Background: Prenatal diagnosis of congenital heart defects (CHD) is important for perinatal planning, yet the gestational week at which CHD is diagnosed varies considerably. In referred cohorts, diagnostic timing may be influenced by maternal, fetal, temporal, and lesion-specific factors. This study examined factors associated with the gestational week of prenatal diagnosis among pregnancies with prenatally recognized and subsequently confirmed CHD referred to a national tertiary fetal cardiology centre. Methods: This study analyzed 833 pregnancies with confirmed CHD managed between 2005 and 2020. The primary outcome was the gestational week of prenatal diagnosis. Univariable associations with binary predictors were assessed using Student’s t-test, Welch’s t-test, or the Mann–Whitney U test according to distributional assumptions. A primary fully adjusted multivariable linear regression model with heteroscedasticity-robust standard errors was used to evaluate variables associated with the gestational week of diagnosis. The model included maternal age, calendar year as a continuous variable, twin pregnancy, amniotic fluid abnormalities, chromosomal status, and selected lesion-specific diagnoses. Chromosomal status was modelled hierarchically as no chromosomal abnormality, Down syndrome, or other chromosomal abnormality. Results: In univariable analyses, advanced maternal age, Down syndrome, and chromosomal abnormalities were associated with earlier diagnosis, whereas oligohydramnios was associated with later diagnosis. In the primary fully adjusted multivariable model, increasing maternal age was associated with earlier diagnosis (β = −0.169 weeks per year, 95% CI −0.238 to −0.099; p < 0.001), as was later calendar year (β = −0.211 weeks per year, 95% CI −0.311 to −0.111; p < 0.001). Coarctation of the aorta/aortic arch stenosis (β = 2.276 weeks, 95% CI 0.787 to 3.764; p = 0.003), pulmonary stenosis (β = 1.996 weeks, 95% CI 0.376 to 3.617; p = 0.016), and oligohydramnios (β = 2.097 weeks, 95% CI 0.228 to 3.965; p = 0.028) were associated with later prenatal diagnosis. Down syndrome showed a borderline association with earlier diagnosis (β = −1.350 weeks, 95% CI −2.702 to 0.002; p = 0.050). The model explained 12.2% of the variability in the gestational week of diagnosis, with an adjusted R2 of 0.107. Conclusions: In this tertiary referral-centre cohort of pregnancies with prenatally recognized and confirmed CHD, the gestational week of prenatal diagnosis was associated with maternal age, calendar year, oligohydramnios, and selected lesion-specific diagnoses. These findings should be interpreted as observational associations within an already recognized referral cohort rather than determinants of prenatal CHD detection in the general pregnant population. Future studies should incorporate referral pathways, screening history, ultrasound quality, operator experience, fetal position, and lesion-specific imaging characteristics to better characterize factors influencing the timing of prenatal CHD diagnosis.
BACKGROUND:Basic science knowledge is essential for understanding clinical studies and enhancing clinical reasoning in medical practice. However, medical students retain only a portion of the knowledge gained during the early years of medical school. We aimed to examine medical students' knowledge retention of repeated and recently learned topics in physiology and microbiology with additional analysis of individual variability. Given that prior studies have raised concerns about the validity of retention rate as an indicator of stable knowledge, we also explored alternative measures of retention. METHODS:Nineteen third- and 22 fourth-year medical students volunteered to repeat the written examinations in physiology and microbiology, respectively, in September 2022 at the University of Pécs. Students previously completed a summative test in the fall semester and another test in the spring semester. Both examinations consisted of multiple-choice questions and the second test included questions from both semesters introducing a unique form of spaced repetition. In our study, students repeated the complete second test after a 16-week non-use retention interval. Besides retention rates, we calculated the percentage of consistently correct and incorrect answers as retention measures. Correlations between retention measures and students' grade point averages (GPAs) were examined. RESULTS:Significant declines in test scores were observed, with physiology scores dropping from 70.4 to 53.5% and microbiology scores from 72.1 to 57.3%. Retention rates varied significantly, with values ranging from 54.5 to 97.2%. Microbiology revealed better results of first-semester content compared to the second semester in some of the retention measures, while physiology showed no difference between semesters. Retention rates did not correlate with GPA, however, the percentage of consistently correct answers showed moderate positive correlations, while the consistently incorrect answers showed moderate negative correlations with GPA. CONCLUSIONS:There was a substantial knowledge loss among medical students with high individual variability indicating the need to explore factors affecting long-term knowledge retention in real-life educational settings more deeply. Previously acquired knowledge in microbiology demonstrated superior retention, potentially attributable to the beneficial effects of spaced repetition. The lack of correlation between retention rates and GPA suggests that other measures may better reflect stable knowledge.
