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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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A posztoperatív pancreasfistula csökkentésére bevezetett innovációink

Our innovations for the reduction of postoperative pancreatic fistula output

Magyar Sebészet
Authors:
Dezső Kelemen
,
Ádám Varga
,
András Palkovics
,
Sándor Ferencz
, and
András Vereczkei

Bevezetés: A posztoperatív pancreasfistula mind proximalis, mind distalis pancreatectomia után a legjelentősebb sebészi szövődménynek számít. A szakirodalomban nincs egyértelműen ajánlott, megbízható módszer ezen probléma kiküszöbölésére, emiatt történnek újítások szerte a világon. Jelen közleményünkben a technikai innovációinkról számolunk be. Anyag és módszerek: 2013. január 1-jétől 2023. november 30-ig terjedő időszakban 205 Whipple-műtétet végeztünk nyitottan, mely során a pancreatojejunalis anastomosist az általunk módosított dohányzacskó-öltéses módszerrel készítettük el. 2019. január 1. és 2023. november 30. között pedig 30 betegnél történt nyitott distalis pancreatectomia, amikor a pancreascsonkot az általunk kifejlesztett technikával, szabad rectus fascia-peritoneum grafttal fedtük, majd azt cirkuláris öltéssel rögzítettük. Közleményünkben ezen két módszerrel elért eredményeket ismertetjük. Eredmények: a demográfiai adatok megfeleltek a betegségnél szokásosnak. A posztoperatív ápolási idő és a transzfúzió igény terén észlelt különbségek tükrözték a kétféle beavatkozás eltérő invazivitását. A releváns pancreasfistula kialakulási rátája kedvező képet mutatott, Whipple-műtét után 7,3% volt, míg distalis pancreatectomát követően nem fejlődött ki. A reoperációs és a halálozási arányok megfeleltek az elvártaknak és korreláltak a műtétek kiterjedtségével. Következtetés: pancreas resectiók utáni komplikációk csökkentésére tett törekvéseink során a módosított dohányzacskó-öltéses pancreatojejunostomia és a pancreascsonk fedésére kidolgozott módszerünk egyaránt kedvező eredményekkel járt.

Open access
Journal of Behavioral Addictions
Authors:
Albert Bellmunt-Gil
,
Victor Vorobyev
,
Riitta Parkkola
,
Jyrki Lötjönen
,
Juho Joutsa
, and
Valtteri Kaasinen

Abstract

Background

Changes in brain structural connections appear to be important in the pathophysiology of substance use disorders, but their role in behavioral addictions, such as gambling disorder (GD), is unclear. GD also offers a model to study addiction mechanisms without pharmacological confounding factors. Here, we used multimodal MRI data to examine the integrity of white matter connections in individuals with GD. We hypothesized that the affected areas would be in the fronto-striatal-thalamic circuit.

Methods

Twenty individuals with GD (mean age: 64 years, GD duration: 15.7 years) and 40 age- and sex-matched healthy controls (HCs) underwent detailed clinical examinations together with brain 3T MRI scans (T1, T2, FLAIR and DWI). White matter (WM) analysis involved fractional anisotropy and lesion load, while gray matter (GM) analysis included voxel- and surface-based morphometry. These measures were compared between groups, and correlations with GD-related behavioral characteristics were examined.

Results

Individuals with GD showed reduced WM integrity in the left and right frontal parts of the corona radiata and corpus callosum (pFWE < 0.05). WM gambling symptom severity (SOGS score) was negatively associated to WM integrity in these areas within the left hemisphere (p < 0.05). Individuals with GD also exhibited higher WM lesion load in the left anterior corona radiata (pFWE < 0.05). GM volume in the left thalamus and GM thickness in the left orbitofrontal cortex were reduced in the GD group (pFWE < 0.05).

Conclusions

Similar to substance addictions, the fronto-striatal-thalamic circuit is also affected in GD, suggesting that this circuitry may have a crucial role in addictions, independent of pharmacological substances.

