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
Listeria monocytogenes is a foodborne opportunistic pathogen, that causes outbreaks and fatal cases worldwide. However, only few studies have been published in Mexico reporting the prevalence of this pathogen in food. Therefore, the objective of this current study is to evaluate the prevalence of L. monocytogenes in cheese sold in Tamaulipas, Mexico, and its potential risk to the population. For this purpose, samples were taken in 100 stores during the months of February, June and October 2023, and a total of 300 cheese products in 10 municipalities of Tamaulipas, Mexico were collected. Identification was performed by culture and PCR. Ten virulence factors were also analyzed and susceptibility testing to 14 antibiotics was performed. As a result, a prevalence of L. monocytogenes was detected in 12%. The most frequently detected virulence factors were actA (83.3%, 30/36) and hly (83.3%, 30/36). The strains were resistant to only 9 of the 14 antibiotics tested. The strains showed resistance in higher percentage to sulfamethoxazole/trimethoprim (STX/TMP: 38.8%, 14/36), penicillin (PE: 16.6%, 6/36), tetracycline (TE: 13.8%, 5/36) and amoxicillin/clavulanic acid (AMC: 13.8%, 5/36). The results of the current study show the presence of L. monocytogenes in cheese products sold in Tamaulipas, Mexico. The low prevalence of L. monocytogenes and low resistance to antibiotics could imply a low risk for public health. However, it is necessary to implement monitoring of L. monocytogenes in food, to monitor its potential risk for the consumer.
Abstract
Background and Aims
There is growing evidence regarding the overlap between trading behaviors and gambling. However, problematic trading behaviors are often assessed using gambling-related instruments, which may not fully capture the nuances of trading. The present study developed and evaluated the psychometric properties of the Trading Disorder Scale (TDS), grounded in in the research criteria proposed by Guglielmo et al. (2016), based on DSM-5 criteria for gambling disorder and internet gaming disorder.
Methods
A cross-sectional survey was administered to 403 Spanish amateur traders. The TDS was tested for reliability, validity, and factorial structure. Latent class analysis (LCA) was used to identify patterns of disordered trading.
Results
EFA and CFA supported a one-factor solution for the TDS, which showed strong internal consistency (ω u-cat = 0.938, KR-20 = 0.877). The scale showed good concurrent validity with PGSI (r = 0.559) and good convergent validity with trading-related variables. LCA identified three classes: non-disordered trading (72.2%), at-risk trading (17.6%), and disordered trading (10.2%). Individuals in the disordered trading group scored higher on TDS, traded more frequently, monitored markets more intensively, and exhibited higher rates of problem gambling (PGSI≥5), impulsivity, and substance use. Guglielmo's cut-off point (≥5 criteria) effectively differentiated individuals with disordered trading behaviors from those at-risk and those without disordered trading.
Conclusions
The TDS is a reliable and valid instrument for assessing disordered trading among amateur investors. Further research is needed to explore the scale's predictive validity.
Abstract
Acinetobacter baumannii is a significant nosocomial pathogen recognized for its multidrug-resistance (MDR) and capacity to endure in hospital settings. This study aims to investigate the clonal relationships of A. baumannii isolates from diverse clinical samples, identify the sequence types of MDR isolates, and examine biofilm formation activity and biofilm-associated genes that contribute to persistence in hospital settings. A total of 90 A. baumannii isolates were analyzed. Bacterial identification and antibiotic susceptibility testing were conducted with MALDI-TOF MS and Vitek-2. REP-PCR was utilized to evaluate clonal connections, MLST was employed for specific isolates. Biofilm formation activity was assessed using the XTT reduction assay, and biofilm-associated genes were identified by PCR. REP-PCR revealed 29 genotypes, with Genotype A being identified as the endemic clone in 59% of isolates. Two isolates representing this genotype were found to belong to the ST2 clone. The majority of A. baumannii isolates possess biofilm-related genes and exhibit strong biofilm activity. In MDR isolates, ompA and csuE positivity were significantly higher than those non-MDR isolates (P = 0.003, P = 0.001). The csuE positive isolates were found to have significantly stronger biofilm activity than negative ones (P = 0.009). This study emphasizes the prevalence of a hospital-endemic, MDR A. baumannii genotype A, ST2 clone, and the genetic variability across isolates. No direct correlation was noted between MDR status and biofilm formation; however, some biofilm-related genes, notably csuE, were linked to stronger biofilm activity. These findings underscore the necessity for ongoing molecular surveillance and infection control measures to avert the dissemination of MDR A. baumannii in healthcare environments.
Abstract
The emergence of carbapenemase-producing Klebsiella pneumoniae poses a significant global health threat, particularly in hospital settings. This study reports on the first detection of a pandrug-resistant (PDR) high-risk ST15 K. pneumoniae strain co-producing NDM-1 and VIM-1 in Greece. The isolate was recovered from a blood culture of a male patient admitted to the Intensive Care Unit (ICU) of Volos Hospital in July 2024. Next generation Sequencing (NGS) confirmed the presence of bla NDM-1 and bla VIM-1 genes. Other beta-lactamase type (CTX-M-15) was detected in association with NDM and VIM enzymes. Furthermore, this isolate was resistant to other antimicrobial agents, including aminoglycosides [aac(3)-II, aac(3)-IIe, aac(6′)-Ib, aadA1, aph(3″)-Ib, aph(6)-Id, aph(3′)-Ia), chloramphenicol (catB3), fluoroquinolones (qnrS1) and sulfonamides (sul1 and sul2). The Multilocus Sequence Typing revealed that the strain belonged to ST15. According to Kaptive the strain belonged to KL48. Our study provides new data about MBL producing K. pneumoniae in Greece. Thus, we report for the first time the co-expression of bla NDM-1 and bla VIM-1 in our country in ST15 K. pneumoniae. This study provides crucial epidemiological data on MBL-producing K. pneumoniae in Greece and highlights the urgent need for enhanced surveillance, infection control strategies, and access to last-resort antibiotics such as aztreonam-avibactam.