Background: The anterior cingulate cortex (ACC) is known for its involvement in various regulatory functions, including in the central control of feeding. Activation of local elements of the central glucose-monitoring (GM) neuronal network appears to be indispensable in these regulatory processes. Destruction of these type 2 glucose transporter protein (GLUT2)-equipped chemosensory cells results in multiple feeding-associated functional alterations. Methods: In order to examine this complex symptomatology, (1) dopamine sensitivity was studied in laboratory rats by means of the single-neuron-recording multibarreled microelectrophoretic technique, and (2) after local bilateral microinjection of the selective type 2 glucose transporter proteindemolishing streptozotocin (STZ), open-field, elevated plus maze, two-bottle and taste reactivity tests were performed. Results: A high proportion of the anterior cingulate cortical neurons changed their firing rate in response to microelectrophoretic administration of D-glucose, thus verifying them as local elements of the central glucose-monitoring network. Approximately 20% of the recorded cells displayed activity changes in response to microelectrophoretic application of dopamine, and almost 50% of the glucose-monitoring units here proved to be dopamine-sensitive. Moreover, taste stimulation experiments revealed even higher (80%) gustatory sensitivity dominance of these chemosensory cells. The anterior cingulate cortical STZ microinjections resulted in extensive behavioral and taste-associated functional deficits. Conclusions: The present findings provided evidence for the selective loss of glucose-monitoring neurons in the anterior cingulate cortex leading to motivated behavioral and gustatory alterations. This complex dataset also underlines the varied significance of the type 2 glucose transporter protein-equipped, dopamine-sensitive glucose-monitoring neurons as potential therapeutic targets. These units appear to be indispensable in adaptive control mechanisms of the homeostatic-motivational-emotional-cognitive balance for the overall well-being of the organism.
Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live births), but it can have serious mental effects. Methods: In our study, we processed the data of 64 pregnant women. They attended a prenatal diagnostic center and genetic counseling from 2005 to 2019 at the Department of Obstetrics and Gynecology at Semmelweis University. Results: The pregnancies had the following outcomes: 52 ended in delivery, 1 in spontaneous abortion, and 11 in termination of pregnancy (TOP) cases (n = 64). The average time of detection with imaging tests was 25.24 gestational weeks. In 16 cases, prenatal magnetic resonance imaging (MRI) was performed. If the abnormality was detected before the 20th week, a genetic test was performed on an amniotic fluid sample obtained from a genetic amniocentesis. Karyotyping and cytogenetic tests were performed in 15 of the investigated cases. Karyotyping gave normal results in three cases (46,XX or XY). In one of these cases, postnatally chromosomal microarray (CMA) was later performed, which confirmed Aicardi syndrome (3q21.3–21.1 microdeletion). In one case, postnatally, the test found Wiedemann–Rautenstrauch syndrome. In other cases, it found X ring, Di George syndrome, 46,XY,del(13q)(q13q22) and 46,XX,del(5p)(p13) (Cri-du-chat syndrome). Edwards syndrome was diagnosed in six cases, and Patau syndrome in one case. Conclusions: We found that corpus callosum abnormalities are often linked to chromosomal problems. We recommend that a cytogenetic test be performed in all cases to rule out inherited diseases. Also, the long-term outcome does not just depend on the disease’s severity and the associated other conditions, and hence proper follow-up and early development are also key. For this reason, close teamwork between neonatology, developmental neurology, and pediatric surgery is vital.
