Clinical Neuroscience

[Drug treatment trials for the treatment of chronic alcoholism (II)* a) About the metronidazole-alcohol reaction ]

KARDOS György1, SZABADOS Pál2

AUGUST 01, 1967

Clinical Neuroscience - 1967;20(08)

[Alcohol aversion or because of the risks and complications of disulfiram cures, interest in the temperance drugs (cyanamide, calcium carbamide citrate, etc.) ensuring relative intolerance has increased in recent years all over the world. Verff. report 117 therapy drinking tests on 50 patients and some self-experiments with trichomonacid-metronidazole. At equal doses of alcohol, the reaction whose main symptoms are described is much milder than the disulfiram-alcohol reaction; on the other hand, at greater alcohol exposure, which, however, corresponds to habitual and relatively insignificant consumption in drinkers, very unpleasant and agonizing nausea (headache, vomiting, dizziness, weakness, etc.) may occur. An overview is given of the isolated clinical-pharmacological data obtained concerning metronidazole, partly in alcoholics, partly in schizophrenics. According to these, the drug is supposed to have a thymoanaleptic effect, reminiscent of MAO inhibitors, as well as an abolishing effect on alcohol dependence. It would be essential to remedy its chronic toxic effect, further to increase the tempering effect by structural changes to the metronidazole molecule, or to favor its usability against alcohol by attenuating the side effect. ]

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  1. Országos Ideg-és Elmegyógyintézet
  2. Országos Ideg-és Elmegyógintézet

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[Bilateral tibialis anterior syndrome]

KÓMÁR József, LEHOCZKY Tibor

[Authors describe bilateral tibialis anterior syndrome after strenuous standing work in a 49-year-old female patient. Based on histopathological examination of muscle biopsy, increased subsidence and leukocytosis, the clinical symptoms are considered to be due to myositis. Treatment with ACTH relieved the patient of symptoms. The syndrome is considered to be polyaetiological and, on the basis of Morger's studies, conservative treatment with anti-inflammatory drugs is recommended instead of fasciotomy. ]

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[Maniform psychosomatic alternating periodic hypersomnia ]

POHL Ödön, HAITS Géza

[The authors describe a 19-year-old male patient who developed a parotitis epidemic 2 years ago and experienced severe drowsiness lasting for days. Since then, his hypersomnia has recurred 5 times over a period of 2-3 weeks, with repeated episodes of manic psychosis in between. Authors hypothesize meningoencephalitis as an aetiological factor accompanying parotitis epidemica and leading to diencephalon, but they also suggest that genetic factors may be involved in the onset of maniform pictures. ]

Clinical Neuroscience

[Follow-up results of trigeminal excisions for tic douloureux]

ZAPPE Lajos, NAGY Vilmos

[Authors report 1-7 year follow-up results of 121 intracranial trigeminal truncations in 120 patients and report the following findings: 1. in the area of the auricle and angulus mandibulae, the separation of the trigeminal and adjacent innervated areas is not sharp, and there is certainly overlap. 2. Any regeneration that may occur after surgery starts from this area, with the loss of sensation extending back towards the medial orbital ridge. 3. After complete shutdown of the nerve, regeneration is limited and neuralgia hardly ever recurs, but anaesthesia dolorosa develops quite often, although it is severe in only 4% of cases. 4. Recurrence is quite frequent after partial excision, occurring predominantly in the first 4 years after surgery - but is usually reversible with further surgery. Their studies have shown that the effect of surgery against T.N. is based on the elimination of the incoming stimuli, deafferentation. During radicotomies, root compression, breaking and stretching at the pyramidal apex have never been observed. Their observations have led to a position on the pathomechanism of the facial nerve root and the therapy to be chosen. It seems best to start with a ganglion treatment resulting in partial disconnection of the nerve. If, however, radicotomy is performed, total root transection is the correct solution. ]

Clinical Neuroscience

[Diagnostic errors in meningiomas of the cerebellum in old age]

ÉDER Mária, LŐRINCZ Gábor

[Diffuse oedematous phenomena were found in the white matter of both cerebral hemispheres, more pronounced on the same side as the tumour. We also observed oedema in the white matter of the cerebellar hemisphere of the cerebellum, which was accompanied by even older and more recent microscopic haemorrhages on the tumour side. The investigators in this case were led to an incorrect pathology by a nearly one and a half year asymptomatic period, a rapidly developing personality change, symptoms characteristic of diffuse cortical damage, a negative fundus finding throughout and last but not least the result of the Gamma EG examination. ]

Clinical Neuroscience

[E250 (phenylisopropylmethylpropynylamine Hcl.) clinical experience]

A. Tibor, LIPÁK János, KLEININGER Ottó

[Authors observed the effects of E250 (phenylisopropylmethyl propinylamine HCl) in a total of 56 patients. Their experience was unfavourable in major depressive disorder associated with marked anxiety and abnormal thought processes. In milder depressions, it has been found to be effective in combination with tranquillisers and sleeping pills. It can also be used as a stimulant in adjusted doses depending on individual tolerance. Almost without exception, it enhanced activation and psychic performance in patients with occupational therapy for epilepsy. This was also convincingly confirmed by concurrent reactio-temporal measurements and psychological test studies (Rorschach, Lüscher test). ]

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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

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

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Clinical Neuroscience

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Clinical Neuroscience

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Clinical Neuroscience

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