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Clinical Neuroscience

JANUARY 30, 2020

[The quality of life of the cluster headache patients during the active phase of the headache]

DIÓSSY Mária, BALOGH Eszter, MAGYAR Máté, GYÜRE Tamás, CSÉPÁNY Éva, BOZSIK György, ERTSEY Csaba

[Introduction - Cluster headache (CH), which affects 0.1% of the population, is one of the most painful human conditions: despite adequate treatment, the frequent and severe headaches cause a significant burden to the patients. According to a small number of previous studies, CH has a serious negative effect on the sufferers’ quality of life (QOL). In the current study, we set out to examine the quality of life of the CH patients attending our outpatient service between 2013 and 2016, using generic and headache-specific QOL instruments. Methods - A total of 42 CH patients (16 females and 26 males; mean age: 39.1±13.5 years) completed the SF-36 generic QOL questionnaire and the headache- specific CHQQ questionnaire (Comprehensive Headache- related Quality of life Questionnaire), during the active phase of their headache. Their data were compared to those of patients suffering from chronic tension type headache (CTH) and to data obtained from controls not suffering from significant forms of headache, using Kruskal-Wallis tests. Results - During the active phase of the CH, the patients’ generic QOL was significantly worse than that of normal controls in four of the 8 domains of the SF-36 instrument. Apart from a significantly worse result in the ‘Bodily pain’ SF-36 domain, there were no significant differences between the CH patients’ and the CTH patients’ results. All the dimensions and the total score of the headache-specific CHQQ instrument showed significantly worse QOL in the CH group than in the CTH group or in the control group. Conclusion - Cluster headache has a significant negative effect on the quality of life. The decrease of QOL experienced by the patients was better reflected by the headache-specific CHQQ instrument than by the generic SF-36 instrument. ]

Lege Artis Medicinae

SEPTEMBER 10, 2019

[Treatment of painful diabetic polyneuropathy ]

KIS János Tibor

[Diabetic polyneuropathy can be present in up to 20-60% of diabetics, making it the most common complication of diabetes, but it is often undiagnosed. The diagnosis is mainly based on symptoms, but also several test options are available. For the prevention of neuropathy, long-term control of glycemic parameters is the most important. The pain caused by diabetic polyneuropathy affects 13-26% of diabetics. After the diagnosis, there are a number of treatment options that can be divided into causal and symptomatic therapy. The author summarizes therapeutic options from a practical point of view. ]

Clinical Neuroscience

MAY 30, 2017

Case report of a woman with anti amphiphysin positive stiff person syndrome

MANHALTER Nóra, GYÖRFI Orsolya, BOROS Erzsébet, BOKOR Magdolna, FAZEKAS Ferenc, DÉNES Zoltán, FABÓ Dániel, KAMONDI Anita, ERÕSS Loránd

Stiff person syndrome is a rare neuroimmunological disease, characterized by severe, involuntary stiffness with superimposed painful muscle spasms, which are worsened by external stimuli. The classical form is associated with high levels of antibodies against glutamic acid decarboxylase. One of the variant forms is associated with antibodies against amphiphysin. This entity is a paraneoplastic syndrome, caused primarily by breast cancer, secondarily by lung cancer. Symptomatic therapy of anti amphiphysin positive stiff person syndrome includes treatment with benzodiazepines and baclofen (including intrathecal baclofen therapy). The effect of immunological therapies is controversial. Treatment of the underlying cancer may be very effective. In this report, we describe a 68 year old female presenting with an unusally rapidly developing anti amphiphysin positive stiff person syndrome, which was associated with breast cancer. Her painful spasms abolished after intrathecal baclofen treatment was initiated. Her condition improved spontaneously and significantly after cancer treatment, which enabled to start her complex rehabilitation and the simultaneous dose reduction of the intrathecal baclofen. The bedridden patient improved to using a rollator walker and the baclofen pump could be removed 18 monthes after breast surgery. This highlights the importance of cancer screening and treatment in anti amphiphysin positive stiff person syndrome cases.

Journal of Nursing Theory and Practice

AUGUST 30, 2016

[The treatment of verruca vulgaris combining conservative and cryotherapy]

ZITÁS Éva, MÉSZÁROS Judit

[Aim of the research: Presenting the combined treatment of and ways of preventing verruca vulgaris (viral wart, simple wart), which is significant considering public health, by the help of general health education according to our own research results. Research and sampling methods: The research was implemented from 1st September, 2014 to 30th June, 2015 in Budapest with 124 patients being treated with verruca vulgaris. The research method is following the treatment, documentation and the analysis of our own research experience. Results: We treated 635 verruca vulgaris of 124 patients combining conservative and cryotherapy. 18,6% of the symptoms recovered after 3-6 weeks; 53,2% of them after 6-9 weeks; and 23,4% of them recovered in 12 weeks; 4,8% of them required further treatment. Conclusions: The optimal treatment of verruca vulgaris is combining conservative and cryotherapy, which is more effective, less painful, and delivers better aesthetic results than monotherapies. ]

