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Clinical Neuroscience

SEPTEMBER 30, 2017

Health anxiety mediates the connection between somatosensory amplification and self-reported food sensitivity

ELIESON M. Linn, DÖMÖTÖR Zsuzsanna, KÖTELES Ferenc

Background - The frequency of self-reported food sensitivity (SFS) is increasing, and has a negative impact on the well-being and everyday functioning of the affected people. A considerable proportion of SFS cannot be medically explained. The lack of knowledge of its origin and treatment causes further stress in those affected. Purpose - This study aims to get a better understanding of the psychological background of the condition. Methods - A non-representative community sample (N=335; age: 35.1±13.18 yrs; 75.8% female) completed an English on-line questionnaire assessing somatosensory amplification, health anxiety, modern health worries (MHWs), beliefs concerning the scientific validity of complementary and alternative medicine (CAM), holistic beliefs on health and illness. Results - In multiple binary logistic regression analyses, SFS were associated with CAM related beliefs, somatosensory amplification, and health anxiety after controlling for age and gender. The connection between somatosensory amplification and SFS were completely mediated by health anxiety. No differences between the two groups were found with respect to MHWs, worries about the harmful effects of various artificial components in food, and holistic health beliefs. Discussion: More positive attitudes toward CAM might be based on the lack of conventional treatment, rather than on higher levels of MHWs or a more holistic worldview. Both the existence of symptoms and the presence of health anxiety might be needed for the development and maintenance of SFS. Conclusions - The findings support the notion that somatosensory amplification and health anxiety might play a role in the development and maintenance of SFS.

Lege Artis Medicinae

JULY 20, 2017

[Relationship between adipokinome and lipid parameters in Hungarian obese patients]

LŐRINCZ Hajnalka

[Since the prevalence of obesity has been dramatically increasing worldwide, a better understanding of obesity-related comorbidities leading to carbohydrate and lipid metabolism disorders has become essential. As an active endocrine organ, white adipose tissue secretes adipokines with diverse biological functions. We have found strong correlations between serum chemerin level and atherogenic lipoprotein sub-fractions in obese non-diabetic patients. To better characterize obese patients with and without manifest insulin resistance, we plan to determine serum levels of novel adipokines (omentin-1, vaspin, visfatin, lipocalin-2 and plasminogen activator inhibitor-1) and various oxidative stress markers including paraoxonase-1 activity, tumor necrosis factor-alfa and interleukin-6 levels, as well as low- and high-density lipoprotein subfractions in them and compare their data with lean individuals. We plan to determine correlations between the levels of novel adipokines and oxidative stress markers and lipoprotein subfractions. Furthermore, based upon our previous observations, we plan to study the potential alterations in the adipokine profile and the ratios of lipoprotein subfractions during a 5-year follow-up in obese patients. Our expected results may help to characterize the involvement of the adipokine profile in the regulation of lipoprotein metabolism. Early screening and treatment of lipid abnormalities may help to reduce the risk of cardiovascular events in obesity. ]

Journal of Nursing Theory and Practice

FEBRUARY 28, 2017

[Community nurses’ challenges and occupational health hazards associated with home health care]

HIRDI Henriett Éva, LUKÁCS Miklós, BURCSEK Tóthné Ildikó, BALOGH Zoltán

[The aim of the study was to assess the occupational health hazards associated with the delivery of home health care among nurses in family practices. Methods: The cross-sectional survey was conducted between 20 January 2016 and 15 April among nurses working in general, child and family practices, selected using a random, sampling method (N=983). The data gathering took place using a web-based, anonymous, self-completion questionnaire. The authors analysed the gathered data with Microsoft Excel 2013 software, employing a descriptive statistical methods. Results: 99,59% of nurses were female with an average of 27,34 years experience. Nurses reported the following frequently health risks at their client’s homes: 71,4% handling sharp devices or equipment, 54,9% contact with human body fluids, 29,51% smoking in home, 13,7% patient handling without slings or handling devices, 8,9% agressive pets, 7,5% neighborhood violence/crime. Conclusions: Results demonstrated an increased biological health risk among nurses. Based on the results, the authors stress the importance of developing and conducting training programs concerning occupational health hazard issues for nurses working in family practices. ]

Clinical Neuroscience

JULY 30, 2017

[Calcium ion is a common denominator in the pathophysiological processes of amyotrophic lateral sclerosis]

PATAI Roland, NÓGRÁDI Bernát, MESZLÉNYI Valéria, OBÁL Izabella, ENGELHARDT József István, SIKLÓS László

