Lege Artis Medicinae

[Public forum of the College of Gastroenterology]

SIMON László

JULY 14, 2008

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

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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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GYŐRFFY Zsuzsa, IMOLA Sándor, CSOBOTH Csilla, KOPP Mária

[BACKGROUND - Whereas the scientific literature regarding physical abuse primarily focuses on female victims, few studies have been performed on the childhood abuse of men. The aim of our study was to examine the potential effects of childhood physical abuse of men on adult mental health status. METHODS - Data of 4675 male participants of the Hungarostudy nation-wide representative survey were analyzed. RESULTS - Altogether almost 13% of our study group reported physical abuse by a parent or other significant person. Compared with men who did not report abuse, depression, suicidal thoughts and attempts were significantly more common among abused men. Smoking, alcohol- and drugabuse, anxiety disorders and sleeping disorders also had a higher occurence. Moreover, we established that abused men had a significantly greater risk of marital distress and were more likely to have fewer children. Interpretation of the results in a multivariate model indicated that physical abuse is a determinate and independent risk factor of depression, suicidal thoughts and attempts, smoking habits and alcohol abuse. CONCLUSIONS - Our results underline that childhood physical abuse can have a significant effect on numerous mental disorders and maladaptive behaviours in adulthood. However, the deeper understanding of the relationship between physical abuse and mental disorders necessitates further studies.]

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[Delirium is a disorder of the vigilance of attention and consciousness, and cognitive functions caused by brain disorders. It has an acute onset and a potentially fluctuating course. The neural dysfunction, which is responsible for the development of this syndrome often appears as a secondary condition due to systemic disorders. This is not a psychiatric illness: primary mental disorders do not cause troubles in the vigilance of consciousness. Among the elderly it occurs rather frequently, might affect approximately a seventy five thousand elderly people in our country. Shockingly, almost two-thirds of these cases remain unrecognised, which has a significance for public health since it increases markedly the risks of morbidity and mortality. Due to the frequent multimorbidity and polypragmasia, the treatment of this syndrome is a challenge requiring complex medical knowledge. Systematic non-pharmacologic preventive strategies have particular significance in its care. ]

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