Abstract
Background and Aims
Recent taxonomies propose that pornography-related problems may arise from problematic pornography use (PPU) and/or moral incongruence (MI). Although religiosity is often viewed as a key factor in MI, religious-based MI has not yet been explicitly examined within these taxonomies, which we address herein.
Methods
Using latent profile analysis of self-report data obtained, we examined distinct and overlapping profiles of PPU and religiosity-based MI in two online samples of male pornography users from the United States (N = 1,356, M age = 36.86, SD = 11.26) and United Kingdom (N = 944, M age = 38.69, SD = 12.26).
Results
Three classes (15–25% of each sample) showed elevated PPU and/or religiosity-based MI: ‘At risk for religiosity-based MI’ (4–8%), ‘At risk for PPU’ (6–10%), and ‘At risk for co-occurring PPU and religiosity-based MI’ (6–8%). Unlike the two groups with elevated PPU, the group with religious-based MI group did not report heightened psychological distress or treatment-seeking tendencies. Respondents were otherwise classified as “not at risk” (40–47%) “low risk” (27–28%), or moderate-severity PPU (14%, Sample 2 only).
Discussion and Conclusions
Although the observed heterogeneity validates a taxonomy of PPU and religiosity-based MI, our findings challenge the assumption of elevated psychological distress and treatment-seeking tendencies among individuals with religiosity-based MI. Future research should further examine the clinical relevance of religiosity-based MI and extend these findings to broader (e.g., clinical, culturally diverse) samples.
Abstract
Introduction
Problematic pornography use (PPU) affects some individuals, causing distress and impaired functioning, and while psychotherapy is considered a first-line intervention, its efficacy remains understudied and unknown to many therapists. This review aimed to comprehensively synthesize the available evidence on psychotherapy for PPU and related problems (i.e., craving).
Methods
For this meta-analytic systematic review, we conducted a systematic literature search, followed by study selection, coding, and data extraction. We then meta-analyzed the resulting studies using a random-effects model with subgroup analyses, meta-regressions, and risk of bias assessments.
Results
20 studies with 2,021 participants met the inclusion criteria. Most studies included cognitive behavioral therapy and acceptance and commitment therapy interventions. Participants receiving psychotherapy improved significantly more than controls on PPU, frequency/duration of pornography use, and sexual compulsivity, with large effect sizes, that were small for craving. Within-subject effects were also large and stable at follow-up. In addition, single-case designs meta-analyses showed clinically significant reductions in PPU, craving, and frequency/duration. We identified moderate effects for related depression symptoms. Most subgroup and meta-regression analyses adjusting for treatment and sample characteristics were not significant.
Discussion
These results supports the efficacy of cognitive behavioral therapy and acceptance and commitment therapy in treating PPU and related problems. This has relevant implications for clinical practice (e.g., treating these problems with evidence-based interventions). However, these findings are limited by methodological issues, including the high risk of bias identified. To address these limitations, future research should use more rigorous methods (e.g., randomized controlled trials) and include more diverse groups.
Az areola mammae bilateralis naevoid hyperkeratosisa
Bilateral nevoid hyperkeratosis of the areola mammae
Neviform hyperkeratosis of the areola mammae is a relatively rare benign lesion observed mainly in women, most often associated with hormonal changes. In this case report, we present an 84-year-old male patient with bilateral hyperkeratotic plaques localized to the areola mammae. Given the rarity of this diagnosis, a histopathological examination was performed, which confirmed the presence of a benign pathology. This case report details the clinical features, diagnostic and therapeutic options, and differential diagnosis of naeviform hyperkeratosis of the areola mammae based on the available literature. Orv Hetil. 2025; 166(12): 478–480.
A magyarországi akut pszichiátriai ellátásban dolgozók munkaköri kompetenciahatár-átlépésének tanulságai a COVID–19-világjárvánnyal összefüggésben
Lessons regarding work-related competence transgression among acute psychiatric professionals in Hungary in the context of the COVID-19 pandemic
Introduction: In psychiatric care, competence is the basis of patient safety. Consequently, competence transgression can have serious legal and ethical consequences. Objective: Our aim in this study was to investigate the relationship between competence transgression and role clarity, role conflict, stress, and burnout and determine whether each professional group (i.e., residents, nurses, psychiatrists, and psychologists) showed a correlation with these factors. Method: An online cross-sectional survey was conducted among acute psychiatric professionals (n = 105) in Hungary between November 2021 and April 2022. The main data collection instrument was the Copenhagen Psychosocial Questionnaire II. Our questionnaire was complemented by a question on competence transgression. Results: Competence transgression was moderately correlated with role clarity (r = –0.387, p<0.01), role conflict (r = 0.430, p<0.01), stress (r = 0.308, p<0.01), and burnout (r = 0.336, p<0.01). There was a negative significant correlation of medium strength between residents and role clarity (r = –0.258, p<0.01). Conclusion: Competence transgression should be considered when reorganising psychiatric care after a pandemic. Residents working in acute psychiatric care do not perceive their job role as being clear. The recommendations of professional organisations should therefore be emphasized in professional education and among policy makers. Orv Hetil. 2025; 166(12): 469–477.
Mennyit felejtenek az orvostanhallgatók?
Stabil tudás kiépítése az orvosképzésben
How much do medical students forget?
