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
Networks of so-called underground, or illegal, psilocybin mushroom practitioners are popularly known to exist, though few systematic investigations of their practices have been conducted. We sought to uncover the experiences of a hidden community of psilocybin practitioners in order to inform scientific and policy dialogues about safe and effective practices in this area.
Methods
An academic-community partnered research team used snowball sampling to recruit 17 underground psilocybin practitioners in a western U.S. state for in-depth individual interviews focused on training, protocols, practices, and policy priorities. Combined deductive and inductive analysis with three independent coders was completed using NVivo v12.
Results
Practitioners were white (76.5%), female-identified (64.7%), aged 31 to 50 (64.7%), non-therapists by training (58.8%), and moderately to highly experienced facilitators. All described multiple years of often difficult personal inner-directed work with psilocybin before guiding others. Benefits ranged from reduction in symptoms of depression, obsessive-compulsive disorder, and addictions to greater self-knowledge, reduced death anxiety, and a greater ability to experience joy. Client screening protocols revealed precautions for persons with severe trauma backgrounds, personality disorders, or lacking social support. Moving too quickly into a high dose mushroom session without adequate preparation or internal resourcing was perceived as a significant risk for harm. Practitioners' direct personal relationship with mushrooms was highlighted as critical to safe practice. Policy priorities centered on respectful reciprocity, defined as an ethos of giving back rather than extraction, and equitable access.
Conclusions
While some psychedelic research actively examines the role of the mystical-type experience in clients' positive outcomes, findings from underground practitioners suggest an even greater role of mysticism, relationality, and expanded concepts of holistic healing that can inform the development of best practice paradigms of an emerging profession.
Abstract
Thoracoabdominal aneurysms with extent I and II usually represent a challenge for endovascular aortic repair, given the absent proximal landing zone for a standard thoracic endovascular aortic repair. We report a successful endovascular treatment of such an aneurysm with a staged complex repair incorporating a total of eight branches, without the need of a surgical bypass.
Abstract
A longstanding challenge in the behavioral addictions field has been determining the point at which gaming involvement becomes clinically significant problematic use. Gaming disorder (GD) and hazardous gaming as recent ICD-11 diagnoses have attracted polarized perspectives due in part to the global popularity of recreational gaming and gaming culture. The broad continuum of gaming can often be perceived differently by different parties, including gamers themselves; what might be seen as regular, harmless, and normative to some, may be considered risky and problematic by others. The ICD-11 guidelines provide some clarity by advising that gaming disorder should not be diagnosed based on persistent gaming alone; that gaming as part of a routine, developing skills, changing mood or relieving boredom, or facilitating social interaction is not sufficient for a diagnosis; and that cultural and peer group norms should be considered in diagnosis. In this paper, we examine gaming normality-disorder boundary issues in the areas of conceptualization, assessment, and interventions. Some examples of the complex personal, social, and cultural considerations that arise in gaming diagnoses are provided. We call for researchers in the addiction and health disciplines to grapple with conceptual controversy and conduct the empirical and clinical research needed to ensure that normal recreational gaming is always clearly distinguished from harm and disorder.
Fejlett technológiák és innovatív megközelítések a neuromusculoskeletalis rehabilitációban
Advanced technologies and innovative approaches in neuromusculoskeletal rehabilitation
In recent years, advanced technology-based devices have become increasingly important in rehabilitation. Modern devices such as virtual and augmented reality, exoskeletons, end-effectors and weight-assisted gait training can be of great benefit in restoring mobility and cognitive function when used as a complement to traditional therapies. The development and implementation of protocols and guidelines are needed to ensure that modern rehabilitation technologies are regulated and based on scientific evidence. Advanced technology-based devices require specially trained therapists who are skilled in their use. Therapists play a crucial role not only in selecting the appropriate device, developing the therapeutic plan and delivering treatments based on the principles of traditional physiotherapy but also in motivating patients, which is important during longer treatment processes. Further research is needed to better understand the effectiveness of the devices and how they are used and to develop new guidelines to support their practical application. Improving the cost-effectiveness of the devices is also important, as this can ensure wider availability of the technology, including their home use. Overall, the widespread availability and adoption of modern technology-based solutions by health professionals could offer new long-term rehabilitation perspectives. Orv Hetil. 2025; 166(5): 175–182.
