Myelomás beteg 11 éves remissziót ért el másodvonalban adott lenalidomiddal – esetismertetés
Myeloma patient achieved 11 years of remission with second line lenalidomide
A myeloma multiplex egy rosszindulatú vérképzőszervi daganatos betegség, melynek kórlefolyását remissziók és relapszusok jellemzik. Egy betegünk kórtörténetét mutatjuk be, aki 5 évig kapott – klinikai vizsgálatban – másodvonalban lenalidomide + dexamethason kezelést és összesen 11 évig remisszióban volt. A beteg egy – szövettanilag nem verifikált – tüdődaganatban hunyt el, melynek kialakulásában inkább az erős dohányzás, kevésbé a tartós lenalidomide-kezelés játszhatott szerepet.
Abstract
Escherichia coli A382 was isolated in July 2024 from a positive blood culture obtained from the central venous catheter of a male patient undergoing chemotherapy at the Hospital of Volos, Thessaly, Greece. Whole-genome sequencing analysis revealed that the isolate A382 is E. coli belonging to the ST410 high-risk clone, which co-harbors the bla KPC-3 and bla SHV-182 genes on an IncX3 plasmid. It also harbors bla TEM-1 and has five replicons, as follows: IncX3, IncQ1, CoIRNAI, IncF1A, and IncFIB. Complete genome analysis revealed that E. coli A382 isolate carries a range of virulence factors (iutA, iucC, fimH, fdeC, yehA, yehD, yehC, yehB, cgs, ahha, ccI, hlyE, papC, irp2, fyuA, lpfA, and nlpl) and many other non-beta-lactam resistance determinants, including dfrA14 and sul2, but it is susceptible to aminoglycosides, nitrofurantoin, tigecycline, colistin and ceftazidime-avibactam. In conclusion in this study, we describe the phenotypic and genome characteristics of an extensively drug-resistant E. coli ST410.
Abstract
Background and Aims
This study sought to identify patterns of psychedelic use among American psychiatrists, to compare the demographic variables across categories of social proximity and personal use, and to determine how these categories influenced psychiatrists' attitudes towards drugs and people who use drugs.
Methods
Respondents (N = 180; mean age = 48.4 [SD = 16.2]; male = 65.5%; trainees = 24.1%) were recruited via email lists/listservs and personal networks (snowball sampling).
Results
Approximately one-third (32.8%) of psychiatrists reported Personal Connection (i.e., history of personal use and social connection) to psychedelics. Psychiatrists with Personal Connection to psychedelics were more likely to be younger (p = 0.006, ηp 2 = 0.057) and have fewer years of practice (p = 0.008, ηp 2 = 0.058). Almost all (92%) of those with No Connection to psychedelics were out of training, compared with only 8% of those in training. Those with Personal and Social Connection to psychedelics were more likely to disagree: that using illegal drugs is morally wrong (p < 0.001, ηp 2 = 0.28), that illegal drug users should go to prison (p < 0.001, ηp 2 = 0.15), are weak minded (p < 0.001, ηp 2 = 0.10), have no future (p < 0.001, ηp 2 = 0.12), are not well educated (F(2.0, 170) = 7.38. p < 0.001, ηp 2 = 0.08), are dishonest (p < 0.001, ηp 2 = 0.10), and that illegal drug users ‘make me angry’ (p < 0.001, ηp 2 = 0.10).
Conclusions
Personal and social connection to psychedelics is associated with decreased stigma towards drug use and people who use drugs. Future research should examine whether proximity to psychedelic use impacts other factors (e.g., empathy, therapeutic alliance) involved in psychiatry training and practice.
Hírek a hematológia világából
News from the world of hematology
Abstract
This article presents a rare case of intra-articular chondroma of the wrist joint diagnosed with the help of MR arthrography.
