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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Abstract

Background

The TIRADS classification system is commonly used in ultrasound imaging to evaluate the risk of malignancy in thyroid nodules, but there is still debate about its accuracy. The BSRTC categorizes FNA biopsy results to determine the likelihood of malignancy in thyroid nodules, and this remains the gold standard for diagnosis.

Methodology

This is a cross-sectional study design conducted in the Radiology Department of Chughtai Lab Head Office in Lahore. This study assessed 154 patients with thyroid nodules. The ultrasound equipment used for the study is the Toshiba Applio 500 model, while the equipment for FNAC included topical anesthesia, 21-gauge 10 CC syringes, glass slides, cell block, and the Olympus CX23 microscope. The sampling technique employed is the consecutive sampling technique.

Results

Out of 154 patients, the mean age was 42.0 ± 13.6 years. Majority were female (89%) while 11% are male. The P-value of <0.0001 suggests a statistically significant association between TIRADS and Bethesda categories. The findings suggested that ultrasonography is a highly reliable and effective method for diagnosis, with a superior degree of sensitivity and specificity in addition to invasive cytology tests. Results from the ROC curve analysis showed an impressive area under the curve of 0.972. The sonographic features show significant associations with TIRADS categories (P-value <0.0001). The association between TIRADS suspiciousness and Bethesda diagnosis is statistically significant (P-value <0.0001). Benign nodules were most commonly classified as not suspicious (56.5%), followed by mildly suspicious (9.7%), while malignant nodules were primarily classified as highly suspicious (11.0%). Notably, no malignant nodules were categorized as benign.

Conclusion

Healthcare professionals may consider utilizing TIRADS as a first-line imaging method and then BETHESDA if needed to provide patients with the most accurate results and minimize unwanted interventional exposure. Combining these two scoring methods appears to yield the most precise outcomes for identifying and distinguishing benign from malignant nodules, which is critical for arriving at a definitive diagnosis in individuals with thyroid malignancies.

Open access

Psychedelic Christianity: Commentary and reply

Commentaries on: McCarthy & Priest (2024). Psychedelic Christianity: From Evangelical hippies and Roman Catholic intellectuals in the sixties to clergy in a Johns Hopkins clinical trial

Journal of Psychedelic Studies
Authors:
Michael J. Winkelman
,
G. William Barnard
,
Marc G. Blainey
,
Jerry B. Brown
,
Thomas B. Roberts
,
Joseph Lorenz
,
Jaime Clark-Soles
,
William A. Richards
,
Harry T. Hunt
,
Timothy R. Gabrielli
,
David M. Odorisio
,
Tracy j. Trothen
,
Brad Stoddard
,
Paul Jonathan Ungerland ii
,
George G. Lake
,
J. Kaleb Graves
,
Bryan McCarthy
, and
Hunt Priest
Open access

Abstract

Background and Aims

Post-Traumatic Stress Disorder (PTSD) is a debilitating condition that affects a sizable proportion of U.S. civilians, military personnel, and veterans. 3,4-Methylenedioxymethamphetamine-Assisted Therapy (MDMA-AT) is a novel treatment approach for PTSD that has both stirred media enthusiasm and drawn criticism. This critical review analyzes individual randomized, controlled trials of MDMA-AT and provides a narrative synthesis.

Methods

A library search and analysis of extant literature reviews was conducted to identify publications containing original research findings with inter-group statistical comparisons from randomized, controlled trials of MDMA-AT. Seven articles were identified. One pilot study was excluded due to a lack of inter-group comparison.

Results

To date, six (four Phase II and two Phase III) randomized, controlled trials of MDMA-AT have been published which met criteria for inclusion in this review. Study design, sponsor, recruitment methods, and participant demographics are similar across trials.

Conclusions

Five out of six reviewed studies provide evidence for the apparent safety and efficacy of MDMA-AT. However, the lack of suitable comparison condition, poor blinding, and rigid study design across trials make interpretation of results difficult. In addition, the high costs of MDMA-AT and lack of head-to-head comparisons with validated PTSD therapies cast doubt on its potential promise as a treatment. The role of the sponsoring organization behind all trials may further introduce bias into findings. Though research to date is encouraging, there is not yet sufficient evidence to suggest that MDMA-AT should be see widespread adoption over current, validated forms PTSD of treatment.

Open access
Physiology International
Authors:
Hasan Kazdagli
,
H. Fehmi Ozel
,
Suleyman Ozturk
,
Deniz Ceylan
,
Burak Erdeniz
,
Mustafa Ozbek
, and
M. Ilgi Semin

Abstract

Anxiety is a common issue among university students, many of them experience anxiety, depression, and stress during their school life. This study aimed to compare the acute physiological stress responses of students divided into two groups according to their perceived anxiety levels (positive test anxiety, PTA+, and negative test anxiety, PTA-). Heart rate variability (HRV) and electrodermal activity (EDA) were used to assess stress.

