Search results

Clinical Neuroscience

NOVEMBER 30, 2020

[Covid-19 associated neurological disorders]

SZÔTS Mónika, PÉTERFI Anna, GERÖLY Júlia, NAGY Ferenc

[The clinical signs of SARS-CoV-2 infection has become more recognisable in recent times. In addition to common symptoms such as fever, cough, dyspnea, pneumonia and ageusia, less common complications can be identified, including many neurological manifestations. In this paper, we discuss three Covid-19 associated neurological disorders (Case 1: Covid-19 encephalitis, Case 2: Covid-19 organic headache, Case 3: SARS-CoV-2-infection and ischaemic stroke). We emphasize in our multiple case study that during the present pandemic, it is especially important for neurologists to be aware of the nervous system complications of the virus infection, thus saving unnecessary examinations and reducing the frequency of patients’ contact with health care personnel. ]

Lege Artis Medicinae

DECEMBER 10, 2019

[Why did I survived? Treatment of acute stress reaction after a road accident]

SZABÓ József, SIPOS Mária

[INTRODUCTION - Survivors and witnesses of traffic accidents often experience an acute stress reaction. Immediate or at least fast psychological support, relieving the subjective suffering is very important in the respect of preventing psychological crisis, post-traumatic stress disorder or depression and the associated increasing risk of suicide. CASE REPORT - We present the case of a 27-year-old male patient who was the victim of a traffic accident and was partly responsible for it. He lost his mother in the accident, his sister was injured, and there was a casualty in the other affected car. He applied for a psychiatric appointment one week after the accident. He complained of insomnia, loss of appetite, sadness, weakness, anxiety. The treatment consisted of low-dose anxiolytic therapy, recommended in case of need, and a psychological support via acute stress protocol (G-tep) of EMDR therapy. Both short-term feedback from his family doctor and psychiatry outpatient follow-up after three weeks showed significant symptomatic improvement. CONCLUSIONS - In the last one and a half year, he has not applied for psychiatrical treatment. According his general practitioner there were no new psychological problems during this time. Our work has been successful in terms of immediate relief of suffering and prevention of psychological crisis and PTSD.]

Clinical Neuroscience

NOVEMBER 30, 2019

[Tracing trace elements in mental functions]

JANKA Zoltán

[Trace elements are found in the living organism in small (trace) amounts and are mainly essential for living functions. Essential trace elements are in humans the chromium (Cr), cobalt (Co), copper (Cu), fluorine (F), iodine (I), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn), and questionably the boron (B) and vanadium (V). According to the biopsychosocial concept, mental functions have biological underpinnings, therefore the impairment of certain neurochemical processes due to shortage of trace elements may have mental consequences. Scientific investigations indicate the putative role of trace element deficiency in psychiatric disorders such in depression (Zn, Cr, Se, Fe, Co, I), premenstrual dysphoria (Cr), schizophrenia (Zn, Se), cognitive deterioration/de­mentia (B, Zn, Fe, Mn, Co, V), mental retardation (I, Mo, Cu), binge-eating (Cr), autism (Zn, Mn, Cu, Co) and attention deficit hyperactivity disorder (Fe). At the same time, the excess quantity (chronic exposure, genetic error) of certain trace elements (Cu, Mn, Co, Cr, Fe, V) can also lead to mental disturbances (depression, anxiety, psychosis, cognitive dysfunction, insomnia). Lithium (Li), being efficacious in the treatment of bipolar mood disorder, is not declared officially as a trace element. Due to nutrition (drinking water, food) the serum Li level is about a thousand times less than that used in therapy. However, Li level in the red cells is lower as the membrane sodium-Li countertransport results in a Li efflux. Nevertheless, the possibility that Li is a trace element has emerged as studies indicate its potential efficacy in such a low concentration, since certain geographic regions show an inverse correlation between the Li level of drinking water and the suicide rate in that area. ]

Clinical Neuroscience

JULY 30, 2019

[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.]

Clinical Neuroscience

JULY 30, 2019

A case report of Morvan syndrome

AYTAC Emrah, ACAR Türkan

Morvan syndrome is a rare disease characterized by peripheral nerve hyperexcitability, encephalopathy, dys­autonomia and significant insomnia. The patient, who was included in the present study, was followed-up at our clinics for confusion, myokymia, hyperhidrosis, epileptic seizures, tachycardia, agitation, hypokalemia, and hyponatremia. The cranial MRI of the patient demonstrated hyperintensities at the T2 and FLAIR sections of the medial temporal lobe and insular lobes. Electromyography and neurotransmission examination results were concordant with peripheral nerve hyperreactivity. Contactin-associated protein-like 2 antibodies and leucine-rich glioma inactivated protein 1 antibodies were detected as positive. The patient was diagnosed with Morvan syndrome; intravenous immunoglobulin and corticosteroid treatment was started. Almost full remission was achieved. This very rare syndrome implies challenges in diagnosis and treatment; however, remission can be achieved during the follow-up. In addition, caution is needed in the long-term follow-up of these patients regarding the development of malignancies.

Lege Artis Medicinae

JUNE 20, 2018

[Why is it important and ethical to treat anxiety patients?]