Building stable knowledge in medical education
Medical training is traditionally divided into theoretical and clinical studies, but more and more medical schools are now offering an integrated curriculum that brings the two closer together. The solid theoretical knowledge acquisition is of paramount importance as it provides the basis for clinical subjects and, after graduation, for everyday clinical thinking and decision-making. Research has shown that students’ knowledge of theoretical subjects after university examinations can be significantly reduced, leading to difficulties in completing clinical studies and even in medical practice. Previous studies suggest that students forget approximately a third to a quarter of what they have learned in a year. However, the extent of forgetting in individual studies varies widely from discipline to discipline. Teaching methods and learning strategies that support active learning – such as retrieval practice and spaced repetition – have been shown to be effective in promoting long-term knowledge retention. Emphasizing the clinical relevance of theoretical material, taking steps towards an integrated curriculum can also contribute to deeper understanding and long-term knowledge retention. The aim of this paper is to present a comprehensive overview of the scientific findings on the long-term knowledge retention of medical students and to provide insights into the field of effective learning and teaching strategies that have been shown to be effective among medical students. The implementation of these strategies could help to improve medical education. Orv Hetil. 2025; 166(12): 450–458.
A szteroidhormonok csodálatos világa a neonatológiában – az első 50 év
Klinikai áttekintő közlemény és intézményi kohorszvizsgálat
The wonderful world of steroid hormones in neonatology – the first 50 years
Clinical review article and institutional cohort study
Professor László Karmazsin established the contemporary neonatal intensive care at the Department of Pediatrics of the University of Debrecen. His research group’s achievements in the field of neonatal immunobiology contributed to advances in perinatology. Investigating the antioxidant system in neonates, he and his group played a major role in uncovering the pathomechanisms of conditions associated with prematurity. At the same time, corticosteroids, applied as antenatal prophylaxis, and another, endogenous steroid hormone, active vitamin D, have also been shown to significantly impact fetal development and perinatal morbidity. Professor Karmazsin’s group pointed out to the relevance of corticosteroid receptors in mediating the effects of the hormone both in type II alveolar cells of neonates, as well as in leukemic cells. In this publication, we performed a literature review to analyze the interactions of these two steroid hormones on outcome results of the management of premature infants. Additionally, we report the results of a cohort study performed in the Neonatal Intensive Care Unit of the Department of Pediatrics of the University of Debrecen. In the presented small-sample study (n: 37), which focused on very low birth weight preterm infants, we examined the potential correlations between insufficient 25(OH)D levels and neonatal morbidities. In the group of preterm infants with insufficient (<50 nmol/L) 25(OH)D levels (N: 6/37) compared to those with sufficient (50–75 nmol/L) or optimal (>75 nmol/L) 25(OH)D levels (n: 31/37), higher incidences were observed in early (1/6 vs. 0/31; p: 0.021) and late (1/6 vs. 1/31; p: 0.183) neonatal infections, bronchopulmonary dysplasia (3/6 vs. 8/31; p: 0.235), necrotizing enterocolitis (1/6 vs. 1/31; p: 0.183), and the severe form of retinopathy of prematurity (1/6 vs. 0/31; p: 0.060). The difference was statistically significant in the case of early infections. Our results should be evaluated considering the limiting role of the small sample size. Orv Hetil. 2025; 166(12): 443–449.
A szülést követő poszttraumás stressz-zavar: klinikai relevancia, mérési lehetőségek
A traumatikus szülési élmények hatása
Post-traumatic stress disorder in postpartum period: clinical relevance, measurement opportunities
The impact of traumatic birth experiences
Among mental health disorders in the perinatal period, postpartum depression and anxiety are particularly common and iteratively attract research interest. Less focus, however, is placed on postpartum post-traumatic stress disorder (PTSD) and that develops following traumatic experiences during childbirth. Previously, post-traumatic stress disorder was primarily associated with wartime experiences, but it is now understood that various situations perceived as traumatic – such as childbirth – can also trigger this disorder. Our study aims to provide an overview of the risk factors contributing to postpartum post-traumatic stress disorder, its prevalence, and the lasting impacts that can challenge the mother-child relationship. Managing post-traumatic stress disorder presents a significant challenge for mental health professionals, necessitating the development of effective therapeutic interventions that offer individuals a chance for recovery. Efforts aimed at preventing childbirth-related post-traumatic stress disorder, as well as moderating its severe consequences, still require changes at conceptual, procedural, and practical levels. The availability of complex, problem-focused psychological support remains limited, with restricted access for affected individuals, as well as a shortage of qualified professionals. Orv Hetil. 2024; 166(12): 459–468.
Abstract
Background and aims
Problematic mobile phone use can disrupt social interaction and well-being, potentially influencing cognitive processes. This study investigated whether mobile phone use problem severity is associated with alterations in the topological organization of brain networks.
Methods
Rs-fMRI and DTI data were collected from 81 healthy participants. Graph theory analyses were applied. The Mobile Phone Problem Use Scale-10 (MPPUS-10) was used to assess mobile phone use problem severity. Correlation analyses were conducted between each graph metric and questionnaire scores.
Results
MPPUS-10 scores correlated with global fMRI metrics: higher scores linked to longer shortest path length (reduced integration) and lower global efficiency (reduced information transfer). Conversely, higher MPPUS-10 scores were correlated with a greater clustering coefficient and higher local efficiency, which reflect increased local connectivity. Furthermore, higher MPPUS-10 scores were associated with a higher sigma value from DTI, indicating altered structural network properties. Some specific brain regions also showed significant correlations with MPPUS-10 scores.
Discussion and conclusion
These findings indicate that higher mobile phone use problem severity is associated with decreased integration and increased segregation of functional networks, alongside enhanced small-worldness in structural networks. Reduced integration aligns with addiction theories suggesting digital overload worsens network dysfunction, disrupting brain connectivity. Additionally, higher severity was correlated with altered connectivity in multiple regions, such as the precentral gyrus, supplementary motor area, and postcentral gyrus. These regions are associated with motor control, sensorimotor processing, and memory function. Further research is needed to explore whether these findings reflect shifts in the integration and integrity of brain information-processing modules.
