Orvosi hetilap最新文献

{"title":"[Silent shift: changes in the types and subtypes of hepatitis C virus in Hungarian patients over three decades (1996-2026)].","authors":"Judit Gervain, Linda Szakasits-Bardon, Erika Bakiné Hodovánszky, Katalin Szabóné Barta","doi":"10.1556/650.2026.33628","DOIUrl":"https://doi.org/10.1556/650.2026.33628","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis C virus (HCV) shows great structural variability. Currently, it has 8 genotypes and 93 subtypes with differing distributions according to geographical regions, ethnicities, and risk groups. In Hungary, HCV infections have been screened since 1992. In our Molecular Diagnostic Laboratory, we have been conducting HCV serotyping since 1996 and genotype and subtype analyses since 2000, both with national coverage.</p><p><strong>Objective: </strong>To analyse the genotype and subtype distributions of our national sample (n = 9067) according to age, sex, geographical region, and their evolution over three decades (1996-2026).</p><p><strong>Methods: </strong>Serotyping was carried out between 1996-1999 (n = 175) followed by genotyping with hybridization between 2000-2016 (n = 4844) and with real-time PCR since 2016 (n = 4223).</p><p><strong>Results: </strong>Over the three decades, GT1b remained the dominant subtype in Hungary, but its relative frequency diminished in comparison to GT1a and GT3. Overall prevalence was the highest among younger males (<40 years) and older females (>60 years). Age under 40 years showed statistically significant association with increased prevalence of GT3 and non-GT1b genotypes. GT3 was the most common in the Southwest region, while non-GT1b was the most frequent in the Northeast region.</p><p><strong>Discussion: </strong>Similarly to international findings, our results confirm a continuous change in the genotype/subtype distribution of HCV in Hungary, too. The observed increase in genetical diversity is linked to migration, travelling and the increasing frequency of intravenous drug use. Genotype monitoring of HCV, therefore, remains important for the early detection of rare subtypes, interpretation of unexpected therapeutic outcomes, and directed epidemiological investigations. It also supports the indirect monitoring of changes in population lifestyle factors and infection routes. Relevant information is necessary for the differentiation of relapse from reinfection. Orv Hetil. 2026; 167(33): 1318-1323.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 33","pages":"1318-1323"},"PeriodicalIF":1.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vestibulocochlear infarct: a challenging diagnosis].","authors":"András Szilágyi, Anita Gáborján, Beáta Bencsik, László Tamás, Ágnes Szirmai, Gábor Polony","doi":"10.1556/650.2026.33625","DOIUrl":"https://doi.org/10.1556/650.2026.33625","url":null,"abstract":"<p><p>Vestibulocochlear infarct, most commonly associated with infarction of a terminal branch of the anterior inferior cerebellar artery, presents with acute vertigo and sensorineural hearing loss. It often mimics peripheral vestibular disorders and may show no abnormal findings on neuroimaging, making the diagnosis particularly challenging. Without appropriate treatment, permanent unilateral hearing loss can significantly impair patients' quality of life. This review synthesizes findings from recent studies regarding the clinical characteristics, diagnostic approach, and therapeutic strategies of this condition. Patients typically present with prolonged vertigo (>24 hours), unilateral hearing loss, tinnitus, and imbalance. On examination, peripheral signs such as a positive head impulse test or horizontal-rotatory nystagmus may be observed, while the only indicator of a central origin is the hearing loss, often subtle or unnoticed even by the patient. Vascular comorbidities, including hypertension and diabetes mellitus, constitute key risk factors. Diagnostic difficulties arise from overlap with idiopathic sudden sensorineural hearing loss and vestibular neuritis; a vascular origin may account for up to 15-20% of acute audio-vestibular syndromes in high-risk populations. Early thrombolysis or antiplatelet therapy may improve outcomes, though thrombolysis is rarely administered due to the lack of imaging evidence. For diagnosis, video head impulse testing, audiometry, and MR neuroimaging are essential. Management relies on vestibular and auditory rehabilitation for persistent vertigo and secondary stroke prevention. Our review highlights the underdiagnosis of vestibulocochlear stroke and advocates for an integrated neuro-otological and vascular diagnostic protocol in patients presenting with vertigo and hearing loss to facilitate faster and more effective treatment. Orv Hetil. 