T B Kipiani

The University of Georgia (Tbilisi), Tbilsi, T'bilisi, Georgia

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Publications (10)0 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Convulsive Status Epilepticus (CSE) is most common neurological emergency in childhood. Condition has been defined as a convulsion lasting at least 30 min or recurrent convulsions occurring over a 30-min period without recovery of consciousness. It is generally accepted that early intervention for terminating seizures is beneficial for outcome. The aim of our study was to evaluate influences of pre-hospital and hospital treatment strategies on the outcome of CSE. Our prospective, hospital-based study was performed in Tbilisi and included 48 Patients with CSE, admitted to the emergency department of M. Iashvili Children's Central Hospital from March 2007 to March 2012. The cases were reviewed according to pre-hospital and hospital treatment strategies and outcome. "North Central London Epilepsy Network for Children & Young People" Guideline-"The Management of Convulsive Status Epilepticus" was adapted for the Georgian reality. Our study identified statistically significant increase of incidence of artificial ventilation in patients receiving more than one dose of BZD in pre hospital as in hospital setting; additionally we found a statistically strong relationship between timely initiation of treatment and appropriate pre-hospital treatment with a short duration of CSE. From our data the number of doses of benzodiazepine and a long period before admission are the main determinants of seizure prolongation. Lack of Standardized pre hospital treatment of pediatric CSE had statistically significant negative influence on outcome of CSE.
    Georgian medical news 06/2014;
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    ABSTRACT: CSE is the most common childhood neurological emergency in developed countries, which can lead to neuro cognitive sequel and death with different hazards and outcome. The majority of authors'agreed that etiology is the main determinant of morbidity, but different studies reported different etiology groups as predictors of the poor outcome. Present study was conducted to evaluate predictive value of etiology in post CSE morbidity. Prospective, hospital-based study was performed in Tbilisi. Patients, aged from one month to18 years with CSE, admitted to the emergency department of M. Iashvili Children's Central Hospital from March 2007 to March 2012 were included. The short-term outcome of CSE was evaluated after 30 days from admission and it was classified into three categories: unchanged neurologic status, neurological consequences (new neurologic deficit compared to the condition before CSE), and lethal outcome. 48 children aged one month- 18 years were analyzed. In our study acute symptomatic, remote symptomatic and progressive encephalopathy were associated with higher morbidity. Progressive encephalopathy is the most frequent etiology group which led to develop new neurological sequel after CSE and long duration of CSE. According to our data we conclude that children with idiopathic or febrile CSE have a favorable outcome. While acute symptomatic etiology group mostly was associated and statistical significant association were found with progressive encephalopathy and development morbidity after CSE. According to our data we conclude that children with idiopathic or febrile CSE have a favorable outcome. While progressive encephalopathy lead to develop morbidity after CSE.
    Georgian medical news 06/2014;
  • N. Tatishvili, S. Cico, T. Kipiani
    European Journal of Paediatric Neurology - EUR J PAEDIATR NEUROL. 01/2011; 15.
  • European Journal of Paediatric Neurology - EUR J PAEDIATR NEUROL. 01/2009; 13.
  • European Journal of Paediatric Neurology - EUR J PAEDIATR NEUROL. 01/2008; 12.
  • N. Tatishvili, T. Kipiani
    European Journal of Paediatric Neurology - EUR J PAEDIATR NEUROL. 01/2007; 11:51-52.
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    ABSTRACT: Prematurity represents one of the risk factors of newborns' mortality, morbidity and derangements of long-term neurological development. With the increase of number of preterm newborns, problems with subsequent neurological development have also increased. Preterm population deserves great interest and a lot of investigations have been carried out in order to study their development dynamically. The goal of our study is evaluation of the preterm newborn, with gestation age <=37 weeks, estimation of their neurological developmet at the later age (6-7) and comparing them with full-term born infants of the same age. Objects of our investigation are preterm newborns, with gestation age <=37 weeks. 