Clinical Neuroscience

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FEBRUARY 20, 2002

Clinical Neuroscience - 2002;55(01-02)

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Clinical Neuroscience

[Pregnancy and psychiatric disturbances]

SZÁSZ Anna, KOVÁCS Zsuzsanna

Clinical Neuroscience

[Contemporary interpretation of rehabilitation]

KULLMANN Lajos

[The study selects some changing and developing aspects of the contemporary considerations of rehabilitation and relates them closely to neurological rehabilitation. Functional diagnostics aims at the assessment of impairments and functioning. Several internationally recognized methods of neurological rehabilitation have already been adapted in Hungary. Author emphasises the use of International classification of functioning, disability and health, officially accepted by the Assembly of the World Health Organization in 2001. Its use for functional diagnostics is also possible. The everyday practice of teamwork is still problematic. Its implementation in rehabilitation is inevitable. The neurological rehabilitation is a special field where the cooperation of many teammembers is needed. The attitude to human beings in rehabilitation is different from medicine at large. It considers man not only as biological but also as social beings with own life history, thus helping to achieve compliance and increasing autonomy. The author mentions the possibility for the cooperation with organisers of the independent living movement. The separation of quality of life and health status assessments is suggested. Attention is called to the requirements of the adaptation of assessment methods and an initial account of own experiences is given.]

Clinical Neuroscience

[Personal comments]

JANSZKY József, RÁSONYI György, BÉKÉS Judit, HOLLÓ András, HALÁSZ Péter

Clinical Neuroscience

[Chemotherapy of recurrent supratentorial malignant gliomas (Phase II study)]

ÁFRA Dénes, SIPOS László, VITANOVICS Dusan

[At the Hungarian National Institute of Neurosurgery 73 recurrent supratentorial malignant tumours were treated by chemotherapy during the last ten years. Chemotherapy was applied after postoperative radiotherapy but in some cases following reoperation only. All cases were clinically and by CT or MRI verified recurrences. Forty-three patients received BCNU-DBD (dibromodulcitol) treatment (23 anaplastic astrocytoma - AA, and 20 glioblastoma multiforme - GM): day 1. BCNU 150 mg/sq.m. in iv. infusion, day 2. dibromdulcitol 1000 mg/sq orally was given. This course was repeated every six weeks, altogether 2-8 times. Sixteen patients with AA responded with complete or partial regression but only 6 did with GM. Median survival was 14 and 7 months, the difference proved to be significant, p=0.0091. PCV combination (procarbazine, CCNU, vincristine) was applied to 16 patients with AA and 14 cases with recurrent oligodendroglioma (O). Treatment started with vincristine 1.5 mg/sq. m. iv. (2.0 mg maximum), the next day CCNU 100 mg/sq.m. was given, followed by procarbazine 60 mg/sq.m. on days 8-22. and finished by the same dose of vincristine on day 30. The course was repeated after one month, mostly six times. Six patients with AA did not respond; in cases of oligodendroglioma all but one responded with complete or partial improvement. It is remarkable that no significant difference was found between the survivals of BCNU-DBD or PCV treated AA patients. Chemotherapy of supratentorial malignant glioma recurrences with nitroso-ureas and their combination proved to be efficacious. It also seems, that in recurrent cases lower grade gliomas show better response rate than glioblastomas.]

Clinical Neuroscience

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Clinical Neuroscience

Evaluation of anxiety, depression and marital relationships in patients with migraine

DEMIR Fıgen Ulku, BOZKURT Oya

Aim - The aim of this study was to evaluate the frequency and characteristics of attacks in patients with migraine, to determine the effects of anxiety or depressive symptoms, and to evaluate the marital relationships of patients with migraine. Method - Thirty patients who were admitted to the neurology outpatient clinic of our hospital between July 2018 and October 2018 and were diagnosed with migraine according to the 2013 International Headache Society (IHS) diagnostic criteria were included in this cross-sectional study. Age, sex, headache frequency and severity, depressive traits, marital satisfaction and anxiety status were examined. We used the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Maudsley Marital Questionnaire (MMQ) and Visual Analogue Scale (VAS) for measuring relevant parameters. Results - The mean severity of migraine pain according to VAS scale was 6.93 ± 1.41 and the mean number of migraine attacks was 4.50 ± 4.24. The mean BDI score of the patients was 12.66 ± 8.98, the mean MMQ-M score was 19.80 ± 12.52, the mean MMQ-S score was 13.20 ± 9.53, the mean STAI-state score was 39.93 ± 10.87 and the mean STAI-trait score was 45.73 ± 8.96. No significant correlation was found between age, number of migraine attacks, migraine duration, migraine headache intensity, and BDI, STAI and MMQ scores (p>0.05). But there was a positive correlation between MMQ-S and scores obtained from the BDI and STAI-state scales (p<0.05). Conclusion - In this study more than half of the migraine patients had mild, moderate or severe depression. A positive correlation was found between sexual dissatisfaction and scale scores of depression and anxiety.