Abstract
Background and aims
Gambling disorder (GD) is a behavioral addiction often co-occurring with various mental health concerns, such as problematic pornography use (PPU). The specific impact of the co-occurrence of GD and PPU on treatment outcome remains underexplored. This study aimed to compare the treatment outcomes of individuals actively receiving treatment for GD (n = 172; 3.49% females), distinguishing between those without PPU (n = 146) and those with co-occurring GD and PPU (n = 26).
Methods
Cognitive-behavioral therapy (CBT) was administered in 16 weekly sessions, with assessments of GD severity, impulsivity, emotion regulation, psychopathology, and personality. Dropout, relapses, number of sessions attended, number of relapses, and amount of money spent during relapses were assessed as the main treatment outcomes.
Results
Patients with co-occurring GD and PPU showed greater GD severity, psychopathology, impulsivity, and difficulties in emotional regulation compared to those with GD and without PPU. Moreover, the presence of PPU appeared to be mainly associated with higher likelihood of treatment dropout, and, consequently, fewer CBT sessions attended.
Discussion and Conclusions
It is important to evaluate GD/PPU co-occurrence and strengthen the CBT approach for GD patients with PPU by using supplementary strategies to improve treatment adherence.
Abstract
Infections caused by colistin resistant Klebsiella pneumoniae are a major global health challenge linked to high mortality rates worldwide. Increased incidence of hypervirulent and drug-resistant Klebsiella causing life-threatening infections in young healthy individuals and asymptomatic carriage in the community has been largely reported in the Asian-Pacific Rim. This study conducted a molecular analysis of two morphologically distinct variants of K. pneumoniae that caused bacteremia and sepsis in a patient. Colony morphology of the isolates was characterized in various growth media, and the morphological variants differed in their mucoviscosity. The isolates were found to be serotype K2 (highly associated with hypervirulent Klebsiella) by molecular serotyping using specific PCR primers. The multidrug-resistant nature of the colony variants was evaluated by antibiotic susceptibility testing and it was found to have a similar antibiogram pattern in in vitro. An increased minimum inhibitory concentration (MIC) of colistin (>64 μg mL−1) was detected in both isolates using broth microdilution, and they were found to be highly resistant to colistin. Molecular analysis revealed that the isolates possessed a chromosomal mutation in mgrB, which causes colistin resistance. The increased incidence of infection caused by colistin-resistant K. pneumoniae requires continuous monitoring, and appropriate measures are necessary to control its adaptive evolution in healthcare settings.
Abstract
In this study, we evaluated the performance of modified rapid antimicrobial susceptibility test (mRAST) with 150 mm Mueller Hinton Agar (MHA) plates which was earlier standardized for 90 mm MHA by EUCAST. Blood culture bottles spiked with ATCC quality control strains were prepared. For quality control Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus ATCC 29213, and Enterococcus faecalis ATCC 29212 strains were used. By calculating and proportioning the surface areas of the plates comparing with 90 mm plates, 350 ± 50 µL undiluted blood culture samples were inoculated in 150 mm MHA, and 12 disks were placed. This process was repeated independently for three days and three times on each day for reproducibility. The mRAST test was performed on 50 samples with positive signals and gram-negative bacilli on Gram-stained samples (20 Klebsiella pneumoniae, 15 E. coli, 10 Acinetobacter baumannii, and five P. aeruginosa).
Comparison of 90 mm MHA and 150 mm MHA showed that the categorical agreement of ATCC strains and 50 gram negative isolates was 100% and >95%, respectively, for all antibiotics. For K. pneumoniae, only 0.4 major error (ME) was detected at 4 h. For E. coli, 3.2, 1.6, and 1.5 ME were detected at 4, 8, and 20 h, respectively, whereas 1.6 very major error (VME) was detected at 4 h and 1.0 VME was detected at both 8, and 20 h, respectively. No errors were detected for P. aeruginosa or A. baumannii.
These results indicated that 350 ± 50 µL of undiluted blood culture in 150 mm MHA was suitable for the mRAST test in vitro.
Az anémia és a COVID–19-megbetegedés prevalenciája 2020–2022 között a Pécsi Tudományegyetem Sürgősségi Betegellátó Osztályán
The prevalence of anemia and COVID-19 disease between 2020 and 2022 at the Emergency Department of the University of Pécs
Bevezető
2021-ben az anémia a világ népességének 24,3%-át érintette. Irodalmi adatok szerint az anémia súlyosbíthatja a fertőzések lefolyását, és felvetődik, hogy az anémiás állapot fokozhatja a fertőzésekre való fogékonyságot. A COVID–19-pandémia lehetővé tette ezen hipotézis vizsgálatát.
Célkitűzés
Retrospektív vizsgálatunk célja az anémia és a COVID–19-betegség előfordulásának vizsgálata sürgősségi ellátást igénylő járóbetegek között.
Módszer
2020 és 2022 között a Pécsi Tudományegyetem – Klinikai Központ, Sürgősségi Orvostani Tanszék, Sürgősségi Osztályára felvett járóbetegek demográfiai és vérkép adatait elemeztük. A tanulmányba 62 924 esetet vontunk be. 4367 esetben volt elérhető a korábbi vérkép eredmény is. Az eseteket korcsoportonként, nemenként és diagnóziscsoportonként elemeztük.
Eredmények
A betegek átlag életkora 60,28 ± 20,04 (SD) év volt. 10 552 esetben volt klinikailag igazolható a COVID–19-betegség. 14 129 esetben találtunk anémiát. A klinikailag diagnosztizált COVID–19-betegek között az anémia előfordulása 6,33%-kal magasabb volt. Az anémiás betegek között a COVID–19-megbetegedés előfordulása magasabb volt, mint a nem anémiás betegek csoportjában összességében, minden korcsoportban és minden évben. A felvételkor anémiás betegek között a COVID–19-betegség nagyobb eséllyel fordult elő (odds ratio – OR: 1,409). Jelentősen magasabb esélyt jelentett a COVID–19-betegség szempontjából a korábban igazolható és felvételkor is fennálló anémiás állapot (OR: 2,420), különösen az 50–65 év közötti betegek csoportjában (OR: 4,816).
