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.

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Journal of Behavioral Addictions
Authors:
Jussi Palomäki
,
Tiina Latvala
,
Anne H. Salonen
,
Virve Marionneau
,
David Hodgins
,
Matthew M. Young
, and
Sari Castrén

Abstract

Background

The lower risk gambling guidelines (LRGG) represent an evidence-based collaborative effort to provide clear advice to people on the limits of safe gambling consumption. The guidelines are as follows: 1) Gamble no more than 1% of household income per month; and 2) Gamble no more than 4 days per month; and 3) Avoid regularly gambling at more than 2 types of games.

Methods

In an online survey study (N = 778), we evaluated the feasibility and acceptability of the LRGG among different subpopulations in Finland.

Results

We found that the guidelines were generally evaluated positively as understandable, sensible, clear, and “just right” in terms of their content. There were some notable differences between subpopulations: Individuals who were at risk of gambling problems evaluated the LRGG more negatively than others, while professionals working in the field of gambling prevention were the most optimistic about the guidelines. Thus, increased level of potentially harmful gambling engagement was linked with a somewhat more pessimistic attitude towards the guidelines. On the other hand, those who had not gambled in the past year viewed the guidelines as too permissive compared with those who had gambled, or those working in gambling prevention.

Discussion

Overall, our results show clear differences of opinion between the various subpopulations, which appear to be associated with the individuals' level and nature of gambling experience. We conclude that the LRGG can likely be adopted into wider use in Finland.

Open access

A mastocytosis ritka megbetegedés: kb. 10 új beteg megjelenésével lehet számolni évente 100 000 lakosra vonatkozóan. Ez annyit jelent, hogy ma Magyarországon ezres nagyságrendben kellene felismerésre és gondozásra kerüljenek, ami nem történik meg. A klinikánkon megalakult Semmelweis Mastocytosis hálózat elnyerte az európai, 21 ország szakembereit magában foglaló European Competence Network on Mastocytosis (ECNM) kiválósági központjaként történő elismerést. Évente 10–15 új beteget látunk és több mint 150 beteget gondozunk. Az egész országból érkeznek hozzánk. A hálózatban bőrgyógyász, hematológus, patológus működik együtt. Differenciáldiagnosztika tekintetében hálózatunkban HANO (örökletes angioneurotikus oedema) kivizsgálás is történik, triptázszintmérés is bevezetésre került, illetve lehetőség van a myeloid panelben vizsgálni a prognosztikus jelentőségű RUNX1, ASXL1 és SF3B1 mutációkat, valamint tervezzük a herediter alpha triptazaemia TPSAB1 gén mutációjának vizsgálatát. Ez utóbbi a következő WHO-klasszifikációban mint minor kritérium fog szerepelni. Alábbiakban az utóbbi években megjelent legfontosabb publikációk rövid ismertetésén túl az ECNM legutóbbi éves konferencián elhangzott a diagnosztikát és terápiát érintő újdonságokról számolok be.

Open access

Az epehólyag adenosquamosus daganata

Gallbladder adenosquamous carcinoma

Orvosi Hetilap
Authors:
Fanni Hegedűs
and
Anita Sejben

Adenosquamous carcinoma is a rare subtype of gallbladder tumours that often spreads to surrounding anatomical structures and, like malignant tumours of the gallbladder, is very aggressive. The 70-year-old female patient presented in this study was investigated due to abdominal pain, and thickened gallbladder wall was revealed with imaging techniques. The gallbladder was removed along with the surrounding liver parenchyma and the adjacent colon due to continuous spread. Histological examination confirmed primary adenosquamous carcinoma of the gallbladder. The squamous cell carcinoma component that revealed keratinization, was positive with p40 immunohistochemistry. In the 1 month since diagnosis, the patient was stable and is currently receiving adjuvant oncological treatment. According to the available literature, gallbladder adenosquamous carcinoma shows female predominance, and is occurring in the 6th–7th decade. Abdominal pain is the most common first symptom. The current WHO classification specifies a minimum of 25% squamous cell carcinoma component during the histological examination. Exclusion of metastatic process is necessary for a definitive diagnosis. Orv Hetil. 2024; 165(49): 1945–1950.

Open access

A gyógyszer-repozicionálás és klinikai diabetológiai vonatkozásai

Drug repositioning and its aspects in clinical diabetology

Orvosi Hetilap
Authors:
Bence Pokoly
and
Anikó Somogyi

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.

Open access

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

Orvosi Hetilap
Authors:
Gergely Bungyi
,
Tamás Pócza
,
Ágnes Zongor
,
Zoltán Takácsi-Nagy
, and
Tibor Major

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.

Open access

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.

Open access

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.

Open access

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.

Open access
Imaging
Authors:
Mario Leporace
,
Ferdinando Calabria
,
Rosanna Tavolaro
,
Maria Toteda
,
Stefania Cardei
,
Antonio Lanzillotta
,
Giuliana Guadagnino
, and
Antonio Bagnato

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.

Open access

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.

Open access