Browse our Medical Journals - AKJournals
Among all scientific traditions alive, medical publishing has a good chance to be the oldest. The first fully peer reviewed academic journal, “Medical Essays and Observations” was launched in 1731 by the Royal Society in Edinburgh. Since then, hundreds of medical journals have been published worldwide. Medical publication in Hungary started in 1857 when the famous physician, Markusovszky founded “Orvosi Hetilap”, which has been published since then every week (with short breaks during the world wars). It is now a most prestigious piece in AKJournals’ portfolio, listed in Journal Citation Reports, with a remarkable impact factor.
Medical and Health Sciences
Abstract
Purpose
The study was designed to evaluate the feasibility of a future full-scale randomized clinical trial (RCT) of the Alice Program, a body awareness therapy, based on the integrability of this approach into oncological rehabilitation, as well as the impact of the Alice Program on managing the adverse consequences of cancer and cancer therapy and improving the health literacy of breast cancer survivors.
Materials/methods
We conducted a single-arm, before-and-after feasibility study with pre- and post-treatment assessment of shoulder and trunk mobility, balance, and health-related quality of life, as well as a 5-year follow-up to assess patient experiences with the Alice Program. Feasibility outcomes included recruitment scope, adherence to the Alice Program, adverse events, and program structure. Twenty-nine women with breast cancer aged between 32 and 65 were included in the study. The Alice Program was conducted at the Rehabilitation Department of Uzsoki Hospital in Budapest.
Results
Ineffective patient recruitment is the biggest obstacle to conducting a future RCT. Patients' experiences demonstrated the acceptability of the Alice Program, and the assessed variables indicated the effectiveness of the Alice Program in a small sample of breast cancer survivors.
Conclusions
Although the findings suggest that it is feasible to conduct a future full-scale RCT of the Alice Program for breast cancer survivors, some changes are needed – for example to the recruitment strategy, selection criteria, and program structure – to optimise the time efficiency ratio.
Abstract
Chromatophoromas are neoplasms arising from pigment cells (chromatophores) and commonly manifest as cutaneous lesions. While brown to black melanophoromas are most prevalent in reptiles, sporadic cases of non-pigmented chromatophoromas have been reported. This case study documents the clinical presentation, histopathological features and IHC (IHC) profile of an oral non-pigmented chromatophoroma in a 13-year-old male savannah monitor (Varanus exanthematicus). Histopathological examination revealed a poorly demarcated tumour located in the mucosa. Non-pigmented neoplastic cells with marked anisocytosis, anisokaryosis, increased nuclear-cytoplasmic ratio and numerous mitotic figures formed solid packets separated by collagenous septa. IHC analysis revealed that tumour cells were positive to melan-A, S100 protein, neuron-specific enolase and cytokeratins AE1/AE3. Based on the histopathological and IHC findings, the tumour was diagnosed as a non-pigmented chromatophoroma. Detailed histopathological and IHC profiling enhances our comprehension of the diversity within chromatophoromas and underscores the diagnostic complexities involved. Immunohistochemistry is a crucial tool for identifying non-pigmented chromatophoromas.
A dohányzás és az emésztőszervi betegségek
Smoking and the digestive system
Smoking is considered to be the most important form among those that harm our health. Nicotine in itself as an additive can build a very strong addiction, but the main health damage is caused by the thousands of chemical components present in the tobacco cigarettes and the smoke, some of them being proven and known carcinogens. It is well known that the risk of lung cancer is at least 16 times higher among smokers, but several other disorders also in the digestive tract have strong connection to smoking. This review tries to collect the most important information regarding upper gastrointestinal disorders like peptic ulcer formation, chronic inflammatory disorders, including inflammatory bowel diseases and diverticulitis, circulatory disturbances and malignant disorders of the gastrointestinal tract. Orv Hetil. 2025; 166(18): 697–703.
Endovascularis aortaaneurysma-rekonstrukciót követő endoleak-karakterizálás dinamikus CT-angiográfia segítségével
Endoleak characterization after endovascular aortic aneurysm repair using dynamic CT angiography
Introduction: Accurately characterizing the types of endoleaks following endovascular aneurysm repair (EVAR) can often be challenging with standard triphasic CT angiography. Dynamic CT angiography is a relatively new CT imaging technique that may enable more precise characterization of endoleaks following EVAR. Method: Between January 2022 and January 2023, dynamic CT angiography acquisitions were performed on 15 patients following EVAR due to uncertain etiology of endoleaks or growing aneurysms using a Philips Brilliance iCT 256 scanner. Depending on the region of interest and the presumed type of endoleak, 12–18 image series were recorded during the examinations, with a 16 cm cranio-caudal coverage and intervals of 4.4 seconds, or 8 cm coverage with intervals of 0.8–2 seconds. The dynamic CT angiography image series were analyzed using the Philips IntelliSpace Portal Functional CT software based on the temporal changes in Hounsfield units in selected regions of interest. Results: Average age was 74.7 ± 9.3 years, with 10 males and 5 females among the patients. Following precise identification of arteries causing retrograde perfusion, two cases previously classified as Type V endoleaks were reclassified as Type II. In five cases with known Type II endoleaks, dynamic CT angiography identified that the inferior mesenteric artery and/or lumbar arteries were the main perfusion sources. In seven cases where endoleak types could not be clearly determined in previous examinations, exact types of endoleaks were successfully identified. In one case, a Type II endoleak from the inferior mesenteric artery was suspected during EVAR follow-up CT angiography, however, subsequent dynamic CT angiography showed no endoleak and an occluded inferior mesenteric artery. Conclusion: The dynamic CT angiography can serve as a promising adjunct to standard triphasic CT angiography examination following EVAR for characterizing difficult-to-diagnose endoleaks and aiding in the planning of future targeted therapeutic interventions. Orv Hetil. 2025; 166(18): 704–709.
Hogyan lehetne mérsékelni a szakmailag nem megalapozott gerinc-MR-vizsgálatok számát?
How could the spine MR investigations without correct indications be reduced?
Introduction: Spinal pain and radiculopathies are often caused by degenerative changes, which are common indications for spinal MR imaging. The detection of disc degeneration, disc protrusion/herniation, spinal canal stenosis and small joint arthrosis, as well as pathological processes affecting the vertebrae and spinal space may require MR examination. Objective: Certain conditions clearly justify the imaging of the spine by MR, for which it is recommended to refer patients based on specific criteria systems. Method: In our hospital, 2105 such examinations were performed in 2023, which were evaluated individually by reviewing the referral criteria and the results. Results: In our hospital, referrals for spinal MR examinations were given by specialists in various fields. In 87% of cases, no neurological cause was proven, and the imaging studies did not show any clinically relevant abnormalities requiring surgical intervention. As a result, our waiting list stretched for several months due to the many “unnecessary” examinations, and in many cases the “14-day rule” for cancer patients was also violated. Discussion, conclusion: Physicians should be encouraged to follow the rules laid down by the profession, by applying these, waiting lists and the costs of care can be reduced, and it would be easier to ensure timely care for truly urgent patients. Orv Hetil. 2025; 166(18): 710–716.