Következtetések
Az anémiás állapot oki kezelése jelentősen javíthatja a betegek életminőségét, csökkentheti fertőzésekre való fogékonyságot és a fertőző betegségekben szenvedők rosszabb klinikai kimenetelének kockázatát. Az anémia kezelése a betegellátás során a jelenleginél nagyobb figyelmet érdemel.
Entity and environment relationships in psychedelic experiences resulting from inhalation of N,N-dimethyltryptamine
DMT entities and their environments
Abstract
Aim
Gaining a more detailed understanding of the patterns of relationship of the content of psychedelic experiences can help build a deeper understanding of the nature of consciousness and assist in navigating those extraordinary experiences for therapeutic, spiritual, exploratory and creative purposes. To help achieve this goal, this study examines the patterns of relationship between Entities and Environments found in narratives of complex psychedelic experiences resulting from smoking N,N-dimethyltryptamine.
Methods
The narrative accounts examined in this study were drawn from a variety of online sites and were analyzed in order to examine the patterns of relationships between different types of Entities and Environments encountered during psychedelic experiences resulting from inhalation of N,N-dimethyltryptamine. In this study different types of Entities were identified and charted in relation to the frequency of the different Environments they appeared within.
Results
Some consistency was found in encounters described with Entities and the Environments they appeared within. Various types of Entities were encountered with greater frequency in some Environments and various Environments had unique mixtures of dominant and less common varieties of Entities.
Conclusions
This study helps advance our understanding of the subjective psychedelic experiences resulting from ingestion of DMT. It reveals some of the distinct relationships between Entities and the Environments in which they appeared and provides a framework for developing a predictive model of those relationships and the progression of those psychedelic experiences.
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.
Abstract
Background
Hemiplegia, a common neurological consequence of moderate to severe traumatic brain injury (TBI) significantly impacts patients' motor and daily living functions. In China, standard treatments for hemiplegia include physical rehabilitation and traditional acupuncture. Scalp acupuncture, rooted in traditional Chinese medicine, has gained attention as a potential alternative. This study compared the efficacy of scalp acupuncture combined with conventional therapy versus conventional therapy alone in improving limb function recovery in patients with hemiplegia after moderate to severe TBI.
Methods
This open-label, single-site, parallel-group randomized trial included 117 patients with hemiplegia post-TBI. Patients were randomized into a control group (n = 58) receiving conventional interventions, and a scalp acupuncture group (n = 59) receiving scalp acupuncture in addition to conventional care. Scalp acupuncture was administered daily for 8 weeks using standardized acupuncture points. Outcome measures included the Brunnstrom Hemiplegia Motor Function Scale, the Fugl-Meyer Assessment (FMA) scale, the modified Barthel Index (MBI), cerebral blood flow assessment (via color Doppler ultrasonography), and serum brain-derived neurotrophic factor (BDNF) levels.
Results
The scalp acupuncture group demonstrated significantly greater improvements in Brunnstrom scale scores, with higher proportions of patients achieving advanced recovery levels (P = 0.015). FMA and MBI scores showed superior improvements in motor function and daily living abilities in the scalp acupuncture group compared to controls (P < 0.05). Enhanced cerebral blood flow velocities and volumes were observed in the scalp acupuncture group, particularly in the anterior and middle cerebral arteries (P < 0.01). Serum BDNF levels were significantly elevated in the scalp acupuncture group post-treatment, suggesting enhanced neural repair.
Conclusions
This study provides evidence that scalp acupuncture combined with conventional therapy can significantly improve motor function, daily living abilities, and neural recovery markers in patients with hemiplegia following moderate to severe TBI. These findings warrant larger, multicenter trials to evaluate the long-term efficacy of scalp acupuncture and to determine its role as a potential gold standard for hemiplegia treatment in neurological rehabilitation.
Abstract
Objective
Although SARS-CoV-2 primarily targets the respiratory system, there is evidence that it can also infect the central nervous system, especially in children, leading to neurological symptoms and long-term consequences. It is imperative to summarize the possible mechanisms, main symptoms, and treatments of neurological symptoms of COVID-19 in children.
Methods
We performed a literature search using the PubMed online database to find studies investigating the mechanisms of COVID-19 infection of the central nervous system and therapies for COVID-19 neurological symptoms in children.
Results
The main mechanisms of action of SARS-CoV-2 virus on the nervous system are direct invasion, systemic inflammation and molecular mimicry. Although the incidence of adverse reactions to intravenous IgG therapy (IVIG) varies greatly and the contraindications are not yet clear, IVIG has been shown to be clearly effective for the neurological symptoms of COVID-19 in children.
Conclusion
However, due to insufficient data, more clinical studies are still needed to confirm its safety and efficacy, further improve the treatment plan, and determine the appropriate dosage to better serve clinical practice.
Significance
The specific regimen of IVIG treatment for COVID-19 in children was explored, which further improved the understanding of COVID-19 and L-C19 neurological diseases in children.
Abstract
Background and Aims
Digital media have become a fundamental aspect of daily life for children and adolescents, influencing cognitive, emotional, and social development. The present work explores the dual nature of digital media use, identifying both positive and negative impacts on well-being and development.
Methods
A comprehensive review of existing literature was conducted to explore the interplay between digital media use and its effects on child and adolescent well-being. The study employs the Digital Media-use Effects (d-MUsE) model to analyze psychological mechanisms and contextual factors mediating these effects.