[Amyotrophic lateral sclerosis (ALS), the most frequent motor neuron disease is characterized by progressive muscle weakness caused by the degeneration of the motor neurons in the spinal cord and motor cortex. However, according to the recent observations, ALS is a rather complex syndrome which frequently involves symptoms of cognitive impairment. Therefore, ALS cases can be interpreted in a clinico-pathological spectrum spanning from the classical ALS involving only the motor system to the fronto-temporal dementia. The progression of the disease, however, manifested in the degeneration of the upper and lower motor neurons, is based on the same complex pathobiology. The main elements of the pathomechanism, such as oxidative stress, excitotoxicity, immune/inflammatory processes and mitochondrial dysfunction are well described already, which operate in orchestrated way and amplify the deleterious effect of each other. It is assumed that calcium ions act as a catalyst in this interaction, hence each of the individual mechanisms has strong, positive and reciprocal calcium dependence thus may combine the individual pathological processes into a unified escalating mechanism of neuronal destruction. This review provides an overview of the role of calcium in connecting and amplifying the major mechanisms which lead to degeneration of the motor neurons in ALS. ]

Clinical Oncology

MAY 20, 2016

[The role of hospice in the management of cancer patients]

TORGYIK Pál

[There is the relationship between the oncological treatment and hospice care proved by the data on morbidity and mortality. Cancer treatment is just partially effective since besides the growing incidence of new patients (90 091 in 2013) in Hungary, the mortality rate is still high (33 278 people in 2013). Revealing the diagnosis of tumorous disease causes an incredible shock for the patients, therefore oncopsychologists have to join to the oncological treatment at a very early stage. They give psychological support to both the patients and their families. By relieving stress and helping to combat the disease, the patients could accept and gradually face to the new situation. The patient keeps hoping as long as the treatment is effective and his/her health does not begin to decline. Today, in most cases the effi cacy of the treatment is just temporary and the patient will reach the stage where only the palliative and hospice care can help to maintain an acceptable but provisional quality of life. A new movement started for the terminally ill patients to keep their dignity. Hospice is an integral part of health care with 205 beds, and 75 home hospice care units (in Hungary). To get into the hospice care we describe the patients’ path including the terminal state, agony and death. We also explain the palliative medical and psychological care as well as the other forms of care at home and in the domestic or hospital care carried out within a team-work. The activity of these two types of care must be integrated and mutually supported. Finally we are going to talk about the problems that prevent the acceptable operation in this system.]

Clinical Neuroscience

MARCH 30, 2017

Electrophysiological alterations and general toxic signs obtained by subacute administration of titanium dioxide nanoparticles to the airways of rats

HORVÁTH Tamara, PAPP András, KOVÁCS Dávid, KÁLOMISTA Ildikó, KOZMA Gábor, VEZÉR Tünde

Introduction and aims - Particles of titanium dioxide (TiO2) with typical size below 100 nm have gained a broad range of application by now, partly involving direct human exposure. Their known properties - high specific surface, mobility within the organism, induction of oxidative stress, release of inflammation mediators etc. - raise the possibility of nervous system damage but the available data regarding this are scarce and contradictory. Based on that, and the experiences with other metal oxide nanoparticles, the aim of the present study was to investigate certain general end nervous system toxic effects of TiO2 nanoparticles applied in the airways of rats. Materials and methods - Young adult Wistar rats (5 groups of 10 rats each) received, daily for 28 days, intratracheal instillations of titanium dioxide nanoparticles of ca. 10 nm diameter, suspended in 1% hydroxyethyl cellulose dissolved in phosphate-buffered saline, in the doses of 1, 3, and 10 mg/kg b. w. Vehicle controls received the suspension medium and there was also an untreated control group. During treatment, the rats’ body weight was measured, and their clinical state observed, daily. After the 28 days, spontaneous cortical activity, sensory evoked potentials and tail nerve action potential was recorded in urethane anesthesia, then the rats were dissected and tissue samples were taken for Ti level determination and biochemical measurements of some oxidative stress indicators. Results - The two higher doses reduced the rate of body weight gain significantly. Sensory evoked potentials and tail nerve action potential were significantly slowed, but the change in the spectrum of spontaneous cortical activity was not significant. Correlation of moderate strength was found between certain evoked potential parameters and brain Ti level and oxidative stress data. Conclusion - Our results underlined the possible neurotoxicity of TiO2 NPs but also the need for further investigations.

