This review article summarizes the development of tumor-infiltrating lymphocyte (TIL) based immunotherapy, from the pioneering work of Rosenberg, Spiess and Lafreniere to the 2024 regulatory approval of lifileucel, the first cell therapy authorized for the treatment of solid tumors. A key advantage of TIL therapy over the chimeric antigen receptor (CAR) T-cell technology is its polyclonal T-cell receptor repertoire, which enables more effective recognition of heterogeneous tumor cell populations. The therapeutic approach is based on the ex vivo expansion and activation of lymphocytes isolated from a patient's own tumor, followed by their reinfusion after lymphodepleting conditioning. The review details the major technological advances in the field, with particular emphasis on the significance of "young TIL" protocols, which preserve proliferative capacity and prevent terminal differentiation by shortening culture duration. Current challenges are also discussed, including the need for more precise selection of tumor-reactive T cells, improved tumor homing and infiltration, and reduction of treatment-associated systemic toxicities. Next-generation strategies, including modified cytokines and genetically engineered TILs, aim to replace high-dose IL-2 and intensive chemotherapy, thereby reducing side effects. Overall, the approval of lifileucel validates the clinical relevance of TIL therapy. Fine-tuning the technology through standardized manufacturing and modulation of the tumor microenvironment promises to expand its application to other solid malignancies, fundamentally reshaping cancer treatment. By addressing the limitations of earlier methods, modern TIL therapy serves not as a final solution, but as a transitional foundation for more precise and controllable cellular immunotherapies. Orv Hetil. 2026; 167(19): 740-745.

Alongside the physical burden of cancer and its treatments, women with gynecologic cancer face substantial psychological and social challenges that strongly shape quality of life. Adaptive coping and timely psychosocial support may facilitate adjustment, adherence, and rehabilitation. To summarize coping strategies used by women with gynecologic cancer and their association with quality of life, and to describe the role of the multidisciplinary care team in delivering psychosocial support. We conducted a systematic search of PubMed, ScienceDirect, Google Scholar, BioMed Central, AKJournals, and ResearchGate for studies published between 2018 and 2025 without language restrictions. The search yielded 1419 records; after screening and full-text assessment, 36 studies were included. We extracted data on coping patterns, psychological outcomes, quality of life, and the contribution of psychosocial care and communication. Adaptive coping - particularly problem solving and seeking social support - was associated with better emotional well-being, lower distress, and higher quality of life. Avoidant coping was linked to higher anxiety, depressive symptoms, and poorer quality of life. Structured psychosocial interventions and consistent, empathic clinician-patient communication reduced tension, strengthened trust, and improved adherence. Integrating psychosocial support into oncologic care for women with genital tumors can enhance adaptive coping and improve quality of life. A patient-centered, interdisciplinary approach should include decision-making support, early assessment of coping and psychological burden, timely referral to appropriate professionals, and continuous development of communication and patient management competencies among providers. Orv Hetil. 2026; 167(18): 691-701.

The authors provide an overview of the effects of physiotherapy on the immune response. Immunomodulation plays a decisive role in the analgesic and anti-inflammatory mechanisms underlying physiotherapy. Exercise is the most prominent physiotherapy treatment, for which the most evidence exists. The skeletal muscle is a secretory organ that releases myokines in response to movement. One of the best-known of these is irisin, a movement-induced myokine. Irisin plays an important role in inhibiting oxidative stress, reducing systemic inflammatory responses, and providing neuroprotection. It also has a positive effect on the functions of regulatory T cells, modulates immune cells, and increases the production of anti-inflammatory cytokines. Physiotherapy plays a significant role in improving the clinical condition of patients with autoimmune diseases. The beneficial tumor-immunological effects of regular physical activity are not accompanied by harmful side effects. Physiotherapy increases the number of natural killer cells, which play an important role in the defense against tumors. Massage, electrotherapy, and photomodulation treatments also affect the immune response. Following radon and sulfur bath treatments, statistically significant reductions in cytokine levels and other inflammatory biomarkers were observed. The anti-inflammatory effect of whole-body cryotherapy may also be due to a decrease in interleukin-6 and tumor necrosis factor levels. Knowledge of the effects of physiotherapy treatments on the immune response may be an important consideration when choosing a treatment strategy for these diseases. Orv Hetil. 2026; 167(17): 651-660.

