There is low awareness about EBM and The Cochrane Library among physicians in Croatia, which creates a need for educational interventions about EBM for the benefit of health care in Croatia.

Multiple sclerosis (MS) is an autoimmune disorder of myelin destruction. Blood-brain-barrier (BBB) disruption precedes pathological or clinical findings and could involve mediators from perivascular brain mast cells, such as histamine and vascular endothelial growth factor (VEGF). Mast cells could be activated by many triggers, including acute stress that has been correlated with MS exacerbations. We considered that the histamine-1 (HI) receptor antagonist hydroxyzine, which also partially inhibits brain mast cells and has anxiolytic properties, may reduce MS symptoms. This open label, pilot, clinical trial investigated the effect on MS of an oral solution of hydroxyzine (100 mg per day), together with caffeine (200 mg per day) to reduce sedation. Twenty patients (8 males; 12 females) with relapsing-remitting or relapsing-progressive MS completed the study (12 ± 1 months) and were evaluated using disability scales. Most patients on hydroxyzine (75%) remained stable or improved neurologically and all but one showed improved mood. Hydroxyzine could be used as an adjuvant in MS, but the small number of patients enrolled and the short duration of the study precludes any definitive conclusions. A double-blind, placebo-controlled study is warranted.Multiple sclerosis (MS) is a human demyelinating disease characterized by brain edema and perivascular infiltrates ("cuffing") of mononuclear cells accompanied by various degrees of neurologic disability (1-2). Affected areas fill with fibrotic tissue forming the MS plaques that also contain activated mast cells (3). Blood-brain-barrier (BBB) breakdown precedes any pathological or clinical signs of MS (4-5). Acute stress can disrupt the BBB in rats (6). Most recently, acute stress was shown to increase BBB permeability to 99 Technetium-g1uceptatethrough the involvement ofbrain mast cells (7) and corticotropinreleasing-hormone (eRR) (7). It is, therefore, of interest that MS symptoms can be precipitated by psychological stress (8-9); a meta analysis and two recent publications confirmed a correlation between stress and MS attacks (10).Mast cells are typically activated by 19E and specific antigen in allergic reactions, as well as in innate and acquired (11) immunity. They have also been increasingly implicated in neuroinflammatory conditions, especially those worsened by stress (12). Mast cells have been associated with brain demyelination (13)(14) and are activated in

55www.cmj.hr Aim To evaluate daily-written 10-question quizzes in a medical anatomy course as a way to integrate assessment into the course and to evaluate their effect on the course success.Methods Students answering correctly 8/10 or more questions were awarded 0.5 points per quiz. There were 34 quizzes with a maximum point score 17. Measurable outcomes of academic progress in anatomy course (pass rates on 4 examination terms, total pass rate, and average marks) were calculated, and 2007/08 academic year was compared with the previous academic year in which daily written quizzes were not a part of the course. The relationship between cumulative points on daily quizzes and 3 components of the final examination (written, practical, and oral) for 2007/08 academic year was assessed by nonparametric correlation testing.Results Individual scores on quizzes ranged from 1.5 to 13.5 points. There was a positive correlation between scores on quizzes and grades on 3 components of the final examination: written (Spearman ρ = 0.784, P < 0.001, n = 79), practical (Spearman ρ = 0.342, P < 0.002, n = 79), and oral (Spearman ρ = 0.683, P < 0.001, n = 79) part. Compared with students in the previous academic year, students attending the course with daily quizzes significantly improved their academic achievement, expressed as the pass rate at the first examination term (39% vs 62%, respectively, χ 2 test, P = 0.006, ) and the average course grade (2.71 ± 1.08 vs 3.38 ± 1.26, respectively; t test, P < 0.001). ConclusionDespite their frequency and possible associated stress, daily quizzes were associated with better academic success in the anatomy course. Anatomy is one of the most important preclinical subjects; not only because of its shear volume and complexity, requiring the adoption of skills and attitudes, but also because it is the first truly medical course for university "novices, " who are still in the process of transition from secondary school pupils to university students. Furthermore, in the traditional medical curriculum, with separate preclinical and clinical subjects, anatomy is perceived as an introduction to "real" medicine, playing an important role in the process of professional socialization (1). Thus, anatomy teachers are not only teaching anatomy but are also university educators with distinct scholarly roles. One of these roles is encouraging students to take a widely cited "deep approach" to studying anatomy (2-4), leading to a more complete understanding of the subject matter. This should also include the capacity of independent, intrinsically motivated study. We believe that these, very much desired, educational aims can be reached only if the following 3 critical components of a good quality curriculum are optimally harmonized: recommended literature, teaching methods/learning activities, and assessment. It is argued that curriculum design, with a true integration of various forms of assessment into learning activities (5,6), should produce a measurable positive impact on students' knowledge and unders...

No abstract

Negative E-cadherin expression like presence of residual tumour after primary cytoreductive surgery and higher FIGO stage seem to predict unfavourable clinical outcome in patients with advanced-stage serous ovarian cancer. Negative expression of E-cadherin was shown to be a significant independent predictor of poorer OS. E-cadherin as marker has prognostic value.