Orvosi hetilap最新文献

{"title":"[Comparison of statin and antiplatelet therapy adherence in primary and secondary cardiovascular prevention patients].","authors":"Rita Szendrei-Lódi, Zsolt Tömő, Szilvia Beke, László Márk","doi":"10.1556/650.2026.33612","DOIUrl":"10.1556/650.2026.33612","url":null,"abstract":"<p><strong>Introduction: </strong>According to epidemiological data from Hungary, cardiovascular diseases cause the greatest loss of health among the population and are responsible for a significant proportion of premature deaths. This reinforces the health policy position that cardiovascular prevention, including improving medication adherence, must be given top priority in patient care. Long-term survival in patients who have experienced acute coronary syndrome depends heavily on medication adherence, particularly regarding statins and anticoagulants; however, domestic surveys indicate deficiencies in the use of preventive medications.</p><p><strong>Objective: </strong>The aim of our study was to compare the attitudes and beliefs regarding antiplatelet agents and cholesterol-lowering drugs among patients in the secondary prevention group who underwent percutaneous coronary intervention and those in the primary prevention control group, using the Beliefs about Medicines Questionnaire (BMQ).</p><p><strong>Methods: </strong>A cross-sectional, questionnaire-based study included 162 secondary prevention patients and 136 primary prevention patients who had undergone percutaneous coronary intervention. Medication attitudes were measured using the specific and general dimensions of the BMQ, and SPSS 27.0 was used for statistical analysis.</p><p><strong>Results: </strong>Among patients in the secondary prevention group, both drug groups were characterized by lower levels of concern and more accepting attitudes, whereas in the primary prevention group, sceptical (p<0.05) and ambivalent attitudes were more common (p<0.001). Based on the analysis of respondents by attitude group and the examination of the BMQ's general subscales, percutaneous coronary intervention significantly influenced beliefs regarding medications. This change was clinically significant in terms of treatment adherence (p<0.001) Discussion and conclusion: Patients who have undergone percutaneous coronary intervention have more favourable attitudes toward medication, which highlights the role of targeted education and psychoeducation in improving adherence in the non-intervention population. However, adherence in the secondary prevention group cannot be considered optimal either, therefore further targeted education is warranted in this patient group as well. Orv Hetil. 2026; 167(31): 1238-1247.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 31","pages":"1238-1247"},"PeriodicalIF":1.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654127","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":"[Angina-induced marked, positive U-waves in leads V1-3].","authors":"János Tomcsányi, Tamás Frész, Marcell Csákányi, Hrisula Arabadzisz, András Marosi","doi":"10.1556/650.2026.33575","DOIUrl":"10.1556/650.2026.33575","url":null,"abstract":"<p><p>U-wave changes during angina are often not recognized, although a change in U-wave polarity may be the only sign of myocardial ischemia. The appearance of a positive U-wave in leads V1-4 during angina suggests posterobasal ischemia and critical stenosis of the CX or RCA coronary artery. The authors present two examples.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 31","pages":"1248-1252"},"PeriodicalIF":1.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654168","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":"[Comparison of the side effect profiles of compounds with central muscle-relaxing effect].","authors":"Csaba Kopitkó, Éva Pettendi","doi":"10.1556/650.2026.33617","DOIUrl":"10.1556/650.2026.33617","url":null,"abstract":"<p><p>In addition to other conditions involving increased muscle spasms, centrally acting muscle relaxants (guaifenesin, tolperisone, methocarbamol, chlorzoxazone, diazepam, baclofen and tizanidin) provide relief for a significant proportion of patients suffering from low back pain. Of these, tolperisone has recently been restricted by official decision due to the high incidence of anaphylactic reactions associated with its use. The aim of our work is to analyze the frequency of side effects of this group of drugs in order to help clinicians choose the appropriate medication. According to data from the World Health Organization, tolperisone is considered a safe drug, except for the aforementioned serious allergic side effect. Mortality (including suicide) associated with the administration of these medicines is the highest among the reported side effects for diazepam, followed by tizanidine and methocarbamol. Ineffectiveness was most commonly reported for guaifenesin, followed by baclofen and tizanidine. Tolperisone was the most favorable drug in terms of both mortality and ineffectiveness. We present in detail the gastrointestinal, major neurological, and psychiatric side effects that make it difficult, and in some cases impossible, to take the drugs, and we also mention the disturbing skin and eye symptoms. Orv Hetil. 2026; 167(31): 1224-1230.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 31","pages":"1224-1230"},"PeriodicalIF":1.