A comparative study of mental health of medical students in two countries

Results from many studies indicate that throughout medical education students experience high levels of stress and depression. The aim of the current study was to assess and compare Bulgarian and Turkish medical students' levels of stress and depression. A cross-sectional study was conducted with 546 students (276 foreign students from Medical University – Sofia and 270 medical students from several medical universities in Ankara). The study instrument included basic socio-demographic questions, Medical Student Stressor Questionnaire (MSSQ-40 items) and Beck Depression Inventory (BDI). Turkish medical students showed higher levels of stress and depression than foreign students from Bulgaria. We found that all types of stressors in medical students had a relationship with depression. Results of our study imply that medical students need access to psychological support throughout their education

Efficient Synthesis of Fluorescent Coumarins and Phosphorous-Containing Coumarin-Type Heterocycles via Palladium Catalyzed Cross-Coupling Reactions

Quantum-chemical calculations on the spectral properties of some aryl substituted 3- phosphonocoumarins were performed, and the effect of the substituents in the aryl moiety was evaluated. The structures possessing promising fluorescent properties were successfully synthesized via Suzuki and Sonogashira cross-coupling. The synthetic protocol was also applied for the phosphorous chemoisomer of 3-phosphonocoumarin, 1,2-benzoxaphosphorin, and their carboxylate analogues. The optical properties of the arylated and alkynylated products were experimentally determined. The obtained quantum-chemical and experimental results give the possibility for a fine tuning of the optical properties of phosphorous-containing coumarin systems by altering the substituent at its C-6 position

Comparative analysis of main clinical features in melanoma patients with and without sentinel lymph node biopsy

Introduction. Sentinel lymph node biopsy is fundamental in the treatment and prognosis of cutaneous malignant melanoma. This study aims to identify differences in baseline clinical characteristics and survival of patients with melanoma with and without a sentinel lymph node biopsy (SLNB) performed.  Material and methods. In 2018, a retrospective study of 151 patients with malignant melanoma (MM) was conducted. The patients were hospitalized at the Second Clinic of University Hospital — Pleven, from 2012 to 2017. The patients were divided into two groups: Group A included 58 (38.4%) patients with SLNB performed; Group B included 93 (61.6%) patients who did not undergo SLNB. A double-detection method was used while performing SLNB.  Results. The incidence of achromatic malignant melanoma is significantly higher in patients without SLNB (12 or 12.9%) than in patients with SLNB (2 or 3.4%) — c2 = 3.796, df = 1, p = 0.051. Of all 151 patients in the study, 46 died, representing 30.5% of patients with melanoma. The mortality rate was higher in the patients without SLNB (32.3% vs. 27.6% in Group A). However, the differences in the two groups are not statistically significant.  Conclusions. Patients with achromatic melanoma have significantly fewer sentinel lymph node (SLN) biopsies performed because of a late diagnosis. Most of our patients are diagnosed at a later stage when lymphatic metastases are already present, which leads to a significant increase in lymph node dissections performed. There is no significant difference in mortality and survival in the SLNB and non-SLNB groups

Pharmacokinetic characteristics and anticancer effects of 5-Fluorouracil loaded nanoparticles

<p>Abstract</p> <p>Background</p> <p>It is expected that prolonged circulation of anticancer drugs will increase their anticancer activity while decreasing their toxic side effects. The purpose of this study was to prepare 5-fluorouracil (5-FU) loaded block copolymers, with poly(γ-benzyl-L-glutamate) (PBLG) as the hydrophobic block and poly(ethylene glycol) (PEG) as the hydrophilic block, and then examine the 5-FU release characteristics, pharmacokinetics, and anticancer effects of this novel compound.</p> <p>Methods</p> <p>5-FU loaded PEG-PBLG (5-FU/PEG-PBLG) nanoparticles were prepared by dialysis and then scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used to observe the shape and size of the nanoparticles, and ultraviolet spectrophotometry was used to evaluate the 5-FU in vitro release characteristics. The pharmacokinetic parameters of 5-FU/PEG-PBLG nanoparticles in rabbit plasma were determined by measuring the 5-FUby high-performance liquid chromatography (HPLC). To study in vivo effects, LoVo cells (human colon cancer cell line) or Tca8113 cells (human oral squamous cell carcinoma cell line) were implanted in BALB/c nude mice that were subsequently treated with 5-FU or 5-FU/PEG-PBLG nanospheres.</p> <p>Results</p> <p>5-FU/PEG-PBLG nanoparticles had a core-shell spherical structure with a diameter of 200 nm and a shell thickness of 30 nm. The drug loading capacity was 27.1% and the drug encapsulation was 61.5%. Compared with 5-FU, 5-FU/PEG-PBLG nanoparticles had a longer elimination half-life (t_1/2, 33.3 h vs. 5 min), lower peak concentration (C, 4563.5 μg/L vs. 17047.3 μg/L), and greater distribution volume (V_D, 0.114 L vs. 0.069 L). Compared with a blank control, LoVo cell xenografts and Tca8113 cell xenografts treated with 5-FU or 5-FU/PEG-PBLG nanoparticles grew slower and had prolonged tumor doubling times. 5-FU/PEG-PBLG nanoparticles showed greater inhibition of tumor growth than 5-FU (p < 0.01). In the PEG-PBLG nanoparticle control group, there was no tumor inhibition (p > 0.05).</p> <p>Conclusion</p> <p>In our model system, 5-FU/PEG-PBLG nanoparticles changed the pharmacokinetic behavior of 5-FU, thus increasing its anticancer activity. 5-Fluorouracil loaded nanoparticles have potential as a novel anticancer drug that may have useful clinical applications.</p

The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas

<p>Abstract</p> <p>Background</p> <p>Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions.</p> <p>Case presentation</p> <p>A female patient presented with 16 breast lesions (eight within each breast), documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome^®excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions.</p> <p>Conclusion</p> <p>This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.</p

From regime-building to implementation: Harnessing the UN climate conferences to drive climate action

The gap between the internationally agreed climate objectives and tangible emissions reductions looms large. We explore how the supreme decision-making body of the United Nations Framework Convention on Climate Change (UNFCCC), the Conference of the Parties (COP), could develop to promote more effective climate policy. We argue that promoting implementation of climate action could benefit from focusing more on individual sectoral systems, particularly for mitigation. We consider five key governance functions of international institutions to discuss how the COP and the sessions it convenes could advance implementation of the Paris Agreement: guidance and signal, rules and standards, transparency and accountability, means of implementation, and knowledge and learning. In addition, we consider the role of the COP and its sessions as mega-events of global climate policy. We identify opportunities for promoting sectoral climate action across all five governance functions and for both the COP as a formal body and the COP sessions as conducive events. Harnessing these opportunities would require stronger involvement of national ministries in addition to the ministries of foreign affairs and environment that traditionally run the COP process, as well as stronger involvement of non-Party stakeholders within formal COP processes. This article is categorized under: Policy and Governance > International Policy Framework