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Clinical Neuroscience

MARCH 30, 2021

hirdetés

[Consensus statement of the Hungarian Clinical Neurogenic Society about the therapy of adult SMA patients]

BOCZÁN Judit, KLIVÉNYI Péter, KÁLMÁN Bernadette, SZÉLL Márta, KARCAGI Veronika, ZÁDORI Dénes, MOLNÁR Mária Judit

[Background – Spinal muscular atrophy (SMA) is an autosomal recessive, progressive neuromuscular disorder resulting in a loss of lower motoneurons. Recently, new disease-modifying treatments (two drugs for splicing modification of SMN2 and one for SMN1 gene replacement) have become available. Purpose – The new drugs change the progression of SMA with neonatal and childhood onset. Increasing amount of data are available about the effects of these drugs in adult patients with SMA. In this article, we summarize the available data of new SMA therapies in adult patients. Methods – Members of the Executive Committee of the Hungarian Clinical Neurogenetic Society surveyed the literature for palliative treatments, randomized controlled trials, and retrospective and prospective studies using disease modifying therapies in adult patients with SMA. Patients – We evaluated the outcomes of studies focused on treatments of adult patients mainly with SMA II and III. In this paper, we present our consensus statement in nine points covering palliative care, technical, medical and safety considerations, patient selection, and long-term monitoring of adult patients with SMA. This consensus statement aims to support the most efficient management of adult patients with SMA, and provides information about treatment efficacy and safety to be considered during personalized therapy. It also highlights open questions needed to be answered in future. Using this recommendation in clinical practice can result in optimization of therapy.]

Clinical Oncology

APRIL 10, 2019

[Metals and cancer]

VETLÉNYI Enikő, RÁCZ Gergely

[We often tend to forget about our environment when looking for the origin of a disease. Inhaled air, drinking water and food, substances in contact with the skin all have an effect on the human body. Metals are indispensable parts of our everyday lives, their mining, processing and use cause a continuous exposure to them. Metal exert their effects on the body in various ways. Many of them are essential for maintaining homeostasis, but excessive or harmful metal intake can lead to health damage, including tumour formation through multiple attack points. Metals substitute each other during different transport processes and in the structure of proteins, they cause oxidative stress and bind to DNA, thereby damaging it. Applying them appropriately, the proapoptotic effect of the metal compounds is brought to the fore, thus becoming a therapeutic tool for tumours. Nowadays, platinum(II) compounds are widely used as chemotherapeutic agents and there are many ongoing studies to fi nd metal compounds with an ideal therapeutic and side-effect profi le. The aims of this article were to draw the attention to the dangers of metals in relation to cancer and to highlight their diverse application possibilities in current and future cancer therapy and diagnostics.]

Clinical Neuroscience

DECEMBER 31, 1954

[Central nervous system and RES. I. Nervous system regulation of liver RES]

CSABA György, RAPPAY György

[Our experiments were carried out on 80 healthy white rats, males and females. The aim of our experiments was to determine the neuromuscular influence and regulation of reticuloendathelium. The experimental methodology used was the stabilized Törő-Velősy procedure. By surgically and pharmacologically performing the experiments with subcortical agents, we found that: 1. RES (hepatic RES) is under the regulation of the central nervous system. 2. Sympathetic excitation increases and parasympathetic excitation decreases RES activity.]

Lege Artis Medicinae

SEPTEMBER 01, 2000

[Bacteriophage therapy and prophylaxis; Renewal of earlier expectations]

MILCH Hedda

[Bacteriophages were discovered 84 years ago by the observation of a lysis of a bacterial culture. The aim of the earliest attempts was the therapeutic employment of bacteriophages. The experiments controlled unsatisfactorily, could not fulfill expecations and successful antibiotic testing resulted the rejection of bacteriophage therapy. Bacteriophages gained importance in biology in the 1950s, as model viruses in biological and genetic research. The decrease in the success of antibiotic therapy caused to renew efforts in experimental phage therapy. The author reviews the early studies carried out mainly on animals as well as human experiments with bacteriophages purified by genetic methods. According to the results, bacteriophage therapy may be effective under certain circumstances for the infections not treatable by antibiotics, and in the case of antiobiotic-susceptible bacteria it can supplement therapy.]

