Bőrápolási gyakorlat a Neonatális Intenzív Centrumokban Magyarországon

Bevezetés: A kora- és újszülöttek bőrének fiziológiája és tudományos alapokon nyugvó ápolási gyakorlata kevéssé ismert terület a betegellátók számára. Célkitűzés: A vizsgálat fő célkitűzése a III-as progresszivitásszintű Neonatális Intenzív Centrumok bőrápolási gyakorlatának felmérése volt Magyarországon. Módszer: A 22 Neonatális Intenzív Centrum számára elektronikus úton elküldött, standardizált kérdőív az újszülöttek bőrállapotának ellenőrzésére, a fürdetésre, az emolliens kezelésre, a köldökápolásra, a glutealis-genitális régió ápolására, az adhezív kötszerek alkalmazására és a bőrfertőtlenítés gyakorlatára vonatkozó kérdéseket tartalmazott. Eredmények: Az intézmények bőrápolási gyakorlata számos aspektusban megegyezett, azonban jelentős különbségeket találtak a bőrápoláshoz, bőrfertőtlenítéshez használt készítmények tekintetében. Következtetések: A felmérés eredménye elősegíti az újszülöttek bőrápolására vonatkozó hazai ajánlások és az egyes intézmények bőrápolási protokolljainak megalkotását bőrgyógyászok, neonatológusok és gyógyszerészek részvételével. Orv. Hetil., 2014, 155(28), 1102–1107. | Introduction: Skin physiology of neonates and preterm infants and evidence-based skin care are not well explored for health care providers. Aim: The aim of our present study was to investigate the skin care methods of the tertiary Neonatal Intensive Care Units in Hungary. Method: A standardized questionnaire was distributed among the 22 tertiary Neonatal Intensive Care Units with questions regarding skin care methods, bathing, emollition, skin disinfection, umbilical cord care, treatment of diaper dermatitis, and use of adhesive tapes. Results: The skin care methods of the centres were similar in several aspects, but there were significant differences between the applied skin care and disinfectant products. Conclusions: The results of this survey facilitate the establishment of a standardized skin care protocol for tertiary Neonatal Intensive Care Units with the cooperation of dermatologists, neonatologists and pharmacists. Orv. Hetil., 2014, 155(28), 1102–1107

The spectraplakin short stop is an essential microtubule regulator involved in epithelial closure in Drosophila

Dorsal closure of the Drosophila embryonic epithelium provides an excellent model system for the in vivo analysis of molecular mechanisms regulating cytoskeletal rearrangements. We investigated the function of the Drosophila spectraplakin Short stop (Shot), a conserved cytoskeletal structural protein, during closure of the dorsal embryonic epithelium.In this study, we show that Shot is essential for the efficient final zippering of the opposing epithelial margins. Using isoform-specific mutant alleles and genetic rescue experiments with truncated Shot variants, we demonstrate that Shot functions as an actin-microtubule cross-linker in mediating zippering. At the leading edge of epithelial cells, Shot regulates protrusion dynamics by promoting filopodia formation. FRAP analysis and in vivo imaging of microtubule growth revealed that Shot stabilizes dynamic microtubules. The actin- and microtubule- binding activities of Shot are simultaneously required in the same molecule indicating that Shot is engaged as a physical crosslinker in this process.We propose that Shot-mediated interactions between microtubules and actin filaments facilitate filopodia formation which promotes zippering by initiating contacting of opposing epithelial cells

Emerging Biomarkers of Multiple Sclerosis in the Bloodand the CSF : A Focus on Neurofilamentsand Therapeutic Considerations

Multiple Sclerosis (MS) is the most common immune-mediated chronic neurodegenerative disease of the central nervous system (CNS) affecting young people. This is due to the permanent disability, cognitive impairment, and the enormous detrimental impact MS can exert on a patient's health-related quality of life. It is of great importance to recognise it in time and commence adequate treatment at an early stage. The currently used disease-modifying therapies (DMT) aim to reduce disease activity and thus halt disability development, which in current clinical practice are monitored by clinical and imaging parameters but not by biomarkers found in blood and/or the cerebrospinal fluid (CSF). Both clinical and radiological measures routinely used to monitor disease activity lack information on the fundamental pathophysiological features and mechanisms of MS. Furthermore, they lag behind the disease process itself. By the time a clinical relapse becomes evident or a new lesion appears on the MRI scan, potentially irreversible damage has already occurred in the CNS. In recent years, several biomarkers that previously have been linked to other neurological and immunological diseases have received increased attention in MS. Additionally, other novel, potential biomarkers with prognostic and diagnostic properties have been detected in the CSF and blood of MS patients.In this review, we summarise the most up-to-date knowledge and research conducted on the already known and most promising new biomarker candidates found in the CSF and blood of MS patients.the current diagnostic criteria of MS relies on three pillars: MRI imaging, clinical events, and the presence of oligoclonal bands in the CSF (which was reinstated into the diagnostic criteria by the most recent revision). Even though the most recent McDonald criteria made the diagnosis of MS faster than the prior iteration, it is still not an infallible diagnostic toolset, especially at the very early stage of the clinically isolated syndrome. Together with the gold standard MRI and clinical measures, ancillary blood and CSF biomarkers may not just improve diagnostic accuracy and speed but very well may become agents to monitor therapeutic efficacy and make even more personalised treatment in MS a reality in the near future. The major disadvantage of these biomarkers in the past has been the need to obtain CSF to measure them. However, the recent advances in extremely sensitive immunoassays made their measurement possible from peripheral blood even when present only in minuscule concentrations. This should mark the beginning of a new biomarker research and utilisation era in MS

