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
While psychedelic substances are extensively studied through the lens of various academic disciplines, their impact on the therapeutic practice of mental health professionals is yet to be explored. This firsthand experience is deemed crucial for effectively assisting patients in the process of integrating a psychedelic experience.
Aims
The aim of this study was to explore the psychological and spiritual dimensions of psychedelic integration among mental health professionals, focusing on understanding how transformation and insights influence their clinical work.
Methods
Utilizing a phenomenological methodology, interviews with eight mental health professionals with substantial first-person experience with psychedelics were conducted.
Results
Our findings indicate a potential, enduring, positive impact of psychedelic meta-integration on the practice of mental health clinicians. The data analysis yielded a multi-faceted model encompassing key aspects of human life including interpersonal and emotional development, relationship with death and nature, concepts of love, meaning, and spirituality, along with elements pertinent to therapeutic work. This comprehensive model integrates these diverse dimensions, offering a holistic understanding of the impact of psychedelics on both personal and professional realms.
Conclusions
The findings of this study lend support to the notion that health professionals involved in clinical work encompassing psychedelic integration should themselves have undergone induced altered states of consciousness, not only for a better empathetic understanding. This might be also predicated on the intrinsic positive transformative effects on their human capacities and as therapists. This dual benefit underscores the importance of personal experience in the effective facilitation of psychedelic integration in clinical settings.
Abstract
Background and aims
The recent resurgence of psychedelic research has led to increased interest in extra-pharmacological factors shaping drug effects (set and setting). Habitually discussed in the context of psychedelic therapy, the relevance of set and setting to determining the outcome of non-psychedelic psychiatric interventions receives strong theoretical and empirical support in the literature. Unfortunately, there has been little research on the subject. The current study addresses this lacuna and investigates the potential of using non-pharmacological interventions to improve the outcomes of psychiatric care including safety, satisfaction, efficacy, and non-habituation.
Methods
110 participants (patients prescribed with psychiatric medication) took part in workshops focused on 1) Relaxation (Anxiolytics) 2) [n = 70] Focus (Stimulant ADHD Medication) [n = 40]. Workshops included a) an educational section designed to increase participants' understanding of their medical conditions and prescribed medications b) an experiential section that included the guided, mindful ingestion of the prescribed drug in a supportive setting including reinforcing cues and the practice of non-pharmacological techniques for coping with underlying medical conditions.
Results
Survey questionnaires (n = 33) indicated a significant improvement in participants' understanding of their medical conditions and the properties of their prescribed medication. Semi-structured interviews demonstrated a strong interest in the idea of mindful use of medication, benefit from the communal setting of ingestion, as well as recurring themes of greater satisfaction with- and improved ability to derive benefit from the use of prescribed drug.
Conclusions
The results of this pilot study demonstrate the impressive potential of providing patients with extra-pharmacological tools to improve the outcomes of prescription drug use and supports the need for further study.
Abstract
In silico, we modelled the possible docking conformation of human WNT16B and the human ERBB2 TMD homodimer, resulting in a mutant complex. The ribbon structure and the C-terminal, N-terminal, and GG4-like motif structures are similar in HER2 TMD and HER TMD: we modelled the possible docking conformation of WNT16B to the HER1 TMD (ErbB), which also resulted in a mutant complex. If a strong relationship exists between TMD mutations that improve the active dimer interface or stabilizing an activated conformation and the potency with which HER2 (and possibly also HER), then the dimerization part of the TMD seems to be the ideal reagent target. The agent we tested –4-(Furan-2-yl)hepta-1,6-dien-4-ol (AKOS004122375) – can connect directly into human ERBB2 TMD (HER2), to the ErbB TMD (HER1) dimer bilayer motif, and human WNT16B, ERBB2 TMD (HER2) and WNT16B ErbB TMD (HER1) mutant complex residues. We tested the agent ligand in vitro and in vivo in several tumor models, which highlighted that targeting the EGFR's TMD with an agent not only reduced treatment-induced metastasis but also radically decreased tumor growth. Because of the analogous structure of HER2 TMD and HER TMD, this dimerization motif targeting can also be successful in HER and HER2 EGFR signalling. In vitro, we reached an antiproliferation rate of 80%–94% in different tumor models, while in vivo we reached a rate of 35%–61% tumor suppression in different tumor models. The metastasis inhibition effect of the compound was between 82% and 87% in different tumor models. The referenced experiments took place in 2015 in Hungary.
