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Clinical Neuroscience

NOVEMBER 30, 2020

Risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under endoscope

YIFAN Xu, YUXIN He, WU Xu, TIANYU Lu, WEIBANG Liang, WEI Jin

Background – Up to now, the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy remain controversial. Purpose – To analyze the risk factors related to intracranial infections after transsphenoidal pituitary adenomectomy under an endoscope, and to provide evidence for preventing and controlling the occurrence and development of infections. A total of 370 patients receiving endoscopic transsphenoidal pituitary adenomectomy in our hospital from January 2014 to October 2017 were selected. The risk factors related to postoperative intracranial infections were analyzed. The hospitalization lengths and expenditures of patients with and without intracranial infections were compared. Of the 370 patients, 18 underwent postoperative intracranial infections, with the infection rate of 4.86%. Intraoperative blood loss >120 mL, cerebrospinal leakage, diabetes, preoperative use of hormones, macroadenoma as well as surgical time >4 h all significantly increased the infection rate (P<0.05). Preoperative use of antibacterial agents prevented intracranial infection. Compared with patients without intracranial infections, the infected ones had significantly prolonged hospitalization length and increased expenditure (P<0.05). Discussion – It is of great clinical significance to analyze the risk factors related to intracranial infection after endoscopic transsphenoidal pituitary adenomectomy, aiming to prevent and to control the onset and progression of infection. Intracranial infections after endoscopic transsphenoidal pituitary adenomectomy were affected by many risk factors, also influencing the prognosis of patients and the economic burden.

Hypertension and nephrology

SEPTEMBER 30, 2020

[Routes of transmission of SARS-CoV-2 virus infection]

KÉKES Ede

[The modes of transmission of SARS-CoV-2 virus have been analyzed in detail recently. It can be stated that the deposition of micro-sized virus particles on different surfaces and in the air is the main reason for the strength and spread of the epidemic all over the world. Spread of virus is present in practically every event of our lives and daily activities. The usual movements of human-human contact, the specific habits of our own lives (face smoothing, eye rubbing etc.) increase the spread. The greatest threat is posed by infected but asymptomatic individuals as carriers of the virus, and the main concern is the speed of transmission dynamics. We have strong evidence that 1.5-2 meter distance, mask wearing, and eye protection are crucial in reducing the rate of virus transmission. It can be assumed that, like normal influenza virus infections, the appearance of the coronavirus shows a seasonal appearance.]

Lege Artis Medicinae

SEPTEMBER 30, 2020

[Frequency and risk factors of “de novo” tumors after kidney transplantation ]

BORDA Bernadett, HÓDI Zoltán, SZEDERKÉNYI Edit, OTTLAKÁN Aurél, SEREGÉLY Edit, LÁZÁR György, KERESZTES Csilla, VIRÁG Katalin

[After kidney transplantation, the administration of immunosuppressive therapy not only renders the patient susceptible to infections, but it may also damage the function of tumor cell recognition and elimination. Our study was performed at the Department of Surgery, University of Szeged. After establishing the inclusion criteria, 570 patients were involved in the study. We examined the age, sex, immunosuppressive therapy of the patients, and searched for the rela­tionship between the different immunosuppressive agents and the type of the tumor. In 81 cases, de novo cancer was diagnosed. Among patients treated with cyclosporin and tacrolimus there was no significant difference in the mean age (p = 0.734) and body mass index (p = 0.543). There was no significant difference in graft function between the two groups of patients (Tac vs Cyc; 44 vs 20). Related to the time passed since the trans­plantation to diagnosing the tumors the earliest were prostate and cervix cancers however without significant difference. Skin cancers are the most frequent followed by post-transplant lym­pho­prolife­ra­tive diseases. The increasing risk of developing tumors is mainly due to immunosuppressive therapy. ]

Lege Artis Medicinae

JULY 01, 2020

[The significance of the identification of SARS-CoV-2 virus and the possible errors of the sampling method]

NOSZEK László

[The COVID-19 pandemic caused by SARS-CoV-2 virus while emerging suddenly and spreading throughout the globe challenged seriously also the modern medicine. Diag­nostic methods recognising viral infections of the upper airways developed essentially in the last 20 years, and it was specifically progressing during the SARS and MERS epidemics thus facilitating the recognition and identifica­tion of infections by influenza, RS- and adenoviruses as well. Nevertheless the present novel coronavirus (SARS-CoV-2) also de­mon­strated that the relatively simple procedures of naso- and oropharyngeal sampling are fallible too. Thus they may have a relatively high risk of false-negative outcomes. However the correct sampling prior the RT-PCR tests provides reliable diagnosis by high sensitivity and specificity. Thus improving the quality of sampling and avoiding failures by correct training and education of the personnel make more reliable the detection of viral infection or indicate recovery after the infection. Finally, this is a key issue while overcoming the present pan­demic.]

