Clinical Neuroscience

[Our experience with the use of Active-C cervical prosthesis]

MISIK Ferenc, BÖÖSI Martina, PAPP Zoltán, PADÁNYI Csaba, BANCZEROWSKI Péter

SEPTEMBER 30, 2016

Clinical Neuroscience - 2016;69(09-10)

DOI: https://doi.org/10.18071/isz.69.0335

[Objective - The most widely used surgical procedure in the treatment of cervical spine disc hernias have been the anterior cervical discectomy and fusion for decades. The usage of cervical disc prostheses enabled us to preserve the movements of the affected segments, hereby reducing the overexertion of the adjacent vertebrae and discs. Our goal is to follow our patients operated with Active-C prosthesis (which is used in the Institute since 2010) to gather information about the change of their complaints and about the functioning and unwanted negative effects of the prostheses. Question - Is the usage of Active-C prosthesis an efficient procedure? Methods - Between 2010 and 2013, performing the survey of neurological conditions and functional X-ray examinations. We measured the complaints of the patients using the Visual Analogue Scale, Neck Disability Index and Cervical Spine Outcomes Questionnaire. The control group consisted of patients who were operated in one segment using the fusion technique. Results - In the study group according to the Neck Disability Index scale after 18 months, seven patients had no complaints, while twelve persons reported mild and the remaining six moderate complaints. In the control group, moderate complaints were present in four patients, while twelve patients reported mild complaints. The other eight persons showed no complaints. According to the results of the Visual Analogue Scale in the group of prosthesis, the degree of referred pain decreased from 8.6 to 1.84 one and a half years after the surgery. A decrease was observable in the case of axial pain too, from 6.6 down to 1.92 (p<0.01). In case of three from the twenty-five patients there was no sign of movement in the level of the prosthesis. Conclusions - According to the present short- and mediumterm studies, the usage of the cervical disc prosthesis can be considered as an efficient procedure, but at the same time the advantages can only be determined in the long run, therefore further following and studies are required.]

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[Eating disorders and pregnancy - a review of literature]

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[Eating disorders are psychosomatic disorders affecting primarily women, and influence reproductive functions as well. They have an impact on ovarial cyclem fertility, course of pregnancy, process of delivery, post partum period. Moreover, some data show that they can influence the adult health status. Extensive research from the last three decades call the attention to the fact that besides the classical eating disorders (anorexia nervosa and bulimia nervosa) the newer types (e.g., orthorexia nervosa), and subclinical disorders also occur in a subgroup of pregnant women. For this reason it is of key importance that the personnel working in the territory of obstetrics and gynecology have a solid knowledge about the symptoms, screening and therapeutical opportunities, and outcome of these disorders. The review summarizes the recent research data about the relationship of eating disorders and pregnancy.]

Clinical Neuroscience

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Background - To investigate contribution of glucocorticoids to the maintenance of gastric mucosal integrity during stress we predominantly used ulcerogenic stress models. Using these models we demonstrated that glucocorticoids released in response to the ulcerogenic stimuli attenuated their harmful action on the gastric mucosa. Purpose - In the present study we hypothesized that mild stressors does not damage the gastric mucosa due to gastroprotective action of glucocorticoids released in response to these stressors. Methods - To verify the hypothesis the effects of normally non-ulcerogenic mild stimuli (15-30 min cold-restraint) on the gastric mucosal integrity have been studied under the circumstances of inhibition of the hypothalamic-pituitaryadrenocortical axis in rats. The hypothalamic-pituitary-adrenocortical axis was inhibited by: 1) fast inhibitory action of metyrapone, inhibitor glucocorticoid synthesis; 2) fast inhibitory action of NBI 27914, the selective antagonist of cortricotropin- releasing factor receptor type 1; 3) delayed inhibitory action of a single pharmacological dose of cortisol injected one week before the onset of stress stimulus. Results - Each of these pretreatments significantly decreased 15-30 min cold-restraint-produced corticosterone levels: 37.2±1 vs 22.5±1.2 (p<0.05) after metyrapone; 52.1±0.9 vs 41.4±1 (p<0.05) after NBI, and 64.2±4.2 vs 16.7±1.5 (p<0.05) after cortisol pretreatment. The inhibition of stress-induced corticosterone rise resulted in an ap - pearance of gastric lesions after the onset of these mild stressors in rats. Conclusions - The results suggest that in rats with inhibited stress-induced corticosterone rise normally non-ulcerogenic stimuli are transformed into ulcerogenic ones and confirm the hypothesis. The findings further support for the point of view that glucocorticoids released during acute stress are gastroprotective factors.

Clinical Neuroscience

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Background and purpose - Attachment theory provides an integrative perspective about the interplay between cognitive, affective, behavioral and interpersonal processes and is relevant for understanding irritable bowel syndrome (IBS) and panic disorder (PD). The aim of the present study was to examine the adult attachment style and parental bonding of IBS and PD patients. Methods - In a cross-sectional questionnaire-based study, 65 PD and 65 IBS patients with clinical diagnosis participated. Measures were Attachment Style Questionnaire, Experiences in Close Relationships Scale - Revised, and Parental Bonding Instrument. Results - The frequencies of insecure attachment (80.0% vs. 63.1%) and paternal neglect (35.4% vs. 16.9%) were higher in IBS than in PD (χ2 (1)=4.571, p=0.033, and χ2 (3)=7.831, p=0.050, respectively). The frequency of secure attachment was significantly higher for optimal paternal bonding than with suboptimal paternal bonding (75.0% vs. 21.9%, χ2 (1)=19.408, p<0.001). According to the results of multiple binary logistic analysis, optimal paternal bonding predicted secure attachment after adjusting for the background variables (OR=9.26, p=0.001). Conclusion - A high frequency of insecure attachment was present in both groups, especially in IBS. With regard to maternal bonding, IBS and PD groups showed similar patterns, while an apparent difference was observed for paternal bonding. These highlighted the developmental similarities of these two, symptomatically different disorders. While optimal maternal bonding did not predict adult attachment security, paternal bonding did thus replete with therapeutic implications. Attachment functions, like responsiveness, attunement and affection modulation were apparent in the psychotherapist-patient relationship as well.

Clinical Neuroscience

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KOLUKISA Mehmet, SOYSAL Pinar, GÜLTEKIN Özdemir Tugce, KARATOPRAK Cumali, BILGEN Rengin Halide, GÜRSOY Esra Azize

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Clinical Neuroscience

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Clinical Neuroscience

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