Orvosi hetilap最新文献

{"title":"[Jean Marie Joseph Capgras (1873-1950) - the describer of the delusion of the double died 75 years ago].","authors":"Tamás Tényi, Csenge Lovig, Borbála Pethő","doi":"10.1556/650.2025.HO2826","DOIUrl":"https://doi.org/10.1556/650.2025.HO2826","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"434-438"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639644","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 prevalence of cerebral visual impairment among high-risk visually impaired children in Hungary].","authors":"Júlia Gellért, Márta Gadó, János Németh, Amarilla Barcsay-Veres","doi":"10.1556/650.2025.33256","DOIUrl":"10.1556/650.2025.33256","url":null,"abstract":"<p><p>Introduction: In cerebral visual impairment (CVI), the disturbance in visual function is not due to a condition of the eyeball but to a malfunction in the neural processing of visual information. The prevalence of cerebral visual impairment is unknown in Hungary. Still, it is essential to initiate a professional debate, as early-onset visual impairment impairs later mental and physical health and social advancement and creates a burden on society. Objective: A pilot study was carried out to assess the prevalence and incidence of cerebral visual impairment, either concomitant or independent of ocular visual impairment, in a cross-sectional survey of the School for the Visually Impaired in Budapest. Methods: We used special education methods to investigate the characteristics of cerebral visual impairment among low-vision children at high risk for cerebral visual impairment. We compared the gender and age distribution of students with and without cerebral visual impairment symptoms, data on birth conditions, and ophthalmological diagnosis. Results: Between 2021 and 2024, data from 120 students were analyzed, of whom 58 students (48.3%) had a history of increased risk of cerebral visual impairment. In the group at high risk for cerebral visual impairment, 33 (56.9%) pupils were found to have cerebral visual impairment abnormalities detected by teachers of visual impairments, while 4 (6.9%) had cerebral visual impairment in an ophthalmological report. Where teaching of visually impaired children methods confirmed cerebral visual impairment in the presence of high risk of cerebral visual impairment, the proportion of boys was higher compared to the non-cerebral visual impairment subgroup (66.7% vs. 36.0%, p = 0.020). Within the high-risk group, birth weight and gestational age did not differ among the cerebral visual impairment and non-cerebral visual impairment groups. Discussion: In children with a declared visual impairment, the teaching of visually impaired children method is the appropriate method for detecting cerebral visual impairment, while an ophthalmological examination may raise suspicion of cerebral visual impairment. As in other countries, cerebral visual impairment is significantly underdiagnosed in Hungary. Our measurements confirmed that boys were overrepresented in the cerebral visual impairment group, but the main etiological role of prematurity was not confirmed. Conclusion: In the high-risk group, teaching of visually impaired children methods are necessary in addition to ophthalmological examination to prove the presence of cerebral visual impairment. Targeted development as early as possible is a pledge to improve visual function. Further studies are needed to assess the prevalence of the condition in Hungary. Orv Hetil. 2025; 166(11): 421–426.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"421-426"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639655","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":"[Sessile serrated lesion with dysplasia and invasion].","authors":"Ádám Ferenczi, Nóra Ördög, Zsuzsanna Újfaludi, Levente Kuthi, Anita Sejben","doi":"10.1556/650.2025.33260","DOIUrl":"10.1556/650.2025.33260","url":null,"abstract":"<p><p>Sessile serrated lesions (SSLs) are not uncommon entities per se, usually localised to the proximal half of the colon and are often flat on endoscopic examination. The presence of dysplasia associated with SSL and, even more so, invasion are considered rare, while dysplastic SSLs (SSL-D) very quickly transform into invasive carcinoma. MLH1 immunohistochemical reaction may help to establish the diagnosis of SSL-D. We present the case of an 88-year-old female patient who presented for colonoscopic resection of suspicious tumours in the coecum and transverse colon. Histological examination revealed medullary carcinoma in the coecum with MLH1 and PMS2 mismatch repair protein deficiency. The polyp removed from the transverse colon was histopathologically confirmed to be SSL with central low-grade dysplasia (SSL-D), confirmed by loss of MLH1, and submucosal invasion was seen at a single focus. A BRAF V600E sequencing was performed to rule out Lynch syndrome, which confirmed the presence of the mutation. Risk factors for SSL-D include older age, the presence of multiple synchronous SSLs and a size greater than 10 mm. In SSL-D, due to the high malignant transformation potential, a complete resection should always be sought. In the SSL – SSL-D – carcinoma sequence, the main driver mutations are in the BRAF and less frequently KRAS genes. In cases with numerous SSLs, the possibility of sessile polyposis syndrome, and less frequently MUTYH-associated polyposis and hereditary mixed polyposis syndrome should also be raised. In both SSL and colorectal carcinoma, microsatellite instability, CpG island methylation phenotype and the presence of BRAF V600E mutation are common. The mismatch repair status can be determined by immunohistochemistry using MLH1, PMS2, MSH2 and MSH6 reactions, the 2 tests complementing each other. Determination of mismatch repair status is crucial for the diagnosis of colorectal carcinoma and the potential indication of immune checkpoint inhibitor treatment. Orv Hetil. 2025; 166(11): 427–433.