Orvosi hetilap最新文献

{"title":"[Neonatal and surgical management of a prenatally diagnosed enteric sublingual cyst causing airway obstruction].","authors":"Viktória Eördögh, László Rovó, Eszter Erdélyi, Hajnalka Orvos, Tibor Novák, Tibor Elekes, Zita Gyurkovits, Judit Kiss, Bence Radics, Zsófia Eszter Széll, Ádám Perényi, Ádám Bach","doi":"10.1556/650.2025.33375","DOIUrl":"10.1556/650.2025.33375","url":null,"abstract":"<p><p>The prenatal detection and neonatal definitive management of congenital expansive lesions affecting the oral cavity – due to potential airway compromise and feeding difficulties – represent a complex, multidisciplinary task requiring high-level professional and technical expertise. In this case report, we present the urgent management and subsequent definitive surgical excision of a cystic mass causing severe oral obstruction in a neonate, identified prenatally by ultrasound examination. The fetus was delivered at 38 weeks of gestation via elective cesarean section with a birth weight of 3400 g. Due to a protruding cyst approximately 6 × 6 cm in size arising from the oral cavity, immediate airway management was performed using a Mayo tube, along with multiple punctions of the cystic mass. This intervention successfully secured the airway. The infant was fed via a nasogastric tube. Following MR imaging, the cyst originating from the sublingual area was completely excised in toto on day 8 of life. The postoperative period was uneventful. Oral feeding was gradually initiated two weeks after surgery. Histopathological examination confirmed an enteric duplication cyst, a rare occurrence in the sublingual region. During an 11-month follow-up period, no signs of recurrence were observed. The infant experienced no breathing or feeding difficulties, and growth in weight and length was appropriate for age. Prenatal care is essential for detecting fetal congenital anomalies. In these cases with potential to cause respiratory compromise, expertise in emergency airway management during planned cesarean delivery is critical. Definitive neonatal treatment of oral cavity masses causing respiratory or feeding difficulties can shorten hospitalization and minimize the physical and psychological burden associated with repeated surgeries. Orv Hetil. 2025; 166(36): 1431–1437.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 36","pages":"1431-1437"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024000","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 adaptation and applicability of dignity therapy in end-of-life care in Hungary].","authors":"Diána Gizella Sipőcz, Éva Zsák, Attila Balázs Farkas, Katalin Hegedűs","doi":"10.1556/650.2025.33383","DOIUrl":"10.1556/650.2025.33383","url":null,"abstract":"<p><p>Dignity therapy is a brief, structured, narrative intervention aimed at alleviating the existential suffering of terminally ill patients and improving their quality of life. The method was developed by Harvey Max Chochinov and supports psychosocial dimensions such as role maintenance, generativity, self-identity, and hope. During its adaptation in Hungary, cultural, communicative, and legal characteristics were also taken into account. International research shows that dignity therapy has a positive effect on the sense of hope of dying people, reduces anxiety and depression, promotes inner peace and self-identity, and supports the deepening of the patient-caregiver relationship. The generativity document created during dignity therapy facilitates social connection and then grief processing. The dignity therapy training course for healthcare and social workers aims to teach them the principles of dignity-preserving care and to develop their empathic communication, self-reflection, and spiritual sensitivity. Participants in the pilot training course highlighted its practical applicability in addition to its attitude-shaping effect. With appropriate training, the dissemination of dignity therapy in Hungary can contribute to making end-of-life care more humane and strengthening a patient-centered professional culture. Orv Hetil. 2025; 166(36): 1412–1419.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 36","pages":"1412-1419"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023930","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 Aurél Stodola (1859-1942) in the development of the Sauerbruch hand prosthesis constructed 100 years ago].","authors":"József Makovitzky","doi":"10.1556/650.2025.HO2842","DOIUrl":"https://doi.org/10.1556/650.2025.HO2842","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 36","pages":"1438-1440"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030264","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":"[Revolutionary innovations in ophthalmology: the enhanced role of robots in microsurgical techniques].","authors":"Ferhat Turgut, Fanni Pálya, Amr Saad, Rui Santos, Tahm Spitznagel, Gábor Márk Somfai, Zoltán Nagy, Matthias Dieter Becker","doi":"10.1556/650.2025.33389","DOIUrl":"10.1556/650.2025.33389","url":null,"abstract":"<p><p>Ophthalmic microsurgery has undergone a remarkable transformation over recent decades, marked by increasing surgical precision and significantly improved anatomical and functional outcomes. The integration of robotic systems into this field represents a new frontier in microsurgical innovation, offering enhanced stability, tremor reduction, and sub-millimeter control during complex intraocular