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
Előrehaladott Parkinson-kóros betegek kezelése levodopa-entakapon-karbidopa intestinalis géllel: az első két év tapasztalata
Two years’ experience with levodopa-entacapone-carbidopa intestinal gel treatment in advanced Parkinson’s disease
Introduction: In advanced Parkinson’s disease, oral or transdermal dopaminergic treatment is not effective enough and have significant side effects, so it may be necessary to use device-aided therapies for continuous dopaminergic stimulation. Objective: Our aim was to compare the clinical parameters of patients with advanced Parkinson’s disease treated with levodopa-entacapone-carbidopa intestinal gel before the start of the treatment and at the discharge from the hospital. Method: We retrospectively analyzed data from patients who started levodopa-entacapone-carbidopa intestinal gel treatment: the patients’ general and neurological condition, previous treatment, medication side effects, and complications of Parkinson’s disease. Results: Levodopa-entacapone-carbidopa intestinal gel treatment was initiated in 29 patients. The patients had an initial off state of 4.7 ± 0.8 hours/day. 20 patients suffered from moderately severe peak-dose dyskinesia (2.8 ± 1.2 hours/day) and 6 patients from severe dyskinesia (2.1 ± 1.0 hours/day). After treatment, the duration of the off state decreased significantly. There was a similar trend for mild or moderate dyskinesias, while severe dyskinesias disappeared completely. The sudden off states that occurred in 7 patients, were not present at discharge. After treatment, the early morning akinesia only occurred in 8 out of the initial 24. Discussion: The introduction of levodopa-entacapone-carbidopa intestinal gel proved to be effective, although our patients started the treatment later than recommended, and with serious motor complications. The mild, transient side effects related to treatment were comparable to literature. No entacapone-naive patient experienced gastrointestinal side effects. Conclusion: The effect of levodopa-carbidopa-entacapone intestinal gel on improving motor complications is similar to that of levodopa-carbidopa intestinal gel, with the advantage of lower daily levodopa dose and a smaller device. Further studies and longer clinical experience are necessary to recommend which of the two types of levodopa-containing enteral gel is more advantageous in individual cases. Long-term safety is also an important aspect in this decision, in order to improve the patients’ quality of life. Orv Hetil. 2025; 166(3): 90–97.
Hozzájárul-e a technológiai fejlődés (robotika) a nők nagyobb szerepvállalásához a sebészeti szakmákban?
Does the technological progress (robotics) contribute to women’s empowerment in surgical professions?
A nem szuicidális önsértési zavar mint lehetséges mentális betegségkategória és a mérésére kialakított kérdőív magyar adaptáció
Non-suicidal self-injury disorder as a possible mental illness category and the Hungarian adaptation of a questionnaire developed to measure
Introduction: Non-suicidal self-injury disorder is a severe form of non-suicidal self-injury, listed in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) as a condition in need of further study. The validity of this diagnostic category, which is still undergoing scientific testing, has been confirmed by a number of studies, highlighting that when it is associated with other mental disorders, more severe symptoms and psychosocial impairment are present. Objective: Our study tested the presence and characteristics of non-suicidal self-injury disorder in an adult clinical sample, while adapting a questionnaire designed to measure this syndrome. Method: In our cross-sectional questionnaire study, 101 psychiatric patients (66.3% female; mean age = 36.88 years; SD = 12.94) answered questions from the first part of the Inventory of Statements About Self-Injury, the Non-Suicidal Self-Injury Disorder Scale and the MMPI-2 (Minnesota Multiphasic Personality Inventory-2) clinical personality and psychopathology test. Results: Nearly 70% of the patients (n = 70) reported having experienced at least one episode of non-suicidal self-injury in their lifetime, but a much smaller proportion of the sample, 20.8% (n = 21), was affected by non-suicidal self-injury disorder, which was identifiable even without borderline personality disorder. Patients with non-suicidal self-injury disorder had significantly higher scores – in the pathological range – on the clinical scales (Hypochondriasis, Depression, Hysteria, Psychopathic Deviate, Paranoia, Psychasthenia, Schizophrenia, Social Introversion), on some personality psychopathology scales (Psychoticism, Neuroticism, Introversion) and on the suicidal scales of the MMPI-2 questionnaire. Hopelessness and engaging in multiple self-injurious methods significantly increase the risk of non-suicidal self-injury as a syndrome. Discussion: Non-suicidal self-injury disorder was also identified in a sample of Hungarian adult psychiatric patients without the presence of borderline personality disorder. The diagnostic level of non-suicidal self-injury was associated with more pronounced clinical symptoms and more severe psychosocial impairment. The psychometric validity of the Non-Suicidal Self-Injury Disorder Scale, designed to measure the syndrome, was also confirmed. Conclusion: Non-suicidal self-injury disorder can be interpreted as a distinct and clinically relevant diagnostic entity, and the scale introduced in the Hungarian test battery provides a reliable and valid measure to this symptomatology. Orv Hetil. 2025; 166(3): 98–108.
