The adoption of simulation-based medical teaching and learning is one of the key phases in curriculum development. Instead of learning through apprenticeship, medical simulation enables the development of clinical skills through purposeful practice. Role-playing games and patient simulations are examples of human simulations. Manikins and computer-based simulations are examples of non-human simulations. At the undergraduate and graduate levels, medical simulation has been shown to improve clinical competence. Additionally, it has been discovered to have several benefits that can raise patient safety and lower medical expenses
Observed the mastery of practical skills, as competencies for compiling OSСE (Objective structured clinical examination), by 6th year students and interns of various specialties in Odessa national medical university (Ukraine). Practical skills were performed on realistic simulation mannequins. The difference in outcomes was based on different learning conditions during the period of changing quarantine restrictions due to the COVID-19 pandemic in The Whole World. The results of observations were evaluated by the following parameters: time spent performing practical skills (in seconds) and the score (in marks) obtained by checklist. The final results testified a crucial part of the offline mode in mastering practical skills as competencies for compiling an Objective structured clinical examination, and the possibility of organizing theoretical learning processes in the online-form with obtaining certain positive results.
The aim of the study is to determine the level of HIF-1α, TNF-α, and NF-kB in the hippocampus of kindled rats treated with rapamycin and axitinib.
Materials and methods. Kindling was produced in 29 rats by administration of three-week pentylenetetrazole (PTZ, 35.0 mg/kg, i.p.). Treatment with rapamycin (0.5 mg/kg, i.p.) and axitinib (2.5 mg/kg, i.p.) was performed for ten days in fully kindled rats. The avidin-biotin-peroxidase method was used for hippocampal slice staining. For negative control, staining was performed using only secondary antibodies.
Results. The HIF-1α expression increased in kindled rats raised by 1.77 times compared to the control (p<0.001). Axitinib treatment resulted in of HIF-1α level of 16.7 % (p<0.05) compared with kindled animals, while combined treatment with rapamycin and axitinib reduced HIF-1α by 33.8 % (p<0.01). In kindled rats, TNF-α expression was 3.74 times greater than in control (p<0.001). Rapamycin treatment reduced TNF-α by 31.0 % (p<0.01). Axitinib treatment caused a reduction of TNF-α by 21.1 % (p<0.05). Combined treatment with rapamycin and axitinib reduced TNF-α by 48.0 % (p<0.001) but still exceeded the TNF-α in control by 1.95 times (p<0.01). NF-kB level in kindled rats exceeded the control by three times (p<0.001). Rapamycin caused a reduction of 19.3 % (p>0.05), while axitinib – by 26.5 % (p<0.05) compared with kindled rats. Combined treatment with rapamycin and axitinib resulted in NF-kB reduction by 56.7 % compared with kindled rats (p<0.001).
Conclusions. PTZ-kindling resulted in an increase in the immunoreactivity of HIF-1α, TNF-α, and NF-kB in the hippocampus. Combined treatment with rapamycin and axitinib engendered prevention of generalized seizures and normalized the level of HIF-1α and NF-kB with a significant reduction of TNF-α. Effects of treatment favours of synergy action of rapamycin and axitinib
Determining the role of endogenous factors as markers of chronic epileptic activity allows pathogenetically justifying new approaches to treating epilepsy. The aim of the work was the immunohistochemical study of the expression of the tumor necrosis factor-alpha (TNF-α) and nuclear factor p-NF-κB in the tissue of the dorsal parts of the hippocampus in rats with kindling seizures. Kindling was produced in 15 rats by three-week i.p. pentylenetetrazole (PTZ, 35.0 mg/kg) administration. 20 control group rats were injected with 0.9% NaCl solution. The avidin-biotin-peroxidase method was used in 10 control group rats for staining. The rest ten rats composed the negative control group and stained using only secondary antibodies. The color intensity of the brain sections of the control and kindling groups was compared with the color of the brain sections of the negative control group using the "Image J" program. In rats with PTZ-kindling, the level of TNF-α was 17.86+0.83 relative units (RU) and exceeded the corresponding indicator in the control group (4.78+0.14 RU), (p<0.001). The expression of p-NF-κB was 5.24+0.61 against 1.73+0.07 RU in control (p<0.001). Determination of the expression of TNF-α and NF-κB in limbic structures can be used as markers of the effectiveness of experimental treatment methods for chronic epilepsy.
Key words: seizures, cytokines, hypoxia, pentylenetetrazol, hippocamp
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