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
Background and aims
Ibogaine, an alkaloid extracted from the root of the Tabernanthe Iboga shrub, holds promise in treating addictive disorders. Individuals receiving ibogaine treatment report decreased withdrawal symptoms, cravings, and addiction severity. These changes are often attributed to ibogaine's psychedelic properties: subjectively meaningful, dream-like experiences. Research demonstrates that ibogaine experiences impact multiple social-ecological dimensions and influence addiction and recovery trajectories. No studies have explored the multidimensional experiences of individuals seeking ibogaine treatment for addictions. The current study examines acute and enduring ibogaine experiences at individual, interpersonal, and behavioral health systems levels.
Methods
Fifteen individuals (5 female, 10 male) who received ibogaine treatment at a medical clinic in Ensenada, Mexico completed semi-structured interviews asking about individual, interpersonal, and behavioral health system experiences post-ibogaine within 12 months of ibogaine treatment (Mdn = 169 days). Transcripts were coded and analyzed using a Consensual Qualitative Research approach.
Results
Many participants reported seeking ibogaine treatment after exhausting other addiction services. Outcomes reported following treatment included alleviated cravings and withdrawal symptoms. Participants indicated that ibogaine experiences prompted insight into their addictions and contributed to their recovery. Self-support and disclosing ibogaine experiences to professional and non-professional supporters were important to participants' recovery post-ibogaine.
Conclusions
Intersecting experiences across social-ecological levels had an enduring impact on participants' addiction recovery after ibogaine treatment. Despite negative experiences with behavioral health systems prior to receiving ibogaine treatment, most participants sought the support of mental health professionals post-ibogaine. Findings are informative for mental health professionals and clients interested in ibogaine treatment.
Abstract
Background and aims
Psychedelic-assisted psychotherapy (PAP) is currently being studied as a possible treatment option for multiple disorders. Despite promising safety and efficacy findings, the high costs of the current PAP model makes it questionable if the treatment will be scalable. Non-hallucinogenic psychedelic analogs have been developed as a potential cost-effective alternative, but it is unclear what psychedelic users perceive as a reasonable cost for treatment and whether they would be open to trying a non-hallucinogenic analog.
Methods
We queried a large sample of people using psychedelics naturalistically (N = 1,221) about their attitudes regarding the role of altered states of consciousness in PAP outcomes, costs of treatment, and their openness to trying a non-hallucinogenic psychedelic analog for treating a mental health condition.
Results
We found that most (76%) participants considered altered states of consciousness as very or extremely important to the therapeutic effects of psychedelics. Despite this, most (61%) were also moderately, very, or extremely likely to try a non-hallucinogenic substance if given the chance. Lastly, participants considered approximately $70–80 per hour to be a reasonable cost for various aspects of psychedelic services (e.g., preparation, integration, and dosing sessions).
Conclusions
Participants valued the role of altered states of consciousness in therapeutic changes attributed to psychedelics, but were still open to trying a non-hallucinogenic analog. Notably, the price participants considered to be a reasonable amount for PAP is well below current market projections. Future research is needed to address limitations of the study as well as to identify ways of lowering treatment costs.
Abstract
Background
While the acute effects of high-load resistance training on the force generating capacity of muscles have been widely examined, limited data exist on the relationship with the force-velocity profile (FV). Evidence suggests high sensitivity of the vertical FV profile to monitor changes in the muscle's mechanical properties according to the type of the exercise protocol. However, the interpretation of the findings seems not as straightforward. Therefore, the purpose of this study was to examine the effects of a high-load resistance training protocol on the muscle's mechanical properties during loaded jumps and on the vertical force-velocity profile (FV) in relation to maximal strength.
Methods
29 resistance-trained male (mean age±SD: 35.4 ± 7.8 years) and 29 female athletes (mean age±SD: 32.5 ± 7.0 years) participated in the study. Five-repetition maximum (5RM) in back squat, unloaded countermovement jump (CMJ) and FV profile were assessed. Loaded jumps were performed against 25, 50, 75, and 100 percent of body mass. Participants performed exercise protocols corresponding to their 5RM. Immediately after, unloaded CMJ and FV profile measurements were repeated.
Results
A significant decrease in CMJ height (∼5–6%) and in average power (∼4%) was recorded for both men and women. The FV profile did not change after the exercise protocol; however, there was a significant decrease in theoretical maximal power (from 4 to 5%) and in theoretical maximal velocity (∼3%). Maximal strength was not associated with the changes in FV profile.
