Lege Artis Medicinae

[Brief News]

FEBRUARY 09, 1991

Lege Artis Medicinae - 1991;1(03)

[High-resolution magnetic resonance imaging of skull base vascular lesions summary study; PET, CT and MR in the differential diagnosis of neuropsychiatric diseases today's applications; Infectious diseases of the brain]

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Lege Artis Medicinae

[The role of computer tomography and magnetic resonance imaging in organic neurological diagnosis]

KENÉZ József

[In the last two decades, neuroimaging became the basic investigative method in the diagnostics of organic neurology due to the rapid development of medical electronics. In the nineties called the "Decade of the Brain", the importance of these methods could hardly bee overestimated. The two outstanding investigations of neuroimaging are computer tomography (CT) and magnetic resonance imaging (MR). Surely in the near future the application of these investigations will be incorporated in the Hungarian healthcare system as well. In this review all the points of view are collected on the basis of neurologic clinical symptomatology to help clinicians to decide, which method and when has to be chosen to gain the most valuable and detailed information on the quickest way, with less risk, and for the least amount of money ]

Lege Artis Medicinae

[Awareness of hypoglycaemia in diabetes mellitus: Prospective clinical-epidemiological investigations]

KERÉNYI Zsuzsa, TAMÁS Gyula, KEMPLER Péter, VARGHA Péter

[In order to survey the frequency of hypoglycaemia and its awareness we investigated 91 insulin- treated diabetic women (48 pregnant and 43 non-pregnant) consecutively using 9 to 15 blood glucose measurements. Subjective hypoglycaemic symptoms of patients were registered by using a structured questionnaire. Biochemically proved hypoglycaemia has been found in two third of patients (62/91). One third of the patients had a loss of awareness, 23 had partial awareness and 19 were aware of hypoglycaemia. No significant difference were found according to age, diabetes duration, daily insulin dose/kg body weight, glycated haemoglobin levels and frequency of diabetic complications. Five standard cardiovascular autonomic reflex-tests were performed in 31 patients. Age, diabetes duration, frequency of diabetic complications of patients with evidence of autonomic neuropathy significantly surpassed that of having normal cardiovascular reflex-tests. Our results confirm from clinical-epidemiological aspect that hypoglycaemia unawareness is not invariably associated with cardiovascular autonomic neuropathy. ]

Lege Artis Medicinae

[Five cases of operated atrial tumors]

NAGY Zsolt, HOLOMAY Miklós, VASZILY Miklós, SZÉCSI János, HORVÁTH Ambrus, PÉTERFFY Árpád

[Between November 1986. and June 1989. five patients underwent excision of an atrial tumour. Two of the patients had previous peripheral embolization, two had cardiac symptoms and one was symptomless. All the tumours were demonstrated by means of echocardiography and in four cases by angiocardiography as well. Four of them were left atrial tumors and one in the right atrium. The tumors were succesfully removed in all patients: in three cases by shaving them from the endocardium, in one case by excising a portion of atrial septum and in one case with a margin of normal atrial wall. Histological examination showed thrombus in one case. All patients survived operation and left hospital in good conditions. During the follow up there were no cardiac complication or local recurrence.]

Lege Artis Medicinae

[Hypothesis of natural birth]

BÁLINT Sándor

[It's supposed by the author that there exists a natural birth. According to his assumption in every woman's subconscionsness there is the code of the natural birth's behaviour (CODE), which can be spontaneously mobilized in the gravid woman. Putting into practice whichever way for the preparation of the birth, this mobilization can be advanced and in this way the child-bearing women's behaving repertory during their birth is increasing and it's drawing near to the equivalent of its own code. This may be the explication of the success and result of the alternative obstetrics end the preparing programs for the different births. The psychological explanation of the theory is given on the basis of C. G. Jung's activity.]

Lege Artis Medicinae

[Report on gastroenterological endoscopic activity in Hungary in 1989]

NAGY György, JUHÁSZ László

[The Endoscopic Section of the Hungarian Gastroenterological Society, under the leadership of Professor Wittmann, published an annual report on the status and development of endoscopy of the digestive organs in Hungary from 1975. In 1976, the report reported 27453 examinations performed at 75 endoscopic workplaces with 163 instruments. The 1987 survey already included 139496 examinations (36623 in Budapest, 102873 in the countryside) performed at 117 workplaces (37 in Budapest, 80 in the countryside) with 565 instruments (219 in Budapest, 346 in the countryside). In a statistical summary of 13 years, 968090 endoscopic examinations resulted in 389 (0.4 per thousand) complications, of which 71 (7 per 100,000) were fatal. The collection of study data was interrupted with the death of Professor Wittmann. ]

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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.

