Lege Artis Medicinae

[The Command of Self-Awareness Work A Discussion with dr. Emőke Bagdy]

FERENCZI Andrea

MARCH 19, 2007

Lege Artis Medicinae - 2007;17(03)

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Further articles in this publication

Lege Artis Medicinae

[Health Learning and Rehabilitation]

dr. KELEMEN Gábor

Lege Artis Medicinae

[PATHOPHYSIOLOGY, DIAGNOSIS AND THERAPY OF THE EXTRAOESOPHAGEAL MANIFESTATIONS OF GASTRO-OESOPHAGEAL REFLUX DISEASE]

ROSZTÓCZY András

[Recently, considerable interest has been focused on the extra-oesophageal manifestations of gastro- oesophageal reflux disease. Vago-vagal reflex mechanisms have been shown to play a leading role in the pathogenesis of the extra-oesophageal manifestations. In addition, proximal reflux and subsequent chemical irritation of the respiratory tract mucosa are important factors in the development of respiratory symptoms. In contrast to the uncomplicated cases of gastrooesophageal reflux disease, the recognition of these variations may pose a diagnostic challenge right because of the lack of typical symptoms. Successful diagnosis rests with the cooperation of the general practitioner, the specialist observing the extra-oesophageal symptom and the gastroenterologist. The establishment of the pathogenic role of gastro-oesophageal reflux may require verification by oesophageal functional tests. Treatment is based on long-term administration (for at least 3 months if respiratory symptoms are present) of an increased-dose proton pump inhibitor. In the long term, laparoscopic anti-reflux surgery is a realistic alternative to medical treatment in suitable patients. Dietary and life-style education of patients has an important complementary role in the successful long term management.]

Lege Artis Medicinae

[Our Forgotten Medical Historians from the 19th Century]

dr. KAPRONCZAY Károly

Lege Artis Medicinae

[19th World Congress of Diabetology]

HIDVÉGI Tibor

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The syndrome of headache with neurologic deficits and cerebrospinal fluid lymphocytosis (HaNDL) is a rare entity. This disease has been related to migrainous headaches. It is a benign, self-limited disorder, which is characterized by fluctuating neurological symptoms and cerebrospinal fluid lymphocytosis. We describe a case of a 47 years old man with acute onset of headache and aphasia. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis (25 cells/μl, 100% lymphocytes). Electroencephalogram showed moderate slow rhythm in the left hemisphere, with temporoparietal predominance, and without epileptiform activity. His blood tests as well as magnetic resonance imaging (MRI) results were normal. With the diagnosis of HaNDL syndrome the patient was accepted in the Department of Neurology and discharged with full recovery.

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Isolated hypoglossal nerve palsy due to a jugular foramen schwannoma

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Introduction – Although the involvement of the hypoglossal nerve together with other cranial nerves is common in several pathological conditions of the brain, particularly the brainstem, isolated hypoglossal nerve palsy is a rare condition and a diagnostic challenge. Case presentation – The presented patient arrived to the hospital with a history of slurred speech and an uncomfortable sensation on his tongue. Neurological examination showed left-sided hemiatrophy of the tongue with fasciculations and deviation towards the left side during protrusion. Based on the clinical and MRI findings, a diagnosis of hypoglossal nerve schwannoma was made. Discussion – Hypoglossal nerve palsy may arise from multiple causes such as trauma, infections, neoplasms, and endocrine, autoimmune and vascular pathologies. In our case, the isolated involvement of the hypoglossal nerve was at the skull base segment, where the damage to the hypoglossal nerve may occur mostly due to metastasis, nasopharyngeal carcinomas, nerve sheath tumors and glomus tumors. Conclusion – Because of the complexity of the region’s anatomy, the patient diagnosed with hypoglossal nerve schwannoma was referred for gamma knife radiosurgery.

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The effects of the level of spinal cord injury on life satisfaction and disability

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Introduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients’ disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.

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