Clinical Neuroscience

JANUARY 30, 2016

Facial virus inoculations infect vestibular and auditory neurons in rats

HELFFERICH Frigyes, LOURMET Guillaume, SZABÓ Rebeka Éva, BOLDOGKŐI Zsolt, PALKOVITS Miklós

Background and purpose – There is growing evidence for the viral origin of the Bell’s facial palsy, vestibular neuritis and sudden sensorineural hearing loss, however their exact pathophysiology is still unknown. We investigated the possibility of brainstem infections following peripheral viral inoculations in rats. Methods – Pseudorabies virus, a commonly used neurotropic viral retrograde tracer was injected into the nasolabial region of rats. Five and 6 days after injections, infected brainstem nuclei were demonstrated by immunohistochemical techniques. Results – Infected neurons were found in the motor facial, the medial vestibular, and the sensory trigeminal nuclei, as well as in the medial nucleus of the trapezoid body. Conclusion – Pseudorabies virus infects auditory and vestibular sensory neurons in the brainstem through facial inoculation. The possible routes of infections: 1. trans-synaptic spread constituted by facio-vestibular anastomoses: primarily infected motor facial neuron infects neurons in the medial vestibular nucleus, 2. via trigeminal sensory nerves: the sensory trigeminal complex innervated by GABAergic medial vestibular neurons, and 3. one bisynaptical route: infected facial motoneurons may receive indirect input from the medial vestibular nucleus and the trapezoid body via connecting neurons in the sensory trigeminal complex. We may assume that latent infections of these areas may precede the infections of the peripheral organs and the reactivation of the virus exerts the symptoms.

Lege Artis Medicinae

SEPTEMBER 10, 2019

[Anti-allergic agents and ICAM-1-antibodies for the control of upper respiratory infections]

SZABADKA Hajnalka

[Rhinoviruses are responsible for more than 50 percent of upper respiratory infections. It is well-established that the „Intercellular Adhesion Molecule 1” (ICAM-1) plays a crucial role in the adhesion of rhinoviruses and the relevant secondary bacterial pathogen Haemophilus influenzae to the epithelial cells of the respiratory tract. Both rhinoviruses and H. influenzae enhance the expression of ICAM-1 promoting their own attachment and mutually promoting that of the associated pathogen. It was experimentally shown that anti-ICAM-1 antibodies will inhibit infection by both rhinoviruses and H. influenzae. Since some anti-allergic agents - desloratadine and levocetirizine - also inhibit the expression of ICAM-1, their use may be beneficial in controlling some respiratory infections ]

Clinical Neuroscience

JULY 30, 2019

Isolated hypoglossal nerve palsy due to a jugular foramen schwannoma

ÖZTOP-CAKMAK Özgür, VANLI-YAVUZ Ebru, AYGÜN Serhat, BASTAN Birgül, EGEMEN Emrah, SOLAROGLU Ihsan, GURSOY-OZDEMIR Yesemin

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.

Journal of Nursing Theory and Practice

JUNE 30, 2018

[The importance of the hand hygiene compliance development in the light of prevention of nosocomial infections]

SAJTI Anikó, CSERNUS Mariann

[Good hand hygiene is the most effective means of preventing healthcare-associated infections, as contaminated hands are the greatest risk of spreading infections. It is critical that the infection control professionals emphasise the importance of good hand hygiene practices and help the health care professionals on the five steps of hand hygiene. The author presents in the case study that the numbers of positive urinary microbiological samples were decreased with systematic hand hygiene examination with direct methods and continuous feedback of experiences among the staff of the intensive care unit. For further development four sensory, alcoholic hand scrubbers with spraying automats were fitted by the management of the unit. Data obtained directly from observation further analysis is our goal a comprehensive study for the profession, which can serve as a positive example later to launch compliance development programs in other hospitals. ]