Clinical Neuroscience

Validation of the Hungarian PHQ-15. A latent variable approach

STAUDER Adrienne, WITTHÖFT Michael, KÖTELES Ferenc

Somatic symptoms without a clear-cut organic or biomedical background, also called “medically unexplained” or “somatoform” symptoms, are frequent in primary and secondary health care. They are often accompanied by depression and/or anxiety, and cause functional impairment. The Patient Health Question­naire Somatic Symptom Scale (PHQ-15) was developed to measure somatic symptom distress based on the frequency and bothersomeness of non-specific somatic symptoms. The study aimed to (1) evaluate the Hungarian version of the PHQ-15 from a psychometric point of view; (2) replicate the bifactor structure and associations with negative affect described in the literature; and (3) provide the Hungarian clinical and scientific community with reference (normal) values split by sex and age groups. PHQ-15, depression (BDI-R), and subjective well-being (WHO-5) scores obtained from a large (n = 5020) and close to representative community sample (Hun­garostudy 2006) were subjected to correlation analysis and linear structural equation modeling. The PHQ-15 showed good internal consistency (Cronbach’s α = 0.810; McDonald’s ω = 0.819) and moderate to strong correlation with the BDI-R (rs = .49, p < 0.001) and WHO-5 (rs = -.48, p < 0.001). Fit of the bifactor structure was excellent; in independent analyses, the general factor was strongly associated with depression (β = 0.656±0.017, p < 0.001) and well-being (β = -0.575±0.015, p < 0.001), whereas the symptom specific factors were only weakly or not related to these constructs. The PHQ-15 score was higher in females and showed a weak positive association with age. The Hungarian PHQ-15 is a psychometrically sound scale which is positively associated with depression and ne­gatively related to subjective well-being. The bifactor structure indicates the existence and meaningfulness of a gene­ral factor representing the affective-motivational component of somatic symptom distress. The Hungarian version of the PHQ-15 is a brief and usable tool for the pre-screening of somatization disorder (DSM-IV) or somatic symptom disorder (DSM-5). The reported reference values can be used in the future for both clinical and research purposes.

Clinical Neuroscience

[The experience of pain: A review of the new results of pain research]

GYULAHÁZI Judit

[According to the basic assumption of pain research, the activity of pain matrix shows an increase in functional neuroimaging studies during nociceptive stimulation whose extent is correlated with the intensity of the stimulus and that of the emerged experience of pain. Research conducted over the past decade has questioned this assumption. In order to understand the controversial findings I have reviewed new results of pain research. In order to get to know more about “hardware”, I reviewed the direct relationships between members of the pain network. With a view to understand the mechanism of the development of pain perception, the “software”, I give a brief description of the functioning of the salient as well as attention and executive control network. To have a better understanding of “hardware”, I examined the behavior of the pain network of patients incapable of feeling pain in aversive situations. In the review I introduced the thought-provoking knowledge of the pain for all experts, regardless of this specialty by presenting the results of pain research.]

Clinical Neuroscience

The yield of electroencephalography in syncope

NALBANTOGLU Mecbure, TAN Ozturk Ozlem

Introduction - Syncope is defined as a brief transient loss of consciousness due to cerebral hypoperfusion. Although the diagnosis of syncope is based on a thorough history and examination, electroencaphalography (EEG) is also an important investigational tool in the differential diagnosis in this group of patients. In this study we aimed to identify the diagnostic value of EEG in patients with syncope. Methods - We retrospectively examined EEG recordings of 288 patients with the diagnosis of syncope referred to the Cankiri State Hospital EEG laboratory, from January 2014 to January 2016. The EEG findings were classified into 6 groups as normal, epileptiform discharges (spike and sharp waves), generalized background slowing, focal slowing, hemispherical asymmetries, and low amplitude EEG tracing. The EEGs were separated according to gender and age. Results - Total of 288 patients were included in this study, 148 were females (51.4%) and 140 (48.6%) were males. Among all the EEG reports, 203 (70.5%) were normal, 8 of them (2.8%) showed generalized background slowing and 7 (2.4%) demonstrated focal slow waves. Epileptiform discharges occured among 13 patients (4.5%). Hemispherical asymmetries were detected in 10 patients (3.5%) and low amplitude EEG tracing in 47 patients (16.3%). There was no significant difference between age groups in EEG findings (p=0.3). Also no significant difference was detected in EEG results by gender (p=0.2). Discussion - Although the diagnosis of syncope, epilepsy and non-epileptic seizures is clinical diagnosis, EEG still remains additional method

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[NEWS OF THE HUNGARIAN OSTEOPOROSIS PATIENTS’ SOCIETY]

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