Thirty-one healthy volunteers participated in the study. Participants completed anxiety assessments, including the Westside Test Anxiety Scale (WTAS), the State-Trait Anxiety Inventory (STAI), and the Test State Anxiety Inventory (TSAI). Based on their scores, participants were categorized into PTA+ and PTA- groups. All participants underwent 24-h continuous recordings of pulse and electrodermal activity (EDA) on two separate occasions: one day prior to a written exam and during a designated exam-free day serving as a baseline control.

We compared the HRV and EDA data obtained on a regular day and on an exam day between the two groups. Results showed that the PTA+ group had significantly higher heart rate, stress index, low frequency, and short-term detrended fluctuation analysis (DFAα1) on the exam day. The tonic EDA component was also higher in the PTA+ group. Stress-related HRV and EDA parameters were negatively correlated with exam scores.

In conclusion, the study found that physiological stress indicators obtained from HRV and EDA are associated with perceived exam anxiety in students.

Restricted access
Journal of Behavioral Addictions
Authors:
Dana Katz
,
Zsolt Horváth
,
Halley M. Pontes
,
Patrik Koncz
,
Zsolt Demetrovics
, and
Orsolya Király

Abstract

Background

While there are calls to restrict the time spent on gaming because it is seen as problematic and potentially leading to gaming disorder (GD), there is conflicting evidence about this issue. We explored the association between the average weekly time spent gaming and reported GD symptoms. Additionally, Latent Profile Analysis was employed to investigate how time spent gaming relates to variables representing psychological distress (PD), such as satisfaction with life, symptoms of depression, and perceived stress.

Methods

Data were collected using surveys with a large sample of highly engaged gamers (N = 14,740; Mage = 24.14 years, SDage = 7.0, 89.3% males).

Results

We observed a positive, close to linear association between time spent gaming and GD symptoms. Groups at risk of GD played for about 42 h (SD = 19) on average, according to the American Psychiatric Association and World Health Organization frameworks. Furthermore, we identified four profiles representing varying levels of PD. Gamers reporting very high levels of PD (4.2% of the sample) played for 33 h per week on average. Remarkably, a substantial percentage of the sample (41.9%) showed no PD despite playing for 26 h per week.

Conclusion

The association between gaming time and PD is complex as even prolonged time spent gaming can be unproblematic for many gamers.

Open access

Abstract

Background and aims

Online communities provide insights into psychedelic consumption, assisting in identification of trends, informing both harm reduction provisions and clinical research. This study extracts forum data on psychedelic substances, dosages, and administration routes, categorising and analysing self-reported consumption to inform care services and guide clinical work with psychedelics.

Methods

Posts (n = 660) from online psychedelic forums (The Shroomery and DMT Nexus) on 'trip sitting' were analysed. Using a Delphi-style expert panel review facilitated by LE, we created drug weight and intensity charts (threshold, light, common, strong and heavy dosages) for psychedelics discussed in these posts. The psychedelic substance, dosage intensity and route of administration [ROA] (smoked/vaporised, oral, injected, insufflated and undisclosed) frequencies and exploring correlations with perceived need for assistance from a psychedelic carer were mapped and correlated with perceived need for psychedelic care.

Results

Psychedelics appearing in our data were 5-MeO-DMT, ayahuasca, changa, LSA, LSD and psilocybin. There was greater commonality between clinical studies and 'common' doses determined through the Delphi method, for more extensively researched substances like LSD and psilocybin. Many posts indicated opinions that psychedelic care was unnecessary or optional for consumers, particularly for LSD and LSA. 5-MeO-DMT was strongly associated with a perceived need for care. A correlation was identified between greater psychedelic purity, dosage intensity, and a perceived need for care. Oral administration, the most common ROA, showed lower dosage intensity.

Conclusion

More research is needed to understand factors influencing psychedelic care practices. Educational information, emphasizing risk management strategies, should be provided to psychedelic consumers, emphasising psychedelic products and administration methods more likely to be dosed at a strong or heavy intensity.

Open access

Abstract

Psychedelic-assisted therapy (PAT) is currently undergoing a resurgence of clinical interest for several mental health ailments. We propose that philosophers can play a significant role in PAT in both the preparation and integration phases of PAT. Philosophers can aid in the former phase by offering philosophical preparatory insights and in the latter phase by providing the conceptual language to articulate the complex philosophical aspects of a psychedelic experience.

Open access

14 062 egészséges, normál testtömegű magyar gyermek és serdülő mérésén alapuló perifériás (brachialis) vérnyomás-normálértékek

Normal values of peripheral (brachial) blood pressure measured in 14 062 Hungarian healthy children and adolescents with normal body mass index

Orvosi Hetilap
Authors:
Erzsébet Valéria Hidvégi
,
Andrea Jakab
,
Attila Cziráki
,
Miklós Illyés
, and
Csaba Bereczki

