A legkorábbi Pázmány-portré „rejtélye“

Abstract The earliest authentic representation of Péter Pázmány is registered by special literature as his portrait as a Somascan monk. It is based on the white hooded garment Pázmány is wearing in the picture. It is obviously not part of a Jesuit's or an archbishop's or cardinal vestments. The interpretation as Somascan, the source of which is the handwritten catalogue of the Pannonhalma collection which preserves the picture, was probably based on the preclusion of other possibilities. To refute this assumption, there are more than one arguments. We know that Pázmány was not entitled to put on the Somascan habit — which was otherwise taken for him from Rome to Prague in July 1616 because his de facto admission into the order was held up (and finally cancelled), and more important still, we can cite Lodovico Ridolfi, chargé d'affairs of the Habsburgs house in Rome, claiming that the habit of the Somascans did not practically differ from that of the Jesuits. In the pertinent catalogue edited by Giancarlo Rocca only a black habit differing in cut from the habit of the Jesuits is mentioned. Upon our inquiry the central archivist of the order P. Maurizio Brioli C.R.S. also answered he had no idea of the white garment in the picture, and there was no trace of it in the order's documents, including the clothes of the novices. Consequently, the depicted habit cannot be Somascan. In the enumeration of Pázmány's earlier positions a post was overlooked, which may be the clue to the solution. It is the provostship in Turóc. Turóc was originally founded by the Premonstratensians, and the Hungarian members of that order were wearing a white mozzetta of a similar cut to Pázmány's in the painting as late as the 18th century. Most probably, Pázmány had to emphasize, also in externalities, mainly during his 1616 summerdiplomatic missions, particularly when facing the Protestant estates, that he was no Jesuit any longer (and hence was liable to take the archiepiscopal chair under the act of 1608). He could hardly have done it in a more evident manner than wearing this white mozzetta, which simultaneously expressed a monastic and a prelatic character. It is interesting, however, that at the time of the painting of the picture — dated between the beginning of his provostship at Turóc on 25 April 1616 and 28 September, Pázmány as a candidate for novitiate was temporarily the member of the Somascan order de iure canonico. Under the white mozzetta with capucinum of Premonstratensian origin he is wearing however a Jesuit's habit with the collar and there is a biretta similar to the Jesuits' on his head

Moderate hypothermia within 6 h of birth plus inhaled xenon versus moderate hypothermia alone after birth asphyxia (TOBY-Xe): a proof-of-concept, open-label, randomised controlled trial

Background Moderate cooling after birth asphyxia is associated with substantial reductions in death and disability, but additional therapies might provide further benefit. We assessed whether the addition of xenon gas, a promising novel therapy, after the initiation of hypothermia for birth asphyxia would result in further improvement. Methods Total Body hypothermia plus Xenon (TOBY-Xe) was a proof-of-concept, randomised, open-label, parallel-group trial done at four intensive-care neonatal units in the UK. Eligible infants were 36–43 weeks of gestational age, had signs of moderate to severe encephalopathy and moderately or severely abnormal background activity for at least 30 min or seizures as shown by amplitude-integrated EEG (aEEG), and had one of the following: Apgar score of 5 or less 10 min after birth, continued need for resuscitation 10 min after birth, or acidosis within 1 h of birth. Participants were allocated in a 1:1 ratio by use of a secure web-based computer-generated randomisation sequence within 12 h of birth to cooling to a rectal temperature of 33·5°C for 72 h (standard treatment) or to cooling in combination with 30% inhaled xenon for 24 h started immediately after randomisation. The primary outcomes were reduction in lactate to N-acetyl aspartate ratio in the thalamus and in preserved fractional anisotropy in the posterior limb of the internal capsule, measured with magnetic resonance spectroscopy and MRI, respectively, within 15 days of birth. The investigator assessing these outcomes was masked to allocation. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00934700, and with ISRCTN, as ISRCTN08886155. Findings The study was done from Jan 31, 2012, to Sept 30, 2014. We enrolled 92 infants, 46 of whom were randomly assigned to cooling only and 46 to xenon plus cooling. 37 infants in the cooling only group and 41 in the cooling plus xenon group underwent magnetic resonance assessments and were included in the analysis of the primary outcomes. We noted no significant differences in lactate to N-acetyl aspartate ratio in the thalamus (geometric mean ratio 1·09, 95% CI 0·90 to 1·32) or fractional anisotropy (mean difference −0·01, 95% CI −0·03 to 0·02) in the posterior limb of the internal capsule between the two groups. Nine infants died in the cooling group and 11 in the xenon group. Two adverse events were reported in the xenon group: subcutaneous fat necrosis and transient desaturation during the MRI. No serious adverse events were recorded. Interpretation Administration of xenon within the delayed timeframe used in this trial is feasible and apparently safe, but is unlikely to enhance the neuroprotective effect of cooling after birth asphyxia

Diffusion tensor imaging and resting state functional connectivity as advanced imaging biomarkers of outcome in infants with hypoxic-ischaemic encephalopathy treated with hypothermia

Therapeutic hypothermia confers significant benefit in term neonates with hypoxic-ischaemic encephalopathy (HIE). However, despite the treatment nearly half of the infants develop an unfavourable outcome. Intensive bench-based and early phase clinical research is focused on identifying treatments that augment hypothermic neuroprotection. Qualified biomarkers are required to test these promising therapies efficiently. This thesis aims to assess advanced magnetic resonance imaging (MRI) techniques, including diffusion tensor imaging (DTI) and resting state functional MRI (fMRI) as imaging biomarkers of outcome in infants with HIE who underwent hypothermic neuroprotection. FA values in the white matter (WM), obtained in the neonatal period and assessed by tract-based spatial statistics (TBSS), correlated with subsequent developmental quotient (DQ). However, TBSS is not suitable to study grey matter (GM), which is the primary site of injury following an acute hypoxic-ischaemic event. Therefore, a neonatal atlas-based automated tissue labelling approach was applied to segment central and cortical grey and whole brain WM. Mean diffusivity (MD) in GM structures, obtained in the neonatal period correlated with subsequent DQ. Although the central GM is the primary site of injury on conventional MRI following HIE; FA within WM tissue labels also correlated to neurodevelopmental performance scores. As DTI does not provide information on functional consequences of brain injury functional sequel of HIE was studied with resting state fMRI. Diminished functional connectivity was demonstrated in infants who suffered HIE, which associated with an unfavourable outcome. The results of this thesis suggest that MD in GM tissue labels and FA either determined within WM tissue labels or analysed with TBSS correlate to subsequent neurodevelopmental performance scores in infants who suffered HIE treated with hypothermia and may be applied as imaging biomarkers of outcome in this population. Although functional connectivity was diminished in infants with HIE, resting state fMRI needs further study to assess its utility as an imaging biomarker following a hypoxic-ischaemic brain injury.Open Acces