Clinical Neuroscience

DECEMBER 22, 1950

[Vegetative nervous system association with the combined use of Cardiazol and Evipan]

ZÁDOR Imre, FRIGYESI György

[According to Pavlov and his students, inhibition and stimulation interact dynamically within the nervous system. The authors tried to enhance the two processes simultaneously with Cardiazol and Evipan, respectively, and investigated the equilibrium between the two effects. Evipan also prevents Cardiazole from causing seizures, elevating blood pressure and heart rate, and inducing psychic excitement. The experiments suggest that both Cradiazole and Evipan act mainly on the cerebral cortex and that their neutralising role would take place there. From the experiments and from the parallel therapeutic experience, it appears that Evipan can also be used as an antiepileptic, especially in status epilepticus.]

Clinical Neuroscience

JANUARY 30, 2016

[A visual based proto-consciousness model of human thinking]

SZŐKE Henrik, HEGYI Gabriella, CSÁSZÁR Noémi, VAS József Pál, KAPÓCS Gábor, BÓKKON István

[Background and objectives – Here we present our results of many years of research on the visual (pictorial) representation model expanded with some new ideas in a simplified form. Our goal is to make available our new pictorial model for a broader scientific community and to point to its possible importance in the future. Method – Own scientific publications, selective literature analysis and preliminary experiments. Results – Our several scientific publications and preliminary experiments were presented outlining our new molecular visual representation model as brain might be able to generate internal images by regulated biophotons in early V1 retinotopic visual regions. We also proposed that some of symptoms and characteristics of autism and savantism may suggest that visual (pictorial) thinking might be a possible cognitive model in the case of healthy people as well. Our model can present a uniform molecular basis for many visual related phenomena. Conclusions – It is possible that a so-called visual proto-consciousness might be developed in evolution, which is directly related to the retinotopic visual areas, and which has a different cognitive ability from verbal abilities. If our model can be exactly proved it presents a common molecular basis for various visual phenomena such as visual perception and imagination, phosphenes ect. and might open new ways in several fields of science such as visual prosthesis for the blind, artificial intelligence, visual neuroscience, cognitive and autism research.]

Clinical Oncology

APRIL 30, 2020

[Hormone replacement therapy in cancer survivors – Review of the literature]

DELI Tamás, OROSZ Mónika, JAKAB Attila

[Rapid advance in oncology leads to increasing survival of oncologic patients. More and more of them live long enough to reach either the natural age of menopause or, as a side effect of their oncotherapy, experience the cessation of gonadal function, leading to premature ovarian insuffi ciency, with disturbing vasomotor symtoms and long-term negative cardiovascular and skeletal effects. Thus, an ever increasing number of cancer survivors search endocrinologic help in the form of hormone replacement therapy (HRT). The misinterpretation of the WHI (Women’s Health Initiative) Study has lead to an irrational fear of female hormone replacement, both by the general population and medical professionals. It has seemed the logical and safe conclusion to many physicians to avoid HRT, supposing that this attitude defi nitely causes no harm, whereas the decision of prescribing estrogen alone or with progestins might bear oncologic and thromboembolic risks and may even lead to litigation in case of a potentially related complication. However, it was known even before the WHI results that premature menopause and hypogonadism decreases the life expectancy of women by years through its skeletal and cardiovascular effects, and this negative effect correlates with the length of the hypoestrogenaemic period. Yet, the oncologic risk of HRT is extremely diffi cult to assess. In this work we review the latest evidence from in vitro experiments to clinical studies. We group tumours regarding the oncologic risk of properly chosen female hormone replacement therapy in cancer survivors as follows: ’HRT is advanageous’ (e.g. endometrial cancer type I, cervical adenocarcinoma, haematologic malignancies, local cutaneous malignant melanoma, colorectal cancer, hepatocellular cancer); ’HRT is neutral’ (e.g. BRCA 1/2 mutation carriers without cancer, endometrial cancer type II, uterinal carcinosarcoma and adenosarcoma, certain types of ovarian cancer, cervical, vaginal and vulvar squamous cell carcinoma, prolactinoma, kidney cancer, pancreatic cancer, thyroid cancer); ’HRT is relatively contraindicated’ for various reasons (e.g. leiomyosarcoma, certain types of ovarian tumours, brain tumours, advanced metastatic malignant melanoma, lung cancer, gastric cancer, bladder cancer); ’HRT is diasadvantageous and thus contraindicated’ (e.g. breast cancer, endometrial stroma sarcoma, meningioma, glioma, hormone receptor positive gastric and bladder cancer).]