procedures. In this narrative review, we explore the current landscape of robotic-assisted surgical techniques in ophthalmology, with a focus on recent advancements, clinical implementation, and future directions. We categorize and analyze the three main types of robotic systems – handheld assistive devices, co-manipulation systems, and telemanipulation platforms – and examine their respective technical features and applications. While several promising prototypes have progressed to early clinical trials, the widespread adoption of these technologies remains limited by regulatory hurdles, high costs, and a lack of large-scale outcome data. In particular, standardized measures for non-inferiority compared to conventional surgery are still missing. Nonetheless, the field is advancing rapidly, driven by interdisciplinary innovation, increased investment, and growing interest in surgical automation. With ongoing improvements in imaging integration, artificial intelligence, and precision control, robotic assistance holds great potential to reshape ophthalmic surgery. Continued research and collaboration will be key to unlocking its full clinical utility – ushering in a new era of safer, more reproducible, and highly precise eye surgery. Orv Hetil. 2025; 166(36): 1403–1411.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 36","pages":"1403-1411"},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023965","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":"[RSV infections: characteristics and prevention strategies].","authors":"Ferenc Balázs Farkas, Éva Karászi, Andrea Kulcsár, Beáta Onozó, Tamás Pék, Diána Tróbert-Sipos, Zsófia Mészner, Botond Lakatos, Csaba Kassa, Csaba Bereczki, Tamás Decsi, Tamás Szabó, J Attila Szabó","doi":"10.1556/650.2025.33364","DOIUrl":"10.1556/650.2025.33364","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) is one of the leading pathogens causing lower respiratory tract infections in childhood, and it is also a significant factor of morbidity and mortality among older and immuno-compromised adults. Although RSV was already a well-known pathogen before the COVID–19 pandemic, the characteristics of the previously typical autumn–winter seasonal epidemics have significantly changed in recent years, placing a considerable additional burden on the healthcare system. Despite decades of research, no widely applicable preventive or therapeutic intervention has been available until now, and only recently have effective immunization strategies emerged that represent a breakthrough in preventing severe infection and its complications. This summary, based on a comprehensive literature review, provides an overview of the currently available vaccination armamentarium against RSV, with particular attention to the latest results, clinical trials, and practical questions of application, taking into account international guidelines and recommendations. Recent breakthroughs include a long-acting monoclonal antibody (nirsevimab) and the development of maternal immunization, which aim to provide passive immunity for newborns. Additionally, several new RSV vaccines for older adults also show promising efficacy in preventing severe illness. These milestones represent a paradigm shift from a toolkit based on symptomatic treatment towards prevention. Therefore, it is particularly important that national health policy decision-makers promptly consider the expansion and long-term sustainable implementation of new RSV immunization strategies. Orv Hetil. 2025; 166(35): 1362–1373.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 35","pages":"1362-1373"},"PeriodicalIF":0.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964543","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 health literacy and health knowledge in the management of rheumatoid arthritis].","authors":"Gabriella Mészáros, Katalin Bezsila, Bernadette Rojkovich","doi":"10.1556/650.2025.33361","DOIUrl":"10.1556/650.2025.33361","url":null,"abstract":"<p><p>Rheumatoid arthritis represents a significant and serious global public health burden, and its prevalence is continuously increasing. It is a chronic inflammatory joint disease based on autoimmune and autoinflammatory mechanisms, characterized by variable clinical manifestations and frequent systemic involvement. Due to its progression, comorbidities, and negative impact on quality of life, it poses a significant medical and societal challenge. Therapeutic advances in recent years – including conventional, biological, and targeted synthetic disease-modifying antirheumatic drugs – have significantly improved patient outcomes, particularly in high-income countries, where early diagnosis is more likely and access to appropriate treatment is more readily available. The development of the disease involves genetic, environmental, and lifestyle factors, while its course is significantly affected not only by biological but also psychosocial factors. This review provides a brief overview of the risk factors and psychosocial effects of rheumatoid arthritis, along with the impact of health literacy and disease knowledge on treatment effectiveness and quality of life. Low socioeconomic status, poor health literacy, along with limited health knowledge are associated with worse clinical outcomes. To improve patients’ quality of life, it is essential to continuously and systematically enhance their health literacy and disease knowledge, ensure the provision of psychosocial support, and incorporate a patient-centered approach into rheumatoid arthritis treatment strategies. Orv Hetil. 