Browse
A vérlemezkében gazdag fibrin alkalmazása a parodontalis sebészetben
Use of platelet-rich fibrin in periodontal surgery
Periodontal disease as a chronic inflammation of multifactorial origins causes the destruction of the supporting tissues of the teeth. Due to intraosseal defects, the prognosis of the affected teeth is questionable. Comprehensive periodontal therapy intends to stop the destruction of the attachment apparatus and reach the regeneration of lost tissues. Periodontal intrabony defects have shown improved regenerative potential due to their morphology. Interest in the use of biological agents to promote periodontal regeneration, including growth factors, has increased significantly in recent decades. Autologous platelet concentrates have been successfully applied in various fields of medicine for more than two decades. Autologous platelet concentrates are being used in more and more areas of medicine. Application of platelet-rich fibrin is the most topical among these therapeutic options. As main advantages, it can be prepared without the addition of anticoagulants, requires only one centrifugation, its high concentration of growth factors is highly supportive for wound healing and can be used in various forms. The application of platelet-rich fibrin may facilitate the successful treatment of periodontal defects. A new generation of platelet-rich fibrin may open up further opportunities, including those in periodontal wound healing. Orv Hetil. 2024; 165(40): 1570–1578.
Abstract
Background and aims
The South Oaks Gambling Screen (SOGS) is a commonly used tool for screening potential gambling problems. The SOGS score has been found to be correlated with the DSM-5 criteria for Gambling Disorder (GD). However, one of its main limitations is the high rate of false positives. The objective of this study was to establish more accurate cutoff points for the SOGS based on the DSM-5 criteria and severity levels, taking into account sex-specific samples. Additionally, we aimed to validate these cutoff points using external measures.
Methods
The study sample comprised 4.516 patients (398 women and 4,118 men) who sought treatment for GD. Of these patients, 4.203 met the DSM-5 criteria for GD, while 313 did not meet the threshold for GD diagnosis.
Results
The recommended cutoff value for the SOGS is eight for men (Sensitivity (Se): 82.9%, Specificity (Sp): 86.2%) and seven for women (Se: 85.6%, Sp: 77.4%). For moderate severity of GD, the cutoff points are nine for men (Se: 82.1%, Sp: 82.0%) and eight for women (Se: 86.3%, Sp: 73.3%), while for severe cases of GD, the cutoff point is ten for both sexes (Se: 83.0%, Sp: 56.7% for men; Se: 80.0%, Sp: 77.4% for women). These cutoff values are validated by evidence of worse psychopathological states, more dysfunctional personality traits, and risky behaviours commonly associated with GD.
Discussion and Conclusions
These findings support adjusting the reference values for the SOGS to eight in males and seven in females to enhance the classification of individuals potentially experiencing GD. The use of higher cutoff values has significant implications for clinical and research purposes, enabling a more precise assessment of the diagnosis and severity of GD.
Malignus pleurális mezotelióma, hajas sejtes leukémia és szplenikus marginális zóna limfóma társulása – esettanulmány
Malignant pleural mesothelioma associated with simultaneous hairy cell leukemia and splenic marginal zone lymphoma – a case report
A visszatérő pleurális folyadék okának megállapítása problémás lehet. Ha egy betegnél korábban diagnosztizálták a rosszindulatú daganatot, akkor ennek a daganatnak és a hidrotoraxnak az összefüggése nyilvánvalónak tűnhet, de ez félrevezetheti a diagnosztikai eljárásokat. Közleményünkben egy idős betegről számolunk be, aki két indolens B-sejtes lép limfómában szenvedett, nevezetesen hajas sejtes leukémiában és szplenikus marginális zóna limfómában. Négy évvel később visszatérő pleurális folyadékgyülem alakult ki, és a kiváltó okként rosszindulatú pleurális mezoteliómát diagnosztizáltak. Tudomásunk szerint az azbesztmentes rosszindulatú pleurális mezotelióma és léplimfóma együttes előfordulását még nem publikálták.
