Hungarian Radiology

[Osteopetrosis in the infancy]

HAJNAL Barbara, BITVAI Katalin, ALMÁSSY Zsuzsanna

OCTOBER 20, 2002

Hungarian Radiology - 2002;76(05)

[INTRODUCTION - The authors present a relatively rare, autosomal recessive osteogenetic disorder, which appearance is typical in the first year of life. The malignant osteopetrosis of infants has characteristic radiologic and haematologic status, which is often an incidental finding. CASE REPORT - A 6-month-old Chinese boy was referred with the suspition of bronchopneumony to perform a chest Xray. On the bases of our findings, additional X-ray studies were done (skull, wrist, dorsal spine, hip, femur). A general increase in the density of the bones with characteristic settlement were demonstrated. CONCLUSION - Reporting such a rare disease may help in the differential diagnosis of the osteopathies with diffusely increased density.]

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Hungarian Radiology

[Intraoperative intracranial ultrasound imaging in neurosurgery]

DOBAI József Gábor, GYARMATI János, IFJ. SZÉKELY György, CSÉCSEI György István

[Diagnostic ultrasound imaging started in the 1940s. Up to the present it underwent on radical changes. Article briefly reviews the major steps of the development of ultrasound technique in neurosurgery, and possibilities of applications of different ultrasound methods in neurosurgery are described. Authors discuss their experiences with Hawk 2102 ultrasound system used in intraoperative procedures in 113 cases. Data compared with the literature. Conclusions are that use of intraoperative ultrasound in neurosurgery is modern and simple and it has various application fields. Intracranial lesions are well localized with its use, so the risk of operations decreases. Main disadvantages that ultrasound imaging requires bony trepanation and special transducers are needed for different lesions.]

Hungarian Radiology

[Examination of pancreatic exocrine function with secretin stimulated magnetic resonance cholangiopancreatography]

ENDES János, CZAKÓ László, TAKÁCS Tamás, BODA Krisztina, LONOVICS János

[INTRODUCTION - The aim of this study was to assess the feasibility and usefulness of SS-MRPD for evaluation of the pancreatic exocrine function. PATIENTS AND METHODS - SS-MRPD was performed in 20 patients with mild (n=8) or severe (n=12) chronic pancreatitis (according to the grade of exocrine pancreatic insufficiency indicated by the Lundh test) and in 10 volunteers without pancreatic disease. MRPD images were evaluated before and 10 min after the iv. administration of 0.5 IU/kg secretin. The changes in pancreatic tissue T2 signal intensity and duodenal filling after the injection of secretin were determined by means of SS-MRPD. The SSMRPD findings were then compared with those of the Lundh test. RESULTS - The basal pancreatic T2 signal intensity was significantly higher in the patients with a mild or a severe exocrine pancreatic insufficiency as compared with the controls (826.5±36.36 and 908±80.51 vs 659.2±41.67). The pancreatic T2 signal intensity exhibited a significant elevation after secretin administration both in the volunteers and in the patients with mild or severe chronic pancreatitis. This elevation was significantly lower in both the mild and the severe chronic pancreatitis patients than in the volunteers (66.85±15.77 and 24.45±5.85, respectively, vs. 200.0± 45.07). After the administration of secretin, the diameter of the duodenum was significantly increased in all three groups. This duodenal filling was significantly reduced in patients with a mild or a severe exocrine pancreatic insufficiency as compared with the volunteers (4.12±1.33 and 1.70±0.77 vs. 15.38± 1.73). There was no significant difference in pancreatic T2 signal intensity changes or in duodenal filling in patients with a mild or a severe exocrine pancreatic insufficiency. There were significant correlations between the pancreatic T2 signal intensity changes and the duodenal filling and the results of the Lundh test (r= -0.616 and -0.78). CONCLUSION - These results demonstrate that the administration of secretin increases the T2 signal intensity of the pancreatic tissue and the diameter of the duodenum to different extents in normal subjects and in patients with chronic pancreatitis. This suggests that SS-MRPD can provide information of value in the assessment of an exocrine pancreatic insufficiency.]

Hungarian Radiology

[Lifelong learning]

SZÁNTÓ Dezső

Hungarian Radiology

[7th Congress of the Society of Hungarian Radiographers]

SOMOGYINÉ CSIKI Mária

Hungarian Radiology

[Before Vienna, after Szeged]

LOMBAY Béla

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[Feeding and eating in infancy and early childhood part II. - Breastfeeding, complementary feeding and weaning in the Large-sample of the “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Complementary feed-ing is the transitional period from exclusive breastfeeding to family foods, while breastfeeding is continued. It should be started, when breastmilk itself no longer meets the infant’s nutritional requirements, ideally at the age of around 6 months. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Comple­mentary feeding practices and issues of weaning were analyzed. RESULTS - In our sample complementary feeding was started at the age of 5.5±1.8 months. 6% of infants younger than 4 months and about two third of infants at the age between 4 and 6 months were started on complementary feeding. 32% of the 7-12 month old infants were continued on breastfeeding. The proportion of breastfed infants and young children in the 12-24 and 25-36 month age group was 24% and 5.5% respectively. The daily feeding frequency of breastfed infants was 6.7±1.6. The infants and young children, who were breastfed along with complementary feeding were feeding 5.6±1.5 times/day. After completed weaning the range of feeding frequency was limited to 4.9±0.9 occasions/day. 60.4% of mothers regarded their feeding style on demand, while 39.6% on set schedule. 16% of mothers reported that their child had feeding difficulties. CONCLUSIONS - Complementary feeding indicators should be part of infant feeding data collection, such as time of introduction of complementary food, feeding frequency, food consistency, energy density of food and safe preparation. Responsive feeding is part of responsive parenting and should be promoted, along with continuing breastfeeding at least till one year of age, and for as long as mother and infant wish to continue. ]