A petefészek-krioprezerváció és -autotranszplantáció mint a termékenység megőrzésének új lehetősége
Ovarian cryopreservation and autotransplantation as a new method for fertility preservation
Ovarian cryopreservation and autotransplantation offer a promising opportunity for preserving fertility in patients undergoing gonadotoxic treatment of malignant diseases. The aim of the procedure is to restore ovarian function following treatment and prevent premature ovarian failure. The aim of this case study is to present the method of ovarian cryopreservation and autotransplantation and to review the current scientific literature on the subject. A 25-year-old female patient diagnosed with acute lymphoblastic leukemia underwent ovarian tissue cryopreservation prior to myeloablative treatment. Following her remission, the ovarian tissue was orthotopically autotransplanted, after which the patient was monitored through weekly hormone level assessments (FSH, LH, estradiol, progesterone) and transvaginal ultrasounds. Gonadotropin and ovarian hormone levels showed no significant changes between postoperative days 7 and 63. By day 145, ovarian endocrine function was restored as indicated by decreased gonadotropin levels and normalized estradiol levels. In the literature, the 5-year survival rate of ovarian grafts during long-term follow-up was reported at 55%, with restoration of reproductive function and spontaneous pregnancies occurring in some cases. The method has proven effective in restoring both endocrine and reproductive functions, with the highest likelihood of achieving pregnancy shortly after the procedure. Previous studies have reported live birth rates as high as 41% following ovarian cryopreservation and autotransplantation. Ovarian cryopreservation and autotransplantation provide a valuable opportunity for preserving fertility in patients undergoing gonadotoxic treatments. Although our experience is limited to a single case, the results are encouraging. Further research is needed to optimize the procedure and expand its clinical application. Orv Hetil. 2025; 166(5): 195–200.
Stresszkezelési stratégiák és prevenciós lehetőségek hatékonysága a magyar sürgősségi betegellátásban
Effectiveness of stress management strategies and preventive measures in Hungarian emergency medical care
Introduction: Professionals working in emergency medical services frequently face intense physical and mental stress, significantly impacting their health and the quality of their work. Objective: This study aims to assess the effectiveness of stress management strategies among Hungarian emergency medical service professionals and the available preventive measures. Method: The study is a cross-sectional investigation conducted between January 2023 and March 2024 in the Southern Transdanubian Region. The data of 202 emergency medical professionals were analyzed, including physiological parameters recorded at various time points (blood pressure, heart rate), the level of subjective stress perception, and cortisol values measured from saliva and hair samples. Mann–Whitney U test, χ2 test, Wilcoxon test, Kruskal–Wallis test, and repeated measures ANOVA were applied. Data processing was performed using IBM SPSS Statistics 26.0, G*Power 3.1, and Matplotlib 3.9.1 software. Results: Most participants work long shifts, often at night, and hold secondary jobs. Emergency departments experienced patient load five times that of prehospital settings, with more mentally demanding cases. Participants mainly rely on family, colleagues, and friends, but only a few seek the help of mental health professionals (7.4%). During emergencies, ambulance workers experienced a 10.7% increase in blood pressure, a 15.3% rise in heart rate, and a 1.7-fold increase in tension (p<0.001). In emergency departments, blood pressure increased by 8.5%, heart rate by 11.9%, and tension by 2.5-fold (p<0.001). The workplace environment and patient care processes in both settings elevated the cortisol levels of healthcare professionals (p<0.001). Hair sample measurements were higher among emergency department workers, reflecting the accumulation of long-term stress. Among ambulance workers, those serving at central stations exhibited higher cortisol levels than those at peripheral stations. Conclusion: Distress is significantly present among domestic emergency care professionals, particularly in work environments characterized by high patient volume and long shifts, posing long-term health risks. Mental health preservation and stress management practices must be integrated into daily routines, and communication efficiency should be improved through multichannel information and personal consultations. Systematic development of social support and workplace mental health services is essential to prevent chronic stress and burnout. Orv Hetil. 2025; 166(5): 183–194.
