Hungarian Radiology

[The diagnostics of paraoesophageal hiatal hernia]

TREXLER Ilona

JUNE 20, 2003

Hungarian Radiology - 2003;77(03)

[INTRODUCTION - The hiatal hernia is among the most common abnormalities of the gastrointestinal tract. The position of the cardia in relation to the diaphragm determines the type of the hernia, wich is important in therapy planning. The type I. sliding hernia is the most common form. Only 5-10% is type II. paraesophageal and type III. mixed hernias, which may involve serious complication. The single contrast X-ray is the best method for demonstrating the type of hiatal hernias. PATIENTS, METHODS AND RESULTS - During a 3 year period the author was investigated 336 gastric cases. Hiatal hernia was found in 73 patients, six of the cases proved to be the rare II. and III. types. A case of paraoesophageal and five mixed type cases of hernia is briefly described. CONCLUSION - Despite of the wide spread use of endoscopy in diagnosis of hiatal hernia, the traditional gastric X-ray still remains an important diagnostic tool.]

COMMENTS

0 comments

Related contents

Clinical Neuroscience

Evaluation of the effectiveness of transforaminal epidural steroid injection in far lateral lumbar disc herniations

EVRAN Sevket, KATAR Salim

Far lateral lumbar disc herniations (FLDH) consist approximately 0.7-12% of all lumbar disc herniations. Compared to the more common central and paramedian lumbar disc herniations, they cause more severe and persistent radicular pain due to direct compression of the nerve root and dorsal root ganglion. In patients who do not respond to conservative treatments such as medical treatment and physical therapy, and have not developed neurological deficits, it is difficult to decide on surgical treatment because of the nerve root damage and spinal instability risk due to disruption of facet joint integrity. In this study, we aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) on the improvement of both pain control and functional capacity in patients with FLDH. A total of 37 patients who had radicular pain caused by far lateral disc herniation which is visible in their lumbar magnetic resonance imaging (MRI) scan, had no neurological deficit and did not respond to conservative treatment, were included the study. TFESI was applied to patients by preganglionic approach. Pre-treatment Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores of the patients were compared with the 3rd week, 3rd month and 6th month scores after the procedure. The mean initial VAS score was 8.63 ± 0.55, while it was 3.84 ± 1.66, 5.09 ± 0.85, 4.56 ± 1.66 at the 3rd week, 3rd month and 6th month controls, respectively. This decrease in the VAS score was found statistically significant (p = 0.001). ODI score with baseline mean value of 52.38 ± 6.84 was found to be 18.56 ± 4.95 at the 3rd week, 37.41 ± 14.1 at the 3rd month and 34.88 ± 14.33 at the 6th month. This downtrend of pa­tient’s ODI scores was found statistically significant (p = 0.001). This study has demonstrated that TFESI is an effective method for gaining increased functional capacity and pain control in the treatment of patients who are not suitable for surgical treatment with radicular complaints due to far lateral lumbar disc hernia.

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Clinical Neuroscience

[Genetically determined diseases associated with pathological brain iron accumulation and neurodegeneration]

ÁCS Péter, MOLNÁR Mária Judit, KLIVÉNYI Péter, KÁLMÁN Bernadette

[The rare, genetically determined group of diseases characterized by pathological accumulation of iron in the central nervous system and progressive, typically movement disorder’s symptoms are called NBIA (neurodegeneration with brain iron accumulation). By the rapid development of molecular genetics, it has become apparent that different mutations in numerous genes can lead to pathological cerebral iron accumulation. Simultaneously, it has also been recognized that the age of onset, the symptoms and the prognosis of NBIA disorders are much more diverse than it was previously perceived. To our knowledge, a review article on the most recent clinical data of NBIA has not been published in Hungarian. In the first part of this publication, we survey the general clinical characteristics and the diagnostic algorithm of NBIA diseases and address some considerations for differential diagnostics. In the second part of this review, the particular NBIA disorders are presented in details. The purpose of this article is to provide a clinical overview that may be useful for neurologists, pediatricians and any other medical practitioners interested in this field.]

Lege Artis Medicinae

[Future Unicornis Award for developing cancer diagnostics support]

VARGA János

Journal of Nursing Theory and Practice

[Role of Atrial Fibrillation in Stroke Prevalence: Implementation of CHA2DS2 – Vasc Risk Stratifi­cation Scale]

PAPP László, VIDA Nóra, BENGŐ Szilvia, KIS Tamás , GAÁL Gabriella, PETŐ Zsófia

[Introduction: Stroke is one of the leading causes of death and disability, therefore is an important public health concern. 20% of ischaemic cerebrovascular diseases are casued by cardiac-related embolism, wiith non-valvular atrial fibrillation (AF) as a major cause, and results in approximately 3-5-fold risk improvement. The aim of this study is to introduce the CHADS2-VASc scoring system, as an important tool in the estimation of stroke risk in AF patients. Recognition of AF and initiation of adequate therapy is a crucial step in the prevention of serious complications. The best-known indexes for AF’s vascular effects are HAS-BLED and CHADS2-VASc. According to European Society of Cardiology, CHADS2-VASc is recommended to use in every AF case with stroke risk, when direct anticoagulant therapy could be implemented. A nurse can work on stroke risk reduction among AF patients in various levels and competences. Primary prevention and health promotion is a responsibility for every health care worker, but at the same time, Advenced Practice Nurse could have a role either in diagnostics or initiating proper therapy.]