Lege Artis Medicinae

OCTOBER 20, 2016

[Conversation with the relatives]

ZELENA András, MONOSTORI Dóra

[In our strong opinion in hospitals the efficient conversation among staff and patient and/or relatives is important. We try to draw attention to the psychosocial aspects of pediatric intensive care and the complex and special case of relative-staff communication via the introduction of a clinical case. Various medical experts were involved in the treatment of the infant and all participants witnessed the 4 months long life and the death of the newborn. The case of the intubed patient was painful and stressful for the medical staff. With our case-report, we try to present the spectrum, which forms during the treatment of a sickly born infant and the changes of the relationship of the medical staff and relatives as well as the engrossment of their interpersonal relationship along with the center of their communication problems and solution-finding. Our paper is centered around the psychosocial aspect of the clinical case and we would like to call the attention on how the medical experts communicated with the parents of the infant. ]

Clinical Neuroscience

JULY 30, 2016

Burning mouth syndrome: Evaluation of clinical and laboratory findings

HALAC Gulistan, TEKTURK Pinar, EROGLU Saliha, CIKRIKCIOGLU Ali Mehmet, CIMENDUR Ozlem, KILIC Elif, ASIL Talip

Background and purpose - Burning mouth syndrome is a chronic and persistent painful condition characterized by burning sensation in the oral mucosa. We investigated the etiological factors of patients presented with the history of burning in the mouth who admitted our outpatient clinics over the 8-years period and who had no underlying identifiable local factors. We also tried to determine their demographic and clinical characteristics. Our aim was to investigate the association between burning mouth and psychiatric disorders such as depression and anxiety, chronic diseases like diabetes mellitus (DM) and other laboratory studies in patients complaining of solely burning in the mouth. Methods - The study included patients with the history of burning in mouth who presented in our outpatient clinic between 2005 and 2012. They were evaluated by a neurologist, a psychiatrist, an internist, and a dentist. Complete blood counts, biochemical analysis and cranial magnetic resonance imaging (MRI) were performed for all patients. Results - A total of 26 (22 (84%) females, 4 (15%) males; mean age 55.9 years) patients were enrolled in this study. Five (19.2%) of the patients had depression, 2 (7.7%) had anxiety disorder, 2 (7.7%) had diabetes mellitus, 8 (30%) had B12 vitamin deficiency, 3 (11.5%) had decreased ferritin levels in blood, and 1 (3.8%) had folic acid deficiency. Cranial MRI of all patients were normal. Nine patients (34.6%) had no etiological causes. Conclusion - A multidisciplinary approach in the management of burning mouth and establishment of common criteria for the diagnosis would provide insight into the underlying pathophysiological mechanism.

Clinical Neuroscience

JULY 30, 2014

[Maybe it hurts more than you think! - Neonatal pain]

MIKOS Borbála

[Neonatal pain is often undertreated. This is based on the assumption that because of the immature nervous system and the lack of the myelinisation preterm and newborn does not feel pain. It is confirmed by a number of articles that the fetus and neonate can experience and respond to painful events. This publication gives a brief overview of the ontogeny of the pain, short-and long-term postnatal consequences, as well as the perception of the possibility of a particularly frail child population: premature infants and neonates, based on animal and human studies.]

Lege Artis Medicinae

JUNE 20, 2014

[Diclofenac/orphenadrin as a combined analgetics in relief of pain Systemic literature review]

ROJKOVICH Bernadette

[The objectives of this paper are to discuss the safety and tolerability of combined infusion -Neodolpasse(®) - containing non-steroidal antiinflammarory drug, diclofenac and central muscle relaxant orphenadrin on the basis of recent data. The author reviewed phase IV randomised, controlled studies published on Medline and in the Hungarian literature. On the basis of the available data, diclofenac/orphenadrin infusion is an effective and safe analgesic, which is easy to administer and to combine with other painkillers in acute low back pain and other painful rheumatic conditions, as well as postoperative pain.]

LAM KID

MAY 30, 2014

[Diclofenac/orphenadrin as a combined analgetics in relief of pain. Systemic literature review]

ROJKOVICH Bernadette

[The objectives of this paper are to discuss the safety and tolerability of combined infusion -Neodolpasse(®) - containing nonsteroidal antiinflammarory drug, diclofenac and central muscle relaxant orphenadrin on the basis of recent data. The author reviewed phase IV randomised, controlled studies published on Medline and in the Hungarian literature. On the basis of the available data, diclofenac/orphenadrin infusion is an effective and safe analgesic, which is easy to administer and to combine with other painkillers in acute low back pain and other painful rheumatic conditions, as well as postoperative pain.]