A SARS-CoV-2-fertőzés iránti fogékonyság és a súlyos COVID–19 hátterében álló genetikai tényezők
Genetic factors underlying the susceptibility to SARS-CoV-2 infection and severe COVID–19
The clinical manifestations of coronavirus disease (COVID–19) are highly variable, ranging from asymptomatic cases to life-threatening complications and death. Severe disease progression is more common in older individuals and males, as well as in the presence of various comorbidities. Beyond these risk factors, the intrinsic characteristics of the virus and the host genetic factors also contribute to the heterogeneous clinical course of COVID–19. Genetic research is fundamental in understanding the biological mechanisms underlying congenital diseases, identifying the genes and proteins responsible for the susceptibility to various inherited conditions, recognizing therapeutically relevant targets, suggesting drug repurposing, and clarifying causal relationships for modifiable environmental risk factors. Although these studies typically take a long time to conduct, especially to translate their findings into clinical practice, the scientific community has swiftly uncovered genetic signals underlying the diverse COVID–19 phenotypes. In this review, in addition to a concise summary of SARS-CoV-2 recognition and the initial steps of the immune responses, we aim to provide an overview of the literature concerning the genetic factors associated with susceptibility to the disease and its severe progression. We also review the pioneering research in identifying the affected genes and the most significant genome-wide association studies, covering both common and rare genetic variants, which have greatly contributed to understand the etiology of the disease and have guided effective COVID–19 treatment during the most challenging times. Orv Hetil. 2025; 166(18): 679–696.
Abstract
Purpose
This study investigated public perception of environmental risks, with a focus on domestic heating in Hungarian villages, and explored associations between risk perception and education, livelihood, gender, and other socio-economic factors by means of a questionnaire survey.
Materials/methods
Using standardised questionnaires, 533 participants were interviewed in small villages in Hajdu-Bihar County. The collected data were processed using Excel and RStudio software for statistical analysis. The chi-square test and logistic regression were used to examine the relationships between risk perception and socio-economic factors.
Results
The study found that public perception of risk in relation to environmental hazards – in this case, air pollution from domestic heating and nuclear power – was often irrational. The Hungarian nuclear power plant (located at least 180 km from the study sites) was incorrectly assumed to be a source of air pollution, while emissions from domestic heating were underestimated. Logistic regression analysis indicated significant associations between risk perception and factors such as education, livelihood, and gender (expressed as odds ratios and 95% confidence intervals). Education was both positively and negatively associated with certain risk factors. Higher economic status was associated with the perception of air pollution as a health risk. Women generally perceived the risks as more serious than men did.
Conclusions
The results of the study highlight the importance of understanding and addressing risk perception among the general public in rural Hungary in the context of environmental health risks. A targeted risk communication strategy is necessary to overcome bias in risk perception.
Abstract
This study aimed to identify yeast species in healthy Anatolian buffaloes and those with subclinical mastitis on smallholder farms using the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS) method and assess antifungal resistance. Milk samples from 390 udder lobes of 100 buffaloes were tested and California Mastitis Test (CMT) results showed 265 negative, 102 suspicious and 23 CMT ≥+1 lobes. A total of 76 yeast isolates (19.5%) were obtained through classical culture methods. MALDI-TOF MS identified seven genera, with the most common species being Pichia kudriavzevii (54%), Kluyveromyces marxianus (21%) and Nakaseomyces glabrata (10.5%). Antifungal resistance was determined by the disk diffusion method, showing the highest resistance to caspofungin (69.7%), followed by fluconazole (65.8%) and ketoconazole (31.6%). This study highlights the presence of diverse yeast species in buffalo milk, emphasizing the importance of understanding their role in mastitis and antifungal resistance for animal and public health. To our knowledge, this is the first study showing the identification of different yeast species isolated from Anatolian buffaloes in smallholder dairy farms in Turkey.
Abstract
Gastrointestinal nematodes (GINs), such as Ostertagia ostertagi and Cooperia spp., are common in cattle worldwide. Although infected cattle are often asymptomatic, production is negatively affected. The present study investigated whether eggs per gram (EPG) of GINs in 32 lactating cows decreased during winter and increased as it became warmer. Larvae recovered by coprocultures mostly consisted of O. ostertagi in autumn, while three GINs, Ostertagia, Trichostrongylus and Meistocirrus, were collected in spring. Daily milk and bulk tank milk samples from cows previously infected with O. ostertagi contained O. ostertagi antibodies based on ELISA developed using SVANOVIER® O. ostertagi-Ab in all survey periods. Even if the faecal diagnosis was negative for GINs, infection was still possible. Therefore, the administration of anthelmintic drugs is recommended.
Abstract
Background and aim
The present study stems from the need to deepen knowledge regarding understanding the psychological mechanisms underlying Love Addiction (LA) and investigate the role of attachment style as a theoretical framework. We conducted a systematic review of the literature and a meta-analysis of the investigated topics to achieve this objective.
Method
Five databases (PsycINFO, PsycARTICLES, MEDLINE, Scopus, and Web of Science) systematically searched for studies that analyzed the relationship between LA and attachment dimensions, published in all years until September 23, 2024.
Results
Overall, we found 27 studies; of these, we included 15 in the meta-analysis, with 3,628 participants. The analyses were conducted using the test of heterogeneity, effect dispersion, and moderator analysis (gender, age, research continent, quality of the studies, and types of attachment instruments). A significant and positive relationship (r = 0.39, p < 0 .05) was observed between Love Addiction and anxious attachment, while a significant and negative relationship was found with avoidant attachment (r = −0.09, p < 0.05).
Conclusions
The systematic review and meta-analysis provide an important starting point for understanding and operationalizing the construct. The association with attachment styles allows postulating the relational nature of Love Addiction, differentiating it from other addictions. In addition, the association with anxious and avoidant attachment shows promise in understanding Love Addict subtypes.
Abstract
Background and Purpose
In the field of medicine, artificial intelligence (AI) is emerging as a promising tool. In this paper, we present our experience with the integration of commercially available AI-based software into our radiotherapy contouring workflow. We also analyzed the accuracy of the automated segmentation system.
Methods and Materials
We analyzed contours of 19 anatomical regions from 24 patients. Comparisons between AI-generated and human-generated contours were made based on volume, Dice coefficients, and contour center of mass shifts.
Results
The data indicate that there are minimal differences between AI-generated and human-generated contours, such as those of the lungs. The volume differences are relatively minor <1 cm3 (P > 0.05). Nevertheless, for certain organs, such as the small intestine, there can be considerable discrepancies, as the AI delineates the entire organ, in contrast to the RTT. Variations of volumes (bowels) > 300 cm3. The AI completes the contouring process in approximately 2 min, whereas human experts take up to 1 h to create the structures for a given region.
Conclusion
The workflow can be highly automated and standardised, resulting in significant time savings. A consistent level of quality can be maintained, regardless of RTT experience. The results are comparable to those reported by Doolan et al.