Abstract
Craving is a central feature of substance use disorders and disorders due to addictive behaviors. Considerable research has investigated neural mechanisms involved in the development and processing of craving. Recently, connectome-based predictive modeling, a data-driven method, has been used in four studies aiming to predict craving related to substance use, addictive behaviors, and food. Studies differed in methods, samples, and conceptualizations of craving. Within the commentary we aim to compare, contrast and consolidate findings across studies by considering conceptual and methodological features of the studies. We derive a theoretical model on the functional connectivity-craving relationships across studies.
Abstract
Background and Aims
Gaming disorder (GD) is a prevalent and complex issue that has recently been recognized as a condition that impairs mental health, underscoring the urgent need for early prevention measures. This evaluation study examined the effectiveness of the Digital Netizen Alliance (D.N.A.) program, a new multicomponent positive psychology program for preventing GD and bolstering mental wellness among Chinese children.
Methods
Drawing on gamification and positive psychology principles, the program builds four key positive skills collectively referred to as the P-A-G-E framework: psychological resilience, active coping, growth mindset, and emotion regulation. A randomized controlled trial was conducted with 264 primary school pupils attending fourth, fifth, or sixth grade in Hong Kong (63% female; mean age = 10.83, SD = 1.18).
Results
The findings revealed that participation in the program effectively promoted active coping, a growth mindset, and emotion regulation. Moreover, program participation alleviated GD symptoms and reduced negative affect. These desirable changes were fully explained by the P-A-G-E framework.
Discussion and Conclusions
The new D.N.A. program, which cultivates the positive psychology skills specified in the P-A-G-E framework, facilitates favorable psychological changes among children. These results emphasize the importance of using multicomponent frameworks for interventions targeting GD prevention.
A Hemophilia, s kiemelten a haemophilia A (HA) kezelése az elmúlt évtizedben jelentős változáson megy át. Az ígéretes hosszított hatású (EHL/UHL) PEGylált/Fc-fúziós készítmények, a bispecifikus-antitest terápia, a klinikai vizsgálatokban jól teljesítő nem-faktoralapú készítmények átrendezik a jelenlegi kezelési ajánlásokat. A legtöbb beteg azonban továbbra is a hatékony standard féléletidejű készítménnyel (SHL) folytatott profilaxist kapja, mely kezelés hátrányait az elmúlt évtizedben jelentősen javította a pharmakokinetikai alapú (PK), személyre szabott kezelés bevezetése. A mára rutinná vált PK meghatározások módszereit, a fontosabb klinikai vonatkázásokat, saját betegeink vizsgálatainak tanulságát tekintem át e rövid összefoglalóban elsősorban a haemophilia A tekintetében. A PK-meghatározás módszere, a személyreszabott kezelés az időközben jelentős teret nyerő hosszított hatású készítmények esetében is kiemelt jelentőséggel fog bírni.
A kék szem elkülönítő kórismei értéke
Differential diagnostic significance of the blue eye
Szerző röviden áttekinti az ún. kék ínhártya („blue sclera”) lehetséges okait, s azok közül a súlyos vashiányra két rövid esetet mutat be. Az áttekintés célja a kórelőzmény felvétel és a fizikális vizsgálat fontosságára ráirányítani a figyelmet nemcsak a ritka kórképek, de az egyik leggyakoribb kórállapot – a vashiány, illetve vashiány anaemia – esetében is.
