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
This study aimed to investigate whether the power Doppler ultrasonography can distinguish between singleton and twin pregnancies on day 50 by determining placentome vascularization in Kıvırcık ewes. A total of 67 ewes were enrolled for the study. Pregnancy was confirmed on day 23 at 51 of 67 sheep that were synchronized. The groups were formed based on the presence of single (Group S; n = 25 ewes) or twin (Group T; n = 26 ewes) foetuses. Placentome diameters on day 50 were not different between the groups (P > 0.05). Placentome blood flow area and the mean, minimum and maximum amount of coloured pixels were unrelated to groups. However, the relationship between the parameters that reflect the placentome vascularity in Group S was statistically detectable. The mean amount of coloured pixels in Group S tended to be moderately correlated with the mean amount of coloured pixels in Group T. There was a positive correlation in the mean, maximum, and area of the coloured pixels in twin pregnancies. In conclusion, power flow Doppler ultrasonography can be used to determine placentome blood perfusion but the number of offspring on day 50 could not be determined by placentome vascularity.
Az agyi eredetű látássérülés hazai előfordulása nagy kockázatú látássérült gyermekek körében
Előzetes eredmények
The prevalence of cerebral visual impairment among high-risk visually impaired children in Hungary
Preliminary results
Introduction: In cerebral visual impairment (CVI), the disturbance in visual function is not due to a condition of the eyeball but to a malfunction in the neural processing of visual information. The prevalence of cerebral visual impairment is unknown in Hungary. Still, it is essential to initiate a professional debate, as early-onset visual impairment impairs later mental and physical health and social advancement and creates a burden on society. Objective: A pilot study was carried out to assess the prevalence and incidence of cerebral visual impairment, either concomitant or independent of ocular visual impairment, in a cross-sectional survey of the School for the Visually Impaired in Budapest. Methods: We used special education methods to investigate the characteristics of cerebral visual impairment among low-vision children at high risk for cerebral visual impairment. We compared the gender and age distribution of students with and without cerebral visual impairment symptoms, data on birth conditions, and ophthalmological diagnosis. Results: Between 2021 and 2024, data from 120 students were analyzed, of whom 58 students (48.3%) had a history of increased risk of cerebral visual impairment. In the group at high risk for cerebral visual impairment, 33 (56.9%) pupils were found to have cerebral visual impairment abnormalities detected by teachers of visual impairments, while 4 (6.9%) had cerebral visual impairment in an ophthalmological report. Where teaching of visually impaired children methods confirmed cerebral visual impairment in the presence of high risk of cerebral visual impairment, the proportion of boys was higher compared to the non-cerebral visual impairment subgroup (66.7% vs. 36.0%, p = 0.020). Within the high-risk group, birth weight and gestational age did not differ among the cerebral visual impairment and non-cerebral visual impairment groups. Discussion: In children with a declared visual impairment, the teaching of visually impaired children method is the appropriate method for detecting cerebral visual impairment, while an ophthalmological examination may raise suspicion of cerebral visual impairment. As in other countries, cerebral visual impairment is significantly underdiagnosed in Hungary. Our measurements confirmed that boys were overrepresented in the cerebral visual impairment group, but the main etiological role of prematurity was not confirmed. Conclusion: In the high-risk group, teaching of visually impaired children methods are necessary in addition to ophthalmological examination to prove the presence of cerebral visual impairment. Targeted development as early as possible is a pledge to improve visual function. Further studies are needed to assess the prevalence of the condition in Hungary. Orv Hetil. 2025; 166(11): 421–426.
A gyermekkorban kezdődő gyulladásos bélbetegség sajátosságai 20 éves tapasztalatunk alapján
The characteristics of pediatric-onset inflammatory bowel disease based on our 20-year-long study
Among inflammatory bowel diseases (IBDs), every tenth develops during childhood, which is characterized by a more complex disease course, more extensive spread, and rapid progression. The presenting symptoms of pediatric-onset IBD are often nonspecific, and diagnostic delays increase the risk of intestinal damage, bowel resection, and growth retardation. Adolescents with IBD exhibit the lowest compliance and medication adherence rates, contributing to the frequent occurrence of complications. The most significant extraintestinal complications in pediatric-onset IBD patients include growth retardation, malnutrition, impaired bone metabolism, malignancies, and opportunistic infections. In this patient group, surgical interventions are required earlier and more frequently, and the hospitalization rate is also higher among them. Ensuring optimal disease progression and quality of life is crucial, making it essential for the physicians managing their care to be well aware of the specific characteristics of the pediatric-onset IBD patient group. Orv Hetil. 2025; 166(11): 403–412.
