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Aug 2019
Objective Antisocial behavior (ASB) in children and youth is public health problem in Georgia. Nevertheless, there has been no systematic study the risk factors for ASB that could counteract on ASB development. To prevent ASB development and acceleration the understanding of biological (assessment of Brain morphology using MRI) and psychological (assessment using Freiburg Personality Inventory) risk factors is critical. This was the aim of this study. Method The children/youth with ASB tendency (AST) were identified by the Freiburg Personality Inventory (FBI). The biological and psychosocial factors contributing to AST were evaluated using a semi-structured clinical interview. Brain anatomy and morphology was studied using magnetic resonance imaging (MRI). Results Children/youth with AST had significant abnormalities in most axial elements of the DSM multi-axial system but not in brain anatomy measured by MRI. Conclusion Early identification of ASB tendencies and a provide correlationship between specific psychiatric, medical and family stress factors will likely reduce the number of children/youth with ASB and will promote their integration into society.
Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652
Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.
Mar 2023 DOI 10.14302/issn.2470-0436.jos-23-4444
A 27-year-old male presented one week after surgical repair of his fractured left zygomatic arch, 5 weeks post-assault, complaining of persistent blurred vision in the left eye and worsening migraine headaches. Magnetic resonance images (MRI) revealed no intra-orbital pathologies or optic neuropathy but demonstrated a clearly delineated air-filled space of the left anterior clinoid process (ACP). No vision threatening pathologies were identified and surgical treatment was not recommended. His blurred vision remained at 6-month follow up. We report a case of delayed vision loss and headache post zygomatic fracture repair surgery in patient with a confirmed ipsilateral ACP pneumatization.
Feb 2022 DOI 10.14302/issn.2470-5020.jnrt-22-4092
Acute disseminated encephalomyelitis (ADEM) is a monophasic, multifocal, demyelinating, autoimmune disease that affects the central nervous system (CNS). It usually occurs after a systemic infection, usually viral, including certain coronavirus infections. A 27-year-old girl presented with complaints of left interscapular pain, paresthesias and weakness in the ipsilateral upper limb. These symptoms followed paresthesias on the fingertips of her right hand the day before her admission. she was treated two weeks earlier for pneumonia with COVID-19. Her clinical pattern resulted in a moderate weakness of the left limbs associated with tactil and algic hypoesthesia in the lower left limb ascending until the C4 level in the left side. Magnetic resonance imaging (MRI) of the brain and spinal cord showed diffuse spontaneous hypersignals on fluid-attenuated inversion recovery (FLAIR) images at the cerebral level and on T2-weighted images at the spinal level. These imaging lesions coupled with the medical history of a recent COVID-19 infection led to the diagnosis of acute disseminated encephalomyelitis (ADEM) post covid-19. The clinical condition improved rapidly with intravenous (IV) corticosteroid therapy and IV immunoglobulin combined with physiotherapy. ADEM is a demyelinating autoimmune disease which is increasingly reported during this current corona virus pandemic.
Nov 2021 DOI 10.14302/issn.3070-3360.ijco-21-3995
Proceeding to hospital immediately stroke occurs is important for early intervention that would minimize the consequences of stroke. But most stroke patients in developing countries prefer herbal centers than hospital. Reasons for this attitude have not been established. Two well-trained assistants were used to interview 117 stroke survivors who attended Bebe Herbal Center (BHC) in Nigeria for at least two visits. The survivors self-reported their experiences in hospitals visited and at BHC. Data obtained were analyzed using Independent t-test, Pearson’s chi-squared test, on SPSS package version 23. Significant value was set at p<0.05. Results showed the survivors comprised 48.7% males and 51.3% females, with mean age 63.98±10.41 years (range: 40-84 years). Following onset of stroke, 61.5% went firstly to hospital, 21.4% to traditional healing places, and 17.1% to BHC. Eventually all survivors went to BHC and 99.1% said they were satisfied with treatment received at BHC. Seventy-nine (68.1%) said they experienced substantial recovery under one month, 25.9% between 1-6 months. All the survivors who went firstly to hospitals said they received inadequate care in them. None of the hospitals they visited had CT or MRI equipment. Pearson’s chi-squared test showed that the impact of stroke had a significant difference between males and females regarding checking of blood pressure after stroke (χ2=7.62; df=3; P<0.05). The inadequate care received in hospitals and the early satisfactory recovery in BHC influence stroke patients in Nigeria to reject going to hospital.
