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 and aims
Time perception is a cognitive process involving both the ability to estimate the duration of an event (time estimation, TE) and the subjective perception of its passage (time passage, TP). Studies show that alteration in TE/TP is associated with substance use disorders. However, little is known about the impact of these alterations in potentially problematic online behaviors. We explore TE and TP while participants were exposed to cues related to videogames, pornography, and TV series, and the relationship of TE and TP with scores from instruments that measure problematic gaming (PG), problematic pornography use (PPU), and problematic binge-watching (BW).
Methods
Participants from three independent samples (40 men from Luxembourg; 99 Spanish men, 111 Spanish women) completed an experimental task designed to assess TE and TP while they were exposed to short clips related to videogames, pornography, TV series, and documentaries (control condition). Participants also completed different self-reports.
Results
Whereas men underestimated the time that they were exposed to pornography and TV series, women overestimated it. For videogames, we showed a consistent pattern of overestimation of time duration. Time was systematically perceived as passing faster while participants were presented with TV series and pornography. Regarding the association between time perception and PG, PPU, and BW, TE did not correlate with any of the indicators of problematic engagement assessed; but TP correlated with several of these indicators.
Discussion and conclusions
The present preliminary results showed mixed evidence regarding the involvement of time perception in gaming, pornography use, and binge-watching.
Abstract
Klebsiella pneumoniae is a major human pathogen as it is responsible for various infections. In the past years hypervirulent K. pneumoniae (hvKP) emerged and disseminated worldwide. In this review a summary will be given about epidemiology, detection and antibiotic resistance of hypervirulent K. pneumoniae. A common feature of hypervirulent K. pneumoniae is a combined expression of several virulence factors. A mucoviscosus phenotype, certain capsulare serotypes (e.g.: K1, K2, K28, K47, K63) together with additional genetic markers namely, magA, rmpA or iucABCD, are needed in combinations to achieve the hypervirulent pathotype. Plasmid coded virulence determinants are also detected, that indicates horizontal gene transfer of hypervirulence factors in K. pneumoniae.
Interestingly, infections caused by hypervirulent K. pneumoniae occur usually in the community in otherwise healthy people, and during these infections multiple infection sites are detected. Clinical pictures include both invasive infections and local abscess formation. Pyogenic liver abscess is the most frequently reported clinical manifestation and abscess formation in brain, spleen and lung are also diagnosed. Additionally, meningitis, endophthalmitis, trombophlebitis, pneumonia can also develop.
In the early reports, hypervirulent K. pneumoniae strains exhibited enhanced virulence but these were susceptible to commonly used antibiotics. However, recently KPC, VIM, NDM and OXA-48 carbapenemase producing hypervirulent K. pneumoniae strains are increasingly reported, furthermore, well-known high-risk K. pneumoniae clones (e.g.: ST11, ST147, ST307) can develop hypervirulent pathotype, that poses an even more alarming challenge.
Abstract
Background and aims
The intertemporal and risk decision-making impairments are vital cognitive mechanisms in internet use disorder (IUD). However, the underlying neural mechanisms for these two decision-making dysfunctions in individuals with IUD remain unclear.
Methods
This study employed Functional Near-Infrared Spectroscopy (fNIRS) to record changes in blood oxygen concentration in the prefrontal cortex of individuals with IUD during intertemporal and risk decision-making tasks.
Results
The findings revealed that the intertemporal decision-making deficits in IUD group were primarily associated with reduced activation in the left dorsolateral prefrontal cortex (dlPFC) and orbitofrontal cortex (OFC) and FC from the left dlPFC to the right dlPFC. On the other hand, risk decision-making impairments were linked to decreased OFC activation and weakened functional connectivity from the left dlPFC to the right dlPFC and OFC.
Discussions and Conslusions
These results suggested that while there were common neural mechanisms underlying intertemporal and risk decision-making impairments in individuals with IUD, specific neural foundations existed for each type of dysfunction.
Abstract
Gaming disorder (GD) screening often involves self-report survey measures to detect the presence of symptoms. Studies have shown that gamers' responses vary greatly across survey items. Some symptoms, such as preoccupation and tolerance, are frequently reported by highly engaged but non-problematic gamers, and therefore these symptoms are thought to lack specificity and are suggested to be less important in classification decisions. We argue that the influence of response categories (e.g., dichotomous responses, such as ‘yes’ or ‘no’; or frequency categories, such as ‘rarely’ and ‘often’) on item responses has been relatively underexplored despite potentially contributing significantly to the psychometric performance of items and scales. In short, the type of item response may be just as important to symptom reporting as the content of survey questions. We propose some practical alternatives to currently used item categories across GD tools. Research should examine the performance of different response categories, including whether certain response categories aid respondents' comprehension and insight, and better capture pathological behaviours and harms.
