[On practical issues in mental health care ]
S. VARGA Katalin1
MAY 01, 1967
Clinical Neuroscience - 1967;20(05)
S. VARGA Katalin1
MAY 01, 1967
Clinical Neuroscience - 1967;20(05)
[The number of mentally ill people is not decreasing. Due to overcrowding in hospital psychiatric wards, the number of patients in mental health institutions is constantly increasing. Adverse external influences are causing relapses and prolonged pathological conditions in the patient's environment. In order to provide better mental health care, the mental health network needs to be expanded with modern institutions.]
Clinical Neuroscience
[In the struggle for the cure of mental illnesses, for the health of the human mind, one of the central issues was therapeutic optimism, therapeutic activitas. The sick person and society as a whole expect the best possible restitution from the doctor, and the doctor's duty as a practitioner is to take responsibility, to take the lead, to apply the most modern methods of treatment. ]
Clinical Neuroscience
[In analysing the development of the concept of "schizophrenia", both in terms of its professional history and its theoretical basis, authors adopt Nyirő's position that "...we cannot speak of schizophrenia, only of schizophrenics..." In the sense of Sternberg's concept, they narrow down their position by stating that a nosological approach and Leonhardian taxonomy are essential requirements for a substantive answer to the question.]
Clinical Neuroscience
[The authors describe their joint research with Nyirő on the therapeutic value of transcerebral electrostimulation. Their experience: 1. electrostimulation is essential not only in the treatment of respiratory paralysis following electrotrauma, but also in the prevention and treatment of certain complications of psychiatric so-called major somatic treatments; 2. it is also a new treatment option for hormone-refractory hypothalamic syndromes, such as amenorrhoea, using more mitigated current parameters. ]
Clinical Neuroscience
[In their communication, the authors deal with the differentiation of acute, typhoidal intoxication states from atypical (pathological) intoxication states, emphasising the sociological importance of the differentiation and defining the legal basis for the differentiation. The work of Nyirő on the subject is discussed in detail, followed by a discussion of the symptoms of atypical intoxication and their diagnostic significance. They also analyse all the external and internal factors that may play a role in the development of atypical drunkenness. It is considered possible to distinguish between the two forms of intoxication only by examining all the factors in each case in context, but it is stressed that a sharp dividing line cannot always be drawn. ]
Clinical Neuroscience
[Authors discuss the psychopathological significance of isolation or deprivation. They draw attention to these specific exogenous factors and stress the importance of a multidimensional approach in their interpretation. Using both the literature and their own clinical experience, they aim to outline certain conclusions on this topic. ]
Clinical Neuroscience
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 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. ]
Clinical Neuroscience
[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmelweis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]
Lege Artis Medicinae
[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.]
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