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"427-433"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639647","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 characteristics of pediatric-onset inflammatory bowel disease based on our 20-year-long study].","authors":"Luca Tóbi, Áron Cseh","doi":"10.1556/650.2025.33249","DOIUrl":"10.1556/650.2025.33249","url":null,"abstract":"<p><p>Among inflammatory bowel diseases (IBDs), every tenth develops during childhood, which is characterized by a more complex disease course, more extensive spread, and rapid progression. The presenting symptoms of pediatric-onset IBD are often nonspecific, and diagnostic delays increase the risk of intestinal damage, bowel resection, and growth retardation. Adolescents with IBD exhibit the lowest compliance and medication adherence rates, contributing to the frequent occurrence of complications. The most significant extraintestinal complications in pediatric-onset IBD patients include growth retardation, malnutrition, impaired bone metabolism, malignancies, and opportunistic infections. In this patient group, surgical interventions are required earlier and more frequently, and the hospitalization rate is also higher among them. Ensuring optimal disease progression and quality of life is crucial, making it essential for the physicians managing their care to be well aware of the specific characteristics of the pediatric-onset IBD patient group. Orv Hetil. 2025; 166(11): 403–412.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"403-412"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639651","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":"Egy utódállam, Csehszlovákia egészségügyi rendszere.","authors":"László Kiss","doi":"10.1556/650.2025.11M","DOIUrl":"https://doi.org/10.1556/650.2025.11M","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"439"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639757","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":"[Vertigo patient population in a vertigo private clinic in Hungary].","authors":"András Molnár, Viktória Molnár, Stefani Maihoub","doi":"10.1556/650.2025.33253","DOIUrl":"10.1556/650.2025.33253","url":null,"abstract":"<p><p>Introduction: Vertigo is a frequent issue in everyday medical practice. Without specific examinations, it can persist, leading to co-occurring symptoms. Objective: To present our experiences gained at a clinic specialising in vertigo. Method: In this study, patients were enrolled at a clinic specialising in vertigo. Detailed case histories, physical assessments of the vestibular system, pure-tone audiometry, brain CT/MRI, and carotid vertebral Doppler ultrasonography results were examined. To assess the impact of symptoms, the Dizziness Handicap Inventory (DHI) and the Tinnitus Handicap Inventory (THI) were administered. Results: 121 patients (51.40 ± 13.38 years; 72 women) were enrolled. The median onset of vertigo was recorded at 5 months, with a maximum of 240 months. Spinning sensations were reported in more than 60% of the attacks, with a median duration of 1.5 hours. Hearing loss occurred in approximately 30%, while tinnitus was noted in 50%, with bilateral tinnitus being the most common (38.7%). Headaches occurred in approximately 30%, with a significant proportion related to vertigo (81.25%). The most frequent diagnoses were benign paroxysmal positional vertigo (24.8%), vestibular migraine (22.3%), non-vestibular causes (19.8%), and Ménière’s disease (18.2%). Spontaneous vestibular signs occurred at low rates (5%). The head-impulse test was positive slightly more often (10%). Positional nystagmus was detected in 13%, which is a low percentage, especially given the high prevalence of benign paroxysmal positional vertigo. Brain CT scan was conducted in 24%, with 65% having negative results. In comparison, brain MRI was performed in 74%, and 35% yielded negative results. Carotid Doppler ultrasonography showed normal results in 62%. Severe vertigo was reported in 41%, while mild (34%) and moderately severe (32%) tinnitus were the most commonly reported handicaps. Conclusion: There are various causes of vertigo, including vestibular and non-vestibular factors. Delays in diagnosis and a lack of specialised testing lead to a delay in treatment, worsening the quality of life and contributing to psychiatric comorbidities. Orv Hetil. 2025; 166(11): 413–420.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 11","pages":"413-420"},"PeriodicalIF":0.8,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639658","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":"[Opportunities offered by molecular diagnostics in the management of invasive fungal infections of oncohematological patients].","authors":"Erik Zajta, Gergely Peskó, G Dániel Knapp, Eszter Vad, Csaba Bödör, János Sinkó","doi":"10.1556/650.2025.33241","DOIUrl":"10.1556/650.2025.33241","url":null,"abstract":"<p><p>Invasive fungal infections pose a particular threat to oncohematological patients. Candidiasis, aspergillosis, mucormycosis, cryptococcosis and Pneumocystis pneumonia are the most common manifestations. Despite various available approaches (culture, histology, serology, imaging), diagnosis of invasive mycoses is challenging. Owing to rapid technological advancements, molecular biological methods are routinely used in diagnostics of bacterial and viral infections. At the same time, molecular tests can be of substantial assistance in the detection and characterization of mycoses, therefore several international guidelines contain recommendations on them. Although some molecular fungal tests have been introduced in Hungarian healthcare, their widespread application is lagging. Here, we provide a review of molecular tools for clinical fungal diagnostics focusing on taxon-specific polymerase chain reaction (PCR), sequencing techniques (Sanger sequencing, next-generation sequencing) and their roles in identification of fungal pathogens and detection of resistance to antifungal medication. Tests available in South-Pest Central Hospital – National Institute of Hematology and Infectious Diseases and at the Department of Pathology and Experimental Cancer Research of Semmelweis University are briefly discussed. Finally, the utility of molecular fungal diagnostics is demonstrated through two case reports. This article aims to contribute to larger implementation of molecular tools in fungal diagnostics in the Hungarian healthcare system. Orv Hetil. 