Új irányelvek az infektív endocarditis megelőzésében és ezek fogászati és szájsebészeti vonatkozásai
New guidelines in infective endocarditis and its dental and surgical aspects
Infective endocarditis is one of the most severe potential complications associated with dental procedures. The mortality of infective endocarditis is still high, but with application of prophylactic measures, the risk can be reduced. It is strongly recommended to be up-to-date with the new (2023) international guidelines and follow its recommendations. Several great works have been published previously in Hungary, now we would like to update them. The previous guideline from the European Society of Cardiology (ESC) was published in 2015. Since then, several new data have come out, resulting in the revision of the guideline. The main changes regarding oro-dental procedures include the more detailed specification of the group of patients with cardiovascular diseases who are recommended to use antibiotic prophylaxis. These affect the patients who live with congenital heart disease. Another major change is in the recommended list of antibiotics. Clindamycin was ruled out, the guideline now includes azithromycin and clarithromycin instead. Our guideline provides a detailed, yet simplified chair-side guide for infective endocarditis prophylaxis. This includes the indication of prophylaxis, antibiotic choice and dosage, available original medications, their dosage and contraindications. We also provide recommendations for the most common problems related to drug intake, like difficulty in swallowing and allergies. Orv Hetil. 2025; 166(5): 163–174.
Abstract
Background and aims
There is a lack of research on the impact of acute stress on the interaction of affective and cognitive processes in online compulsive buying-shopping disorder (CBSD). Therefore, this project addressed stress response, cue reactivity, attentional bias, and implicit associations in individuals with online CBSD.
Methods
Women with CBSD (n = 63) and women with non-problematic online buying-shopping (n = 64) were randomly assigned to the Trier Social Stress Test or a non-stress condition. After the stress/non-stress induction, participants performed a cue-reactivity paradigm, a dot-probe paradigm, and an implicit association task, each with addiction-related (online buying-shopping) and control (social networks) cues.
Results
Individuals with CBSD showed stronger affective responses towards the addiction-related and control cues than the control group and rated the addiction-related pictures with higher ‘arousal’ and ‘urge’ than the control images. No group differences emerged in the dot-probe paradigm and implicit association task. Acute stress showed no effect on performance in the behavioural tasks. Regression models investigating the impact of craving on the relationship between stress response and implicit cognitions within the group with CBSD were not significant.
Discussion
The findings demonstrate the involvement and generalization of cue reactivity in online CBSD, but do not provide support for effects of acute stress on cue reactivity, attentional bias and implicit associations.
Conclusions
Future studies should not be restricted to women and combine laboratory and naturalistic study designs to investigate the complex psychological mechanisms in online CBSD.
Abstract
This article critically addresses one of the most pressing questions of the current moment of the psychedelic wave: Is mainstreaming psychedelics a good thing? Our aim is not to provide a simple “yes” or “no” as an answer but to explore the tensions, controversies, disparities, inequalities, and risks that have risen in the last decades. We discuss the limits of psychedelic science as the paradigm leading this movement and the risks of an overemphasis on biomedicalization to the detriment of the social sciences, humanities, and traditional knowledge. We also examine policy considerations, the dangers of commodification, and the ecological burdens that the expansion of the use of psychedelics is causing. Additionally, the article reflects on the tendency to prioritize the psychotherapeutic approach to care, a topic that has been neglected in the field. The authors put forward the need for inclusion, ethics, and reciprocity to balance the inequalities that risk recreating the psychedelic movement as another expression of mainstream capitalist endeavors. Given the Food and Drug Administration's delay in approval of MDMA for PTSD and the hurdles for regulating access to psychedelics in ceremonial and therapeutic contexts, such as Colorado and Oregon, there is an urgent need to engage in an informed conversation about the future of the psychedelic movement. It is important to avoid the tendency to romanticize this landscape and to do a proper assessment of the contemporary challenges and ethical risks that we face in the future.
Abstract
We report a case of a female patient in her 40s who presented with right upper quadrant pain and abdominal discomfort. Surgical removal was not possible due to the location of the lesion. Between 2021 and 2022, the patient had four additional sessions of conventional transarterial embolization (TAE) with Lipiodol, but none succeeded in sufficiently reducing the hemangioma's size or permanently improving the symptoms. In November 2022, we used transarterial chemoembolization (TACE) with a Bleomycin-Lipiodol emulsion. Follow-up MRI scans showed a gradual reduction in the hemangioma volume, but the symptoms only improved partially. Hence, the patient underwent a second bleomycin TACE embolization in November 2023. By August 2024, control showed a total volume reduction of 409 cm³ (56%) and significant symptom improvement. This case demonstrates that Bleomycin-Lipiodol TACE can effectively reduce the size of giant liver hemangiomas, even after the failure of other interventional therapies.