(1) Introduction: Topical dithranol is still commonly used today as an effective treatment for psoriasis. Dithranol treatment is often supplemented with balneotherapy, which has been shown to increase effectiveness and reduce side effects. The inorganic salts (sulfhide, selenium, zinc) are usually thought to be responsible for the effect. The antioxidant effect of the waters is thought to be behind the therapeutic effect, for which inorganic substances (sulfides, selenium, zinc) are thought to be responsible. The organic matter content of medicinal waters is also particularly important, as humic acids, which are often found in medicinal waters, have antioxidant effects. (2) Methods: In this short-term experiment, we aimed to test the possible protective effect of Szigetvár medicinal water and its organic matter isolate on HaCaT cells exposed to dithranol. Malondialdehyde levels were measured, and RT-qPCR was used to investigate the gene expression of selected cytokines relevant in the oxidative stress response (IL-6, IL-8, TNF-α, GM-CSF) and the expression of microRNA-21. (3) Results: Szigetvár medicinal water and the organic isolate prevented the increase in malondialdehyde levels caused by dithranol treatment. The cytokine gene expressions elevated by dithranol exposure were reduced by the treatment. (4) Conclusions: Szigetvár medicinal water and organic substances alone may have a protective effect on patients’ healthy skin surfaces against dithranol damage. We also demonstrated that the organic compounds are also responsible for the protective effect.
Dermal photoaging refers to the skin’s response to prolonged and excessive ultraviolet (UV) exposure, resulting in inflammation, changes to the tissue, redness, swelling, and discomfort. Betanin is the primary betacyanin in red beetroot (Beta vulgaris) and has excellent antioxidant properties. Yet, the specific molecular mechanisms of betanin in HaCaT cells have not been fully clarified. The objective of this study was to investigate the activity of betanin and the underlying mechanisms in HaCaT cells; furthermore, in this study, we explored the protective effect of various concentrations of betanin against UVB irradiation on HaCaT cells. Additionally, we assessed its influence on the transcription of various epigenetic effectors, including members of the DNA methyltransferase (DNMT) and histone deacetylase (HDAC) families. Our findings demonstrate a notable downregulation of genes in HaCaT cells, exhibiting diverse patterns upon betanin intake. We considered the involvement of DNMT and HDAC genes in distinct stages of carcinogenesis and the limited exploration of the effects of daily exposure dosages. Our results indicate that betanin may protect the skin from damage caused by UV exposure. Further investigation is essential to explore these potential associations.
Introduction: Toxoplasmosis is a parasitism transmitted by Toxoplasma gondii, part of the TORCH complex, the most prevalent parasitism worldwide. It is asymptomatic in immunocompetent individuals but causes severe infections and developmental abnormalities in pregnant women, mainly affecting the central nervous system and the gastrointestinal system. Methods: In our prospective study, we analyzed cases of recent maternal Toxoplasma infections confirmed by serological testing between 1996 and 2020 at the Department of Obstetrics and Gynecology, Semmelweis University. Amniocentesis, followed by PCR, was performed in cases of recent infection confirmed by serological testing during pregnancy. After birth, a neonatological, microbiological, pediatric neurological and ophthalmological examination and a follow-up was carried out. Results: During the study period, a total of 238 cases of amniotic fluid Toxoplasma PCR testing due to Toxoplasma recent infection were performed. In terms of pregnancies, there were 219 deliveries and seven abortions. Twelve cases had no data available on the outcome of the pregnancy. In total, 133 cases of ultrasound abnormalities were detected during pregnancy, while in 105 cases, no abnormalities were detected on ultrasound examination. During amniocentesis, eight cases of Toxoplasma infection were revealed in amniotic fluid samples by PCR, and in 230 cases, the result was negative. Neonatal follow-up was performed in 139 cases, with no abnormalities during follow-up in 117 cases, and in 22 cases, there was a detectable complication that was likely to be related to Toxoplasma infection. In all 22 cases, amniotic fluid PCR Toxoplasma testing was negative. Conclusions: The most common ultrasound abnormalities involve the nervous system and the gastrointestinal system. In cases of suspicion, it is recommended to perform amniocentesis Toxoplasma PCR testing besides the indirect methods to help the pregnant woman decide whether to carry the pregnancy to term. During follow-up, a multidisciplinary team experienced in pregnancies complicated by toxoplasmosis must carry out the follow-up, care and subsequent development.
