Background and purpose-Numerous studies in the international literature address workplace traumatic experiences affecting psychiatry residents and their impacts. No such survey has been conducted in Hungary so far, so Iset as my goal to assess the occurrence of stressful situations affecting Hungarian psychiatry residents and their psychological consequences. Emphasizing the mental health of psychiatry residents and improving prevention in specialist training is an essential condition for training stable, well-prepared specialists. Methods-A total of 80 psychiatry residents from the specialist training programs of the 4 Hungarian universities were included in the survey. The questionnaire consisted of 5 parts: occurrence of stressful situations; psychological reactions; Mini-Oldenburg Burnout Inventory (MOLBI); coping mechanisms; needs for specialist training development. Results-Among stressful situations, verbal abuse and discriminatory remarks were the most common. Physical assault affected 34.6% of respondents, and patient suicide occurred in 34.5% of cases. Burnout criteria were met in 62.5% of residents. High scores were achieved on the MOLBI Disengagement subscale by 65% and on the Exhaustion subscale by 90%. Although burnout and disengagement levels were similar, the proportion of those with significant exhaustion was significantly higher in the Budapest sample compared to the national average (94.2% vs. 84.6%). For processing cases, young residents most commonly chose discussion with fellow residents. 100% of respondents supported the development of specialist training programs that would aid the professional processing of difficult situations. Conclusion-The occurrence of stressful situations shows similar trends to international literature data. However, burnout and exhaustion levels are significantly higher, which may have several explanations. The two most important factors to build future development strategies around are more thorough preparation for difficult situations and the programmatic implementation of professional and regular case processing.
Background and purpose Migraine has been associated with systemic inflammatory alterations in a limited number of studies, although the evidence remains inconsistent. In this context, immature granulocytes (IGs), early indicators of bone marrow activation, have been proposed as potential biomarkers in migraine research. The aim of this study was to evaluate IG levels in patients with episodic migraine during attack and interictal periods and to investigate their relationship with hematological inflammatory markers and clinical features. Methods This prospective case-control study enrolled 53 patients with episodic migraine and 53 healthy controls matched for age and sex. Blood samples were collected during acute migraine attacks and interictal periods. Inflammatory parameters, including IG, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and platelet indices were analyzed. Correlations with clinical characteristics such as headache frequency, aura, white matter lesions, and migraine disability assessment scale (MIDAS) scores were assessed. Results IG levels did not differ significantly between migraineurs and controls. However, lower IG levels were associated with higher headache frequency (rho = -0.453, p = 0.001) and MIDAS scores (rho = -0.291, p = 0.037). LMR was significantly lower and SIRI higher in the attack-period patients versus controls (p = 0.028 and p = 0.023, respectively). Platelet indices such as MPV, PDW, and P-LCR elevated during attacks, while platelet counts increased during interictal periods. ROC analyses showed limited discriminative power of platelet indices (AUC < 0.61). Conclusion These findings suggest that IG levels and inflammatory indices such as LMR and SIRI may reflect migraine-related immune activity and disease burden during the migraine attack phase, though their clinical utility requires further validation.
Hereditary spastic paraplegia (HSP) refers to a group of rare, progressive neurodegenerative disorders characterized by spasticity and weakness predominantly affecting the lower limbs, with significant clinical and genetic heterogeneity. Clinically, HSP is classified into "pure" and "complicated" forms. SPG15 (ZFYVE26) is a rare autosomal recessive subtype typically presenting in childhood with cognitive decline, followed by the development of gait disturbances and spasticity, often accompanied by thinning of the corpus callosum. Here, we report the case of a 19-year-old female patient, born to consanguineous parents, presenting with gait disturbance, lower limb spasticity, and dysarthria. Neurological examination revealed motor and mental retardation, bilateral lower limb spasticity, increased deep tendon reflexes, thinning of the corpus callosum on brain MRI, white matter hyperintensities, and the characteristic "lynx ear sign". Electromyography demonstrated marked sensorimotor demyelinating polyneuropathy in the lower limbs and evidence of anterior horn cell involvement. Genetic analysis, prompted by clinical and radiological findings, revealed a homozygous mutation in exon 19 of the ZFYVE26 gene: c.3382C>T p.Q1128*.
Background and purpose-Long-term motorcycle use may lead to various health problems, such as musculoskeletal disorders and peripheral nerve compression. This study aims to evaluate the effects of prolonged motorcycle use on the peripheral nervous system. Methods-Electroneuromyography (ENMG) data for the axillary nerve and accessory nerve were compared between motorcycle users and non-users. The study included 50 volunteers who had been actively riding motorcycles for at least five years and 50 individuals who did not use motorcycles. Anthropometric measurements were also recorded, and nerve conduction parameters were statistically analyzed. Results-The results revealed that the latencies of the right and left axillary nerves were significantly increased in the motorcycle group (p<0.05), while the amplitude of the left axillary nerve showed a significant decrease (p<0.05). Moreover, a significant increase in the latency of the right accessory nerve was observed in the same group (p<0.05). Conclusion-These findings indicate that long-term motorcycle use can cause neurophysiological alterations in upper extremity nerve conduction. The outcomes of this study may support the development of ergo- nomic interventions and protective strate-gies to mitigate the potential risks associated with prolonged motorcycle use.
The spinal arteriovenous malformations are rare and comprise a heterogeneous spectrum of disease. Paraspinal arteriovenous fistulas (PSAVF) are defined as pathologic connections between arteries and veins in the paraspinal space. Microsurgical, transarterial or combined transarterial and transvenous embolization has been published as the treatment of choice of such lesions. In this report, we elaborate on the principles of the pathoanatomy of the PSAVF with its implications on the concept of purely transvenous treatment. We present two patients with paraspinal arteriovenous fistula treated with purely transvenous approach and describe the procedure. The rationale of purely transvenous embolization relies on the possibility of direct access of the primary venous structure affected by the PSAVF. The multiple existing connections between the internal and external periverterbal venous plexus, the condylar system and the vertebral veins allows for very precise and restricted occlusion of the pathology, reducing the risk of arterial ischemia of the spinal cord.