Open access

Abstract

Background and Aims

Many individuals with substance use disorders (SUDs) present with co-occurring mental health disorders and other addictions, including behavioral addictions (BAs). Though several studies have investigated the relationship between SUDs and BAs, less research has focused specifically on compulsive sexual behaviour (CSB). Given that poly-addiction can hinder treatment outcomes, it is necessary to better understand the impact of co-occurring CSB and SUD. Therefore, the current study aimed to 1) determine the rate of CSB in a sample seeking treatment for SUDs, 2) identify demographic and clinical correlates of co-occurring CSB, and 3) to determine if co-occurring CSB impacts treatment outcomes for SUD.

Methods

Participants were 793 adults (71.1% men) ranging in age from 18–77 (M = 38.73) at an inpatient treatment facility for SUDs who were assessed for CSB upon admission into treatment. Participants completed a battery of questionnaires upon admission and at discharge to assess psychological and addiction symptoms.

Results

Rates of CSB were 24%. Younger age and being single were associated with greater CSB. Mental distress and addiction symptoms were higher in participants with CSB. Predictors of CSB severity included greater symptoms of traumatic stress and interpersonal dysfunction. Rates of treatment completion were similar between participants with and without CSB.

Discussion and Conclusions

These results highlight several clinical and demographic correlates of CSB amongst individuals in treatment for SUD. However, CSB was not associated with poorer treatment outcomes. Further identifying characteristics associated with CSB can help clinicians identify individuals who may be at higher risk.

Open access

Abstract

Given the many obstacles faced during the treatment of ovarian cancer, usually due to diagnosis at advanced stages, it is crucial to use different means to plan the therapeutic procedure in order to achieve optimal results. Positron emission tomography–computed tomography (PET/CT) is a recent hybrid method of medical imaging that can provide various information on the anatomic and biochemical status of a tumor, as well as possible metastases and hence provide better insights to clinicians for the therapeutic procedure. To this end, the present mini-review explores the role of PET/CT scanning in planning surgical procedures, systemic anticancer therapy and radiotherapy and summarizes the current status of studies that examine the use of PET/CT in the personalized therapy of ovarian cancer. Nonetheless, more clinical and observational studies are required to further verify the use of PET/CT in planning therapeutic procedures for patients with ovarian tumors.

Open access

Abstract

Objective

The present study aimed to evaluate the efficacy of a mindfulness-based cognitive therapy (MBCT) intervention in reducing problematic mobile phone use, depression, and sleep disorders among adolescents. Additionally, it sought to investigate whether the decrease in problematic mobile phone use acted as a mediator in the relationship between the MBCT intervention and adolescent depression and sleep disorders.

Methods

In a randomized controlled trial, a total of 104 adolescents were randomly assigned to the mindfulness group (n = 52) or the wait-list control group (n = 52). The mindfulness group students completed eight 45-min sessions of mindfulness training in four weeks. The outcomes were measured at baseline, postintervention, and at the 2-month follow-up.

Results

Compared with the control group, the mindfulness group had significantly greater levels of mindfulness and lower levels of problematic mobile phone use, depression, and sleep disorders postintervention. The intervention effects were maintained at the 2-month follow-up. In addition, decreased problematic mobile phone use significantly mediated the association between the MBCT intervention and decreased depression and decreased sleep disorders.

Conclusion

The findings suggest that MBCT could improve adolescent depression and sleep disorders and that decreasing problematic mobile phone use is an effective pathway accounting for the MBCT intervention effect on adolescent depression and sleep disorders.

