Orvosi hetilap最新文献

{"title":"[Guideline on the safe use of neuromuscular blocking agents].","authors":"Réka Nemes, Adrienn Pongrácz, László Asztalos, György Nagy, Zoltán Szabó-Maák, Marianna Fedor, Béla Fülesdi","doi":"10.1556/650.2025.33285","DOIUrl":"10.1556/650.2025.33285","url":null,"abstract":"<p><p>Inappropriate use of muscle relaxants leads to postoperative residual neuromuscular block (PORNB), which is still a significant problem nowadays and is an independent risk factor for postoperative pulmonary complications. To decrease its incidence, the European Society of Anesthesiology and Intensive Care and the American Society of Anesthesiologists published their guidelines on the safe use of muscle relaxants in 2023. In this publication, the Edömér Tassonyi Neuromuscular Task Force of the University of Debrecen Clinical Center summarizes its recommendations. Based on international guidelines, objective neuromuscular monitoring should be performed in every patient who received non-depolarizing muscle relaxants during surgery. Since postoperative residual neuromuscular block can lead to several complications, it is essential for patient safety to ensure that the effect of the muscle relaxants is gone and train-of-four (TOF) ratio has returned to 0.9 (90%) before extubation. Clinical signs and subjective neuromuscular monitoring are not suitable for diagnosing residual curarization at the end of surgery. Therefore, whenever a patient receives non-depolarizing muscle relaxant, objective neuromuscular monitoring should be performed to exclude residual neuromuscular block. Neuromuscular monitoring should be performed in the hand. Objective neuromuscular monitoring should be started before muscle relaxant administration by calibrating the monitoring device. To ensure optimal intubating conditions and prevent airway injuries, TOF count should drop to 0 (all muscle responses evoked by nerve stimulation should disappear). TOF measurements should be repeated at regular intervals during surgery to follow the course of muscle relaxation. The effect of reversal agents (both neostigmine and sugammadex) should always be objectively monitored. The effect of bensilisoquinolin muscle relaxants can only be reversed with neostigmine when there is twitch response to TOF stimulation. Sugammadex is the most effective reversal agent for steroidal muscle relaxants (vecuronium, rocuronium and pipecuronium), but neostigmine can be used as well when there is twitch response to TOF stimulation. Orv Hetil. 2025; 166(15): 569–577.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 15","pages":"569-577"},"PeriodicalIF":0.8,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987201","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":"[Diphtheria on Teleki Square].","authors":"Katalin Szendi, Csaba Varga","doi":"10.1556/650.2025.HO2827","DOIUrl":"https://doi.org/10.1556/650.2025.HO2827","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 15","pages":"592-596"},"PeriodicalIF":0.8,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010610","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":"[Amyloid goiter in the materials of our surgical department].","authors":"Zoltán Farsang, Zsófia Pánczél, Anna Szilágyi, András Vereczkei, Áron Altorjay","doi":"10.1556/650.2025.33269","DOIUrl":"10.1556/650.2025.33269","url":null,"abstract":"<p><p>Introduction: In surgical departments where a sufficient number of thyroid surgeries are performed, relatively rare histopathological diagnoses may also be encountered. Knowledge of these histopathological diagnoses is essential for understanding the etiology and selecting the appropriate treatment for the disease. Objective: We aimed to determine the prevalence of amyloid goiter and to examine its associations with related conditions. Method: Between 2001 and 2023, we performed 2,215 thyroid surgeries. We conducted a retrospective review of the histopathological findings and correlated these results with the patients’ medical histories. Result: Out of the 2,215 operated cases, amyloid goiter was diagnosed histopathologically in only 2 cases, accounting for just 0.09% of all cases. Discussion: Amyloid goiter typically appears in association with other conditions. In our cases, it was linked to chronic renal failure with prolonged dialysis treatment and inflammatory bowel disease (Crohn’s disease). The surgical indication is based on the mechanical compression caused by the enlarged thyroid gland. Conclusion: In cases of diffuse goiter with compression symptoms of unknown origin, amyloid goiter should be considered. Total thyroidectomy resolves the patient’s symptoms. However, the exact diagnosis is usually confirmed only through the histopathological examination of the surgical specimen. Orv Hetil. 2025; 166(15): 588–591.