120 éve született Szodoray Lajos bőrgyógyászprofesszor (1904–1980)
Lajos Szodoray dermatologist professor was born 120 years ago (1904–1980)
A biztonságra törekvő radikalitás helye, szerepe és dilemmái a pajzsmirigysebészet mindennapjaiban
Safety-driven radical approaches in routine thyroid surgery: roles and challenges
Introduction: In thyroid surgery, the primary objectives are to facilitate effective hormone replacement therapy and to prevent recurrent diseases. Thyroid lobectomy is often the optimal approach to achieve these goals. Objective: This study aims to establish the criteria for safety-driven radicality and identify the appropriate surgical approaches. Methods: A total of 2215 thyroid surgeries were performed between 2001 and 2003. Among these, 86.1% were uni- or bilateral lobectomies, and 12.3% were near-total resections. Substernal extension was observed in 28.9% of cases, and recurrent disease was found in 5.3%. Partial sternotomy was required in 1.8% of cases. Results: Of the 2215 thyroid specimens analyzed, 27.9% were tumors, 19.6% showed hyperplasia, and 18.1% exhibited inflammation. Among the 216 cases of papillary carcinoma, the occult form was present in 42.1%, encapsulated form in 30.1%, multinodular form in 26.4%, bilateral involvement in 12.5%, and mixed appearance in 8.3%. Lymph node involvement in the central region was detected in 41% of cases. Co-occurrence of tumors with Hashimoto’s thyroiditis was significantly more common than with hyperplasia. Transient laryngeal nerve paresis occurred in 3.3% of cases, while permanent paresis was observed in 0.49%. Discussion: Radicality in thyroid surgery aims to minimize residual tissue while ensuring the functional integrity of nerves and parathyroid glands. These objectives are challenged by tissue inflammation, cancer, substernal extension, recurrent disease, and undetected metastases in the central paratracheal lymph nodes. Our analysis of routine lobectomies with meticulous nerve preparation revealed a significantly higher incidence of recurrent laryngeal nerve paresis in cases involving recurrent disease. Conclusion: Maintaining blood-free surgical conditions, cooling the nerves during preparation, meticulous dissection of nerves at the superior pole of the thyroid, and experience in excising non-inflammatory thyroid tissue are crucial for achieving safety-driven radicality. These practices are effective not only in cancer cases but also in the presence of hyperplasia, inflammation, and recurrent disease. Orv Hetil. 2024; 165(39): 1548–1557.
Myeloma multiplexben szenvedő betegek túlélési eredményei a Semmelweis Egyetem Belgyógyászati és Hematológiai Klinikáján
Survival of patients affected with multiple myeloma at the Department of Internal Medicine and Haematology of Semmelweis University
Introduction: Survival in multiple myeloma has improved over the past two decades, mostly due to the emergence of new treatment options. Results from clinical trials, however, may differ from real-world experiences, underscoring the importance of collecting “real-world” data as well. Objective and method: We examined the clinical and survival data of all myeloma patients diagnosed at the Department of Internal Medicine and Haematology (formerly the 3rd Department of Internal Medicine) of Semmelweis University, between 2008 and 2021. We evaluated survival depending on the date of diagnosis and additional factors including the International Staging System, karyotype, presence of bone lesions, renal failure, and first-line therapy. Since 2013, myeloma patients have been looked after in a subspecialty clinic, which may also affect outcomes. Results: Overall, we diagnosed 284 patients in this period, with the annual number of diagnoses tripling in recent years. Treatment strategies underwent significant changes, with novel drugs replacing chemotherapy, increasingly administered in triple or quadruple combinations. The median overall survival (OS) for the entire group was 54 months, but it significantly varied based on the era of diagnosis: it was 35 months for patients diagnosed between 2008 and 2011, 44 months between 2012 and 2015, and 50 months between 2016 and 2019, respectively, with the most recent period post-2020 yet to reach the median. Conclusion: Our study confirms that the introduction of new drugs nearly doubled the expected median survival in real life as well. This improvement can be attributed, in part, to a significant reduction in early mortality (related to refractoriness and septic complications) in comparison to prior periods and also to the availability of more options at relapse. Additionally, we consider the accumulated experience, the unified approach to treatment and monitoring, and the availability of clinical trials in our dedicated myeloma clinic non-negligible factors in this improvement. Orv Hetil. 2024; 165(39): 1539–1547