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Ramona Filipescu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Risk factors in pediatric central nervous system tumors

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Risk factors in pediatric central nervous system tumors

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ABSTRACT

Central nervous system (CNS) tumors are the first encountered solid tumor in pediatric oncology and represent an important therapeutic challenge for a multidisciplinar team. Brain tumors are diagnosed at any age; sign and symptoms are related to age, site and tumor growth. Histological features are important to classification (Bailey and Cushing, Kernohan, World Health Organisation) and prognosis. Aim of the present study was to find prognostic features of pediatric CNS tumors. We studied a group of 99 children diagnosed with CNS tumors between 1990 and 2008, 66 boys, 33 girls; 59.6% from rural areas. Median age at onset was 8 years and 5 months, without gender difference. Time of onset ranged from 4 hours to 2 years. There were 46 astrocytomas, 23 medulloblastomas, 17 ependymomas, 3 craniopharingiomas, 1 hipophiseal tumor and 9 other types of tumors. Onset symptoms included increased intracranial pressure (70 cases), neurological disorders (74 cases), visual disturbances (24 cases), seizures (7 cases), other symptoms (14 cases) and coma (2 cases). Surgical treatment was: total tumor resection (34 cases), subtotal resection (27 cases) and partial resection (19 cases); 6 cases underwent only tumoral biopsy, 8 cases did not undergo surgery. Median value of Erythrocite Sedimentation Rate (ESR) at onset – 17.00 mm/h. Median values of Fibrinogen (FG) at onset – 3.6150 g/L. Median value of Lacticdehidrogenosis (LDH) – 379.5 IU/L. Overall survival was variable, from less than 1 year in 34 cases, between 1 and 3 years in 19 cases and over 3 years in 46 cases. 50% of cases were dead in the first 3 years after diagnose. Analysis of survival according to ESR, FG and LDH showed no statistically significant differencies between them but between type of surgery and death is a direct relationship. Survival analysis for the event death according to age at onset revealed no significant differences between categories of patients ordered by age. Type of surgery seems to be the most important feature involved in prognosis in CNS tumors of children.

Key words: central nervous system tumors

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FACTORI DE RISC IMPLICATI IN PATOLOGIA TUMORALA CEREBRALA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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DOI - Crossref
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

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FACTORI DE RISC IMPLICATI IN PATOLOGIA TUMORALA CEREBRALA LA COPIL

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REZUMAT

Tumorile sistemului nervos central (SNC) sunt cele mai frecvente tumori solide din patologia tumorală pediatrică şi reprezintă o provocare terapeutică pentru o echipă medicală multidisciplinară. Tumorile cerebrale pot fi diagnosticate la orice vârstă; semnele şi simptomele depind de vârsta pacientului, de sediul tumoral, precum şi de ritmul de creştere al tumorii. Clasificarea (Bailey şi Cushing, Kernohan, Organizaţia Mondială a Sănătăţii – OMS) şi prognosticul sunt dictate de histologia tumorală. Prezentul studiu îşi propune evidenţierea unor factori de prognostic implicaţi în evoluţia tumorilor SNC la copil. Lotul de studiu a inclus 99 de copii diagnosticaţi cu tumori SNC în perioada 1990-2008, 66 de băieţi şi 33 de fete; 59,6% din mediul rural. Vârsta medie la debut a fost de 8 ani şi 5 luni, fără diferenţe pe sexe. Durata debutului a variat de la 4 ore la 2 ani. Histologic, au fost 46 de astrocitoame, 23 de meduloblastoame, 17 ependimoame, 3 craniofaringioame, un caz de tumoră hipofizară şi 9 alte tipuri de tumori. Simptomatologia de debut a inclus hipertensiunea intracraniană (70 cazuri), tulburările neurologice (74 cazuri), tulburările vizuale (24 cazuri), convulsiile (7 cazuri), alte simptome (14 cazuri) şi coma în 2 cazuri. Intervenţiile chirurgicale au fost de tipul: ablaţie totală (34 cazuri), subtotală (27 cazuri), parţială (19 cazuri); în 6 cazuri a fost efectuată doar biopsia tumorală, iar în 8 cazuri nu s-a intervenit chirurgical. Investigaţiile biologice efectuate au arătat: VSH – valoarea medianei – 17 mm ⁄ h, Fg – 3,6150 g/L, LDH – 379,5 UI/L. În primii 3 ani de la diagnostic au decedat 50% dintre pacienţi, cu o rată de supravieţuire repartizată astfel: 34 de cazuri mai puţin de 1 an, 19 cazuri între 1 şi 3 ani, 46 de cazuri peste 3 ani. În lotul studiat nu au fost descoperite diferenţe semnificativ statistice între valorile VSH, Fg, LDH, vârstă la debut şi supravieţuire; doar sexul masculin şi tipul intervenţiei chirurgicale se corelează statistic cu supravieţuirea şi pot fi considerate de importanţă prognostică.