2026; 167(33): 1309-1317.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 33","pages":"1309-1317"},"PeriodicalIF":1.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A review of the European Resuscitation Council (ERC) 2025 first aid and adult basic life support practical guidelines: implications for Hungarian practice].","authors":"József Betlehem, Henrietta Bánfai-Csonka, Enikő Kovács, Bálint Bánfai","doi":"10.1556/650.2026.33623","DOIUrl":"https://doi.org/10.1556/650.2026.33623","url":null,"abstract":"<p><p>The scientific approach to first aid has gained significant prominence in medical literature over recent decades. This process represents a paradigm shift: immediate care is no longer viewed merely as an altruistic \"Good Samaritan\" act, but as a discipline demanding the rigour of evidence-based medicine. Since global survival rates for various emergencies continue to show significant variance, it has become essential to establish a scientifically grounded framework for both laypeople and healthcare professionals. This review aims to present and analyze the latest 2025 European Resuscitation Council (ERC) guidelines for first aid and adult out-of-hospital basic life support (BLS). Particular emphasis is placed on the importance of aligning the initial steps taken by lay rescuers with the professional protocols of emergency medical service systems. These guidelines are based on the 2025 International Consensus on Science with Treatment Recommendations (CoSTR) developed by the International Liaison Committee on Resuscitation (ILCOR). The ERC writing group conducted extensive literature synthesis, utilising published systematic reviews and scoping analyses. During the development of these recommendations, \"Evidence to Decision\" tables and narrative expert opinions ensured that each guideline is underpinned by high-level scientific evidence. The evidence base and level of evidence for the guidelines vary by topic; in certain areas, good practice statements based on expert consensus are also included. Our manuscript focuses on a narrative summary and the possibilities for domestic adaptation, while the systematic synthesis of evidence was part of the ERC/ILCOR methodology. The updated recommendations advocate for a unified primary approach based on the ABCDE assessment framework for all critical conditions, including internal medicine pathologies, traumatic injuries, and environmental emergencies. A defining element is the improvement of survival rates for out-of-hospital cardiac arrest, which can be achieved through the integration of technological innovations and the promotion of bystander education. Standardized professional protocols and practice-oriented education are the cornerstones of effective emergency care. To enhance the efficiency of the chain of survival, it is vital to ensure a seamless transition between lay first aid and interventions performed by emergency professionals, as supported by the latest international scientific consensus. Orv Hetil. 2026; 167(33): 1294-1308.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 33","pages":"1294-1308"},"PeriodicalIF":1.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lajos Markusovszky memorial meeting, 2026].","authors":"","doi":"10.1556/650.2026.33673","DOIUrl":"https://doi.org/10.1556/650.2026.33673","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 33","pages":"1324-1332"},"PeriodicalIF":1.0,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical and preprocedural factors influencing in vitro fertilization outcomes: a machine learning-based analysis].","authors":"Bernadett Nádasdi, Viktor Vedelek, Kristóf Bereczki, Petra Lilla Zádori, Blanka Mátyus, Rita Sinka, János Zádori, Anna Vágvölgyi","doi":"10.1556/650.2026.33608","DOIUrl":"https://doi.org/10.1556/650.2026.33608","url":null,"abstract":"<p><p>Infertility affects 15-20% of the reproductive-age population, and assisted reproductive technologies, particularly in vitro fertilization (IVF), play an increasingly important role in its management. IVF success is multifactorial and influenced by numerous clinical and biological factors. Our aim was to review the most important preprocedural and procedural factors influencing IVF outcomes, with special emphasis on predictors identified by machine learning models. A narrative literature review was conducted, focusing on studies applying machine learning approaches, including results from the Gametogenesis Research Group at the University of Szeged. Machine learning models consistently identify maternal age and embryo quality (embryo score) as