Abstract
Background and aims: With surges in digital technologies, concerns over adolescents' screen use have intensified. Previous studies often relied on self-reported screen time, neglecting the experiential and motivational aspects of different screen activities (e.g. social media, gaming, and smartphones), possibly leading to heterogeneous associations. This study aimed to examine whether the severity of problematic screen use, conceptualized as a continuous measure of screen-related functional impairment, plays a more central role in development than self-reported screen time or phone-checking frequency, and to explore its influence within the broader adolescent ecosystem (i.e. family conflict, peer involvement, and school participation). Methods: Cohort data were obtained from the Adolescent Brain Cognitive Development (ABCD) study Release 5.1. Screen use was obtained from self-report questionnaires, capturing both activity time and functional impairments. Among cross-sectional networks derived from 9,054 youth (4,272 girls, 47.18%) at 2-year follow-up (T2, ages 11–12 years) and 4,007 youth (1,896 girls, 47.32%) at 4-year follow-up (T4, ages 13–14 years), problematic use showed higher centrality than screen time and checking behavior, owing to stronger connections with behavioral tendencies. Cross-lagged-panel-network analyses of problematic use included 3,954 youth (1,863 girls, 47.12%). Results: Problematic use exhibited high out-strength, which was associated with worsening psychopathologies and environmental conditions. Conversely, problematic use at T4 appeared less influenced by factors at T2. Conclusion: This study underscores the pivotal role of problematic screen use, which showed greater centrality and stronger predictive effects on adolescent well-being than self-reported screen time, highlighting the need for policies and interventions addressing screen-related functional impairments to promote healthier screen habits in developing youth.
Abstract
Background and aims
The shift from goal-directed to habitual control is a well-documented phenomenon in addiction research and is considered a critical factor in the development and maintenance of addictive behaviors. Whether Internet Gaming Disorder (IGD) is also associated with such a shift is not yet clear. The current study investigated the imbalance between goal-directed and habitual control in individuals with IGD.
Methods
Goal-directed and habitual control, as informed by model-based (MB) and model-free (MF) learning, were assessed with a two-step sequential decision-making task during functional magnetic resonance imaging (fMRI) in 33 young adults with IGD and 32 healthy controls (HCs). Self-report data regarding addictive symptoms, game craving, and impulsivity were also collected.
Results
Individuals with IGD relied more heavily on habitual control to guide subsequent choices compared to HCs. According to a hybrid reinforcement learning model, individuals with IGD also exhibited a reduced MB weight related to HCs, which was correlated with more severe addictive symptoms. fMRI results revealed that individuals with IGD showed increased MF reward prediction error (RPEMF) signals in the right triangular part of the inferior frontal gyrus (IFG). No significant group differences were found in the contrast of RPEMB maps.
Discussion and conclusions
Our study provides both behavioral and neural evidence highlighting an imbalance between goal-directed and habitual control, favoring habitual control in individuals with IGD. This imbalance is associated with the severity of addictive symptoms, suggesting an indication of habit inclination in IGD could potentially contribute to the development or maintenance of the addiction.
Abstract
The proliferation of hostile behaviors among players in online multiplayer video games has become a growing concern in recent years. Toxic behaviors negatively impact individual and team performance, diminish game enjoyment, and risk the psychological well-being of gamers. This paper overviews current scientific knowledge on the manifestations and characteristics of this phenomenon, provides a taxonomy of the various behaviors, and outlines future research directions. The authors suggest that further research needs to focus on a deeper understanding of the mechanisms underlying toxicity. Prevention and intervention efforts are crucial to reduce the harms associated with engagement in toxic interactions and to improve the safety and inclusivity of online gaming environments.
Abstract
Background and aims
Online shopping has become a primary form of consumption in daily life, inevitably accompanied by the emergence of problematic online shopping. Attentional bias towards online shopping cues influences individuals' online shopping behavior. This study examined attentional bias mechanisms in problematic online shoppers using two experiments.
Methods
This study combines the dot-probe task and eye-tracking technology to explore attentional bias and temporal dynamics toward shopping-related cues among problematic online shoppers. Experiment 1 recruited 84 participants to investigate attentional bias toward proximal cues, while Experiment 2 recruited 76 participants to examine attentional bias toward distal cues.
Results
The results of Experiment 1 showed that both problematic online shoppers and control individuals exhibited shorter first fixation latency, longer gaze duration, and total fixation duration toward proximal cues. And only problematic online shoppers exhibited slower first exit saccade velocity and average exit saccade velocity. The results of Experiment 2 indicated that problematic online shoppers exhibited longer gaze duration and total fixation duration, as well as faster first entry saccade velocity toward distal cues.
Discussion and conclusions
In summary, problematic online shoppers exhibit similar attentional bias toward both shopping proximal and distal cues, which are presented as the vigilance-maintenance pattern. For problematic online shoppers, distal cues have gradually acquired incentive value comparable to that of proximal cues. However, it should be noted that control individuals also exhibited attentional bias toward proximal cues.
„Fehérköpenyes gyilkosok.” Sztálin utolsó gaztette, a cionista orvosper
“Killers in white coat”. Stalin’s last crime, the plot against the Zionist doctors
Felnőtt betegek farmakokinetikai-farmakodinamikai célértékek segítségével vezérelt intravénás kezelése vankomicinnel
Intravenous vancomycin therapy of adults guided by pharmacokinetic-pharmacodynamic targets
Multidrug-resistant pathogens and those with extended antimicrobial resistance significantly burden the healthcare system. The introduction of anti-infective therapy protocols that flexibly ensure effective treatment and the suppression of the evolution of resistant strains of pathogens has become an urgent task. Therapeutic drug monitoring (TDM), which has recently developed into a multidisciplinary field, makes a significant contribution. Vancomycin is used worldwide in inpatient wards for suspected or documented infections caused by Gram-positive pathogens. The currently generally accepted consensus recommendation for the treatment of severe MRSA infections with vancomycin presents in detail the aspects of the clinical use of the drug in addition to TDM for different patient populations (critically ill, obese, and patients receiving renal replacement therapy). Based on existing guidelines and available calculator software, treatment can be individualized from its most critical early stage. We aim to summarize the views and recommendations formulated in the consensus guideline, integrate these into subsequent scientific publications, and facilitate their clinical implementation to take us closer to a harmonized practice in Hungary. We also aim to present the perspectives of using vancomycin pharmacokinetic calculators. Finally, we make methodological recommendations for individualized decisions regarding vancomycin therapy in adult care. Orv Hetil. 2025; 166(17): 638–651.
A neonatológiai ellátás mennyiségi és minőségi mutatói a Maternity Szülészeti és Nőgyógyászati Magánklinikán 2023-ban
Quantitative and qualitative indicators of neonatological care at the Maternity Private Obstetric and Gynecologic Hospital in 2023
Introduction: In recent years, as a result of the structural and legal changes observed in the healthcare system, private healthcare has received increasing emphasis, therefore a significant increase in the annual number of births was observed at the Maternity Private Clinic. From the very beginning, the basic aim of the Clinic is to provide high-level obstetric and perinatological care based on professional protocols for all patients, regardless of patient turnover. Objective: The purpose of the current study is to analyze and summarize the neonatological quantitative and qualitative indicators of the Maternity Private Clinic in 2023. Method: In our retrospective study, data of newborn infants born between 1st of January 2023 and 31st of December, 2023 were analyzed and relevant results are presented in graphs. Results: In 2023, 1,461 newborns were born at the Maternity Private Clinic, the vast majority of newborns were in the 38–39. gestational week (n = 1010, 69%). 34 newborns were born before the 37. week of pregnancy (5 of them were premature at 35 weeks). The rate of cesarean sections was 78%. 92% of the newborn infants were discharged after two or three days after an uneventful hospitalization. 71% (n = 1027) of all newborn infants received exclusive breastfeeding on the day of discharge. 85 newborn infants received phototherapy due to neonatal jaundice, the vast majority of treatments took 1–2 extra days. In the examined period, antibiotic treatment was started for a total of 12 newborns due to suspicion of neonatal sepsis, of which 5 newborn infants received a complete 5-day antibiotic therapy course. In 32 cases, NCPAP (nasal continuous positive airway pressure) respiratory support was necessary in the neonatal ward due to respiratory problems and in 15 of these cases we were able to successfully discontinue the respiratory support after a few hours of treatment, transfer was necessary in 17 cases. Of the 1,461 newborns, altogether only 36 (2.4%) required transfer to a Level 2 or 3 neonatal intensive care unit. Two newborn neonates had congenital anomaly (one ventricular septal defect and one hypospadias). No newborn infant died in our department. Discussion: The neonatal care model of the Maternity Private Clinic is in accordance with the requirements of the 21th century, taking into account patient safety, it operates on the basis of professional protocols and provides newborn infants and families with an undisturbed, safe environment for the initiation of the mother-newborn relationship and breastfeeding during the first hours and days after birth. Orv Hetil. 2025; 166(17): 658–668.
