[Stable, since it is changing]
JUNE 10, 2005
Hungarian Radiology - 2005;79(03)
JUNE 10, 2005
Hungarian Radiology - 2005;79(03)
[INTRODUCTION - In palliative treatment of malignant bile duct obstruction the endoscopic and the percutaneous methods are the possible options. In multiple lesions the percutaneous method must be preferable. Decrease of the bilirubin level to normal gives an opportunity for further treatment of the oncology patients. CASE REPORT - Authors report three patients’ case history, when following an unsuccessful endoscopic retrograde cholangiopancreatography, percutaneous cholangiography revealed multiple biliary stenoses. In all cases successful stent implantations were performed (three stents in one patient, two stents in two patients). The bilirubin levels decreased rapidly and the quality of life improved in all cases. Following the stent implantation selective cytostatic treatment (one patient) and systemic cytostatic treatment (one patient) were performed. The mean survival time was 300 days. CONCLUSION - In the case of multiple biliary stenoses the percutaneous stent implantation is an acceptable palliative method, which permit the possibilities of further interventional radiological or oncological treatments.]
Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients’ disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.
Hypertension and nephrology
[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]
Drop foot is defined as difficulty of dorsiflexion of the foot and ankle due to weak anterior tibial, extensor hallucis longus and extensor digitorum longus muscles. Cauda equina syndrome, local peroneal nerve damage due to trauma, nerve entrapment, compartment syndrome and tumors are common etiologies. A 32-year-old male patient was applied with difficulty in dorsiflexion of both of his toes, feet and ankles after he had squatted in toilette for 6-7 hours (because of his haemorrhoid) after intense alcohol intake 2 weeks before. Acute, partial, demyelinating lesion in head of fibula segment of peroneal nerves was diagnosed by electromyography. This case was reported since prolonged squatting is an extremely rare cause of acute bilateral peroneal neuropathy. This type of neuropathy is mostly demyelination and has good prognosis with physical therapy and mechanical devices, but surgical intervention may be required due to axonal damage. People such as workers and farmers working in the squatting position for long hours should be advised to change their position as soon as the compression symptoms (numbness, tingling) appear.
Lege Artis Medicinae
[Energy drinks have been gaining unbroken popularity, especially among youngsters and children since they were introduced to the market. Manufacturers promise to improve performance and stamina with consuming the products, classified as non-alcoholic soft drinks. In addition to the vitamins and plant extracts, they contain a significant amount of caffeine and other stimulants (taurine, guarana). Among the active ingredients, caffeine has an outstanding effect and thereby a danger, since its overconsumption – in addition to milder hemodynamic changes – can cause severe cardiovascular consequences, cardiac arrhythmias, ion channel diseases, increased blood coagulation, myocardial infarction or reduced cerebral blood flow in susceptible consumers. Many case studies have also reported serious cardiovascular attacks among young chronic energy drink consumers. Health impairments of excessive and long-term consumption of energy drinks have been studied increasingly, however there is limited and contradictory evidence on the safety of consumption and the effectiveness of performance enhancement. ]
Purpose - To develop an evidence-based, standardized structured reporting (SR) method for brain MRI examinations in neonatal hypoxic-ischemic encephalopathy (HIE) suitable both for clinical and research use. Materials and methods - SR template development was based on comprehensive review of the pertinent literature with the basic sections and subdivisions of the template defined according to MRI sequences (both conventional and diffusion-weighted, MR-spectroscopy (MRS), and T2*-weighted imaging), and the items targeted on age-related imaging patterns of HIE. In order to evaluate the usability of the proposed SR template we compared data obtained from the brain MR image analysis of 87 term and 19 preterm neonates with the literature. The enrolled 106 infants were born between 2013 and 2015, went through therapeutic hypothermia according to the TOBY criteria due to moderate to severe asphyxia and had at least one brain MRI examination within the first two weeks of life. Ethical approval was obtained for this retrospective study. Descriptive statistical analysis was also performed on data exported from the structured reporting system as feasibility test. Results - The mean gestational age of the study population was 38.3±2.2 weeks; brain MRI was performed on 5.8±2.9 day of life, hence in 78% of our patients after the conclusion of therapeutic hypothermia. Our main imaging findings were concordant to the pertinent literature. Moreover, we identified a characteristic temporal evolution of diffusion changes. Interestingly 18% (n=19/106) of the clinically asphyxiated infants had isolated axial-extraaxial haemorrhage without any imaging sign of HIE. Conclusion - In this article our approach of reporting HIE cases with our novel SR template is described. The SR template was found suitable for reporting HIE cases, moreover it uncovered time and location dependent evolution of diffusion abnormalities (and pseudonormalization, as well), suggesting its usefulness in clinical research applications. The high number of isolated intracranial haemorrhages, and the changing diffusion pattern emphasizes the importance of early imaging in HIE.
Clinical NeuroscienceAlexithymia is associated with cognitive impairment in patients with Parkinson’s disease
Lege Artis Medicinae[COVID-19-cardiology at spring, 2020]
Clinical NeuroscienceLate carcinomatous meningitis as vertigo
Hypertension and nephrology[Continuing medical education]
Hypertension and nephrology[Ventricular arrhythmia]
Hypertension and nephrology[Treatment and care of hypertensive patients during and after the Covid-19 pandemic. Possibilities and effectiveness of telemedicine]
Hypertension and nephrology[Post-career development of cardiometabolic changes and hypertension in competitive athletes]
Hypertension and nephrology[Kidney transplantation in Hungary]