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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.

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Spontán légző, nem intubált, valamint intubált és gépi lélegeztetett betegeken végzett videoasszisztált torakoszkópos tüdőlebeny-eltávolítások összehasonlítása

Comparison of non-intubated, spontaneously breathing and intubated, mechanically ventilated videothoracoscopic lobectomy

Orvosi Hetilap
Authors:
Attila Farkas
,
Katinka Andrási
,
Evelin Szűcs
,
Ferenc Rárosi
,
László Kecskés
, and
József Furák

Bevezetés: A minimálinvazív műtéti technika a mellkassebészetben, a tüdődaganatok ellátása kapcsán előtérbe került az elmúlt évtizedekben, melynek egyik kiemelkedő részét alkotják a spontán légzés mellett elvégzett mellkassebészeti műtétek. Célkitűzés: Jelen közleményünkben a nem intubált és nem relaxált videoasszisztált torakoszkópos (I. csoport) és az intubált és relaxált videoasszisztált torakoszkópos (II. csoport) tüdőlebeny-eltávolítások eredményeit hasonlítottuk össze. Módszer: Az I. csoportban 118, míg a II. csoportban 211, uniportalis tüdőlebeny-eltávolításon átesett beteg adatait hasonlítottuk össze, majd propensit score elemzéssel kiválasztott 70-70 betegnél végeztük el hasonlóan a statisztikai elemzést. Eredmények: A teljes betegcsoportot tekintve a műtéti idő 91,6 és 91,1 perc (p = 0,857), az átlagos dréneltávolítás 3,43 és 4,62 nap (p<0,001), az elhúzódó légáteresztés 12,8% és 20,8% (p = 0,07), a redrenázs 7,7% és 6,16% (p = 0,624), a reoperáció 2,5% és 5,2% (p = 0,393), a morbiditás 18,8% és 27,9% (p = 0,065) volt az I. és a II. csoportban külön-külön. 30 napos mortalitás csak a II. csoportban fordult elő. ’Propensity score’ értékelés után az átlagos műtéti idő 92,08 és 95,25 perc (p = 0,442), az átlagos dréneltávolítás 3,01 és 4,57 nap (p <0,01), az elhúzódó légáteresztés 11,4% és 20% (p = 0,164), a redrenázs 5,7% és 7,14% (p = 0,730), a reoperáció 2,8% és 5,6% (p = 0,681), a morbiditás 15,7% és 27,1% (p = 0,099) volt az I. és a II. csoportban külön-külön. 30 napos mortalitás egyik csoportban sem fordult elő. Következtetés: A nem intubált, nem relaxált uniportalis videoasszisztált torakoszkópos tüdőlebeny-eltávolítás általánosságban kedvezőbb eredményeket mutatott az intubált, relaxált uniportalis videoasszisztált torakoszkópos tüdőlebeny-eltávolítással szemben. A műtét után hamarabb került sor a mellkasi drén eltávolítására, és a szövődmények aránya is kisebb volt. Orv Hetil. 2024; 165(10): 393–399.

Open access

Új minimálinvazív kezelési lehetőségek jó- és rosszindulatú fül-orr-gégészeti betegségekben nanoszerkezetű hatóanyag-leadó rendszerek alkalmazásával

New minimally invasive treatment options in benign and malignant otorhinolaryngological diseases using nanostructured drug delivery systems

Orvosi Hetilap
Authors:
Diána Szabó
,
László Janovák
,
Mohamed Abdelgafour
,
Tamás Takács
,
Miklós Csanády Jr.
,
Gabriella Spengler
,
László Szakács
,
Miklós Csanády
, and
László Rovó

