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Clinical Neuroscience

SEPTEMBER 30, 2020

Neuroscience highlights: Main cell types underlying memory and spatial navigation

KRABOTH Zoltán, KÁLMÁN Bernadette

Interest in the hippocampal formation and its role in navigation and memory arose in the second part of the 20th century, at least in part due to the curious case of Henry G. Molaison, who underwent brain surgery for intractable epilepsy. The temporal association observed between the removal of his entorhinal cortex along with a significant part of hippocampus and the developing severe memory deficit inspired scientists to focus on these regions. The subsequent discovery of the so-called place cells in the hippocampus launched the description of many other functional cell types and neuronal networks throughout the Papez-circuit that has a key role in memory processes and spatial information coding (speed, head direction, border, grid, object-vector etc). Each of these cell types has its own unique characteristics, and together they form the so-called “Brain GPS”. The aim of this short survey is to highlight for practicing neurologists the types of cells and neuronal networks that represent the anatomical substrates and physiological correlates of pathological entities affecting the limbic system, especially in the temporal lobe. For that purpose, we survey early discoveries along with the most relevant neuroscience observations from the recent literature. By this brief survey, we highlight main cell types in the hippocampal formation, and describe their roles in spatial navigation and memory processes. In recent decades, an array of new and functionally unique neuron types has been recognized in the hippocampal formation, but likely more remain to be discovered. For a better understanding of the heterogeneous presentations of neurological disorders affecting this anatomical region, insights into the constantly evolving neuroscience behind may be helpful. The public health consequences of diseases that affect memory and spatial navigation are high, and grow as the population ages, prompting scientist to focus on further exploring this brain region.

Lege Artis Medicinae

NOVEMBER 30, 2020

[Focus on Lege Artis Medicinae (LAM)]

VASAS Lívia, GEGES József

[Three decades ago, LAM was launched with the goal of providing scientific information about medicine and its frontiers. From the very beginning, LAM has also concerned a special subject area while connecting medicine with the world of art. In the palette of medical articles, it remained a special feature to this day. The analysis of the history of LAM to date was performed using internationally accepted publication guidelines and scientific databases as a pledge of objectivity. We examined the practice of LAM if it meets the main criteria, the professional expectations of our days, when publishing contents of the traditional printed edition and its electronic version. We explored the visibility of articles in the largest bibliographic and scientific metric databases, and reviewed the LAM's place among the Hun­ga­rian professional journals. Our results show that in recent years LAM has gained international reputation des­pite publishing in Hungarian spoken by a few people. This is due to articles with foreign co-authors as well as references to LAM in articles written exclusively by foreign researchers. The journal is of course full readable in the Hungarian bibliographic databases, and its popularity is among the leading ones. The great virtue of the journal is the wide spectrum of the authors' affiliation, with which they cover almost completely the Hungarian health care institutional sys­tem. The special feature of its columns is enhanced by the publication of writings on art, which may increase Hungarian and foreign interest like that of medical articles.]

Hypertension and nephrology

APRIL 24, 2020

[Possibilities and limitations. Dietary difficulties of chronic renal failure in childhood]

REUSZ György, SZABÓ Adrienn

[In chronic kidney disease (CKD), the role of the kidney in assuring homeostasis is gradually deteriorating. Besides fluid, electrolyte and hormonal disturbances, detoxification and control of blood pressure is insufficient without external help. In children, in addition to achieving equilibrium it is also essential to ensure optimal physical and cognitive/psychological development. Adequate calorie intake is a major determinant of growth during infancy. Among the therapeutic options it is essential to ensure a proper diet. In addition to reflecting the special needs of renal failure in its composition, it must be palatable for the child. Children with kidney disease should have a normal energy diet. Protein intake should not be reduced from the baseline recommendation, but lower phosphorus and high bioavailability should be preferred. A low sodium and potassium diet is recommended for a significant proportion of patients and is based on dietary advice. Further, diet planning may be problematic if the child has special dietary requirements and is in need of nasogastric tube feeding. Because diet planning is a complex task, it is difficult to achieve optimal protein supply and mineral restriction along with high energy intake. In such cases, enteral nutrition with special formulas/ drinks developed for pediatric nutrition may provide a solution.]

