Background and objectives: Non-motor symptoms in the form of increased sensitivity are often associated with the onset of idiopathic Bell’s palsy (IBP). The aims were to determine whether the pain threshold in the retroauricular regions (RAR) in IBP patients and the time of its occurrence is related to IBP severity. Materials and Methods: The study was conducted among 220 respondents (142 IBP patients, 78 healthy subjects (HS)). The degree of IBP was graded using the House–Brackmann and Sunnybrook Grading Scales (II—mild dysfunction, VI—total paralysis), whereas the pain thresholds were measured using the digital pressure algometer. Results: We found no difference in the degree of the pain threshold between the right and left RAR in the HS group. IBP patients belonging to groups II, III, IV, and V had lower pain thresholds in both RARs than HS and IBP patients belonging to group VI. There was no difference in the degree of pain threshold in RAR between the affected and unaffected side in IBP patients. The incidence of retroauricular pain that precedes paralysis and ceases after its occurrence in groups II and III of IBP patients is noticeably lower and the incidence of retroauricular pain that occurred only after the onset of paralysis is more frequent. Also, we found that the incidence of retroauricular pain that precedes paralysis and ceases after its occurrence in groups V and VI of IBP patients was more frequent. Conclusions: The degree of pain threshold lowering in RAR (bilaterally) is inversely related to the severity of IBP. We suggest that the occurrence of retroauricular pain before the onset of facial weakness is associated with higher severity of IBP while the occurrence after the onset is associated with lower severity of IBP.

Background/Objectives: Poor responder patients represent the greatest challenge in ART. An inadequate response to COS strongly correlates with a reduced chance of conception. A novel classification of poor responders overcame a deficiency in the Bologna criteria and distinguished an expected and unexpected low ovarian response, allowing for an individual treatment approach to be created. In this study, we compared the clinical outcomes in poor responders, according to two different ovarian stimulation protocols, GnRH agonists and antagonists, classified according to the Poseidon criteria, to determine the most effective protocol for each group. Methods: This retrospective study involved 1323 low-prognosis women ranked according to the Poseidon classification and a control group of normal responders. Results: The GnRH-antagonist protocol showed some advantage in the Poseidon 1b group whereas the GnRH-agonist protocol was more effective in the Poseidon 4 group. There were no differences in live births or miscarriage rates in poor responders among these two protocols. Conclusions: Using both the agonist/antagonist approaches, live birth rates are two or even three times less in Poseidon patients in comparison to normal responders. The number of obtained oocytes, their maturity and quality, and women’s ages were found to be the most influential determinants for a successful outcome. Further investigations into ovarian stimulation strategies are required to enhance oocyte number and live birth occurrence.

Background and Objectives: POSEIDON 4 (P4) patients face the most adverse outcomes among poor responders. Oocyte donation has overcome unsatisfactory live birth rates (LBRs) in P4 patients and has become an indispensable approach. However, many patients refuse oocyte donation despite poor live birth likelihood using autologous oocytes. This study aimed to determine clinical outcomes and live birth chances in P4 patients using autologous and donated oocytes. We also identified influencing factors of fertility outcome in P4 patients who underwent donor cycles. Materials and Methods: Retrospective data of 345 P4 patients who explored the first ovarian stimulation cycle (control group) were compared to 105 patients who failed to conceive and underwent repeated autologous ovarian stimulations with an increased starting gonadotropin dose and 100 unpregnant patients who received donated oocytes. Univariate analysis was used to identify prognostic factors of oocyte donation outcomes in P4 patients. Results: LBRs were significantly higher in the donor oocyte group. A higher number of retrieved and good-quality oocytes without differences in the blastocyst number and LBRs were found in the autologous patient group with adjusted gonadotropin dose compared to the control group. Univariate analysis showed that oocyte and embryo quality as well as blastocyst development had a positive impact on live birth in the donor patient group. Conclusions: Autologous in vitro fertilization (IVF) retreating and oocyte donation should be strongly advised for poor-prognosis P4 patients. Still, efforts in tailoring ovarian stimulation to obtain higher oocyte and embryo numbers in autologous cycles should be continued.

