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Abstract

The aim of this study was to evaluate the efficacy of electroacupuncture in acute and chronic phases of radial and ulnar nerve injuries in histopathological, immunohistochemical and biochemical aspects. In the study, the rabbits were divided into four groups namely acute nerve injury (ANI) group, chronic nerve injury (CNI) group, positive control (PC) group and negative control (NC) group. In the ANI, CNI and PC groups, damage was created on the nervus radialis and nervus ulnaris by applying pressure for 60 seconds using a hemostatic forceps under anesthesia. No damage was created in the NC group. Fifteen sessions of electroacupuncture were applied to the rabbits in the ANI, CNI, and NC groups every other day using LI-4 (Large Intestine Meridian-4, He Gu), LI-10 (Large Intestine Meridian-10, Shou San Li), LR-3 (Liver Meridian-3, Tai Chong), and ST-36 (Stomach Meridian-36, Zusanli) electroacupuncture points. Electroacupuncture was not applied to the rabbits in the PC group. Decapitation was performed under general anesthesia at the end of electroacupuncture applications. After the euthanasia procedure, the samples obtained were evaluated for histopathological, immunohistochemical and biochemical parameters. In conclusion, degenerative foci in the treatment groups were found to be fewer than in the PC group whereas NGF and S-100 immunoreactivity were higher in the treatment groups than in the PC group. Whereas no statistically significant difference was observed between the treatment groups and the NC group in terms of oxidative stress factors, there was a statistically significant difference between the treatment groups and the PC group. In light of all these data, we have concluded that electroacupuncture is an effective treatment method for peripheral nerve injuries.
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Authors and Affiliations

E. Polat
1
C. Gunay
1
H. Eroksuz
2
S. Yilmaz
3
E. Kaya
3
B. Karabulut
2
C. Akdeniz Incili
2

  1. Fırat University, Faculty of Veterinary Medicine, Department of Surgery, Elazig, 23100 Turkey
  2. Fırat University, Faculty of Veterinary Medicine, Department of Pathology, Elazig, 23100 Turkey
  3. Fırat University, Faculty of Veterinary Medicine, Department of Biochemistry, Elazig, 23100, Turkey
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Abstract

Background: The right phrenic nerve is vulnerable to injury (PNI) during cryoballoon ablation (CBA) isolation of the right pulmonary veins. The complication can be transient or persistent. The reported incidence of PNI fluctuates from 4.73% to 24.7% depending on changes over time, CBA generation, and selected protective methods.
Methods: Through September 2019, a database search was performed on MEDLINE, EMBASE, and Cochrane Database. In the selected articles, the references were also extensively searched. The study provides a comprehensive meta-analysis of the overall prevalence of PNI, assesses the transient to persis-tent PNI ratio, the outcome of using compound motor action potentials (CMAP), and estimated average time to nerve recovery.
Results: From 2008 to 2019, 10,341 records from 48 trials were included. Out of 783 PNI retrieved from the studies, 589 (5.7%) and 194 (1.9%) were persistent. CMAP caused a significant reduction in the risk of persistent PNI from 2.3% to 1.1% (p = 0.05; odds ratio [OR] 2.13) in all CBA groups. The mean time to PNI recovery extended beyond the hospital discharge was significantly shorter in CMAP group at three months on average versus non CMAP at six months (p = 0.012). CMAP (in contrast to non-CMAP procedures) detects PNI earlier from 4 to 16 sec (p <0.05; I2 = 74.53%) and 3 to 9º (p <0.05; I2 = 97.24%) earlier.
Conclusions: Right PNI extending beyond hospitalization is a relatively rare complication. CMAP use causes a significant decrease in the risk of prolonged injury and shortens the time to recovery.
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Authors and Affiliations

Marcin Kuniewicz
1 2
ORCID: ORCID
Marcin Kowalski
3
Grzegorz Karkowski
2
Nicholas Jackob
1
Rafał Badacz
4
Tomasz Rajs
4
Jacek Legutko
4

  1. Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
  2. Department of Electrocardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
  3. Department of Medicine, Division of Cardiac Electrophysiology, Staten Island University Hospital, Staten Island, New York
  4. Department of Interventional Cardiology John Paul II Hospital, Kraków, Poland

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