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
A gyógyszer-repozicionálás és klinikai diabetológiai vonatkozásai
Drug repositioning and its aspects in clinical diabetology
Drug repositioning is a special and increasingly utilized way of drug development. As a result of the procedure, drugs and active ingredients that are already on the market for the treatment of certain diseases or are in various phases of development are being successfully used with new indications, some of which are sometimes completely different from the original ones. In the first half of our review, we give a brief overview of this process, outline its various advantages and potential pitfalls. After the general introductory part, we will examine the more successful areas of application of the drugs that were previously marketed as antidiabetics, and then we will mention some preparations that can now also be used in the treatment of diabetes mellitus, due to their significant blood sugar lowering properties that have been recognized in the meantime. Orv Hetil. 2024; 165(49): 1919–1926.
Mesterséges intelligencián alapuló szervkontúrozó szoftverek alkalmazása és eredményeinek összehasonlítása sugárterápiás besugárzástervezés során
Application of artificial intelligence-based organ contouring software and comparison of results in treatment planning for radiotherapy
Introduction: The first step in the radiotherapy treatment of cancer patients is the treatment planning, which involves delineations of the target volume (tumour) and organs at risk on a series of CT scans. This process is called contouring or segmentation. The delineation is performed in two dimensions on axial CT slices, but the dose distribution calculation and plan evaluation are carried out in three dimensions. Contouring has traditionally been done manually, but automatic organ contouring software are now available to make the process more accurate and consistent. Objective: To compare the quality of contouring software using artificial intelligence-based algorithms, and to define the organs that can be outlined with the best consistency, and those organs where there are large differences in segmentation between different software. Method: Contours of organs at risk defined by three contouring software (MVision, ART-Plan, Limbus) in four anatomical regions on a series of 93 CT scans were compared. MVision contours were the references, and contours defined by the two systems were compared with them based on volumes, centers of mass location, and spatial similarity and conformity indices. We ranked the spatial similarity, defining the organs with the smallest and largest differences. Results: Order of the organs with the best agreement: lungs, brain, liver, spleen, stomach, heart, eyes, mandible, kidneys, spinal cord, breasts, and bladder. The largest deviations were found at small-volume organs: thyroid, chiasma, left anterior descending artery, and pituitary. Large variations were found in the prostate and differences in the trachea were due to different interpretations of the anatomical boundaries. Discussion: For organs where the tissue density differs significantly from their surroundings (air–soft tissue, bone–soft tissue), the software can determine the organ in question with the appropriate quality. Small differences in contours were found for larger and relatively large differences for smaller organs. Conclusions: The contours were defined with good agreement by the software for most of the organs, large deviations were found only in small-volume organs. Orv Hetil. 2024; 165(49): 1934–1944.
Abstract
Background and aims
The authors of the present study wanted to know whether the previously reported psychiatric comorbidities of internet gaming disorder (IGD) based on DSM-5 criteria were also more prevalent among gaming disorder (GD) or hazardous gaming (HG) based on ICD-11 criteria. Therefore, the present case-control study evaluated the psychiatric comorbidities and associative factors of GD and HG based on ICD-11 criteria.
Methods
A sample of 60 individuals with GD, 45 with HG, and 120 controls were assessed with an ICD-11 criteria-based diagnostic interview along with attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), depressive disorder, and social anxiety disorder (SAD). Participants also completed Conners' Continuous Performance Test (CCPT), Dickman's Impulsivity Inventory, the Emotion Regulation Questionnaire, and the Behavior Inhibition System and Behavior Approach System Scales.
Results
GD was associated with ADHD, depressive disorder, and GAD. ADHD was the most associative comorbidity of HG. Depressive disorder was associated with GD relative to HG. Moreover, individuals with lower reappraisal, higher aversion sensitivity, and impulsivity were more likely to be diagnosed with GD. Those with higher fun-seeking were more likely to be diagnosed with HG.