A szituációs syncope speciális formája: a pertussis által kiváltott kollapszus
A special form of situational syncope: pertussis-induced collapse
Pertussis, caused by Bordetella pertussis, is a severe respiratory infection which can lead to syncope as a rare but significant complication. This article provides a detailed overview of the pathophysiology, classification, diagnostic, and therapeutic challenges of pertussis-induced cough syncope and also highlights the risk of delayed diagnosis through a case presentation. The increased intrathoracic pressure during coughing episodes can lead to transient cerebral hypoperfusion and loss of consciousness, especially in elderly patients or in those with comorbidities. Autonomic nervous system dysfunction caused by the pertussis toxin may also contribute to the loss of consciousness. Accurate diagnosis relies on detailed history taking and targeted investigations, while appropriate antibiotics and vaccination are pivotal for management and prevention. Orv Hetil. 2025; 166(17): 652–657.
Abstract
Background and Aims
This systematic review examines the association between psychedelic use and enhanced life purpose and meaning, as assessed by the Meaning in Life Questionnaire (MLQ) and the Purpose in Life Scale (PILS). Interest in psychedelics' therapeutic potential has grown, with some studies suggesting that these substances encourage meaningful psychological insights that contribute to well-being. This review aims to determine whether psychedelics positively impact users' sense of life purpose.
Methods
Following PRISMA guidelines, using specific search terms, a comprehensive search was conducted in databases, including PubMed, PsycINFO, Scopus, and Google Scholar. Eligible studies were those examining psychedelics such as psilocybin, LSD, and ayahuasca and that reported results from MLQ or PILS. Studies were screened independently, and a narrative synthesis approach was adopted due to heterogeneity across designs.
Results
Seven studies met the inclusion criteria, encompassing clinical, ritualistic, and recreational settings. Overall, results indicate a generally positive association between psychedelic use and an enhanced sense of life purpose, particularly in structured clinical or ritual contexts. Recreational use produced mixed outcomes; however, intentional use combined with mindfulness practices was linked to greater life meaning.
Conclusions
Psychedelics, particularly in structured settings, may enhance life's purpose. The evidence supports moderate certainty regarding these effects, though further randomized controlled trials are needed to clarify the role of specific contextual and individual factors in moderating these outcomes. These findings suggest potential applications in clinical settings for enhancing psychospiritual well-being.
Abstract
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is one of the major Gram-negative bacteria in human infections, which can cause pneumonia, sepsis, meningitis, and abscess. However, the current therapy for CRKP infection is polymyxin and tigecycline. The aim of this study is to analyze the in vitro antibacterial effects of cefoperazone/sulbactam (SCF) combined with ceftazidime (CAZ), imipenem/cilastatin (IMI), and meropenem (MEM) against CRKP harbouring different antibiotic resistance genes. In this study, fifteen clinical isolates of CRKP from January to December 2023 were taken from our hospital for bacterial identification and confirmation of carbapenemase genotypes, and the minimum inhibitory concentration (MIC) of SCF, CAZ, IMI, and MEM were determined by broth microdilution method. The results of combined drug sensitivity test were determined by checkerboard method and characterized with fractional inhibitory concentration (FIC). The combined antibacterial activity was determined by time-kill curve. The results showed that among the 15 CRKP strains, 9 carried bla KPC gene, 3 carried bla NDM gene and 3 carried bla OXA-48-like gene. The MIC values determined by broth microdilution method showed better sensitivity of KPC-producing CRKP to four antimicrobial drugs including SCF. However, bla NDM as well as bla OXA-48-like genotypes showed strong resistance to all four antimicrobial drugs. The FIC values of SCF combined with CAZ, IMI and MEM showed that all tested antibacterial agents had the best effect on KPC-producing CRKP, and had no obvious additive effect on other CRKP. The results of time-kill curve showed that SCF combined with IMI had good antibacterial effect. This study found that SCF combined with IMI has a synergistic antibacterial effect on KPC producing carbapenem-resistant K. pneumoniae, which could provide reference for clinical practice.
Abstract
Background
Research has shown that psychedelics may have therapeutic potential in treating mental disorders like depression and anxiety. However, the mechanisms and actions underlying their effects are still not fully understood. Similarly, while the significance of mindset and setting in shaping psychedelic experiences and therapeutic outcomes is well established, information about the influence of the body is comparatively scarce.
Aim
This paper introduces the concept of bodyset, defined as the state of the body, including both the body and brain. We suggest it as a vital element in preparing for psychedelic experiences and beyond, broadening the traditional ‘set and setting’ framework.
Methods
Through an extensive literature review, we demonstrate the likely importance of the body in wellbeing, peak performance and peak experiences.
Results
Comprehensive multidisciplinary research, particularly focusing on various biomarkers, is needed to elucidate the potential role of bodyset in the psychedelic experience and therapy outcomes, and to guide future treatment approaches for mental health disorders.
Conclusion
Our exploration of the bodyset concept emphasizes the importance of considering not only psychological and environmental factors (mindset & setting), but also the physical state of the body in preparation for psychedelic experiences and psychedelic therapy. This holistic perspective may enhance our comprehension of their effects, therapeutic potential and inform the application of other treatment modalities, such as breathwork, in mental health care.
Abstract
Background and aims
Researchers have suggested that subtypes of problematic social media use (PSMU) should be identified for purposes of prevention and intervention. However, most studies have overlooked the heterogeneous characteristics of PSMU trajectories, and no research has systematically examined which interpersonal factors could predict these trajectories. In the present study, we identified classes of developmental trajectories of PSMU and examined differences across classes in adolescents' interpersonal functioning in family, school, and peer contexts.
Methods
Participants were 357 Chinese adolescents enrolled in two middle schools in China (52.1% girls, aged 12–15 years). The students completed questionnaires in their classrooms over the course of one year in a three-wave longitudinal study.
Results
Latent growth mixture modeling (LGMM) revealed three developmental trajectory classes of PSMU based on the intercepts and slopes of PSMU scores over time: high risk-gradual increase group (37%), low risk-sharp increase group (39%), and low risk-stable group (24%). Parent-adolescent attachment (family context), teacher-student relationships (school context), and deviant peer affiliation (peer context) were associated with variations in developmental trajectories.
