Lege Artis Medicinae

[A Street Child’s Way to the Nobel Prize]

KÖVES Péter

JULY 14, 2008

Lege Artis Medicinae - 2008;18(06-07)

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Further articles in this publication

Lege Artis Medicinae

[Polycystic ovary syndrome – in 2008]

PETRÁNYI Gyula

Lege Artis Medicinae

[Management of Transplantation Waiting Lists]

MATKÓ Ida

Lege Artis Medicinae

[IMMUNE-MEDIATED NEUROLOGICAL DISORDERS]

CSÉPÁNY Tünde

[Multiple sclerosis, myasthenia gravis and chronic inflammatory neuropathies share the common feature of chronic course with potential development of disability due to the damage caused by immunological processes. Early detection and precise diagnosis is very important, because most patients respond well to proper immunomodulatory treatment. The diagnosis requires extensive knowledge of the disease and is based on the clinical symptoms recognised by the GP, as well as on complex assessment of the results of special neurophysiological, radiological and laboratory examinations. The present paper reviews the major immune-mediated neurological disorders and discusses their targeted immunological treatment.]

Lege Artis Medicinae

[Thrombosis Prevention after Previous Placental Thrombosis]

Lege Artis Medicinae

[Public forum of the College of Gastroenterology]

SIMON László

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Clinical Neuroscience

Delirium due to the use of topical cyclopentolate hydrochloride

MAHMUT Atum, ERKAN Çelik, GÜRSOY Alagöz

Introduction - Our aim is to present a rare case where a child had delirium manifestation after instillation of cyclopentolate. Case presentation - A 7-year old patient was seen in our outpatient clinic, and cyclopentolate was dropped three times at 10 minutes intervals in both eyes. The patient suddenly developed behavioral disorders along with gait disturbance, and complained of visual hallucinations 20-25 minutes after the last drop. The patient was transferred to intensive care unit and 0.02 mg/kg IV. physostigmine was administered. The patient improved after minutes of onset of physostigmine, and was discharged with total recovery after 30 minutes. Conclusion - Delirium is a rare systemic side effect of cyclopentolate. The specific antidote is physostigmine, which can be used in severely agitated patients who are not responding to other therapies.

Clinical Neuroscience

A case with reversible neurotoxicity induced by metronidazole

EREN Fulya, ALDAN Ali Mehmet, DOGAN Burcu Vasfiye, GUL Gunay, SELCUK Hatem Hakan, SOYSAL Aysun

Background - Metronidazole is a synthetic antibiotic, which has been commonly used for protozoal and anaerobic infections. It rarely causes dose - and duration - unrelated reversible neurotoxicity. It can induce hyperintense T2/FLAIR MRI lesions in several areas of the brain. Although the clinical status is catastrophic, it is completely reversible after discontinuation of the medicine. Case report - 36-year-old female patient who had recent brain abscess history was under treatment of metronidazole for 40 days. She admitted to Emergency Department with newly onset myalgia, nausea, vomiting, blurred vision and cerebellar signs. She had nystagmus in all directions of gaze, ataxia and incompetence in tandem walk. Bilateral hyperintense lesions in splenium of corpus callosum, mesencephalon and dentate nuclei were detected in T2/FLAIR MRI. Although lumbar puncture analysis was normal, her lesions were thought to be related to activation of the brain abscess and metronidazole was started to be given by intravenous way instead of oral. As lesions got bigger and clinical status got worse, metronidazole was stopped. After discontinuation of metronidazole, we detected a dramatic improvement in patient’s clinical status and MRI lesions reduced. Conclusion - Although metronidazole induced neurotoxicity is a very rare complication of the treatment, clinicians should be aware of this entity because its adverse effects are completely reversible after discontinuation of the treatment.

Hypertension and nephrology

[Professor István Taraba MD., the scientist, physician and man. - „Difficulties are to defeat them!”]

POLNER Kálmán

[Only few such outstanding physicians lived, whose achievements and personality influenced the development of the Hungarian nephrology as remarkably as professor István Taraba did. He started his university career as an experimental researcher at the Institute of Physiology on Semmelweis University, Budapest, then at the age of 34, after completing his Ph.D thesis, decided to treat patients to utilize his acquired knowledge in the field of renal failure’s pathophysiology. This way he devoted himself to cure patients with kidney failure being in very poor circumstances at that time. Besides his daily clinical activity, he accomplished outstanding organizing work in establishing and leading the Hungarian Nephrology Society, and also in initiating specialty training for nephrologists and nephrology nurses. The hallmark of his professional work was that in spite of extremely adverse circumstances he forced to improve the quality of dialysis treatment to approach European standards. Among the renal replacement treatment modalities- antecedently to his age - he respected peritoneal dialysis equal to hemodialysis, and attempted to popularize it in his country. Under his leadership the Nephrology Department of Margit Hospital in Budapest became the therapeutic and educational centre of Hungarian nephrology. His achievements have been acknowledged internationally, and his early death is substantial loss for Hungarian nephrology as a whole. It was a great honour to me to work beside him during the whole period he spent in the Margit Hospital, and since March of 1997 I have the opportunity to lead the department he had established in his intellectuality.]

Lege Artis Medicinae

[Csontváry, the Painter of the “Way of the Sun” ]

CZEIZEL Endre

Clinical Neuroscience

[The winners of the Schaffer Károly Prize 2010.]