Conclusions
Findings suggest that an acute high-load exercise decreased vertical jump performance and maximal power output, but without a concomitant change in FV profile. The large interindividual variability in FV measures indicates a less straightforward connection of the applied exercise with the acute response in the FV profile, highlighting the complexity of the FV profile to monitor changes in response to an acute training load.
Abstract
Background and aims
This qualitative ethnographic study of a psychedelic integration group in the Southeastern United States contributes to an understanding of the role of supportive communities in processing psychedelic experiences. This article proposes the concept of ‘social efficacy’ to capture the importance of social relationships to the efficacy of psychedelics. Social efficacy refers to a source of efficacy that includes not just the immediate social environment in which psychedelics are experienced and processed, but also the broad range of social relationships and political economic and historical contexts that frame their use.
Methods
This year-long ethnographic research project took place with a psychedelic integration group in an urban center in the Southeastern United States. It was based on observation, interviews, and a focus group.
Results
Overall, the participants in the integration group see the group as critical to their ability to effectively process their psychedelic experiences. The group is important as a supportive community of like-minded people that facilitates enduring cognitive and affective transformation.
Conclusions
Community-based non-therapeutic integration groups can play a vital role in the positive integration of psychedelic experiences, improving mental health and quality of life for users. The important role of community-based groups has significance for both the legalization and the medicalization of psychedelics. It highlights the need for safe and legal spaces in which people can talk about their psychedelic experiences and for medical models of efficacy that include social, relational elements.
Abstract
Over the past decade, numerous open-label studies and early clinical trials have shown that psychedelics hold promise for the fast and possibly lasting relief of a wide range of conditions ranging from major depressive disorder, end-of-life anxiety, and obsessive-compulsive disorder to smoking, alcohol use, and eating disorders. Among the questions still to be resolved in this endeavor are questions related to the importance of the metaphysical and phenomenological aspects of the psychedelic experience. Are the hallucinatory experiences engendered by classical psychedelics necessary to their therapeutic action, or could a trip that doesn't go anywhere have the same effect on depression and other conditions? This commentary considers the value of the phenomenological psychedelic experience and asks the larger question, what are any of our phenomenological experiences for?
Abstract
With a surge in critiques levelled against the evidence generated by randomised controlled trials in the study of psychedelic-assisted therapy (PAT), and the legalization of PAT in select jurisdictions such as Australia, and Oregon and Colorado in the United States, we consider what form the real-world evidence of its effects could take. Specifically, we propose to complement individual-level data-gathering (the usual remit of pharmacovigilance procedures) with evidence of PAT's collective effects. Taking our cue from long-standing claims that psychedelics are agents of social transformation, we draw upon the ‘transformative paradigm’ of evaluation, an approach that is itself oriented around social justice and change vis-à-vis marginalised expertise – or what we approach as ‘the grassroots’. To illustrate the potential of such grassroots evaluations, we offer eight examples of social issues that have been discussed in relation to PAT and psychedelics use and, for each, discuss the kinds of expertise that could be brought into the evaluation team and the kinds of questions that could be asked. We further describe our grassroots approach according to three values inspired by the qualities of grass roots themselves: rhizomatic accountability, dark reflexivity, and more-than-human hosting. We argue that these values align with the contemporary experience, practice, and context of PAT. We hope to generate discussion, innovation, and – ultimately – action toward specific study designs that are adequate to the task of documenting, and working with, the transformative potential of psychedelics in contemporary medicalized societies.
Az emlőrák kezelése során alkalmazott hormonterápia csonthatásainak áttekintése
Review of bone health in women receiving endocrine therapy because of breast cancer
Az emlőrák – a fejlett országokhoz hasonlóan – hazánkban a nők leggyakoribb rosszindulatú daganata. A sikeres szűrőprogramoknak köszönhetően a felfedezett emlőrákok gyakorisága nő, miközben a szűrésből kiemelt preklinikai esetek nagyobb arányának és a korszerű sebészi és onkológiai terápiának köszönhetően a halálozás csökkenő tendenciát mutat. Az emlődaganatok közel kétharmada hormonreceptor-pozitív, humán epidermális növekedési faktor receptor-2 negatív, azaz jól reagál a hormoncsökkentő terápiára. Az endokrin terápiával kezelt emlőrákos betegeknél – mivel a betegség krónikus jellegűvé vált – számolnunk kell a terápia hosszú távú hatásaival is. A kezelés hatására a csontvesztés üteme felgyorsul, az ásványi csonttömeg csökken, ami a csonttörési kockázat növekedését is okozza. Ez külön jelentőséggel bír a már egyébként is postmenopausában lévő betegeknél, de a fiatal, mesterséges menopausát kiváltott esetében is figyelni kell rá. A jelen összefoglaló közleményben az elmúlt három évtized szakirodalmi adatainak áttekintésével szeretnénk ráirányítani a figyelmet a téma jelentőségére. Az időben elvégzett diagnosztikus lépések elengedhetetlenek a csontvesztés korai felismerése és a törésprevenciós kezelés bevezetése érdekében. Orv Hetil. 2024; 165(21): 813–821.