Abszcizinsav – táplálkozási lánc és humán egészség
Abscisic acid – food chain and human health
Abscisic acid is an ancient, universal compound on different levels of phylogenetic development and helps organisms adapt to their environment. In the 1940s, attention was first given to a substance that inhibits the growth of plants, which in the mid-1960s turned out to be a phytohormone that regulates the dormant state of plants. Research conducted in the 2010s revealed the biosynthesis of abscisic acid. Bioactive abscisic acid, an oxygen-rich diterpene molecule, is the product of the degradation of xanthophylls synthesized from mevalonic acid as a starting compound. Abscisic acid, as a secondary metabolic product, affects many physiological processes in plants. In the last two decades, molecular-genetic, biochemical and pharmacological studies have discovered the universal signaling pathway of abscisic acid. In 1986, during animal experiments carried out in parallel with these studies, it was realized that abscisic acid is also produced in the animal body. After the turn of the millennium, more and more people became interested in the role of abscisic acid in animal organs, tissues, and cells (leukocytes, monocytes/macrophages, granulocytes, microglial cells, pancreatic cells, mesenchymal stem cells etc.). There is now an enormous amount of literature on the versatile physiological effects of this compound. It is proven that it is a human endogenous hormone. In both animals and humans, abscisic acid regulates many physiological functions in a manner very similar to the signaling pathway known in plants. It regulates cell growth, development and immune responses to various stimuli. It has also become known that abscisic acid, as a growth regulator, is not toxic to the animal body, but at the same time inhibits the growth of cancer cells. It has a favorable effect on carbohydrate metabolism and also has anti-inflammatory properties but its inflammatory effect has also been described. Currently, the possibility of its use in human medicine is being researched. Orv Hetil. 2025; 166(2): 43–49.
Az anaemia gyakoriságának felmérése, osztályozása, prediktív tényezői gyulladásos bélbetegségben szenvedő betegekben
Anemia classification, prevalence and predictive factors in inflammatory bowel disease
Introduction: Anemia is a common complication of inflammatory bowel disease and serves as an indicator of severe disease. Objective: This study aims to evaluate the prevalence, etiology, predictive factors, and treatment of anemia in patients with inflammatory bowel disease from two tertiary centers. Method: In this retrospective, cross-sectional study, we assessed the frequency of anemia among patients presenting within a specified calendar year (June 1, 2022, to May 31, 2023), focusing on the lowest hemoglobin levels recorded during this period. We collected demographic data, disease activity scores, treatment regimens, inflammatory markers, and laboratory parameters related to iron balance. Clinical disease activity was evaluated using the Crohn’s Disease Activity Index and the partial Mayo Score. The World Health Organization’s criteria were utilized for anemia classification and severity assessment. Absolute iron deficiency was defined as a serum ferritin level <30 µg/L, while anemia of chronic disease was defined as a ferritin level >100 µg/L in conjunction with clinical or biochemical evidence of active disease. Results: The study included 400 patients (277 with Crohn’s disease and 123 with ulcerative colitis). Among the Crohn’s disease patients, 17.7% exhibited complex disease behavior, and 40.7% of the ulcerative colitis patients had extensive colonic involvement. Biological treatments were administered to 75% of the participants. Anemia was identified in 32.5% (130) of the patient cohort, with 57% classified as mild, 35% as moderate, and 8% as severe. In the subset of non-macrocytic anemia (116 patients), iron status data were available for 51% (n = 66). Of these, 73% had iron deficiency anemia, 6% had anemia of chronic disease, and 17% had chronic disease with functional iron deficiency. Anemia predictors included steroid treatment (p<0.001; OR: 4.2), clinical disease activity (p<0.001, OR: 381), and laboratory markers of disease activity (p<0.001, OR: 2.9). Intravenous iron supplementation was administered to 43 patients, while 12 received oral iron supplementation. Conclusion: The findings highlight the high prevalence of anemia, predominantly iron deficiency anemia, among patients with inflammatory bowel disease, which is closely associated with clinical and laboratory markers of disease activity. This study underscores the importance of diagnosis, classification (through assessment of iron balance parameters), and treatment of anemia in patients with inflammatory bowel disease. Orv Hetil. 2025; 166(2): 60–66.