Béta-laktám antibiotikumok terápiás gyógyszerszint-monitorozása kritikus állapotú felnőtt betegekben: egycentrumos, prospektív, obszervációs pilotvizsgálat
Therapeutic drug monitoring of beta-lactam antibiotics in critically ill adult patients.
A single-center prospective observational pilot study
Introduction: Beta-lactams are among the most commonly used antibiotics. Their efficacy is time-dependent, thus the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) recommends that their plasma concentrations should remain above the minimal inhibitory concentration (MIC) of the pathogenic bacteria throughout the dosing period (100%fT>MIC). However, according to several studies, it appears that the plasma concentrations of beta-lactam antibiotics can be suboptimal in critically ill patients. Objective: The aim of our study was to determine the pharmacodynamic target achievement of beta-lactam antibiotics (meropenem, piperacillin/tazobactam, and ceftriaxone) among critically ill adult patients admitted to an intensive care unit. Method: We conducted a prospective, observational single-centre study in a teaching hospital. Critically ill patients who were prescribed meropenem, piperacillin or ceftriaxone were enrolled. Trough antibiotic plasma concentration was measured using high-performance liquid chromatography (HPLC) and liquid chromatography–tandem mass spectrometry (LC–MS/MS) to assess the achievement of the pharmacodynamic target of 100%fT>MIC. The target concentration was determined based on the definitions of the European Committee on Antimicrobial Susceptibility Testing (EUCAST), depending on the pathogen. The primary endpoint was the proportion of patients not achieving therapeutic plasma concentrations. Results: A total of 60 antibiotic level measurements were performed in 28 patients. The median age of the patients was 64.5 ± 28,7 years, 80% (n = 22 patients) were male. The reason for admission was medical in 35.7% (n = 10), surgical/trauma in 53.5% (n = 15) and burns in 10.7% (n = 3) of patients. The therapeutic target was not achieved in 39.3% (n = 11) of patients, 66.6% (n = 6) in the meropenem group, 41.6% (n = 5) in the piperacillin group and 12.5% (n = 1) in the ceftriaxone group. Discussion: A significant proportion of critically ill patients receiving beta-lactam antibiotics did not achieve their target concentration, particularly piperacillin and meropenem. Conclusion: Our pilot study confirms the importance of therapeutic drug monitoring in critically ill patients receiving beta-lactam therapy. Orv Hetil. 2023; 164(48): 1904–1911.
A bölcsességfogak sebészete 2023-ban.
Változások, irányelvek
Wisdom tooth surgery in 2023.
Changes, guidelines
One of the most common dentoalveolar surgical procedures, with the most difficulties and complications, is the surgical removal of wisdom teeth. The topic is very topical, both because of its frequency and its diversity. It is diverse because its diagnostic evaluation in relation to the root canal mandibulae requires great expertise, the surgical technique is not standardised in the majority of the cases and the surgeon is often forced to improvise. The complications, the treatment of which is part of our daily tasks, are relatively frequent and sometimes require a strong institutional background. The literature on the subject is vast and the guidelines proposed often change from year to year. The authors review the indications, contraindications, diagnostics, surgical management, complications associated with the surgical removal of the wisdom teeth and their management. The authors present an overview of the protocols of the different international schools and formulate current recommendations for general practitioners, dentists and dentoalveolar surgeons in Hungary. Orv Hetil. 2023; 164(48): 1887–1894.
Húgyhólyag-schistosomiasis.
Az első hazai dokumentált eset
Schistosomiasis of the urinary bladder.
The first documented case in Hungary
Schistosomiasis, a worm infection known as bilharziasis or blood fluke, typically occurs in tropical regions. In temperate climates like Hungary, only imported cases are reported. The disease can affect the skin, gastrointestinal tract, or bladder, depending on the subtype of the worm. We present the case of a 32-year-old male of African origin who visited the urology clinic with macroscopic hematuria. Despite initial antibiotic therapy, the hematuria persisted. A cystoscopy revealed polyp-like lesions in the bladder, which were resected. Histological examination excluded bladder cancer and described a granulomatous and eosinophil granulocyte-rich inflammation. On top of that, the presence of Schistosoma haematobium eggs and sexually mature parasites in the venules was confirmed. After that, antihelmintic therapy was administered, leading to the resolution of symptoms. Notably, this case is the first documented instance of bladder schistosomiasis diagnosed in Hungary. Our paper aims to raise awareness of this rare condition while providing insights into its development, treatment, and potential complications. Orv Hetil. 2023; 164(48): 1920–1924.
