Clinical Neuroscience

[Effect of strophanthin on blood flow to the brain, potassium and sodium balance, and cerebral venous pressure]

SOLTI Ferenc, PÉTER Ágnes, SIMONYI Gusztáv, ISKUM Miklós, RÉFI Zoltán, DUBSKY Mária, RANDL János

MARCH 01, 1960

Clinical Neuroscience - 1960;13(03)

[The effects of strophanthin on cerebral circulation and brain potassium and sodium balance were studied in circulatory healthy people. The blood flow through the brain increases with acute strophanthin, while the resistance of cerebral blood vessels decreases. Cerebral venous pressure is also markedly reduced. The brain releases potassium in response to Strophanthin. It is considered likely that strophanthin has a significant brain attack point. Alteration of the brain's potassium balance is a major cause of the central effect of strophanthin.]

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Clinical Neuroscience

[LSD studies in schizophrenic patients treated with electroshock ]

IRÁNYI Jenőné

[1. Based on a comparison of the symptoms of eight schizophrenic patients with ES block before and after treatment with 50- 125 gamma LSD, the change in response after treatment was analysed from a pathophysiological and localisation point of view. 2. ES block treatment did not completely prevent the development of LSD intoxication symptoms, but the reactio was strikingly poor. No activating effect was observed. 3. Symptoms partially corresponded to specific LSD symptoms. No cortex localisable intoxication symptoms developed. 4. Subcortical and midbrain symptoms were present. Brainstem movement disturbances and neurovegetative changes were suggestive of diencephalic dysregulation.]

Clinical Neuroscience

[Data for the biography of Ferenc Schwartzer]

VARGA Lajos

[The author presents a detailed description of Ferenc Schwartzer, found in the Hungarian National Archives, written by Adolf Hollán, the counsellor of the Interior Ministry, in his own handwritten submission for the award of the medal on 27 October 1871.]

Clinical Neuroscience

[Intravascular use of Novocaine in epilepsy]

BŐHM Tivadar

[Based on his observation of 30 epileptic patients, the author found intravascular N. given in combination with standard antiepileptic drugs to be therapeutically effective in the majority of cases in the treatment of affective and mood disorders, and in the elimination of foggy states of consciousness. The anticonvulsant action of N. was pronounced in the resolution of both sporadic and status seizures. The improvement was confirmed by EEG studies along with clinical symptoms. Based on the literature on the pathomechanism of epileptic disease symptoms and his own clinical and EEG observations, he attempts to explain the complex effect of N. He considers its use to be justified mainly in cases where conventional treatments have not led to satisfactory results. ]

Clinical Neuroscience

[Effect of Andaxin ( meprobamate) on skeletal muscle phosphorylase activity]

KOCSÁR László, VERESS Olivia, KAJTOR Ferenc

[1. The effect of Andaxin (meprobamate) on skeletal muscle phosphorylase activity of dogs, rats, rabbits and guinea pigs after 4-6 days of enteral meprobamate administration was investigated. 2. Our results show that after Andaxin treatment, the phosphorylase activity of dog muscle decreased by 25-73% (45% on average) and that of rat muscle by 19-56% (40%). 3. Rabbit muscle phosphorylase activity increased by -9.3 -( +170.0)% (43%) and guinea pig by 114% after Andaxin administration. 4. The phosphorylase activity of skeletal muscle of dog, rat, rabbit, guinea pig was not affected by Andaxin in vitro.]

Clinical Neuroscience

[Comment on the article "The problem of remuneration for occupationally mentally ill people"]

GOLDSCHMIDT Dénes, VÁRHELYI Gyula

[The development of specific operating rules for institutions for the treatment of the mentally ill, different from those for hospitals, in line with their specific situation, and taking into account the following aspects: 1. in the case of rehabilitation institutions, economic profitability, with appropriate deductions for the remuneration of patients. 2. in the case of a therapeutic establishment, the therapeutic aspect, with the possibility of rewarding the patient in various ways for psychotherapeutic purposes and, at the same time, with appropriate social care. 3. formation of a joint committee of appropriate financial and mental health professionals to clarify various financial issues.]

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

NÉMETH Klára Zsófia, SZÛCS Anna , VITRAI József , JUHÁSZ Dóra , NÉMETH Pál János , HOLLÓ András

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

Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Although vertigo is one of the most common complaints, intracranial malignant tumors rarely cause sudden asymmetry between the tone of the vestibular peripheries masquerading as a peripheral-like disorder. Here we report a case of simultaneous temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting as acute unilateral vestibular syndrome, due to the reawakening of a primary gastric signet ring cell carcinoma. Purpose – Our objective was to identify those pathophysiological steps that may explain the complex process of tumor reawakening, dissemination. The possible causes of vestibular asymmetry were also traced. A 56-year-old male patient’s interdisciplinary medical data had been retrospectively analyzed. Original clinical and pathological results have been collected and thoroughly reevaluated, then new histological staining and immunohistochemistry methods have been added to the diagnostic pool. During the autopsy the cerebrum and cerebellum was edematous. The apex of the left petrous bone was infiltrated and destructed by a tumor mass of 2x2 cm in size. Histological reexamination of the original gastric resection specimen slides revealed focal submucosal tumorous infiltration with a vascular invasion. By immunohistochemistry mainly single infiltrating tumor cells were observed with Cytokeratin 7 and Vimentin positivity and partial loss of E-cadherin staining. The subsequent histological examination of necropsy tissue specimens confirmed the disseminated, multi-organ microscopic tumorous invasion. Discussion – It has been recently reported that the expression of Vimentin and the loss of E-cadherin is significantly associated with advanced stage, lymph node metastasis, vascular and neural invasion and undifferentiated type with p<0.05 significance. As our patient was middle aged and had no immune-deficiency, the promoting factor of the reawakening of the primary GC malignant disease after a 9-year-long period of dormancy remained undiscovered. The organ-specific tropism explained by the “seed and soil” theory was unexpected, due to rare occurrence of gastric cancer to metastasize in the meninges given that only a minority of these cells would be capable of crossing the blood brain barrier. Patients with past malignancies and new onset of neurological symptoms should alert the physician to central nervous system involvement, and the appropriate, targeted diagnostic and therapeutic work-up should be established immediately. Targeted staining with specific antibodies is recommended. Recent studies on cell lines indicate that metformin strongly inhibits epithelial-mesenchymal transition of gastric cancer cells. Therefore, further studies need to be performed on cases positive for epithelial-mesenchymal transition.

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

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Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

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