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654191","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":"[Non-pharmacological pain management methods in pediatrics and their application at the Bethesda Children's Hospital of the Hungarian Reformed Church].","authors":"Adrienn Vargay, Alexandra Sára Bencsik, Virág Szabó, Ilona Zsófia Székely, Lilla Károlyi, Katalin Forgács-Kristóf, Kristóf Perczel, Andrea Gyimesi-Szikszai, János Major","doi":"10.1556/650.2026.33576","DOIUrl":"10.1556/650.2026.33576","url":null,"abstract":"<p><p>Over recent decades, non-pharmacological pain management approaches have gained increasing importance in pediatric care, as they can be applied with low cost and minimal time investment while significantly contributing to the improvement of care quality. The aim of this review article is to provide an overview of non-pharmacological options for procedural pain management based on the literature, and to present the dissemination of this approach in Hungary through the support of a child-centered, trust-based healthcare model. This paper presents a narrative review of the key findings of international literature on non-pharmacological management of procedural pain. In addition, it describes the practical implementation of an interdisciplinary non-pharmacological pain management program based on the principles of the Comfort Promise, which has been operating since 2021 at the Bethesda Children's Hospital of the Hungarian Reformed Church. The article outlines the steps of implementation, the tools and techniques applied, and summarizes clinical experiences. Methods shown to be effective in the literature - such as distraction, breathing exercises, comfort positioning, breastfeeding, and the use of various sensory tools - are, in line with international evidence, also supported by clinical experience as contributing to the reduction of children's anxiety, increasing parental satisfaction, and improving the quality of care. Experience suggests that integrating non-pharmacological methods into everyday clinical practice does not require significant additional resources; however, it does necessitate a shift in mindset and a structured implementation process. Interdisciplinary collaboration, staff training, the establishment of a volunteer network, and the active involvement of parents and children are key factors for sustainable implementation. Based on current experience, the combined application of this approach and its methods has proven to be effective. According to international literature, anxiety-reducing interventions - including parental presence, appropriate information provision, distraction, and relaxation techniques - contribute to the alleviation of procedural pain through neural mechanisms influencing pain perception, which is also supported by the institutional experience presented. Orv Hetil. 2026; 167(31): 1215-1223.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 31","pages":"1215-1223"},"PeriodicalIF":1.0,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654147","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":"[The role of photon-counting CT technology in the detection of pulmonary diseases].","authors":"Mátyás Rédei, Kriszta Beáta Gurza, Pál Maurovich-Horvat, Nikolett Marton","doi":"10.1556/650.2026.33603","DOIUrl":"https://doi.org/10.1556/650.2026.33603","url":null,"abstract":"<p><p>Computed tomography of the chest is a cornerstone imaging modality in the diagnosis of pulmonary diseases; however, conventional systems based on energy-integrating detectors have inherent physical limitations, including restricted spatial resolution, electronic noise, and reduced image quality at low radiation doses, which may compromise diagnostic accuracy in certain clinical scenarios. Photon-counting detector computed tomography represents a novel technological approach based on the individual detection and energy discrimination of incoming X-ray photons. This enables improved dose efficiency, reduced image noise, higher spatial resolution, and intrinsic spectral imaging from a single acquisition. The aim of this review is to provide an overview of the role of photon-counting detector computed tomography in pulmonary imaging. Based on the available literature, this technology offers particular advantages in the detection and characterization of small pulmonary nodules, subsolid and ground-glass lesions, as well as in the assessment of fine morphological features of interstitial lung diseases. In addition, it improves the visualization of infectious, vascular, and traumatic pulmonary abnormalities. Spectral imaging capabilities, including virtual monoenergetic reconstructions and iodine maps, provide additional functional information on tissue perfusion, lesion characterization, and treatment response. The technique also shows promise in interventional applications by improving the visualization of target lesions and interventional devices. Photon-counting detector computed tomography represents a significant technological advancement in lung imaging. However, its widespread clinical implementation is currently limited by restricted availability, high costs, and challenges related to inter-system comparability. Nevertheless, current evidence suggests that this technology will play an increasingly important role in pulmonary diagnostics in the future. Orv Hetil. 2026; 167(30): 1186-1198.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 30","pages":"1186-1198"},"PeriodicalIF":1.0,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592891","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":"[Adolescent prevention as a tool for reducing healthcare system burden].","authors":"Rézan Watti, Nermin Watti, Jezdancher Watti, Aranka Baranyi","doi":"10.1556/650.2026.33610","DOIUrl":"https://doi.org/10.1556/650.2026.33610","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescence is of particular importance in the prevention of non-communicable chronic diseases, as health behavior patterns established during this life stage may influence adult morbidity in the long term. The healthcare system and societal burden of chronic diseases justify the development of prevention programs initiated early in life and adapted to the needs of the target population.