Clinical Neuroscience

[Intravascular use of Novocaine in epilepsy]

BŐHM Tivadar1

MARCH 01, 1960

Clinical Neuroscience - 1960;13(03)

[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. ]

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  1. Országos Ideg-és Elmegyógyintézet III/B Női Elmeosztály

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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

[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

[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.]

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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Clinical Neuroscience

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

Cholinesterase inhibitors and memantine for the treatment of Alzheimer and non-Alzheimer dementias

BALÁZS Nóra , BERECZKI Dániel, KOVÁCS Tibor

In aging societies, the morbidity and mortality of dementia is increasing at a significant rate, thereby imposing burden on healthcare, economy and the society as well. Patients’ and caregivers’ quality of life and life expectancy are greatly determined by the early diagnosis and the initiation of available symptomatic treatments. Cholinesterase inhibitors and memantine have been the cornerstones of Alzheimer’s therapy for approximately two decades and over the years, more and more experience has been gained on their use in non-Alzheimer’s dementias too. The aim of our work was to provide a comprehensive summary about the use of cholinesterase inhibitors and memantine for the treatment of Alzheimer’s and non-Alzheimers’s dementias.

Lege Artis Medicinae

[Thiazide- or thiazide-like diuretics should be used in the treatment of patients with hypertension? Particularities of the situation in Hungary]

VÁLYI Péter

[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothia­zide and indapamide, and their combination drugs in Hungary.]

Clinical Neuroscience

A cross-sectional study on the quality of life in migraine and medication overuse headache in a Hungarian sample: understanding the effect of headache characteristics

MAGYAR Máté , KÖKÖNYEI Gyöngyi , BAKSA Dániel, GALAMBOS Attila, ÉDES Edit Andrea , SZABÓ Edina , KOCSEL Natália , GECSE Kinga , DOBOS Dóra , GYÜRE Tamás , JUHÁSZ Gabriella , ERTSEY Csaba

Previous studies using generic and disease specific instruments showed that both migraine and medication overuse headache are associated with lower health-related quality of life (HRQoL). The aim of our study was to assess HRQoL differences in migraineurs and in patients with MOH and to examine how headache characteristics such as years with headache, aura symptoms, triptan use, headache pain severity and headache frequency are related to HRQoL. In this cross-sectional study 334 participants were examined (248 were recruited from a tertiary headache centre and 86 via advertisements). The Comp­rehensive Headache-related Quality of life Questionnaire (CHQQ) was used to measure the participants’ HRQoL. Data showed normal distribution, therefore beside Chi-squared test parametric tests (e.g. independent samples t-test) were used with a two-tailed p<0.05 threshold. Linear regression models were used to determine the independent effects of sex, age, recruitment method, headache type (migraine vs. MOH) and headache characteristics (presence of aura symptoms, years with headache, headache pain severity, headache frequency and triptan use) separately for each domain and for the total score of CHQQ. Significance threshold was adopted to p0.0125 (0.05/4) to correct for multiple testing and avoid Type I error. Independent samples t-tests showed that patients with MOH had significantly lower scores on all CHQQ domains than migraineurs, except on the social subscale. Results of a series of regression analyses showed that triptan use was inversely related to all the domains of HRQoL after correction for multiple testing (p<0.0125). In addition, headache pain severity was associated with lower physical (p=0.001) and total scores (p=0.002) on CHQQ subscales. Based on the results, different headache characteristics (but not the headache type, namely migraine or MOH) were associated with lower levels of HRQoL in patients with headache. Determining which factors play significant role in the deterioration of HRQoL is important to adequately manage different patient populations and to guide public health policies regarding health service utilization and health-care costs.

Journal of Nursing Theory and Practice

[Assessing Nurses’ Knowledge of Surgical Wound Care, Complications and Knowledge of Bandages]

FERENCZY Mónika, BÁLINT Beáta, KOMLÓSI Kálmánné, KARÁCSONY Ilona

[Aim of our research was to assess the knowledge of nurses working in surgical departments about surgical wound treatment, phases of wound healing, its complications, and intelligent bandages. Our quantitative, cross-sectional, descriptive examination was carried out in a hospital in Transdanubia with non-random, expert sampling and a self-made questionnaire. Our target group was nurses working in the surgical departments of the hospital (N=85). During the data analysis, the descriptive statistical methods of MS Office Excel 2016 software were calculated: mean, standard deviation, frequency. A χ2-test was used to examine the relationship between variables (p <0.05). Knowledge of bandages was not affected by educational attainment (p>0.05). Those who perform wound care in their daily work have more knowledge about the wound treatment sequence of the wounds that are primarily healing, as well as about intelligent dressings (p<0.1). For the classes, there was a significance for the recognition of complicated wounds, knowledge of the benefit of the absorbable suture and the use of analgesic procedures (p<0.001). In the interests of patient safety, nurses’ knowledge of wound treatment needs to be continuously improved. It is necessary to provide an accessible source of information and further training.]