RADICS Judit

[The identification of anxious patiens is not always an easy task. The diagnose is clear in that case, when the symptoms (psychic or somatic) are evident or/and patients complain about anxiety. Anxiety itself is not a pathological symptom if it is adequate in strength and duration. Anxiety reactions have large individual variety -, they are pathological if inadequate and irrelevante and don’t match with the actual situation. According to epidemilogical data one third of patients of family doctors suffer from anxiety but somatic symptoms come to the front, so the patients participate in a great number of medical examinations. It is important to emphasise that medical examinations are necessary to preclude the possibility of any somatic disease. The di­ag­nostic criteria of DSM-5. are an excellent assistance for a good diagnosis. Anxiety is a risk factor for cardiological diseases and diabetes mellitus. The prevalence of anxiety disorders are 12.6-17.2%. Anxiety di­sorders are well-manageable, they need complex therapy: benzodiazepines, antidepressants, hypnotics and psychotherapy. They frequently co-exist with depression and insomnia so they have to be treated together. ]

Clinical Neuroscience

MAY 30, 2018

[Pharmacological and nonpharmacological treatment of insomnias with regard to sleep medicine]

FALUDI Béla, ROZGONYI Renáta

[Insomnia - one of the most prevalent sleep complain - has a great impact on the everyday life. Basically two different form of insomnia can be defined: the insomnia disorder and the co-morbid insomnias. To treat adequately determination of background pathology is essential, which is based on the help of Sleep Medicine Centers. According to the newest guidelines, the treatment of insomnia disorder is based on cognitive behavioural therapies followed by pharmaceutical intervention. In this review we provide the short description of cognitive behavioural therapies and basic principles of hypnotic drugs. Despite the availability of insomnia guidelines the huge variation of the insomnia medication can be seen in the daily practice. Due to the above mentioned reasons we summarize the good clinical practice of hypnotic drug administration for insomnia patients.]

Clinical Neuroscience

SEPTEMBER 30, 2017

[Diabetes, dementia, depression, distress]

SZATMÁRI Szabolcs, ORBÁN-KIS Károly, MIHÁLY István, LÁZÁR Alpár Sándor

[The number of people living with diabetes continues to rise. Therefore neurologists or other health care practitioners may be increasingly faced with comorbid neuropsychiatric disorders commonly presented by diabetic patients. More recently there has been an increasing research interest not only in the interactions between diabetes and the nervous system, the fine structure and functional changes of the brain, but also in the cognitive aspects of antidiabetic treatments. Patients with both types of diabetes mellitus may show signs of cognitive decline, and depression. Comorbid insomnia, anxiety, and distress may also occur. The bi-directional relationships between all these phenomena as well as their connection with diabetes can lead to further health and quality of life deterioration. Therefore it is important that all practitioners involved in the care of diabetic patients recognize the presence of comorbid neuropsychiatric disturbances early on during the healthcare process. Identifying higher risk patients and early screening could improve the prognosis of diabetes and may prevent complications.]

Lege Artis Medicinae

JUNE 20, 2016

[Organic and non-organic perspectives in feeding and eating disorders under three years of age]

SCHEURING Noémi, DANIS Ildikó, KAROLINY Anna, SZABÓ László

[Providing optimal nutrition to infants and toddlers is a critical issue for both parents and experts. Besides the quality and quantity of food, indications of feeding behaviour such as feeding method and acceptance by the child are also crucial when determining feeding issues. The development of self-feeding is a significant part of the healthy somatomental development of a toddler between the age of 0-3 years. Efficient treatment of infants and toddlers with feeding disorders is often challenging in clinical practice. These symptoms frequently appear together with additional behaviour disorders, therefore functional reasons have to be taken into consideration in such cases. Due to the complexity of manifestations, applying tools beyond me­dical competence and involvement of special related professions are necessary. The general diagnostic systems of BNO-10 (International Classification of Diseases) and DSM-V (Statistical Manual of Mental Disorders) which are also applied in our country cannot be used appropriately for clear classification of early childhood feeding disorders and for examination of their backgrounds. DC:0-3R (Diagnostic Classi­fication of Mental Health and Develop­men­tal Disorders of Infancy and Early Childhood- Zero to Three), generally used in Anglo-Saxon countries, can be considered as a complex diagnostic system. Using the DC:0-3R classification system (1), we will present six types of feeding disorders affecting children between the age of 0-36 months in which organic and functional origins have been examined as well. In our article we argue for the complex, psychosomatic interpretation and treatments of early childhood feeding disorders.]

Journal of Nursing Theory and Practice

OCTOBER 20, 2015

[The effects of perceived work-related stress on the life style, health and sleep of nurses]

GÁL-INGES Dóra, NÉMETH Anikó

[Aim of the research: The present study aim to assess how the stress level influences the life style, health and sleep. Research and sampling methods: A self-developed questionnaire was administered online during April and May 2015 (N=556). SPSS 9.0 was used for the data analysis; chi square, independent samples t-test and Spearman’s rank correlation were applied (p<0.05). Results: The higher the level of perceived stress is at work, the worse the self-rated health condition (p<0.001), quality (p<0.001) and quantity (p<0.001) of sleep and dietary habits (p<0.001) are. In the group with higher stress level at work intermittent insomnia (p=0.009) and tired mornings (p<0.001) were more frequent. Participants reported their meals to be irregular (p<0.001) and hasty (p=0.006). There were no significant differences regarding chronic illnesses and addictions compared to the group with lower work-related stress levels. Conclusions: According to these results the level of work-related stress correlates negatively with dietary habits, sleep and self-reported health status. ]