Az öntőláz (fémfüstláz) története és lehetséges patomechanizmusai
History and possible pathomechanisms of metal fume fever
Győr-Moson-Sopron vármegye orvosainak körében gyakori a kiégés
High prevalence of burnout among physicians in Győr-Moson-Sopron County, Hungary
Bevezetés: Az orvosok kiégése mára megkerülhetetlen kérdéssé vált világszerte, így a magyar orvosok körében is. A COVID–19-pandémia fokozta a kiégés gyakoriságát. Célkitűzés: A kiégés prevalenciájának és a demográfiai mutatókkal, valamint az ellátási típusokkal való összefüggéseinek feltárása Győr-Moson-Sopron vármegyében. Módszer: Keresztmetszeti vizsgálat (n = 481), melyben a kiégést a Maslach Kiégés Leltár HSS (Humán Szféra Kérdőív) változatával mértük fel. A kiégés és az egyes változók prevalenciájának elemzéséhez leíró statisztikai elemzést alkalmaztunk (átlag, szórás, gyakoriság). A folytonos változók esetén a csoportok átlagai közötti különbségeket független mintás t-teszttel, illetve varianciaelemzéssel, a kategóriás változók esetén a csoportok arányai közötti különbségeket χ2-teszttel vizsgáltuk. Eredmények: 481 orvossal végzett vizsgálat alapján a megkérdezettek 89,6%-át érintette a kiégés legalább egy dimenziója. A minta felére volt jellemző (52,8%) a nagy fokú érzelmi kimerülés. A deperszonalizáció magas szintje a minta 42,8%-át érinti, míg a személyes teljesítmény csökkenésének gyakori érzése a megkérdezettek 45,9%-ában volt jelen. Közel minden negyedik (24,7%) orvos esetén a kiégés mindhárom dimenziójában nagy értékeket találtunk. A mintát differenciálva azt találtuk, hogy a fiatalok körében (25–35 éves korosztály) különösen nagy a kiégés prevalenciája. A csak magánegészségügyben tevékenykedő orvosok csoportjában ritkább volt a kiégés. Következtetés: A kiégés prevalenciája nagy az általunk vizsgált orvosok körében. Szükséges lenne egy nemzeti prevenciós és intervenciós stratégia kidolgozása az orvosok kiégésének csökkentésére, már az orvosi egyetemeken megkezdve. Orv Hetil. 2024; 165(21): 822–831.
A pro-, pre- és szinbiotikumok hatása a szénhidrát-, illetve lipidanyagcserére
The effect of pre-, pro- and synbiotics on the carbohydrate and lipid metabolism
A diabetes és előállapota − a praediabetes − prevalenciája világszerte exponenciális mértékben emelkedik. Mind több adat támasztja alá a bélmikrobiomnak a kórforma kialakulásában játszott szerepét. Jól ismert, hogy a pre-, a pro- és az ezek kombinációjából álló szinbiotikumok befolyásolhatják a bélflóra összetételét, s így szerepük lehet a diabeteshez vezető patogenetikai folyamatok megváltoztatásában, lassításában. Azt is mind több megfigyelés támasztja alá, hogy különböző gyógyszerek − köztük kiemelkedő jelentőséggel az antidiabetikumok − módosíthatják a mikrobiom összetételét. Munkánk irodalmi adatok alapján áttekinti a pre-, pro- és szinbiotikumok szénhidrát- és lipidanyagcserét befolyásoló hatását, valamint az 1-es és a 2-es típusú diabetes patogenezisét potenciálisan befolyásoló szerepét, emellett röviden kitér az antidiabetikumok bélflórát befolyásoló természetére is. Orv Hetil. 2024; 165(21): 803–812.
