Lege Artis Medicinae

[The Wonderful Infant ]

LŐRINCZ Jenő

DECEMBER 15, 2015

Lege Artis Medicinae - 2015;25(11-12)

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Clinical Neuroscience

[Sleep habits among preschool- and schoolchildren]

FUSZ Katalin, RITECZ Bernadett, BALOGH Brigitta, TAKÁCS Krisztina, SOMLAI Eszter, RAPOSA L. Bence, OLÁH András

[Objective - Our aim is to evaluate sleep habits, sleep quality and influencing factors among preschool- and schoolchildren. Method - Two questionnaires were recorded. Questionnaire 1 dealt with sleeping habits, breastfeeding and health behavior of preschool children and infant, and it contained the abbreviated version of the Children’s Sleep Habits Questionnaire. Questionnaire 2 dealt with health behavior and the application of sleep hygiene rules, as well as it contained the Athens Insomnia Scale. Subjects - We assessed a total of 1063 questionnaires: 516 kindergarten children participated in our online survey across the country; 547 primary and secondary school students participated in the 2nd questionnaire survey in Szolnok. Results - Parents’ observation shows that the average nighttime sleeping time of kindergarten children is 10 hours 20 minutes on weekdays and 10 hours 36 minutes on weekends. The most popular sleeping habits in kindergarten age: teal reading (65.1%) and co-sleeping (42.8%). Parents of infants used breastfeeding (50.4%) and rocking (43.2%) most frequently before sleep. Co-sleeping has a positive influence on the length of lactation. Among the preschool sleeping habits we have proved a number of positive effects of teal reading, while watching television have negative effects. The sleep quality of school-age children according to the Athens Insomnia Scale is 6.11 points (SD: 4.11), 19% of the children are insomniac. Their sleep time is 7 hours 31 minutes on weekdays and 9 hours 30 minutes on weekends. The usage of good health behavior and sleep hygiene rules positively influence sleep quality and sleep duration. Conclusions - With our results, we would like to draw the attention of children and parents to the importance of sleeping and using sleep hygiene rules.]

Lege Artis Medicinae

[Feeding and eating in infancy and early childhood part II. - Breastfeeding, complementary feeding and weaning in the Large-sample of the “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Complementary feed-ing is the transitional period from exclusive breastfeeding to family foods, while breastfeeding is continued. It should be started, when breastmilk itself no longer meets the infant’s nutritional requirements, ideally at the age of around 6 months. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Comple­mentary feeding practices and issues of weaning were analyzed. RESULTS - In our sample complementary feeding was started at the age of 5.5±1.8 months. 6% of infants younger than 4 months and about two third of infants at the age between 4 and 6 months were started on complementary feeding. 32% of the 7-12 month old infants were continued on breastfeeding. The proportion of breastfed infants and young children in the 12-24 and 25-36 month age group was 24% and 5.5% respectively. The daily feeding frequency of breastfed infants was 6.7±1.6. The infants and young children, who were breastfed along with complementary feeding were feeding 5.6±1.5 times/day. After completed weaning the range of feeding frequency was limited to 4.9±0.9 occasions/day. 60.4% of mothers regarded their feeding style on demand, while 39.6% on set schedule. 16% of mothers reported that their child had feeding difficulties. CONCLUSIONS - Complementary feeding indicators should be part of infant feeding data collection, such as time of introduction of complementary food, feeding frequency, food consistency, energy density of food and safe preparation. Responsive feeding is part of responsive parenting and should be promoted, along with continuing breastfeeding at least till one year of age, and for as long as mother and infant wish to continue. ]

Clinical Neuroscience

[Young neurologists XI. forum]