Állkapocsízületi diszfunkció kezelése skeletalis horgonylattal kombinált fogszabályozással
Skeletal anchorage combined orthodontic treatment of temporomandibular disorder
Temporomandibular disorder is the most common form of orofacial pain. Today it affects 15% of the adult population and 7% of adolescents. It is characterised by pain originating from the muscles and/or the temporomandibular joint and vocal symptoms accompanying jaw movements, as well as muscle fatigue, lockjaw and tooth wear. Chronic pain due to jaw dysfunction can lead to the deterioration of the patient’s psychological state and negatively affect their quality of life. As the temporomandibular joint is closely related to dentition, any modification of the existing bite must be taken into account from gnathological aspects. Orthodontic treatment can also be seen as a guided change of occlusion, and therefore the greatest possible attention should be paid to maintaining the stability of the temporomandibular joint (orthopaedic stability) when planning treatment, as this is closely related to joint health. If gnathological considerations are not met during treatment planning, altered bite position may lead to craniomandibular dysfunction; on the other hand, restoring stability may be an effective way to reduce symptoms. The aim of our case presentation and brief summary of the literature is to provide an overview of the pathology of temporomandibular joint complaints due to orthopaedic instability, the characteristics and symptomatology of stable and unstable occlusion, and the possible prevention and therapeutic options for temporomandibular joint dysfunction. Orv Hetil. 2024; 165(37): 1472–1477.
A cochlearis implantátumok fejlesztési iránya a perimodiolaris diszkriminációs elhelyezkedés korrekciójára
Direction of cochlear implant developments used for the correction of perimodiolar discrimination location
Introduction: Cochlear implant is a hearing enhancement device that directly stimulates nerve cells with electrical impulses. The optimal placement of the implanted electrode array is crucial for device wearers. Numerous domestic and international studies have confirmed a significant correlation between the quality of restored electrical hearing after surgery. During optimal implantation, electrodes are placed as close as possible to the spiral ganglion cells, allowing for more focused stimulation to improve speech perception and speech intelligibility. Objective: Our aim is to investigate the positioning of the electrode array and optimize the smallest distance to the cochlear midline. Additionally, we analyze the favourable position virtually and digitally redesign the shape of the inserted electrodes. Method: For our research, we analyzed the positioning results of 10 perimodiolar implanted electrode arrays. The results of intraoperative imaging procedures were compared with electrophysiological methods (impedance, neural response telemetry examination). Results: Based on our measurements, we compared virtually created electrode arrays with differentially deformed basal segments (0°, 15°, 30° and 45°). Electrophysiological and imaging techniques confirm that the electrode array is in a more favourable position when it is closer to the cochlear midline. Conclusion: The repositioning of the reshaped electrode array can have a drastic impact on future speech perception, speech quality, and device energy consumption. Orv Hetil. 2024; 165(37): 1452–1460.
A digitális 3D tomoszintézises mammográfia az emlőrák diagnosztikájában és szűrésében
Digital 3D tomosynthesis in the diagnosis and screening of breast cancer
Breast cancer mortality and morbidity are significantly reduced with the introduction of the mammography screening program. From the point of view of complete recovery, there is an extremely high demand for early detection. Digital 3D tomosynthesis is a complementary modality to digital mammography (full-field digital mammography – FFDM), which has been accepted by the FDA since 2011, and is well suited for the diagnosis of breast diseases and breast screening. Basic principle of digital 3D tomosynthesis: during the examination, an x-ray tube moving in a given circular arc takes 10–15 overlapping digital images of the breast – with a small dose of radiation – in a short time. From the data set obtained in this way, thin-slice layer images (3D tomosynthesis) and reconstructed, so-called synthetic 2D images – similar to the traditional mammographic image – are also produced. In addition to the advantages (higher cancer detection rate, more accurate assessment of abnormal patterns, structural distortion, asymmetric density, reduction of the number of unnecessary biopsy, decreasing recall rate in screening), knowing the dilemmas related to the disadvantages (e.g., radiation exposure, need for larger storage space) is also important. Orv Hetil. 2024; 165(37): 1443–1451.
