Brain-derived neurotrophic factor levels under chronic natalizumab treatment in multiple sclerosis. A preliminary report

Aim of the study Our main purpose was to investigate if the chronic treatment with the disease-modifying drug natalizumab shows quantifiable effect on BDNF levels in multiple sclerosis patients. Materials and Methods BDNF plasma concentration was evaluated using enzyme-linked immunosorbent assay in healthy individuals, not treated multiple sclerosis patients and patients treated with natalizumab. Results Multiple sclerosis patients have a significantly lower amount of peripheral BDNF than healthy individuals. Patients treated with natalizumab have significantly higher BDNF levels than not treated patients. Conclusions Chronic natalizumab treatment is associated with significantly increased plasma BDNF concentration in multiple sclerosis

Neuroprotection and Recovery in Multiple Sclerosis

Multiple sclerosis is a complex and heterogeneous immune-mediated disease that results in the progressive accumulation of mental and physical symptoms. Currently approved disease-modifying drugs (DMDs) are immunomodulatory or immunosuppressive, but these drugs have little effect on disease progression. In addition to studies that have directly targeted inflammation and immune responses, a large number of studies, most of them experimental, have investigated neuroprotective therapies and remyelination strategies. However, to date, attempts to provide neuroprotection have failed not just in multiple sclerosis but in neurological disorders in general; this situation has emphasized the need to revise the old paradigm of a “magic bullet” with a single mechanism of action. Remyelination strategies involve either promoting endogenous remyelination or replacing lost myelinating cells through exogenous sources. However, several puzzle pieces regarding the physiology of remyelination remain unknown, including feasible treatment monitoring methods, the selection of patients, and the optimal time of treatment initiation. This chapter will describe the direct and indirect neuroprotective effects of DMDs, as suggested by basic research studies and confirmed by clinical studies in some cases. Current knowledge of potential neuroprotective therapies and remyelination strategies is also reviewed

Sclerosis multiplex stroke jellegű tünetekkel: kihívó diagnózis egy eset kapcsán

Absztrakt A stroke jellegű relapsus sclerosis multiplex esetén kihívást jelentő diagnózis, amelynek megállapítására gyors és hatékony döntés szükséges a megfelelő terápia kiválasztása érdekében. A szerzők az eset bemutatása kapcsán a differenciáldiagnosztikai nehézségekre összpontosítanak. A megtévesztő jelek ellenére a lépésenkénti specifikus vizsgálatokra felépített megközelítés felfedte a legvalószínűbb diagnózist és ezáltal az optimális klinikai ellátást. Orv. Hetil., 2015, 156(37), 1514–1518

Untargeted LC-QTOF (ESI +) MS Analysis of Small Serum Metabolites Related to Prostate Cancer and Prostate Specific Antigen

Prostate cancer has an increasing incidence and there is an urgent need for development of new serum biomarkers for early diagnostic as the ones known are ineffective. The aim of the study was to use untargeted metabolomics in order to identify and characterize small metabolite fingerprints in patients with normal vs pathologic values of PSA ( previously determined by electrochemiluminiscence). A cohort of one hundred patients with different Prostate Specific amtigen values were investigated by untargeted metabolomics. The serum small metabolite profile determined by high performance liquid chromatography coupled with mass spectrometry, LC-QTOF(ESI+)MS in order to identify specific biomarkers, for normal patient group (PSA = 0-4 ng.ml) and four pathologic groups, having PSA values from 4 to >1000 ng/ml. The major molecules identified in the samples were polar phospholipids, maily lysophosphatidyl choline derivatives, having m/z values from 496 to 524, like LPC(O-16:0/O-1:0), LPC(18:1/2:0) or PS(18:1(9Z)/0:0), LPC(18:2(9Z,12Z)/0:0 and their isomers and  LPC(O-18:1(11Z)/2:0), respectively. Also, small molecules (free fatty acids and prostaglandin derivatives) were identified and are significantly different in pathologic vs normal serum samples. Generally the pathologic samples had increased concentrations of all above mentioned molecules. The Principal Component analysis showed , by plot and loadings scores, significant clustering of normal vs pathological groups

Factors influencing alcohol and illicit drug use amongst first year medical students

The aims of this study were a) to investigate patterns of alcohol, smoking and illicit drug use and b) evaluate the relationship between substance abuse and personality factors in a cohort of 267 first year medical students. 12.3 % (men) and 11.8% (female) medical students reported to be drinking above the “low risk” level of alcohol. Illicit drug use was present amongst the students surveyed, with 12.4% having experimented with cannabis at some stage during their life. A significant proportion of the students (44.1%) suffered from anxiety. There are personality characteristics like extraversion and openness that influence the drug taking and drinking habits of students, suggesting that such individuals may still pursue these habits although they know these are not healthy habits. Considering these, it may be prudent to consider the promotion of harm reduction and safer use of drugs and alcohol in medical student

Shifting Horizons:The Impact of Global Events on the Intention to Migrate of the Next Generation Romanian Nurses

Background: This article investigates the determinants of the intention to migrate of nursing students at a major medical university in Romania and relates them to major international developments, specifically the Brexit referendum and the COVID-19 pandemic. Methods: An online survey about the intention to migrate was made available to nursing students at the University of Medicine and Pharmacy “Iuliu Hațieganu”, Cluj-Napoca, Romania, in 2016 (before Brexit) and again in 2016 (after Brexit), 2017, 2018, and 2021 and 2022 (during the pandemic). A total of 549 students responded (response rate: 84.6%). Results: Before the Brexit referendum, 62.6% of the respondents had a plan to seek employment abroad, whereas after the Brexit referendum, only 34.7% indicated that they had such a plan after graduation. Before the pandemic, 43.6% of the students expressed an intention to work abroad, while during the pandemic, only 19.8% had such plans. Conclusions: This study documented the effect of significant international developments—such as the Brexit referendum and the COVID-19 pandemic—on decreasing the intention to migrate. As expected, the change in preference for the UK as a destination country changed dramatically. Additionally, the study provides both theoretical and empirical insights into the types of and the consistency of preparation for migration of nursing students

