Abstract OBJECTIVES: Transcranial magnetic stimulation (TMS) has been used to measure cortical excitability as a functional measurement of corticomotor pathways. Given its potential application as an assessment tool in stroke, we aimed to analyze the correlation of TMS parameters with clinical features in stroke using data from 10 different centers. METHODS: Data of 341 patients with a clinical diagnosis of stroke were collected from studies assessing cortical excitability using TMS. We used a multivariate regression model in which the baseline cortical excitability parameter "resting Motor Threshold (rMT)" was the main outcome and the demographic, anatomic and clinical characteristics were included as independent variables. RESULTS: The variable "severity of motor deficit" consistently remained significant in predicting rMT in the affected hemisphere, with a positive β coefficient, in the multivariate models after sensitive analyses and adjusting for important confounders such as site center. Additionally, we found that the correlations between "age" or "time since stroke" and the rMT in the affected hemisphere were significant, as well as the interaction between "time since stroke" and "severity of motor deficit". CONCLUSIONS: We have shown that severity of motor deficit is an important predictor for rMT in the affected hemisphere. Additionally, time since stroke seems to be an effect modifier for the correlation between motor deficit and rMT. In the unaffected motor cortex, these correlations were not significant. We discuss these findings in the context of stroke rehabilitation.

Abstract BACKGROUND: No epidemiological studies on the prevalence of compressive neuropathy have been undertaken in Arab countries. The aim of the study was to estimate the prevalence of the most common types of compressive neuropathies in Qena governorate/Egypt. METHODS: The study was part of a community-based survey carried out to assess the prevalence of neuromuscular disorders among the Qena population. A random sampling of 10 districts, 5,039 inhabitants aged ≥20. There were 3,050 urban residents (60.5%) and 1,989 (39.5%) from the rural community. Patients were diagnosed using a screening questionnaire for diagnosis of entrapment neuropathies. Positive cases were referred to the Qena University Hospital. They were given full clinical, electrophysiological and laboratory investigations. RESULTS: Compressive neuropathy was recorded in 165 cases giving a CPR = 3.3% of population at risk (≥20 years). Carpal tunnel syndrome (CTS) was diagnosed in 155 cases giving a CPR = 3.1% with a significantly higher prevalence among females than males (5.3 vs. 0.9%) and in rural compared with urban populations (4.6 vs. 2.1%). Ulnar neuropathy at the elbow was the second common type of entrapment with a CPR = 0.1% followed by radial nerve palsy, tarsal tunnel syndrome and common peroneal nerve palsy. CONCLUSION: The overall crude prevalence rate of CTS is comparable with that in other countries. TRIAL REGISTRATION: ClinicalTrials.gov .

Abstract BACKGROUND: No epidemiological studies on the prevalence of compressive neuropathy have been undertaken in Arab countries. The aim of the study was to estimate the prevalence of the most common types of compressive neuropathies in Qena governorate/Egypt. METHODS: The study was part of a community-based survey carried out to assess the prevalence of neuromuscular disorders among the Qena population. A random sampling of 10 districts, 5,039 inhabitants aged ≥20. There were 3,050 urban residents (60.5%) and 1,989 (39.5%) from the rural community. Patients were diagnosed using a screening questionnaire for diagnosis of entrapment neuropathies. Positive cases were referred to the Qena University Hospital. They were given full clinical, electrophysiological and laboratory investigations. RESULTS: Compressive neuropathy was recorded in 165 cases giving a CPR = 3.3% of population at risk (≥20 years). Carpal tunnel syndrome (CTS) was diagnosed in 155 cases giving a CPR = 3.1% with a significantly higher prevalence among females than males (5.3 vs. 0.9%) and in rural compared with urban populations (4.6 vs. 2.1%). Ulnar neuropathy at the elbow was the second common type of entrapment with a CPR = 0.1% followed by radial nerve palsy, tarsal tunnel syndrome and common peroneal nerve palsy. CONCLUSION: The overall crude prevalence rate of CTS is comparable with that in other countries. TRIAL REGISTRATION: ClinicalTrials.gov .

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During the first half of the 20th century, thoracoscopy was used almost exclusively for the management of pleural effusions and pulmonary tuberculosis starting with nonspecific instruments, a cystoscopy, and continue to develop with the increasing use with time until the tremendous success of laparoscopic procedures in the 1980s which gave impetus to surgeons to apply this technology to increase feasibility and use of minimal invasive approaches in more difficult thoracic surgery operations. But what if we do not have this technology of high definition cameras, specialized VATS instruments or endostaplers. Most literature reviews recommendation about learning curves for VATS lobectomy is to do more than 100 cases of minor VATS procedure before starting to perform VATS lobectomy. We try to demonstrate our local experience of implementing a VATS lobectomy program in a cardiothoracic surgery department after completing our first 51 cases of minor VATS procedures.

