Clinical Neuroscience

[Prognosis of newborns of very low birthweight]

BEKE Anna1, FEHÉRNÉ Szekszárdi Márta2, CSIKY Erzsébet3, KUCSERÁNÉ Gráf Rózsa4, NÉMETH Tünde1, SZABÓ Györgyné1

NOVEMBER 20, 1997

Clinical Neuroscience - 1997;50(11-12)

[Development of 357 ventilated newborns born from January 1989 to 30 September 1996, who weighed 1500 gm or less at birth, was investigated in follow-up studies. Of the 357 infants, 9 died after one month of age. The outcome of 348 survivors was followed up by a team after the same protocol. Infants were divided into two groups according to year of birth. In the first four-year group, there were 168 children (from 1989 to 1992), in the second one there were 180 children (from 1993-1996). The two periods are different in the obstetrical and neonatological therapeutic methods. Comparing the results of follow-up studies, the authors investigated the influence of the new therapeutic methods on the neonatal morbidity and prognosis of newborns of very-low birthweigt. Although the survival rate increased from 61% to 78% between the two four-year periods, and the survival rate of newborns of very very low birth weight became two times higher (from 19.8% to 41 %), the neurological morbidity (rate of cerebral palsy), did not changed essentially. Important improvement was found in the ophthalmological outcome. The conclusion is that the quality of life for infants and children born of very-low birthweight has not yet improve significantly in every area of development.]


  1. Semmelweis OTE, I. sz. Szülészeti és Nőgyógyászati Klinika, Budapest
  2. Nemzetközi Pető Intézet, Budapest
  3. Bárczy Gusztáv Gyógypedagógiai Tanárképző Főiskola, Budapest
  4. Budai Területi Gyermekkórház, Budapest



Further articles in this publication

Clinical Neuroscience

[Antecendents and epilepsy in dyskinetic/dystonic cerebral palsy]

BALOGH Erzsébet, KOZMA Gyuláné, VARGÁNÉ Kiss Anna

[The rate of cerebral palsy (1-3/1000) is not diminishing, but the prevalence of athetosis seems to be decreasing. 234 athetosis cases (born 1972–1992) have been studied in Budapest (n=149) and in London (n=85) for birth weight, icterus, hypoxia and/or neonatal convulsion and epilepsy. The majority of athetosis cases were born with a birth weight above 2500 g. Kernicterus has not been found, but 43.3% (Budapest) and 75.3% (London) of the cases showed clinical signs of hypoxia with or without perinatal convulsion. Hypoxia and icterus were rarely found together. Athetosis with epilepsy occurred in one fourth and one third of the cases, respectively. Long term hypoxia of mature infants has to see the most relevant risk factor for the severe cerebral palsy with (29.5% Budapest, 23.5% London) and without epilepsy.]

Clinical Neuroscience

[Advances in the diagnostics of spinal muscular atrophy]


[The three most common types of childhood spinal muscular atrophy (SMA) are type I or Werdnig Hoffmann disease, type II or intermediate form, and type III or Kugelberg-Welander disease. The clinical features of these three types are characteristic, profound limb hypotonia, wasting of muscles and areflexia. All three forms of SMA reveal an autosomal recessive mode of inheritance. The gene responsible for all three types of SMA is located on the long arm of chromosome 5 in the region of 5q11.2-913.3. Starting from 1993 blood samples were collected from 87 Hungarian families with all 3 types of SMA. DNA samples of all family members were analysed with the currently available highly informative microsatellite DNA markers in the locus 5q11.2 q13.3. Moreover, affected persons and their family members have been analysed for deletions of the survival of motor neuron gen (SMN). Prenatal diagnoses were performed in 28 cases at the request of the affected families. The possibility of prenatal diagnosis is a major step forward in helping these families, as the risk of recurrence of this devasting, untreatable disease is 25% in affected families.]

Clinical Neuroscience

[99 M TC HMPAO SPECT in children with intractable epilepsy]

NEUWIRTH Magdolna, BORBÉLY Katalin, KOPCSÁNYI Zsuzsanna

[We examined the role of HMPAO SPECT examinations in presurgical evaluation of children with intractable partial epilepsy. SPECT studies (ictal, interictal) were performed on 31 children aged 1-18 years. The focus was restricted in 18 cases and extensive, ie, a whole hemisphere or some lobes, in 4 cases. SPECT indicated pathological changes in the relevant areas in 15 of 18 cases, but in 9 children with temporal epilepsy in all. The focus was extensive in 4 cases, e.g. in 3 children with Rasmussen syndrome. SPECT was pathologic in all of them when MRI did not yet show hemiatrophy of the brain. In 3 cases of partial epilepsy MRI did not demonstrate lesion, the focus was not well-defined by EEG, in contrast to SPECT. Thus it can be stated that SPECT provides valuable information on presurgical evaluation in children with intractable partial epilepsy.]

