ali shamsa
Abstract
Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about the changes of biological markers. Studies suggest that MRS can be helpful in the prognosis of patients with diffuse axonal injury (DAI)Methods: PubMed and Scopus as two major database were systematically ...
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Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about the changes of biological markers. Studies suggest that MRS can be helpful in the prognosis of patients with diffuse axonal injury (DAI)Methods: PubMed and Scopus as two major database were systematically searched in June 2015 by using following search strategy ((((Magnetic resonance spectroscopy OR MRS OR MR spectroscopy)) AND (Diffuse axonal injury OR DAI)) AND Prognosis) to find relevant articles in which the prognostic value of MRS had been investigated in patients with traumatic DAI. All necessary information were extracted and used for data synthesis based on the main purpose of this study. Of total 19 articles found in PubMed and 151 found in Scopus, 8 documents were selected for data extraction in several steps of article selection according to inclusion/exclusion criteria. Total number of patients participated in the selected documents was 197. All of the selected documents showed that MRS can be used for quantitative analysis of metabolite changes in patients with DAI.Discussion: The results of studies show that MRS imaging as a sensitive method can quantitatively determine even small variation of metabolites. Since any changes in metabolite level of the brain after traumatic injury may be useful in the prediction of patient’s outcome; therefore, if such sensitivity of MRS is proven, this method can have prognostic value in patients with DAI. Based on the concluded results of included articles, MRS as a sensitive tools is helpful in the prognosis of patients with DAI.
Ali Akbar Momen; Reza Azizi Malamiri
Abstract
Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have ...
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Epilepsies and epileptic syndromes are among the most common chronic neurological disorders in neonates, infants, and children. Remission occurs in 70% of epileptic children, while other cases experience frequent seizures and become refractory to various treatment modalities. Refractory seizures have a significant adverse impact on the quality of life of epileptic children and their families. Prognosis of epilepsies is determined based on the risk of seizure or convulsion recurrence. Some of the most important risk factors for recurrence are the age at seizure presentation, neurodevelopment of the child, etiology of seizures, seizure frequency before anticonvulsant withdrawal, response to antiepileptic medications, type of epileptic syndromes, and electroencephalography of the patient. Recognition of the risk factors for seizure recurrence results in the optimal management of the treatment protocols, thereby reducing the adverse effects of epileptic seizures on patients and their families. The present study aimed to provide a narrative review of the most important risk factors for the recurrence of epilepsies in children by two child neurologists.
Ali Shamsa
Abstract
Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about changes in biological markers. Studies suggest that MRS can be helpful in determining the prognosis of patients with diffuse axonal injury (DAI).Methods: The PubMed and Scopus databases ...
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Introduction: Magnetic resonance spectroscopy (MRS) is an imaging technique that provides spectroscopic information about changes in biological markers. Studies suggest that MRS can be helpful in determining the prognosis of patients with diffuse axonal injury (DAI).Methods: The PubMed and Scopus databases were systematically searched in June 2015 using following search strategy: (“Magnetic resonance spectroscopy” OR MRS OR “MR spectroscopy”) AND [(“Diffuse axonal injury” OR DAI] AND Prognosis) to find relevant articles in which the prognostic value of MRS had been investigated in patients with traumatic DAI. All relevant information was extracted from the identified articles and used to synthesize the data for the purpose of this study.Result: In total, 19 articles were found in PubMed and 151 in Scopus. Of these, eight documents were selected for further data extraction following the application of the inclusion/exclusion criteria. The total number of patients who participated in the research studies described in the selected documents was 197. All of the selected documents showed that MRS can be used to quantitatively assess metabolite changes in patients with DAI.Discussion: The results of the studies indicate that MRS imaging as a sensitive method can quantitatively determine even small variations in metabolites. Any changes in the metabolite level of the brain after traumatic injury may be a useful predictor of a patient’s outcome; therefore, if the sensitivity of MRS is proven, this method can have prognostic value when employed with patients with DAI.Conclusion: Based on the results of this systematic review, MRS is a sensitive tool that is helpful in determining the prognosis of patients with DAI.
Abdollah Banihashem; Ali Ghasemi; Lueisa Tavasolian
Abstract
Acute lymphoblastic leukemia (ALL) is the most common type of neoplastic disorder diagnosed in childhood. It is the cause of one third of all pediatric malignancies. ALL is characterized by the abnormal production and proliferation of immature lymphoblasts in bone marrow (BM). It seems that ALL occurs ...
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Acute lymphoblastic leukemia (ALL) is the most common type of neoplastic disorder diagnosed in childhood. It is the cause of one third of all pediatric malignancies. ALL is characterized by the abnormal production and proliferation of immature lymphoblasts in bone marrow (BM). It seems that ALL occurs due to a genetic mutation in DNA structure producing white blood cell (WBC) stem cells. Because ALL is a systemic disease, its primary management is based on chemotherapy.There are important risk factors responsible for the poor prognosis of ALL in children less than 1 year old and greater than 10 years old, such as: high WBC, mature T cell ,mature B cell, central nervous system (CNS) involvement, DNA index < 1 (hypodiploid), triploidy, tetraploidy, Mixed-Lineage Leukemia (MLL) gene re-arrangement on 11q23, the Philadelphia chromosome t(9;22), reduction in platelet count, hemoglobin>10 at diagnosis, no remission at the end of induction therapy and Minimal residual disease at the end of consolidation therapy. Complications might appear during the treatment including tumor lysis syndrome, bleeding, renal failure, sepsis, seizure, thrombosis, etc. Some consequences might identify after a long-term follow-up such as learning impairment, growth retardation, and secondary malignancies. It is estimated that up to 90% of pediatric ALL cases are curable.