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Clinical Neuroscience

SEPTEMBER 30, 2019

[Newer studies on the strong link between sleep and epilepsy: Epilepsy as an epileptic transformation of sleep plastic functions]

HALÁSZ Péter

[Aims - Overview of the new data about the strong link of sleep and epilepsy and conjoining cognitive impairment. Methods - Search for relevant references and summary of our own research activity on the topic. Results - Strong interrealtionship exists between epilepsy and plastic brain functions (memory processing and synaptic homeostasis) and the working modes of NREM sleep. In the most frequent childhood and adult epilepsy networks responsible for plastic functions can be derailed to an epileptic level of excitability, and suffer a transitory or permanent epileptic transformation. Exampling on the three big epilepsies: absence epilepsy; medial temporal lobe epilepsy; and childhood idiopathic focal age dependent epilepsy spectrum we demonstrate the most important features of this epileptic transformation. The association of cognitive impairment to certain sleep dependent epilepsies gains explanation by the epilepsy caused interference with slow wave decline (ICFE) and memory consolidation (MTLE) during NREM sleep. This paper serves also to introduce the concept of sleep dependent system epilepsies. Conclusions - We provide evidences about shared mechanisms among sleep related epilepsies being the derailment of sleep plastic funcions toward exaggerated excitability determined by the inherent possibilities of the signal transduction properties. ]

Journal of Nursing Theory and Practice

DECEMBER 30, 2017

[How it all started: Untold Chapters of Nursing History in Hungary as testified by foxed Documents Part 1.]

SÖVÉNYI Ferencné, PERKÓ Magdolna, FEDINECZNÉ Vittay Katalin

[The article elaborates on the untold chapters of nursing history in Hungary, based on research in archives. The situation of nursing in Hungary in the first half of the 20th century is described, when nursing and nursing education became issues of outstanding importance and secular nursing appeared alongside faith based nursing. Several nursing organisations worked to address the unacceptable situation of nursing and strove to raise the status of nursing so as to allow this self-sacrificing vocation to take its rightful place in society. The tools to achieve this goal included providing professional education and training, creating professional literature and safeguarding nurses’ interests. The Hungarian National Association of Female and Male Nurses that came into being as a grass-root organisation in 1902, and its president, József Michalicza, an unreasonably forgotten figure in Hungarian secular nursing were instrumental in pursuing these goals. The article also mentions several dedicated figures in Hungarian nursing history, due to whose commitment Hungarian nurses were represented in the International Council of Nurses from 1933 until the interference of politics. ]

Lege Artis Medicinae

MAY 20, 2017

[Mazes and compass in prognostic value of cardiovascular risk factors]

KÉKES Ede, KISS István

[The risk assessment of cardiovascular disease is dispensable in everyday practice, because this disease-group gives the high-est death rates all over the world - in developed countries, in Central European Region, including Hungary. Based on reliable surveys world side, we need in addition to coronary heart disease, stroke has been reckoned today to peripheral vascular disease, type-2 diabetes, and chronic kidney diseases as well. It seems useful to the new name i.e., atherosclerotic cardiovascular diseases. It stands as smoking, hypertension, dyslipidemia risk factors among this group of diseases in the background, but more and more importance is given to visceral obesity, physical inactivity, alcohol consumption and psycho-social status. It has to count with the fact that the individual factors together and appear further worsen to mortality rate. The greatest interference arises because the cardiovascular risk estimation proposed by embodiments of non-uniform principles. Undoubtedly, the resolution of ACC/AHA 2010 was the first correct compass, because the classification and utility values of the factors precisely regulated. But in addition, it is essential that in the risk assessment not only the “global estimation” (tables, other forms) will be conducted, but also other important parameters characterizing the extended factors (vascular structure, obesity, psycho-social status, etc.) - set schedule and regulations - acting on to be carried out. We presented in cardiovascular risk assessment methodology and the most profitable methods of estimation based on the preventive guidelines, extern opinions generally accepted now and own experiences. We propose to modify the risk assessment me-thod.]

Clinical Neuroscience

JANUARY 30, 2014

[The role of sleep in the implicit learning processes]

CSÁBI Eszter, NÉMETH Dezsõ

[The role of sleep in different memory processes is debated. Probably it plays an active role in the memory consolidation or possibly it prevents forgetting by protecting against interference or it makes the memory performance more efficient by facilitating the forgetting. The beneficial effect of sleep in explicit memory is well demonstrated, while the role of sleep in implicit mechanisms has not been comprehensively characterized so far. There are several factors which affect the appearance of sleep effect, such as the structure, the length and the complexity of sequence being used, the awareness of the sequence, the length of the learning blocks and the offline period. Besides the classical sleep deprivation methods with healthy participants, examining patients with sleep disorders could be a new method of the investigation of the sleep effect which enables us to enrich our knowledge not only about the sleep-dependent memory consolidation but also the cognitive dysfunction related to sleep pathologies. This new line of research can help the development of more effective rehabilitation programs.]