A fej-nyaki daganatok ma Magyarországon a 4. leggyakoribb daganatos betegségek. Az etiológiai faktorokat tekintve vezető tényező a dohányzás és az alkoholfogyasztás. Ezek hiányában a HPV-pozitivitás számít oki tényezőnek. Az eredményes kezelés egyénre szabottan ötvözi a sebészi, kemo-, sugár- és immunterápiát. Munkánkban a kemoterápiás szerek mellékhatásprofiljának szűkítését próbáltuk csökkenteni két ismert és széles körben használt kemoterapeutikumot, ciszplatint és mitomicin C-t tartalmazó, új nanotechnológiai gyógyszerbeviteli rendszer kialakításával. A poli(vinil-alkohol)-tartalmú szintetikus polimerből gyógyszerbeviteli rendszert alakítottunk ki, mely tartalmazza a ciszplatin vagy mitomicin C kemoterapeutikumot. A nanotechnológiai gyógyszerleadó rendszer a célterületre való bevitel után a hatóanyagot koncentrációfüggő mennyiségben, időkontrolláltan adja le a kívánt hatás eléréséhez. Vizsgált szintetikus polimerünk a mukoadhezív, biokompatibilis, biodegradábilis tulajdonságait kiaknázva a hatóanyag leadása után eliminálódik. Ez a korszerű nanotechnológiai gyógyszerbeviteli rendszer egy új lokális kemoterápia lehetőségét veti fel, mellyel nagy fokban csökkenthetjük a kemoterápiás szerek ismert, sok esetben a kemoterápiás kezelés felfüggesztését okozó, súlyos, életet veszélyeztető mellékhatásait. Orv Hetil. 2024; 165(10): 370–378.

Open access

Abstract

Background and objectives

Work addiction (WA), characterized by dimensions such as overcommitment, difficulties in detachment from work, and work-life imbalance, is presumed to be associated with increased smartphone usage, even during risky activities like driving. The study investigated the connection between WA and future problematic and hazardous smartphone use, considering personality factors: anxiety, rumination, and worry.

Methods

A three-wave longitudinal study (N = 1,866) was conducted from March to July 2019, June to September 2020, and June to November 2021, involving a representative sample of 18-34-year-old residents in Hungary's capital. The study employed Hungarian versions of the Bergen Work Addiction Scale, Problematic Mobile Phone Use Questionnaire, Ruminative Response Scale, Anxiety subscale of the Brief Symptom Inventory 18, and Penn-State Worry Questionnaire. Additionally, author-developed questions on mobile phone use while driving were included.

Results

At baseline, those at risk for WA showed more frequent mobile phone use while driving at both time points 2 and 3 compared to the non-risk group. Path analyses revealed rumination, anxiety at time 1, and worry at time 2 as significant mediators between baseline WA and mobile phone use while driving at time 3. However, when analyzing all three mediators together, only anxiety at time 1 and worry at time 2 remained significant.

Discussion and conclusion

This study demonstrates that WA predicts future mobile phone use while driving through mediation by anxiety and worry. Our findings add to the growing evidence highlighting the detrimental aspects of WA, emphasizing the need for improved prevention and treatment strategies.

Open access

Abstract

Background

An imbalance between model-based and model-free decision-making systems is a common feature in addictive disorders. However, little is known about whether similar decision-making deficits appear in internet gaming disorder (IGD). This study compared neurocognitive features associated with model-based and model-free systems in IGD and alcohol use disorder (AUD).

Method

Participants diagnosed with IGD (n = 22) and AUD (n = 22), and healthy controls (n = 30) performed the two-stage task inside the functional magnetic resonance imaging (fMRI) scanner. We used computational modeling and hierarchical Bayesian analysis to provide a mechanistic account of their choice behavior. Then, we performed a model-based fMRI analysis and functional connectivity analysis to identify neural correlates of the decision-making processes in each group.

Results

The computational modeling results showed similar levels of model-based behavior in the IGD and AUD groups. However, we observed distinct neural correlates of the model-based reward prediction error (RPE) between the two groups. The IGD group exhibited insula-specific activation associated with model-based RPE, while the AUD group showed prefrontal activation, particularly in the orbitofrontal cortex and superior frontal gyrus. Furthermore, individuals with IGD demonstrated hyper-connectivity between the insula and brain regions in the salience network in the context of model-based RPE.

Discussion and Conclusions

The findings suggest potential differences in the neurobiological mechanisms underlying model-based behavior in IGD and AUD, albeit shared cognitive features observed in computational modeling analysis. As the first neuroimaging study to compare IGD and AUD in terms of the model-based system, this study provides novel insights into distinct decision-making processes in IGD.

Open access
Journal of Behavioral Addictions
Authors:
Elise Victoria Tørdal
,
Ståle Pallesen
,
Dominic Sagoe
,
Lise Øen Jones
, and
Farha Mahjabeen

Abstract

Introduction

The overall prevalence of gambling problems across prison populations is currently unknown. The objective of the present study was therefore to quantitatively synthetize prevalence estimates of gambling problems in prison populations using a random effects meta-analytic model and to investigate if the estimates were moderated by time frame, cut-off levels, and sample size.