Jean Marie Joseph Capgras (1873–1950) – 75 éve hunyt el a hasonmástéboly leírója
Jean Marie Joseph Capgras (1873–1950) – the describer of the delusion of the double died 75 years ago
Sessilis serrated laesio dysplasiával és invázióval
Esetismertetés és diagnosztikus dilemma
Sessile serrated lesion with dysplasia and invasion
Case presentation and diagnostic dilemma
Sessile serrated lesions (SSLs) are not uncommon entities per se, usually localised to the proximal half of the colon and are often flat on endoscopic examination. The presence of dysplasia associated with SSL and, even more so, invasion are considered rare, while dysplastic SSLs (SSL-D) very quickly transform into invasive carcinoma. MLH1 immunohistochemical reaction may help to establish the diagnosis of SSL-D. We present the case of an 88-year-old female patient who presented for colonoscopic resection of suspicious tumours in the coecum and transverse colon. Histological examination revealed medullary carcinoma in the coecum with MLH1 and PMS2 mismatch repair protein deficiency. The polyp removed from the transverse colon was histopathologically confirmed to be SSL with central low-grade dysplasia (SSL-D), confirmed by loss of MLH1, and submucosal invasion was seen at a single focus. A BRAF V600E sequencing was performed to rule out Lynch syndrome, which confirmed the presence of the mutation. Risk factors for SSL-D include older age, the presence of multiple synchronous SSLs and a size greater than 10 mm. In SSL-D, due to the high malignant transformation potential, a complete resection should always be sought. In the SSL – SSL-D – carcinoma sequence, the main driver mutations are in the BRAF and less frequently KRAS genes. In cases with numerous SSLs, the possibility of sessile polyposis syndrome, and less frequently MUTYH-associated polyposis and hereditary mixed polyposis syndrome should also be raised. In both SSL and colorectal carcinoma, microsatellite instability, CpG island methylation phenotype and the presence of BRAF V600E mutation are common. The mismatch repair status can be determined by immunohistochemistry using MLH1, PMS2, MSH2 and MSH6 reactions, the 2 tests complementing each other. Determination of mismatch repair status is crucial for the diagnosis of colorectal carcinoma and the potential indication of immune checkpoint inhibitor treatment. Orv Hetil. 2025; 166(11): 427–433.
Tapasztalataink egy, a szédüléses panaszok ellátására szakosodott hazai magánrendelésen
Vertigo patient population in a vertigo private clinic in Hungary
Introduction: Vertigo is a frequent issue in everyday medical practice. Without specific examinations, it can persist, leading to co-occurring symptoms. Objective: To present our experiences gained at a clinic specialising in vertigo. Method: In this study, patients were enrolled at a clinic specialising in vertigo. Detailed case histories, physical assessments of the vestibular system, pure-tone audiometry, brain CT/MRI, and carotid vertebral Doppler ultrasonography results were examined. To assess the impact of symptoms, the Dizziness Handicap Inventory (DHI) and the Tinnitus Handicap Inventory (THI) were administered. Results: 121 patients (51.40 ± 13.38 years; 72 women) were enrolled. The median onset of vertigo was recorded at 5 months, with a maximum of 240 months. Spinning sensations were reported in more than 60% of the attacks, with a median duration of 1.5 hours. Hearing loss occurred in approximately 30%, while tinnitus was noted in 50%, with bilateral tinnitus being the most common (38.7%). Headaches occurred in approximately 30%, with a significant proportion related to vertigo (81.25%). The most frequent diagnoses were benign paroxysmal positional vertigo (24.8%), vestibular migraine (22.3%), non-vestibular causes (19.8%), and Ménière’s disease (18.2%). Spontaneous vestibular signs occurred at low rates (5%). The head-impulse test was positive slightly more often (10%). Positional nystagmus was detected in 13%, which is a low percentage, especially given the high prevalence of benign paroxysmal positional vertigo. Brain CT scan was conducted in 24%, with 65% having negative results. In comparison, brain MRI was performed in 74%, and 35% yielded negative results. Carotid Doppler ultrasonography showed normal results in 62%. Severe vertigo was reported in 41%, while mild (34%) and moderately severe (32%) tinnitus were the most commonly reported handicaps. Conclusion: There are various causes of vertigo, including vestibular and non-vestibular factors. Delays in diagnosis and a lack of specialised testing lead to a delay in treatment, worsening the quality of life and contributing to psychiatric comorbidities. Orv Hetil. 2025; 166(11): 413–420.
