approximately 5.7 % . Based on data obtained from medical records Bhayangkara Hospital Palembang in 2010 the number of achievement when seen from the percentage of contraceptive use is only 9.10 % The purpose of this study is known age and parity relationship with the selection of contraceptive methods Surgery Women ( MOW ) in Palembang RS.Bhayangkara obstetrics clinic in 2012 . This study uses the analytic survey with cross sectional approach . The population in this study were women who become new acceptors were recorded in medical records at the hospital . Palembang Bhayangkara Hospitals January 1, 2012 to December 31 in 2012 . The sample in this study is part of a whole number of new acceptors ( either using contraception methods MOW and other family planning methods ) were registered in the hospital . Palembang Police Hospitals of January 1, 2012 to December 31 years of data 2012.Analisa univariate and bivariate statistical Chi - Square test with significance level α = 0.05 . The results showed there were 80 respondents ( 46.3 % ) who became MOW contraceptive acceptors , acceptors who have old age by 45 respondents ( 56.3 % ) and who has a young age by 35 respondents ( 43.8 % ) . acceptors which have high parity were 44 respondents ( 55 % ) who had low parity and a total of 36 respondents ( 45 % ) . From the results of Chi-square test value obtained ρ = 0.00 is smaller than α = 0.05 . There is a significant correlation between age and the selection of MOW Chi square test results obtained ρ value = 0.00 and there was a significant association between parity with the election MOW Chi square test results obtained ρ value = 0 , . From these results , it is expected to power health, especially family planning services at the hospital . Palembang Police Hospitals in order to improve the quality of family planning services in an effective, efficient , and safe are considered particularly suitable for users of contraception OperatingMethodWomen(MOW).                                      ABSTRAK Di negara sudah maju jumlah pilihan kontrasepsi mantap (kontap) sekitar 10% dari semua metode KB nasional, sedangkan di Indonesia baru mencapai sekitar 5,7 %. Berdasarkan data yang diperoleh dari Rekam medik  Rumah Sakit Bhayangkara Palembang tahun 2010 Jumlah pencapain tersebut jika dilihat dari persentasi penggunaan kontrasepsi MOW hanya  9,10% Tujuan penelitian ini adalah diketahuinya hubungan umur dan paritas dengan pemilihan alat kontrasepsi Metode Operasi Wanita (MOW) di poliklinik kebidanan RS.Bhayangkara Palembang Tahun 2012. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah wanita yang menjadi akseptor KB Baru yang tercatat di rekam medik  di RS. Bhayangkara Palembang tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012. Sampel dalam penelitian ini adalah sebagian dari seluruh jumlah akseptor KB Baru (baik yang menggunakan alat kontrasepsi Metode MOW maupun Metode KB lain) yang teregister di RS. Bhayangkara Palembang dari tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012.Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan dari 80 responden terdapat (46,3%) yang menjadi akseptor kontrasepsi MOW, akseptor yang memiliki umur tua sebanyak 45 responden (56,3%) dan yang memiliki  umur muda sebanyak 35 responden (43,8%). akseptor yang memiliki paritas tinggi sebanyak 44 responden  (55%) dan yang memiliki  paritas rendah sebanyak 36 responden (45%). Dari hasil uji Chi square didapatkan ρ value = 0,00 lebih kecil dari α = 0,05. Ada hubungan yang bermakna antara umur dengan pemilihan MOW dari hasil uji Chi square didapatkan ρ value = 0,00 dan ada hubungan yang bermakna antara paritas dengan pemilihan MOW hasil uji Chi square didapatkan ρ value = 0,.Dari hasil penelitian ini, diharapkan kepada tenaga kesehatan khususnya pelayanan KB  di RS. Bhayangkara Palembang  agar dapat meningkatkan kualitas pelayanan KB secara efektif, efisien, dan aman yang dianggap cocok bagi penggunanya khususnya mengenai kontrasepsi Metode Operasi Wanita (MOW).    


