Aim:The objective of the present study was to develop a method for surface electromyographic (EMG) registration of muscle activity in infants, with the perspective of assessing neuromuscular function/prognosis in infants with obstetric brachial plexus palsy (OBPP).Method: Fifteen healthy infants, aged 1-4 days, were recruited for the study. EMG signals were registered from the biceps, triceps and palmar portion of thenar muscles on both arms and hands. For this purpose surface electrodes for bipolar recording were developed using two sintered Ag/AgCl pellets that had been cast in silicone rubber. The Moro reflex was used to elicit a standardised motor stimulus. The reflex was elicited 5 times, and during EMG recording the procedure was video taped. To define the onset of muscle activity the running block threshold method was adapted to time signals.Results: The custom-made electrodes performed well and EMG signals of good quality were obtained from the different sites. The onset algorithm worked automatically, giving stable and visually correct registration. The signals could clearly describe the onset of muscle activity during the Moro reflex with a symmetrical pattern in both arms and hands. The extension/abduction phase of the reflex was characterised by predominant activity in the triceps muscle with concomitant low-grade activity in the antagonistic biceps muscle. During the embracing phase, occurring up to 1 second after onset of abduction, the opposite pattern was seen. Thenar activation, causing flexion/opposition of the thumb, was salient only during the embracing phase.Conclusion: Surface EMG can be used in infants to objectively assess the normal motor pattern in muscles innervated by different branches of the brachial plexus. This convenient method shall be applied to evaluate the status and possibly the prognosis in infants with OBPP. (REF, nϭ56, GA 34Ϯ5 wks), and normal newborns (noRDS, nϭ167, GA 39Ϯ2 wks). We amplified a 637 base pair product that included codon 292 and subjected amplicons to BsrG1 restriction analysis and agarose gel electrophoresis. THE E292V VARIANT IN ABCA3 IS OVER-REPRESENTED IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME (RDS)TResults: Excluding 1 each of concordant twins in the REF and noRDS groups, 3 RDS (2.4%), 5 REF (9.1%), and 2 noRDS (1.2%) infants were heterozygous for E292V (Pϭ0.009). Males and females were equally represented. One infant with E292V in the noRDS group was Black, all others with E292V were White. Symptomatic infants (REFϩRDS) with E292V were more mature than those without E292V (35Ϯ3 vs 32Ϯ5 wks, Pϭ0.007). Duration of mechanical ventilation, and need for supplemental oxygen were not significantly different. Infants with RDS and E292V developed pneumothoraces more frequently (78%) than infants with RDS but without E292V (9%) (PϽ0.001). Six infants had resolution of symptoms within 1 month of birth; the noRDS individuals with E292V remained asymptomatic.Conclusions: The E292V variant in ABCA3 is significantly more prevalent in infants with RDS than in ...
Aim:The objective of the present study was to develop a method for surface electromyographic (EMG) registration of muscle activity in infants, with the perspective of assessing neuromuscular function/prognosis in infants with obstetric brachial plexus palsy (OBPP).Method: Fifteen healthy infants, aged 1-4 days, were recruited for the study. EMG signals were registered from the biceps, triceps and palmar portion of thenar muscles on both arms and hands. For this purpose surface electrodes for bipolar recording were developed using two sintered Ag/AgCl pellets that had been cast in silicone rubber. The Moro reflex was used to elicit a standardised motor stimulus. The reflex was elicited 5 times, and during EMG recording the procedure was video taped. To define the onset of muscle activity the running block threshold method was adapted to time signals.Results: The custom-made electrodes performed well and EMG signals of good quality were obtained from the different sites. The onset algorithm worked automatically, giving stable and visually correct registration. The signals could clearly describe the onset of muscle activity during the Moro reflex with a symmetrical pattern in both arms and hands. The extension/abduction phase of the reflex was characterised by predominant activity in the triceps muscle with concomitant low-grade activity in the antagonistic biceps muscle. During the embracing phase, occurring up to 1 second after onset of abduction, the opposite pattern was seen. Thenar activation, causing flexion/opposition of the thumb, was salient only during the embracing phase.Conclusion: Surface EMG can be used in infants to objectively assess the normal motor pattern in muscles innervated by different branches of the brachial plexus. This convenient method shall be applied to evaluate the status and possibly the prognosis in infants with OBPP. (REF, nϭ56, GA 34Ϯ5 wks), and normal newborns (noRDS, nϭ167, GA 39Ϯ2 wks). We amplified a 637 base pair product that included codon 292 and subjected amplicons to BsrG1 restriction analysis and agarose gel electrophoresis. THE E292V VARIANT IN ABCA3 IS OVER-REPRESENTED IN NEWBORNS WITH RESPIRATORY DISTRESS SYNDROME (RDS)TResults: Excluding 1 each of concordant twins in the REF and noRDS groups, 3 RDS (2.4%), 5 REF (9.1%), and 2 noRDS (1.2%) infants were heterozygous for E292V (Pϭ0.009). Males and females were equally represented. One infant with E292V in the noRDS group was Black, all others with E292V were White. Symptomatic infants (REFϩRDS) with E292V were more mature than those without E292V (35Ϯ3 vs 32Ϯ5 wks, Pϭ0.007). Duration of mechanical ventilation, and need for supplemental oxygen were not significantly different. Infants with RDS and E292V developed pneumothoraces more frequently (78%) than infants with RDS but without E292V (9%) (PϽ0.001). Six infants had resolution of symptoms within 1 month of birth; the noRDS individuals with E292V remained asymptomatic.Conclusions: The E292V variant in ABCA3 is significantly more prevalent in infants with RDS than in ...
reduction in nonfatal strokes (3 trials; N5784; RR 0.40; 95% CI, 0.10-1.91), reduction of cardiovascular mortality (3 trials; N5784; RR 0.95; 95% CI, 0.48-1.86), or reduction of all-cause mortality (3 trials; N5785; RR 0.80; 95% CI, 0.51-1.25). The author noted that the scope of the study was heavily influenced by one small trail, thus limiting the validity of the results.A 2018 longitudinal cohort study (n516,678) investigated the relationship between estimated glomerular filtration rate (eGFR), albuminuria, and risk of cardiovascular and all-cause mortality in patients with type 2 diabetes. 2 Patients had a mean age of 60 years old, 47% female, and the majority had a duration of diabetes around 12 years. Patients were categorized by their baseline eGFR, which was calculated by serum creatinine according to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Patients were further characterized by their Kidney Disease Improving Global Outcomes categories for eGFR and their degree of albuminuria by urine albumin to creatinine ratio categories. Cardiovascular disease hospitalizations occurred at a significantly higher rate in patients with macroalbuminuria compared with patients with normal albuminuria or microalbuminuria (18% vs 8.2% and 14% per 1,000 person-years, P,.5). The rate of all-cause mortality also occurred at a significantly higher rate in patients with macroalbuminuria compared with patients with normal albuminuria or microalbuminuria (39% vs 14% and 26% per 1,000 person-years, P,.05).A 2019 evidence-based clinical practice guideline from the American Diabetes Association recommended annual screening by assessing urinary albumin and eGFR in all patients with type 2 diabetes (level B: moderate supportive evidence from cohorts). 3 The guideline advocated for surveillance of albuminuria and eGFR to enable timely diagnosis of CKD, monitor progression of CKD, detect superimposed kidney diseases including acute kidney injury, assess risk complications, dose drugs appropriately, and determine whether nephrology referral is needed.
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