Nov 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3596
Background Reversible posterior encephalopathy syndrome (RPE) is a clinical and radiological entity characterized by the acute or subacute fitting of symptoms covering headache, vomiting, visual disturbances, seizures and impairment of consciousness. The pathophysiology of RPE syndrome is poorly described. RPE syndrome is characterized by a reversible cerebral edema of often posterior topography in magnetic resonance imagery (MRI). Cases Presentation We consider RPE syndrome four cases under various conditions that are known as airplane flight, hypertension, non-steroidal anti-inflammatory medication, pregnancy and oldness with several pathologies. The RPE was described with several symptoms like headaches, vomiting, focal motor deficit, paresthesia, seizures, disorders of consciousness and photophobia. The imagery findings were varying from cortical hypersignals in Flair sequences to edema of both cortex and sub cortex. The outcome was good with a complete regression of symptoms and imagery lesions. Conclusion The pathophysiological mechanism of RPE syndrome remains unknown. High blood pressure, renal failure and drugs (anti-depressants, NSAIDs, immunosuppressants) are the most etiological factors. The diagnosis is based on clinical arguments and brain MRI. The main location is posterior. The clinical outcome was good with all the patients in our study, no recurrence was noted.
Apr 2020 DOI 10.14302/issn.2372-6601.jhor-20-3293
Objective Meningiomas are most common intracranial benign tumors comprising around one third of all intracranial neoplasms, and typically have benign and indolent nature with slow-growing behaviour. Benign meningiomas are slow growing tumors typically following an indolent disease course. Nevertheless, atypical or anaplastic meningiomas may follow a more aggressive disease course with invasion of critical structures and recurrences. In the current study, we evaluate the incorporation of magnetic resonance imaging (MRI) for radiosurgery treatment planning of atypical meningiomas. Materials and Methods Atypical meningioma radiosurgery target volume determination with and without incorporation of MRI has been evaluated. Ground truth target volume used as the reference has been outlined by the board-certified group of radiation oncologists after comprehensive assessment, thorough collaboration and consensus. Results Target volume definition by use of Computed Tomography (CT)-only imaging and by CT-MR fusion based imaging has been comparatively evaluated in this study for linear accelerator (LINAC)-based radiosurgical management of atypical meningioma. Ground truth target volume defined by the board-certified radiation oncologists after detailed evaluation, collaboration, colleague peer review and consensus has been found to be identical to target determination by use of CT-MR fusion based imaging. Conclusion Despite significant progress in neurosurgical techniques over the years, complete surgical resection may not be feasible in the presence of meningiomas located at eloquent brain areas in close association with important neurovascular structures. RT may have a role in multidisciplinary management of meningiomas. Incorporation of MRI into treatment planning for radiosurgery of atypical meningiomas may improve target definition despite the need for further supporting evidence.
Oct 2019 DOI 10.14302/issn.2574-612X.ijpr-19-3045
Emotional conflict control refers to the ability to select task-relevant emotional information and ignore task-irrelevant emotional distractors. Previous fMRI studies provide some evidence about brain structure and function related to emotional conflict control. Yet, the underlying resting-state functional connectivity was largely unknown. Here, this is the first study to explore the resting-state functional connectivity related to emotional conflict. According to the literature which used the whole-brain analysis to investigate the key brain area associated with emotional conflict, we select the amygdala (AMY) as the seed region. We then investigated the association between emotional conflict and functional connectivity between amygdala (AMY) and another brain region in a large sample. We found the emotional conflict effect was positively correlated with functional connectivity strength between AMY (the seed ROI) and right supplementary motor area (SMA). This finding implied that the functional connectivity between AMY and SMA was linked to emotional conflict and that AMY was the key region which plays a crucial role in emotional conflict.
Apr 2019 DOI 10.14302/issn.2998-4211.jalr-19-2658
Alzheimer’s Disease (AD) is one amongst the overwhelming types of dementia that distresses the brain nerve cells leading to a perpetual loss in memory and creating a lot of difficulties for the family members in caretaking. The prediction of the disease at an earlier stage is a common problem. The most prevalent imaging modalities used for diagnosing AD are Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT). They can provide valuable information regarding the changes in internal and external brain regions and activities for diagnosing AD. But the relevant studies made on retina reveals that in addition to brain changes there are some variations on the retina layers of the AD patients. Therefore, the retina can be used as a biomarker for diagnosing AD. There are different techniques available for an eye examination. Most noticeable of them are Fundus Imaging and Optical Coherence Tomography (OCT). In this paper, we have focused on OCT retinal images of AD patients for the early diagnosis of AD.
