Update in present diagnosis and treatment associated with vestibular neuritis

This group also had significantly shortened overall survival compared with others (38.4 months vs. 67.9 months P = .024). CONCLUSION Our data suggest that there is correlation between PD-L1 positivity and EBV positivity in tumor RS cells that are also associated with extranodal involvement, intermediate and high IPS score, presence of B symptoms, and advanced-stage disease. In addition, we identified a group of triple-positive (EBV+, RS-PD-L1+, mic-PD-1+) cHL patients who have a very high-risk disease. INTRODUCTION AND OBJECTIVES Many scoring systems in liver diseases use static values of liver function parameters. These parameters may change significantly in liver transplant (LTx) recipients over time due to various processes. The study was aimed at building a new model for survival prediction after LTx based on variability of selected parameters. MATERIALS AND METHODS The study included 450 LTx recipients who survived a minimum one year after transplantation. We analyzed liver enzymes and hematology parameters static values and their variability during the first year after transplantation. Modeling patients' survival was performed using Cox regression. Various sets of parameters (both static and variability and trends values) were tested to predict survival in our study group. Models' performance was measured using the concordance index. RESULTS The single predictors of the patients survival were the static values of AST with C-index 0.706 (0.5883-0.7494), ALT 0.6102 (0.4843-0.6857) and bilirubin 0.6224 (0.5537-0.6695). High prediction scores were observed for variability in creatinine 0.6023 (0.5409-0.6451), PLT 0.6350 (0.5491-0.7043), RBC 0.5689 (0.5065-0.6213) and WBC 0.6506 (0.5095-0.7124). Our best-fitted and proposed model for patients survival after LTx has C-index 0.8273 (IQR 0.7767-0.8649). The model uses the following indicators for mortality prediction the static value of AST, variability measure of PLT and trend measures of WBC and PLT. CONCLUSIONS Adding variability and trend measures increases predictive accuracy in modeling patients survival after LTx. We propose a high-accuracy survival model in which variability and trend of PLT measures in the first year after transplantation are strong predictors of long-term mortality. OBJECTIVES Balloon test occlusion (BTO) is performed to evaluate ischemic tolerance for large and giant cerebral aneurysms and head and neck tumors that may require parent artery occlusion. However, ischemic tolerance for the temporary test occlusion does not always guarantee a tolerance for permanent occlusion. In this study, we evaluated the utility of computed tomography (CT) perfusion during BTO to quantify ischemic tolerance for detecting delayed ischemic stroke. MATERIALS AND METHODS Forty-one patients who underwent BTO for the internal carotid artery were included. The correlations between the parameters of CT perfusion and collateral angiographic appearance or stump pressure during BTO were evaluated. The cerebral blood flow (CBF), cerebral blood volume, mean transit time (MTT), and time to peak (TTP) were obtained through CT perfusion, and the asymmetry ratios were determined. Collateral angiographic appearances were categorized into 5 grades (0-4). RESULTS The collateral angiographic appearance showed moderate correlations with CBF, MTT, and TTP that was significant. Of these, the absolute value of the correlation coefficient was the highest for MTT. MTT also showed a moderate correlation with stump pressure. CBF and MTT were significantly different between the poor collateral group (grades 2 and 3) and the good collateral group (grade 4). Based on the MTT, the good collateral group was identified with high sensitivity (75.0%) and specificity (81.2%). CONCLUSIONS In BTO, the MTT obtained through CT perfusion showed a correlation with collateral angiographic appearance and stump pressure. Thus, the MTT might be useful to quantify ischemic tolerance for detecting delayed ischemic stroke. OBJECT Plexiform neurofibroma is a characteristic lesion of Von Recklinghausen's disease. Conservative surgery is the most widely adopted treatment. However, it is very challenging because of its hemorrhagic nature and the infiltrative aspect of the lesions. Teniposide datasheet The aim of this study was to evaluate our management. PATIENTS AND METHOD A retrospective study over 16 years was realized and during this period 35 patients with neurofibroma with cervico-facial location were included. RESULTS There were 18 men and 17 women with an average age of 23 years (3-50 years). The familial form was found in 9% of patients. Aesthetic discomfort was noted in all patients and functional impairment only occurred in 10% of patients. The NFP was localized at the hemiface in 11 cases, periorbital in 6 cases, naso-labial in 5 cases, scalp in 4 cases, jugal in 4 cases and cervico-chin in 5 cases. Size of the lesions averaged 11.6cm (4-45cm). Eighteen patients (51.4%) were operated including 10 by modeling resection, 05 cervico-facial lifting and 3 complete resections. Complication rate was 28% dominated by disunion wound. The average number of procedures was 1.6 (1 to 5). After 3 years average follow-up, aesthetic et functional results was assessed as good over 75 per cent of patients. CONCLUSION Cervico-facial plexiform neurofibromas is challenging. Conservative surgery should be the gold standard and long time follow-up is recommended. Paragangliomas and pheochromocytomas (PPGL) are rare neuroendocrine tumours characterized by a strong genetic determinism. Over the past 20 years, evolution of PPGL genetics has revealed that around 40% of PPGL are genetically determined, secondary to a germline mutation in one of more than twenty susceptibility genes reported so far. More than half of the mutations occur in one of the SDHx genes (SDHA, SDHB, SDHC, SDHD, SDHAF2), which encode the different subunits and assembly protein of a mitochondrial enzyme, succinate dehydrogenase. These susceptibility genes predispose to early forms (VHL, RET, SDHD, EPAS1, DLST), syndromic (RET, VHL, EPAS1, NF1, FH), multiple (SDHD, TMEM127, MAX, DLST, MDH2, GOT2) or malignant (SDHB, FH, SLC25A11) PPGL. The discovery of a germline mutation in one of these genes changes the patient's follow-up and allows genetic screening of affected families and the presymptomatic follow-up of relatives carrying a mutation.