Sequential sonographic features in neonatal renal vein thrombosis

Objectives: Renal vein thrombosis in newborns is a rare but serious and acute disease. Clinical representations of RVT can vary from discrete symptoms to life-threatening conditions. Therefore imaging, and in particular sonography, plays an important role in the diagnosis of RVT in neonates. Gray-scale, color and spectral/power Doppler ultrasound are all used in the diagnosis of RVT. Material and methods: We present retrospective sequential ultrasonic imaging of three patients (two term and one preterm infant) with findings characteristic of RVT. Results: Initial ultrasound diagnostic features include: renal enlargement, echogenic medullary streaks, lack of the flow pattern characteristic of arcuate vessels and subsequently loss of corticomedullary differentiation, reduced echogenicity around pyramids and echogenic band at the extreme apex of the pyramid. Higher resistance index or less pulsatile venous flow on the affected kidney are helpful Doppler signs. Conclusions: Knowledge and identification of specific features of each phase of the evolution of RTV seems essential to prompt diagnosis. We would like to highlight the evolution of specific sonographic features in each subsequent phase of RVT

Cladribine tablets for highly active relapsing-remitting multiple sclerosis in Poland: a real-world, multi-centre, retrospective, cohort study during the COVID-19 pandemic

Introduction. Treatment with cladribine tablets is indicated in highly active relapsing-remitting multiple sclerosis (RRMS). Cladribine tablets proved safe and effective in the pivotal CLARITY trial, but that trial included primarily treatment-naïve patients. In clinical practice however, cladribine tablets are often given to patients who have failed other treatments. Therefore, this study investigated the real-world safety and efficacy of cladribine tablets. Material and methods. We gathered data from nine MS clinical centres across Poland for patients with RRMS who started treatment with cladribine tablets from December 2019 to June 2022. Results. We enrolled 140 patients, with follow-up data available for 136 in year 1 and for 66 in year 2. At baseline, the mean age was 35.6 years, mean disease duration was 7.3 years, median EDSS score was 2.5, and 94% of patients were treatment- -experienced. Thirty-nine patients (27.9%) had undergone COVID-19, and 94 (67.1%) were vaccinated against COVID-19. The annualised relapse rate (ARR) decreased from 1.49 at baseline to 0.33 in year 1 (p < 0.001) and to 0.25 in year 2 (p < 0.001). The percentage of relapse-free patients increased from 11.5% at baseline to 70.2% in year 1 and 82.1% in year 2. The percentage of patients with active lesions decreased from 91.4% at baseline to 36.2% in year 1 and 18.2% in year 2. EDSS score remained stable or improved in 83.7% of patients in year 1 and 89.6% in year 2. No evidence of disease activity (NEDA-3) was achieved in 42.7% of patients in year 1 and 66.7% in year 2. Only one patient (0.72%) had grade 4 lymphopenia and 21 (15.1%) had grade 3 lymphopenia. Varicella zoster virus infections occurred in three patients. Eight patients discontinued treatment with cladribine: five due to inefficacy, one due to lymphopenia, and two due to a personal decision. Conclusions. Cladribine tablets proved safe and effective in a real-world cohort of treatment-experienced patients. However, the efficacy measures improved to a lesser extent in our cohort than in the pivotal clinical trial, which is probably due to a higher proportion of treatment-experienced patients in our cohort

“Animal in the Belvedere” – birth of the myth warsaw about Grand Prince Constantine

Constantine Pawlowicz Romanow is a character, which had infamously enrolled on cards of history. Thanks to nineteenth-century diarists, we know why he deserved on this opinion. Other people saw his behavior as very exotic and those situations resulted in stories about savage man living in a Belvedere Palace. Consecutive years brought another, very extension stories about Russian Tsar`s son, which released imagine for next generations, allowing for growing the legend of “wild animal Constantine” – man, who persecuted inhabitants of capital. To look carefully, how myth about Grand Duke was born and prevailed, we have to know about historical developments in nineteenth-century Warsaw. Trying to describe daily life in Warsaw, slowly pushing people to revolution, I have noticed that everybody had seen Constantine like main protagonist of this situation. His “foreignness” and “russianness” were the main reasons for provocateurs calling for actions against Russian Empire. For Poles, Constantine was like Russian Empire in Warsaw. Prince, as a representative of this empire, became the mortal enemy. Prince did not take into account polish elite. He considered himself as a simple tributary of his brothers, but he liked using his position. Nobody understood his aggression in one moment and big happiness in the next. He liked power, which he recognized living in the Polish Kingdom. The November Uprising deprived him everything and drove abroad. His senses came too late. Constantine refused to send his troops against the revolutionaries, saying: “The Poles have started this disturbance, and it’s Poles that must stop it”, and left the suppression of the revolt in the hands of the Polish government. He himself retreated behind Russian lines but following the failure of the uprising expressed admiration for the valor of the Polish insurgents

“Animal in the Belvedere” – birth of the myth warsaw about Grand Prince Constantine

Constantine Pawlowicz Romanow is a character, which had infamously enrolled on cards of history. Thanks to nineteenth-century diarists, we know why he deserved on this opinion. Other people saw his behavior as very exotic and those situations resulted in stories about savage man living in a Belvedere Palace. Consecutive years brought another, very extension stories about Russian Tsar`s son, which released imagine for next generations, allowing for growing the legend of “wild animal Constantine” – man, who persecuted inhabitants of capital. To look carefully, how myth about Grand Duke was born and prevailed, we have to know about historical developments in nineteenth-century Warsaw. Trying to describe daily life in Warsaw, slowly pushing people to revolution, I have noticed that everybody had seen Constantine like main protagonist of this situation. His “foreignness” and “russianness” were the main reasons for provocateurs calling for actions against Russian Empire. For Poles, Constantine was like Russian Empire in Warsaw. Prince, as a representative of this empire, became the mortal enemy. Prince did not take into account polish elite. He considered himself as a simple tributary of his brothers, but he liked using his position. Nobody understood his aggression in one moment and big happiness in the next. He liked power, which he recognized living in the Polish Kingdom. The November Uprising deprived him everything and drove abroad. His senses came too late. Constantine refused to send his troops against the revolutionaries, saying: “The Poles have started this disturbance, and it’s Poles that must stop it”, and left the suppression of the revolt in the hands of the Polish government. He himself retreated behind Russian lines but following the failure of the uprising expressed admiration for the valor of the Polish insurgents