Hungarian Radiology

[Once more on the Six Sigma]

FEBRUARY 20, 2002

Hungarian Radiology - 2002;76(01)

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Hungarian Radiology

[Sub pondere crescit palma Dr. Laczay András]

LOMBAY Béla

Hungarian Radiology

[Conference of the Senior Club and Youth Committee of the Society of the Hungarian Radiologists]

BARKOVICS Mária

Hungarian Radiology

[Errors and mistakes]

LACZAY András

Hungarian Radiology

[Web pages of the Society of the Hungarian Radiologists]

BÁGYI Péter, URBÁN László

Hungarian Radiology

[Frequency and diagnosis of pediatric air gun injuries]

MAKRA József, LOMBAY Béla, RIVASZ-TÓTH Gyula

[INTRODUCTION - Air guns are frequently given to children as toys. Air guns have a pellet caliber of 0.17 or 0.22 and are propelled by compressed gas. Though they have little penetrating effect, they may cause life threatening injuries. Our purpose was to evaluate the frequency and the development of the diagnostic opportunities in children with air gun injuries during the last 30 years (1971-2000). PATIENTS AND METHODS - 52 patients (39 boys and 13 girls) were admitted to our pediatric surgery department due to of air gun injuries. The average age was 9 years (range 2 to 14 years). During the first fourteen years conventional X-ray (plain film and fluoroscopy), since 1984 ultrasonography and later (1986) CT has also been used for the diagnosis. RESULTS - In the first ten years 12 patients, in the second decade 18 patients and in the third ten years 22 patients were admitted and treated with air gun injuries. The sites of injury included upper, lower extremities (n=23), head (n=10), neck (n=5), chest (n=9) and the abdomen (n=5). The majority of patients had superficial injury and Xray plain films in different views were obtained, only. Major complication occured in 10 cases: bone fracture (n=1), soft tissue abscess (n=4) pneumothorax and hemothorax (n=4), bowel perforation (n=1). In these cases ultrasonography and/or CT was performed and they were helpful to establish the correct diagnosis. CONCLUSION - The general conception that air guns are toys, is basically wrong. The practice of placing air guns in the hands of children by their parents is very dangerous. On the basis of our results, the frequency of air gun injuries in children increased significantly in the last decade and the injuries were more serious than before (due to thew technologic modification of air gun). Ultrasonography and CT have important role in the diagnosis, but conventional X-ray remains the basic method in most of cases.]

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Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

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The etiology and age-related properties of patients with delirium in coronary intensive care unit and its effects on inhospital and follow up prognosis

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Delirium is a syndrome frequently encountered in intensive care and associated with a poor prognosis. Intensive care delirium is mostly based on general and palliative intensive care data in the literature. In this study, we aimed to investigate the incidence of delirium in coronary intensive care unit (CICU), related factors, its relationship with inhospital and follow up prognosis, incidence of age-related delirium and its effect on outcomes. This study was conducted with patients hospitalized in CICU of a tertiary university hospital between 01 August 2017 and 01 August 2018. Files of all patients were examined in details, and demographic, clinic and laboratory parameters were recorded. Patients confirmed with psychiatry consultation were included in the groups of patients who developed delirium. Patients were divided into groups with and without delirium developed, and baseline features, inhospital and follow up prognoses were investigated. In addition, patients were divided into four groups as <65 years old, 65-75 yo, 75-84 yo and> 85 yo, and the incidence of delirium, related factors and prognoses were compared among these groups. A total of 1108 patients (mean age: 64.4 ± 13.9 years; 66% men) who were followed in the intensive care unit with variable indications were included in the study. Of all patients 11.1% developed delirium in the CICU. Patients who developed delirium were older, comorbidities were more frequent, and these patients showed increased inflammation findings, and significant increase in inhospital mortality compared to those who did not develop delirium (p<0.05). At median 9-month follow up period, rehospitalization, reinfarction, cognitive dysfunction, initiation of psychiatric therapy and mortality were significantly higher in the delirium group (p<0.05). When patients who developed delirium were divided into four groups by age and analyzed, incidence of delirium and mortality rate in delirium group were significantly increased by age (p<0.05). Development of delirium in coronary intensive care unit is associated with increased inhospital and follow up morbidity and mortality. Delirium is more commonly seen in geriatric patients and those with comorbidity, and is associated with a poorer prognosis. High-risk patients should be more carefully monitored for the risk of delirium.

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