Dr. Steinberger Sarolta (1875–1966) és az ártatlanság vélelme
Sarolta Steinberger, MD (1875–1966) and the presumption of innocence
Újszerű bariátriai bypassműtéttel (SASI) szerzett tapasztalataink
Experiences with a novel bariatric bypass procedure (SASI)
Introduction: Obesity is a problem of endemic proportions, which is not simply an aesthetic problem, but rather a systemic disease. Regarding its treatment, surgery is more effective than conservative methods. Laparoscopic „single anastomosis sleeve ileal” (SASI) bypass is a novel bariatric procedure not yet broadly in practice that combines advantageous features of restrictive and malabsorptive techniques. SASI can be effective for both „amount eaters” and „sweet eaters”, while the risk of impaired absorption remains minimal. Objective: In this report, we present the results of SASI bypass procedures performed by our team between August 1, 2022 and September 1, 2024. Methods: Regarding criteria of qualification and conducting the study, the protocol of the international bariatric society was followed. After creating a gastric sleeve in the first stage, an anastomosis with a maximal width of 4 cm was created between the ileum and remaining stomach. Follow-ups were carried out 3 and 6 months after surgery. Gastric emptying was examined with isotopic method in two voluntary patients. Results: A group of 25 patients (17 women, 8 men) who underwent SASI bypass surgery were evaluated in the study (mean age 40.1 ± 11.3 years). Mean preoperative BMI was 43.7 ± 6.7 kg/m2. Postoperative BMI decreased by 6.1 ± 3.4 kg/m2 (13.9 ± 6.3%) at 3 months and 11.6 ± 6.2 kg/m2 (26.1 ± 12.0%) at 6 months. Hypertension resolved in 9 out of 11 cases, prediabetes normalized in 2 out of 2 cases. We observed postoperative reflux in 6, sleep disorder in 1, fatigue in 5, hair loss in 9 cases. Lasting diarrhea did not occur. With isotopic examination we found that 90% of gastric content empties into the efferent ileum and 10% goes into the duodenum. Discussion: SASI bypass combines advantages of restrictive and malabsorptive bariatric procedures effectively, while – according to our experience so far – the risk of impaired absorption, vitamin- and mineral-deficiency remains minimal. A significant regression can be expected regarding comorbidities and required medications in the first 6 months after surgery. Conclusions: SASI bypass is a safe procedure that achieves effective weight loss and quick resolution of comorbidities, thus it may become the leading bariatric procedure in the near future. Orv Hetil. 2025; 166(2): 67–76.
