Neuralgic amyotrophy is an acute painful inflammatory neuropathy involving, as a rule, the trunks of the brachial plexus in one side. A clinical case of a bilateral form of neuralgic amyotrophy is presented with successively involvement of the brachial plexus on both sides in a 62-year-old man and relief of neuropathic pain in response to high doses of glucorticosteroids.
Thoracic outlet syndrome (TOS) is challenging to diagnose of it`s different etiology and pathophysiology. For now, all the physical examinations and investigations lack sensitivity and/or specificity. Recent efforts have been made to more clearly define a set of diagnostic criteria that will bring consistency to the diagnosis of TOS. Surgical management remains the mainstay of operative treatment for all patients, who have failed conservative therapy, because of it`s low efficiency.This article aims to review the etiology and pathophysiology, clinical presentations, diagnosis, and management of thoracic outlet syndrome.
Introduction. Peripheral nerve ultrasound helps in the differential diagnosis of amyotrophic lateral sclerosis (ALS) and treatable diseases with a similar clinic. The cross–sectional area (CSA) values of the nerves of the hands and spinal nerves in ALS is normal or even reduced in comparison with control. The CSA of the nerves in a clinically similar condition – multifocal motor neuropathy (MMN) increases and has a characteristic ultrasound pattern of changes in the form of an increase in CSA in the proximal parts of the nerves of the hands and spinal nerves of the brachial plexuses.Materials and methods. Cervical root and peripheral nerve CSA on both sides was performed in 31 patients with ALS and 25 patients with MMN, using a 8–15 MHz linear array probe (ultrasound scanner «Sonoscape S20» (China). The control group included 92 healthy people without diseases of the nervous system, as well as conditions potentially causing damage to the peripheral nervous system.Results. The average values of the CSA of cervical roots and peripheral nerves in the upper limb in ALS patients were normal. However, there was an increase in the CSA of the median nerve at the shoulder level on the left by 23 %, the radial nerve on the right by 24 %, and the ulnar nerve on the left at the wrist level by 33 % in the ALS group compared with the control group. The CSA of nerves in MMN patients was significantly higher than in ALS and compared with the control group. In MMN nerve trunks increase was observed in the proximal parts of the nerves in the upper limb and cervical roots on both sides.Conclusions. Peripheral nerve ultrasound is a reliable tool for differential diagnosis ALS and ALS mimics. It can be widely used in routine clinical practice.
The article describes the mechanism of adaptation support to work and development of employment and career centers in universities by enlisting volunteers and reveals key components of this mechanism. It can be labour markets of young people; requirements of business entities to personnel competences; the process of employment and career in universities; basic goals, objectives and principles of setting-up and developing such centers; analysis of advantages and drawbacks of their work, building and developing the administration system; use of volunteers’ work; academic and methodological tools; organizational and economic features and trends in center development; appraisal of such centers work and development; programs of development. All these mechanisms of adaptation support of work and development of employment and career centers in universities were studied and analyzed in view of volunteers’ role in these centers’ work. It gives an opportunity to provide comparable development of volunteer movement and net apprenticeship, to use different methods of interaction with labour market participants depending of factors of surroundings impact and to meet social request on specialists of certain professions with regard to goals of state policy of population employment.
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