A Rövidített Sürgősségi Osztályos Betegelégedettségi Skála hazai validációja
Validation of the Brief Emergency Department Patient Satisfaction Scale in Hungary
Introduction: Measuring patient satisfaction is crucial for quality improvement processes. Due to the specific characteristics of emergency care, it is essential to use an adapted measurement tool. The Brief Emergency Department Patient Satisfaction Scale is an internationally validated questionnaire specifically developed to measure patient satisfaction in emergency care settings. Its reliability and validity have not yet been studied in Hungary. Objective: The aim of this study was to analyze the reliability and applicability of the Hungarian version of the survey, as well as to examine the components of patient satisfaction, based on data collected from a Hungarian emergency department. Method: Data collection took place between January 2023 and August 2024. A total of 683 non-traumatology patients and/or their relatives who visited the Semmelweis University Emergency Department completed the questionnaire. For the analysis, Cronbach’s alpha was calculated to assess reliability, a median test was used to analyze differences across satisfaction subscales, and factor analysis was conducted. Results: The overall and subscale Cronbach’s alpha values indicated excellent reliability and internal consistency (Cronbach’s alpha: 0.86–0.94). The median test showed significant differences between satisfaction with staff and overall patient satisfaction (χ² = 7.57, p = 0.006) and between satisfaction with staff and family satisfaction (χ² = 4.90, p = 0.027), while differences between satisfaction with staff and environment perception (p = 0.064) and between satisfaction with staff and medical care (p = 0.056) were not significant. According to Cliff’s delta, the largest effect size was observed between satisfaction with staff and overall patient satisfaction (Cliff’s delta = 0.17). Factor analysis identified five main factors explaining the total variance. Discussion: The questionnaire demonstrated high reliability in measuring various aspects of patient satisfaction. Strong correlations between subscales and the results of the factor analysis confirmed the complexity of the questionnaire, indicating that it effectively captures the essential dimensions of patient satisfaction. As expected, overall patient satisfaction was the most significantly influenced by satisfaction with the staff. Conclusion: The Hungarian adaptation of the questionnaire is a reliable tool with face validity for measuring patient satisfaction in emergency departments. Further studies are recommended for a more detailed statistical analysis with expanded demographic variables, potentially including multiple centers, to refine the findings. With a broader implementation, the tool could contribute to a deeper understanding of patient satisfaction across emergency care settings in Hungary. Orv Hetil. 2025; 166(3): 109–115.
A SPOCK1 fehérje szerepe a máj egészséges és kóros működéseiben
The role of the SPOCK1 protein in healthy and pathological liver processes
Diseases of the liver pose a significant global health challenge, often being diagnosed late and difficult to treat. Therefore, understanding the pathological processes of the liver and identifying new biomarkers and therapeutic targets are of paramount importance, as these efforts may contribute to early diagnosis, more effective treatment strategies, and better patient outcomes. The SPARC/Osteonectin CWCV and Kazal-like domains proteoglycan 1 (SPOCK1) protein, first described in 1992, may play a crucial role in healthy and pathological liver processes, particularly in liver cancer and liver fibrosis. SPOCK1 is a multi-domain protein located both in the extracellular matrix and intracellularly, especially near the mitochondria. It is present in small amounts in a healthy liver, but its expression increases significantly in pathological conditions, such as HCV infection, cirrhosis, and liver cancer. SPOCK1 promotes cell growth, migration, and invasion, while inhibiting apoptosis, thus contributing to tumor and fibrosis progression through the activation of multiple signaling pathways. SPOCK1 represents a potential biomarker and therapeutic target for liver cancer and other liver diseases. However, further research is needed to understand its clinical applications and significance, particularly regarding its functions and secretion mechanisms. Orv Hetil. 2025; 165(3): 82–89.
Abstract
Background
Non-face-to-face interventions offer promise, with cognitive training showing potential but inconsistent efficacy in problem gambling.
