Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals.

Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds

Cystás fibrosisban szenvedő betegek életminőségének felmérése Magyarországon

Bevezetés: A cystás fibrosis progresszív genetikai betegség, amely korlátozhatja a betegek mindennapi életét, befolyásolja életminőségüket. Célkitűzés: A szerzők célul tűzték ki a hazai cystás fibrosisban szenvedő betegek életminőségének felmérését. Módszer: Az életminőség értékelésére betegségspecifikus kérdőív (The Cystic Fibrosis Questionnaire – Revised) magyar nyelvre validált változatát alkalmazták. A betegség súlyossági állapotát Shwachman–Kulczycki-pontszám segítségével határozták meg. Spirometriai vizsgálat is történt. Eredmények: A vizsgálatban 59 beteg (átlagéletkor 14,03±4,8 év) vett részt öt magyarországi centrumból. A 8–13 éves korosztályban a gyermekek és szüleik válaszai között a következő korrelációkat állapították meg: fizikai aktivitás = 0,77 (p<0,001); érzelmi állapot = 0,07 (p<0,001); étkezési zavarok = 0,51 (p<0,001); kezelés terhe = 0,21 (p<0,001); testkép = 0,54 (p<0,001); légúti tünetek = 0,49 (p<0,001); emésztési tünetek = 0,40 (p<0,001). Következtetések: A gyermekkori életminőség felmérése során a gyermekek és szüleik véleménye szorosan megegyezett azokban a dimenziókban, amelyek a fizikális területre vonatkoztak, azonban a pszichoszociális doménekben lényeges különbségek voltak mérhetők. Cystás fibrosisos gyermekek életminőség-vizsgálata során mind a gyermekek, mind a szülők véleményének figyelembevétele ajánlott. Orv. Hetil., 2013, 154, 784–791. | Introduction: Cystic fibrosis is a progressive multisystemic disease which affects the quality of life of patients. Aim: The aim of the study was to evaluate quality of life in Hungarian patients with cystic fibrosis. Methods: Validated Hungarian translation of The Cystic Fibrosis Questionnaire – Revised was used to measure quality of life. Clinical severity was determined on the basis of Shwachman–Kulczycki score. Lung function was measured using spirometry. Results: 59 patients were included from five centres in Hungary. The relationships between 8–13 year-old children self-report and parent proxy report was 0.77 (p<0.001) in physical functioning, 0.07 (p<0.001) in emotional functioning, 0.51 (p<0.001) in eating, 0.21 (p<0.001) in treatment burden, 0.54 (p<0.001) in body image, 0.49 (p<0.001) in respiratory symptoms and 0.40 (p<0.001) in digestive symptoms domains. Conclusions: In contrast to physical domains weak correlations were observed between answers obtained from children and their parents in psychosocial domains. The perception of both patients and their parents should be assessed when measuring quality of life in paediatric patients with cystic fibrosis. Orv. Hetil., 2013, 154, 784–791

Cyclodextrins in Drug Delivery Systems and Their Effects on Biological Barriers

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A bariátriai műtétek egészségpolitikai szerepe a 2-es típusú cukorbetegségben szenvedő elhízott betegek ellátásában // Health policy implications of bariatric surgeries for the management of obese patients with type 2 diabetes

Annak ellenére, hogy a 2-es típusú cukorbetegségben szenvedő elhízott betegek kezelése népegészségügyi prioritás, és a bariátriai műtétek jelentős egészségnyereséget és egészségügyi költségmegtakarítását eredményeznek e betegeknél, ezek a műtétek csak a magán egészségügyi szektorban elérhetőek egy szűk vagyonos réteg számára. Számos akadály gátolja az elhízott cukorbetegeknél végzett bariátriai műtétek széles körű elterjedését, így az egészségpolitikai döntéshozók támogatásának hiánya, a bariátriai műtétek szerepének meghatározatlansága az egészségügyi rendszerben, ebből következően az ilyen műtétek közfinanszírozásának hiánya, közfinanszírozott kapacitások korlátozottsága, valamint a szakmai kompetenciák kidolgozatlansága. A szerzők ezen korlátok áthidalására tesznek konszenzusos javaslatot. // Despite the fact that the treatment of patients with type 2 diabetes and obesity present a public health priority and bariatric surgeries generate remarkable health gain and savings in health care costs in these patients, metabolic surgeries are accessible only in the private health care sector for a selected wealthy population. Several barriers hinder the widespread adoption of bariatric surgeries for diabetic patients living with obesity, including a lack of support from health policy-makers, limited clarity regarding the role of bariatric surgeries in the public health care system and consequently a lack of public funding for these surgeries, limited capacities of providers in the publicly financed health care system, and the limited elaboration of professional competencies. The authors aim to provide a consensus proposal to overcome these barriers

Self-Nanoemulsifying Drug Delivery Systems Containing Plantago lanceolata—An Assessment of Their Antioxidant and Antiinflammatory Effects

The most important components of Plantago lanceolata L. leaves are catalpol, aucubin, and acteoside (=verbascoside). These bioactive compounds possess different pharmacological effects: anti-inflammatory, antioxidant, antineoplastic, and hepatoprotective. The aim of this study was to protect Plantago lanceolata extract from hydrolysis and to improve its antioxidant effect using self-nano-emulsifying drug delivery systems (SNEDDS). Eight SNEDDS compositions were prepared, and their physical properties, in vitro cytotoxicity, and in vivo AST/ALT values were investigated. MTT cell viability assay was performed on Caco-2 cells. The well-diluted samples (200 to 1000-fold dilutions) proved to be non-cytotoxic. The acute administration of PL-SNEDDS compositions resulted in minor changes in hepatic markers (AST, ALT), except for compositions 4 and 8 due to their high Transcutol contents (80%). The non-toxic compositions showed a significant increase in free radical scavenger activity measured by the DPPH test compared to the blank SNEDDS. An indirect dissolution test was performed, based on the result of the DPPH antioxidant assay; the dissolution profiles of Plantago lancolata extract were statistically different from each SNEDDS. The anti-inflammatory effect of PL-SNEDDS compositions was confirmed by the ear inflammation test. For the complete examination period, all compositions decreased ear edema as compared to the positive (untreated) control. It can be concluded that PL-SNEDDS compositions could be used to deliver active natural compounds in a stable, efficient, and safe manner