Lege Artis Medicinae

[Influence of alcohol on the nervous system]

BARACZKA Krisztina1

JANUARY 31, 1994

Lege Artis Medicinae - 1994;4(01)

[Prevention and treatment of addictions such as alcoholism require a multidisciplinary approach. Sociological and social psychiatric studies have revealed many factors which may play a part in the development of alcoholism, however biological studies increasingly indicate an organic origin of alcoholism. The aim of the present comprehensive study was to summarise the clinical manifestations of alcohol toxicity based on biological alterations. The results of genetic and immunological studies are summarized. Some aspects of the investigations in the field of biogenic amines are presented. The primary toxic, long lasting withdrawal effects are discussed, from the clinical point of view.]

AFFILIATIONS

  1. Országos Reumatológiai és Fizioterápiás Intézet Ideggyógyászati Osztály Budapest

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Further articles in this publication

Lege Artis Medicinae

[Contrast media for magnetic resonance imaging in clinical practice]

FÁBIÁN Lajos

[The author's main goal is to introduce the generally available contrast media for magnetic resonance imaging. After a brief survey of this topic, the principal agents are classified into three main subgroups. The four Ti-type contrast agents are compared and discussed on the basis of the available data in the literature. Finally, the possible future direction of contrast media research in MRI is discussed. ]

Lege Artis Medicinae

[Correspondence - The doctor's relationship with patients]

RÁCZ Egon

[It's been a decade since I read in a Hungarian medical journal about the doctor's behaviour, his attitude, his relationship with the patient, his colleagues, his co-workers. Based on my decades of medical practice (and my frequent illness - which has only prevented me from practising my profession in the last two years), I will try to summarise what the patient's expectations of the doctor are, and how well the doctor can meet them.]

Lege Artis Medicinae

[The present and future of radiology]

HARKÁNYI Zoltán

[Conversation with Professors Charles Gooding and Gretchen Gooding]

Lege Artis Medicinae

[EEG mapping in focal cerebral disorders]

NIKL János, KUKOR Gyula

[EEG mapping is a new method which serves for processing the data of the quantitative analysis of the brain electrical activity. In its final form it is a neuroimaging technique. The present study was designed to examine the localization reliability and clinical utilization of the mapping. 103 patients with focal cerebral disorders were investigated: 70 patients with cerebrovascular diseases, 33 patients with tumour, epilepsy, migraine, meningoencephalitis, subdural haematoma, subarachnoid cyst. The EEG mapping, the routine EEG and the CT were performed and their findings were compared. In comparison with the traditional EEG, the mapping has the advantage that it can detect the alpha asymmetry. It shows the focal, functional damages more correctly than the EEG does. The mapping provides information about the ischemic lesions before the CT can visualize the tissue hypodensity. In comparison with the CT, the mapping has a good localization reliability although there are some sources of error in the method. It can detect minimal cerebral damages. It is applicable for follow-up studies on transient ischemic attacks. ]

Lege Artis Medicinae

[MTC-pertechnetate scintigraphy used to identify bleeding from meckel's diverticulum]

KÁPOSZTA Rita, MARÓDI László, BAJNOK László

[99 mTc-pertechnetate scinti graphy has got an important diagnostic role in pediatrics, as it can detect ectopic ventricular mucosa, and Meckel's diverticulum. In this paper the case of a 12-year-old boy is reported who has presented recurrent rectal bleedings and abdominal pain due to an undiagnosed Meckel's diverticulum for three years. The patient was admitted with serious rectal bleeding and melena. On admission aortography and selective angiography did not give valuable information about the origin of the bleeding. Previous surgical report on laparotomy necessitated by appendicitis at the age of 3,5 years impeded the diagnosis describing the lack of Meckel's diverticulum. The source of bleeding was identified with red blood cell scintigraphy and the presence of Meckel's diverticulum was confirmed with laparotomy. His topathological examination revealed ectopic gastric mucosa in the diverticulum. 99 mTc red blood cell imaging has a valuable diagnostic role in the localization of gastrointestinal bleeding. The examination can be performed repeatedly, and it should be used before aortography and selective angiography. It is emphasized here that Meckel's diverticulum must be considered in any patients presented with rectal bleeding without fever and clinical or laboratory signs of infection or inflammation.]

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VIDA Nóra, PAPP László

[Delirium is defined as a disturbance of consciousness and cognition that develops over a short period of time and fluctuates over time. During the last decade, the number of publications dealing with different aspects of delirium have been grown. The key points in most articles are pharmacological prevention and treatment, but because the rise of health care expenditures, all activities, which cost-effectively support the care process, is getting more and more important. The aim of the study: The aim of this research is to review the non-pharmacological prevention and treatment possibilities of delirium in elderly patients undergoing hip surgery. Systematic review, using articles published between 1999 and 2019 in PubMed and Wiley Online Libraries. Non-pharmacologic treatments significantly reduced the incidence (p=0.003–0.045) and duration (p=0.009–0.03) of delirium. The interventions also contributed to decrease the number of episodes (p=0.03), and to make the symptoms lighter. Early mobilisation and adequate fluid and electrolyte intake are key factors in reducing the incidence of delirium. Measuring oxygen saturation and support, appropriate nutrition, effective pain treatment, minimizing drug-interactions, maintaining good sleep and managing sensory dysfunctions have an effect on incidence, duration and severity of delirium.]

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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.

Lege Artis Medicinae

[Interdisciplinary aspects of alcoholism and smoking from the perspective of primary care]

DARVAI László, RIHMER Zoltán, BALCZÁR Lajos, CSERHÁTI Zoltán, TÚRI Gergő, BÉLTECZKI Zsuzsa, KALABAY László, TORZSA Péter

[There is a complex and multi-directional relationship between alcoholism, smoking, depression, anxiety disorders, cardiovascular disorders and type 2 diabetes. They are risk factors not only for each other but - because of their relationship with depression - also for suicide. The effect of successful therapy of depression and anxiety plays a role not only in reducing suicide but also in reduction of alcoholism, cardiovascular morbidity and mortality, and smoking. Therefore, the effect of the appropriate specific treatments appears (even to a lesser extent) also in the field of another medical discipline. On the other hand, the reduction of smoking may be - in addition to decreasing mortality and morbidity of chronic obstructive pulmonary disease, lung cancer, ischemic heart disease, and so on - a causal factor in decreasing suicidal morbidity and mortality, as well as in decreasing morbidity of depression. The purpose of this article is to raise awareness of the relevant professions and healthcare financiers and decision-makers to these hidden benefits (appearing in other fields of expertise). The presented data justify not only the better funding for Mental Health Services but also the extension of the competence of primary care physicians to the mild and moderate (not psychotic and not suicidal) depression and anxiety disorders. ]

Clinical Neuroscience

[Alcohol as a risk factor for hemorrhagic stroke (in English language)]

SAJJAN Daniel, BERECZKI Dániel

[Purpose - Whereas the protective effect of mild-to-moderate alcohol consumption against ischemic stroke has been well recognized, there is conflicting evidence regarding the link between alcohol consumption and hemorrhagic strokes. The aim of the present study is to summarize the results of case-control and cohort studies published on this issue. Methods - Recent epidemiologic articles on the relationship between alcohol consumption and hemorrhagic stroke were identified by Medline searches limited to title words using the following search terms: ”alcohol AND cerebrovascular dis*”, ”alcohol AND stroke”, ”alcohol AND cerebral hemorrhage” and ”alcohol AND hemorrhagic stroke”. Results - Most case-control and cohort studies either repor-ted only on total strokes or on a combined group of hemorr-hagic strokes including intracerebral as well as subarachnoid hemorrhages. There was a consensus among reports that heavy alcohol consumption was associated with a higher risk of hemorrhagic strokes. Controversy remains regarding the effect of mild-to-moderate alcohol consumption: while some studies reported a protective effect, others found a dose-dependent linear relationship between the amount of alcohol consumed and the risk of hemorrhagic stroke. The differential effect of moderate alcohol consumption on hemorrhagic compared to ischemic strokes is mostly attributed to alcohol- and withdrawal- induced sudden elevations of blood pressure, and coagulation disorders. Conclusions - Heavy drinking should be considered as one of the risk factors for hemorrhagic stroke. In contrast to the protective effect of mild-to-moderate alcohol use against ischemic strokes, moderate drinking might result in an increased risk of hemorrhagic strokes.]

Lege Artis Medicinae

[’THE CYCLE OF VIOLENCE’ IN THE LIFE OF ALCOHOLICS]

GEREVICH József, BÁCSKAI Erika

[INTRODUCTION - ’The cycle of violence’ have long been a known phenomenon. The present research is aimed at answering the question of whether abuse suffered in childhood creates a tendency to aggressive behaviour in adulthood and whether there is a connection between these two forms of behaviour. METHODS - The sample studied comprised 235 clinically treated alcoholics. The instruments used for the investigation were the European Addiction Severity Index (EuropASI), the Buss and Perry Aggression Questionnaire, and the Janus Questionnaire. RESULTS - The most important finding is that persons who were physically abused in childhood by their parents were very likely to strike or beat someone in the course of their lives (χ2=9.79, p<0.001). Within the most aggressive group, 18 % had not suffered abuse in childhood, while 81 had been abused (χ2=13.25, p<0.001). If the patient had been physically abused, struck or beaten, that person later abused, struck or beat someone else (Pearson r=.397). CONCLUSION - The results draw attention to the importance of preventing and treating aggression in alcoholics undergoing clinical treatment.]