Background and Objectives: Bell’s palsy (BP) is the most common cause of acute unilateral peripheral facial nerve paralysis. The aim of this study was to evaluate the time to complete clinical recovery in patients with BP treated with acupuncture and to identify baseline clinical and electrophysiological predictors of recovery outcomes. In addition, electrophysiological characteristics at the time of complete clinical recovery were examined. Materials and Methods: This prospective, observational, uncontrolled cohort study included 1050 patients with clinically confirmed BP who received acupuncture as the only therapeutic intervention between January 2017 and August 2025. Clinical severity was assessed using the House–Brackmann (HB) and Sunnybrook (SB) grading systems. Electrophysiological evaluation included compound muscle action potential (CMAP) analysis and needle electromyography (EMG). Time-to-event analysis was performed using the Kaplan–Meier method and Cox proportional hazards regression analysis. Results: Complete clinical recovery was achieved in 843 patients (80.3%). The median time to recovery was 40 days (IQR 30–60). Patients with milder baseline deficits (HB II–IV) demonstrated significantly faster recovery than those with severe paralysis (HB V–VI) (log-rank p < 0.001). In multivariable Cox regression analysis, higher baseline HB grade, older age, and more severe EMG denervation were independently associated with slower recovery. Residual electrophysiological abnormalities persisted in most patients despite complete clinical recovery. Conclusions: Recovery from BP is a dynamic and heterogeneous process, significantly influenced by initial clinical severity and the degree of electrophysiological impairment. Combined clinical and electrophysiological assessment may contribute to more precise prognostic stratification and follow-up of patients with BP. Persistent electrophysiological abnormalities despite complete clinical recovery suggest that complete clinical recovery may precede complete neurophysiological regeneration of the facial nerve.

Introduction. Identifying patients with nutritional risk, nutritive assessment, and individual nutritional support are essential factors for the quality of treatment. Showing the importance of nutritional and clinical parameters as the essential indicators of the need for perioperative nutritional support. Differences in albumin and protein concentrations in the preoperative and postoperative periods of urology patients are directly related to the patients? age. Material and Methods. In 130 urological patients with malignancies, nutritional status was evaluated based on preoperative appetite reduction, unintentional body mass loss in the preoperative period, body mass index, the thickness of skin folds, percentage of fat tissue, the difference between normal and measured body weight, the level of albumins and total serum proteins preoperatively and postoperatively and other clinical parameters such as the presence of cardiovascular diseases and according to the classification of the American Society of Anesthesiologists patients status. Interviews, medical history, and anthropometric measurements were used in the research. Results. Of the total number of respondents, 81.5% did not have a decreased appetite, and 69.2% did not lose body weight. According to the body mass index, the highest percentage (50.77%) was normally nourished, while the malnourished group only comprised of 0.77%. A decrease in albumin and protein concentration was proven throughout the perioperative period. Older patients had lower concentrations of albumin and protein in this period. Conclusion. It is necessary to use several parameters, including body mass index and percentage fat percentage measurement to assess the nutritional status. Adequate perioperative protein nutritional support should be primarily be administered to elderly patients.

Background/ Aim. Infertility is one of the posible causes for a decrease in fertility rates. It is a significant social and medical problem affecting one in six couples worldwide with the current prevalence of infertility being 8- 12% among women aged 20-44. The most significant and influental factor of infertility is women’s age. This study aims to evaluate clinical outcomes among different infertility causes in women aged ≥35, as well as to investigate the prevalence of infertility causes. Methods: medical records were obtained from 873 women subjected to an IVF (in vitro fertilization) treatment cycle. Incidence and clinical outcomes of four infertility causes and factors leading to female cause of infertility were investigated. Results: The highest proportion of couples who had taken part in an assisted reproduction program, did so due to female cause of infertility, particullary due to ovulatory problems. Statistically significant differences between the four causes of infertility were found in terms of the number of retrieved and mature oocytes, fertilization rates. Differences in pregnancy and live birth rates were found between factors leading to female causes of infertility. Conclusions: Female factors, especially ovulatory problems are, as expected, the most common cause of infertility in the investigated age group and are associated with an increased risk of adverse clinical outcomes. This is useful information for the management of infertility but further investigation of infertility causes and prevalence is necessary.