Abstract (1) Purpose: Non-small cell Lung cancer (NSCLC) is one of the leading causes of cancer mortality globally. Hydrogen (H2) gas is a possible anticancer agent. Long non-coding RNAs (lncRNA), including LINC-PINT and lincRNA-P21, involves in regulating the apoptotic proteins’ expression. Therefore, our study aim was to investigate the H2 treatment effect on the LINC-PINT and lincRNA-P21's expression in NSCLC cells; (2) Methods: A549 cells were treated with three H2 gas concentrations at different times. qRT-PCR was used to assess the LINC-PINT and lincRNA-P21’s expressions. One-way analysis of variance (ANOVA) and linear regression were carried out to analyse the differences; (3) Results: The expression of LINC-PINT was significantly correlated with the increasing (0-10%) H2 concentrations, after both 2-hour-30-minute and 3-hour hydrogen treatment (R22H30=0.52, R23H=0.57, both P<0.05). This positive relationship -between expression and H2 concentrations- was also observed for lincRNA-P21 expression after 2-hour-30-minute H2 treatment (R2=0.88, P<0.01). In contrast, the expression of LINC-PINT showed a significant negative correlation with H2 after 3-hour-40-minute (R2=0.81, P<0.01); (4) Conclusions: The expressions of LINC-PINT and lincRNA-P21 were upregulated after H2 gas treatment. Thus, it appears highly probable that the therapeutic effect of hydrogen gas is achieved by upregulating LINC-PINT and lincRNA-P21’s expressions in NSCLC cells.
A molaterhesség a terhességi trophoblastbetegségek közé sorolt, rendkívül ritka kórkép. A kórkép patogenezise egyedülálló, hiszen az anyai daganat eredete maga a terhességi szövet. Előfordulását tekintve főleg a reproduktív korú nőket érinti. Esetbemutatásunkban egy 53 éves nőbeteg postmenopausalis vérzési rendellenességet okozó panaszainak hátterében igazolódott molaterhesség. A molaterhesség fokozott kockázattal járó veszélyállapot, mely esetén a mihamarabbi befejezés alapját a megfelelő diagnosztika adja. Kezdeti tünetei megtévesztőek lehetnek, ectopiás terhességet vagy inkomplett abortuszt, anovulációs vérzési rendellenességet utánozhatnak. Esetismertetésünk célja, hogy felhívja a figyelmet a molaterhesség atipikus megjelenésére; postmenopausalis nőbetegünk kapcsán áttekintjük a molaterhesség kezelésének alapelveit, és bemutatjuk egy sikeresen kezelt eset diagnosztikus és terápiás lépéseit. Orv Hetil. 2023; 164(7): 273–277.
Hydatidiform mole is an extremely rare gestational trophoblastic disease. The pathogenesis is unique in that the maternal tumor arises from pregnancy tissue. In terms of occurrence, it mainly affects women of reproductive age. In our case report, a 53-year-old female patient was diagnosed with molar pregnancy as the background of her perimenopausal bleeding disorder. Mola is a high-risk disease because the symptoms can be deceiving and may be very similar to those of an incomplete miscarriage, ectopic pregnancy or perimenopausal bleeding. Appropriate diagnosis is key to terminating the pregnancy as soon as possible. The purpose of our case report is to draw attention to the atypical appearance of molar pregnancy; in relation to our perimenopausal female patient, we review the basic principles of treatment of hydatidiform mole and present the diagnostic and therapeutic management of a successfully completed case. Orv Hetil. 2023; 164(7): 273-277.