</p><p><strong>Objective: </strong>The aim of our study was to assess program awareness, health behavior characteristics and perceptions of prevention programs among the target population of the \"Youth for a Healthy Future\" (YHF) program.</p><p><strong>Method: </strong>A cross-sectional quantitative questionnaire-based study was conducted in 2025 using convenience sampling. The 26-item online questionnaire was completed by 427 examined individuals; data processing was performed using IBM SPSS Statistics 30.0 software. In addition to descriptive statistics, cross-tabulation, Pearson's χ² test and Cramér's association coefficient were applied.</p><p><strong>Results: </strong>The sample comprised 46% boys and 52.0% girls; the mean age was 18.0 years (SD = 1.73). The YHF program was known by 16% of respondents, and 29 examined individuals reported direct participation. Regular smoking was reported by 16% and occasional smoking by 17% of respondents. A significant association was found between school type and smoking status (χ² = 36.798; p<0.001; Cramér's V = 0.29): a lower smoking rate was observed among grammar school students, whereas regular smoking was more frequent among vocational secondary school and technical school students. Awareness of the YHF program was also associated with school type (χ² = 12.070; p = 0.002; Cramér's V = 0.17), with higher awareness among grammar school students. Among barriers to participation, insufficient information was reported by 61% of respondents, lack of free or discounted participation by 58%, and the insufficiently practical nature of programs by 38%. Among future program topics, stress management, mental health and sports events attracted the greatest interest.</p><p><strong>Conclusion: </strong>Based on our findings, improving the reach of the YHF program and similar prevention initiatives requires more targeted communication, program structures better adapted to differences by school type and sex, and a stronger emphasis on practical and interactive program elements. Due to the cross-sectional design, causal conclusions cannot be drawn; however, the results may provide a basis for future longitudinal and controlled studies. Orv Hetil. 2026; 167(30): 1207-1212.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 30","pages":"1207-1212"},"PeriodicalIF":1.0,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592736","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":"[Current issues and digital technologies in pulmonary rehabilitation].","authors":"Erik Palmer, Lőrinc Polivka, Mónika Fekete, Virág Pándi, Ábel Megyaszai, Zsolt Rozgonyi, József Lukácsovits, Tamás Komáromi, Zsuzsanna Kováts, János Tamás Varga","doi":"10.1556/650.2026.33590","DOIUrl":"https://doi.org/10.1556/650.2026.33590","url":null,"abstract":"<p><p>Chronic respiratory diseases - including asthma, chronic obstructive pulmonary disease (COPD), interstitial lung diseases, lung cancer, and post-COVID conditions - are associated with substantial morbidity and reduced quality of life. In addition to pharmacological therapy, chest physiotherapy and pulmonary rehabilitation play a crucial role in improving functional capacity and patient outcomes. This review aims to summarize contemporary approaches in pulmonary rehabilitation, with particular emphasis on the integration of digital technologies and telerehabilitation strategies. A narrative review of the literature was conducted focusing on the structure of pulmonary rehabilitation programs, training modalities, maintenance strategies, and the clinical applicability of telemedicine-based solutions. Pulmonary rehabilitation, particularly when combined with structured exercise programs, maintenance interventions, and telemonitoring systems, can significantly improve exercise tolerance, symptom control, and health-related quality of life. Modern digital technologies enable real-time monitoring of patient status, facilitate individualized rehabilitation strategies, and support early detection of disease exacerbations. Telemedicine platforms, smart inhalers, and wearable sensors represent promising tools for the management of chronic respiratory diseases. Data generated by these technologies may contribute to improved clinical decision-making and optimization of rehabilitation outcomes. The integration of pulmonary rehabilitation with digital health technologies may play a key role in the future management of chronic respiratory diseases and in maintaining long-term functional stability in affected patients. Orv Hetil. 2026; 167(30): 1199-1206.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 30","pages":"1199-1206"},"PeriodicalIF":1.0,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592923","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":"[Systems saving lives: a systems-based approach to cardiac arrest management].","authors":"Bálint Bánfai, József Betlehem, Enikő Kovács, Henrietta Bánfai-Csonka","doi":"10.1556/650.2026.33615","DOIUrl":"10.1556/650.2026.33615","url":null,"abstract":"<p><p>Out-of-hospital cardiac arrest remains a major public health challenge worldwide, with survival largely determined by the timeliness, quality, and organization of care. The 2025 Systems saving lives guidelines of the European Resuscitation Council (ERC) emphasize that meaningful improvements in outcomes depend not on isolated interventions but on the coordinated functioning of the entire system of care. This paper, representing the position of the Hungarian Resuscitation Society, summarizes the key elements of the guideline. The recommendations focus on the concepts of the chain of survival and the formula of survival, highlighting the combined importance of scientific evidence, effective education, and local implementation. Increasing community awareness, strengthening advocacy, initiating cardiopulmonary resuscitation