The role of professional associations in the system of continuing professional development of pediatricians and family doctors

Стаття присвячена ролі Одеської асоціації лікарів педіатрів та неонатологів у системі безперервного професійного розвитку лікарів-педіатрів і сімейних лікарів. Освітлено історію створення Одеської асоціації лікарів педіатрів та неонатологів. Наведено систему безперервного професійного розвитку в Україні. Показано участь асоціації у післядипломній освіті лікарів-педіатрів і сімейних лікарів як Одеського регіону, так і всієї країни.The article is devoted to the role of the Odesa Association of Pediatricians and Neonatologists in the system of continuous professional development of pediatricians and family doctors. The history of the creation of the Odesa Association of Pediatricians and Neonatologists since 1849 and its current achievements are highlighted. The analysis of the formation of the system of continuous professional education in European countries is carried out. The system of continuous professional development of doctors in Ukraine is presented. Examples of formal training in the form of thematic improvement cycles, informal training in the form of seminars, trainings, including using simulation equipment, participation in scientific and practical conferences are shown. Methods and models of continuous professional development in the world and in Ukraine are described. Emphasis is placed on changing the methodology of postgraduate education aimed at mastering skills, mastering competencies in real professional activity instead of obtaining only theoretical knowledge. The role and responsibilities of providers in the continuous professional development of doctors are demonstrated. The active participation of the Odesa Association of Pediatricians and Neonatologists in the postgraduate professional development of pediatricians and family doctors, both in the Odesa region and throughout the country is shown. An opinion was expressed about the involvement of professional associations as providers in the system of continuous professional development of doctors in Ukraine

Cancer stem cells (CSCs) : metabolic strategies for their identification and eradication

Phenotypic and functional heterogeneity is one of the most relevant features of cancer cells within different tumor types and is responsible for treatment failure. Cancer stem cells (CSCs) are a population of cells with stem cell-like properties that are considered to be the root cause of tumor heterogeneity, because of their ability to generate the full rep- ertoire of cancer cell types. Moreover, CSCs have been invoked as the main drivers of metastatic dissemination and therapeutic resistance. As such, targeting CSCs may be a useful strategy to improve the effectiveness of classical anticancer therapies. Recently, metabolism has been considered as a relevant player in CSC biology, and indeed, onco- genic alterations trigger the metabolite-driven dissemination of CSCs. More interestingly, the action of metabolic pathways in CSC maintenance might not be merely a conse- quence of genomic alterations. Indeed, certain metabotypic phenotypes may play a causative role in maintaining the stem traits, acting as an orchestrator of stemness. Here, we review the current studies on the metabolic features of CSCs, focusing on the bio- chemical energy pathways involved in CSC maintenance and propagation. We provide a detailed overview of the plastic metabolic behavior of CSCs in response to microenvironment changes, genetic aberrations, and pharmacological stressors. In addition, we describe the potential of comprehensive metabolic approaches to identify and selectively eradicate CSCs, together with the possibility to ‘force’ CSCs within certain metabolic dependences, in order to effectively target such metabolic biochemical inflexibilities. Finally, we focus on targeting mitochondria to halt CSC dissemination and effectively eradicate cancer

Contemporary principles of treatment ofchronicpainsyndromeinpatientswithbreastcancer

Contemporary principles of treatment ofchronicpainsyndromeinpatientswithbreastcance

The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

Abstract Background This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term. Results A retrospective case–control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp. Conclusion We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes