[Systemic autoimmune diseases characteristically show multiple organ involvements. Hence, Clinical manifestations and the outcome are quite variable. The survival has continuously been improving due to more sophisticated diagnostic tools and therapeutic possibilities. Despite the technical development, complications and organ manifestations may lead to emergency or often provoke permanent functional or morphologic deterioration of the affected organs. Critical situations can be directly attributed to the manifestations of the underlying disease, deterioration of the affected organs, side effects of immune suppressive therapy complications of Intercurrent or co-incidental diseases also may induce the occurrence of critical complications. The Authors describe all conditions that may lead to the development of critical situations at systemic autoimmune disease regarding different organ and organ systems. The symptoms and diagnostic possibilities are also analysed. A checklist is given about those systemic autoimmune disorders where particular critical events can be present. Medication in general and other possible immune modulator managements with beneficial effects are discussed.]

[Nociceptive, neuropathic and central me­chanisms are involved in the perception, transmission and processing of chronic pain and shaping of cerebral pain image. Alar­mins – molecules alarming defence and signing the presence of pathogens and tissue damage - trigger a series of pathogenic events resulting in inflammatory pain stimuli. Proinflammatory cytokines play a determining role in the pain perception at the level of the nervous system. Continuous inflammatory stimuli while sensitizing the periferic and central neurons activate the pain-related cerebral areas and develop the complex pain image, the pain matrix. Ce­reb­ral functional connections are operating in networks and can be visualized by functional MRI. Cytokines activate the neurons directly or indirectly by other neuromediators. Cytokine receptors are expressed on no­ciceptors and even on higher-level neurons and on various non-neural cells, such as microglia and astrocytes. The most ubiquitous cytokines are the Tumour Necrosis Factor and Interleukin 6 in the nervous sys­tem. The signaling pathways are the Nuclear Factor κB and the Janus-kinase enzyme system. The proinflammatory cytokines and the Janus-kinase are therefore primary therapeutic targets. Anti-cytokine biologicals and small molecular kinase inhibitors decrease the pain and improve functional activity in rheumatoid arthritis. Decrease of pain was more pronounced than expected only from the decrease of the clinical biomarkers of inflammation. The early and ra­pid painkiller effect of targeted biological and chemical-biological response modifiers is attributed to their direct analgesic effect on the brain.]

[INTRODUCTION - In the social vulnerability model the concept of Life Events is the measure of forces and life events presenting in the social field that makes someone susceptible to mental illnesses. The stress value of these events add up. The Life Events Scale by Paykel is a questionnaire used in international practice. The objective of this study is the Hungarian adaptation and introduction of the Life Events Scale in the national practice, the international comparison of our results, the comparison of healthy people with the patient population and the analysis by social data. PATIENTS AND METHOD - The questionnaires were filled in by both healthy people and different patient populations. The participants rated the life events between 0-7 points according to their degree of causing stress, then they indicated whether it had happened with them. This was followed by a questionnaire about social data. We separated question groups by factor analysis: losses, changes, failures, difficulties, joyful events. RESULTS - When making the international comparison we only found differences in two areas: becoming unemployed and infidelity/divorce. Young people scored losses higher, while older ones scored changes higher. Those who declared themselves as religious scored suicide attempts higher. The mean scores of patient populations were higher compared to healthy subjects. The number of life events occurred was the highest in the depression-suicide attempt group. CONCLUSION - Our results can be used in everyday clinical practice and may be extremely important in suicide prevention.]

[Neonatal pain is often undertreated. This is based on the assumption that because of the immature nervous system and the lack of the myelinisation preterm and newborn does not feel pain. It is confirmed by a number of articles that the fetus and neonate can experience and respond to painful events. This publication gives a brief overview of the ontogeny of the pain, short-and long-term postnatal consequences, as well as the perception of the possibility of a particularly frail child population: premature infants and neonates, based on animal and human studies.]