Results
Functional media use promotes positive mental, physical, and social outcomes, while dysfunctional use is linked to negative psychological consequences, such as increased anxiety, depression, and social isolation. The proposed d-MUsE model highlights the interplay of psychological mechanisms and contextual factors—both proximal and distal—that mediate the effects of digital media on short- and long-term well-being.
Discussion
The present work endeavours to refine our existing comprehension of the intricate interplay of elements and mechanisms underpinning functional and dysfunctional employment of digital media. Prospective research trajectories, which spotlight factors that hitherto remained at the periphery of investigative scrutiny, find discourse in this synthesis.
Abstract
Acute pulmonary thromboembolism (PTE) can range from asymptomatic cases to severe presentations with cardiogenic shock. We report a 67-year-old male with diabetes and hypertension, presenting with progressive dyspnea and hemodynamic instability. Clinical examination revealed sinus tachycardia, right ventricular dysfunction on echocardiography, and elevated biomarkers indicative of PTE. Chest X-ray showed classic signs including Westermark's, Palla's, Fleischner's and Chang's signs, raising suspicion for PTE, which was confirmed via CT pulmonary angiogram showing extensive thrombi. The patient was treated with intravenous thrombolysis and anticoagulation, resulting in clinical improvement and normalization of imaging findings. This case underscores the diagnostic relevance of chest X-ray in emergency settings for suspected PTE.
Abstract
There is a plethora of evidence that suggests infection may either directly or indirectly trigger chronic inflammatory processes which may then act as a risk factor for diabetes mellitus and atherosclerosis. Inflammatory periodontal disease like periodontitis, is among the most prevalent oral infectious disease. It affects the tissues that support the teeth and has reportedly been linked to systemic conditions like diabetes mellitus and atherosclerosis. The onset and progression of periodontitis is significantly influenced by the plaque-biofilm and the host-inflammatory response to it. Evidence from numerous studies included in this review supports the hypothesis that there is an association between periodontal pathogens and systemic conditions like diabetes mellitus and atherosclerosis. An overview of some of the periodontal pathogens associated with periodontitis and the proposed mechanisms by which these pathogens can evade and invade the human defence system triggering the onset of chronic diseases like diabetes mellitus and atherosclerosis are presented in this article.
Abstract
Background and aims
The Interaction of Person-Affect-Cognition-Execution (I-PACE) model of behavioral addictions is used relatively often as a scientific framework to specify research hypotheses and to interpret empirical findings in behavioral addiction research. There are, however, controversial interpretations in the literature regarding some specific elements of the model, which may require a more precise definition of specific constructs and processes that are central to the I-PACE model.
Methods
This is neither a comprehensive literature review nor a proposal for a new version of the I-PACE model. We aim to provide a selective, critical evaluation of some interpretations of the model and to include recent developments regarding addiction theories and controversial debates.
Results
The role of gratification and compensation and therefore positive and negative reinforcement are specified. The concepts of cue-reactivity and craving are considered in the context of desire thinking and permissive beliefs. The relationships between impulsive, habitual, and compulsive behaviors in behavioral addictions are discussed. The effects of general self-control and situation-specific executive functions are elaborated. Punishment (in)sensitivity is discussed as a further important process potentially involved in behavioral addictions. These constructs and processes (through their interactions) are considered in the context of changes over time in the course of addictive behaviors.
Conclusion
This viewpoint article aims to provide greater precision and clarity regarding some specific elements of the I-PACE model, which may help stimulate research and theory building and advance clinical care in the behavioral addiction field.
Abstract
Background and aims
Despite the inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the ICD-11, there are many open questions on its neuronal pathogenesis, especially regarding the role of the amygdala. In this study, we aimed to further unravel this issue via a parcellation method based on Recurrence Quantification Analysis (RQA).
Methods
The RQA pipeline was applied to resting-state functional magnetic resonance imaging data from 45 heterosexual males with CSBD and 26 Healthy Controls. Each amygdala was divided into two subdivisions in each group. In the CSBD group, the scores of psychological questionnaires were used as covariates in a second-level seed-to-voxel connectivity analysis with the amygdala as a region of interest.
Results
Obtained parcellations revealed bilateral differences in the sizes of dorsomedial (DM) and ventrolateral (VL) amygdala between groups. Mean values of Shannon's Entropy in the left DM and right VL amygdala correlated negatively with depression level, anxiety, and impulsivity, which might represent a vulnerability to CSBD, but only the right VL was implicated in the severity of CSBD symptoms. Multiple correlations between resting-state functional connectivity of the amygdala subdivisions and CSBD severity were observed, especially between the left VL amygdala and several default mode network nodes.
Discussion and Conclusions
This is the first attempt to explore the role of the amygdala in CSBD by a parcellation method. Our results suggest the importance of the right VL amygdala in understanding the pathogenesis of the severity of CSBD symptoms, which highlights the rising need to explore the amygdala as a complex structure with diverse functions.