Hypertension and nephrology

SEPTEMBER 12, 2018

[Treatment of hypertension in kidney transplant patients]

KOVÁCS Tibor, WAGNER László

[Most of the renal transplant recipients suffer from hypertension. Hypertension substantially contributes to the high cardiovascular mortality in this population. The recommendation of the Hungarian Society of Hypertension and the international guidelines suggest to achieve less than 130/80 mmHg as target blood pressure in these patients. Several factors may be in the background of hypertension after kidney transplantation, which can be summarized as factors from the recipient-side, the donorside and factors provoked by transplantation itself. In most of the cases early after transplantation high doses of immunosuppressive drugs (especially calcineurin inhibitors and steroids) are responsible for the increased blood pressure. There are some further special methods apart from the general recommendations which are needed during the examination of hypertension of kidney transplant patients: e.g. measurement of blood trough-level of immunosuppressive drugs, investigation of bone-mineral disorder, screening for the level and causes of anaemia, check-up of the renal graft circulation. Kidney transplant patients suffering from hypertension usually need more than two antihypertensive drugs beyond the use of non-pharmaceutical antihypertensive methods. In the early posttransplantation period calcium channel blockers are preferred antihypertensive medications, because they counterbalance the vasoconstrictive effect of calcineurin inhibitors. The administration of renin-angiotensin-aldosterone inhibitors are rather suggested after the stabilization of renal function (from the 1-3 months posttransplantation). When designing antihypertensive strategy, comorbidities and special factors should be regarded as well, especially volume overload, proteinuria, allograft function (GFR), diabetes, other cardiovascular risk factors, previous cardiovascular events. The setup of an individual therapeutical strategy is advised in view of all these factors, which is different according to the timing after transplantation: the perioperative, the early postoperative phases and from 1-3 months after transplantation have special focuses.]

Lege Artis Medicinae

MARCH 10, 2020

[Summary data of Hungary's comprehensive health screening program (MAESZ) 2010-2019]

BARNA István, KÉKES Ede, HALMY Eszter, BALOGH Zoltán, KUBÁNYI Jolán, SZŐTS Gábor, NÉMETH János, PÉCSVÁRADY Zsolt, MAJOROS Attila, DAIKI Tenno, ERDEI Ottilia, DANKOVICS Gergely

[The comprehensive screening program of Hun­gary (MAESZ) 2010-2020-2030 is a unique initiative in Hungary and worldwide too. This largest humanitarian program provides by the latest technology free scree­ning tests for all residents in Hungary. The program developed by 76 pro­fessional organizations offers 38 scree­ning tests to every participants free of charge, in a special designed screening truck. Screening program performed by MAESZ includes cardiovascular, ophthalmologic, dermatologic, gynecologic, and neurologic investigations, lab tests, audiometry, blood pressure and arterial stiffness measurements, and venous Doppler ultrasound examinations. More­over, screening tests for lactose intolerance, colon malignancy, inflammatory bowel disease, reflux disease, urine incontinency, prostatic cancer and physical activity level were evaluated. Starting 2020, a dental screening station will be added to the mobile unit for early detection of oral cancers. Beyond screening tests, special attention is paid to assess health threatening risk factors, such as smoking, alcohol con­sumption, physical inactivity, un­healthy nutrition, and obesity. The program demonstrates the key elements of first aid from reanimation to bandage of burns in cooperation with professional and civil organisations. Furthermore, during the waiting time, participants get lifestyle recommendations and a health booklet with a bar code enabling the immediate computer analysis of test outcomes. Since the 2018/2019 school year the official prevention program for children entitled “Travel around the Empire of Health” was started. During its 10 years, the MAESZ performed 7 million free of charge screening tests on 1,886 scenes, enrolled 560,000 participants, invested 16,000 hours for prevention, handed out 1,200,000 health booklets and 391,000 prevention info packages to thousands of fami­lies. More than 20,000 health professionals (GPs, nurses, dietetics, health development agents, public health government officials, Accident Prevention Committee of National Police Headquarters, General Directorate of Social Affairs and Child Protection and non-governmental organizations) have been participated. The program designed to improve social health aims to help more and more Hun­garian citizens to be informed about their health status and to reminds them of the importance of prevention. ]

Journal of Nursing Theory and Practice

AUGUST 30, 2019

[Meta-analysis about the Incontinence-associated dermatitis prevention ]

KÓSZÓ Lilla, NAGY Erika

[Background: The maintenance of tissue integrity is an essential part of qualitative nursing. There is a wide scale of products serving the prevention of Incontinence-associated Dermatitis (IAD). However, there is little evidence nurses know about them, making their choice of strategy difficult. Aim: To produce an evidence based publication about the preventive products of IAD, helping nurses in their choice of strategy. Method: In our meta analysis we examined the content of the Medline and Scopus database with special focus on English and Hungarian publications from the last ten years. From the 17459 articles relevant in this topic we analyzed and included 9 studies serving our criteria. Records: We found several methods of prevention; Washing without water, special absorbent pants, protocols and a study about the ’perineal pouch’. The studies were compared from the aspect of IAD prevalence, severity and cost effects. The 3in1 products and protokolls are should be used is the hungarian nursing practice.]