Background Endometriosis is a chronic condition affecting 6–10% of women of reproductive age, with endometriosis-related pain and infertility being the leading symptoms. Currently, the gold standard treatment approach to surgery is conventional laparoscopy (CL); however, the increasing availability of robot-assisted surgery is projected as a competitor of CL. This study aimed to compare the perioperative outcomes of robot-assisted laparoscopy (RAL) and CL in endometriosis surgery. Objectives We aimed to compare the effectiveness and safety of these two procedures. Methods A systematic search was conducted in three medical databases. Studies investigating different perioperative outcomes of endometriosis-related surgeries were included. Results are presented as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI). Results Our search yielded 2,014 records, of which 13 were eligible for data extraction. No significant differences were detected between the CL and RAL groups in terms of intraoperative complications (OR = 1.07, CI 0.43–2.63), postoperative complications (OR = 1.3, CI 0.73–2.32), number of conversions to open surgery (OR = 1.34, CI 0.76–2.37), length of hospital stays (MD = 0.12, CI 0.33–0.57), blood loss (MD = 16.73, CI 4.18–37.63) or number of rehospitalizations (OR = 0.95, CI 0.13–6.75). In terms of operative times (MD = 28.09 min, CI 11.59–44.59) and operating room times (MD = 51.39 min, CI 15.07–87.72;), the RAL technique remained inferior. Conclusion RAL does not have statistically demonstrable advantages over CL in terms of perioperative outcomes for endometriosis-related surgery. Graphical abstract
The evaluation of natural biomass sources is a promising strategy in accelerating the development of novel anti-cancer medications. Our study aimed to evaluate the activity of W. ugandensis ethanolic roots and stems extracts on the expression of five targeted genes (COX-2, CASPS-9, Bcl-xL, Bcl2 and 5-LOX) in colorectal cancer (CRC) cell lines (Caco-2). Plant extracts were obtained using serial exhaustive extraction and dissolved in Dimethyl sulfoxide appropriately for bioassay. Caco-2 cell lines were passaged, treated with plant extracts at varying concentrations and their RNA's isolated for evaluation. Our unique study reports on W. ugandensis as efficient natural inhibitors of CRC growth, by directly linking its phytoconstituents to; downregulation of COX-2, 5-LOX, Bcl-xL, Bcl2 and upregulation of CASPS9 genes dose-dependently. We present W. ugandensis ethanolic roots and stems extracts as promising natural inhibitors for CRC carcinogenesis and recommend in vivo and subsequent clinical trials, with substantial clinical effects postulated. We further suggest studies on identification and characterization of the specific metabolites in W. ugandensis involved in the modulatory mechanisms, resulting to inhibition of CRC growth and possible metastases.
Hypertension and andropause both accelerate age-related vascular deterioration. We aimed to evaluate the effects of angiotensin-II induced hypertension and deficiency of testosterone combined regarding the resistance coronaries found intramurally. Four male groups were formed from the animals: control group (Co, n = 10); the group that underwenr orchidectomy (ORC, n = 13), those that received an infusion of angiotensin-II (AII, n = 10) and a grous that received AII infusion and were also surgically orchidectomized (AII + ORC, n = 8). AII and AII + ORC animals were infused with infusing angiotensin-II (100 ng/min/kg) using osmotic minipumps. Orchidectomy was perfomed in the ORC and the AII + ORC groupsto establish deficiency regarding testosterone. Following four weeks of treatment, pressure-arteriography was performed in vitro, and the tone induced by administration of thromboxane-agonist (U46619) and bradykinin during analysis of the intramural coronaries (well-known to be resistance arterioles) was studied. U46619-induced vasoconstriction poved to be significantly decreased in the ORC and AII + ORC groups when compared with Co and AII animals. In ORC and AII + ORC groups, the bradykinin-induced relaxation was also significantly reduced to a greater extent compared to Co and AII rats. Following orchidectomy, the vasocontraction and vasodilatation capacity of blood vessels is reduced. The effect of testosterone deficiency on constrictor tone and relaxation remains pronounced even in AII hypertension: testosterone deficiency further narrows adaptation range in the double noxa (AII + ORC) group. Our studies suggest that vascular changes caused by high blood pressure and testosterone deficiency together may significantly increase age-related cardiovascular risk.
