Parameters of stimulation electroneuromyography in patients with primary hypothyroidism

Background. The purpose of the work is to identify the parameters of stimulation electroneuromyography (ENMG) in patients with primary hypothyroidism against the background of autoimmune thyroiditis and postoperative hypothyroidism. Materials and methods. The study involved 56 patients with hypothyroi­dism as a result of autoimmune thyroiditis and 19 patients with postoperative hypothyroidism. The control group consisted of 20 apparently healthy persons. Fifty seven (76 %) patients received substitution therapy using synthetic derivatives of L-thyroxine, and 18 (24 %) patients had subclinical hypothyroidism. Patients were examined using clinical-neurological and electrophysiological methods. The electroneuromyography was carried out on the computerized software complex M-TEST (DX-systems, Kharkiv, Ukraine). Integra­ted ENMG examination was conducted using standard program package in a specially equipped laboratory. ENMG helped evaluate the parameters of the maximum amplitude of the motor M-response of the limb muscles, the reduction of which is a diagnostic criterion for axon injury, and determine the nerve conduction velocity by the motor fibers of the distal parts of the limb nerves. Reduction of nerve conduction velocity is observed with demyelination of nerve fibers. Results. In case of autoimmune thyroiditis, the sensory nerves of the lower extremities (superficial peroneal and sural ones) were damaged by the mixed type. Signs of axonopathy manifested by a decrease in the action potential amplitude of the superficial peroneal nerve by 32.7 % (p < 0.05) and the sural one by 27.5 % (p < 0.05) compared with the control group, and there was a reduction of nerve conduction velocity of peroneal nerves by 21.9 % (p < 0.05) indicating a damage to the myelin sheath. Patients with postoperative hypothyroidism had mostly signs of axonopathy as evidenced by a decrease in the action potential amplitude of the superficial peroneal nerve by 27.9 % (p < 0.05). While studying the function of the motor fibers of the peripheral nerves (median, peroneal and tibial), we found that the injury to motor fibers was demyelinating in 78.8 % of cases, in the remaining patients (22.2 %) polyneuropathy was mixed (with signs of injury to the myelin sheath and axons). Damage to the ulnar and tibial nerves was obligate, whereas the signs of median nerve injury were observed in 72.8 % of cases. The demyelination of the fast conducting fibers of the peroneal and tibial nerves manifested as prolongation of residual latency by 31.7 % (p < 0.05) and 31.6 %, respectively (p < 0.05), a decrease in nerve conduction velocity during peroneal nerve test by 21.5 % (p < 0.05) and by 19.4 % at the examination of the tibial nerves. 22.2 % of patients with autoimmune thyroiditis had signs of combined myelin lesion and axonal injury, when, in addition to reducing the nerve conduction velocity by the motor fibers of the tibial and peroneal nerves and some prolongation of the residual latency, there was a reliable decrease in the M-response amplitude by 15.6 and 14.8 %, respectively. The patients with postoperative hypothyroidism had the signs of myelinopathy only. Conclusions. ENMG allowed revealing the demyelinating and mixed nature of motor fiber injury and the axonal nature of the peripheral nerve injury, with more pronounced changes observed in autoimmune thyroiditis than in polyneuropathy against the background of postoperative hypothyroidism

Analysing prevalence and morbidity of diabetes and its consequences in the population of Chernivtsi region during 2014-2016

Diabetes mellitus (DM) in all its forms is a heavy social and economic burden for any country in the world, regardless of us income. The paper analyzes the prevalence and incidence of diabetes and its consequences in the population of Ukraine and the Chernivtsi region during the period of 2014-2016. We have generalized and analysed the data taken from the report of the endocrinology service in the Chernivtsi region for the 2014-2016 as well as the data of statistical reports of the Medical statistics Centre in the Ministry of Health of Ukraine for the same period. The increase m die prevalence of diabetes in Ukraine is (-69.2%), the increase in the incidence and prevalence of diabetes for 2014- 2016 tends to be negative. This can be explained by underestimation of a large percentage of patients with diabetes, a large number of patients with undiagnosed or hidden diabetes, by poor quality of care and collection of statistical data. On the other hand, according to the Center for Health Statistics in the Ministry of Health of Ukraine the increase of prevalence of diabetes, calculated on the population of Ukraine for 2014- 2016. was -r 55.1%, the incidence rate of primary (identification) diabetes was + 59.2%, consequently, the incidence and prevalence rose almost 2 times, leading to disability, premature death and health care costs

The dynamics of parameters of stimulation electroneuromyography in 3 and 6 months after treatment of diabetic polyneuropathy

The authors have studied the indices of parameters of stimulation electroneuromyography, namely: the amplitude of the M-response and the rate of conducting excitations along the motor nerve fibers n. medianus; n. ulnaris; n. tibialis, n. peroneus 3 and 6 months after a course of multimodality treatment with a supplementary prescription of mildronat and thiotriazolin in patients with diabetes mellitus and diabetic polyneuropathy

Лікування діабетичної полінейропатії

The authors have studied the effect of mildronat and thiotriazolin on the processes of lipid peroxidation, the oxidative modification of proteins and the state of the blood antioxidant system 3 and 6 months following a course of multimodality treatment in patients with diabetes mellitus and diabetic polyneuropathy

The indicators of stimulation electromeuromyography in with diabetic polyneuropathy

The work is dedicated to researching of the effect of cocarnit on the functional state of the peripheral nerves based on the findings of stimulation electroneuromyography in multimodality treatment of diabetic polyneuropathy. The most positive influence on the amplitude of M-response of the nerves of the upper and lower extremities has been detected in case of use of cocarnit in comparison with the basic treatment