2020 ◽  
Vol 2 (1) ◽  
pp. 53-59
Author(s):  
Josimara A. de Araújo Varela ◽  
Tatiana F.T. Palitot ◽  
Smyrna L.X. de Souza ◽  
Alidianne F.C. Cavalcanti ◽  
Alessandro L. Cavalcanti

Objective: This study aimed to analyze the presence of lesions in the skull and face and the associated factors in pedestrian victims of traffic accidents. Methods: A cross-sectional, descriptive-analytical study carried out through the analysis of medical records of pedestrian victims of traffic accidents in an emergency service in the city of Campina Grande, Brazil, during the year of 2016. Information was collected regarding gender, age group, day of the week, time of the accident, type of vehicle involved, presence of trauma to the skull and face, and outcomes. The Chi-square and Fisher's Exact tests were used, with a significance level of 5%. Results: A total of 1,884 medical records were evaluated, out of which 7.1% (n = 133) involved pedestrians. Men were the most frequent victims (68.4%), and victims of age 60 years old or over (30.5%) predominated. Almost one-third of the cases were recorded during the weekends (30.5%), and the most prevalent time was at night (52.7%). Regarding the type of vehicle involved, motorcycles predominated (47.4%). Head trauma was present in 37.6% of victims, while facial injuries corresponded to 8.2%. In 12% of cases, the victims died. The variables of gender, age group, occurrence on weekends, and trauma to the face showed a statistically significant association with the occurrence of traffic accidents (Chi-square test; p<0.05). Conclusion: Among pedestrian victims of traffic accidents, there is a predominance of men aged 65 years or over. Accidents are frequent at night, and motorcycles are the main vehicles involved. The presence of trauma to the skull and face regions is high.


2021 ◽  
Vol 95 ◽  
Author(s):  
D. Rubel ◽  
N. Flaibani

Abstract The aim of this study was to explore through cross-sectional study the variation in the prevalence of parasitic helminths in canine faeces collected from green spaces of Buenos Aires according to the human density (HD) and economic level (EL) in the surroundings. HD and EL were considered as independent variables with three categories each. Twenty public squares (one hectare of surface) were randomly selected for each existing combination of the two independent variables. Ten random samples of fresh canine faeces were obtained in each square and analysed for helminths by the sedimentation and flotation techniques. The prevalence for each of the species was analysed using generalized linear models (GLM). The prevalence was modelled with a binomial error distribution and a logit link function. Helminth eggs were detected in 45 out of the 200 (22.5%) faecal samples collected and in 18 of the 20 green spaces sampled. The species observed were Ancylostoma caninum (13% of samples), Trichuris vulpis (8%) and Toxocara canis (4.5%). The GLM indicated that the prevalence of A. caninum in the slum areas (very high HD and very low EL) was higher than that in the other areas studied. However, the HD seemed to contribute more than the EL to the variations in the prevalence of A. caninum in faecal samples. The GLM showed no differences in the prevalence of the other parasite species for the different levels of the independent variables.


Author(s):  
Eglė Slabšinskienė ◽  
Andrej Gorelik ◽  
Aistė Kavaliauskienė ◽  
Apolinaras Zaborskis

Although burnout has been described as a serious hazard for personal and professional lives and has been surveyed among dentists in many countries, no study has been published regarding burnout among dentists in Lithuania. This study aimed to evaluate the burnout level among Lithuanian dentists and its association with demographic variables, job satisfaction, and other job-related variables. The data were collected among dentists online or during professional conferences while using an anonymous questionnaire (n = 380). The Maslach Burnout Inventory (MBI) was used to evaluate the burnout level. A Poisson regression was applied for the analysis of relationships between variables. We observed that 42.3% of the respondents had a high emotional exhaustion (EE) (95% confidence interval (CI): 37.4–42.3%), while 18.7% (95% CI: 15.0–22.9%) and 28,2% (95% CI: 23.4–32.6%) had high depersonalization (DP) and low personal accomplishment (PA), respectively. Nonetheless, 15.3% (95% CI: 11.8–18.9%) of the study population experienced a high level of overall burnout. An original job satisfaction index was elaborated. It was significantly associated with sum scores of all burnout dimensions: with the EE sum score (Ratio of Sum Score Means (RSSM) 1.54; 95% CI: 1.46–1.62), DP sum score (RSSM 1.59; 95% CI: 1.45–1.74), and PA sum score (RSSM 0.88; 95% CI: 0.84–0.92). It was concluded that Lithuanian dentists can be characterised by high burnout intensity and high prevalence of burnout, being especially evident in emotional exhaustion. The dentist with low job satisfaction appeared to be the most vulnerable to all burnout dimensions.


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