肛门括约肌肌电图中运动单位电位复杂性的评估

Objective: Motor unit potential (MUP) morphology can bequantified using parame ters describing electrophysiological size and shape (complexity). Traditionally, MUP complexity has been estimated using parameters number of phases and turns. Recently, ‘irregularity coefficient’(IR), measuring the length of the MUP curv e normalized with its amplitude, has been introduced. The aim of this study was to evaluate IR in the external anal sphincter muscle. Methods: Sensitivity was e xamined in 61 patients with chronic cauda equina lesions, and specificity in 75 controls using a standard concentric EMG needle and EMG system with multi-MUP a nalysis. Results: When evaluated separately the sensitivity of IR was 16%lower, and specificity 5%higher compared to number of turns, with both differences de creasing to only 2 and 1%, respectively, when each of these parameters was adde d to MUP area and duration.Conclusions: Our present results suggest that IR prov ides a similar diagnostic usefulness, but a more appropriate description of MUP complexity compared to traditional MUP parameters.Significance: IR seems to be s uitable to complement one of MUP parameters measuring electrophysiological MUP s ize in the future quantitative EMG.

肛门括约肌定量肌电图中神经病变的诊断标准

For the external anal sphincter muscle, both normative values and an optimal s et of motor unit potential (MUP) parameters have been defined. However, criteria for the diagnosis of neuropathic conditions have not yet been validated. Theref ore, in this study, sensitivity was examined in 86 patients with cauda equina le sions (227 muscles), and specificity in 77 controls (119 muscles), using multi MUP analysis. Six previously defined diagnostic criteria (mean values and outlie rs for MUP area, duration, and number of turns) were used. An increase in the nu mber of diagnostic criteria required for muscle abnormality (two and three inste ad of one), and the application of more stringent normative limits resulted in a progressive increase in specificity from 74%to 99%(controls), and a decrease in sensitivity from 70%to 21%(patients). The data suggest that no single cut off diagnostic criterion has both satisfactory sensitivity and specificity. Intr oduction of the diagnostic categories of “possible,”“probable,”and “definit e”neuropathic abnormalities into quantitative electromyographic analysis is pro posed.

Linking the Paul Coverdell National Acute Stroke Program to commercial claims to establish a framework for real-world longitudinal stroke research

Background Non-interventional large-scale research on real-world patients who had a stroke requires the use of multiple data sources ensuring access to longitudinal data from large populations with clinically-detailed information.We sought to establish a framework for longitudinal research on patients hospitalised with stroke by linking information-rich,deidentified inpatient data from the Paul Coverdell National Acute Stroke Program(PCNASP)to commercial and Medicare Advantage longitudinal claims data.Methods All stroke admissions in PCNASP between 2008 and 2015 were evaluated for linkage to longitudinal claims from a commercial insurer using an algorithm based on six available common data fields(patient age,gender,admission date,discharge date,discharge diagnosis and state)and a hospital match.We evaluated the linkage quality(via the percentage of unique records in the linked dataset)and the representativeness of the linked population.We also described medical history,stroke severity and patterns of medication use among the PCNASP-claims linked cohort.Results The linkage produced uniqueness equal to 99.1%.We identified 5644 linked and 98896 unlinked patients who had an ischaemic stroke hospitalisation in claims data.Linked patients were younger than unlinked(69.7 vs 72.5 years),but otherwise similar by medical history,prestroke medication use or lab values.Stroke severity was mild and most patients were discharged home.Prestroke and discharge use of antihypertensive and statins in the PCNASP were greater than their use as measured by filled prescriptions in claims.Conclusions High-quality linkage between the PCNASP and commercial claims data is feasible.This linkage identified differences between reported or recommended versus actual out-of-hospital medication utilisation,highlighting the importance of longitudinal data availability for research aimed to improve the care of patients who had a stroke.

Zingiber officinale(Ginger)Methanol Extract Abates Kidney Dysfunction in Mice Co-exposed to Sub-chronic Alcohol Intoxication and Post-traumatic Stress Disorder

Background:Increasing number of people globally gives in to indiscriminate consumption of excess alcohol as a coping mechanism to relieve any form of physical or psychological stress.Previously,ethnomedicinal use of Zingiber officinale Roscoe(Ginger)have been shown to exhibit broad range of pharmacological benefits but no data has reported the phytotherapeutic treatment of Zingiber officinale methanol extract(MEZO)on alcohol-use disorder(AUD)and post-traumatic stress disorder(PTSD)-induced oxidative and inflammatory stress relevant to disruption of kidney functions in animal model.Objective:To investigate the protective effect of MEZO on kidney-oxidative and inflammatory biomarkers in sub-chronic alcohol exacerbation of PTSD symptoms in mice.Methods:Male Swiss mice were administered 30%ethanol for two weeks and thereafter introduced to single pro-longed stress to induce AUD and PTSD respectively prior to post-treatment with MEZO and vitamin C.Markers of oxidative stress,inflammatory cytokines,kidney functions,HPA-axis signaling molecules,vasodilator substance,and histopathology of the kidney were evaluated.Results:Sub-chronic alcohol intoxication heightened PTSD-induced oxido-inflammatory stress,altered the kidney function indices and HPA-axis,and reduced nitric oxide production,which were ameliorated by the phytother-apeutic treatment with MEZO.Furthermore,severe degeneration and atrophy of renal tubules were observed.Meanwhile,MEZO interventions strongly abated all these effects.Conclusions:Herein,the study shows that phytotherapeutic treatment with MEZO prevents the damaging effects of co-exposure to sub-chronic alcohol intoxication and PTSD.