The rapid development of artificial intelligence in recent years has opened new dimensions in access to health-related information and in individual health management. As a result, an increasing number of people are turning to digital tools to support lifestyle-related decisions or to obtain information on preventive measures and screening examinations. The aim of our study was to investigate the extent to which individuals use the ChatGPT service in relation to primary and secondary prevention. To address this aim, we employed a self-developed questionnaire consisting of four sections and data on participants' key demographic characteristics, internet usage habits, health literacy, as well as their attitudes toward, knowledge of, and behavioral patterns related to the use of ChatGPT. This initial pilot testing was conducted with the participation of 112 respondents. The majority of participants were females (83.0%, n = 93), with a mean age of 33.99 years. Regarding internet usage, most respondents reported using the internet on an hourly basis (78.6%, n = 88). With respect to the impact on health-related decision-making, the sample demonstrated a heterogeneous pattern. Overall, 17.86% of respondents reported that the use of artificial intelligence had a distinctly positive influence on their decisions related to a healthy lifestyle and participation in screening examinations. The pilot application and initial testing of the questionnaire developed by our research group were successfully completed, examining the preventive use of large language models in our sample. While the present findings are suitable for exploring early patterns of technology use, future studies are planned to apply the questionnaire to larger and more heterogeneous samples. Orv Hetil. 2026; 167(16): 628-636.

Albumin is the most abundant plasma protein, playing a key role in maintaining oncotic pressure, modulating the inflammatory response and transporting both endogenous and exogenous substances. Its immunomodulatory and antioxidant properties further support the role in mitigating systemic inflammation. Albumin supplementation has gained increasing attention as a therapeutic strategy in critically ill patients in the intensive care setting. Clinical trials and meta-analyses suggest that albumin administration can improve hemodynamic stability, enhance fluid responsiveness, and reduce positive fluid balance in severe sepsis and septic shock, particularly in patients with hypoalbuminemia. Hypoalbuminemia is common among septic patients and serves as an important marker of poor outcomes, organ dysfunction, and disease severity. It represents a major determinant of morbidity and mortality in critically ill patients, with its development largely driven by uncontrolled immune responses during inflammation and sepsis, leading to endothelial dysfunction and increased capillary leakage. Current therapeutic guidelines advocate individualized fluid therapy, with albumin preferentially administered to patients requiring substantial crystalloid resuscitation and/or presenting with low serum albumin levels. Despite recognized benefits, the optimal timing, dosing, and patient selection for albumin therapy remain subjects of ongoing investigation. Serum albumin levels not only reflect disease severity but also represent a rational therapeutic target. Based on evidence-based strategies, achieving near-target albumin concentrations in the intensive care setting may improve the condition and outcomes of critically ill, septic patients. Orv Hetil. 2026; 167(12): 456-465.

Weight gain and obesity are significant side effects of psychotropic pharmacotherapy in older adults, contributing to increased cardiometabolic risk and impaired functional capacity. Among psychotropic drugs, olanzapine, clozapine, quetiapine, mirtazapine, valproate, and lithium are associated with the most significant weight gain through complex mechanisms (H1 blockade, 5-HT2C antagonism, metabolic effects); however, other antipsychotics, mood stabilizers, and antidepressants may also contribute to weight increase. In older adults, obesity particularly increases the risk of diabetes, cardiovascular diseases, malignancies, sarcopenic obesity, and frailty - a geriatric syndrome characterized by reduced physiological reserves and increased vulnerability. Prevention hinges on preferring agents with lower metabolic risk (e.g., aripiprazole, venlafaxine, lamotrigine), regular monitoring, and proactive lifestyle interventions. Therapeutically, switching medications, intensive lifestyle programs, metformin, or GLP1 agonists may be employed. For younger-old adults (65-74 years), weight reduction is a primary goal, while for the oldest-old (≥75 years), preserving functional capacity is paramount, requiring a multidisciplinary approach. Orv Hetil. 2026; 167(11): 410-418.