Clinical Neuroscience

JANUARY 20, 2017

The timing of weaning alters the vulnerability to stress-induced gastric erosion in adult rats

LUDMILA Filaretova, LUDMILA Vataeva, ZELENA Dóra

Background - Weaning is an important period of life and its timing may influence the resilence for later stress. One of the most important stress-related disorder is gastric ulceration. Purpose and methods - Therefore we aimed to investigate the sensitivity of gastric mucosa to cold (at 16°C) water immersion stress (WIS for 3h) in adult (75-day-old) female and male rats after weaning them at different timepoints (at 17, 21, 30, 36 or 42 postnatal days). The connection with stress was studied by comparing control groups to those underwent WIS at the time of weaning and measuring corticosterone levels at the time of collecting the stomach samples. Results - The timing of weaning has strong impact on all studied parameters. Stress-induced erosion development was the smallest in rats weaned at 36-day independently from preconditioning with WIS at weaning, or sex, despite a clear sex-effect on blood corticosterone levels and body weight. WIS at weaning influenced only the body weight in adult rats weaned at 30-day, being higher in stressed than in control groups. There was no clear overall correlation between erosion area and blood corticosterone measures. Conclusions - Taken together our results confirm that the timing of weaning has long-lasting impact on the resiliance of gastric mucosa to ulcerogenic stressful events. In rats the postnatal day 30-36 seems to be optimal for weaning in both sexes as both earlier and later weaning increased vulnerability. Females seems to be more vulnerable to the effect of weaning than males.

Hypertension and nephrology

DECEMBER 20, 2016

[Deeper analysis of nebivolol effects]

KÉKES Ede

[Author presents the formation of nitric oxide as a largest vasodilator of human endothelium as well as the endothelial dysfunction a result of formation at adrenergic stimulus. He demonstrates in detail the benefits of selective β-1 blocker and β-3 adrenergic agonist nebivolol in the vascular system. This drug has also receptor independent effects. Complex effects of nebivolol causes vasodilation, inhibits oxidative stress and it is capable to neutralize the effects of free oxygen radicals and as a result the endothelial function will be better. Its clinical effects and the less wellknown beneficial properties are listed. The use of drug is discussed especially in hypertensives with smoking, COPD or PAD. The β-3 agonist effect provides positive reactions not only in the adipocytes and the myocardial tissue. but in the skeletal muscle as well: Increase in energy expenditure - as a compensatory mechanism - is increased in obesity and the glucose uptake + storage on skeletal muscle cells are increased in hyperglycemia. The insulin sensitivity will be better, leptin level is decreased, adiponectin level is increased by nebivolol. It is assumed this drug has antidiabetic and anti-obesity effects.]

Clinical Neuroscience

NOVEMBER 30, 2016

Unilateral thalamic infarction causing downward gaze palsy in a patient with uncorrected tetralogy of fallot: a case report

ANNUS Ádám, BENCSIK Krisztina, JÁRDÁNHÁZY Tamás, VÉCSEI László, KLIVÉNYI Péter

Introduction - Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease (CHD). Adults with surgically uncorrected forms of this condition are extremely rare, since operation is recommended in childhood to prevent cyanosis. Cyanotic CHD increases the risk of thromboembolic events. An endothelial dysfunction caused by chronic hypoxia and shear stress due to rheological alterations with a platelet dysfunction appear to be the explanation behind this finding. Paramedian thalamic infarction causing vertical gaze palsy without midbrain involvement is an infrequent finding. We report here a rare case of a patient with untreated TOF, who suffered a left-sided unilateral thalamic infarction presenting as downward gaze palsy and diplopia. Case presentation - A 44-year-old women complained of sudden onset diplopia and vertigo. Neurological examination revealed a downward gaze palsy with other symptoms related to a vertebrobasilar territory circulatory disturbance. The MRI scan revealed an acute infarction, 8 mm in diameter in the left medial thalamic region without midbrain involvement. Discussion - Adults with uncorrected forms of TOF are extremely uncommon, and descriptions of stroke in these patients are therefore rarities. We set out to give a concise survey of the literature regarding TOF patients with stroke. Conclusion - We present a rare case of unilateral thalamic infarction causing downward gaze palsy in an adult patient with uncorrected TOF. Cyanotic CHD is regarded as one of the risk factors of stroke. Besides other pathologic conditions, ischaemic stroke at an early age should raise the suspicion of a cardioembolic origin and, in rare cases, might result from cyanotic CHD.

Lege Artis Medicinae

OCTOBER 20, 2016

[Basics of the medical use of ayahuasca: physiology of dimethyltryptamine]

FRECSKA Ede, KOVÁCS Attila, SZABÓ Attila, FERENCZ Csaba, MÓRÉ Csaba

[Ayahuasca is a brew made of two admixture plants containing dimethyltryptamine (DMT) and b-carbolines (harmine and tetrahydroharmine). The indigenous groups of the Amazonas basin have been using it for centuries as an ethnomedical substance in healing and spiritual-religious rituals. During the last two decades the brew has raised increased scientific and public interest worldwide about its healing effects. Present paper addresses the therapeutic potentials of ayahuasca use and outlines the cellular mechanisms behind - in focus of the s-1 receptor mediated action of DMT. The scientific investigation of ayahuasca is complicated by methodical problems, legal issues, and sociocultural preconceptions.]