Clinical Neuroscience

[Mental hygiene (mental health protection) some questions on the organisation of ]


AUGUST 01, 1969

Clinical Neuroscience - 1969;22(08)

[We can only talk about modern standards in the psychiatric sector of health care for the population if we set our approach and organisation at the level of mental hygiene. This is a major challenge, partly because of a lack of vision, decades of neglect and serious cadre problems, and partly because of the proliferation of problems in this area. In this overview study, we will discuss in general terms the problems, facts and ideas that the mental hygiene doctor working in this field encounters, and more specifically what is being achieved in Csepel under relatively favourable conditions.]


  1. XXI. ker. Tanács Ideggondozó-(mental-hygiénés) intézet



Further articles in this publication

Clinical Neuroscience

[Study of the antiepileptic effect of Seduxen (Chronic Diazepam treatment)]


[The most striking feature of the clinical and EEG effects of Sx is the initial strong antiepileptic effect, followed by a return of seizures as the EEG deteriorates. Similar experiences were reported by Trolle (1965), who, after a pause in the treatment, observed a return to the initial good effect on renewed administration. The findings of our EEG studies suggest not simply a loss of effect due to chronic use, but that after a while the effect of Sx is reversed and now no longer improves but worsens the epileptic mechanism in the direction of the grand mal mechanism (repetitive spikes). The hypersensitivity to the pharmacological denervation induced by the drug is most likely to underlie such a drug effect. However, further studies on this point are needed. In our experience, in the PM. varians epilepsy mechanism, Sx is very effective in preventing spike-wave paroxysms and the corresponding clinical seizures. However, in all cases of repetitive rapid discharges in sleep, it should be used with caution, as the susceptibility to such discharges is increased by Sx. The best clinical effect was obtained in patients with temporal epilepsy resistant to other medications, despite the fact that EEG foci were not completely suppressed by Sx. Probably just as we have seen with Valium, it abolishes generalisational potentials. The effect of Sx on petit mal epilepsy in 2 patients is of course not established, but the initial good effect seen in other epilepsy types was not seen in both patients and the spike-wave mechanism in both cases shifted towards a grand mal mechanism. Compared with foreign Valium, qualitatively quite similar effects were observed in 6 cases. In some patients, the antiepileptic effect of per os Sx was stronger than that of injected Valium, probably because of the more consistent and sustained blood levels. It can therefore be concluded that in drug-resistant severe epileptic patients, Sx given for about 4 weeks has proven to be a very effective antiepileptic adjuvant. We consider it probable - and this would coincide with the hypothesis of the development of denervation hypersensitivity - that by taking drug breaks, the long-term treatment with S adverse effect on the patient will be prevented. Nevertheless, the indications for diazepam are mainly in the treatment of frequent seizures resistant to other drugs, cumulative seizures or status epilepticus, in the form of i.V. shock therapy.]

Clinical Neuroscience

[Distribution of "external" cholinesterase activity in the brainstem and telencephalon of the domestic rabbit based on histochemical studies]

PAPP Mátyás

[According to Gerebtzoff, using the modified Koelle method, it can be shown in the rabbit CNS that the cell clusters with "external" cholinesterase activity are roughly identical to the termination sites of the cholinesterase-containing systems (ascending cholinergic reticular system, cholinergic limbic system) described in Shute and Lewis in the rat. Some bundles of fibres belonging to these cholinesterase-containing systems can be observed without pathological evidence.]

Clinical Neuroscience

[Essential familial myoclonus]

ZONDA Tamás, SZABÓ Endre

[Authors describe the literature on the pathology of essentialis familiaris myoclonus and the evolution of the concept of the pathology. They share their own observed cases within a family. They discuss diagnostic difficulties and differential diagnosis of the syndrome. They describe the hereditary history of their family. ]

Clinical Neuroscience

[The operation of the neurological institutes in 1967 ]

SIMEK Zsófia

[1. The tasks set for the I.I.s can only be achieved if in the coming years local administrations make it possible to have a psychiatrist (in care) for every 40-50 000 inhabitants. Debrecen and Budapest are currently the closest to this, but in most counties (especially those without a mental health bed) it is a major problem to achieve this. To achieve this plan would require about 250 psychiatrists working in the care network. At the beginning of 1968 (including hospital psychiatrists) the number of psychiatrists was 210. Given the need to increase the number of psychiatric beds in the same period, training of specialists is essential. Temporary neurologists working in outpatient clinics, who currently treat neurotic patients for a large part of their practice, could be called in to help. The total number of neurologists at the beginning of 1968 was 292. 2. there is a need to draw up a code of organisation and operation which will enable the psychiatrists working in the I.I. under the present framework to see their tasks clearly and to interpret them uniformly in the care of both the urban and the rural population. 3. To address common professional and other problems in the form of training, methodological letters and other written material. 4. The need to implement close functional cooperation between the I.I.s and hospital departments. 5. Starting from the existing neurosurgeons, prepare for the complex tasks of the future by providing adequate space and specialists.]

Clinical Neuroscience

[Electrophysiological changes after local electron irradiation of the brain]


[The somatosensory area of the cat brain was irradiated with electron beams from a Van de Graaf generator. The electroencephalographic changes following irradiation were studied using chronic epidural and deep electrodes. 1. Within the 50-210 Krad radiation range, the higher the radiant intensity applied, the sooner the irritative phase occurred and the more pronounced the activation of the curves. 2. 3. The excitatory stage was followed by a depressive EEG phase lasting one to two days, characterized by intact occipital alpha activity in addition to local permanent flattening. 4. In 210 Krad dozis, the lesions were irreversible. The EEG picture appeared to be normalized for doses of 50-150 Krad, but electrical activity in the deep structures remained reduced throughout. The animals lost sensation and tactile function and none of them regained it during the 2-month survival period. 5. The reduced electrical activity in the ventrobasal structures of the thalamus was associated with retrograde cell degeneration through thalamo-cortical connections.]

All articles in the issue

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[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]


Clinical Neuroscience

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey

ÜNSAL Ünlü Ülkün, ŞENTÜRK Salim

Microdiscectomy (MD) is a stan­dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in­terlaminar lumbar discectomy (PELD) is another surgical op­tion that has become popular owing to reports of shorter hos­pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD). Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups. The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist’s costs), hospital stay, anesthetic drugs and materials, laboratory wor­kup, nur­sing care, and postoperative me­dication diffe­red significantly among the two main groups (PELD-MD) (p<0.01). This study demonstrated that PELD is less costly than MD.

Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]


[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Lege Artis Medicinae

[Vaccines against COVID-19 pandemic]


[The rapidly spreading SARS-CoV2 respiratory virus has evoked an epidemic with serious aftermath around the world. In addition to the health effects, the global economic damage is actually unpredictable. At the same time, the pandemic has launched a series of unprecedented collaborative scientific research, including the development of vaccines. This study summarizes up-to-date information on vaccines, immune memory, and some emerging clinical effects.]

Lege Artis Medicinae

[A short chronicle of three decades ]


[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]