Conclusions
The findings can inform the design of prevention and intervention programs for specific subgroups of adolescents who show problematic social media use.
Abstract
Background and aims
Improved outcomes for substance use disorders have been described following non-clinical (“naturalistic”) psychedelic use. This exploratory study aimed to describe the naturalistic psychedelic experiences of people with substance use concerns and their reported needs and perceived utility of psychosocial support following naturalistic psychedelic use to integrate experiences and achieve positive change. We also explored preferred formats of delivery of integration support to inform future co-design processes necessary for developing new services.
Method
English-speaking participants aged ≥18 years, who were concerned about their substance use and had consumed a classical psychedelic (i.e. psilocybin, lysergic acid diethylamide (LSD), N,N-Dimethyltryptamine (DMT) or Ayahuasca, mescaline) at least once in the past year, were recruited online for a 10–20-minute survey. Questions explored experiences of psychedelic use and perceptions of the need for and models of integration support. Data were analysed descriptively.
Results
Of 108 participants, 94 (87.0%) thought that integration support following naturalistic psychedelic experiences would have been useful, with the majority of those interested (n = 61, 64.9%) endorsing a model of individual support, led by a psychologist (n = 63, 67.0%) or peer worker (n = 55, 58.5%) with lived experience of psychedelic use, and primarily focusing on how to apply the insights gained during the psychedelic experience into life (n = 68, 63.0%).
Discussion
In our sample of participants with substance use concerns, potential benefits of psychosocial support following naturalistic psychedelic experiences were identified. These findings could be complemented with a qualitative exploration of the desire for integration support following naturalistic psychedelic experiences.
Az Egészségügyi Tudományos Tanács feladatai, funkciója a magyar kutatásetikai közigazgatás kialakításában
The tasks of the Hungarian Medical Research Council, its function in the development of the Hungarian research ethics public administration
The Medical Research Council (ETT) is the legal successor of the National Public Health Council, founded in 1868. It is an advisory body of health government. It consists of professionals and has become an organization operating committee. Currently, the ethical tasks of the Council are the most important, the research ethics committees with national competence, performing various tasks, such as administering TUKEB (Scientific and Research Ethical Committee), KFEB (Clinical Pharmacological Ethical Committee), HRB (Human Reproduction Committee), REKEBET (Board of Chairmen of Regional Research Ethical Committees), and OEB (National Ethics Committee). Two codes: the Code of Bioethics published by the ETT in its third edition in 2022, and the Code of Medical Ethics also created by the ETT in 2023, contain the systems of criteria for the decisions of research ethics committees and medical ethics boards, respectively. In addition, the ETT is the operator of the ISZT (Forensic Expert Board working in the health area). The paper mainly presents the specifics of scientific clinical research in medicine, its distinguishing features from other scientific fields, the international aspects of research ethics public administration and its historical development, as well as the history of research ethical committees in Hungary. The ETT represents the internationally accepted professional-ethical values and norms; their basis is the interest and safety of patients. Orv Hetil. 2025; 166(16): 599–605.
Az érzelmi evés és a rágódás kapcsolata
The relationship between emotional eating and rumination
While the prevalence of overweight and obesity is increasing in developed societies in both adults and children, prevention and treatment are insufficiently successful. Therefore, it is crucial to explore obesogenic eating behaviors and their background as comprehensively as possible. Emotional eating is a learned coping strategy for alleviating negative emotional states caused by psychosocial stressors, which, in addition to predisposing to obesity, is one of the biggest intrapersonal obstacles to effective weight control. The tendency to emotional eating is related to rumination. Rumination can be defined as perseverative thinking, which involves a repetitive, passive focus on the feeling of distress and its possible causes and consequences. Ruminative thoughts are difficult to control, disrupt cognitive functioning, and may be associated with emotional dysregulation and more intensive negative emotions. In this study, we review the studies supporting the relationship between emotional eating and rumination and formulate practical recommendations for those working in the clinic. Orv Hetil. 2025; 166(16): 606–612.
Genetikai vizsgálattal igazolt Blau-szindróma ritka klinikai megjelenése
A rare clinical presentation of a patient with Blau syndrome confirmed by genetic analysis
Blau syndrome is a rare autoimmune disease with autosomal dominant inheritance, typically involving the skin, joints and eyes. It is considered to be the early-onset form of sarcoidosis. Our patient is currently a 23-year-old young man who first developed skin symptoms in infancy, followed by inflammation of the small and large joints at the age of one and a half years. He also developed uveitis, iridocyclitis and glaucoma in early childhood. Despite intensive anti-inflammatory and various biological therapies, the arthritis progressed, and over time, severe contractures developed, confining him to wheelchair. Over time, the complexity and progression of his ophthalmological problems led to almost complete loss of vision, and required several surgical interventions. Unusually for Blau syndrome, our patient developed extensive central nervous system involvement one and a half years ago, which regressed on corticosteroids. The proband’s two-year-old sister also showed early symptoms of Blau syndrome in addition to Down syndrome. Next-generation sequencing using an immune gene panel identified the heterozygous pathogenic variant of the NOD2 gene c.1000C>T, p.(Arg334Trp) in the little sister, which has been previously reported in association with Blau syndrome. The presence of this variant was also detected in our proband by Sanger sequencing, but the carrier status was excluded in both asymptomatic parents and the asymptomatic middle child. In addition to presenting the clinical and genetic features of this rare disease, this paper highlights two unusual phenomena of Blau syndrome in our patient: involvement of the central nervous system, and suspected germline mosaicism in one of the parents. Orv Hetil. 2025; 166(16): 623–630.
Magzatrablás az anyaméhből hasfelmetszéssel
Newborn infant kidnapping by abdominal section
A parodontitis progresszióját jelző potenciális biomarkerek (GOT, CRP és albumin) értékelése 2-es típusú cukorbetegek nyálmintáiban
Assessing of possible biomarkers (AST, CRP, and albumin) indicating the progression of periodontitis in saliva samples of type 2 diabetic patients
Introduction: Periodontitis is one of the most common diseases affecting teeth over the age of 40 years, a process that can be exacerbated by diabetes. People with diabetes are more prone to periodontal disorders. The determination of biomarkers in saliva may be useful for evaluating abnormal periodontal processes. Objective: The main aim of this study was to identify possible biomarkers (aspartate aminotransferase [AST], C-reactive protein [CRP], and albumin) in saliva that could help assess periodontal progression in type 2 diabetic patients. Method: Patients were selected at the Department of Periodontology of the Faculty of Dentistry, University of Debrecen. Considering the study criteria, 18 diabetic and 19 non-diabetic patients were recruited with an average age of 62 ± 9 years. After anamnesis was taken, resting saliva sample was collected from each study participant, and periodontal screening test was performed. In addition to the routine laboratory tests, AST activity, CRP and albumin concentrations were determined in the saliva samples. Using ROC curve analysis, we further evaluated the diagnostic value of AST based on the area under the curve (AUC) value. Results: AST activity values measured in the saliva samples of the diabetic patients were significantly higher compared to the control group (56 [44–107] vs. 33 [14–64] U/L, P = 0.02), however, there was no significant correlation between HgbA1c values and salivary AST levels. Nevertheless, increased AST values in the saliva samples can be attributed to the presence of the combined effect of diabetes mellitus and periodontitis (n = 13), as we observed an even higher AST activity in diabetic patients who developed periodontitis (92 [55–154] vs. 48 [31–55] U/L, P = 0.019) compared with the subgroup showing milder gingivitis (n = 5). On the other hand, compared to the control group, the saliva samples of diabetic patients did not show significant differences in CRP and albumin levels, furthermore, the age did not influence AST results in diabetes mellitus (r = 0.217, P = 0.415). Finally, based on the ROC curve analysis, AST measured in saliva was able to differentiate gingivitis and periodontitis subgroups (AUC: 0.803, P = 0.005) as well as diabetic patients from controls (AUC: 0.744, P = 0.021) at a 49 U/L cut-off value. Conclusion: AST enzyme activity that can be measured in saliva can be a potential laboratory biomarker for the effective investigation of the periodontal clinical status in diabetic patients. Orv Hetil. 2025; 166(16): 613–622.