Clinical Neuroscience

FEBRUARY 10, 1953

[About commulative electroconvulsive therapy]

NYIRŐ Gyula

[The active therapies proposed by Wagner-Jauregg, Klaesi, Sakel, Meduna, Cerletti broke therapeutic nihilism, transformed the inside of mental institutions and brought about a major change in the society's attitude towards the mentally ill. Even if the positions of the various authors are not identical and the debate on the ranking and indicative areas of the different therapeutic procedures is not yet over, it can be concluded that since the introduction of active therapeutic procedures the average daily care per patient has decreased substantially and the amount of untreated sediment remaining in institutions has decreased considerably. In the following, we will deal with a modified form of active treatment, electroshock (ES), cumulative electroshock (HES), or as it is called in the western literature, the intensive shock or block treatment. We wish to report on this occasion the results of our therapeutic experiments and observations made on about 570 female mental patients over a period of more than 4 years, using HES.]

Hypertension and nephrology

FEBRUARY 24, 2021

[Prevention of polyuria during lithium treatment. Recent research and history]

[Renal toxicity of lithium is a highly important subject which may jeopardize the use of an agent needed by millions suffering from recurrent episodes of bipolar disorder. Lithium induced severe renal damage leading to end stage renal disease can be almost prevented today using lowered plasma lithium levels. But administration of medicines are necessary for the prevention of the lithium induced disturbance in renal concentrating operation and development of nephrogenic diabetes insipidus. Use of thiazides, non-steroid anti-inflammatory compounds (indomethacine) amiloride, high doses of desmopressin and their combinations are our present armamentarium. The present therapy for lithiuminduced nephrogenic diabetes insipidus in man is to counter anti-vasopressin action of lithium. The “future” treatment seems to be (on the basis of recent animal experiments) to enhance the sensitivity of the kidney to vasopressin action by administering pharmacologic blockade of the renal P2Y12 receptor by using clopidrogel or prasugrel.]

Clinical Neuroscience

MARCH 11, 1954

[Brain tumour and pregnancy]

MAJERSZKY Klára

[1. Data from the literature differ on the association between brain tumor and pregnancy. Some say in animal experiments that pregnancy delays or has no effect on tumor growth, others say it specifically accelerates it. Few cases have been reported in humans in which pregnancy did not adversely affect brain tumor symptoms. In 80% of adverse events, childbirth exacerbated brain tumor symptoms. 2. In 14 years among 221 women with brain cancer , 17 pregnant, resp. we observed patients who already had a brain tumor during the last pregnancy. 3. In six cases, pregnancy and childbirth had no detectable effect on the tumor. With the onset of cancerous symptoms, resp. pregnancy can be directly related to pregnancy in 6 cases and childbirth in 2 cases (47%). In three cases, the co-occurrence of pregnancy and cancer symptoms is apparently an accidental encounter. 4. Based on our own cases, the essence of the issue of the relationship between pregnancy and brain tumor is not the growth retardation or in the problem of acceleratio, but the cases are approx. half of it is seen in the upset of intracranial hydrodynamic balance due to gestational disorders. 5. Things to do change from time to time. Radical neurosurgery or, if this is not possible, subtemporal or posterior scala decompression. In the latter case, cesarean delivery may be recommended. In previously operated cases, if the surgery was not radical or the tumor is prone to recurrence, an abortion is warranted if the patient's condition has not deteriorated. If you have already had threatening tumor symptoms, reoperation is the right solution. In the case of pituitary adenoma, artificial abortion must be performed when the tumor symptoms worsen.]