Lege Artis Medicinae

[Against the Pharma Industry or for the More Reliable Knowledge?]

BÁNFALVI Attila

DECEMBER 20, 2005

Lege Artis Medicinae - 2005;15(12)

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Lege Artis Medicinae

[THE EFFECT OF BALNEOTHERAPY AND HIDROTHERAPY IN LOCOMOTOR DISEASES - AN OLD THERAPY REBORN]

BENDER Tamás

[Hungary is respected as an “Empire of thermal water” and balneotherapy has been an important part of health tourism. Recently, an increasing number of articles have been published which investigate the effect of thermal water on patients suffering from locomotor diseases. Balneotherapy has a beneficial painkiller effect and improves the quality of life in several cases of inflammatory and degenerative disorders of joint and bone diseases. The physical effect in its mechanism plays much greater role than the chemical one. A great number of evidence can be found in the medical databases proving the positive effect of balneotherapy in musculoskeletal diseases. Balneotherapy stands as an important factor in the National Development Plan of Hungary but we should like to emphasise that without basic research there is no effective balneotherapy.]

Lege Artis Medicinae

[Results of IDEAL study]

CZURIGA István

Lege Artis Medicinae

[In the focus: locomotor diseases]

GÉHER Pál

Lege Artis Medicinae

[PENILE VEIN THROMBOSIS AT YOUNG AGE]

KOVÁCS GÁBOR, GASZTONYI Beáta, BATTYÁNY István, NAGY Ágnes, BUZOGÁNY István, KASSAI Miklós, HUNYADY Béla, LOSONCZY Hajna

[INTRODUCTION - Mondor’s disease is an uncommon disorder occuring mostly in middleaged women and characterized by superficial thrombophlebitis classically involving the thoraco- epigastric veins. Rarely, cases have been reported in atypical sites (upper arms, abdomen, groin and penis). CASE REPORT - This is the first case being published in the Hungarian literature. The young male patient's complaints were caused by penile vein thrombosis which was demonstrated on physical examination and Doppler ultrasonography. Since hereditary thrombophilia and malignancy has been ruled out, we assume that local trauma and venous stasis caused by previous abdominal surgery have been the etiological factors of the disease. CONCLUSION - We give a review of the literature and would like to draw the attention to this rare type of thrombosis, its risk factors and the difficulties of the therapy.]

Lege Artis Medicinae

[SEROTYPE AND ANTIBIOTIC SENSITIVITY DETERMINATION OF SELECTED ISOLATES OF INVASIVE STREPTOCOCCUS PNEUMONIAE STRAINS]

PÁSZTOR Mónika

[INTRODUCTION - Streptococcus pneumoniae (S. pneumoniae) is a very important pathogene of community acquired invasive infections. The aim the study was to collect data on the serotype distribution of invasive S. pneumoniae strains in Hungary and their resistance. In the light of the results it can be determined how effective the currently available polysaccharide vaccine is against the infections caused by invasive S. pneumoniae strains. MATERIALS AND METHODS - The seroprevalence and antibiotic sensitivity of 44 randomly selected isolates of Streptococcus pneumoniae isolated from sterile sites of human body were analysed over a 4 year period (2000-2003). Samples were randomly analysed by the Quellung method. Detection of sensitivity of S. pneumoniae to penicillin and erythromycin were carried out by disc diffusions and E-test method in the microbiological laboratory of the St. Laszlo Hospital. RESULTS - The invasive isolates belong to 22 different serotypes. The prevalence of penicillin and erythromycin sensitivity was 79,5%, and 68% respectively. CONCLUSION - The 23 valent polysaccharide vaccine could provide coverage of 82% of invasive pneumococcal diseases caused by strains analysed in this study.]

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[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

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[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.]

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Cases of inborn errors of metabolism diagnosed in children with autism

CAKAR Emel Nafiye, YILMAZBAS Pınar

Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

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Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

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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.