Methods

To be included the studies had to report original data on the prevalence of gambling problems in a prison sample and to be written in a European language, whereas data based on abstracts or qualitative reports were excluded. The search ended on December 1, 2023 and were conducted in Web of Science, PubMed, Cinahl, PsycINFO, Embase, Google Scholar, Grey Literature Report, and GreyNet. Risk of bias was assessed with a standardized 10-item measure for epidemiological studies.

Results

A total of 26 studies comprising 9,491 participants were included. The vast majority of the participants were males. The most commonly used instrument for assessment of gambling problems was the South Oaks Gambling Screen. The pooled random-effects gambling problems prevalence estimate was 30.8% (95% CI = 25.1–37.3). The meta-regression analysis showed that none of the three moderator variables (criteria, timeframe, sample size) were related to the gambling problems prevalence. Common limitations of the included studies entailed not being representative nationally or for the target population, lack of randomization, and low response rate. The meta-analysis was restricted to studies published in a European language.

Conclusions

Overall, the studies show that 1 in 3 prisoners has gambling problems and suggests that more emphasis on relevant prevention and treatment is warranted for this population. The study was funded by the Norwegian Competence Center for Gambling and Gaming Research and pre-registered at PROSPERO (CRD42023390552).

Open access

Abstract

Background and Aims

The high prevalence of internet addiction (IA) has become a worldwide problem that profoundly affects people's mental health and executive function. Empirical studies have suggested trait anxiety (TA) as one of the most robust predictors of addictive behaviors. The present study investigated the neural and socio-psychological mechanisms underlying the association between TA and IA.

Methods

Firstly, we tested the correlation between TA and IA. Then we investigated the longitudinal influence of TA on IA using a linear mixed effect (LME) model. Secondly, connectome-based predictive modeling (CPM) was employed to explore neuromarkers of TA, and we tested whether the identified neuromarkers of TA can predict IA. Lastly, stressful life events and default mode network (DMN) were considered as mediating variables to explore the relationship between TA and IA.

Findings

A significant positive correlation between TA and IA was found and the high TA group demonstrated higher IA across time. CPM results revealed that the functional connectivity of cognitive control and emotion-regulation circuits and DMN were significantly correlated with TA. Furthermore, a significant association was found between the neuromarkers of TA and IA. Notably, the CPM results were all validated in an independent sample. The results of mediation demonstrated that stressful life events and correlated functional connectivity mediated the association between TA and IA.

Conclusions

Findings of the present study facilitate a deeper understanding of the neural and socio-psychological mechanisms linking TA and IA and provide new directions for developing neural and psychological interventions.

Open access

Abstract

Background

Slot-scanning EOS radiography is increasingly utilised in skeletal imaging. It has been shown that EOS often reveals significant incidental findings including cardiopulmonary abnormalities. Furthermore, the slot-scanning image acquisition of EOS can substantially influence depiction of cardiac morphology, which can be confusing for those unfamiliar with the technique.

Patients and methods

We aimed to explore the relationship between the depicted cardiac anatomy EOS and chest x-ray, by analysis of the differences in the measurements of the cardiothoracic ratio in 52 patients who had an erect, postero-anterior chest radiograph in deep inspiration, with less than a year difference to the EOS spine radiograph. Internal chest and cardiac diameter were measured, and the cardiothoracic ratio (CTR) was calculated as a surrogate marker for gross cardiac size.

Results

We have found that EOS consistently yields a lower internal chest diameter, and as a result higher CTR (P < 0.0001). However CTR measured on EOS and plain radiograph show strong correlation (P < 0.0001). Bland-Altman plots also revealed a consistently higher CTR on EOS, and a high intra-individual variability of cardiac and chest diameters on EOS vs. x-ray. CTR measured on EOS showed correlation with age (P < 0.05).

Discussion

We show that the CTR on EOS radiographs is consistently higher compared to the chest radiography, and while cardiac diameter shows only minimal difference, chest diameter measured on EOS is markedly lower. This should be considered by those reporting spine EOS imaging to avoid overcalling incidental cardiomegaly.

Open access

Abstract

Background

The primary purpose of this study was to assess the interreader reliability of a grading system for UIP based on the quantification of normal lung. This grading system considers each of the following lung regions: right upper and middle lobes, right lower lobe, left upper lobe, and left lower lobe. Each is assigned a grade based on the following: 0: 0% normal lung; 1: 1–49% normal lung; 2: 50–74% normal lung; 3: 75–89% normal lung; 4: 90–99% normal lung; 5: 100% normal lung. The secondary purpose was to compare the grades rendered by non-cardiothoracic subspecialty trained radiologists to grades established by cardiothoracic radiologists, which were considered the gold standard.