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 15","pages":"588-591"},"PeriodicalIF":0.8,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006981","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":"[Secondary tumors of the pancreas - from origins to therapeutic options].","authors":"Tivadar Bara, Zsolt Fülöp, Mircea Gabriel Muresan, Tivadar Bara, Georgiana Alexandra Scurtu","doi":"10.1556/650.2025.33276","DOIUrl":"10.1556/650.2025.33276","url":null,"abstract":"<p><p>The pancreas is an unusual site for the development of metastases. Metastatic tumors affecting pancreas can be isolated or diffuse, and regarding the time of appearance they can be synchronous or metachronous. According to their origin, the prognosis of different secondary pancreatic tumors varies. The purpose of the literature review is to provide a clearer picture of metastases in the pancreas and their therapeutic potential. We conducted a retrospective review of the literature between 2014 and 2023 using the PubMed database. Using the data obtained during our search, we classified secondary pancreatic tumors based on their incidence, site of primary malignant tumor, clinical symptoms, diagnosis, mechanisms of development and treatment principles. Secondary tumors of the pancreas are rare, accounting for 2–5% of malignant pancreatic tumors. Clear cell renal cell carcinoma is the most common cause of pancreas metastasis. Pancreatic metastases are difficult to diagnose being often asymptomatic, and they can be confused with primary tumors of the pancreas. Histological and immunohistochemical examinations are necessary. In the development of secondary pancreatic tumors, the systemic-hematogenous metastasis mechanism is the accepted one. Surgical treatment prolongs survival, and the use of systemic, molecular targeted therapy has recently proven to be effective. Orv Hetil. 2025; 166(15): 563–568.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 15","pages":"563-568"},"PeriodicalIF":0.8,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008567","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 Declaration of Helsinki is 60 years old].","authors":"Péter Kakuk, Tamás Kardon, Barna Szamosi, Judit Sándor","doi":"10.1556/650.2025.HO2828","DOIUrl":"10.1556/650.2025.HO2828","url":null,"abstract":"<p><p>At its October 2024 General Assembly, the World Medical Association adopted a new, modified version of the Declaration of Helsinki. We analyze the novelties of the Declaration to present the new version of the Declaration to the biomedical research community by briefly reviewing the most important changes of the document. In the Appendix, a professionally verified text translated from the English original into Hungarian is published.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"549-556"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796120","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":"[Ernst Karl Abbe (1840-1905), the perfectionist of microscope from Jena, died 120 years ago].","authors":"József Makovitzky","doi":"10.1556/650.2025.HO2830","DOIUrl":"https://doi.org/10.1556/650.2025.HO2830","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"557-558"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796118","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":"[Associations between attention deficit hyperactivity disorder and accident proneness in children and adolescents].","authors":"Gabriella Szegleti, Szelmináz Faradzs-Zade, Péter Nagy","doi":"10.1556/650.2025.33272","DOIUrl":"10.1556/650.2025.33272","url":null,"abstract":"<p><p>Introduction: In children and adolescents with attention deficit hyperactivity disorder the incidence of accidental injuries is significantly higher than in the general population. The majority of attention deficit hyperactivity disorder accident victims have not been diagnosed before and are not receiving any treatment though attention deficit hyperactivity disorder medications have a protective effect on the risk of unintentional injuries. Objective: The relationship between attention deficit hyperactivity disorder and increased accidental rates was investigated in a Hungarian pediatric population sample of emergency trauma surgery patients. Method: Questionnaires completed by parents were used to record the circumstances and characteristics of the accident, screening for attention deficit hyperactivity disorder and any associated emotional and behavioral difficulties. For our analysis, we were able to use data from 115 of the 126 completed questionnaires received. Results: The incidence rate of attention deficit hyperactivity disorder in our sample was above population rate: 13.9% of our total sample qualified for being at risk for attention deficit hyperactivity disorder based on the presence of clinical symptoms whereas 19.1% were identified based on a less strict approach using total scores. Attention deficit hyperactivity disorder inattentive symptoms were the most prominent. Difference between attention deficit hyperactivity disorder and non-attention deficit hyperactivity disorder groups was detected on the Strengths and Difficulties Questionnaire emotional and conduct problems and hyperactivity subscales and oppositional symptoms. Conclusion: It is hoped that our research will contribute to the incorporation of routine screening for attention deficit hyperactivity disorder into the practice of pediatric trauma/emergency care in Hungary with the aim of accident prevention. Orv Hetil. 