Clinical Neuroscience

[Treatment of paranoid psychotics combined with group discussions in care]

KAPPÉTER István1, BOROS Magdolna1

AUGUST 01, 1985

Clinical Neuroscience - 1985;38(08)

[For more than three years in a psychiatric unit, they have managed to engage 6 of the 36 paranoid psychotics referred to them for an hour a week, who need extra help. At his request, 2 sensitive neurotics with neurotic neuroses were linked to the group. The group, which had been operating under the same conditions as before, was characterised by the emotional and experiential involvement of the therapists, treating the patients as equals and observing the group process passively and impartially. The results of such complementary treatment are good, although miracles are not expected. As a new finding compared to the scarce literature worldwide on outpatient group psychotherapy with psychotics, we found that disengagement in such groups is difficult and requires even greater empathy and more developed self-awareness of the therapists than the group design. ]

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  1. Fővárosi Tanács „Balassa János” Kórház-Rendelőintézet Ideggondozója

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[Some problems in genetic counselling in schizophrenic psychoses]

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[Authors summarize the key principles of diagnosis, genetics and genetic counselling of schizophrenic psychosis for practicing psychiatrists and the medical geneticist from the perspective of genetic counselling. With regard to the strategy of genetic counseling, the importance and simultaneous consideration of socio-cultural, socio-psychological factors and the family emotional-atmosphere are emphasized, in addition to nosological aspects. The special situation of schizophrenic (and psychiatric) patients and their families makes it advisable to set up a separate psychiatric genetic counselor. ]

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[Clinical genetic aspects of neurocutaneous diseases - tuberous sclerosis and neurofibromatosis, HLA-antigen testing and computed tomography diagnosis]

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[The authors performed HLA typing in 5 families with tuberous sclerosis (ST), demonstrating a significantly higher prevalence of HLA-A w31 antigen, without involvement of the B an antigen group. An autosomal dominant origin was confirmed in 4 families and a first gene mutation origin in 1 family, based on UV light examination of the outer skin of the family members, with detectable fluorescence of depigmented spots. Of 6 cases of neurofibromatosis (Nf), 4 were forme fruste forms, the inheritance pattern was autosomal dominant in 4 families and first gene mutation in 1 family was proven. The authors also discuss the diagnostic value of computed tomography in the above pathologies. ]

Clinical Neuroscience

[Myasthenic myasthenia gravis: Total muscle lactic acid dehydrogenase (LDH) activity and LDH isoenzyme distribution]

SZATHMÁRY István, SELMECI László, PÓSCH Elek, SZOBOR Albert, MOLNÁR János

[The authors determined the total activity of lactic dehydrogenase (LDH) and malic dehydrogenase (MDH) per wet weight and the percentage distribution of LDH isoenzymes in muscle samples taken during thymectomy from the sternothyroid muscle of 62 patients with myasthenia gravis, and calculated the MDH/LDH ratio and the percentage of H and M subunits. In comparing their results with clinical data, they found that significant decreases in the percentage of LDH; isoenzyme and M subunit, and trend-like decreases in total LDH activity and increases in the MDH/LDH ratio per case, correlated with the degree of histopathologically detected ischemia in the samples and the frequency of clinically manifest ischemia and respiratory crises in the history. In their opinion, the biochemical abnormalities observed in the damaged muscle samples indicate a decrease in anaerobic glycolysis in the form of myasthenia gravis with myasthenia gravis associated with muscle atrophy. The histological examination revealed similar but milder abnormalities in intact muscle samples, in addition to an early biochemical sign of muscle destruction, raising the possibility of a possible biochemical level adaptive compensatory mechanism in myasthenic muscle. This study may be a useful adjunct to other known methods for the early detection of muscle wasting as a complication of myasthenia gravis. ]

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[Traumatic aneurysm in the cortical branch of the middle cerebral artery]

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[The course of a female patient with a traumatic aneurysm of the cortical branch of the cerebral medial artery two months after a covered skull injury with a lineal fracture of the lamina vitrea is described. It highlights the importance of performing angiography in cases where the cause of deterioration following trauma is not detected by CT scanning. It provides data to identify the morphological features of traumatic intracranial aneurysms by histological processing of the aneurysm. ]

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[The authors report on 15 patients with double or multiple tunnel syndrome at the wrist (carpal, thenar and Guyon tunnel syndrome). They draw attention to the importance of electrophysiological investigations and the suspicion of thenar tunnel syndrome. They stress that in carpal tunnel syndrome surgery, the nerve should be followed until it enters the muscle. ]

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We aimed to investigate the association between fluoxetine use and the survival of hospitalised coronavirus disease (COVID-19) pneumonia patients. This retrospective case-control study used data extracted from the medical records of adult patients hospitalised with moderate or severe COVID-19 pneumonia at the Uzsoki Teaching Hospital of the Semmelweis University in Budapest, Hungary between 17 March and 22 April 2021. As a part of standard medical treatment, patients received anti-COVID-19 therapies as favipiravir, remdesivir, baricitinib or a combination of these drugs; and 110 of them received 20 mg fluoxetine capsules once daily as an adjuvant medication. Multivariable logistic regression was used to evaluate the association between fluoxetine use and mortality. For excluding a fluoxetine-selection bias potentially influencing our results, we compared baseline prognostic markers in the two groups treated versus not treated with fluoxetine. Out of the 269 participants, 205 (76.2%) survived and 64 (23.8%) died between days 2 and 28 after hospitalisation. Greater age (OR [95% CI] 1.08 [1.05–1.11], p<0.001), radiographic severity based on chest X-ray (OR [95% CI] 2.03 [1.27–3.25], p=0.003) and higher score of shortened National Early Warning Score (sNEWS) (OR [95% CI] 1.20 [1.01-1.43], p=0.04) were associated with higher mortality. Fluoxetine use was associated with an important (70%) decrease of mortality (OR [95% CI] 0.33 [0.16–0.68], p=0.002) compared to the non-fluoxetine group. Age, gender, LDH, CRP, and D-dimer levels, sNEWS, Chest X-ray score did not show statistical difference between the fluoxetine and non-fluoxetine groups supporting the reliability of our finding. Provisional to confirmation in randomised controlled studies, fluoxetine may be a potent treatment increasing the survival for COVID-19 pneumonia.

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[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

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

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