Cuvinte cheie: tumorile sistemului nervos central

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GLIOAMELE CAILOR OPTICE IN NEUROFIBROMATOZA DE TIP 1 LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 1, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

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GLIOAMELE CAILOR OPTICE IN NEUROFIBROMATOZA DE TIP 1 LA COPIL

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REZUMAT

Gliomul de căi optice are expresie clinică maximă în copilărie, în jurul vârstei de 5 ani, fiind a doua tumoră ca frecvenţă în neurofibromatoza tip 1. Topografic se descriu 3 tipuri de glioame de căi optice: tipul I – glioame retrobulbare prechiasmatice, tipul II – glioame de tract optic şi tipul III – glioame chiasmatice. Examenele neuroimagistice sunt esenţiale în stabilirea diagnosticului şi a indicaţiei neurochirurgicale. Managementul acestor tumori este dificil chiar dacă au caracteristici histopatologice benigne. Pacienţii cu glioame de nerv optic simptomatice şi progresie documentată neuroimagistic au indicaţie de rezecţie tumorală. Glioamele de nerv optic aso ciate neurofibromatozei tip 1 au în general o evoluţie bună, factorii de prognostic nefavorabil fiind reprezentaţi de debutul clinic precoce, sub vârsta de 6 ani şi de afectarea chiasmatică şi retrochiasmatică.

Cuvinte cheie: gliom de căi optice, neurofibromatoză tip 1, copil

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THE OPTIC PATHWAYS GLIOMAS IN CHILDREN WITH NEUROFIBROMATOSIS 1

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 1, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

THE OPTIC PATHWAYS GLIOMAS IN CHILDREN WITH NEUROFIBROMATOSIS 1

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ABSTRACT

Optic pathways gliomas have the maximal clinical expression in childhood around the age of 5, being the second tumor in neurofibromatosis type 1 in frequency. Considering their location,it describes three types of optic pathways gliomas: type I - retrobulbar gliomas, type II - optic tracts gliomas and type III - chiasmatic gliomas. Neuroimaging exams are essential in diagnosis and selection surgical patients. Management of these tumors is often difficult even they exhibit histological benign features. Patients harboring optic nerve gliomas with symptomatic and documented neuroimaging progression have indication of tumor resection. Optic nerve gliomas associated with neurofibromatosis type 1 have generally a good prognosis. Unfavorable prognostic factors are represented by the early clinical onset under 6 years of age and chiasmatic and retrochiasmatic location.

Keywords: optic pathways gliomas, neurofibromatosis type 1, children

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ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

ACCIDENT VASCULAR CEREBRAL ISCHEMIC LA UN COPIL CU CARDIOPATIE CONGENITALA CIANOGENA COMPLEXA

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REZUMAT

Accidentul vascular cerebral (AVC) este rar la copil comparativ cu adultul. Cauzele cele mai comune de AVC la copil sunt cardiopatiile emboligene pentru infarctul cerebral şi malformaţiile arteriovenoase pentru hemoragiile cerebrale, dar un număr de cazuri rămân idiopatice, fără a li se putea afi rma etiologia precisă. Autorii prezintă cazul unui copil diagnosticat în perioada de sugar cu malformaţie congenitală de cord cianogenă complexă, dar neoperată, internat cu semne clinice şi radiologice de pneumonie, care a evoluat favorabil sub tratament antibiotic şi simptomatic. În timpul perioadei rezolutive a pneumoniei, copilul devine brusc somnolent, prezentând hemiplegie dreaptă cu absenţa refl exelor de aceeaşi parte. Examenul clinic corelat cu CT cranio-cerebral au stabilit diagnosticul de AVC ischemic sylvian bilateral. Evoluţia a fost favorabilă sub tratament conservator (antiagregante plachetare, fi zioterapie), persistând însă hemiplegia dreaptă.

Cuvinte cheie: accident vascular ischemic, malformaţie congenitală cardiacă, copil, hemiplegie

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ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 3, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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Ebsco Host - Medline
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HIGHLIGHTS

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

ISCHEMIC STROKE IN A CHILD WITH COMPLEX CYANOTIC CONGENITAL HEART DISEASE

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ABSTRACT

Stroke is rare in children compared to adults. Most common causes of stroke in children are heart diseases that cause embolism and cerebral infarction and arteriovenous malformations for the brain hemorrhages, but a number of cases remain idiopathic, without being able to say precise etiology. The authors present the case of a child diagnosed in infancy with complex cyanotic heart malformation, but not operated, admitted with clinical and radiological signs of pneumonia, which evolved favorably with antibiotic and symptomatic therapy. During resolution of the pneumonia, the child becomes suddenly drowsy, presenting right hemiplegia, with absence of refl exes on the same side. Clinical examination correlated with cranio-cerebral CT have established the diagnosis of bilateral Sylvian ischemic stroke. The evolution was favorable under conservative treatment (antiplatelet drugs, physiotherapy), but right hemiplegia persisted.

Keywords: ischemic stroke, congenital heart disease, child, hemiplegia

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