Nanonewton scale adhesion force measurements on biotinylated microbeads with a robotic micropipette

Binding force between biomolecules has a crucial role in most biological processes. Receptor-ligand interactions transmit physical forces and signals simultaneously. Previously, we employed a robotic micropipette both in live cell and microbead adhesion studies to explore the adhesion force of biomolecules such as cell surface receptors including specific integrins on immune cells. Here we apply standard computational fluid dynamics simulations to reveal the detailed physical background of the flow generated by the micropipette when probing microbead adhesion on functionalized surfaces. Measuring the aspiration pressure needed to pick up the biotinylated 10 μm beads on avidin coated surfaces and converting it to a hydrodynamic lifting force on the basis of simulations, we found an unbinding force of 12 ± 2 nN, when targeting the beads manually; robotic targeting resulted in 9 ± 4 nN (mean ± SD). We measured and simulated the effect of the targeting offset, when the microbead was out of the axis (off-axis)of the micropipette. According to the simulations, the higher offset resulted in a higher lifting force acting on the bead. Considering this effect, we could readily correct the impact of the targeting offset to renormalize the experimental data. Horizontal force and torque also appeared in simulations in case of a targeting offset. Surprisingly, simulations show that the lifting force acting on the bead reaches a maximum at a flow rate of ~ 5 μl/s if the targeting offset is not very high (<5 μm). Further increasing the flow rate decreases the lifting force. We attribute this effect to the spherical geometry of the bead. We predict that higher flow rates cannot increase the hydrodynamic lifting force acting on the precisely targeted microbead, setting a fundamental force limit (16 nN in our setup) for manipulating microbeads with a micropipette perpendicular to the supporting surface. In order to extend the force range, we propose the offset targeting of microbeads

Rosszindulatúan elfajult nyaki branchiogen cysts

A nyaki branchiogen cysta az egyik leggyakoribb nyaki fejlődési rendellenesség. Ismert a malignus elfajulása, melynek diagnosztizálására, az ismeretlen lokalizációjú primer laphámcarcinoma nyaki áttététől való elkülönítésére szigorú kritériumrendszerek léteznek. Ugyanakkor a szakirodalomban a diagnózis létjogosultsága a mai napig vita tárgyát képezi. Közleményünkben egy 69 éves nőbeteg esetét ismertetjük, aki bal oldali, állkapocs alatti duzzanat miatt jelentkezett Klinikánkon. Hosszas kivizsgálást követően felmerült ismeretlen primer tumor nyaki áttétének gyanúja, mely miatt pánendoszkópiát és módosított radikális nyaki dissectiót végeztünk. Végül a szövettani feldolgozást köve- tően lateralis nyaki cysta talaján kialakult laphámcarcinoma igazolódott. A műtétet követően a beteg adjuváns kemo- terápiában és sugárkezelésben részesült. Az eset kapcsán ismertetjük a diagnózis felállításának nehézségeit, differenciáldiagnosztikai problémáit és a kapcsolódó nemzetközi irodalmat

The 7-year follow-up of the Hungarian BICAMS validation cohort implies that cognitive performance may improve in multiple sclerosis patients.

Cognitive impairment (CI) is a frequent symptom of multiple sclerosis (MS) and has a great impact on the patients' quality of life, so screening is essential. The brief international cognitive assessment for multiple sclerosis (BICAMS) was developed for this purpose. However, longitudinal data is lacking with the use of the battery.This study is to assess the performance of patients after 5 and 7 years of the original BICAMS validation study and to identify any influencing factors.BICAMS was used to measure cognitive function of 52 relapsing-remitting MS patients (RRMS) from the original validation study after 5 years (n = 43) and again, after 7 years (n = 42). Patients filled out the fatigue impact scale (FIS) and multiple sclerosis quality of life-54 (MSQoL-54) questionnaire, and we evaluated expanded disability status scale (EDSS).There was an improvement in the BVMT-R and the CVLT-II assessments at both the 5-year (p<0.001 and p=0.025) and the 7-year retest (p<0.001 and p=0.002). The prevalence of CI significantly decreased at the 5-year mark (p=0.021) but remained stable after that. There was no deterioration in MSQoL scores during the study. The basic cognitive performance is the most important influencing factor, but the duration of the disease, the EDSS score, and the escalation of the therapy also affect the cognitive scores.This is the longest longitudinal study utilizing the BICAMS battery, reinforcing its feasibility as a clinical screening tool. It seems that cognitive performance may improve in the long term and early initiation of effective therapy may influence this outcome

Label-free Microfluidic Sensing by Detection of Interaction-triggered Change in Blood Flow Characteristics

Abstract Microfluidic devices exploit combined physical, chemical and biological phenomena that could be unique in the sub-millimeter dimensions. The blood is a non-Newtonian fluid, containing particulate and soluble elements, which penetrates the whole body carrying a wealth of biomedical information. The design of microfluidic devices capable of extracting immediately this information is the current goal of development Point-of-Care (POC) medical devices. We examined the characteristics of blood flow in specially designed microfluidic devices having different geometric structure and material composition with the aim of defining suitable conditions for sensitive detection of changes in the interactions between particulate elements of the blood and the adequately modified surfaces of the microfluidic system. As a model experiment we demonstrated the fast analysis of the AB0 blood group system, applying respective antibody reagents and capillary blood samples with different blood groups. We showed that by tuning the hydrophilicity of the surface and capillary dimensions of the microfluidic system it is possible to detect precisely the red blood cell binding to the capillary walls by monitoring the flow rate characteristics in an autonomous microfluidic system. Our proof-of-concept results point to a novel direction in blood analysis in autonomous microfluidic systems and also provide the basis for the construction of a simple quantitative device for blood group determination