Myeloma megelőző állapotok
Myeloma precursor states
A myeloma megelőző állapotok, az MGUS és a smoldering myeloma (SMM) a népesség igen jelentős részét érintik, együttes előfordulásuk a 40 év feletti átlagpopulációban meghaladja a 3-4%-ot. Nagy jelentősége van tehát annak, hogy ebben a hatalmas, heterogén betegcsoportban meg tudjuk különböztetni azokat, akiknél az MGUS véletlen lelet, és irreleváns állapotuk szempontjából, illetve azokat, akik kiemelten fenyegetettek a myelomába történő progresszió által. A rendelkezésre álló biomarkerek (M protein-, és könnyűláncszintek, a termelt immunglobulin típusa, a csontvelői plazmasejtek aránya és citogenetikai eltérései) alapján határozhatjuk meg azon MGUS-betegeket, akiknél további vizsgálatok (csontrendszeri képalkotók, csontvelővizsgálat) és intenzív követés szükséges. SMM esetén mindenképpen szükséges a hematológiai gondozás. Újabb vizsgálatok szerint a SMM gyakorisága sokszorosan meghaladhatja a korábban becsült incidenciát (40 év felett néhány ezrelék lehet!). Bár több folyó klinikai vizsgálat igyekszik megoldást találni, sem MGUS, sem SMM esetén nem áll jelenleg rendelkezésünkre olyan terápiás lehetőség, amellyel a myelomába történő progresszió megállítható vagy visszafordítható lenne. Az érintettek gondozásakor ezért a minél pontosabb rizikóbecslés alapján történő követés az elsődleges, a progresszióval jelentkező visszafordíthatatlan szövődmények (veseelégtelenség, csonttörések, könnyűlánc amyloidosis) megelőzése céljából.
Az iszony- és ihlet-hipertónia (50 éve hunyt el Németh László)
Repulsion- and inspiration-hypertension (László Németh died 50 years ago)
Digitális egészségügyi megoldások a COVID–19-járvány alatt és után
Két reprezentatív lakossági felmérés eredményei
Digital health solutions during and after the COVID–19 epidemic
Results of two representative population surveys
Introduction: Before the COVID–19 pandemic, the uptake of digital health solutions had been hindered by regulatory and strategic gaps, but during the pandemic, the rapid adoption of digital tools became necessary. With the pandemic over, the regulatory conditions are now in place in Hungary to support the use of digital health solutions, while the imperative for digital solutions has diminished. The question is how patient interest and demand for digital solutions will change in this situation. Objective: In our two nationally representative population surveys, we sought to answer the question of how the COVID–19 pandemic affected the population’s usage patterns, attitudes and needs for digital health solutions. Methods: We compared the results of two national representative population surveys. The first survey was carried out in October 2021, during the COVID–19 pandemic, by interviewing 1,500 people over telephone. The second survey was conducted in February 2024 by interviewing 1000 people (+100 elderly boost sample) online. Both samples are representative of the Hungarian adult population by gender, age, education and municipality type. Data collection for both surveys was carried out by Ipsos Zrt. Results: The results of the two population surveys show that the frequency and method of searching for health information online has changed significantly. The proportion of people who did not search for information online at all continued to decrease. The popularity of websites for health-related internet use increased, while the interest in blogs, podcasts and social platforms decreased. Awareness and use of digital tools also increased, particularly for online appointment booking, healthcare data sharing and social media use. Positive perceptions of the effectiveness of care decreased slightly, while concerns about technological frustration also eased. Conclusion: As the COVID–19 pandemic passed, digital health regulations emerged and the use of digital health technologies became commonplace among the population. Awareness and use of digital technologies increased significantly, especially for online appointment booking, e-prescription and wearables. Concerns about the potential disadvantages of using digital tools decreased, while expectations of benefits did not change significantly, indicating a more realistic perception. Patients’ need for digitalisation has now become an integral part of their care, supporting a more informed and active engagement in the healing process. Orv Hetil. 2025; 166(10): 377–384.
A méhátültetés céljából történő szervkivétel sebészi lépései agyhalott donor esetében
Surgical steps of organ retrieval from deceased donor for uterus transplantation
Introduction: A new surgical treatment method for absolute uterine infertility is uterus transplantation. We performed cadaver surgeries in preparation for human deceased donor uterus transplantation. Objective: The objective of the surgeries was to identify anatomical structures, to demonstrate the steps of graft retrieval, and to practice the collaboration of the medical staff as a team. Method: With the approval of the ethical committee, respecting the mercy and personal rights of the deceased, we dissected the ureter from its entry into the minor pelvis, also dissected the parietal and visceral branches of the internal iliac artery and vein, then clamped and cut them, while keeping the vascular bundles of the parametrium intact. Finally, a hysterectomy was performed along with the long vaginal cuff. Results: The operation was successful in 3 out of 3 cases, as it was possible to remove the uterus with bilaterally intact parametrium and intact vasculature. Discussion: During uterus transplantation, the graft can originate from a living or deceased (brain-dead) donor. Both interventions have many advantages and disadvantages. Currently, it is a matter of scientific debate which is the preferred method of organ removal, but in any case, proper preparation and practice are essential. Conclusion: We consider and recommend cadaver surgeries as it is suitable for preparation for human brain-dead donor uterus transplantation. Orv Hetil. 2025; 166(10): 385–391.
A molekuláris diagnosztika lehetőségei onkohematológiai betegek invazív gombainfekcióinak ellátásában
Opportunities offered by molecular diagnostics in the management of invasive fungal infections of oncohematological patients
Invasive fungal infections pose a particular threat to oncohematological patients. Candidiasis, aspergillosis, mucormycosis, cryptococcosis and Pneumocystis pneumonia are the most common manifestations. Despite various available approaches (culture, histology, serology, imaging), diagnosis of invasive mycoses is challenging. Owing to rapid technological advancements, molecular biological methods are routinely used in diagnostics of bacterial and viral infections. At the same time, molecular tests can be of substantial assistance in the detection and characterization of mycoses, therefore several international guidelines contain recommendations on them. Although some molecular fungal tests have been introduced in Hungarian healthcare, their widespread application is lagging. Here, we provide a review of molecular tools for clinical fungal diagnostics focusing on taxon-specific polymerase chain reaction (PCR), sequencing techniques (Sanger sequencing, next-generation sequencing) and their roles in identification of fungal pathogens and detection of resistance to antifungal medication. Tests available in South-Pest Central Hospital – National Institute of Hematology and Infectious Diseases and at the Department of Pathology and Experimental Cancer Research of Semmelweis University are briefly discussed. Finally, the utility of molecular fungal diagnostics is demonstrated through two case reports. This article aims to contribute to larger implementation of molecular tools in fungal diagnostics in the Hungarian healthcare system. Orv Hetil. 2025; 166(10): 363–376.