Abstract
Background and aims
Psychedelic and MDMA-assisted psychotherapy are at the forefront of new treatment models for mental illnesses such as PTSD and depression, as well as improving well-being. Mindfulness meditation and loving-kindness meditation have also gained research traction, showing promise for enhancing emotional regulation and psychological well-being. This paper explores the therapeutic convergence of these modalities, highlighting their neurobiological, psychological, and phenomenological overlap, and suggesting potential bidirectional synergy as a foundation for psychedelic or MDMA-assisted therapy.
Methods
A narrative and theoretical review of the current literature was conducted, examining the neurobiological, psychological, and phenomenological effects of MDMA, psychedelics, and meditation. Studies focusing on their potential synergy and mechanisms of action were prioritized and used as a backing for a theoretical framework.
Results
Psychedelics may improve psychological flexibility, prosocial behaviors, empathy, and neuroplasticity. Meditation research suggests similar benefits, including enhanced decentering capacity, emotional regulation, and well-being. Both modalities influence overlapping neural circuitry, particularly the amygdala, hippocampus, and default mode network. Integrating meditation with MDMA or psychedelic-assisted therapy may stabilize insights gained during altered states of consciousness, promote sustained therapeutic benefits, and minimize distress during therapy.
Conclusions
The convergence of meditation and psychedelics or MDMA-assisted therapy is a novel and promising approach for enhancing mental health treatments. Future research should investigate structured protocols combining these modalities, focusing on optimizing “set and setting” and long-term integration practices.
Abstract
Background
In the European Union, it is estimated that the number of stroke patients will increase by 27% between 2017 and 2047, due to an ageing population and improved survival rates. The most common complications of acute stroke are malnutrition, aspiration and subsequent aspiration pneumonia, which is often fatal.
Purpose
The aim of this study was to assess dietitians' knowledge of the concept of dysphagia, its detection, and risk factors and nutritional options for post-stroke patients diagnosed with dysphagia.
Materials/Methods
An online questionnaire was developed for dietitians working in healthcare institutions. The inclusion criteria were working in a healthcare institution, dealing with people affected by the investigated condition in their daily work, and/or working with elderly people. The exclusion criterion was failure to meet any of the inclusion criteria. The questionnaire was available for completion between 9 September and 11 November 2020. Out of the total of 83 respondents, 19 did not meet the inclusion criteria. The questionnaire contained 12 questions aimed at assessing the knowledge, attitudes, and needs of dietitians working in Hungarian healthcare institutions, mainly with stroke patients, with respect to dysphagia, its complications, and diet. The questionnaire was distributed by the National Association of Hungarian Dietitians (MDOSZ) to its members for completion. Knowledge of dysphagia and its complications is crucial for early detection and for the proper rehabilitation of post-stroke patients.
Result
The dietitians who participated in the study identified malnutrition and aspiration pneumonia as the most common complications of dysphagia but lacked a consistent approach, daily protocols, and standard recommendations for the dietary management of stroke patients.
Conclusions
Dietitians play a prominent role in the multidisciplinary teams caring for dysphagic stroke patients, thus there is a need for educational materials on dysphagia and nutritional therapy to provide them with consistent professional knowledge and practical support based on the latest professional recommendations.
Abstract
Background and aims
Sexual craving and the alleviation of negative emotions are fundamental driving forces underlying problematic pornography use (PPU). In healthy individuals, these processes can be effectively attenuated through cognitive strategies mediated by the prefrontal cortex. However, PPU is associated with impaired cognitive control functions. This study aimed to investigate whether transcranial direct current stimulation (tDCS) targeting the right dorsolateral prefrontal cortex (dlPFC) could enhance the regulation of craving and negative emotions in individuals at risk for PPU.
Methods
A randomized, within-subject, placebo-controlled design was used, in which 45 male individuals at risk for PPU (mean age = 20.18 years, SD = 1.03) received both active (2.5 mA for 20 min) and sham tDCS to the right DLPFC, with sessions separated by one week. During tDCS, participants at risk for PPU performed the regulation of craving (ROC) task, comparing cue-induced craving with instructed regulation, and the emotion regulation (ER) task, contrasting negative affect with instructed regulation. Subjective ratings of craving and negative emotions were collected for each trial.
Results
Our results demonstrated that individuals at risk for PPU effectively regulated their craving and negative affect when guided to use cognitive strategies. Furthermore, anodal tDCS of the right dlPFC during the craving regulation condition significantly reduced craving ratings compared to sham stimulation. However, no facilitative effect of right dlPFC anodal tDCS on ER was observed.
Discussion and conclusions
These findings highlight the potential of tDCS as a novel therapeutic intervention for individuals with PPU, offering the first experimental evidence to support its effectiveness in reducing craving.
Ajánlás az izomrelaxánsok biztonságos perioperatív használatára
Guideline on the safe use of neuromuscular blocking agents
Inappropriate use of muscle relaxants leads to postoperative residual neuromuscular block (PORNB), which is still a significant problem nowadays and is an independent risk factor for postoperative pulmonary complications. To decrease its incidence, the European Society of Anesthesiology and Intensive Care and the American Society of Anesthesiologists published their guidelines on the safe use of muscle relaxants in 2023. In this publication, the Edömér Tassonyi Neuromuscular Task Force of the University of Debrecen Clinical Center summarizes its recommendations. Based on international guidelines, objective neuromuscular monitoring should be performed in every patient who received non-depolarizing muscle relaxants during surgery. Since postoperative residual neuromuscular block can lead to several complications, it is essential for patient safety to ensure that the effect of the muscle relaxants is gone and train-of-four (TOF) ratio has returned to 0.9 (90%) before extubation. Clinical signs and subjective neuromuscular monitoring are not suitable for diagnosing residual curarization at the end of surgery. Therefore, whenever a patient receives non-depolarizing muscle relaxant, objective neuromuscular monitoring should be performed to exclude residual neuromuscular block. Neuromuscular monitoring should be performed in the hand. Objective neuromuscular monitoring should be started before muscle relaxant administration by calibrating the monitoring device. To ensure optimal intubating conditions and prevent airway injuries, TOF count should drop to 0 (all muscle responses evoked by nerve stimulation should disappear). TOF measurements should be repeated at regular intervals during surgery to follow the course of muscle relaxation. The effect of reversal agents (both neostigmine and sugammadex) should always be objectively monitored. The effect of bensilisoquinolin muscle relaxants can only be reversed with neostigmine when there is twitch response to TOF stimulation. Sugammadex is the most effective reversal agent for steroidal muscle relaxants (vecuronium, rocuronium and pipecuronium), but neostigmine can be used as well when there is twitch response to TOF stimulation. Orv Hetil. 2025; 166(15): 569–577.
