Rejected

Many disease-specific questionnaires, which analyze patients' functional status, quality of life or the progression of the disease, have been validated in Hungarian. The low back pain (LBP) patients' knowledge about their problem has not been measured by an officially validated Hungarian tool. The aim of our study was to translate and validate the Low Back Pain Knowledge Questionnaire (LKQ) and to assess its validity and reliability. We used the translation-back translation method as the first step. Then we used a synthesis of the back translations reviewed by independent translators. We enrolled 218 people in our study: 101 of them were chronic LBP patients and 73 acute LBP patients. For the validation process, we used the Roland-Morris Disability Index to compare our questionnaire. We calculated Cronbach's alpha values and correlation coefficients. The Hungarian version of LKQ correlated well with the Roland-Morris Index and it proved to be a valid questionnaire (correlation coefficient: -0.393; Cronbach's alpha value 0.894). We found the Hungarian version of LKQ a valid and reliable tool to measure patients' knowledge about LBP. We recommend future studies should apply bigger and more homogenous populations to assess LBP disease-specific knowledge in this country. Orv Hetil. 2019; 160(42): 1663-1672.

pain is one of the most often symptoms experienced by patients with advanced or chronic diseases which can cause a decrease in the quality of life of palliative patients. Pain in palliative patients has not yet received enough attention, especially factors associated with pain and its management. This study aimed to determine the factors associated with pain in palliative patients and also assess whether there is a two-way relationship between psychological factors and pain. In addition, we will also see whether spiritual services play a role in relieving pain.

Chronic pain affects up to a third of the population. Ongoing epidemiology studies suggest that the impact of chronic pain on the population is accelerating [1]. While advances have been made in understanding how chronic pain develops, there are still many important mysteries about how acute pain transitions to a chronic state. In this review, I summarize recent developments in the field with a focus on several areas of emerging research that are likely to have an important impact on the field. These include mechanisms of cellular plasticity that drive chronic pain, evidence of pervasive sex differential mechanisms in chronic pain and the profound impact that next generation sequencing technologies are having on this area of research.

Idiopathic intracranial hypertension is a rare neurologic condition characterized by elevated intracranial pressure with normal cerebrospinal fluid analysis and neuroimaging. A subset of pediatric idiopathic intracranial hypertension patients are coincidentally found to have papilledema and elevated intracranial pressure without symptoms (eg, headache, visual blurring, tinnitus). This study aims to investigate the features of asymptomatic pediatric idiopathic intracranial hypertension.

Arachis hypogaea L. (peanut) leaves have been popularly used for the treatment of insomnia and inflammation, but no toxicological study has been performed for this plant preparation. This study aimed to examine the phytochemical composition of peanut leaf hydroalcoholic extract (PLHE) and describe its potential toxic effects and antioxidant and anti-inflammatory properties. The qualitative chemical analysis of PLHE by UHPLC-ESI-HRMS allowed the identification of eight metabolites types (totaling 29 compounds). The 1,1-diphenyl-2-picryl-hydrazyl (DPPH) assay revealed that PLHE had strong antioxidant effects; it also exhibited nitric oxide (NO)-scavenging capacity. Human peripheral blood mononuclear cells (PBMCs) exposed to PLHE showed no reduced cell viability or increased free double-stranded DNA, NO, or reactive species production. PLHE reversed the cytotoxicity, pro-inflammatory (release of interleukin-1β), and pro-oxidant effects of HO on human PBMCs. Acute PLHE toxicity analysis was performed in vivo using the Organization for Economic Co-operation and Development (OECD) 423 guidelines. PLHE single injection (2000 mg/kg, intragastric) did not cause mortality or morbidity or induce changes in hematological or biochemical parameters after 14 days of administration. Thus, PLHE could be a source of bioactive compounds and possesses antioxidant and anti-inflammatory properties without elicitin cytotoxicity or genotoxicity in human PBMCs or acute toxicity in rats.

The surgical treatment of Chiari type 1 (CM1) malformation is controversial and depends largely on the preference of the surgeon. The evolution of neuroimaging resulted in an increased number of asymptomatic patients incidentally diagnosed.

Multimodal analgesia is important for postoperative recovery in laparoscopic colorectal surgery. Multiple randomized controlled trials have investigated the use of transversus abdominis plane local anesthetic infiltration as a method of decreasing postoperative pain and opioid consumption, with variable results.

Recurrent Artery of Heubner aneurysms are very rare, with only seven reported cases in the literature to date. In evaluating cerebral aneurysms, cerebral Digital Subtraction Angiogram (DSA) is considered the gold standard, and demonstrated the RAH aneurysms in previous case reports. We present a case of spontaneous subarachnoid haemorrhage (SAH) secondary to RAH aneurysmal rupture, with initial DSA misleading, suggesting minor aneurysmal filling of a presumed thrombosed A1 segment aneurysm instead.

Obeticholic acid (OCA), a farnesoid-X-receptor (FXR) ligand, shown effective in reducing steatosis and fibrosis in NASH patients. However, OCA causes major side effects including pruritus, while increases the risk for liver decompensation in cirrhotic patients. Ursodeoxycholic acid (UDCA), is a safe and unexpensive bile acid used in the treatment of liver disorders whose mechanism of action is poorly defined. Here we have compared the effects of OCA and UDCA in a mouse model of NASH. In mice exposed to a diet rich in fat/cholesterol and fructose (HFD-F), treatment with OCA or UDCA effectively prevented body weight gain, insulin resistance, as demonstrated by OGTT, and AST plasma levels. After 12 weeks HFD-F mice developed liver microvesicular steatosis, inflammation and mild fibrosis, increased expression of inflammatory (TNFα, IL6, F4/80) and fibrosis (αSma, Col1α1, Tgfβ) markers, reduced liver expression of FXR, dysregulated liver FXR signaling and elevated levels of Tauro-α and β-muricholic acid (T-α and βMCA), two FXR antagonists in mice. Both compounds prevented these changes and improved liver histopathology. OCA reduced primary bile acid synthesis worsening the T-CA/T-βMCA ratio. UDCA effectively transactivated GPBAR1 in vitro. By RNAseq analysis we found that among over 2400 genes modulated by the HFD-F, only 32 and 60 genes were modulated by OCA and UDCA, with only 3 genes (Dbp, Adh7, Osgin1) being modulated by both agents. Both agents partially prevented the intestinal dysbiosis. CONCLUSIONS: UDCA is a GPBAR1 ligand and exerts beneficial effects in a rodent model of NASH by activating non-overlapping pathway with OCA.