Clinical Characteristics and Visual Outcomes of Pediatric Optic Neuritis: A Single Center Experience

INTRODUCTION: The aim of this study was to describe the clinical characteristics, visual outcomes of pediatric patients presenting with first-episode of optic neuritis. METHODS: We reviewed medical records of the patients newly diagnosed with optic neuritis younger than 18 years between January 2014 and December 2018 retrospectively. RESULTS: Twenty-eight patients were included to this study. The mean age at first onset of optic neuritis was 13.2+-3.1 years (range 6.2-17.3 years). The mean follow-up period was 4.2+-3.2 (range 0.6-13.08) years. 7 of 28 (25%) patients had recurrent optic neuritis. Optic neuritis involvement was unilateral in 17 of 28 (60%) patients. Forty percent of the patients had idiopathic optic neuritis. Of the six patients with demyelinating lesions in cranial magnetic resonance imaging (MRI) at the first admission, three were diagnosed with multiple sclerosis (MS) at the time of first optic neuritis attack, and three were diagnosed within 13.4+-4.8 months after the first episode. Eight of 21 optic neuritis patients (38%) had oligoclonal band positivity and the incidence of MS was significantly higher in these patients (p=0.014). The mean visual acuity at nadir was 0.48+-0.27 at admission. Whereas it was 0.74+-0.31 and 0.76+-0.33 at 1 and 6 months respectively. There was a strong correlation between first and sixth-month visual acuity (r=0.98, p=0.00). DISCUSSION AND CONCLUSION: Our study demonstrated that poor visual acuity (worse than 0.5) at 1 month can predict poor vision at 6 months. The patients with demyelinating lesions in cranial MRI at their first optic neuritis episode, are more likely to develop MS during the follow-up

Hematopoietik Kök Hücre Nakil Alıcılarında Pulmoner Rehabilitasyonun Etkilerinin Araştırılması

The purpose of this study is to investigate the effects of pulmonary rehabilitation on pulmonary functions, respiratory and muscle strength, functional capasity and quality of life in hematopoietic stem cell transplantation recepients. Thirty three patients were included in this study. These patients were randomized into two groups. Training group followed a program consists of inspiratory muscle training, in addition to mobilisation aerobic exercise training and strength training. Control group were offered the standard mobilization program and incentive spirometry exercises. Pulmonary functions, respiratory muscle strength, functional exercise capasity, peripheral muscle strength, quality of life, physical activity level, dispnea perception and fatigue were assessed. Results showed that in pulmonary rehabilitation group pulmonary functions, respiratory and peripheral muscle strength didn't change (p>0.05). In control group functional exercise capasity, respiratory and peripheral muscle strength decreased statistically significant (p0.05). Kontrol grubunda fonksiyonel kapasite, solunum ve kas kuvveti istatistiksel olarak anlamlı azaldı (p<0.05). Sonuç olarak hematopoietik kök hücre nakil alıcılarında pulmoner rehabilitasyon fonksiyonel kapasiteyi korumaktadır. Hastalara nakil süresince pulmoner rehabilitasyon uygulanmalıdır

The Effect of Blood Pressure Regulation on Arterial Stiffness in Individuals with Stage I-II Hypertension