Mar 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2655
Reverse Shapiro’s syndrome is described as unexplained hyperthermia coexisting with agenesis of the corpus callosum. Its pathophysiology dwells on the role of dopaminergic hypersensitivity caused by hypothalamic dysfunction. Until now, only 5 cases have been described in the literature as reverse Shapiro’s syndrome. We present a case of a 6-month-old girl who is now the sixth patient described in the literature. A 6-month-old female patient was admitted to the pediatrics unit for fever of unknown origin. Her fever occurred 2-3 times a day on average between 38°C and 39.5°C, and lasted for 1-2 hours. The fever was not diurnal, and antipyretics or staying in an air-conditioned room had no effect. She also had 2 convulsions during her hospital stay. Cranial magnetic resonance imaging (MRI) was requested owing to the patient’s convulsion history and retarded development. The cranial MRI showed diffuse hypoplasia of the corpus callosum in the midline sagittal T2-weighted image. T1-weighted imaging showed hypointensity due to delayed myelination of the genu of the corpus callosum (Figure 2, white arrow), which should normally appear hyperintense like the posterior limb of the internal capsule. Although dopamine agonists and serotonin agonists are recommended for the treatment, the rate of response to medical treatment is very low. Our patient did not benefit from cyproheptadine and methyl prednisolone.
Dec 2017 DOI 10.14302/issn.2997-2086.jfs-17-1846
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.
Oct 2017 DOI 10.14302/issn.2574-4526.jddd-17-1497
Volvulus occurring during pregnancy is a rare complication, still potentially lethal nowadays for both the mother and child due to several, early arising complications. We report here a case of small bowel volvulus in a 28 weeks and 4 days, 29 years-old, pregnant woman with a past medical history of appendectomy in her childhood. Patient presented in emergency department with abdominal pain and abnormal hepatic tests. Cholangio-MRI suggested bowel obstruction due to volvulus that was confirmed by gastroscopy (showing the obstruction) and intestinal MRI. Patient was first treated by laparoscopy but, due to a very complicated abdominal status with the presence of several adhesions of the small bowel, surgery was changed to an open laparotomy, which allowed discovery and repositioning of small bowel malrotation and removal of adhesions. Both patient and the foetus were healthy after surgery and the patient was then discharged. In the light of this particularly rare case of small bowel volvulus due to malrotion, we will describe the pathology of bowel obstruction and more particularly volvulus during pregnancy and discuss its diagnosis and treatment.
Feb 2016 DOI 10.14302/issn.2379-8572.joa-15-906
Objective: We compared preoperative data of physical examination, CT and diffusion MRI findings of temporal bone with our intraoperative observations. We investigated the diagnostic efficiency of single-shot spin echo echoplanar diffusion MRI (SS SE EPI) on primary cholesteatoma. Methods: 33 patients with chronic otitis media who had been admitted to Otolaryngology Department of Haydarpasa Numune Training and Research Hospital between June 2010 and September 2011 were involved in this study. All patients did undergo otoscopic and audiometric examination. After imaging of temporal bone by CT and diffusion MRI, patients were operated and intraoperative observations were recorded. Patients with intraoperatively approved cholesteatoma were defined as group 1 and those without cholesteatoma were defined as group 2. Perioperative and preoperative findings of physical examination, CT and MRI of all patients were compared one by one. Results: Positive physical examination findings have been superior to MRI and CT, having a sensitivity of 96%, specifity of 87.5%, positive predictive value of 96% and negative predictive value of 87.5%. In terms of effectiveness of MRI in diagnosing intraoperative cholesteatoma, we had a sensitivity of 80%, specifity of 50%, positive predictive value of 83.3% and negative predictive value of 44.4%. These values are also lower than previously reported results. Conclusion: When we had preoperative suspection of cholesteatoma on physical examination and diffusion MRI, in addition with bone tissue erosion on CT, we found that physical examination is superior to MRI and CT in terms of capability of diagnosing the disease.
Oct 2015 DOI 10.14302/issn.2470-0436.jos-14-571
Purpose: To describe a new functional magnetic resonance imaging (fMRI) method for measuring the influence of regular astigmatism, both against-the-rule (ATR) and with-the-rule (WTR), on the human visual cortex. Setting: Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan. Design: Experimental study. Methods: Images were acquired in two healthy volunteers using a 1.5 T scanner equipped for echo planar imaging. Horizontal and vertical sine wave grating flickering at a frequency of 8 Hz were simultaneously presented during the 20-second stimulation period. During the control period , subjects fixated on a control target. Stimulations were performed under three different conditions that included with hard contact lenses that were equal to emmetropia without astigmatism (condition 1); with hard contact lenses and cylindrical glasses of +6.00D at 0°, imitating WTR (condition 2); and with hard contact lenses and cylindrical glasses of +6. 00 D at 90°, imitating ATR (condition 3). Raw data were processed using in-house software with the significance of activation determined by Statistical Parametric Mapping (SPM 99). Results: Although higher activation was found in the primary visual cortex for condition 1 versus conditions 2 and 3, activation in the dorsal pathway was higher in conditions 2 and 3 compared to condition 1. Dorsal pathway activation was also higher in condition 3 versus condition 2. Conclusions: Study findings showed the potential influence of ATR and WTR on the human visual cortex , with fMRI able to detect the influence of regular astigmatism on the visual cortex. Our current results suggest that fMRI may be useful in exploring the influence of astigmatism on vision.