Open access

Abstract

As the wider culture is experiencing what some call a “psychedelic renaissance,” various Christian voices are beginning to comment on this cultural moment in the press and social media. Some are curious, even open minded, about the developments; others are expressing concern about what they see as the inauthenticity and danger of psychedelics as a spiritual practice. In the academic literature, most work on the intersection of Christianity and psychedelic medicine treat either the historical question of psychedelics' possible role in the foundations of the religion or on the practical question of “should we or shouldn't we?” Absent, however, is discussion of how a Christian psychedelic practice might look. This article seeks to address this shortfall by showcasing three extant examples of what we term “psychedelic Christianity”: 1) hippies who converted to Christianity while still using psychedelic substances during the “Jesus movement”; 2) mid-twentieth-century Catholic intellectuals experimenting with the compounds for spiritual and therapeutic reasons; and 3) contemporary clergy who participated in the Johns Hopkins and NYU study with psychedelics and religious professionals. In all of this, we give special attention to the healing experienced by these Christians who undertook a psychedelic Christianity in their recourse to these substances.

Open access

Abstract

Background and aims

Psychedelics show promise for treatment of mental health conditions (MHCs). But there is relatively little research on indigenous psychedelics conducted in the Global South (GS). Much research is carried out in the Global North, where there are different cultural perceptions of mental health and psychedelics. Therefore, this paper appraises research on psychedelics for treatment or therapy where research was carried out in the GS.

Method

A systematic review of research literature was conducted from 1st January 2010 to 31st July 2023. Medline, PsychINFO and Global Health databases were searched for studies of patients undergoing treatment for MHCs with psychedelics.

Results

Data from 27 papers were extracted and narratively synthesized. A total of 984 participants were included suffering from depression, obsessive-compulsive disorder, substance use disorder, post-traumatic stress disorder and eating disorders. The studies investigated the feasibility of psychedelic treatments and presented evidence for their safety. There was preliminary efficacy data for ayahuasca, iboga, 5-MeO-DMT, psylocibin, and MDMA in the treatment of some MHCs. All studies were conducted in line with ethical and medical guidelines, and no serious adverse events were reported.

Conclusion

A renaissance of clinical psychedelic research on substances that have been used as traditional medicines in the GS presents promising evidence for treatment efficacy and safety across a range of MHCs. Psychedelics present an exciting new treatment approach for people in the GS, in a health area with considerable unmet need. Moreover, research demonstrated cost-effectiveness, while results suggested no significant safety concerns or side effects.

Open access

A hideg agglutinin betegség diagnosztikája és ellátási gyakorlata

Diagnosis and treatment of cold agglutinin disease

Hematológia–Transzfuziológia
Authors:
Boglárka Brúgós
,
Zsófia Simon
,
Ildikó Zsigmond Soós
, and
Árpád Illés

A hideg agglutinin betegség az autoimmun hemolitikus anémiák ritka altípusa, egy indolens, low-grade lymphoproliferatív betegség, amely nem meríti ki a B-sejtes lymphoma kritériumait. A keringésben kimutatható a vörösvértestek felszínén lévő „I” antigén ellenes, rendszerint IgM típusú autoantitest. Hideg hatására a pentamer szerkezetű antitest a perifériás keringésben az antigénhez kötődve agglutinációt, súlyosabb esetben komplement aktivációt és hemolízist okoz. Vércsoport-szerológiai vizsgálat során erős C3d-pozitivitás igazolható. A betegség tünetei, a klasszikus „fatigue”, fáradékonyság, gyengeség részben a hemolitikus anémia, részben a komplement aktiváció, proinflammatorikus citokin emelkedés következményei. A hideg indukálta, IgM mediálta agglutináció felelős a betegség vaszkuláris tüneteiért (acrocyanosis). A betegség kezelésében B-sejt depléciós és komplentgátló kezelések javasoltak, de nagy, nemzetközi randomizált klinikai vizsgálatok hiányában a kezelésre vonatkozóan csak ajánlások állnak rendelkezésre. Közleményünkben a betegség kivizsgálására és kezelésére vonatkozó ajánlásokat foglaltuk össze.