Conclusion
In the present study, ADHD was the psychiatric comorbidity most significantly associated with GD, followed by depressive disorder and GAD, as previously reported for IGD. ADHD was also associated with HG. Depressive disorder was more associated with GD compared to HG. Intervention for HG and GD should be tailored by the consideration of the clients' psychiatric comorbidity as well as their reappraisal skills, impulsivity, aversion sensitivity, and fun-seeking.
Abstract
Purpose
We investigated health development offices (HDOs) in Hungary as key providers of preventive healthcare services (nutrition, exercise, and mental hygiene programmes) for the general population, with a particular emphasis on health maintenance among people aged 60 and over.
Materials and Methods
Our research was informed by the fact that there are currently 113 HDOs operating in Hungary. We carried out a short online survey, for which the sample size (n = 44) was big enough to apply descriptive statistical methods and make statistically significant estimates for different age groups, using a significance level of α = 5% for the target group.
Results
Our research yielded a remarkable finding: around one in two of the clients using the services of the HDOs were over the age of 60. As many as 89% (39 out of 44) of the HDOs participating in the survey provided specific health promotion programmes for individuals over 60 years of age.
Conclusions
Our research showed that HDOs are key players in the field of primary prevention among older people, suggesting that they are an important aspect of gerontological care.
Abstract
As the changeful history of psychedelic research and therapy since the 1950s can be assumed to be well enough known to this journal's audience, it is only recalled briefly in this article. Rarely has it been addressed, though, that the discursive struggles through which this history has been spawned have antecedents in much older controversies in the 18th and 19th centuries. As knowledge of this prehistory may shed new light on the current state of affairs in psychedelic matters, this article starts with an account of the transformations that animal magnetism underwent during the so-called ‘long century of mediumship’, transformations by which it was ultimately tamed by science. Based on this historical sensitization, the text then turns to a recent strand of the scientific debate on psychedelic therapy – to seminal journal articles from the Johns Hopkins research group – and subjects these articles to a fine-grained discourse analysis. In doing so, the inner cohesion of the forces that are currently tugging at the psychedelic, mostly pushing aside its emancipatory, resistive, utopian, and ‘spiritual’ connotations, becomes more apparent.
Abstract
Objective
2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([18F]-FDG PET/CT) can be developed in association with contrast-enhanced CT (ceCT), specifically in oncologic patients. This study aimed to evaluate emergency cases incidentally detected in our clinical practice with [18F]-FDG PET/ceCT.
Method
We retrospectively evaluated 3661 [18F]-FDG PET/ceCT, developed between 2017 and 2023, collecting emergency cases needing prompt treatment.
Results
In 34/3661 patients (0.9%) an emergency case was recorded, in particular through contrast-enhanced CT, linked to a vascular (65%) or extravascular (35%) disease. The more frequent findings were pulmonary thromboembolism (0.5%). [18F]-FDG PET/CT was positive in 13/34 cases.
Conclusions
A significant minority of patients undergoing PET/ceCT present vascular or extravascular emergency diseases. The [18F]-FDG uptake improves confidence in diagnosing inflammatory findings. Properly trained diagnostic physicians approaching PET/ceCT can change the prognosis of a small but significant number of cancer patients through a life-saving approach. Future studies are needed to ensure the possibility of emergency findings with non-[18F]-FDG tracers.
Abstract
Psychedelic drugs show promising therapeutic potential; however, some users experience extended difficulties following their use. This study investigated the prevalence, severity, duration, and associated coping strategies of post-psychedelic difficulties. We conducted an online survey of 159 participants, all of whom reported experiencing difficulties lasting more than one day after psychedelic use within the past 2–10 years. Participants rated the severity and duration of 11 types of difficulties and indicated effective coping strategies. Results revealed that social disconnection (72%), anxiety and panic attacks (68%), and existential struggle (65%) were the most prevalent difficulties. Anxiety and panic attacks were rated as most severe, while existential struggle and diminished self-esteem persisted the longest, with mean durations exceeding 15 months. Derealization and depersonalization, despite being common, were consistently rated as less severe than other difficulties. Self-education emerged as the predominant coping strategy for multiple difficulties, including social disconnection and existential struggle. Professional therapy was most effective for depression and diminished self-esteem, while peer and family support were particularly beneficial for managing anxiety and panic attacks. These findings highlight the diverse nature of post-psychedelic difficulties and the varying effectiveness of different coping strategies. Our results contribute to the development of more nuanced, effective approaches to harm reduction and integration in psychedelic use, emphasizing the importance of multifaceted support systems that include professional, educational, and community-based resources.