During the first half of the 20th century, thoracoscopy was used almost exclusively for the management of pleural effusions and pulmonary tuberculosis starting with nonspecific instruments, a cystoscopy, and continue to develop with the increasing use with time until the tremendous success of laparoscopic procedures in the 1980s which gave impetus to surgeons to apply this technology to increase feasibility and use of minimal invasive approaches in more difficult thoracic surgery operations. But what if we do not have this technology of high definition cameras, specialized VATS instruments or endostaplers. Most literature reviews recommendation about learning curves for VATS lobectomy is to do more than 100 cases of minor VATS procedure before starting to perform VATS lobectomy. We try to demonstrate our local experience of implementing a VATS lobectomy program in a cardiothoracic surgery department after completing our first 51 cases of minor VATS procedures.

During the first half of the 20th century, thoracoscopy was used almost exclusively for the management of pleural effusions and pulmonary tuberculosis starting with nonspecific instruments, a cystoscopy, and continue to develop with the increasing use with time until the tremendous success of laparoscopic procedures in the 1980s which gave impetus to surgeons to apply this technology to increase feasibility and use of minimal invasive approaches in more difficult thoracic surgery operations. But what if we do not have this technology of high definition cameras, specialized VATS instruments or endostaplers. Most literature reviews recommendation about learning curves for VATS lobectomy is to do more than 100 cases of minor VATS procedure before starting to perform VATS lobectomy. We try to demonstrate our local experience of implementing a VATS lobectomy program in a cardiothoracic surgery department after completing our first 51 cases of minor VATS procedures.

During the first half of the 20th century, thoracoscopy was used almost exclusively for the management of pleural effusions and pulmonary tuberculosis starting with nonspecific instruments, a cystoscopy, and continue to develop with the increasing use with time until the tremendous success of laparoscopic procedures in the 1980s which gave impetus to surgeons to apply this technology to increase feasibility and use of minimal invasive approaches in more difficult thoracic surgery operations. But what if we do not have this technology of high definition cameras, specialized VATS instruments or endostaplers. Most literature reviews recommendation about learning curves for VATS lobectomy is to do more than 100 cases of minor VATS procedure before starting to perform VATS lobectomy. We try to demonstrate our local experience of implementing a VATS lobectomy program in a cardiothoracic surgery department after completing our first 51 cases of minor VATS procedures.

BACKGROUND: A growing body of evidence suggests that chronic cigarette smoking causes detrimental effects on brain morphology. AIM OF WORK: To study the structural changes in auditory cortex region (Layer V), under the influence of nicotine. MATERIAL AND METHODS: Three animal groups (10 each) were used; group I (control) and groups IIa and IIb received 3 and 6mg/kg nicotine respectively. The specimens from the auditory cortex were examined using light and electron microscopy and morphometry. RESULTS: Neurons and blood capillaries of the auditory cortex (layer V), were influenced by chronic nicotine treatment in a dose dependent manner. The neurons and their processes revealed disorganization and dissociation of microtubules. The neuronal cells nucleoli characteristically revealed large fibrillar centers detected by silver stain and ultrastructure. The blood capillaries revealed collapse, irregular lumen, thickened basal lamina, abnormal forms of nuclei and organization of microtubules. Neuroglia revealed marked reactivity. Morphometrically, there was a significant decrease in the thickness of the auditory cortex and the number of light neurons and a significant increase in the number of dark neurons in comparison to the control. CONCLUSION: Nicotine affects the integrity of the auditory cortex possibly by reducing metabolic and transcription activities.

BACKGROUND: A growing body of evidence suggests that chronic cigarette smoking causes detrimental effects on brain morphology. AIM OF WORK: To study the structural changes in auditory cortex region (Layer V), under the influence of nicotine. MATERIAL AND METHODS: Three animal groups (10 each) were used; group I (control) and groups IIa and IIb received 3 and 6mg/kg nicotine respectively. The specimens from the auditory cortex were examined using light and electron microscopy and morphometry. RESULTS: Neurons and blood capillaries of the auditory cortex (layer V), were influenced by chronic nicotine treatment in a dose dependent manner. The neurons and their processes revealed disorganization and dissociation of microtubules. The neuronal cells nucleoli characteristically revealed large fibrillar centers detected by silver stain and ultrastructure. The blood capillaries revealed collapse, irregular lumen, thickened basal lamina, abnormal forms of nuclei and organization of microtubules. Neuroglia revealed marked reactivity. Morphometrically, there was a significant decrease in the thickness of the auditory cortex and the number of light neurons and a significant increase in the number of dark neurons in comparison to the control. CONCLUSION: Nicotine affects the integrity of the auditory cortex possibly by reducing metabolic and transcription activities.