Background The hypothalamus of the central nervous system is implicated in the development of diabetes due to its glucose-sensing function. Dysregulation of the hypothalamic glucose-sensing neurons leads to abnormal glucose metabolism. It has been described that fractalkine (FKN) is involved in the development of hypothalamic inflammation, which may be one of the underlying causes of a diabetic condition. Moreover, iron may play a role in the pathogenesis of diabetes via the regulation of hepcidin, the iron regulatory hormone synthesis. MicroRNAs (miRNAs) are short non-coding molecules working as key regulators of gene expression, usually by inhibiting translation. Hypothalamic miRNAs are supposed to have a role in the control of energy balance by acting as regulators of hypothalamic glucose metabolism via influencing translation. Methods Using a miRNA array, we analysed the expression of diabetes, inflammation, and iron metabolism related miRNAs in the hypothalamus of a streptozotocin-induced rat type 1 diabetes model. Determination of the effect of miRNAs altered by STZ treatment on the target genes was carried out at protein level. Results We found 18 miRNAs with altered expression levels in the hypothalamus of the STZ-treated animals, which act as the regulators of mRNAs involved in glucose metabolism, pro-inflammatory cytokine synthesis, and iron homeostasis suggesting a link between these processes in diabetes. The alterations in the expression level of these miRNAs could modify hypothalamic glucose sensing, tolerance, uptake, and phosphorylation by affecting the stability of hexokinase-2, insulin receptor, leptin receptor, glucokinase, GLUT4, insulin-like growth factor receptor 1, and phosphoenolpyruvate carboxykinase mRNA molecules. Additional miRNAs were found to be altered resulting in the elevation of FKN protein. The miRNA, mRNA, and protein analyses of the diabetic hypothalamus revealed that the iron import, export, and iron storage were all influenced by miRNAs suggesting the disturbance of hypothalamic iron homeostasis. Conclusion It can be supposed that glucose metabolism, inflammation, and iron homeostasis of the hypothalamus are linked via the altered expression of common miRNAs as well as the increased expression of FKN, which contribute to the imbalance of energy homeostasis, the synthesis of pro-inflammatory cytokines, and the iron accumulation of the hypothalamus. The results raise the possibility that FKN could be a potential target of new therapies targeting both inflammation and iron disturbances in diabetic conditions. Graphical Abstract
Prenatal testing has changed greatly over the past two decades, which may affect the diagnosis of congenital heart disease (CHD) in Down syndrome. The present study aimed to analyze changes in the prevalence and distribution of CHD diagnosed via ultrasonography and fetopathology in 462 fetuses with trisomy 21 between two consecutive 10-year periods (1999-2018), as well as the associations between CHDs, ultrasound markers, and extracardiac malformations. Overall, the frequency of cardiovascular malformations in trisomy 21 was 27.7 and 26.5%, and ultrasound identified 70 and 62% of CHDs during these periods. A profound increase in first-trimester ultrasound findings and associated anomalies with CHDs (ventricular septal defect, Tetralogy of Fallot) since 2009 were observed. Second-trimester nonstructural heart abnormalities were associated with ultrasound anomalies (74%) and major extracardiac malformations (42.9%). During both study periods, mothers carrying fetuses with CHD were significantly younger than those without CHD (p = 0.038, p = 0.009, respectively). Comparing the two 10-year periods, there were no changes in the prevalence and detection of CHDs. Trend analysis revealed that, although the frequency of CHD remained stable, the diagnostic spectrum had shifted between the study periods. Detection of nonstructural heart abnormalities necessitates detailed follow-up for cardiac/extracardiac malformations and chromosomal disorders.
Background/Aim: Manual therapy (MT) is a frequently applied intervention offering individualized treatment in the clinic. In addition to the traditional approaches of MT, measuring molecular response to MT may offer better understanding of MT outcomes in order to provide specific personalized treatment. The aim of this study was to summarize MT-related registered clinical trials, as well as to search for any evidence on MT and genetics. Patients and Methods: A comprehensive search was conducted within the Clinical Trials database with predefined keywords mining for all types of MT-related clinical trials. Results: From the 47 trials, 20 had results and 27 had no results. MT alleviated pain and improved function almost in all trials. One registered clinical trial had investigated molecular outcomes of MT. Conclusion: MT is an effective and individualized treatment offering option in the management of several conditions. Interestingly, a clinical trial was found investigating molecular genetics and MT pinpointing an already existing link between genetics and MT. Therefore, further clinical trials may focus on genetics and MT for providing specific personalized treatment in future.