Open access

LGL-leukémia: Dasatinib mellett molekuláris remisszióban lévő chronikus myeloid leukémia ritka szövődménye a splenomegália hátterében

LGL leukemia: A rare complication of chronic myeloid leukemia in molecular remission with dasatinib in the background of splenomegaly

Hematológia–Transzfuziológia
Authors:
Botond Timár
,
Gábor Szalóki
,
Erik Zajta
,
Imre Bodó
, and
Ágota Szepesi

A nagy granuláris lymphocyta (LGL) leukémia leggyakrabban normál LGL-sejtek expanzióját kiváltó krónikus antigén stimulációt okozó állapotokkal, mint például krónikus vírus infekcióval, autoimmun betegségekkel és elsősorban hematológiai malignitásokkal társul. A bemutatott esetben az LGL-leukémia egy ritka okát, tünetét és diagnosztikai lehetőségeit tárgyaljuk. A várandós nőbetegnél rutin vérvizsgálat során észlelt thrombocytosis és splenomegália hátterében chronikus myeloid leukémia igazolódott. Az interferon terápiával indult kezelést autoimmun pneumonitis miatt, a másodvonalban elindított glivec terápiát pedig súlyos neutropénia és társuló MRSA sepsis miatt kellett elhagyni. Harmadvonalban császármetszés után indított dasatinib terápia 16 hónap elteltével major molekuláris választ eredményezett. A betegség kezdetétől észlelt splenomegalia és neutropenia azonban nem szűnt meg. További kivizsgálás során JAK2, CALR, MPL mutáció nem igazolódott, a beteg a lép biopsziába nem egyezett bele. A splenomegália hátterében végső soron a perifériás vérben észlelt monoclonalis T-LGL-sejtszaporulat és cytotoxikus T-sejtek csontvelői infiltrációja alapján diagnosztizált LGL-leukémia állhat. Míg a klonális LGL lymphocytosis a dasatinib kezeléshez ismerten társuló gyakori jelenség, klinikai tüneteket okozó esetet nem találtunk az irodalomban. Miután az LGL lymphocytosis chronikus myeloid leukémia válaszra kifejtett kedvező hatásáról számolnak be, és betegünknél az LGL-leukémia csak egy könnyen uralható enyhe neutropeniát okozott, így a dasatinib kezelésen egyelőre nem változtattunk.

Open access
Acta Veterinaria Hungarica
Authors:
Dominik Gulyás
,
Gábor Kovács
,
István Jankovics
,
Máté Hidvégi
,
Béla Dénes
,
Lilla Kálfalvy-Molnár
,
Rebeka Nagypál
, and
Márta Lőrincz

Abstract

The interplay of regulatory T cells (Tregs) within the tumour microenvironment presents a significant challenge in anticancer immunotherapy. This study investigates the potential of Treg blockade to enhance the efficiency of effector T cells. Two distinct treatment cocktails were examined: 3p-hpRNA (5′ triphosphate hairpin RNA) combined with unmethylated CpG oligonucleotide (CpG); CpG in combination with OX40 receptor-specific monoclonal antibody (anti-OX40). Treatment efficacy was assessed using a murine model of kidney adenocarcinoma.

Renca cells (renal cortical cells with adenocarcinoma) were subcutaneously engrafted in 30 BALB/c mice, then animals were allocated into three treatment groups: Group 1: CpG+anti-OX40, Group 2: CpG+3p-hpRNA, Group 3: untreated control. Treatment efficacy was evaluated based on tumour growth, the occurrence of metastases and overall survival.

On day 28 post-implantation, experiments had to be terminated due to tumour progression. Although comparisons of survival times and primary tumour sizes thus became inconsequential, histological examinations provided valuable insights. We observed distinct variations in primary tumour characteristics among the different groups: Groups 1 and 2 displayed demarcations, while Group 3 exhibited diffuse tumours with necrosis. Lung metastases were evident in 70% of untreated mice, whereas none were observed in either of the treated groups.

Our findings instil confidence in the potential efficacy of the treatments, thereby laying a solid foundation for future investigations.

Open access