A virtuális valóság használatának lehetőségei gyermekek perioperatív ellátásában
The potentials of virtual reality in pediatric perioperative care
Each year, millions of children worldwide undergo general anesthesia for various surgical or diagnostic procedures. In Hungary, approximately 20,000 to 30,000 children are treated in pediatric surgical centers annually, and additional 5,000 to 10,000 children undergo operation in adult otolaryngology departments. Treating children is a challenge, as their cognitive and emotional development levels may pose difficulties for them in understanding the procedures ahead and may make the processing of the stressful experiences of the intervention uncertain. Preoperative anxiety can often lead to increased postoperative pain, confusion, extended hospital stays, and undesirable behavioral changes. Various methods are available to manage perioperative anxiety and pain (such as administering anxiolytics as premedication, allowing parental presence during anesthesia induction, and postoperative pain relief). Although distraction methods like music or cartoons have proven effective, pharmacological treatment remains the gold standard. The use of newer, alternative solutions (such as psychoeducation or virtual reality) has not yet become part of routine practice. Virtual reality is a new, innovative tool that offers an immersive, three-dimensional audiovisual experience, diverting children’s attention away from unpleasant experiences. The use of virtual reality in pediatric settings is particularly promising, as children’s attention can easily be engaged through virtual games, reducing the anxiety and pain caused by medical procedures. This article presents the pediatric applications of virtual reality and the possibilities of its use in procedural and perioperative environments based on literature data, in relation to the fact that personal experience with the method has begun at the Pediatric Center of Semmelweis University. Orv Hetil. 2025; 166(2): 50–59.
Abstract
Background and aims
Uncontrollable gaming behavior is a core symptom of Internet Gaming Disorder (IGD). Attentional bias towards game-related cues may contribute to the difficulty in regulating online gaming behavior. However, the context-specific attentional bias and its cognitive mechanisms in individuals with IGD have not been systematically investigated.
Methods
We compared individuals with IGD to healthy controls (HC) using a rapid serial visual presentation (RSVP) task to measure temporal attentional bias. By applying game-related and neutral stimuli as targets, we specifically assessed how attentional resources were allocated to game-related stimuli compared to neutral stimuli.
Results
The IGD group showed enhanced attentional blink effect when a game-related stimulus was the first target and a neutral target was the next, reflecting IGD's difficulty in disengaging from game-related stimuli. Both IGD and HC individuals exhibited decreased accuracy in identifying a neutral first target followed by a game-related second target at shorter lags, indicating increased attentional engagement with game-related stimuli in general.
Discussion
The results provide a cognitive basis for recurrent and uncontrollable gaming behaviors in individuals with IGD. Game cues have priority in the allocation of attentional resources in individuals with IGD. The results shed new light on the development of specific treatments for IGD.
Abstract
Background and aims
Internet gaming disorder (IGD) is a highly engrossing activity with the individual spending up to 10 h per day gaming, this causes issues in accomplishing their tasks and personal goals. Also, to generate in them increased anxiety, impulsivity and lack of social skills, this impacts the good personal development and individual's quality of life. Therefore, it is vital to better understand, in terms of treatment, which factors are associated with therapeutic outcomes (largely to achieve control over the use of video games and the lack of relapses) following a standardized Cognitive Behavioral Therapy (CBT) protocol. This study aimed to explore sociodemographic and personality variables and their relation to treatment outcome in patients with IGD.
Method
The sample included n = 105 patients with IGD, considered between January 2005 and December 2022 and recruited from the Behavioral Addictions Unit at the University Hospital of Bellvitge. Data at baseline was registered (sociodemographic and clinical measures), as well as the therapy outcomes (compliance with the guidelines, presence of relapses and dropouts).
Results
Patients were mainly males (n = 95) with a mean age of 24.97 (SD = 12.03). All patients included in this sample had individual CBT treatment in relation to their problematic gaming behavior. In terms of patients who relapsed, they had higher interpersonal sensitivity, hostility and persistence with lower self-directedness. Patients who dropped out were males with an older age of IGD onset. When looking at treatment noncompliance, it was related to higher psychoticism and reward dependence, and lower cooperation. Patients with IGD show higher levels of treatment noncompliance.
Conclusion
These findings evidence a positive and promising effect of CBT on IGT. The factors identified as predictors of good and poor treatment outcomes should be considered for developing new evidence-based interventions focused on learning healthier key coping strategies to manage both cravings and triggers.