Abstract
This review explores the advancements in artificial intelligence for radiograph fracture diagnosis, emphasizing technological developments and inherent limitations. Artificial intelligence improves diagnostic accuracy and manages workflow efficiency. The review categorizes artificial intelligence applications in fracture diagnosis into four primary tasks: recognition, classification, detection, and localization. The most popular performance metrics, such as diagnostic accuracy, precision, sensitivity, specificity, and area under the curve analysis, are used to compare artificial intelligence systems with traditional radiological methods and are explained as serving as a guide. Each task and performance metric is illustrated with practical examples and success stories from recent literature, offering insights into the strengths and weaknesses of various artificial intelligence approaches, such as support vector machines, convolutional neural networks, and generative adversarial networks. We also incorporate case analyses, underscoring the potential and limitations of artificial intelligence in fracture detection. In particular, challenges were posed by external factors such as casts and anatomical complexities. Future directions are explored, emphasizing human-artificial intelligence collaboration and the development of more advanced, transparent artificial intelligence systems alongside parallel evolving ethical considerations and regulatory frameworks. This review aims to equip clinicians with the knowledge to understand and utilize artificial intelligence technologies effectively in their practice.
Abstract
Often dismissed as contaminants in blood cultures, Corynebacterium species can also cause infective endocarditis, a severe condition. We report an unusual case of Corynebacterium propinquum endocarditis in a non-immunocompromised individual on a native valve. Conflicting clinical and microbiological data led to 16S ribosomal sequencing to confirm the causative agent. Our case illustrates C. propinquum as a cause of infective endocarditis, and it demonstrates the utility of ancillary molecular diagnostic techniques to identify etiologic agents in difficult cases of infective endocarditis. C. propinquum should be recognized as a potential cause of infective endocarditis even on a native valve.
Abstract
Objective
This study aimed to investigate the role of levetiracetam (LEV) and gabapentin (GBP) on mechanical and thermal pain thresholds, as well as n-acetylcysteine (NAC) as an adjuvant, in the pentylenetetrazol (PTZ)-induced post-traumatic epilepsy (PTE) model after mild-traumatic brain injury (TBI) in male Sprague-Dawley rats.
Methods
Animals were randomly divided into 7 groups (Control, PTE, PTE+LEV, PTE+GBP, PTE+NAC, PTE+LEV+NAC and PTE+GBP+NAC). Rats received 50 mg kg−1 LEV, 100 mg kg−1 GBP, and combinations of these antiepileptics with 100 mg kg−1 NAC for 14 days after TBI.
Results
While the thermal pain threshold decreased significantly in the PTE group (P < 0.05), it increased in the PTE+LEV, PTE+GBP, and PTE+LEV+NAC groups (P < 0.05, P < 0.001 and P < 0.01, respectively). Interestingly, NAC alone did not affect the thermal pain threshold, but the combination of PTE+LEV+NAC increased the thermal pain threshold. Furthermore, PTE+GBP+NAC administration prevented the effect of GBP on the thermal pain threshold.
Conclusions
The presented study is the first to examine the effect of LEV and GBP in PTE. It was found that PTE decreased the thermal pain threshold, but LEV and GBP applied for 14 days prevented the decrease in PTE-related pain threshold and increased the thermal pain threshold. NAC, which was used as an adjuvant to support antiepileptic drugs, did not influence the thermal pain threshold alone; however, it increased the pain threshold more by potentiating the effect of LEV. Both LEV and GBP have an antihyperalgesic effect in the PTE model facilitated by PTZ, and NAC further reinforces the antihyperalgesic effect of LEV.