Pharmacological Benefits of Herbal Formulations in the Management of <i>Psoriasis vulgaris<i>

Psoriasis is a chronic inflammatory skin disease, with an important impact on the patient's quality of life. Its incidence and prevalence are continuously increasing. The complex ethiopathology of this disorder is only partially known; there is a clear genetic predisposition, which associates a number of environmental triggering factors such as an unbalanced diet and lifestyle. The conventional therapeutic options are not always satisfactory in terms of efficiency and safety, therefore, complementary and alternative medicine approaches are frequently chosen by patients, mostly as self-medication. This review, based on recent literature flow data, outlines the pharmacological benefits of herbal formulations with antipsoriatic activity. It also reveals the molecules esponsible for their effects, as well as their interference with the metabolic and immunopathogenic mechanisms of this disease. An important number of plants have been proved to act as antipsoriatic agents, many botanical-based preparations containing key-phytochemical molecules (belonging mainly to phenolics, triterpenoids and phytosterols or unsaturated fatty acids, as mentioned in specific phyto-pharmaceutical databases). Specific mechanisms of action, which can explain their activity (such as lipoxygenase inhibition, antioxidant, anti-inflammatory, anti prostaglandin), were recently described. Only some of these formulations have been actively tested in vitro or in vivo . Most publications in the field agree on the need for more in vitro and in vivo studies, especially clinical assessment on patients with Psoriasis vulgaris . These would provide more accurate data on the efficacy and safety of such herbal formulations for this disease

Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular, Metabolic, Hepatic, and Renal Disorders

Berberine-containing plants have been traditionally used in different parts of the world for the treatment of inflammatory disorders, skin diseases, wound healing, reducing fevers, affections of eyes, treatment of tumors, digestive and respiratory diseases, and microbial pathologies. The physico-chemical properties of berberine contribute to the high diversity of extraction and detection methods. Considering its particularities this review describes various methods mentioned in the literature so far with reference to the most important factors influencing berberine extraction. Further, the common separation and detection methods like thin layer chromatography, high performance liquid chromatography, and mass spectrometry are discussed in order to give a complex overview of the existing methods. Additionally, many clinical and experimental studies suggest that berberine has several pharmacological properties, such as immunomodulatory, antioxidative, cardioprotective, hepatoprotective, and renoprotective effects. This review summarizes the main information about botanical occurrence, traditional uses, extraction methods, and pharmacological effects of berberine and berberine-containing plants

Ethical aspects of smoking cessation among the population from Transylvania

Ethical aspects related to the approach of persons addicted to tobacco use are a particular concern of pneumologists. Considered for a long time ”an expression of the modern way of life”, smoking is viewed today as a pandemic disease, being at the same time an epidemic that can be completely prevented. We present the ethical aspects of the approach of persons addicted to tobacco use, the peculiarities of the medical approach in smoking cessation and implicitly, of the doctor-patient relationship and how to make patients responsible for their own health within this relationship. The final aim of the medical intervention was to restore patient’s autonomy in making decisions regarding smoking cessation, along with a change in lifestyle. In changing the patients’ attitude, the principles of autonomy and non-maleficence represented a strong motivation, the patients benefiting from the presence and implementation of a National Smoking Cessation Progra

Both baseline clinical factors and genetic polymorphisms influence the development of severe functional status in ankylosing spondylitis

Functional severity in ankylosing spondylitis (AS) patients is variable and difficult to predict early. The aim of our study was to assess whether a combination of baseline clinical factors and genetic markers may predict the development of severe functional status in AS. We performed a cross-sectional association study on AS patients included in the Spanish National Registry of Spondyloarthropathies-REGISPONSER. Bath Ankylosing Spondylitis Functional Index (BASFI) was standardized by adjusting for disease duration since the first symptoms (BASFI/t). We considered as severe functional status the values of BASFI/t in the top of the 60th (p60), 65th (p65), 70th (p70), and 75th (p75) percentile. We selected 384 single nucleotide polymorphisms (SNPs) distributed in 190 genes to be analyzed. The study cohort included 456 patients with mean age 50.8(±10.5) years and with mean disease duration since first symptoms 24.7 (±10.1) years. Older age at disease onset and neck pain at baseline showed statistical significant association with severe BASFI/t. Polymorphisms associated in the allele frequencies test with severe BASFI/t in all classifications were: rs2542151 (p60 [P =.04], p65 [P =.04], p70 [P =.001] and p75 [P =.001]) and rs2254441 (p60 [P =.004], p65 [P =.02], p70 [P =.01] and p75 [P<.001]). Genotype association, after adjustment for covariates, found an association in three of the four patients' classifications for rs2542151 and in two of the classifications for rs2254441.Forward logistic regression did not identify any model with a good predictive power for severe functional development. In our study we identified clinical factors and 24 polymorphisms associated with development of severe functional status in AS patients. Validation of these results in other cohorts is requiredThis work was supported by the Ministerio de Ciencia e Innovación of Spain [Proyect PSE-01000-2006-1] and by Progenika Biopharma S.