Methods
We conducted a non-face-to-face, parallel, randomized, controlled, single-blinded trial to evaluate training programs in adults with problem gambling (CPGI ≥5). Participants were randomized 1:1 to a web-based cognitive training program targeting inhibition unrelated to addiction cues or a control program on visuo-spatial functioning. Both programs benefited from weekly phone calls to support engagement and transferability to daily life. A mixed community and out-patient sample was recruited at the national-level. The primary outcome was change in CPGI at week 6. Secondary outcomes were change in impulsivity, gambling behavior and quality of life at 6 and 14 weeks.
Results
187 participants were screened, with 185 randomized: 93 to intervention and 92 to control. No significant differences were found between groups for any outcome. Mean PGSI change at 6 weeks was −2.75, 95% CI [−12.95; 7.44] in the experimental arm versus −2.44, 95% CI [−13.52; 8.64] in controls, p = 0.76. 34% of participants were classed as no longer problem gamblers at week 14. Intervention acceptability was moderate, with 21 participants (22.58%) in the experimental group, and 32 (34.78%) controls never accessing the platform (p = 0.07).
Conclusions
Further research is needed to optimize cognitive interventions in problem gambling, to improve engagement and to demonstrate their added value beyond minimal intervention. For a number of problem gamblers, minimal telephone interventions appeared to be sufficient to reduce gambling. Objective account-based gambling data will provide valuable insights into long-term and objective effects.
Abstract
Background and Aims
The widespread popularity of video games reflects their appeal to meet fundamental needs. This study aims to investigate the psychological factors of gaming use, identifying profiles ranging from healthy to gaming disorder.
Methods
In this cross-sectional study, 5,222 participants were surveyed. This international sample included adolescents and adults (16–69 years, M = 25.6 years, SD = 6.44), 48.66% men (n = 2,541; M = 26.4, SD = 7.03), 42.32% women (n = 2,210; M = 25.1, SD = 5.78), and 9.02% non-binary individuals (n = 471; M = 23.3, SD = 5.23), spanning from casual gamers to esports professional players. Latent Profile Analysis (LPA) was employed to identify distinct psychological profiles. The profile indicators included emotional regulation and motivations for playing video games. The profile correlates analysed included gaming disorder symptoms, time spent gaming and sociodemographics.
Results
The LPA revealed four profiles labelled as avoidant (20.16%), engaged (38.95%), relational (26.01%), and dysregulated (15.78%). Results suggested that the dysregulated profile had the most emotional regulation difficulties, a low level of general motivation, and less interest in recreational gaming, presenting the highest risk for gaming disorder.
Discussion and Conclusions
This study's findings present the first profiles encompassing key detailed psychological factors affecting gamers' behaviour across all game genres, considering three genders. These profiles can aid researchers and clinicians in developing further research on targeted prevention and intervention programs tailored to each profile's characteristics to promote healthy gaming habits and mitigate the risks and harm associated with gaming disorder.
Abstract
Background and Aims
The study of stigma contributes greatly to our understanding of individuals' experiences of mental disorders. Addictive disorders are often associated with public misconceptions of the disorder, which can contribute to shame, discrimination, and reticence to seek help. This review aimed to: (1) evaluate the nature, frequency, and prevalence of addiction stigma; (2) identify the correlates of addiction stigma; and (3) examine the psychometric qualities of addiction stigma measures.
Methods
A search of Web of Science, PubMed, Scopus, PsycINFO, and PsycNet, had 5,515 results which were screened for eligibility using Covidence. Eligible papers were quantitative, peer-reviewed studies, which reported an outcome variable of stigma related to an addiction.
Results
A total of 99 studies were included in the review, including 70 studies of substance-based addictions, 19 studies of behavioral addictions, and 10 studies which examined both. Thirteen of the 20 studies examining the impact of familiarity with addiction reported that greater familiarity was associated with lower public stigma. Studies comparing substance and behavioral addictions (n = 5) typically reported greater public stigma towards vignettes depicting substance-based addictions than for behavioral addictions. Between 22% and 40% of individuals with an addictive disorder identified stigma as a significant barrier to seeking help; however, the relative importance of stigma among other barriers was unclear.
Discussion and Conclusions
Evidence for countermeasures to prevent and/or reduce stigma is currently limited. Further research on the nature and prevalence of addiction stigma is needed to inform the development of effective clinical and public health countermeasures.
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.
