Prognostic and Clinical Role of Contrast Enhancement on Magnetic Resonance Imaging in Patients with Bell’s Palsy

Objective:To investigate the prognostic value of the magnetic resonance imaging in Bell’s palsy patients.Methods:Patients who were diagnosed and treated with Bell’s palsy between October 2013 and March 2016 retrospectively selected. House–Brackmann grades, pre- and post-treatment pure tone audiograms, stapedial reflexes were analyzed and magnetic resonance imaging (MRI) scans with gadolinium-based contrast agents were evaluated. Contrast-enhanced segments of the facial nerve were determined. MRI findings were compared statistically with pre- and post-treatment grade, recurrence rate of Bell’s palsy, MRI scanning timing, presence of stapes reflexes and posttreatment recovery data.Results:No significant correlation was observed between pretreatment House–Brackmann grades and enhancement (p>0.05). Similarly, there was no significant correlation between clinical recovery and enhancement (p>0.05). Also, no significant correlation was observed between MRI scanning time, the recurrence rate of Bell’s palsy and MRI findings (p>0.05). None of the MRIs showed neoplastic contrast enhancement.Conclusion:The routine use of the contrast-enhanced temporal MRI is not recommended in the diagnosis and monitoring of Bell’s palsy patients, because the contrast enhancement pattern of the facial nerve has no effect on the prognosis of Bell’s palsy. MRI should be used in cases that do not heal despite treatment, for the differential diagnosis of facial nerve tumors and in patients who are candidates for surgical decompression

Polatuzumab vedotin, rituximab, and bendamustine combination in relapsed or refractory diffuse large B-cell lymphoma: A real-world data from Turkey

Polatuzumab vedotin (Pola) with bendamustine and rituximab (BR) is a promising option for patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). We analyzed the data of 71 R/R DLBCL patients who had been treated with Pola-BR in the named patient program from March 2018 to April 2021 from 32 centers in Turkey. All patients received up to six cycles of Pola 1.8 mg/kg, rituximab 375 mg/m2 on day 1, and bendamustine 90 mg/m2 on days 1–2 of each cycle. Median age at Pola-BR initiation was 55 (19–84). The overall response rate was 47.9%, including 32.4% CR rate when a median of 3 cycles was applied. With a median follow-up of 5 months, the median OS was 5 months. Grade 3–4 neutropenia and thrombocytopenia were the most common hematological toxicities. The real-world data from our cohort showed the Pola-BR is an effective option with a manageable toxicity profile

Use of covered stents in simultaneous management of coarctation of the aorta and patent ductus arteriosus

WOS: 000429628000003PubMed ID: 29578201Objective: To report clinical and procedural characteristics of twelve patients who received a covered stent for the treatment of aortic coarctation and concurrent patent ductus arteriosus (PDA). Methods: A single center database was retrospectively evaluated to obtain data of patients with combined aortic coarctation and PDA. We selected patients in whom a covered stent was used for the treatment of both pathologies. The stent length was chosen so as to cover the entire length of the lesion from healthy to healthy tissue and also cover the ampulla of PDA. Results: The median age of the patients was 15 (range, 6.5-35) years. The diameter of the coarctated segment increased from a median of 8.4 (range, 2.6-10.8) mm to 16 (range, 9-24) mm (p<0.005), whereas the pressure gradient decreased from a median of 43 (range, 10-71) mm Hg to 0 (range, 0-8) mm Hg (p<0.005). Fourteen covered stents were used for 12 patients. Following deployment, seven stents were flared with larger and low-pressure balloons because of the gap between the distal end of the stent and the poststenotic dilated segment of the aorta, which caused residual PDA shunts and/or instability of the stent. After the procedure, no residual PDA shunt was present in any patient. Conclusion: To the best of our knowledge, this study includes the largest series of patients reported in literature in whom covered CP stents were used for simultaneous percutaneous treatment of coarctation and PDA. The procedure was successful and stable results were obtained during follow-up in all cases

Yenidoğan ve infant döneminde sağ ventrikül çıkım yoluna stent yerleştirilmesi: Çok merkezli, retrospektif çalışma