Amyloidstruma sebészeti osztályunk anyagában
Amyloid goiter in the materials of our surgical department
Introduction: In surgical departments where a sufficient number of thyroid surgeries are performed, relatively rare histopathological diagnoses may also be encountered. Knowledge of these histopathological diagnoses is essential for understanding the etiology and selecting the appropriate treatment for the disease. Objective: We aimed to determine the prevalence of amyloid goiter and to examine its associations with related conditions. Method: Between 2001 and 2023, we performed 2,215 thyroid surgeries. We conducted a retrospective review of the histopathological findings and correlated these results with the patients’ medical histories. Result: Out of the 2,215 operated cases, amyloid goiter was diagnosed histopathologically in only 2 cases, accounting for just 0.09% of all cases. Discussion: Amyloid goiter typically appears in association with other conditions. In our cases, it was linked to chronic renal failure with prolonged dialysis treatment and inflammatory bowel disease (Crohn’s disease). The surgical indication is based on the mechanical compression caused by the enlarged thyroid gland. Conclusion: In cases of diffuse goiter with compression symptoms of unknown origin, amyloid goiter should be considered. Total thyroidectomy resolves the patient’s symptoms. However, the exact diagnosis is usually confirmed only through the histopathological examination of the surgical specimen. Orv Hetil. 2025; 166(15): 588–591.
A citológiai vizsgálatra épülő méhnyakszűrés kálváriája Magyarországon
Calvary of cytology-based cervical screening in Hungary
The paper reviews the development of cervical screening based on cytological examination in Hungary from its appearance to the present day. It notes that, although the organizational conditions for organized population screening would be ensured, the practice of screening tests lacks documentable results because the system used by screening of personal invitation and follow-up to optimize public participation is not sufficiently used by the public, furthermore, the results of organized screening tests are not reported to the screening registry. As a result, the insurance pays around twenty times more under “diagnostic cervical examination” (OENO 26601) than under “cervical screening” (OENO 42520). Cervical screening is a joint task of gynecologists (smear-taking) and pathologists (evaluation of smear). The gynecologists’ task is the take care fort the patient, and to report the result to central registry. This is the only way to obtain data on compliance and the effectiveness of the screening program. The paper takes into account the factors that hinder the following of the international guidelines, thus the successful implementation of the screening programs. Orv Hetil. 2025; 166(15): 578–587.
Diftéria a Teleki téren
Diphtheria on Teleki Square
A hasnyálmirigy áttétes daganatai – kialakulásuktól a terápiás lehetőségekig
Irodalmi áttekintés
Secondary tumors of the pancreas – from origins to therapeutic options
Review of the literature
The pancreas is an unusual site for the development of metastases. Metastatic tumors affecting pancreas can be isolated or diffuse, and regarding the time of appearance they can be synchronous or metachronous. According to their origin, the prognosis of different secondary pancreatic tumors varies. The purpose of the literature review is to provide a clearer picture of metastases in the pancreas and their therapeutic potential. We conducted a retrospective review of the literature between 2014 and 2023 using the PubMed database. Using the data obtained during our search, we classified secondary pancreatic tumors based on their incidence, site of primary malignant tumor, clinical symptoms, diagnosis, mechanisms of development and treatment principles. Secondary tumors of the pancreas are rare, accounting for 2–5% of malignant pancreatic tumors. Clear cell renal cell carcinoma is the most common cause of pancreas metastasis. Pancreatic metastases are difficult to diagnose being often asymptomatic, and they can be confused with primary tumors of the pancreas. Histological and immunohistochemical examinations are necessary. In the development of secondary pancreatic tumors, the systemic-hematogenous metastasis mechanism is the accepted one. Surgical treatment prolongs survival, and the use of systemic, molecular targeted therapy has recently proven to be effective. Orv Hetil. 2025; 166(15): 563–568.
Mielodiszpláziás neoplazmák: A diagnosztika, a prognosztika és a terápiás megközelítés újdonságai
Myelodysplastic neoplasma: Novelties of diagnostics, prognostics, and therapy
A mielodiszpláziás szindrómák (MDS), más néven mielodiszpláziás neoplazmák, a hemopoetikus őssejtek klonális mieloid eredetű daganatai, amelyek a vérképzési zavarok széles spektrumával jellemezhetők. Az MDS fő jellemzői közé tartozik a citomorfológiai diszplázia, az ineffektív vérképzés, ennek köszönhetően citopéniák kialakulása. A betegség továbbá magában hordozza az akut mieloid leukémiába való átalakulás kockázatát. A betegséget gyakran kísérik visszatérő kromoszómarendellenességek; jelentős klinikai és genetikai sokféleség jellemzi, így a kórjóslat széles tartományban mozog. Az elmúlt évtizedekben a betegséggel kapcsolatos ismereteink folyamatosan bővültek, ami lehetővé tette, hogy a citogenetikai és molekuláris vizsgálatok meghatározó szerepet kapjanak a prognózis megbecslésében és a kezelési terv kialakításában. Az MDS legújabb, 2022-es osztályozása a World Health Organization Classification of Hematolymphoid Tumors és az International Consensus Classification alapján történik. Az alacsony kockázatú MDS kezelésének célja elsősorban a citopénia tüneteinek enyhítése szupportív terápiával, míg a magas kockázatú formák esetén – amennyiben a beteg általános állapota lehetővé teszi – a betegség definitív kezelése a fő cél. Az egyetlen kuratív terápia az allogén hematopoetikus őssejt-transzplantáció. Az elmúlt években a molekuláris és celluláris útvonalakra irányuló új terápiás megközelítések számos új gyógyszert és potenciális gyógyszercélpontot eredményeztek. A jövőbeni kutatások reményeink szerint lehetővé teszik a mielodiszpláziás betegek számára a személyre szabottabb kezelést, ezáltal csökkentve a betegség morbiditását és mortalitását. Ezen áttekintés célja, hogy összefoglalja a felnőttkori mielodiszpláziás szindróma kezelésében elért legújabb diagnosztikai, prognosztikai és terápiás eredményeket.
Abstract
Background
Adipose-derived stem cell (ADSC) derived exosomes have been widely studied in disease treatment. Exosomes are able to deliver bioactive molecules, including non-coding RNAs and proteins. Long non-coding RNAs (lncRNAs) are non-coding RNAs longer than 200 nucleotides and are enriched in exosomes. This work aimed to explore the effects of lncRNA KLF3 antisense RNA 1 (KLF3-AS1) that delivered by ADSC-derived exosomes on ovarian aging.
Methods
ADSCs were isolated and characterized with the surface biomarkers. Exosomes were isolated from ADSCs. The biomarkers of ADSC-derived exosomes were identified using western blotting. Exosomes were labeled with PKH26 and internalized by primary granulosa cells (pGCs), and relative images were taken under fluorescence microscope. ADSCs were transfected with KLF3-AS1, and exosomes were isolated for treatment of aging female mice. The ovary weight was recorded. The follicular development was measured by Hematoxylin and eosin (H&E) staining and Masson's trichrome staining. Apoptosis of ovary tissues was detected by TUNEL assay. The senescence and apoptosis of pGCs were determined by S-β-gal staining kit and Annexin V/PI detection kit. RNA pulldown and RNA Immunoprecipitation Chip (RIP) assay were performed to determine the interaction of Y box binding protein 1 (YBX1) with KLF3-AS1.
