Clinical Neuroscience

[Data on spontaneous aliquorrhoea, - 3 cases]

ZAPPE Lajos1, ÁFRA Dénes1

MARCH 01, 1966

Clinical Neuroscience - 1966;19(03)

[The authors present the case histories of three patients with spontaneous aliquorrhoea. In case I, the symptoms developed with tremendous rapidity ; the cerebrospinal fluid deficiency was associated with a picture of severe vasoanoxic brain damage. In cases II and III, the chronic onset was suggestive of a brain tumour ; the congestion of the orbits in the third patient was strongly suggestive. The diagnosis was confirmed in all three cases by a long follow-up and multiple control examinations. All three patients were cured, essentially with the use of fluid therapy and vasodilator drugs. Authors, based on the clinical features of their cases and anatomical and physiological data from the literature, attempt to explain the pathomechanism of aliquorrhoea on the basis of a unified hypothesis. In their hypothesis, they give an important role to pathological reflexes triggered by a decrease in CSF pressure due to accidental causes. They explain the persistence and deepening of the disorder and the different degrees of cerebral and ocular pathology. CSF hypotension and aliquorrhoea are not considered either as a disease or as a syndrome, but as a specific type of vegetative reaction. ]

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Clinical Neuroscience

[Data on traumatic confabulosis]

POHL Ödön, HAITS Géza

[In four cases, the authors describe a particular form of post-traumatic confabulosis in which confabulosis persisted for a long time after the regression of the cardinal symptoms of amnestic syndrome, and became the leading symptom of the disease. The specific state of consciousness of these patients, which cannot be characterized by the classical psychopathology types of pathological alterations of consciousness, is discussed in detail, and the pathomechanism of the phenomena described is examined. ]

Clinical Neuroscience

[Cerebellar degeneration in neonatal hyaline membrane disease]

SCHÉDA Vilmos

[The author studied the brains of 12 infants who died of hyaline membrane disease. He found the cerebrum intact, while in the cerebellar cortex he found characteristic lesions, partial or complete absence of Purkinje cells and an increase in Bergmann cells. The lesions are thought to be anoxic in origin. ]

Clinical Neuroscience

[Some modern socio-psychiatric therapeutic approaches]

FÜREDI János

[Drawing on his experiences in Australia and England, the author describes modern forms of extra-hospital treatment for the mentally ill and praises their usefulness and justification. He highlights the transformative impact of new forms of treatment on public opinion and domestic initiatives. ]

Clinical Neuroscience

[Ocular fundus lesions in cases of panencephalitis nodosa]

SZABADI Elemér, OLÁH Imre

[In 130 cases of panencephalitis nodosa, abnormal orbital lesions were found in 61 patients (47%), 39 (76.5%) of 51 cases in the Neurology Clinic. In 79 and 76% of the fundus lesions, respectively, the papilla and 21-24% of the extrapapillary lesions were visible. In 14 cases, yellowish-white dots similar to old-age lipoid deposits were observed near the aequator. No parallel between the course of panencephalitis and the fundus image can be drawn on the basis of previous studies.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

Clinical Neuroscience

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Clinical Neuroscience

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Clinical Neuroscience

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[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

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[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]