Bevezetés: Korábban a gyermekek és serdülők vérnyomás-referenciaértékeire vonatkozó ajánlások adatbázisai a túlsúlyos/elhízott egyének adatait is tartalmazták. A vérnyomás és a túlsúly/elhízás közötti szoros összefüggés, valamint a túlsúly/elhízás előfordulási gyakoriságának az elmúlt évtizedekben világszerte tapasztalt emelkedése miatt a gyermekekre és serdülőkre vonatkozó vérnyomás-referenciaértékek meghatározásának módja felülvizsgálatra szorul. Célkitűzés: Célunk volt keresztmetszeti vizsgálatban meghatározni a 3–19 éves korú, normál testtömegű gyermekek és serdülők vérnyomásértékeit Magyarországon, valamint összehasonlítani a normál testtömegű gyermekek és serdülők vérnyomásértékeit a túlsúlyos/elhízott társaikéval. Módszer: 17 828 (9350 fiú) egyén esetében végeztünk antropológiai méréseket és oszcillometriás vérnyomásmérést. A normál testtömegű (n = 14 062, 7195 fiú), a túlsúlyos (n = 2527, 1427 fiú) és az elhízott (n = 1239, 728 fiú) csoportot a testtömegindex percentilisértékei alapján különítettük el. A vérnyomás-percentilisgörbéket és -értékeket LMS-módszerrel képeztük. Eredmények: Mind a systolés, mind a diastolés vérnyomás emelkedett az életkor előrehaladtával mindkét nemben, minden súlykategóriában. A normál testtömegű csoportban a medián testmagasságon mért systolés és diastolés vérnyomás 50. percentilisértéke 94/59 Hgmm-ről 124/68 Hgmm-re emelkedett a fiúkban, míg 94/59 Hgmm-ről 116/68 Hgmm-re a lányokban. A pubertás előtt a systolés vérnyomás nem különbözött szignifikánsan a nemek között, ezt követően fiúkban jelentősebben emelkedett. A diastolés vérnyomás tekintetében nem találtunk klinikailag releváns szignifikáns különbséget a nemek között. A vérnyomás-percentilisértékek a túlsúlyos és az elhízott páciensek csoportjában szignifikánsan magasabbak voltak a normál testtömegűekhez képest (p<0,001). Következtetés: A közölt vérnyomás-normálértékek a jelenkori magyar gyermek- és serdülőpopulációra vonatkozó ismereteinket gyarapítják. Miután a túlsúlyos/elhízott gyermekek és serdülők vérnyomásértékei magasabbak, mint normál testtömegű társaiké, adataikat elkülönítve javasolt tanulmányozni. Orv Hetil. 2024; 165(28): 1086–1100.

Open access

A Himnusz és az állati mágnesesség – Kölcsey Ferenc levelei a mesmerizmusról, 1823-ban

The Hungarian national anthem and animal magnetism – the letters of Ferenc Kölcsey about mesmerism in 1823

Orvosi Hetilap
Author:
László Kiss
Restricted access

A kísérletes uterus-autotranszplantációs juhmodell

Felkészülés a humán méhátültetésre

The experimental uterus autotrasplantation sheep model

Preparation for human uterus transplantation
Orvosi Hetilap
Authors:
Bálint Farkas
,
Kálmán Kovács
,
Szilárd Kolumbán
,
Martin Rozanovic
,
Emőke Hegedűs
,
Gábor Jancsó
,
József Bódis
, and
Gábor Fazekas

Bevezetés: Az abszolút méh eredetű infertilitás új sebészi kezelési módszere az uterustranszplantáció. Célkitűzés: A humán méhátültetésre való felkészülés jegyében élő donoros uterus-autotranszplantációs műtéteket végeztünk juhokban. A műtétek célja az anatómiai képletek azonosítása, a graft előkészítése beültetésre, az érvarratok elvégzése és a szakorvosi stáb csapatként való munkájának begyakorlása volt. Módszer: Az uterust ellátó ereket eredésükig kipreparáltuk, majd hosszú vascularis nyéllel együtt hysterectomiát végeztünk. Egyórás hidegischaemiát követően a nátrium-heparinos fiziológiás sóoldattal perfundált szervet az azonos oldalra visszaültettük, cervicovaginalis anastomosist és „end-to-side” (vég az oldalhoz) artériás és vénás anastomosist képezve az arteria iliaca externa elülső felszínére. Eredmények: A műtétet 4 esetből 2-ben sikeresnek minősítettük, mivel az autotranszplantált szerv a színét, hőmérsékletét és keringését is teljes mértékben visszanyerte. Az életben maradt két állaton ezután eutanáziát hajtottunk végre. Megbeszélés: Az uterustranszplantációs modell új perspektívát nyitott az abszolút méh eredetű infertilitásban szenvedő nők kezelésében. A megfelelő felkészülés és gyakorlás nagy testű kísérleti állatokon elengedhetetlen. A kísérletes uterustranszplantációs juhmodell lehetőséget biztosít mind az élő donoros, mind a cadaver donoros beavatkozások gyakorlására. Következtetés: A juh kísérletes élő donoros állatmodellt alkalmasnak tartjuk és ajánljuk a humán uterustranszplantációra való felkészülés céljából. Orv Hetil. 2024; 165(28): 1079–1085.

Open access