2025; 166(10): 363–376.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 10","pages":"363-376"},"PeriodicalIF":0.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586596","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":"[Digital health solutions during and after the COVID-19 epidemic].","authors":"Edmond Girasek, Bence Döbrössy, András Wernigg, Zsuzsa Győrffy","doi":"10.1556/650.2025.33243","DOIUrl":"10.1556/650.2025.33243","url":null,"abstract":"<p><p>Introduction: Before the COVID–19 pandemic, the uptake of digital health solutions had been hindered by regulatory and strategic gaps, but during the pandemic, the rapid adoption of digital tools became necessary. With the pandemic over, the regulatory conditions are now in place in Hungary to support the use of digital health solutions, while the imperative for digital solutions has diminished. The question is how patient interest and demand for digital solutions will change in this situation. Objective: In our two nationally representative population surveys, we sought to answer the question of how the COVID–19 pandemic affected the population’s usage patterns, attitudes and needs for digital health solutions. Methods: We compared the results of two national representative population surveys. The first survey was carried out in October 2021, during the COVID–19 pandemic, by interviewing 1,500 people over telephone. The second survey was conducted in February 2024 by interviewing 1000 people (+100 elderly boost sample) online. Both samples are representative of the Hungarian adult population by gender, age, education and municipality type. Data collection for both surveys was carried out by Ipsos Zrt. Results: The results of the two population surveys show that the frequency and method of searching for health information online has changed significantly. The proportion of people who did not search for information online at all continued to decrease. The popularity of websites for health-related internet use increased, while the interest in blogs, podcasts and social platforms decreased. Awareness and use of digital tools also increased, particularly for online appointment booking, healthcare data sharing and social media use. Positive perceptions of the effectiveness of care decreased slightly, while concerns about technological frustration also eased. Conclusion: As the COVID–19 pandemic passed, digital health regulations emerged and the use of digital health technologies became commonplace among the population. Awareness and use of digital technologies increased significantly, especially for online appointment booking, e-prescription and wearables. Concerns about the potential disadvantages of using digital tools decreased, while expectations of benefits did not change significantly, indicating a more realistic perception. Patients’ need for digitalisation has now become an integral part of their care, supporting a more informed and active engagement in the healing process. Orv Hetil. 2025; 166(10): 377–384.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 10","pages":"377-384"},"PeriodicalIF":0.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586581","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":"[Soft tissue protecting operative treatment of complex ankle fractures in elderly patients using fibular nailing].","authors":"Máté Burkus, Andreas Bruch","doi":"10.1556/650.2025.33242","DOIUrl":"10.1556/650.2025.33242","url":null,"abstract":"<p><p>The incidence of ankle fractures in older patients shows a clear upward trend. However, their proper treatment is often challenging and may be associated with a high complication rate. The primary reasons for the increased complication rate can be attributed to the specific characteristics of the patient population, such as frequently complex morbidities, weakened bone structure, and less than optimal soft tissue conditions. These problems are more likely to arise with standard invasive operative methods, such as plate osteosynthesis, which can have a pronounced negative impact on the already sensitive soft tissues. To reduce complications associated with the treatment of multiple, complex ankle fractures in geriatric patients, a soft tissue-protecting alternative may be the intramedullary nailing of the distal fibula. In this case presentation, we aim to demonstrate the advantages of the anatomical intramedullary fibula nailing method using the examples of complex ankle fracture therapy in an 86-year-old and a 74-year-old patient. This technique offers anatomical fixation while ensuring significant soft tissue protection. It allows for (partial) weight-bearing after surgery, thereby facilitating the early mobilization of patients. With appropriate indications, this method can yield particularly good results in the operative treatment of ankle fractures in geriatric patients. Orv Hetil. 2025; 166(10): 392–397.</p>","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 10","pages":"392-397"},"PeriodicalIF":0.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586613","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":"[Repulsion- and inspiration-hypertension (László Németh died 50 years ago)].","authors":"László Kiss","doi":"10.1556/650.2025.HO2824","DOIUrl":"https://doi.org/10.1556/650.2025.HO2824","url":null,"abstract":"","PeriodicalId":19911,"journal":{"name":"Orvosi hetilap","volume":"166 10","pages":"398-400"},"PeriodicalIF":0.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586611","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}