Methods

Chest CT images of patients were obtained by searching the radiology record system for the terms “usual interstitial pneumonia” and “UIP”. Each case was confirmed by radiologist review; pathology was not assessed given the small fraction of cases that underwent biopsy due to the high risk of complications in patients with fibrotic lung disease. Two cardiothoracic radiologists evaluated each CT and reached a consensus grade. Two different radiologists who were not subspecialty trained in cardiothoracic radiology independently graded each case. Spearman correlation analysis was performed to compare the two reader's grades as well as each reader's grade independently to the gold standard score.

Results

Our analysis demonstrated a strongly positive statistically significant interreader correlation coefficient (RS) = 0.7062, P < 0.001. Our analysis of each reader compared to the gold standard demonstrated an Rs = 0.77559, P < 0.001 and an RS = 0.69958, P < 0.001 for readers 1 and 2, respectively, both representing statistically significant strongly positive correlations.

Conclusions

These results demonstrate strong interreader reproducibility and show that radiologists without subspecialty training in cardiothoracic radiology render grades that correlate strongly with those given by cardiothoracic radiologists. These findings support the use of this grading system for UIP both to monitor clinical progression and as a surrogate endpoint for antifibrotic drug trials.

Open access

Abstract

Though several treatments effectively address the pervasive impact of trauma, they do not achieve complete symptom resolution for all clients, inspiring the search for alternatives. Internal Family Systems (IFS) therapy has grown popular, especially in informal psychedelic-assisted treatments (PAT). Compared to stereotypes of empirically validated, exposure-based treatments, IFS has novel facets with widespread appeal. The model encourages improved quality of interactions among multiple, naturally arising “parts” or subpersonalities potentially generated by traumatic experience. The body of IFS literature is extensive, enthusiastic, and thought-provoking. Outcome data for applying the model to Post-Traumatic Stress Disorder are limited. Attempts to operationalize and falsify the theory's assumptions and proposed mechanisms will likely prove challenging. Nevertheless, the model's popularity underscores a problem with perceptions of the empirically-supported treatments. Contemplating ethical ways to present the IFS approach given the state of relevant research, we note strategies that would apply to recommendations for PAT of any type. These strategies include detailed psychoeducation about empirically-supported treatments, candid description of the experimental nature of alternatives, frequent assessments of improvement, and detailed monitoring of potential iatrogenic effects. Drawing on facets of IFS to improve perceptions of the empirically validated treatments might provide an efficient way to appeal to more clients, decrease drop out, and increase gains as we await results of empirical investigations of IFS-influenced PAT. These steps can allow clients to choose an approach consistent with their own impressions of a credible intervention, potentially leading to better outcomes.

Open access

Abstract

Purpose

The training load required at elite level can lead to shoulder pain even among the youngest swimmers, thus, besides modern water training plans and swimming technique development, the planning of dryland training with a preventive approach is of the utmost importance. The aim of the present study was to map kinetic patterns and sports injury risk factors among young competitive swimmers (between 9 and 12 years of age) and to investigate the effectiveness of a complex injury prevention programme on dry land.

Materials and methods

A total of 37 swimmers (19 girls and 18 boys, aged 10.8 ± 1 yrs) participated in the research. We performed a physical examination using the PostureScreen11.1 application, a digital goniometer, a manual dynamometer, and functional and diagnostic orthopaedic tests. The swimmers were divided into a trained group and a control group. A three-month complex injury prevention programme was developed for the trained group. We analysed our data using Statistica for Windows.

Results

We found that 19% of the swimmers had experienced shoulder pain since starting swimming. We also found several postural faults, a reduction in the rotational arc of motion in the shoulder joint, rotational muscle imbalance, serratus anterior weakness, and scapular dyskinesia. Following the programme, swimmers in the trained group showed significant improvement in the rotational arc of the shoulder joint, internal rotational range of motion, rotational muscle strength, and upper limb stability. Progress was also made in many other areas, although these results were not significant.

Conclusions

As shoulder pain and its risk factors can be observed even among the youngest competitors, a dryland training plan tailored to this group can reduce the occurrence of sports injuries.

Open access