In Hungary, the Smart Plate is a widely used dietary recommendation developed by the Hungarian Dieticians' Association in the absence of an official national guideline. Internationally, the Planetary Health Diet is a diet that integrates both health and environmental sustainability. As climate change progresses, the environmental footprint of dietary patterns is becoming increasingly relevant due to its health impacts. To compare the Smart Plate and the Planetary Health Diet with the average Hungarian diet, and to assess their effects on human health and environmental footprint. The average Hungarian diet was described using data from the 2019 National Nutrition and Nutritional Status Survey (OTÁP). Daily intakes of major food groups were determined for all three diets. Effects on human health were assessed according to the Global Burden of Disease optimal intake ranges across nine food groups. Consuming these optimal amounts would theoretically minimize the risk of related diseases. Environmental footprints - greenhouse gas emissions and land use - were calculated using the SHARP Indicator Database. Among the diets examined, the Planetary Health Diet met four Global Burden of Disease optimal intake categories and thus appeared the healthiest. The Smart Plate and OTÁP diets each met one optimal category. OTÁP showed the highest greenhouse gas and land use footprints, the Smart Plate showed intermediate values, while the Planetary Health Diet had the lowest environmental footprint. The Planetary Health Diet demonstrated both the most favorable health profile and the smallest environmental impact. The Global Burden of Disease optimal intake ranges are considered reliable due to their basis in systematic reviews, meta-analyses, and validation in large cohort studies. The environmental footprint results align with published evidence. Adapting and recommending the Planetary Health Diet in Hungary should be considered, as current findings indicate clear health and environmental advantages over both the Smart Plate and the average Hungarian diet. Orv Hetil. 2026; 167(9): 337-346.

Technetium-99m-MIBI (methoxy-isobutyl-isonitrile) is a radiopharmaceutical agent used in the evaluation of myocardial perfusion and parathyroid pathologies. MIBI scintigraphy is a commonly applied diagnostic method in the assessment of parathyroid adenomas for lesion localization and to exclude the presence of ectopic adenomas. However, tracer uptake may also occur in thyroid adenomas, thyroid carcinomas, and other lesions with high mitochondrial density. In our study, we present the case of a 79-year-old female patient. The patient had been under endocrinological care since 1997 due to osteoporosis. Since late 2023, intermittent hypercalcemia accompanied by elevated parathyroid hormone levels has been consistent with a diagnosis of primary hyperparathyroidism. Neck ultrasound and parathyroid scintigraphy with SPECT/CT confirmed an abnormality suggestive of an adenoma of the left superior parathyroid gland, and there was also an intense isotope accumulation in the left retro/parapharyngeal region, suggesting the possibility of malignancy. Based on MRI, the parapharyngeal lesion was not suspected to be malignant. During surgical exploration, the adenoma of the left lower parathyroid gland and the lesion located in the parapharyngeal space were removed, the latter using a minimally invasive, transoral endoscope-assisted technique. Histology confirmed parathyroid adenoma and salivary gland oncocytoma. This case highlights the importance of parathyroid scintigraphy with SPECT/CT in the localization of parathyroid adenomas and that increased isotope accumulation does not always indicate a parathyroid abnormality. Orv Hetil. 2026; 167(9): 351-358.

Heart failure remains one of the leading causes of cardiovascular morbidity and mortality, impairing the quality of life. Based on randomized, controlled clinical trials, SGLT2 inhibitors significantly improve outcomes and reduce symptoms. However, real-world evidence is essential to better assess their effectiveness and safety in everyday clinical practice. To evaluate the effects of empagliflozin therapy on the quality of life and functional status, as well as to assess its safety profile in the Hungarian cohort of the international Emp-Activity study, covering the full spectrum of heart failure. This prospective, non-interventional, multicenter, observational study involved symptomatic heart failure patients enrolled from 11 Hungarian centers. A total of 106 patients were enrolled, of whom 101 were assigned to the empagliflozin cohort and 5 to the non-empagliflozin cohort. Patients received empagliflozin as part of routine heart failure therapy and completed the Kansas City Cardiomyopathy Questionnaire (KCCQ-12) at baseline and after 24 weeks. Functional status was assessed using the New York Heart Association (NYHA) classification. 101 patients were enrolled to the empagliflozin cohort (median age 69 years, 28.7% female), primarily in NYHA class II and III. Among them, 57% had HFrEF, 19% HFmrEF, and 22% HFpEF. The most frequent etiology was ischemic heart disease (42%). The most common comorbidities included hypertension (58%), atrial fibrillation (33%), diabetes mellitus (26%), and hyperlipidemia (25%). A significant improvement was observed in the KCCQ-12 overall score (74.3 ± 19.5 vs. 67.1 ± 19.5, p<0.01), with clinically meaningful improvement (≥5-point increment) in 53% of patients. The NYHA class improved significantly. Systolic blood pressure decreased (131 ± 16 mmHg vs. 127 ± 17 mmHg, p = 0.02), while diastolic blood pressure, serum creatinine, and potassium levels remained stable during the 24-week follow-up. In Hungarian patients with heart failure, 24-week empagliflozin treatment resulted in significant improvements in the quality of life and functional capacity, while being well tolerated. These findings support the effectiveness and safety of empagliflozin in routine clinical practice across the full spectrum of heart failure. Orv Hetil. 2026; 167(7): 257-264.