Интраоперационная оценка восстановления проведения импульса по спинному мозгу у пациентов с шейной спондилогенной миелопатией

The previous studies have data concerning surgery and diagnostic methods of cervical spondylotic myelopathy (CSM). The aim of this case was to study the on‑line assessment of the functions of corticospinal and somatosensory pathways changed due to surgical decompression of cervical spinal cord. Our study included 11 patients (6 men and 5 women, mean age 59,3 ± 9,2 years old) with MRI‑confirmed cervical spine stenosis (CSS). All of them had intraoperative neurophysiological monitoring standing for transcranial electric stimulation (TES) and recording of the median nerve somatosensory evoked potentials (SEP). Investigations were performed before and 10–15 minutes after surgical spinal cord decompression. The obtained data provides additional information about the spinal cord pathways functional status and it is a reliable predictor of neurological outcome.В литературе крайне мало встречается информации относительно восстановления проведения импульса по спинному мозгу в афферентном и эфферентном направлениях в ответ на декомпрессию в режиме реального времени, что и послужило основанием для проведения данной работы. Интраоперационному нейрофизиологическому мониторингу подверглось 11 пациентов (6 мужчин и 5 женщин, средний возраст 59,3 ± 9,2 года) с подтвержденным стенозом позвоночного канала по данным магнитно-резонансной томографии. Степень восстановления проведения по кортикоспинальному тракту и проводникам соматической афферентации оценивали с помощью регистрации вызванных моторных ответов (ВМО) при транскраниальной электростимуляции и записи соматосенсорных вызванных потенциалов (ССВП) при билатеральной стимуляции срединного нерва. Регистрацию ВМО и ССВП проводили до декомпрессии и через 10−15 мин после нее. Полученные данные отражают незамедлительное изменение проведения импульса в афферентном и/или эфферентном направлениях и коррелируют с неврологическим статусом в послеоперационном периоде

Governing drug reimbursement policy in Poland: The role of the state, civil society, and the private sector

This article investigates the distribution of power in Poland’s drug reimbursement policy in the early 2000s. We examine competing theoretical expectations suggested by neopluralism, historical institutionalism, corporate domination, and clique theory of the post-communist state, using data from a purposive sample of 109 semi-structured interviews and documentary sources. We have four concrete findings. First, we uncovered rapid growth in budgetary spending on expensive drugs for narrow groups of patients. Second, to achieve these favorable policy outcomes drug companies employed two prevalent methods of lobbying: informal persuasion of key members of local cliques and endorsements expressed by patient organizations acting as seemingly independent “third parties.” Third, medical experts were co-opted by multinational drug companies because they relied on these firms for scientific and financial resources that were crucial for their professional success. Finally, there was one-way social mobility from the state to the pharmaceutical sector, not the “revolving door” pattern familiar from advanced capitalist countries, with deleterious consequences for state capacity. Overall, the data best supported a combination of corporate domination and clique theory: drug reimbursement in Poland was dominated by Western multinationals in collaboration with domestically based cliques.Piotr Ozieranski is indebted to the Department of Sociology, University of Cambridge and St Edmund’s College for research grants

Clusters of repetition roots: single chains

This work proposes a new approach towards solving an over 20 years old conjecture regarding the maximum number of distinct squares that a word can contain. To this end we look at clusters of repetition roots, that is, the set of positions where the root u of a repetition uℓ occurs. We lay the foundation of this theory by proving basic properties of these clusters and establishing upper bounds on the number of distinct squares when their roots form a chain with respect to the prefix order