Amaç: Hipertansif hastalarda sub-klinik organ hasarı göstergelerinden biri de arteryel sertliktir. Çalışmamızda Evre I-II hipertansiflerde kan basıncı düzenlemesinin arteryel sertlik üzerine etkilerini değerlendirdik. Gereç ve Yöntem: 18-65 yaş Evre I-II hipertansif 60 (34 Evre I, 26 Evre II) hastaya tedavi öncesi ve en az bir ay sonrası olmak üzere 24 saatlik ayaktan kan basıncı izlemi yapıldı. Hastaların tedavileri, arteryel sertlik parametrelerine kör olan hastanın kendi doktorunca verildi. Kan basıncı kontrol altına alınan (Grup 1, n30) ve alınamayan (Grup 2, n30) olarak iki grup oluşturuldu. 24 saatlik holter izleminden hesaplanan aortik sertlik parametrelerinin her iki grupta tedavi öncesi ve sonrası değerleri karşılaştırıldı. Bulgular: Tedavi sonrası; grup 1 hastaların kan basınçları ve arteryel sertlik parametrelerinde [Augmentasyon basıncı (13,46, 10.75.6, p0.001), Augmentasyon indeksi (29,68,2, 26,08,0, p0.001), nabız basıncı (479, 416, p0,001), nabız dalga hızı (7.70.9, 7.10.9, p0.001)] anlamlı düşme izlendi (p0,05). Grup 2 hastaların ortalama diyastolik kan basıncı (948, 918, p0,01) ile kalp hızında (788, 748, p0,03) anlamlı düşme, Augmentasyon basıncında (12,05,1, 14,05,9, p.03) anlamlı yükselme (p0,05) izlenirken, diğer parametrelerde anlamlı değişim görülmedi. Sonuç: Evre I ve Evre II hipertansif hastalarda kan basıncı kontrolü, arteryel sertlik parametrelerinde anlamlı düzelme sağlamaktadır. Yeterli kan basıncı kontrolünün sağlanamadığı durumda ise antihipertansiflere rağmen arteryel sertlik parametreleri düzelmemektedir.Aim: One of the indicators of sub-clinical organ damage in hypertensive patients is also arterial stiffness. We evaluated the effects of blood pressure regulation on arterial stiffness in stage I-II hypertensives. Material and Method: A total of 60 patients ageing 18-65 with stage I-II hypertension (34 stage I, 26 stage II) underwent 24-hour ambulatory blood pressure monitoring before and at least one month later treatment. The treatments were performed by their physi- cians who blind to parameters of arterial stiffness. Two groups were generated including blood pressure regulated- (Group 1, n30) and non-regulated (Group 2, n30). Aortic stiffness parameters, calculated by 24-hour monitoring, before and after treatment were compared in both groups. Results: After treatment, the blood pressures and arterial stiffness parameters [Augmentation pressure (13.4±6, 10.7±5.6, p>0.001), Augmentation index (29.6±8.2, 26.0±8.0, p0.001), pulse pressure (47±9, 41±6, p>0.001), pulse wave velocity (7.7±0.9, 7.1±0.9, p>0.001)] of group 1 were significantly decreased. Whereas mean diastolic blood pressures and heart rates of group 2 were significantly decreased, augmentation pressure was significantly increased, other parameters did not change significantly. Conclusion: Blood pressure regulation resulted in statistically significant improve of arterial stiffness parameters in stage I-II hypertension. When blood pressure could be not regulated, aortic stiffness parameters wasnt improved despite using the antihypertensive drugs

Assessment of sensorimotor and strength related function of breast cancer patients during systemic drug therapy: a prospective observational study

Abstract Background Chemotherapy is a well-known risk factor for sensorial and motor disturbances. Chemotherapy induced peripheral neuropathy (CIPN) which predominantly affects sensory nerves might cause a diminished fine motor function. This prospective observational study aimed to assess the sensorimotor functions of breast cancer patients before, during, and after chemotherapy. Methods A total of 56 breast cancer patients were evaluated at three different times as follows: T1 (before chemotherapy), T2 (middle chemotherapy), and T3 (completion of chemotherapy). Motor function was assessed with handgrip strength (HGS), peripheral muscle strength (PMS), and the Minnesota Manual Dexterity Test (MMDT). Semmes Weinstein Monofilament Test (SWMT) was performed to assess the sensory function. Fatigue was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Module Cancer Related Fatigue (EORTC-QLQ-FA12), respectively. Results HGS and MMDT were found significant (χ2: 11.279, p = 0.004 and χ2: 9.893, p = 0.007, respectively) whereas PMS was not found significant (F (2,110) = 1.914, p = 0.152). Pairwise comparisons with Bonferroni adjustments revealed that HGS was found significant between T1 and T3, while significant results were obtained between T1 and T2 as well as T2 and T3 in MMDT (p = 0.01 and p = 0.042). There were significant results in some reference points of SWMT, though they were not found after pairwise comparisons with Bonferroni adjustment (p > 0.05). Fatigue was found significantly increased from T1 through T3 (Median: 19.44 vs 27.77, z: -2.347, p = 0.019, Wilcoxon test). Conclusion Our study showed that decreased handgrip strength and fine motor function, as well as increased fatigue, are evident during the chemotherapy. SWMT can be an optional assessment in the context of tracking changes in cutaneous sensation during chemotherapy due to its non-invasive, cheap, and easily repeatable features among cancer patients. To preserve functional capacity as well as independence in daily living, precautions and follow up assessments during the systemic therapy process should be integrated as early as possible to prevent future deteriorations in daily life for patients who undergo chemotherapy. Trial registration NCT04799080