Lege Artis Medicinae

FEBRUARY 20, 2012

[Potentials and limitations of the application of RNA interference]

KISS-TÓTH Éva, JUHÁSZNÉ Szalai Adrienn, KOSKA Péter, KISS-TÓTH Emőke, BARKAI László, FODOR Bertalan

[The discovery of RNA interference revolutionised our knowledge about regulation. Small interfering RNA sequences, which have a central role in this phenomenon, go through a complex maturation process. By means of their antisense effect, they result in the degradation of homologuous RNA sequences or transcriptoinal repression in the cell. Due to its advantages, the application of gene silencing has rapidly become prevalent in basic research, especially in the field of molecular biology. Besides, an increasing effort has been made to utilise it in certain incurable diseases, viral infections, neurodegenrative disorders as well as in oncological diagnostics and therapy. However, in the interest of safe application, researchers in this area call our attention to the importance of answering a number of questions.]

Hungarian Immunology

AUGUST 20, 2003

[The role of Toll-like receptors in the early steps of innate inmunity. Signaling pathways, responses on the level of cells and the organism]

PRECHL József

[The family of Toll-like receptors are currently one of the most intensively studied group of proteins in immunology. Their ligands include a wide range of microbe-derived molecules, they are expressed on a number leukocyte populations and regulate immune responses very efficiently. In this review we characterize known common and individual signaling pathways of the receptor family and their interference with effects of other receptors, and describe the outcome of TLR signaling on the level of the cells and the organism.]

Clinical Neuroscience

MARCH 30, 2006

[THE USE OF INTRAVENOUS IMMUNGLOBULIN IN THE TREATMENT OF AUTOIMMUNE NEUROMUSCULAR DISEASES]

MOLNÁR Mária Judit

[Intravenous immunglobulin given in autoimmune neuromuscular disorders modulates the immune system by complex actions, including, 1. the modification of the expression and function of Fc receptors, 2. interference with the activation of the complement and the cytokine network, 3. neutralisation of antiidiotypic antibodies, 4. effects on the activation, differentiation and effector functions of the T and B cells. Controlled trials have shown that intravenous immunglobulin is effective as first-line therapy in patients with Guillain-Barré syndrome and multifocal motor neuropathy. In case of steroid resistance or coexisting diabetes mellitus, intravenous immunglobulin can be the first line therapy in chronic inflammatory demyelinating polyneuropathy as well. As an alternative therapy it can be a second-line choice in dermatomyositis, myasthenia gravis, Lambert-Eaton myasthenic syndrome, and stiff person syndrome. While it has a remarkably good safety record for long term administration the following side effects have been observed: headache, skin rash, thromboembolic events and renal tubular necrosis. In some disorders, the appropriate dose and frequency of infusions that maintain a satisfactory therapeutic response is well defined on the basis of data of evidencebased medicine, whereas in others it still remains to be defined. For the analysis of pharmacoeconomical aspects and the mechanism(s) of response differences in the same disease categories, further studies are necessary.]

Clinical Neuroscience

JANUARY 20, 2005

[THE PERISYLVIAN EPILEPTIC NETWORK A unifying concept]

HALÁSZ Péter, KELEMEN Anna, CLEMENS Béla, SARACZ Judit, ROSDY Beáta, RÁSONYI György, SZŰCS Anna

[In this work the authors provide evidences for a unifying concept of the syndromes of benign focal childhood epilepsies, Landau-Kleffner syndrome, and electrical status epilepticus in sleep treating them as a spectrum of disorders with a common transient, age dependent, non lesional, genetically based epileptogenic abnormality, the nature of which is still not known. The electro-clinical features of these syndromes are congruent with the different degree involvement of the perisylvian cognitive network and with the involvement of the thalamo-cortical associative system of variable degree. These epilepsies are characterized by the abundance of regional epileptiform discharges in sharp contrast with the rare and in several cases lacking seizures. The nature and severity of interictal cognitive symptoms are closely related to localization within the network and amount of epileptic interictal discharges. Spike-wave discharges are attributed to an alternation of overexcitation (spikes) and overinhibition (waves). The recurrent overinhibition represented by the wave of the discharges may interfere with the continuous depolarization of the cells of a large population of neurons, which is a requirement of the overt seizures. The overinhibition also interfere with cognitive processes which are correlated with the continuous presence of the fast (gamma) activity, binding the required cortical areas. Hence the recurrent inhibition works against the existence of the binding fast frequency activity. This is the assumed reason for the co-existence of the relative lack of overt seizures and in the same time for the frequently observed epileptogenic cognitive deficit symptoms ("cognitive epilepsies"). The time course of these syndromes overlaps with important developmental milestones. The frequent epileptic discharges alters the evolution of the perisylvian network developing late after early childhood and is very vulnerable for any interference in this imprinting time for speech and other cognitive functions. This spectrum of disorders represents a type of age linked, mild to severe ‘epileptic encephalopathy’ limited to the perisylvian network, where the cognitive impairment is underlied by epileptic discharges interfering with cognitive development.]