2025; 166(14): 543–548.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"543-548"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796117","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":"[Interdisciplinary consensus statement about the diagnosis and treatment of chronic fatigue syndrome/myalgic encephalomyelopathy].","authors":"Gábor Simonyi, J Róbert Bedros, János Réthelyi, Anna Polgár, Emese Kiss","doi":"10.1556/650.2025.33259","DOIUrl":"10.1556/650.2025.33259","url":null,"abstract":"<p><p>Chronic fatigue syndrome/myalgic encephalomyelopathy is a disease entity that has become recognized in the international literature during recent decades, but is less acknowledged in the Hungarian medical literature. Its symptoms are diverse, including somatic, cognitive, psychological and functional symptoms. The etiological background of the disease is unclear. However, the number of patients is rising, hence it is important to review the relevant literature. In this paper, we explore the above questions through the presentation of the international literature and guidelines, our goal is to provide appropriate information for professionals working in the Hungarian health care system: physicians, psychologists, physiotherapists, and dietitians. We also suggest potential treatment options for chronic fatigue syndrome/myalgic encephalomyelopathy. Orv Hetil. 2025; 166(14): 523–531.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"523-531"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796119","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":"Tisztelt Szerkesztőség!","authors":"Tamás Tényi, Noémi Somorjai","doi":"10.1556/650.2025.14M","DOIUrl":"https://doi.org/10.1556/650.2025.14M","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"559"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796122","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 first 10 years of Hungary's full membership of Eurotransplant].","authors":"Sándor Mihály, Kinga Trnka-Szántay, Orsolya Deme, Emese Holtzinger, Ágnes Samu-Pásztor, Brigitta Auer, István Hartyánszky, Ferenc Rényi-Vámos, László Ablonczy, Balázs Nemes, Péter Szakály, Edit Szederkényi, Anikó Szilvási, László Piros, Andrea Bayerné Matusovits","doi":"10.1556/650.2025.33264","DOIUrl":"10.1556/650.2025.33264","url":null,"abstract":"<p><p>Introduction: The main aim of Hungary’s joining to Eurotransplant was to improve the chances of Hungarian patients receiving organs, as well as graft and patient survival. Objective: The results of the Eurotransplant cooperation were examined from the Hungarian perspective, including the realization of the initial goals. Method: Data analysis was performed using absolute and annual average data from the first 10 years of full membership (from 2013), and a comparison was made between the data from the examined period and the data from the last 5 years before the Eurotransplant membership, as well as, where available, data from the previous 10 years. During the examined period, the numbers and circumstances of organ donors, multi-organ donors, donated organs, and transplants in Hungary were analyzed, along with the development of waiting lists and international organ exchanges. Results: In the 10 years following Hungary’s membership in Eurotransplant, the number of reported donors decreased by 17%. However, excluding the years affected by the COVID–19 pandemic, the number of actual donors increased by 12.53%. The most significant improvement was observed in the multi-organ donor rate (40.38% vs. 71.23%). During the period examined, the number of transplants increased by 18.95% (3325 vs. 3955). 23.49% of domestic transplants were carried out with foreign organs. The number of new patients on the waiting list increased by 25.16% (average per year 461 vs. 577), while the waiting time decreased. In the case of kidneys, 0 to 3 HLA mismatches increased by 10.7%, while the proportion of higher mismatches decreased by 10.9%. In the first 10 years of the Eurotransplant cooperation, 801 additional life years were gained to our kidney recipients. The number of successful transplants performed from the doubled acute list nearly tripled. Discussion: Joining to Eurotransplant proved to be an effective and successful decision, which increased the chances of organ availability for patients on the Hungarian waiting list and improved post-transplant survival rates. Conclusion: In Hungary, the chances of receiving an organ improved due to the availability of organ donation, facilitated by the establishment of a hospital coordinator network beside our Eurotransplant accession. The improvement in the actual donor and transplant rates also indicates that international organ exchange supports the more efficient allocation of donor organs, to avoid losing suitable organs. Orv Hetil. 2025; 166(14): 532–542.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 14","pages":"532-542"},"PeriodicalIF":0.8,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796121","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}