Search

Objective: This study aimed to investigate the physiological and anatomical factors influencing the flexor carpi radialis (FCR) H-reflex and to establish reference values for FCR H-reflex parameters in relation to these factors. Methods: The FCR H-reflexes, elicited by median nerve stimulation, were assessed in 80 healthy individuals both at rest and during isometric voluntary contraction (IVC). Multiple linear regression analyses were performed with H-reflex parameters as the dependent variables, while age, gender, height, arm length, and weight were included as independent variables. Results: The FCR H-reflex was recorded bilaterally in nearly all healthy individuals (76 out of 80) during IVC, while it could be obtained in only 35% (28 out of 80) of these individuals at rest. During IVC, the maximum H-reflex amplitude (Hmax) and its ratio to the maximum M-response amplitude (Hmax/Mmax ratio) were significantly increased (p < 0.001). However, there were no changes in H-reflex latency, latency difference, conduction velocity (HRCV), or amplitude ratio (p > 0.05). In both conditions, age and arm length were the most important factors affecting H-reflex latency (p < 0.001), while HRCV was influenced only by age (p < 0.01). Women exhibited shorter H-reflex latencies (p < 0.01), and both Hmax amplitude and Hmax/Mmax ratio were higher in women during IVC (p < 0.05). The H-reflex amplitude ratio during IVC showed a tendency to decrease with age (p < 0.05). Conclusion: These findings suggest that FCR H-reflexes are more reliably elicited during IVC, and that both physiological and anatomical factors should be considered when assessing H-reflex abnormalities. [ABSTRACT FROM AUTHOR]

Aims: This study uncovered the links between circadian preferences, social jet lag, and diabetes mellitus (DM) risk screening results of nurses working shifts. Methods: In this cross-sectional study design, sociodemographic data, the American Diabetes Association (ADA) Diabetes Risk Test, Morningness-Eveningness Stability Scale Improved (MESSi), sleep awake and bedtimes, and shift count were collected via survey. Participants were split into DM risk-positive and negative groups to compare them for MESSi scores, circadian preference and social jetlag. Results: Short sleep keepers were 61.8% of all 212 nurses aged 32.25±6.99 years. Abnormal social jetlag was detected in 18.9% of the study population. The group that experienced abnormal social jetlag exhibited a significantly lower morning affect and a higher eveningness (EV) compared with the normal jetlag group (p=0.003 and p=0.004, respectively). DM risk was present in 6.6% of all. A higher risk of DM was observed in individuals with older age, longer job experience, higher body mass index (BMI), male gender, and lower EV score (p<0.001, p<0.001, p<0.001, p=0.006 and p=0.042, respectively). Distinctness scores were positively correlated with DM risk scores (r=0.168; p=0.014), whereas they inversely correlated with night shift count (r=-0.149; p=0.022). Higher values of BMI (odds ratio=1.255; 95% confidence interval=1.036-1.520; p=0.020) and male sex (odds ratio=7.350; 95% confidence interval=1.265-42,161; p=0.026) were associated with increased risk for DM. Conclusions: This study reports that circadian preference, but not social jetlag time, may be related to DM risk among nurses working shifts. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to evaluate and compare the clinical and electrophysiological features of post-COVID-19 Guillain--Barré syndrome (GBS) and non-COVID-19 GBS patients over the last five years. Methods: We retrospectively analyzed patients diagnosed with GBS between October 2016 and September 2021. They were divided into five groups according to the flu season and the COVID-19 pandemic. Groups 1-4 were identified as non-COVID-19 groups, whereas Group 5 constituted the post-COVID-19 group. At the sixth month the Hughes functional grading scale score (HFGSS) was noted. Clinical and electrophysiological findings were compared between the groups. Results: Fifty-nine GBS patients were enrolled in this study. Post-COVID-19 GBS patients had more facial diplegia than non-COVID-19 GBS patients. Except for facial diplegia, post-COVID-19 GBS patients did not differ from non-COVID-19 GBS patients regarding the need for mechanical ventilation, loss of ambulation, type of GBS, response to treatment, and patient outcomes. In 67% of post-COVID-19 GBS patients, HFGSS was ≤2. Acute inflammatory demyelinating polyneuropathy (AIDP) was the most common subtype in post-COVID-19 GBS patients. The 2018-2019 flu season saw more ambulation loss than other flu seasons. The 2017- 2018 influenza season had the highest number of patients (39%). Conclusion: The clinical and electrophysiological features of GBS may differ according to year, infectious etiology, and severity of seasonal viral infections. Post-COVID-19 GBS patients mostly had the AIDP subtype with frequent facial diplegia. The prognosis of post-COVID-19 GBS patients was good. The patients responded well to treatment with intravenous immunoglobulin and plasma exchange. [ABSTRACT FROM AUTHOR]

Background: Hernia repair is one of the most common surgical procedures, and some patients suffer from chronic pain after hernia surgery. The aim of the present study was to evaluate [...]

Myasthenia gravis (MG) is an autoimmune disease mediated by autoantibodies predominantly against the acetylcholine receptor (AChR). Specific T cell subsets are required for long-term antibody responses, and cytokines secreted mainly from CD4+ T cells regulate B cell antibody production. The aim of this study was to assess the differences in the cytokine expressions of CD4+ T cells in MG patients with AChR antibodies (AChR-MG) and the effect of immunosuppressive (IS) therapy on cytokine activity and to test these findings also in MG patients without detectable antibodies (SN-MG). Clinically diagnosed AChR-MG and SN-MG patients were included. The AChR-MG patients were grouped as IS-positive and -negative and compared with age- and sex-matched healthy controls. Peripheral blood mononuclear cells were used for ex vivo intracellular cytokine production, and subsets of CD4+ T cells and circulating follicular helper T (cTfh) cells were detected phenotypically by the expression of the chemokine and the costimulatory receptors. Thymocytes obtained from patients who had thymectomy were also analyzed. IL-21, IL-4, IL-10, and IL-17A productions in CD4+ T cells were increased in AChR-MG compared to those in healthy controls. IS treatment enhanced IL-10 and reduced IFN-γ production in AChR-MG patients compared to those in IS-negative patients. Increased IL-21 and IL-4 productions were also demonstrated in SN-MG patients. Among CD4+ T cells, Th17 cells were increased in both disease subgroups. Treatment induced higher proportions of Th2 cells in AChR-MG patients. Both CXCR5+ and CXCR5− CD4+ T cells expressed higher programmed cell death protein 1 (PD-1) and inducible costimulatory (ICOS) in AChR-MG and SN-MG groups, mostly irrespective of the treatment. Based on chemokine receptors on CXCR5+PD-1+ in CD4+ T (cTfh) cells, in AChR-MG patients without treatment, the proportions of Tfh17 cells were higher than those in the treated group, whereas the Tfh1 cells were decreased compared with those in the controls. The relevance of CXCR5 and PD-1 in the pathogenesis of AChR-MG was also suggested by the increased presence of these molecules on mature CD4 single-positive thymocytes from the thymic samples. The study provides further evidence for the importance of IL-21, IL-17A, IL-4, and IL-10 in AChR-MG. Disease-related CD4+T cells are identified mainly as PD-1+ or ICOS+ with or without CXCR5, resembling cTfh cells in the circulation or probably in the thymus. AChR-MG and SN-MG seem to have some similar characteristics. IS treatment has distinctive effects on cytokine expression. [ABSTRACT FROM AUTHOR]