Összetett bokatörések lágyrész-kímélő operatív kezelése idős pácienseken fibulaszegezéssel
Soft tissue protecting operative treatment of complex ankle fractures in elderly patients using fibular nailing
The incidence of ankle fractures in older patients shows a clear upward trend. However, their proper treatment is often challenging and may be associated with a high complication rate. The primary reasons for the increased complication rate can be attributed to the specific characteristics of the patient population, such as frequently complex morbidities, weakened bone structure, and less than optimal soft tissue conditions. These problems are more likely to arise with standard invasive operative methods, such as plate osteosynthesis, which can have a pronounced negative impact on the already sensitive soft tissues. To reduce complications associated with the treatment of multiple, complex ankle fractures in geriatric patients, a soft tissue-protecting alternative may be the intramedullary nailing of the distal fibula. In this case presentation, we aim to demonstrate the advantages of the anatomical intramedullary fibula nailing method using the examples of complex ankle fracture therapy in an 86-year-old and a 74-year-old patient. This technique offers anatomical fixation while ensuring significant soft tissue protection. It allows for (partial) weight-bearing after surgery, thereby facilitating the early mobilization of patients. With appropriate indications, this method can yield particularly good results in the operative treatment of ankle fractures in geriatric patients. Orv Hetil. 2025; 166(10): 392–397.
Beszámoló a 13. Nemzetközi Hodgkin lymphoma Szimpóziumról (ISHL)
(2024. október 26–28., Köln)
Abstract
Purpose
Scoliosis may create muscle imbalance and disturb muscle metabolism. However, no studies have examined muscle cell metabolism in scoliosis. This study evaluates lactate concentration in female college students with scoliosis.
Methods
One hundred fifty female college students followed this cross-sectional analytic study. Inclusion and exclusion criteria were applied. Scoliosis was measured using a scoliometer. A scoliometer reading of 5° was considered scoliosis. Lactate concentration was measured using a lactate analyzer, and a lactate value above 2 mg dL−1 was denoted as ‘elevated.’ Anova and post hoc tests were used to analyze differences in the variables between scoliosis and normal subgroups. The results were significant if P < 0.05.
Results
One hundred participants (66.7%) had a spinal curve angle of more than 5°. Only weight in thoracic scoliosis was lower than normal (P = 0.022). Lactate was significantly higher than normal in all scoliosis subtypes (P < 0.001). Lactate in both types was considerably higher than thoracic and lumbar scoliosis (P = 0.04 and 0.03, respectively).
Conclusion
Lactate concentration increased in female students with scoliosis.
Abstract
Behavioral addictions share symptomatological features with substance addiction. From the associative learning perspective, these characteristics include excessive and unregulated self-administration of sensory and other reinforcers, potentially reflecting the transition from goal-directed actions (action → outcome associations) to habitual responses (stimulus → response associations). In laboratory mice, light stimulation at an optimal intensity possesses some incentive properties and a brief light pulse represents an effective reinforcer for persistent operant responding. The operant light self-administration paradigm with clearly defined sensory reinforcers and reinforcement schedules may be utilized to elucidate the general mechanisms of excessive habitual responding to seek non-drug and non-feeding cues in mice. This cross-species approach can shed light on some maladaptive habits that have emerged recently in our modern society, including digital technology-based disorders.
Abstract
Purpose
This study aimed to determine the effects of yoga on the recovery of the cardiac autonomic nervous system and immunosuppression after intense exercise.
Methods
Seven healthy adult men were enrolled in two trials: rest for 30 min in a seated position (CON) and yoga for 30 min (YOG) after a treadmill running for 60 min at 75%
Results
NK cell activity was significantly decreased in the CON trial (P < 0.05) but not in the YOG trial. The decrease in NK cell activity from Pre at P0, P1, and P2 in the CON trial was significantly larger than that in the YOG trial (P < 0.05). Testosterone secretion rate tended to be higher after yoga than at rest (P = 0.052). The square root of the mean squared difference of successive normal-to-normal intervals (RMSSD) at P0 in the YOG trial was significantly higher than that in the CON trial (P < 0.05). Changes in NK cell activity correlated with changes in RMSSD (r = 0.445, P < 0.05).
Conclusion
This study showed that yoga can alleviate the decline of NK cell activity after intense exercise by enhancing parasympathetic nerve activity, thus suggesting that yoga may be an effective recovery method for athlete conditioning.
Abstract
Bovine spongiform encephalopathy (BSE) is a progressive neurodegenerative disorder in cattle that poses risks to public health and has economic consequences. The shadow of prion protein encoded by the shadow of prion protein (SPRN) gene affects prion disease progression. A 12-base-pair indel polymorphism in the SPRN gene has been implicated in BSE susceptibility in Polish cattle. Building upon our previous research, we aimed to investigate the SPRN gene polymorphisms in Jeju black cattle — a Korean native breed with distinct genetic features and compared them with those in Hanwoo and Korean Holstein. Our findings reveal that the Jeju black cattle SPRN gene, with only two synonymous single nucleotide polymorphisms, has lower genetic diversity than that in Hanwoo and Korean Holstein. Moreover, we contrasted the distribution of c.199_210delGCCGCGGCGGGG (67_70delAAAG) polymorphisms in the SPRN gene between BSE-infected Polish cattle and Korean cattle to assess BSE susceptibility. The results suggest that Jeju black and Korean Holstein demonstrate a higher genetic potential for BSE resistance compared to the Hanwoo breed. To the best of our knowledge, this study provides the first report of the SPRN gene in Jeju black cattle, along with a comparative analysis of SPRN gene polymorphisms across three Korean cattle breeds.
