مجله تعالی بالینی
سال دوم شماره 2 (پیاپی 4، تابستان 1393)

With advances in imaging techniques such as ultrasound، Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI)، wide spectrum of the brain cysts are demonstrated in the childhood period. Due to different tissues in the brain and ectopia، a wide variety of congenital and acquired cysts، benign or malignant tumors occur in the brain. Brain cycts may be intra or extera parnchymal. Cystic – like lesions، arachnid cysts، congenital cysts and colloid cysts are most common cystic brain lesions. These cysts are divided to normal variation of brain cysts and cysts due to injury before birth، developmental، congenital، tumoral، and traumatic cysts and finall cystic like changes. Some characteristic finding on brain imaging could point out to the most relevant differential diagnosis، like location and size of the cyst، type of perifocal edema، consistency of the lesion، present and feuture of calcification.

Juvenile idiopathic arthritis (JIA) refers to a group of disorders characterized by chronic arthritis. It is a chronic rheumatic disease and one of the major causes of disability in children. The diagnosis of JIA disease in children younger than 16 years with arthritis (swelling or effusion or two about decreased range of motion، warmth، pain or tenderness) for at least 6 weeks and rule out of other causes of arthritis with which they would be identifiable. The incidence and prevalence of JIA from 1 to 20 per 100،000 to 400 per 100،000 have been reported. There are several separated classification criteria for patients under 16 years of age who have chronic arthritis. The most practical and acceptable criteria are presented by American College of Rheumatology (ACR)، European League against Rheumatism (EULAR)، and the International League of Associations for Rheumatology (ILAR). Furthermore، spondyloarthritis in young children، including psoriatic arthritis and ankylosing spondylitis are being diagnosed with difficulty. Here in we discussed about chronic arthritis in children and the differences between these classification criteria.

Heart failure (HF) is the most common cardiovascular disorder as a chronic، progressive and disabling disease. The prevalence and incidence of the disease rises with age، so that in Western countries، about 1 to 2% of adults suffer from this disease. Because of advances in surgical and medical therapy for patients who have survived a myocardial infarction، heart failure can develop subsequently. Therefore، finding new and effective laboratory tests for early detection and monitoring of the disease is important. In this review، heart failure، Galectin-3 and fibrosis keywords were searched in the PubMed، SID، Google Scholar، Science Direct، Springer and Iranmedex databases. Five and more than fifty articles were found in English and Persian language، respectively during 1992 to 2014. Finally two Persian and fifty English articles were selected. The results of these studies was suggested that Galectin-3 is involved in numerous physiological and pathological processes some of which، inflammation and fibrosis، are pivotal contributing pathophysiological mechanisms to the development and progression of HF. Because galectin-3 expression is maximal at peak cardiac fibrosis and virtually absent after recovery، routine measurement in patients with HF may prove valuable to identify those patients at highest risk for readmission or death. This review summarizes the most recent advances in galectin-3 research، with an emphasis on the role galectin-3 plays in the development and progression of HF.

Curcumin as a natural product has many biological and pharmacological properties. Curcumin has preventive and therapeutic effects on cancer cells through different cellular and molecular mechanisms. It has low side effects and it is possible to use it as a supplement in patients during cancer therapy. Several clinical studies were investigated for efficacy of curcumin in patients with cancer. Results showed that curcumin reduced side effects induced by anticancer therapy and radiotherapy in patients. In the present work، the clinical studies of curcumin were reviewed and several parameters such as dose of curcumin، placebo group، and size of sample and overall results of each study were discussed.

Diabetes Melitus is a complex disease. For most people، it’s a new way of life، and it affects relationships in all areas as much as it affects eating and physical activity. If blood sugar level remains consistently higher than normal، over time it can make dameges on organs like heart، eyes، kidneys، nerves، and other parts of the body. Sometimes people with diabetes melitus don''t realize that they have the disease until they begin to have other health problems. In management of diabetes melitus، the aim is to help people to minimize the risk of developing future complications with control their blood glucose levels. Since ancient times، plants have been an exemplary source of medicine. Researches conducted in last few decades on plants mentioned in ancient literature or used traditionally for diabetes have shown anti-diabetic property of some kinde of plants. The present paper reviews 15 such plants that have shown experimental or clinical anti-diabetic activity.

Diabetes during pregnancy has considerable adverse effects on the mother and her fetus or neonate. Mother’s hyperglycemia may induce hyper insulinemia and pancreatic Beta cells hyperplasia in fetus. Excess Insulin secretion in fetus blood may cause macrosomia، increase basal metabolism rate، increase oxygen consumption and even fetus hypoxemia. Fetal hypoxia may fallow by erythropoietin over production، red blood cell hyperplasia and increased hematocrit level. Polycythemia may enhance blood circulation and cause hyper bilirubinemia. On the other hand hyperglycemia may cause exaggerated production of oxygen radicals in mitocondrias and produce hydroperoxides which are prostacyclin inhibitors. Erythropoietin excess and polycythemia induce catecholamine release، hypertension and myocardial hypertrophy respectively. The last may be one of the etiology of still birth in poor control diabetic pregnancies. Rigorous glycemic control before and during pregnancy may decrease the prevalence of these complications.

Human T-Lymphotropic Virus Type 1–Associated Myelopathy، or Tropical Spastic Paraparesis (HAM/TSP) is a slowly progressive disease with characteristics such as spastic paralysis، sensory dysfunction in lower limbs and sphincteric dysfunction which infection with HTLV-1 virus is responsible for it. Clinical course of this disease is almost progressive and without treatment results in severe disability. Human T Lymphocytic Virus-type 1 which is endemic in north east of Iran، Khorasan، in 3% of carriers results in HTLV-1 Associated Myelopathy /Tropical Spastic Paraparesis. Although chronic inflammation of spinal cord seems to play a major role in the pathogenesis of this disease، immunomodulatory treatments have not shown significant improvement in this disorder. Since، different approaches such as prednisolone، danazol، plasma exchange and alfa interferon are used for treatment of this disease، although، these treatments were not completely successful and one distinct protocol was not proposed. As HTLV-1 infection is endemic in Khorasan، clinical studies about this disorder and its treatment is necessary.

Thalassemia، the most common genetic disorder worldwide is a genetic disease in globin chain. Complete absence of beta chain is defined as thalassemia major. These patients suffer from severe hemolytic anemia. Iron overload and chronic immune-stimulation by repeated blood transfusions، splenectomy and alteration in immune system posse these patients to increased risk for severe and serious infections. Several component of immune system may affected by this disease. Increase in number and activity of suppressor T cells (CD-8) in addition to decrease in number and proliferative capacity of helper T- Cells (CD-4) leading to decreased CD4/CD8 ratio، as well as defective activity of natural killer (NK) cells. Immunoglobulin levels and count of B- lymphocytes were found to be increased. Neutrophil chemotaxy activity and macrophages phagocytosis capacity has been defective. Suppressed function of complement system both in classic and alternative pathways، with reduced levels of C3 and C4 has also been reported. Results of various researches about immune system in thalasemic patients are not conclusive and in a lot of reports are controversial.