94 preterm newborns and 50 full-term newborns were estimated in the neonatal period and then later at the age of 6-7; methods of evaluation at the age of 6 years there were used: Standard full neurological investigation, GMFM scale (gross motor functional measure), Towen Scale for evaluation of minor motor activity, Raven Color Matrix for estimation of non-verbal cognitive functions, Coners Questionnaire for parents - for revelation of dysadaptation;. Cerebral palsy among preterm infants was observed in 15 cases-16%; in control group- 1 case-2%; Dyspraxia syndrome was observed in 32 cases-34%, in control group 9 cases-18%. The results of evaluation gross motor function with GMFM score for term group is higher,than for preterm group: 95,86 vs 83,52, p<0,001. The results of the evaluation nonverbal cognitive function with Color matrix of Raven test is higher in term group:20,20 vs 16,6; p<0,001 Syndromes of behavioral disadaptation have been observed more often among preterm newborns Score for each parts(problem of control; impulsivity, index of hyperactivity) are higher in preterm children, p<0,001. Low birth gestation can be a real risk factor for the later neurological development.. Cerebral palsy and dyspraxial syndrome is probably more among newborns with low gestation than among control group contingent;The results of the evaluation nonverbal cognitive function with Color matrix of Raven test is higher in term group. Syndromes of behavioral disadaptation have been observed more often among preterm newborns. Because of frequent//high percent of neurolodevelopmental problems preterm contingent require continuing monitoring,evaluation in dynamicaly for early distincting mild problems.
    Georgian medical news 01/2007;
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    ABSTRACT: Disorder of the cognitive function and psychomotor retardation in the preschool and early preschool children is a result of neonatal bacterial meningitis in most cases. We have investigated 142 patients after neonatal bacterial meningitis and bacterial sepsis. We followed these children during 7 years (1998-2005). The whole contingency was divided into three groups: I group - bacterial meningitis (64 cases), II group - bacterial meningitis and sepsis (56 cases) and III (control) group - 22 patients with bacterial sepsis of different degrees. With the purpose of estimation of the psychomotor development, we have applied: Bayley screening test of infant developmental test (0 -2 y); Denver developmental screening test, and Denver-2 (0-6 y); Raven progressive matrices (5-11 y); Wechsler Intelligence scale for children (6-15 y). We have determined that the results of neonatal bacterial meningitis are predictors of severe long-term outcome of the disease. Analysis of the obtained data enables us to conclude that outcome of neonatal bacterial meningitis and sepsis in combination with bacterial meningitis is more severe than of bacterial sepsis.
    Georgian medical news 06/2006;
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    ABSTRACT: The correct management of perinatal period, timely recognition and intervention of existing and prospective problems, definition of preventive measures gives us an opportunity to avoid and reduce all possible pathologic conditions, complications and their consequences. The goal of our investigation was the evaluation of neurological assessment of the pre-term and full-term newborn infants using Dubowitz scale and establishment of relations between obtained indices and neurodevelopmental outcome in children of this cohort. It was shown that Dubowitz neurological scale for infants gives an opportunity not only to separate the norm from pathology and detect particular problems of neonatal period, but also to determine contiguous conditions and define risk-factors. The results of our investigation coincide with reference data, which confirms that children of the risk-group more frequently have problems connected with the neurological development.
    Georgian medical news 04/2006;
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    ABSTRACT: 154 patients, who were hospitalized in M. Iashvili Children's central hospital in 1998-2005 were investigated. In 70 cases the diagnosis was neonatal bacterial meningitis, in 62 cases -- bacterial sepsis and neonatal meningitis and 22 cases patients were in control group with the diagnosis of neonatal bacterial sepsis. From base investigation group -132 patients were divided in two group, in which patients were united by the starting point of disease from the birth: first group included newborns with signs of disease on earlier stage (sings of the disease showed up during 24-72 hours from the birth); second group included newborns with later signs of disease (after 72 hours from the birth). Our conclusion is- outcome of bacterial meningitis depends on the starting point of disease. Meningitis which began earlier than 72 hours of life, characterized by severe prognosis. Mother's chronic infection diseases and brain injury of newborn are predictors of severe complications of neonatal bacterial meningitis. Such complications of bacterial meningitis as are: brain abscess, ventriculitis, neonatal seizures, coma and neutropenia, become predictors of severe latest outcome.
    Georgian medical news 01/2006;

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Institutions

  • 2014
    • The University of Georgia (Tbilisi)
      Tbilsi, T'bilisi, Georgia
  • 2007
    • Children's Hospital Central California
      Madera, California, United States