Clinical Neuroscience

[Vascular traffic studies in neurological patients with special reference to Hallervorden-Spatz disease]

SZÁNTÓ József1, GALLYAS Ferenc1

JULY 01, 1965

Clinical Neuroscience - 1965;18(07)

[Four out of 20 neurological patients (2 Friedreich's, 1 Wilson's, 1 gargoylism) were found to have abnormal overall iron metabolism by isotope analysis. In contrast, the general iron turnover of our Hallervorden-Spatz patients was found to be normal despite abnormal iron metabolism in the pallidum and substantia nigra. Iron storage in these formulas is continuous. These findings can be used in the pathogenesis of Hallervorden-Spatz disease. ]

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  1. Pécsi Orvostudományi Egyetem Ideg-és Elmeklinika

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Clinical Neuroscience

[Recording of pulsus-frequency and amplitude variation and its significance during posterior scala surgery]

OROSZ Éva

[The most delicate neurosurgical interventions are those involving manipulation of the midline structures, supratentorially near the hypothalamus and infratentorially near the pons, medulla oblongata. Not only direct damage to these structures, but also temporary circulatory disturbances caused by pressure or traction may result in consequential oedema or atony, which may lead to a very serious condition of the patient, possibly death. While there are little or no signs of hypothalamic injury during surgery, even minor lesions of the posterior scala of the brain stem are immediately apparent in the form of vegetative reactions (in the anaesthetised patient), changes in pulse, blood pressure and respiration. It is the anaesthesiologist's task to monitor these very carefully and report them to the surgeon.]

Clinical Neuroscience

[About "aseptic" meningitis]

MOLNÁR Sándor

[Worming in aseptic meningitis should be considered in the presence of varying degrees of eosinophilia in the blood and CSF, especially in the presence of ascaris lumbricoides, cysticercosis and trichinellosis which may have spread to the nervous system. Meningitis tends to be partly toxic and partly neuroallergic. The CSF pattern of so-called sympathetic or concomitant meningitis, maintained by inflammatory foci, mainly purulent, of the body or brain, is always dependent on the development of the underlying disease. Changes in the latter are followed by changes in both the quantitative and qualitative cellular picture of the CSF and, to a lesser extent, in the protein levels. ]

Clinical Neuroscience

[Data for the isolation of midline subfrontal meningiomas]

HULLAY József

[The author, reviewing the surgical descriptions of 20 cases of meningiomas with midline subfrontal and praesellar localization, found that in 5 cases the tumor was located on the lamina cribrosa and crista galli, in 3 cases it was located in the tuberculum sellae but also spread to the limbus sphenoidalis, and in 12 cases, the most frequent, it was located on the planum (jugum) sphenoidalis. He found the striking frequency of meningiomas adherent to the planum remarkable because in the publications on meningiomas this variant is not listed as a separate group, but is classified with the two former variants. - The correct analysis of the anamnesis, the osteo-, angio- and pneumographic images, and the justification for this is that while the site of adhesion of olfactory meningiomas is the os ethmoidale, that of planum meningiomas is the os sphenoidale, and while the former tends to destroy the base of the anterior scala, the latter tends to cause bone outgrowth. Although the tuberculum meningioma and planum meningioma are attached to the same bone and the limbus may be blurred, the former may show at most a slight bone lesion at the site of attachment, whereas the latter usually shows marked hyperostosis and specific bone outgrowth. On these grounds, he considers it justified to include planum meningioma as a separate variant alongside tuberculum meningioma and olfactory meningioma.]

Clinical Neuroscience

[Use of Nuredal (Niamide) in neuropsychiatry]

NAGY A. Tibor, ZSADÁNYI Ottó

[Authors report their experience with Nuredal (Niamide) in 52 patients. The effect on psychomotor inhibition, a core symptom of depression, was found to be indisputable and primary, and they suspect this to be an extension of the scope of psychotherapy. This potential is seen in the possibility of transforming reactive depressive disorders into neurotic depression.]

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Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study

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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.

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

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Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Clinical Neuroscience

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Clinical Neuroscience

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