Abstract
Background and aims
Deficits in emotion regulation (ER) are considered a key factor in the development of addiction, highlighting ER as a potential target for treatment. However, ER in problematic pornography use (PPU) remains poorly understood.
Methods
The current study investigated both spontaneous and instructed ER in male individuals at-risk for PPU (n = 35, average age = 20.40 ± 1.29) and in a control group (n = 33, average age = 20.06 ± 1.44). Initially, participants were evaluated with the Emotion Regulation Profile-Revised (ERP-R) to measure their spontaneous use of eight ER strategies across various negative emotion-eliciting scenarios. Subsequently, they completed an emotion reappraisal task, in which they were instructed to either observe or reappraise their reactions to negative images. Subjective emotional ratings (valence and arousal) and event-related potentials (ERPs) were recorded to examine the effects of deliberate ER on emotional processing.
Results
The results indicated that individuals at-risk for PPU reported less frequent spontaneous use of reappraisal compared to those in the control group. Furthermore, in both groups, reappraisal led to a decrease in the late positive potential (LPP) and the self-reported intensity of emotions elicited by negative images.
Discussion and conclusions
This indicates that both groups were able to effectively downregulate negative emotions through reappraisal when instructed. Our findings underscore the importance of incorporating ER skills, particularly reappraisal-based strategies, into the prevention and psychotherapy of PPU.
Abstract
Background
Gambling content on streaming platforms has gained popularity. Given their intense, cue-laden nature, watching gambling streams may trigger cravings among viewers. At the same time, people who gamble may be motivated to watch gambling streams in an attempt to regulate their cravings.
Methods
We tested these ideas across two preregistered online studies, recruiting i) people who gamble to compare a subgroup of gambling stream viewers with non-viewers (Study 1; n viewers = 221, n non-viewers = 642), and ii) a group of gambling stream viewers (Study 2; n viewers = 271).
Results
Gambling stream viewers were younger, tended to identify as men, and displayed higher levels of problem gambling and gambling cravings compared to non-viewers. Problem gambling severity was correlated positively with both the motivation to use gambling streams to regulate cravings and with cravings elicited by watching gambling streams.
Discussion
Our findings indicate that while viewers with higher levels of problem gambling may use gambling streams to regulate their cravings, doing so might evoke cravings.
Az orrmelléküregek mucormycosisa
Mucormycosis of the paranasal sinuses
Until nowadays, mucormycosis is the most aggressive fungal disease spreading in humans. Currently the Rhizopus, Lichtheimia and Mucor species are responsible for the development of diseases in the greatest number. The prevalence of mucormycosis appears to be much higher because in many cases achieving histological sample is difficult and the presence of risk factors is getting higher. While the classification systems, examination protocols, pharmaceutical and surgical treatment methods have developed, it is important to highlight that the continuous increase in the number of diabetes and the accompanying ketoacidosis, the recurrence of the COVID–19 epidemics in our overpopulated society had a high benefit factor in the spread of the disease, especially the one which affects the paranasal sinuses: the rhino-orbito-cerebral form. The purpose of this publication is to provide a detailed presentation of the disease, in which the effective treatment depends in many cases on the establishment of an accurate, early diagnosis, through a targeted drug therapy and, in several cases, an aggressive surgical debridement is indispensable. Orv Hetil. 2024; 165(48): 1878–1887.