Clinical Neuroscience

[Comparative study of digital subtraction angiography and MR-angiography in ischemic stroke of children]


[A report is given on 10 children suffering from ischemic stroke. In all children the ischemic lesions were confirmed by CT scans. The patients underwent both Digital Subtraction Angiography (DSA) and MRA. In five cases of stenotic or occlusive changes the MRA correlated well with DSA findings. However 3 cases of moyamoya disease, 1 case of arterial spasm and 1 case of stenotic change were not shown on MRA. MRA can be a valuable alternative method to DSA in occlusion of major intracerebral arteries.]

Clinical Neuroscience

[Pedigree analysis of hungarian rett syndrome girls]


[Rett syndrome is a neurodevelopmental disorder that has been reported exclusively in females. It was first described by Andreas Rett in 1966. The disorder is characterized by a progressive loss of cognitive and motor skills as well as the development of stereotypic hand movements, occurring after an apparently normal 6 to 18 months of development. The aetiology of the syndrome is still unknown. Since genetic origin can be presumed we examined the potential gene sources of the Hungarian Rett syndrome patients. Genealogical tests were carried out based on 22 Hungarian families with Rett syndrome girls. None of our 23 probands was born to first-cousin couples, but we found an increased number of consanguineous marriages among the ancestors of the patients: in two families first-cousin marriages among the great grandparents on the maternal sides; in one family, one second-cousin marriage on the maternal side. Considering the rate of the consanguineous marriages in Hungary the observed rate is highly increased. On investigating the place of origin of the Rett families we found a predominance in the north east part of Hungary. Our results support the findings of a Swedish analysis.]

All articles in the issue

Related contents

Hypertension and nephrology

[Effect of angiotensin-converting enzyme gene insertion/deletion polymorphism on survival of hemodialyzed patients]

KISS István, SZEGEDI János, KULCSÁR Imre, AMBRUS Csaba, KERKOVITS Lóránt, TISLÉR András, KISS József Zoltán

[Introduction: There are inconsistent observations regarding the earlier studies of the connection between ACE gene I/D polymorphism and the cardiovascular mortality. In the case of hemodialyzed patients suffering from chronic kidney disease the DD polymorphism connected to the elevated ACE levels was pointed out to be connected to the mortality rate primarily in patients with diabetes. The previous observations were verified by us during the analyzation of the short-term (three year period) survival data. We hypothesized that the significance of the ACE gene I / D polymorphism in chronic kidney disease would be verified and that during long-term observations (10 year period) the previous results could be validated. Method: In our non-invasive, prospective and multicentre study clinical data was collected from 746 patients whose blood samples were genotyped for ACE gene I/D single nucleotide polymorphism. Three genotype groups (I/I, I/D és D/D) were created during the analyzation of the mortality that was done using multivariate Cox proportional hazard models. Results: The mean age of the HD patients was 54.9 years, 46,8% of all patients were female. The prevalence of diabetes was 19.3%. ACE inhibitor therapy was prescribed for 47.9% of all patients. The median duration of dialysis before the start of the study was 23.8 months (IQR 11.2-47.1). The most frequent genotype was I/D (42.6%), followed by D/D (37.7%) and I/I (19.7%) genotypes. During the ten year follow- up of patients, the median follow-up was 29.8 months (IQR 12.6-63.4). The D/D genotypes showed lower survivability (I/I vs. D/D: log-rank test: p=0.04) from the group of patients without ACE inhibitor therapy. In multivarite Cox regression models D/D genotype compared with I/I genotype only showed that it significantly determines mortality in patients with no ACE inhibitor therapy (HR 0.67, 95% CI 0.46-0.97, p=0.03). Conclusions: There was no difference in survival among unselected patients with different genotypes. Our data suggests that hemodialyzed patients with the D/D genotype might have inferior outcome, and ACE inhibitor therapy may be associated with improved survival in this subgroup.]

Lege Artis Medicinae



[The meta-analysis by Nissen and Wolski suggested a potential ischemic cardiac side effect of rosiglitazone. Studies in order to verify this suggestion finished until now had a short duration and a low frequency of harmful cardiac events that made them unable to decide this question. Nevertheless, several running studies will presumably have an adequate follow-up period of ten or more years and the desired frequency of observed cardiac events. Completion of these studies and publication of their results can be expected in the following two years. Until then, the European Medicines Agency’s standpoint of 18th October 2007 will be valid stating the benefits of rosiglitazone surpass its risks.]

Lege Artis Medicinae

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]