Background: The pharmacist career is constantly adapting to societal and health care needs. The past decade has seen a growing demand for curricular development to align graduation outcome with workforce competencies. Objective: This study aims to identify expectations for both didactic and experiential components of a new curriculum based on young pharmacist practitioner views. Methods: An online survey questionnaire was used in 2019–2020 to evaluate the pharmacy curriculum to detect indicators or key areas which require comprehensive reform. Results: The predominant majority of the 205 study participants recommended reduction in credit hours for Natural Sciences (78.54%) and a similar increase in the Theoretical and Practical Expertise Module (77.9%). Pharmaceutical care, clinical therapeutics and clinical pharmacy competencies should also be more highlighted in the program. Findings indicate the current training does not prepare for problem-solving and daily workplace challenges (72.7%) or for extended pharmacist skills and competencies (71.71%). Results show inconsistency in practical training experience, as all respondents participated in practical training for drug manufacturing and analysis but 61.0% reported no hands-on skills training in a hospital-clinical simulation setting. Indications for practitioner involvement into the natural sciences and biomedical subjects (86.3%) confirm the obvious need for more practice-oriented education. Conclusions: Educational reforms seem to be inevitable to achieve measurable improvement in professional practice and skills competency. The country specific demand for a needs-based pharmacy education reflects global trends but may also provide useful insights for individual transitions to transform education through practice and improve practice through education.
OBJECTIVE: To investigate the proportion of the various fetal anatomy disorders associated with polyhydramnios or oligohydramnios during prenatal ultrasonography. STUDY DESIGN: In our study we processed the prenatal sonographic and postnatal clinical and fetopathological data of 1,200 fetuses with developmental disorders over a 7-year period. We studied the association of fetal disorders with polyhydramnios or oligohydramnios. RESULTS: The fetal craniospinal malformations were significantly associated with polyhydramnios (28.49%). Although in some of the cardiovascular malformations (atrioventricular septal defect, double outlet right ventrick, tetralogy of Fallot) the association rate with polyhydramnios was high, we found a moderate combined association rate (19.7%). For fetuses with abdominal and abdominal wall malformations, polyhydramnios occurred in 40% of the cases. In two-thirds of the cases of urogenital malformations, quantitative differences of the amniotic fluid occurred: oligohydramnios in 41.23%, while polyhydramnios in 28.25%. We found that, in addition to the urogenital and abdominal malformations, polyhydramnios has a significant association rate with bone and limb developmental malformations (25.32%). CONCLUSION: In cases of polyhydramnios and oligohydramnios, fetal echocardiography and the sonographic examination of the urogenital system, abdominal organs, skull and spine, and limbs should be performed.
The anterior cingulate cortex (ACC), is known to be intimately involved in food-related motivational processes and their behavioral organization, primarily by evaluating hedonic properties of the relevant stimuli. In the present study, the involvement of cingulate cortical interleukin-1β (IL-1β) mediated mechanisms in a) gustation associated facial and somato-motor behavioral patterns of Wistar rats were examined in taste reactivity test (TR). In addition, b) conditioned taste aversion (CTA) paradigm was performed to investigate the role of these cytokine mechanisms in taste sensation associated learning processes, c) the general locomotor activity of the animals was observed in open field test (OPF), and d) the potentially negative reinforcing effect of IL-1β was examined in conditioned place preference test (CPP). During the TR test, species specific behavioral patterns in response to the five basic tastes were analyzed. Response rates of ingestive and aversive patterns of the cytokine treated and the control groups differed significantly in case of the weaker bitter (QHCl, 0.03 mM), and the stronger umami (MSG, 0.5 M) tastes. IL-1β itself did not elicit CTA, it did not interfere with the acquisition of LiCl induced CTA, and it also failed to cause place preference or aversion in the CPP test. In the OPF paradigm, however, significant differences were found between the cytokine treated and the control groups in the rearing and grooming, the number of crossings, and in the distance moved. Our results indicate the involvement of cingulate cortical IL-1β mechanisms in the control of taste perception and other relevant behavioral processes.
Medicinal thermal waters consist of a mixture of different organic and inorganic compounds. Traditionally, these waters are only characterized and classified by their inorganic composition; however, the bioavailability of the majority of these inorganic compounds is limited. Many authors investigate the organic fractions of thermal waters. These authors propose that these compounds have a potential effect on health. To elucidate the underlying mechanisms, it is crucial to know the composition of the organic fractions. The absorption of these compounds on intact skin or mucosa is notable. Some of them have local anaesthetic effect or affect receptors in the central nervous system. In the knowledge of the chemical composition, we are able to estimate the possible pharmacological effect or might be able to assess possible toxicity risks. In the present article, we aim to review possible health effects of two of the identified organic fractions: benzene and alkylbenzenes and phenolic compounds that might correlate with the therapeutic effect on rheumatological or other diseases.