ABSTRACT
INTRODUCTION: Following policy implementations to redress previous racial and gender discrepancies, this study explored how gender impacted on the clinical experiences of final-year medical students during their undergraduate training. It also gathered their perceptions and expectations for the future. METHODS: This cross-sectional, mixed-method study used a purposive sampling method to collect data from the participants (n=94). Each respondent was interviewed by two members of the research team. The quantitative data were entered into Excel and analyzed descriptively. The qualitative data were transcribed and thematically analyzed. RESULTS: The majority of the respondents still perceived clinical practice as male dominated. All respondents agreed that females faced more obstacles in clinical practice than males. This included resistance from some patients, poor mentoring in some disciplines, and less support from hostile nurses. They feared for their personal safety and experienced gender-based stereotyping regarding their competency. Males thought that feminization of the profession may limit their residency choices, and they reported obstacles when conducting intimate examinations and consultations on female patients. Both males and females expressed desire for more normalized work hours to maintain personal relationships. CONCLUSION: Social redress policies have done much to increase equal access for females to medical schools. Cultural values and attitudes from mentors, peers, and patients still impact on the quality of their clinical experiences and therefore also their decisions regarding future clinical practice. More mentoring and education may help to address some of the perceived obstacles.
ABSTRACT
Expression of thyroid-stimulating hormone receptor (TSH-R) has been demonstrated in adipocytes, lymphocytes, bone, kidney, heart, intestine and rat brain. Immuno-reactive TSH-R has been localised in rat brain and human embryonic cerebral cortex but not in adult human brain. We designed a pilot study to determine whether anti-thyroid auto-antibodies immuno-localise in normal adult human cerebral cortex. Forensic samples from the frontal, motor, sensory, occipital, cingulate and parieto-occipito-temporal association cortices were obtained from five individuals who had died of trauma. Although there were no head injuries, the prior psychiatric history of patients was unknown. The tissues were probed with commercial antibodies against both human TSH-R and human thyroglobulin (TG). Anti-TSH-R IgG immuno-localised to cell bodies and axons of large neurones in all 6 regions of all 5 brains. The intensity and percentage of neurones labelled were similar in all tissue sections. TSH-R immuno-label was also observed in vascular endothelial cells in the cingulate gyrus. Although also found in all 5 brains and all six cortical regions, TG localised exclusively in vascular smooth muscle cells and not on neurones. Although limited by the small sample size and number of brain areas examined, this is the first study describing the presence of antigenic targets for anti-TSH-R IgG on human cortical neurons, and anti-TG IgG in cerebral vasculature.
Subject(s)
Cerebral Cortex/immunology , Cerebral Cortex/pathology , Immunoglobulins, Thyroid-Stimulating/metabolism , Adult , Endothelial Cells/immunology , Female , Humans , Image Processing, Computer-Assisted , Immunochemistry , Immunoglobulin G/immunology , Immunoglobulin G/metabolism , Immunoglobulins, Thyroid-Stimulating/immunology , Immunohistochemistry , Male , Neurons/immunology , Receptors, Thyrotropin/immunology , Receptors, Thyrotropin/metabolism , Thyroglobulin/metabolismABSTRACT
OBJECTIVE: To test the hypothesis that the thiazolidinedione agent, pioglitazone, mediates its chronic BP lowering action via improving vascular reactivity. METHODS AND RESULTS: Lean (Fa/fa) and obese (fa/fa) Zucker rats were treated with or without pioglitazone (20 mg/ kg/day) for 4 weeks (n=8 animals per group). Pioglitazone treatment was associated with a significant improvement in oral glucose tolerance in the obese animals (p<0.05 compared with untreated obese). Pioglitazone prevented the development of hypertension seen in obese untreated rats (SBP 126+/-1 versus 138+/-1 mmHg; p<0.0001). Aortic ring preparations from pioglitazone-treated obese rats showed improved relaxation responsiveness (ED(50) 0.28 versus 1.15 U/ ml, p<0.001) to SOD, a NO potentiator, compared with untreated obese animals. CONCLUSIONS: SOD-mediated vasorelaxation may contribute to the chronic antihypertensive effect and/or the improvement in insulin sensitivity following pioglitazone treatment.