the strongest predictors of IVF success, maternal age above 35 years is associated with reduced success rates, besides body mass index, anti-Müllerian hormone, follicle-stimulating hormone levels, as well as endometrial thickness play relevant roles with variable impact. Preprocedural thyroid-stimulating hormone levels within the normal range show no clear association with outcomes. Overall, the results confirm that IVF success is determined by complex interactions among multiple factors. Machine learning models enable the determination of the relative weight of these well-established and repeatedly validated factors and improve the accuracy of prediction. Machine learning represents a promising tool for predicting IVF outcomes and may support personalized treatment strategies in reproductive medicine. Orv Hetil. 2026; 167(32): 1262-1268.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 32","pages":"1262-1268"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Focus on testicular torsion: differential diagnosis of acute scrotum].","authors":"Ádám Hodoniczki, Máté Zsolt Scherer, Zsuzsanna Fejes, Gyula Pásztor, Zoltán Bajory","doi":"10.1556/650.2026.33621","DOIUrl":"https://doi.org/10.1556/650.2026.33621","url":null,"abstract":"<p><p>Testicular torsion is a urological emergency caused by twisting of the spermatic cord around its longitudinal axis, resulting in acute impairment of testicular blood flow. Its incidence is approximately 1/4000 in individuals under the age of 25, with a bimodal distribution and peak occurrence in the neonatal period and puberty. Although prevalence decreases with age, testicular torsion remains an important in the differential diagnosis of acute scrotum across all age groups. Delayed diagnosis may lead to irreversible ischemia and subsequent testicular loss; therefore, minimizing the time to definitive management is essential. The aim of the present study is to summarize current diagnostic approaches to testicular torsion based on a review, with particular emphasis on the predictive value of individual physical examination findings. Evidence indicates that in cases of strong clinical suspicion, immediate surgical exploration is warranted in order to maximize testicular salvage rates and minimize the critical time of ischemia. Orv Hetil. 2026; 167(32): 1255-1261.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 32","pages":"1255-1261"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vision saved: the first four years of the pediatric ophthalmology screening program of the Hungarian Charity Service of the Order of Malta - Part II.]","authors":"Johanna Barbarics, Katalin Vadas-Varga, Patrícia Domsa, Éva Mária Bankó","doi":"10.1556/650.2026.33591","DOIUrl":"10.1556/650.2026.33591","url":null,"abstract":"<p><strong>Introduction: </strong>Amblyopia is one of the most common causes of preventable permanent visual impairment in childhood; its prevention requires early detection and targeted treatment. Children living in socioeconomically disadvantaged settlements have markedly limited access to ophthalmic care and are therefore at increased risk.</p><p><strong>Objectives: </strong>The aim of this study was to present the outcomes achieved during the first four years (2020-2023) of the pediatric ophthalmology screening program of the Hungarian Charity Service of the Order of Malta in the detection, prevention, and treatment of amblyopia, including the effectiveness of refractive correction, occlusion therapy, and surgical interventions.</p><p><strong>Methods: </strong>A total of 19,724 children from 127 settlements participated in a two-step ophthalmic screening program. Amblyopia was defined based on best-corrected visual acuity and amblyogenic refractive risk factors. Treatment outcomes were evaluated by analyzing spectacle compliance, occlusion therapy, and postoperative follow-up. Data were derived from examinations conducted between 2020 and 2023, supplemented by available follow-up and surgical data from 2024.</p><p><strong>Results: </strong>The prevalence of amblyopia was 4.9% (960 children). Spectacle correction alone resulted in complete visual acuity recovery in 60% of the affected children. Occlusion therapy was initiated in 206 cases, with verified patch compliance in 20%. Among compliant children, 57% showed at least one-line improvement, with a mean gain of three to four lines of visual acuity. During the study period, 14 deprivation-eliminating surgeries (cataract, ptosis) and 30 strabismus surgeries were performed, leading to significant functional and/or aesthetic improvement.