Lege Artis Medicinae

[Neuropsychiatric complications of COVID-19 infection]

FRECSKA Ede, BALLA Petra

[Initially, the studies of COVID-19 infection focused primarily on the acute and subacute somatic symptoms of limited duration, but later on with the spread of the pandemic the scope was extended to prolonged symptoms recognized as complications. Data are mounting about after-effects in circulation, respiration, coagulation, problematic outcomes in rheumatology, dermatology, ophthalmology, as well as about the acute and prolonged symptoms of the dysfunctional central nervous system. Initially, sporadic case reports, later results of population based studies and animal models were available, and the first systematic review articles were emerging during preparation of our survey. Lesions of the central nervous system may manifest themselves both in neurological symptoms and diseases or psychiatric complaints and syndromes. The scale of symptoms is broad, the pathomechanisms are not perfectly mapped thus all therapeutic approaches are in their infancy yet. Epidemiological data of neuropsychiatric complications are incomplete for the time being though they have been rapidly becoming more accurate. Conservative estimates assume tens of millions of people affected worldwide. More time is necessary to assess the persistence or improvement of the prolonged symptoms. Besides every efforts to block the spread of the virus, the utmost importance is to analyze the effects of the virus on the central nervous system and to develop effective treatment strategies. According to our current knowledge, the pathomechanism of neuropsychiatric complications is multifactorial. Beyond the direct deleterious effect of the virus on neuronal and glial functions, more important is that the serious consequences of cerebrovascular dysfunction and poor oxygenation have to be taken into consideration together with extended and prolonged systemic immunological processes, which markedly harm the brain tissue, notably neurons, axons, synapses and glia cells. Based on a non-systematic lite­ra­ture review our work details these me­chanisms and addresses therapeutic options as well. ]

Lege Artis Medicinae

[Organic and non-organic perspectives in feeding and eating disorders under three years of age]

SCHEURING Noémi, DANIS Ildikó, KAROLINY Anna, SZABÓ László

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Clinical Neuroscience

[The evaluation of paroxysmal events in neonates and infants]

NAGY Eszter, FARKAS Nelli, HOLLÓDY Katalin

[Introduction - Differential diagnosis of neonatal and infantile seizures based only on inspection poses a challenge even for specialists. Aims - To investigate the evaluations of neonatal and infantile paroxysmal events based only on inspection. Research question - Is there any difference in the opinion of neonatologists, paediatric neurologists and neurologists about the assessment of common paroxysmal events in infancy? Patients and methods - Video recordings about paroxysmal movements of 15 neonates or infants (aged 2 days- 5 months) were displayed for 47 paediatric neurologists, 35 neonatologists and nurses working in Neonatal or Perinatal Intensive Care Units and 43 neurologists. They had to decide without knowing the past medical history or EEG results whether events presented were epileptic or nonepileptic in nature. Results - Answers of neonatologists and paediatric neurologists were correct in 67% of cases (824/1230), no significant difference was found between their results. The largest uncertainty was in the judgement of discrete hand movements and very rapid clonus with epileptic origin, they were judged correctly by only one third of participants. The result of neurologists was only slightly, but not significantly different from that of paediatric neurologists. Conclusion - In most cases, the correct diagnosis of neonatal and infantile paroxysmal events requires video-EEG recording. No significant difference was revealed between the evaluation of neonatologists and paediatric neurologists about the differential diagnosis of movements. The ongoing cooperation of paediatric neurologists and neurologists going back to several decades facilitates the shaping of a common perspective.]

Lege Artis Medicinae

[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project ]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project INTRODUCTION - After introducing adequate complementary food to the diet of breastfed/formula-fed babies, the frequency and amount of semisolid/solid food is increasing, the breastmilk/formula intake is decreasing and finally the weaning process is completed. During this process the developing feeding skills of the infant enables them to self-feed. The self-feeding infant and toddler should participate in family meals. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Issues concerning the development of self-feeding skills were analyzed. RESULTS - With advancing age the proportion of infants/toddlers, reported to be able to (partially) self-feed, has increased. The age, at which the majority of toddlers (83.1%) were reported to self-feed, was at 13-15 months. By the age over 2 years 57.2% of the toddlers were fully self-feeding, 39.3% were self-feeding with some assistance, and 3.5% were still completely fed by their mother/caregiver. While self-feeding became more prevalent, the proportion of toddlers with feeding problems and insufficient weight gain has increased. With more prevalent complementary feeding more parents assessed their feeding style rather scheduled than on demand. In the whole sample the proportion of infants/toddlers, who ate with the family, was 43.8%. CONCLUSIONS - In our sample, as previously described in the scientific literature, the developmental readiness to self-feed has developed in the majority of infants by the age of 13-15 months. During progres­sion of weaning an increasing proportion of parents thought, that feeding was rather scheduled than on demand. This finding points at the importance of educating parents about the importance of responsive feeding during and after weaning. For self-feeding toddlers, responsive feeding means, that the mother/caregiver offers a choice of healthy and adequate amount of food, at a proper place, at proper times, responds to the hunger and satiety cues of the child and the toddler decides, whether to eat, what and how much to eat.]