2025; 166(35): 1374–1381.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 35","pages":"1374-1381"},"PeriodicalIF":0.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964473","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":"[Chemiluminescence measurements on phagocytes isolated from peripheral human blood to evaluate the efficacy of drug therapy in patients with hypertension].","authors":"Sándor Sipka, Andrea Nagy, Sándor Baráth, Attila Gábor Szöllősi, Attila Bácsi, Judit Kovács, Sándor Sipka","doi":"10.1556/650.2025.33366","DOIUrl":"10.1556/650.2025.33366","url":null,"abstract":"<p><p>Introduction: The increased activity of nicotinamid adenine dinucleotid phosphate (NADPH) oxidase, which produces superoxide anions causing photon emission (chemiluminescence) in luminol milieu is a crucial factor in the pathogenesis of hypertension. Many antihypertension drugs have dual effects: a) acting on special targets to reduce hypertension, b) blocking of production of reactive oxygen species (ROS). Objective: To test the efficacy of antihypertension therapy, two types of chemiluminescence measurements were performed on peripheral phagocytes from 20-20 donors with and without hypertension. In all patients, the blood pressure was in a well-controlled range. Furthermore, to analyze to interaction of “superoxide” anions and “ferryl peroxide complex” on the chemiluminescence values in peripheral phagocytes. Method: A luminometer was used to measure chemiluminescence in luminol milieu (expressed in relative luminescence units, RLU) originated from a) superoxide molecules during zymosan phagocytosis, b) [Fe3+O22–] “ferryl peroxide complexes” from cytochrome c + H2O2 reaction. For the uniform opsonization of zymosan, 10% fetal calf serum milieu was used for each donor. Results: The two chemiluminescence values showed additive effects, but no significant differences were found between the two groups. However, the RLU values of both types of ROS molecules were slightly lower in the hypertensive patients. The chemiluminescence producing capability of phagocytes from drug-treated patients did not differ significantly from that of controls, it reflected the actual good clinical states. Conclusion: The measurements of phagocytic chemiluminescence verified and confirmed the efficacy of anti-hypertension therapy due ROS production, too. The molecules of “ferryl peroxide complex” are newly recognized weak but active components of ROS molecules which may also play some roles in hypertension. The chemiluminescence measurements can complete the results of traditional instrumental measurements. However, they are able to detect even slighter alterations, too. Orv Hetil. 2025; 166(35): 1383–1390.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 35","pages":"1383-1390"},"PeriodicalIF":0.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964481","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":"[Changes in the child protection work of doctors, health visitors and health professionals, recommendations for the further work].","authors":"Zsuzsanna Soósné Kiss, Zoltán Sebők, Péter Schmidt","doi":"10.1556/650.2025.33367","DOIUrl":"10.1556/650.2025.33367","url":null,"abstract":"<p><p>Introduction: From 13 June 1915, when the National Stefania Association was founded, for almost a century, the health visitors, alongside the doctors, were the health-social-child protection carers of children and families with children, the coordinators of this work. Objective: (1) To review the changes in the last decades that have changed the work of doctors, health visitors and health professionals in child protection; (2) to describe their place and responsibilities in the child protection system; (3) to make suggestions based on our professional experience on how they can work more effectively to better represent the interests of children in need. Method: We studied the legislation, professional regulations and literature related to the topic, and we also carried out systematic and analytical work based on our own professional experience. Results: Act III of 1993 on social welfare, Act XXXI of 1997 on child protection, and the creation of the family and child welfare services and centres in 2016, brought radical changes. Health professionals play a key role in the child protection signalling system and work together with other child protection actors. Our own health-child protection DDTT (Detection–Diagnosis–Treatment–Therapy) model and checklist, which have proved successful in our own work, can be used to help health professionals in their health-child protection work. Discussion: The place and responsibilities of doctors, health visitors and health professionals in the child protection system have become clearer. The role of all health professionals is very important in this work. Conclusion: More attention should be focused on cases within their own competence, on primary prevention in the field of health and child protection. Teamwork, traditionally important in the health sector, is also important in the health and child protection field. Also to follow the changes, participation in training courses is recommended. For more effective work, we recommend the use of the DDTT model and checklist, which have been well proven in our own work in health and child protection. Orv Hetil. 