Oct 2015 DOI 10.14302/issn.2379-8572.joa-15-691
Background. Nasopharyngeal carcinoma (NPC) is a rare disease in the pediatric age group; it represents 1% of all pediatrics malignancies, however, it is the predominant malignancy arising in the nasopharynx in this age group. Although NPC is a chemo-radiosensitive disease yet, the optimal dose of radiotherapy and optimal timing of chemotherapy is still not standardized. Methods. This is a retrospective study including all the newly diagnosed pediatric NPC who were diagnosed and treated at the Children Cancer Hospital Egypt (CCHE) during the period from July 2007 to December 2012. All imaging studies (e.g., CT or MRI scans) were reviewed by a senior head and neck radiologist for proper staging and assessment of tumor response. Patients were staged according to AJCC staging system. Modified version of the Response Evaluation Criteria in Solid Tumor (RECIST) was used to assess response. Results. Twenty-six patients were diagnosed and received treatment as NPC in CCHE. Median age was 12 years (range 7.8-17 years). There was a male predominance. Eleven patients (42.3%) were stratified as stage 4, and 11 (42.3%) as stage 3. All patients received 3 cycles of neo-adjuvant chemotherapy followed by concurrent chemo-radiotherapy. IMRT was used to deliver radiotherapy in all patients. The overall response rate (CR and PR) to induction therapy was 73%, 19.3% had SD, while 7.7% had PD. By the end of the study, 18 patients (69.2%) were alive in CR, 5 patients (19.2%) had PD, and 3 patients (10%) lost for follow up. The Mean duration of follow up was 35 months, range 5-66 months. The 3 year OS and EFS and rates were 84.6% and 69.3 % respectively. OS for M0 was 91.3% and for M1 33.3% with statistical significance (p =0.032). Conclusion. Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy using IMRT lead to good clinical end results with limited toxicity. Metastatic disease at presentation was identified as the adverse prognostic factor.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-211
Recruitment of couples is important for study success. The multi-centered HPTN 052 clinical trial was designed to evaluate whether immediate versus delayed use of ART by HIV-infected individuals would reduce transmission of HIV to their HIV-uninfected partners. The objective of this study was to retrospectively compare several approaches for community recruitment at our site in Kisumu, Kenya based on a) feedback from recruitment staff, b) associated cost, and c) number of eligible couples enrolled. A secondary objective was to assess the discordant couples’ acceptability of the community recruitment approaches relative to the a) main recruitment venues, b) educational materials, and c) local language best suited for explaining the trial. 241 couples were screened for eligibility using nine recruitment approaches. We compared the approaches used for the 60 couples found to be eligible to those used for the 56 ineligible couples for whom that information was available. Analyses for association were carried out. In-depth interviews were conducted with 20 staff and 29 discordant couples. Records were kept of the costs associated with each approach. Overall, staff interviews revealed that acceptability of the approaches was high. Challenges were present with all approaches ranging from one member of the couple not wanting to reveal their positive HIV status to their partner (Patient Support Center or PSC approach), to not finding people at home (home based counseling and testing or HBCT approach). The PSC and the HBCT recruitment approaches were the most effective in terms of recruiting eligible participants. There was an overall significant difference between the proportion of eligible and ineligible participants among the 9 approaches (χ2 (8) =33.5; p<0.0001). Analyses for association showed that the PSC approach resulted in attracting a greater proportion of couples who were eligible than ineligible (χ2 (1) =6.6; p=0.016). The cost for the PSC approach was less than one-third that of the HBCT approach. All discordant couples interviewed found the two main recruitment venues (PSC and their home) acceptable. Among couples who saw the educational materials, the majority found them useful (poster 72.7%; pamphlet 90.9%; flyer 88.9%). All couples found the language they were told about the study acceptable. The evaluation of recruitment approaches indicated that working with local partners, specifically the PSC staff and HBCT staff, was the most effective way to recruit eligible discordant couples. A focus on collaborations and partnerships between research and clinical organizations will help study recruitment efforts. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions. Funding for this substudy was provided by the Kenya Medical Research Institute (KEMRI) through a cooperative agreement with the U.S. Centers for Disease Control and Prevention.