education at an early age, and engaging trained lay responders are essential to ensure early intervention. Organizational aspects of emergency care - particularly dispatcher-assisted cardiopulmonary resuscitation, optimization of automated external defibrillator accessibility, and the availability of adequately trained emergency medical teams - further enhance system performance. In-hospital rapid response systems, cardiac arrest centers, and structured follow-up of survivors and their families play a key role in improving long-term outcomes and quality of life. Emerging technologies, including digital tools and artificial intelligence, offer promising opportunities to support early recognition, high-quality resuscitation, and education, although their implementation requires further evaluation and appropriate legal and ethical frameworks. Adopting a comprehensive, system-based approach is essential to improve out-of-hospital cardiac arrest outcomes and to develop sustainable, effective life-saving systems at the national level. Orv Hetil. 2026; 167(30): 1175-1185.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 30","pages":"1175-1185"},"PeriodicalIF":1.0,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592868","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":"[Surgical treatment of giant ovarian cysts in adolescents].","authors":"Viktor Zvoncsár, Dorottya Balogh, Zoltán Fekete, Tamás Szabó, Gergely Garab, Csaba Busznyák, Zoltán Farkas Kispál, Péter Antali","doi":"10.1556/650.2026.33564","DOIUrl":"10.1556/650.2026.33564","url":null,"abstract":"<p><p>Cystic lesions of the ovaries are common in adolescent girls. Follow-up is recommended to monitor any changes in size. In more than 90% of cases, these cysts are benign. Our aim is to draw attention to the fact, that even extremely large lesions can develop during puberty and in every case our goal is to perform accurate imaging and organ-preserving surgical management. Between 2023 and 2025, four adolescent girls underwent surgery for giant cystic ovarian lesions at the Department of Pediatric Surgery of the Győr-Moson-Sopron County Petz Aladár University Teaching Hospital. We performed a detailed retrospective analysis of the patients' medical histories and a review of the relevant literature. In all four cases, pediatric surgical and gynecological examinations, tumor marker level assessments, abdominal ultrasound, and abdominopelvic magnetic resonance imaging were performed within a short period of time. Based on the findings, surgery was carried out within a few days. Laparoscopic surgery was performed in two patients, open surgery in the other two. In every case, a large cystic lesion was identified, and no clear evidence of malignancy arose during the operations. Organ-preserving surgery was successfully performed in two patients; in the remaining cases, removal of the affected ovary and fallopian tube was necessary. The histopathological findings differed in all four cases. In the first patient, a mucinous cystadenoma was confirmed, which recurred, and needed reoperation. In the second patient, histology revealed mucinous adenocarcinoma, which is a particularly rare malignancy in this age group. In the third case, fluid accumulation caused by torsion was identified as the underlying condition. In the fourth patient, the histopathological diagnosis was a mature cystic teratoma. Although cystic ovarian lesions are common during adolescence, they rarely grow to an extreme size. Accurate imaging and analysis of tumor marker levels are essential for surgical planning. Minimally invasive procedures and organ-preserving surgery should always be preferred if possible. Histopathological findings greatly influence the need for further follow-up or additional treatment. Orv Hetil. 2026; 167(29): 1164-1171.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 29","pages":"1164-1171"},"PeriodicalIF":1.0,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497894","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":"[How can the profession of psychiatry become attractive again?]","authors":"Tamás Treuer, Andrea Pejin","doi":"10.1556/650.2026.33618","DOIUrl":"10.1556/650.2026.33618","url":null,"abstract":"<p><p>The issue of psychiatric workforce renewal is no longer merely a human resource problem; it lies at the intersection of professional identity, training structure, and the organizational logic of the healthcare system. International medical education literature describes professional identity formation as a gradual process of socialization in which the novice physician progresses from performing professional tasks to internalizing the vocation itself. This process is strongly influenced by the clinical learning environment, the presence of role models, structured reflection, the gradual transfer of responsibility, psychological safety, and whether the resident is truly able to practice the chosen specialty. A specific challenge in Hungarian psychiatry is that the process of becoming a psychiatrist is often constrained by systemic pressures that lead to blurred professional boundaries, distortion of training, increased risks to patient safety, and erosion of professional self-identity. The aim of this paper is to examine the educational and organizational conditions necessary for psychiatry to become an attractive and sustainable career choice again. The article is based on a synthesis of the international literature on professional identity formation, Hungarian research on psychiatric professional identity, and a qualitative case-based analysis. Orv Hetil. 2026; 167(29): 1142-1151.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"167 29","pages":"1142-1151"},"PeriodicalIF":1.0,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497835","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}