[Correlation between carotid artery lesions and cerebral perfusion (Carotid Duplex scan and brain SPECT). Stenosis or dissection? Differential diagnostic issues in carotid circulation disorders. AVM diagnosed by 3D TCD. Possible diagnostic errors in supraaortic duplex UH scans and angiography. Causes of diagnostic errors in duplex ultrasound studies of the carotid arteries and ways to avoid them. The role of duplex ultrasonography in the surgical evaluation of common carotid artery occlusion (case report). Follow-up of Moyamoya disease with transcranial Doppler (TCD). Platelet function tests in the acute and chronic phase of cerebral circulatory disease. Multicausal cerebral circulatory disorders. Co-occurrence of parkinsonism and giant aneurysm (case report). Teratoma adultum, germinoma, spinal and cerebral metastases in the background of intermittent headache - 5-year patient follow-up Differential diagnosis of meningeal tumours. Extracranial tumours presenting with symptoms of brain metastasis. Pitfalls in the diagnosis of craniocervical transitional and high cervical space occupying processes. Diagnosis of benign spinal tumours. Spinal dermoid cyst - data on the aetiology of low back pain syndrome. Experimental and clinical potential of brain microdialysis. Treatment of multiple intracranial tumours. Tremor and reflex tests in Parkinson's disease. HMPAO SPECT studies in Parkinson's disease. Aurorix treatment in cases of Parkinson's syndrome complicated with depression. Drug therapy of Parkinson's syndrome with special reference to diurnal performance fluctuations. Jumex in the early phase of Parkinson's syndrome. Conductive education in parkinsonism. Use of biophysical methods in the study of the pathomechanism of neurological diseases. Large blind spot syndrome. Investigation of optokinetic nystagmus in solitary frontal laesio. Hypocalcaemia and epilepsy. Difficulties in the recognition of epileptic seizures. Hypnosis treatment in partial epilepsy. Migraine, depression, anxiety. Verbalization features of headaches. Fahr's disease in our class material. CT scanning of cerebral vascular lesions and differential diagnostic difficulties. Binswanger's disease. CT lesions in patients with psychopathological symptoms. The importance of 3D MR angiography in occlusive cerebral vascular disease. Comparative study of cervical large vessel imaging. Difficulties in the diagnosis of craniocervical transition in a case report. Differential diagnosis of spinal cord disease. History and epidemiology of Parkinson's disease. Recent data on the pathomechanism of parkinsonism; experimental therapies Diagnostic errors in Parkinson's syndrome. Sinemet CR - advances in drug therapy. Oxidant phenotype studies in Parkinson's syndrome patients. Madopar-HBS treatment of patients with Parkinson's syndrome. Co-occurrence of complicated migraine and idiopathic cerebral atrophy. Family study in adreno-leuko-dystrophy. Electrophysiological study of patients with anaemia perniciosa. Cartilage drift into the sacral dura sac. Results of electrophysiological studies in patients with Parkinson's syndrome. EMG-SCAN studies in patients with Parkinson's syndrome. A case of adult myotubular myopathy in our department. Advanced picture of Kugelberg-Welander syndrome. Immunological study of idiopathic inflammatory myopathies. Recessive generalized myotonia (Becker). Differential diagnosis of myotonia in a case report. Glossopharyngeal neuralgia with syncope. Familial occurrence of multisystemic atrophy. Apert syndrome in the light of modern diagnostics. Infant with Reit syndrome (video case presentation). Juvenile cardiogenic stroke. Sneddon syndrome. Cerebrovascular patients in our department in the first half of 1993. Cerebellar haemorrhages. Changes in the assessment of prognosis in the patient population of our department. A case of medial thalamic atrophy thought to be multiple sclerosis. Extrapyramidal damage caused by stroke. Cases of bilateral occipital lobular atrophy. Case of severe brainstem lesion (central pontine myelinolysis). Long-term follow-up of the cellular and humoral immune response in patients with multiple sclerosis. Current problems of Lyme borreliosis in our departmental practice. Listeria monocytogenes as a possible causative agent of purulent meningitis. Incidence of lower limb root pains causing diagnostic difficulty in our department. Peripheral neuropathy in hypereosinophilic syndrome. Eye movement disorders caused by brain stem diseases. Depression in patients with Parkinson's syndrome, with particular reference to the possibility of presuicidal syndrome (RINGEL).]

Lege Artis Medicinae

[Selective abortion in twin pregnancies discordant for congenital fetal anomaly]

PATKÓS Péter, HRUBY Ervin, PAPP Csaba, TÓTH-PÁL Ernő, PAPP Zoltán

[INTRODUCTION - In special cases of twin pregnancy where one of the fetuses is affected by severe congenital anomaly or disease confirmed with prenatal diagnostic methods and the other fetus is healthy, selective abortion has been accepted as the method of choice for twenty years to save the healthy sibling and to improve its life expectations. PATIENTS AND METHODS - The authors present their clinical experience of the past 15 years from 14 cases of selective abortion performed in twin pregnancies discordant for congenital fetal anomaly. Indication for the intervention was the anomaly of the second fetus in eleven cases and the anomaly of the first twin fetus in three cases. RESULTS - Out of eleven selective abortions performed on the second twin fetus, only one ended with the loss of the entire pregnancy. All three cases of selective abortion performed on the first twin fetus resulted in abortion of the entire twin pregnancy. All ten surviving fetuses were born living and healthy, followed by unharmed infant and childhood development. CONCLUSIONS - To offer the possibility of selective abortion to the parents seems to be indicated only in those cases of twin pregnancy where the discordant fetal disease or congenital anomaly is severe, placentation is dichorionic or at least diamniotic and where the second twin is affected.]

Lege Artis Medicinae

[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project ]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project INTRODUCTION - After introducing adequate complementary food to the diet of breastfed/formula-fed babies, the frequency and amount of semisolid/solid food is increasing, the breastmilk/formula intake is decreasing and finally the weaning process is completed. During this process the developing feeding skills of the infant enables them to self-feed. The self-feeding infant and toddler should participate in family meals. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Issues concerning the development of self-feeding skills were analyzed. RESULTS - With advancing age the proportion of infants/toddlers, reported to be able to (partially) self-feed, has increased. The age, at which the majority of toddlers (83.1%) were reported to self-feed, was at 13-15 months. By the age over 2 years 57.2% of the toddlers were fully self-feeding, 39.3% were self-feeding with some assistance, and 3.5% were still completely fed by their mother/caregiver. While self-feeding became more prevalent, the proportion of toddlers with feeding problems and insufficient weight gain has increased. With more prevalent complementary feeding more parents assessed their feeding style rather scheduled than on demand. In the whole sample the proportion of infants/toddlers, who ate with the family, was 43.8%. CONCLUSIONS - In our sample, as previously described in the scientific literature, the developmental readiness to self-feed has developed in the majority of infants by the age of 13-15 months. During progres­sion of weaning an increasing proportion of parents thought, that feeding was rather scheduled than on demand. This finding points at the importance of educating parents about the importance of responsive feeding during and after weaning. For self-feeding toddlers, responsive feeding means, that the mother/caregiver offers a choice of healthy and adequate amount of food, at a proper place, at proper times, responds to the hunger and satiety cues of the child and the toddler decides, whether to eat, what and how much to eat.]