2025; 166(35): 1391–1400.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 35","pages":"1391-1400"},"PeriodicalIF":0.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964538","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":"[Histopathological growth patterns of liver metastases].","authors":"Anita Sejben, Ádám Ferenczi, Abbasi Parsa, Boglárka Pósfai, Tamás Zombori, Tamás Lantos","doi":"10.1556/650.2025.33358","DOIUrl":"https://doi.org/10.1556/650.2025.33358","url":null,"abstract":"<p><p>According to current knowledge, histopathological growth patterns of liver metastases carry prognostic significance; however, they do not yet have therapeutic implications in clinical practice. The existing literature has predominantly focused on liver metastases originating from colorectal carcinomas, and to date, only two studies have investigated histopathological growth patterns in consecutively collected patient cohorts. Our aim was to study the histopathological growth patterns of all patients with liver metastases between 2011 and 2016 in a consecutive manner. Clinicopathological features were extracted from the medical records of the cases included in the study period. Histological slides of the metastases were evaluated by an expert gastrointestinal pathologist. Statistical analyses were carried out by using the Kruskal–Wallis and Fisher’s exact test. The Kaplan–Meier method was used to estimate progression-free survival, overall survival and time-to-progression curves, and the log-rank test was applied to compare survival curves. All statistical tests were two-sided, and p-values less than 0.05 were considered statistically significant. Altogether 41 patients were included in our study. The majority were diagnosed with colorectal adenocarcinoma primary tumor (n = 32). Replacement pattern proved to be the most common (n = 22), followed by desmoplastic (n = 15), and pushing (n = 4). There was no significant association found between histopathological growth patterns and stage (p = 0.105), secondary tumour focality (p = 0.898), largest diameter primary (p = 0.316) and secondary carcinoma (p = 0.441), completeness of resection (p = 0.492), and the presence of venous spread (p = 1). There were no significant results found between histopathological growth patterns and progression-free survival (p = 0.417), overall survival (p = 0.297), and time-to-progression (p = 0.267). Our results suggest that the prognostic value of histopathological growth patterns may be limited in a consecutively collected patient cohort. Further studies regarding the prognostic utility of histopathological growth patterns have to be carried out in the future. Orv Hetil. 2025; 166(34): 1323–1332.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 34","pages":"1323-1332"},"PeriodicalIF":0.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964619","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":"[Challenges in determining red blood cell and platelet counts in severely burned patients].","authors":"István Papp, Gabriella Kiss, Zoltán Horváth-Szalai, Balázs Szirmay","doi":"10.1556/650.2025.33348","DOIUrl":"https://doi.org/10.1556/650.2025.33348","url":null,"abstract":"<p><p>The number of burned patients requiring hospital treatment in Hungary is between 4000 and 5000 per year. Complete blood count test is substantial in their care, but caution is needed in assessing the results. Cytoskeletal proteins of red blood cells can be damaged by strong heat, resulting in reduced cellular deformability, which can lead to the formation of spherocytes, fragmentocytes and microvesicles. In such cases, the peripheral blood smear exhibits an appearance similar to hereditary pyropoikilocytosis. During blood count analysis, depending on the measurement principle, interference can occur between red blood cell fragments, microvesicles and platelets. Therefore, the results can be misleading, particularly regarding platelet counts (pseudothrombocytosis). In our retrospective study, we describe this phenomenon through the cases of three patients who suffered severe (extensive, grade II–III) burns from different types of heat exposure. In two cases, marked thermal poikilocytosis was observed in the peripheral blood smears. In addition, platelet counts measured by the impedance principle which is commonly available in analyzers were strikingly different compared with the values determined by specific fluorescence staining. Only a few microvesicles were seen in the smear of the third patient, and platelet count values did not differ substantially. Our results suggest that severe burns are not necessarily associated with the development of thermal poikilocytosis, it may depend on the type of heat source, the duration of heat exposure and heat transfer. Our study points out the advantage of complete blood count analyzers having a channel for specific, fluorescent platelet counting in the care of severely burned patients. In their absence, peripheral blood smear preparation and evaluation is recommended. Since the reliability of results depends on the methodology, we also emphasize the importance of consultation between clinicians and the laboratory. Orv Hetil. 2025; 166(34): 1340–1346.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 34","pages":"1340-1346"},"PeriodicalIF":0.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144964609","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}