A kognitív érzelemszabályozás szerepe az evészavartünetekben egyes serdülőkori krónikus betegségekben
The role of cognitive emotion regulation in disordered eating among chronically ill adolescents
Introduction: The association of chronic diseases with eating disorders requires increased attention due to the potential for serious complications and increased risk of mortality. Eating disorders and sub-clinical eating disorders are associated with maladaptive emotion regulation, which may be both triggers and maintaining factors of the disease. To our knowledge, the role of cognitive emotion regulation in eating disorders in adolescents with inflammatory bowel disease and type 1 diabetes mellitus has not been investigated to date. Objective: We analysed the relationship between cognitive emotion regulation and symptoms of eating disorder in adolescents aged 14 to 18 years, focusing on young people with type 1 diabetes mellitus and inflammatory bowel disease. Our research aimed to identify the role of specific cognitive emotion regulation strategies in eating disorders in patient populations with chronic disease. Method: In our study, 300 adolescents completed the Cognitive Emotion Regulation Questionnaire and the Self Administrated Psychiatric Scales for Children and Adolescents after informed consent. The four study groups consisted of 157 physically healthy adolescents, 51 adolescents diagnosed with IBD, 61 adolescents diagnosed with type 1 diabetes mellitus and 31 adolescents diagnosed with anorexia nervosa. Results: The results of our study showed that rumination and positive reframing were significantly associated with symptoms of eating disorders in adolescents with inflammatory bowel disease, and self-blame and rumination were significantly associated with symptoms of eating disorders in adolescents with type 1 diabetes mellitus diagnosis, through an indirect pathway. Discussion: Our results suggest that cognitive emotion regulation strategies are indirectly related to symptoms of eating disorders among adolescents with the chronic illness studied. More frequent use of negative emotion regulation strategies of self-blame and rumination increases the incidence of eating disorder symptoms, and less frequent use is associated with fewer eating disorder symptoms. Greater use of positive reappraisal is associated with fewer eating disorder symptoms. Conclusion: We recommend the incorporation of cognitive emotion regulation strategies in the complex care of chronically ill adolescents, both in screening and in interventions. Orv Hetil. 2023; 164(48): 1895–1903.
Orvostanhallgatók sztereotípiái különböző társadalmi csoportokkal kapcsolatban
Stereotypes of medical students about different social groups
Introduction: Knowledge and prejudices of medical students regarding marginalised patient groups can influence their interactions with patients. Objective: The perceptions of medical students from the point of view of which social groups they would be less likely to accept as patients. Method: Medical students of the University of Szeged completed a voluntary, anonymous questionnaire (n = 410) in 2021, which included several groups of questions (sociodemographic characteristics, family background, career choice motivations, shaping of medical identity, future professional plans, working during university; warmth and competence, social distance, own experiences among 19 social groups). Results: Students were least likely to meet abusers, vaccine deniers and prisoners in their future work. Female medical students were more reluctant to meet abusers, while their male counterparts homeless, alcoholic, AIDS and psychiatric patients, and senior students the vaccine denial group and AIDS patients. Their experiences with different social groups also varied widely. Most of them personally knew Romani people, drug users, psychiatric patients and alcoholics. In clinical practice, they encountered Romani people, alcoholics and psychiatric patients the most. During their education, they heard most often about vaccine deniers, alcoholics, Romani people, homeless people, AIDS patients. Discussion: Overall, the students were accepting patients from different social groups. However, their personal and educational experiences behind their prejudices were very diverse. Conclusion: It would be important to strive to meet and get to know different social groups during university studies in behavioural sciences and public health as well as during clinical work, so that students can learn to communicate with them appropriately. Orv Hetil. 2023; 164(48): 1912–1919.
Abstract
This analysis of current and historical research and clinical reports observes that the relationship between psychedelics and schizophrenia is complex and there are reports of psychedelics benefiting this population. Specifically, lower doses of psychedelics (mostly LSD) appear to have a potential beneficial impact on the negative symptoms of schizophrenia.