Clinical Oncology

APRIL 10, 2019

[Oncological treatment on certain special cases]

FUTÓ Ildikó, HORVÁTH Dorottya Katalin, LANDHERR László

[Even in the absence of clinically signifi cant co-morbidities, cancer care is a major challenge for both patients and healthcare professionals. Routine anticancer treatment may be complicated by special clinical situations such as pregnancy or organ transplantation. The dosage of certain oncotherapy agents may be further affected by impaired renal and hepatic function or diabetes mellitus. These days, given the improved prognosis of cancerous diseases and increased survival, personalized therapy and prevention of long-term side effects is becoming particularly important, especially in the above-mentioned oncological situations. In this summary, we review the anticancer treatments recommended by ESMO in specifi c clinical situations.]

Lege Artis Medicinae

JUNE 20, 2018

[The psychological preparation of Zala Special Rescue Team for operating during crises]

SZABÓ József, HORVÁTH Péter

[The experiences of interventions in disasters and crises of the last decade evidenced that in addition to the professional state forces specially equipped and mentally prepared volunteer and professional rescue groups were necessary operated. The goal of this article is to demonstrate the importance of psychological preparation for helpers and the risks of its hiatus during an intervention. The preparation of Zala Special Rescue Team is presented in our article along with its results. Authors’ review in connection with the rescue team members, their stress pressure, and the possible strategies was based on their long-term experience and relevant literature. ]

Lege Artis Medicinae

JUNE 07, 2021

[Hypertension, COPD and COVID-19. Focus on antihypertensive therapy]

FARSANG Csaba

[Chronic obstructive pulmonary disease is a very common comorbidity of hypertension and it is often unrecognised by physicians. The factors involved in the pathomechanism of both diseases should be realised when choosing treatment. Among factors, hypoxia, increased tone of sympathetic nervous system and activation of renin-angiotensin-aldosterone system should primarily be considered. Vascular wall damage and endothelial dysfunction has an important role in both conditions. The goals of treatment are elimination of risk factors, optimizing the blood pressure, the consequential prevention of cardio-cerebrovascular, renal and pulmonary damage; finally prolonging the patients’ life and improving their quality of life as well. Both hypertension and COPD significantly worsen the condition of COVID-19 patients since they increase the severity of the disease and the rate of in-patients’ and their mortality. In the treatment of hypertension among COPD and COVID-19 patients there must be emphasized the medication inhibiting of renin-angiotensin-aldosterone system, such as angiotensin-converting en­zyme inhibitors or angiotensin-II AT1 re­cep­tor antagonists. Special attention concerned the beneficial effect of mineralocorticoid receptor antagonist spironolactone. Other antihypertensive drugs (calcium channel blockers, thiazide-like diu­retics, high selectivity β1 receptor antagonists) may supplement the treatment if necessary. Long-acting β2 receptor agonists, muscarinic receptor antagonists and inhalation corticosteroids may be administered in double or triple combination also in hypertension and COPD as well. It is important to note, that statin therapy and also vitamin D3 improve the condition of COVID-19 patients.]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2020

[The Course and Role of the Military Caregivers during World War II]

HIRDI Henriett Éva

[Since the wars of the world, women have continued to play an essential role in the military and the workforce. During the World War II Hungarian women took up jobs in factories, warehouses, offices, and other locations that supported the wartime needs. However the work programs conducted on a voluntary basis did not reach enough workpower. As progressed, the need for more industrial workers became apparent and the government changed its policy regarding women in industry. It was announced in May 1944, that unmarried women between 18 and 30 years of age were called up for compulsory work. Special efforts were made to protect the health of these women. Dr. Mária Baloghy on 1944 introduced a new course based on the factory nursing program, to establish a paid military caregiver serving directly under the control of the Ministry of Defense. The following essay on the course and the support role of the Military Caregivers a series of studies on the history of Nursing.]