Electrographic Patterns In Patients With Posterior Reversible Encephalopathy Syndrome(PRES) And Seizures (P2.088)
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OBJECTIVE:To look for correlation between MRI lesions and origin of electrographic dysfunction in patients with PRES and seizures. BACKGROUND:PRES is a clinico-neuroradiological entity with characteristic radiographic findings, presenting with headaches, altered mental status (AMS), seizures and visual disturbances. Although the association between PRES and seizures is known, not much is known about the pathophysiological correlation between the two, or the relation between MRI and EEG findings in this subset of patients. DESIGN/METHODS:In a retrospective review, we looked at the clinical, radiographic and electroencephalogram (EEG) records of 46 cancer patients at MD Anderson Cancer Center between 2007 and 2012 diagnosed with PRES, presenting with seizures. RESULTS: Average age at presentation was 49.9+/-19.72 years. 34(73.9[percnt]) patients were women and 12(26.1[percnt]) were men. 22(47.8[percnt]) patients had primary hematological malignancies and 24(52.1[percnt]) patients had other solid tumors. 33(71.7[percnt]) patients had received some form of chemotherapy while 13(28.2[percnt]) had not. Mean systolic Blood pressure(SBP) at baseline was 99.8+/-9.36 mmHg, mean SBP at onset of symptoms was 123.6+/-15.7 mm Hg with a mean difference of 23.7+/-16.4 mm Hg. On MRI, out of 46 patients, 34(73.9[percnt]) had predominant lesions in the parieto-occipital region while 12(26.08[percnt]) had a fronto-parieto-occipital predominance. 33(71.7[percnt]) had abnormal EEG findings. Of these 15 showed diffuse slowing and 18 showed focal dysfunction including 3 patients with Non Convulsive Status Epilepticus. 4(8.6[percnt]) patients had focal dysfunction originating from areas with no corresponding MRI lesion. 13(28.2[percnt]) had normal EEG findings. CONCLUSIONS:Not much is known about the exact mechanism of seizures in patients with PRES. Origin of seizures seen on scalp EEG may not correlate with radiographic abnormalities. Seizures associated with PRES do not necessarily follow typical localization principles raising the possibility of greater degree of dysfunction which may exist beyond those areas seen on the diagnostic MRI. Study Supported by:Cite
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Hypertensive encephalopathy
Etiology
Pathophysiology
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Background. Neurological complications occur between 50 and 70% of patients with heart transplantation, including cerebrovascular events, infections, seizures, encephalopathy, and neurotoxicity due to pharmacological immunosuppression. Mortality associated with cerebrovascular complications is 7.5% in the first 30 days and up to 5.3% after the first month and up to the first year after transplantation. Case Reports. Three heart-transplanted patients (2 men and 1 woman) treated with tacrolimus were identified. They presented with posterior reversible encephalopathy syndrome on days 5, 6, and 58 posttransplantation, respectively. In these reported cases, no sequelae were observed at 6 months follow-up. Conclusions. Posterior reversible encephalopathy syndrome as a neurological complication in patients with HT occurred early after the procedure. Early diagnosis and treatment might reduce the risk of serious complications and mortality.
Immunosuppression
Neurotoxicity
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Neurological dysfunction in AIDS is common, occurring in as many as eighty percent of children. Thus, it is important to recognize the central nervous system imaging appearance of HIV, in particular those of HIV encephalopathy, as this is an AIDS defining illness and with distinct neuro-imaging features essential for early diagnosis and timely therapeutic interventionTo identify the clinical features in HIV-1 infection of the central nervous system and their associated neuroradiological correlates.Retrospective review of the records of all children with HIV-1 encephalopathy identified among children with neurological and developmental problems and who were on follow up at a child development and neurology clinic in an African city.A total of 22 children (10 male and 12 female) with HIV-1 encephalopathy were identified among 2382 children with various forms of neurological and developmental problems and who were on follow up at a child development and neurology clinic for a little bit over eight years period. All the children acquired the infection vertically. The age range of these children was between 10 months to 14 years. The median age was 5.6 years. The mean duration of symptom was 3.2 years. Global delay or regression in development along with signs of pyramidal tract involvement and seizures were the commonest clinical signs observed in these children. Neuro-behavioral problems were commonly observed among preschool and school aged children. In older children and preadolescents focal seizures with or with out neurologic deficit and neuroradiological findings were common. Nonhemorrhagic stroke was rare and occurred in one child and another child had cortical blindness. Three children had no neurological deficit. Rapid progression of the disease carried grave prognosis. Opportunistic infections and tumors of the central nervous system were also uncommon among these children. Brain volume loss with dilatation of the lateral ventricle, bilateral symmetrical or asymmetrical calcification of the basal ganglia and periventricular involvement of the white matter were the commonest neuro-radiological findings observed in these children.Atrophy of the brain with dilatation of the lateral ventricles and calcification of the basal ganglia and peri-ventricular involvement of the white matter were the commonest neuro-radiological findings in children with HIV-1 encephalopathy. Similarly global delay or regression in development along with pyramidal tract signs and seizures were the commonest neurological findings. Behavioral problems were common in preschool and school aged children. Focal seizures were common in older children and preadolescents. Rapid progression of the disease carried grave prognosis.
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Hypertensive encephalopathy
Hypertensive crisis
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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