Background: The aim of this study was to evaluate the outcomes of right ventricular outflow tract stenting for palliation during the newborn and infancy periods. Methods: Between January 2013 and January 2018, a total of 38 patients (20 males, 18 females; median age 51 days; range, 3 days to 9 months) who underwent transcatheter right ventricular outflow tract stenting in three centers were retrospectively analyzed. Demographic characteristics, cardiac pathologies, angiographic procedural, and clinical follow-up data of the patients were recorded. Results: The diagnoses of the cases were tetralogy of Fallot (n=27), double outlet right ventricle (n=8), complex congenital heart disease (n=2), and Ebstein's anomaly (n=1). The median weight at the time of stent implantation was 3.5 (range, 2 to 10) kg. Five cases had genetic abnormalities. The median pre-procedural oxygen saturation was 63% (range, 44 to 80%), and the median procedural time was 60 (range, 25 to 120) min. Acute procedural success ratio was 87%. Reintervention was needed in seven of patients due to stent narrowing during follow-up. During follow-up period, seven cases died. Total correction surgery was performed in 26 patients without any mortality. While a transannular patch was used in 22 patients, valve protective surgery was implemented in two patients, and the bidirectional Glenn procedure was performed in two patients. Conclusion: Based on our study results, right ventricular outflow tract stenting is a form of palliation which should be considered particularly in cases in whom total correction surgery is unable to be performed due to morbidity.Amaç: Bu çalışmada yenidoğan ve infant döneminde palyasyon amaçlı sağ ventrikül çıkım yoluna stent uygulanan olguların değerlendirilmesi amaçlandı. Ça­lış­ma pla­nı: Ocak 2013 ve Ocak 2018 tarihleri arasında, üç merkezde, sağ ventrikül çıkım yoluna transkateter yoldan stent yerleştirilen toplam 38 hasta (20 erkek, 18 kadın; medyan yaş 51 gün; dağılım 3 gün-9 ay) retrospektif olarak incelendi. Hastaların demografik özellikleri, kardiyak patolojileri, anjiyografi işlem ve klinik izlem verileri kaydedildi. Bulgular: Tanılar Fallot tetralojisi (n=27), çift çıkışlı sağ ventrikül (n=8), kompleks doğumsal kalp hastalığı (n=2) ve Ebstein anomalisi (n=1) idi. Stent yerleştirme sırasında medyan ağırlık 3.5 (dağılım, 2-10) kg idi. Beş olguda genetik anormallikler mevcuttu. İşlem öncesi medyan oksijen satürasyonu %63 (dağılım, %44-80) ve medyan işlem süresi 60 (dağılım, 25-120) dk. idi. Akut işlem başarısı %87 idi. Takip döneminde stent daralması nedeniyle yedi hastaya tekrar girişim uygulandı. Takip döneminde, yedi olgu kaybedildi. Hastaların 26’sına mortalite olmaksızın tam düzeltme ameliyatı yapıldı. Yirmi iki hastada transanüler yama kullanılırken, iki hastada kapak koruyucu tam düzeltme ve iki hastada çift yönlü Glenn operasyonu gerçekleştirildi. So­nuç: Çalışma sonuçlarımıza göre, sağ ventrikül çıkım yoluna stent yerleştirilmesi, özellikle morbidite nedeni ile tam düzeltme ameliyatı yapılamayan olgularda akla gelmesi gereken bir palyasyon çeşididir

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8&plusmn;16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is seenBackground: Immune thrombocytopenia (ITP) is an au-toimmune disorder. It is characterized by thrombocyto-penia due to thrombocyte destruction mediated by auto-antibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogen-esis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied.Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP.Study Design: Descriptive study.Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hos-pitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Rela-tion between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated.Results: The study included 165 patients (124 female, mean age=42.8&plusmn;16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resis-tant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149).Conclusion: This is the first study showing seasonal as-sociation of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Medi-terranean climate is see

Seasonal Association of Immune Thrombocytopenia in Adults

Background: Immune thrombocytopenia (ITP) is an autoimmune disorder. It is characterized by thrombocytopenia due to thrombocyte destruction mediated by autoantibodies; however, cytotoxic and defective regulatory T-lymphocytes play an important role in its pathogenesis. While childhood ITP is usually acute, self-limiting and generally seasonal in nature, ITP in adults is usually chronic; its relation with seasons has not been studied. Aims: We investigated whether months and/or seasons have triggering roles in adults with ITP. Study Design: Descriptive study. Methods: A retrospective case review of adult patients with primary ITP diagnosed at various University Hospitals in cities where Mediterranean climate is seen was performed. Demographic data, date of referral and treatments were recorded. Corticosteroid-resistant, chronic and refractory cases were determined. Relation between sex, corticosteroid-resistant, chronic and refractory ITP with the seasons was also investigated. Results: The study included 165 patients (124 female, mean age=42.8±16.6). Most cases of primary ITP were diagnosed in the spring (p=0.015). Rates of patients diagnosed according to the seasons were as follows: 35.8% in spring, 23% in summer, 20.6% in fall, and 20.6% in winter. With respect to months, the majority of cases occurred in May (18.2%). Time of diagnosis according to the seasons did not differ between genders (p=0.699). First-line treatment was corticosteroids in 97.3%, but 35% of the cases were corticosteroid-resistant. Steroid-resistant patients were mostly diagnosed in the spring (52.1%) (p=0.001). ITP was chronic in 52.7% of the patients and they were also diagnosed mostly in the spring (62.7%) (p=0.149). Conclusion: This is the first study showing seasonal association of ITP in adults and we have observed that ITP in adults is mostly diagnosed in the spring. The reason why more patients are diagnosed in the spring may be due to the existence of atmospheric pollens reaching maximum levels in the spring in places where a Mediterranean climate is seen