</p><p><strong>Discussion: </strong>The program substantially contributes to early amblyopia detection and achieves measurable improvements across multiple therapeutic modalities. The main limiting factors are poor patient compliance, restricted access to screening and follow-up care, and adverse social circumstances.</p><p><strong>Conclusion: </strong>The screening program effectively reduces the risk of untreated amblyopia among children living in disadvantaged settlements. Increasing the frequency of follow-up examinations, improving data management, and involving local healthcare professionals are expected to further enhance treatment success and increase the number of visions saved. Orv Hetil. 2026; 167(32): 1277-1287.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 32","pages":"1277-1287"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Energy drinks: composition, physiological effects and health risks].","authors":"Éva Kocsis, Zita Botkáné Katona, Henriette Pusztafalvi","doi":"10.1556/650.2026.33611","DOIUrl":"https://doi.org/10.1556/650.2026.33611","url":null,"abstract":"<p><p>Energy drink consumption has increased significantly in recent years, particularly among adolescents, where the prevalence of consumption may reach 50-70% according to some studies. Due to their high caffeine and sugar content, as well as other stimulant ingredients, their consumption is also of particular importance from a public health perspective. The aim of this study was to provide an overview of the history, composition, and physiological effects of energy drinks, with special emphasis on adolescents and associated health risks. A narrative literature review was conducted based on international and national publications, focusing on epidemiological and clinical findings related to energy drink consumption among adolescents. The main components of energy drinks, especially caffeine, may enhance alertness and physical performance in the short term; however, excessive consumption is associated with several adverse health effects. The literature indicates associations between energy drink consumption and cardiovascular alterations, sleep disturbances, and risk-taking behaviours such as alcohol use and smoking. Among adolescents, consumption often co-occurs with the use of other psychoactive substances and may be related to mental well-being. Regular consumption of energy drinks during adolescence may pose potential health risks. For prevention, it is particularly important to provide appropriate information to young people and to promote conscious consumption habits. Orv Hetil. 2026; 167(32): 1269-1276.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 32","pages":"1269-1276"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Data for cultural history of malaria in Hungary].","authors":"László Kiss","doi":"10.1556/650.2026.HO2886","DOIUrl":"https://doi.org/10.1556/650.2026.HO2886","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 32","pages":"1288-1291"},"PeriodicalIF":1.0,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Albuminuria for detection of chronic kidney disease: biomarker and therapeutic target].","authors":"Barna Vásárhelyi, András Tislér","doi":"10.1556/650.2026.33622","DOIUrl":"10.1556/650.2026.33622","url":null,"abstract":"<p><p>Albuminuria is one of the most important biomarkers of chronic kidney disease and also a target that can be influenced by treatment. The amount of albumin excreted in the urine is an independent predictor of declining kidney function, cardiovascular events, and all-cause mortality. It is most easily determined based on the albumin-to-creatinine ratio (ACR) measured in the first morning urine sample; in the vast majority of cases, 24-hour urine collection is not required. The pathophysiology of albuminuria centers on damage to the glomerular filtration barrier - particularly podocytes - hemodynamic hyperfiltration, inflammation associated with tubular protein reabsorption, and activation of the renin-angiotensin-aldosterone system (RAAS). Modern four-pillar pharmacotherapy - RAS inhibitors (ACE inhibitors/ARBs), SGLT2 inhibitors, non-steroidal mineralocorticoid receptor antagonists (finerenone), and GLP1 receptor agonists in type 2 diabetes - acts on these processes through complementary mechanisms. When tailored to the degree of albuminuria and eGFR, this treatment significantly slows the progression of chronic kidney disease and reduces cardiovascular risk. Measuring and monitoring albuminuria must therefore be an essential part of daily clinical practice. Orv Hetil. 2026; 167(31): 1231-1237.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 31","pages":"1231-1237"},"PeriodicalIF":1.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}