Clinical Neuroscience

[Earlier and more efficiently: the role of deep brain stimulation for parkinson’s disease preserving the working capabilities]

DELI Gabriella, BALÁS István, KOMOLY Sámuel, DÓCZI Tamás, JANSZKY József, ASCHERMANN Zsuzsanna, NAGY Ferenc, BOSNYÁK Edit, KOVÁCS Norbert

[Background – The recently published “EarlyStim” study demonstrated that deep brain stimulation (DBS) for the treatment of Parkinson’s disease (PD) with early fluctuations is superior to the optimal pharmacological treatment in improving the quality of life and motor symptoms, and preserving sociocultural position. Our retrospective investigation aimed to evaluate if DBS therapy was able to preserve the working capabilities of our patients. Methods – We reviewed the data of 39 young (<60 years-old) PD patients who underwent subthalamic DBS implantation at University of Pécs and had at least two years follow-up. Patients were categorized into two groups based on their working capabilities: Patients with active job (“Job+” group, n=15) and retired patients (without active job, “Job-” group, n=24). Severity of motor symptoms (UPDRS part 3), quality of life (EQ-5D) and presence of active job were evaluated one and two years after the operation. Results – As far as the severity of motor symptoms were concerned, similar (approximately 50%) improvement was achieved in both groups. However, the postoperative quality of life was significantly better in the Job+ group. Majority (12/15, 80%) of Job+ group members were able to preserve their job two years after the operation. However, only a minimal portion (1/24, 4.2%) of the Job- group members was able to return to the world of active employees (p<0.01, McNemar test). Conclusion – Although our retrospective study has several limitations, our results fit well with the conclusions of “EarlyStim” study. Both of them suggest that with optimal timing of DBS implantation we may preserve the working capabilities of our patients.]

Journal of Nursing Theory and Practice

[Does the fear of losing their jobs play any role in the everyday lives of health care workers?]

IRINYI Tamás, NÉMETH Anikó

[Aims: To assess the degree of fear from becoming unemployed among health care workers in Csongrád County, and the impact of this fear on physical and psychic health, or rather the intent to leave the profession. Methods: This is a cross-sectional study carried out through a self-designed self-report questionnaire sent to registered members of MESZK living in Csongrád County. Results: Those with worse psychosomatic status (p=0.003) and greater rate of burnout (p<0.000) are more afraid of losing their jobs. The fear has a great impact on the intent to leave the profession (p<0.000). Who are not afraid of becoming unemployed feel that they would be physically and psychically able to work in their profession till retirement. Conclusions: Fear is present in the everyday lives of health care workers, and affects their physical and psychic health. ]

Hungarian Radiology

[General assembly of the Society of Hungarian Radiologists]

NAGY Gyöngyi

Journal of Nursing Theory and Practice

[The patients with sensory system impairment in peritoneal dialysis]

VARGANÉ SZABÓ Tünde, KERESZTESI Sándor

[The sensory system is responsible for perceiving information, which enables us to connect with the outside world. Its impairment could limit an individual’s chances to an equal role in society. Introduction of a special training programme that provides equal opportunities for patients with disabilities to participate in the peritoneal dialysis (PD) programme. In visually impaired patients training was not based on the visual teaching aids but on verbal communication (constant repetition, questioning). In patients with hearing loss visualisation and dexterity are in focus. Speech impediment, a condition often coexisting with hearing loss, made communication more difficult; therefore the training is built on writing, articulation and sign language. By acquiring the theoretical and technical bases of PD treatment, our patients is able to complete safe solution exchanges in their own homes. Once self-care treatment commenced, their nursing continued on an individual basis. Self-care treatment of PD patients with sensory impairment requires prudence, adequate training and aftercare; however according to our experience it does not necessarily imply a higher occurrence rate of complications. ]