Results
The ADSC-derived exosomes could deliver KLF3-AS1 to pGCs. Treatment with ADSC-derived exosomes notably elevated the ovary weight and enhanced follicular development in aged mice, whereas depletion of KLF3-AS1 reversed these effects and promoted cell apoptosis. ADSCs-derived exosomes alleviated senescence and apoptosis of pGCs, while KLF3-AS1 depletion blocked these phenotypes. KLF3-AS1 directly interacts with YBX1. KLF3-AS1 depletion inhibited phosphorylation of PI3K, Akt, and mTOR in pGC, and overexpression of YBX1 reversed these phenotypes.
Conclusion
ADSC-derived exosomal KLF3-AS1 could improve ovary aging and enhance pGC viability via targeting the YBX1 and PI3K/AKT/mTOR signaling.
Cardiovascularis betegségek, antithrombotikus terápia idős, súlyos haemophiliás betegekben
Antithrombotic therapy of cardiovascular disorders in elderly patients with severe haemophilia
Súlyos haemophiliás betegek vérzésveszélye jelentősen nő, ha antithrombotikus terápia alkalmazása válik szükségessé. Az elmúlt években a haemophiliás betegek átlagéletkora elérte az általános férfi populáció átlagéletkorát (>70 év). A haemophilia a cardiovascularis (pitvarfibrilláció, coronaria betegségek) vagy a cerebrovascularis betegségektől (TIA/stroke) nem véd, ezért az antithrombotikus terápia (antikoaguláns vagy vérlemezkeműködés-gátló) egyre gyakoribb igény súlyos haemophiliás betegekben is. Az antithrombotikus terápia azonban jelentősen fokozza a vérzésveszélyt veleszületett vérzékenyekben, emiatt növelni kell az alkalmazott faktorkoncentrátumok mennyiségét. A közlemény összefoglalja a cardiovascularis betegségekben szenvedő, antithrombotikus terápiában részesülő idős haemophiliások kezelésének újabb elveit.
Abstract
Background and aims
Scientific evidence for underpinning mechanisms of Compulsive Sexual Behavior Disorder (CSBD) is still scarce. This study explores impaired sexual delay discounting in compulsive sexual behavior (CSB) and its relationship with sexual sensation seeking (SSS) and borderline personality disorder (BPD) features in a general population sample.
Methods
Data were collected via an online survey in a German convenience sample. Participants (n = 311; 71.3% women, 27.3% men, 1.6% gender-diverse individuals) completed the Sexual Delay Discounting Task (SDT), Compulsive Sexual Behavior Disorder Scale-19 (CSBD-19), Sexual Sensation Seeking Scale (SSS scale), and Borderline Symptom List-23 (BSL-23).
Results
Higher CSB and SSS were linked to greater sexual delay discounting and a lower preference for condom or dental dam use, particularly in women. BPD features were associated with higher levels of CSB and SSS but did not moderate the relationship between these behaviors and sexual delay discounting. Men exhibited significantly more symptoms of CSB and SSS than women.
Discussion and Conclusions
The findings contribute to our understanding of CSB, especially in women, and suggest a relationship between sexual delay discounting, SSS and CSB. This finding suggests a need for gender-sensitive approaches and awareness of excitement seeking behavior in research and clinical interventions for CSB.
Abstract
Background and aims
Problematic social media use (PSMU), a potential behavioral addiction, has become a worldwide mental health concern. An imbalanced interaction between Pavlovian and instrumental learning systems has been proposed to be central to addiction. However, it remains unclear whether individuals with PSMU also over-rely on the Pavlovian system when flexible instrumental learning is required.
Methods
To address this question, we used an orthogonalized go/no-go task that distinguished two axes of behavioral control during associative learning: valence (reward or punishment) and action (approach or avoidance). We compared the learning performance of 33 individuals with PSMU and 32 regular social media users in this task. Moreover, latent cognitive factors involved in this task, such as learning rate and reward sensitivity, were estimated using a computational modeling approach.
Results
The PSMU group showed worse learning performance when Pavlovian and instrumental systems were incongruent in the reward, but not the punishment, domain. Computational modeling results showed a higher learning rate and lower reward sensitivity in the PSMU group than in the control group.
Conclusions
This study elucidated the computational mechanisms underlying suboptimal instrumental learning in individuals with PSMU. These findings not only highlight the potential of computational modeling to advance our understanding of PSMU, but also shed new light on the development of effective interventions for this disorder.
Abstract
Background and Aims
The evidence concerning the relationships between loneliness, gambling to escape, and problem gambling is mixed. This study aimed to investigate how loneliness relates to gambling to escape and gambling problems using a longitudinal approach.
Method
This population-based, longitudinal study included five time points, with data having been collected between April 2021 (T1) and April-May 2023 (T5). Participants were 18–75-year-old Finnish residents. Only those who had taken part in the study at each time point (T1–T5) and had gambled at least once a month at some point in the follow-up period were included in the study (n = 612; 54.58% male; Mage = 51.85 years). Loneliness was measured with the UCLA 3-Item Loneliness Scale, and gambling to escape was measured with three questions concerning negative escapism taken from the Motivations to Play Inventory. Problem gambling was measured using the Problem Gambling Severity Index (PGSI). Random intercept cross-lagged panel modeling was used to analyze the relationships.
Results
Gambling problems predicted future loneliness on a within-person level, but loneliness did not predict future gambling problems. Also, gambling to escape predicted future gambling problems on a within-person level. On a between-person level, loneliness, gambling to escape and gambling problems were positively correlated.
Discussion and Conclusion
Gambling problems may predispose individuals to future loneliness. However, the relatively small effects observed indicate that individual differences play a significant role in this regard.
Abstract
Background
Existing research on facial emotion processing in Internet gaming disorder (IGD) has focused on single facial expression but little is known about crowd facial emotion (present multiple facial expressions simultaneously) ensemble coding. Thus, this event-related potential (ERP) study aimed to investigate temporal dynamics of crowd facial emotion ensemble coding under interference in IGD.
Methods
17 IGD and 17 control group (CG) participants completed a task of extracting mean emotion from crowd facial expressions under emotional interference while electroencephalographic activity was recorded.
Results
The N170 amplitudes elicited by crowd facial expressions in IGD were significantly smaller than in CG. Angry crowd faces evoked larger N170 amplitudes than happy crowd faces in IGD. Happy crowd faces elicited more negative early posterior negativity (EPN) amplitudes than angry crowd faces in CG, while no difference was found in IGD. In the later ensemble coding stage, we found a significant three-way interaction between the group, emotional valence and interference in the frontal negative slow wave component.
Conclusions
IGD participants exhibited weaker ensemble coding ability of crowd facial expressions. They showed an automatic processing bias towards angry crowd faces in the early stage, as well as insensitivity to happy crowd faces in the subsequent selective processing stage during mean emotion extraction. In the later stage, IGD participants failed to actively adopt appropriate cognitive strategies to inhibit interference. This study first provided electrophysiological evidence for the characteristics of crowd facial emotion ensemble coding in IGD and contributed to clarifying how IGD affects social cognition.
