Hungarian Radiology

[The Society of Hungarian Radiologists Held a General Assembly in June]

JUNE 20, 2003

Hungarian Radiology - 2003;77(03)

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Hungarian Radiology

[Role of ultrasound in the diagnosis of Crohn’s disease]

KUKLA Edit, BEVÍZ József, MAKULA Éva, PALKÓ András, VÁRKONYI Ágnes, FÜZESI Kristóf

[INTRODUCTION - The peak incidence of Crohn’s disease is the second and third decades of life. Twenty-five percent of new cases occur in individuals less than 20 years of age. Typically the clinical presentation of Crohn’s disease is not different in children from in adults. The sudden onset of the disease with serious symptoms is not rare in pediatric patients The signs of acute abdomen, the rapid deterioration of the patient's physical condition needs urgent surgical intervention. Ultrasound is the first imaging method of choice can reveal specific signs of the disease and early accurate diagnosis can be established. The radiation burden can be decreased on this way and the unnecessary surgical intervention can be avoided. CASE REPORT - A child who presented typical signs of acute appendicitis was investigated first by ultrasound. Based on this investigation the diagnosis of Crohn’s disease was suspected, but unfortunately the adequate diagnosis was established only 5 months later after appendectomy and right sided hemicolectomy. CONCLUSION - Authors draw the attention to the importance of the ultrasound investigation in the diagnosis of Crohn’s disease in the childhood.]

Hungarian Radiology

[Board Meeting of the Society of Hungarian Radiologists Budapest, 26 May 2003]

NAGY Gyöngyi

Hungarian Radiology

[Health Insurance and Funding from a Medical Perspective]

SZÁNTÓ Dezső

Hungarian Radiology

[Entry for Artists]

LOMBAY Béla

Hungarian Radiology

[Management and Economics: A Radiologist Postgraduate Training Program is Launching]

FORRAI Gábor, HORVÁTH István

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Creutzfeldt-Jakob Disease: A single center experience and systemic analysis of cases in Turkey

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We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey. Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. In a total of 13 patients, progressive cognitive decline was the most common presenting symptom. Two patients had a diagnosis of Heidenhain variant, 1 patient had a diagnosis of Oppenheimer-Brownell variant. Seven patients (53.3%) had been misdiagnosed with depression, vascular dementia, normal pressure hydrocephalus or encephalitis. Eleven patients (87%) had typical MRI findings but only 5 of these were present at baseline. Asymmetrical high signal abnormalities on MRI were observed in 4 patients. Five patients (45.4%) had periodic spike wave complexes on EEG, all appeared during the follow-up. There were 74 published cases in Turkey bet­ween 2005 and 2018, with various clinical presentations. CJD has a variety of clinical features in our patient series as well as in cases reported in Turkey. Although progressive cognitive decline is the most common presenting symptom, unusual manifestations in early stages of the disease might cause misdiagnosis. Variant forms should be kept in mind in patients with isolated visual or cerebellar symptoms. MRI and EEG should be repeated during follow-up period if the clinical suspicion still exists.

Clinical Neuroscience

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

ALTAY Servet, GÜRDOGAN Muhammet, KAYA Caglar, KARDAS Fatih, ZEYBEY Utku, CAKIR Burcu, EBIK Mustafa, DEMIR Melik

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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[Advanced Parkinson’s disease characteristics in clinical practice: Results from the OBSERVE-PD study and sub-analysis of the Hungarian data]

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