bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacoeconomic Analysis of the Use of Thrombopoietin Receptors Agonists in Idiopathic Thrombocytopenic Purpura Therapy
Authors: Shuvaev Vasilii Anatol'evich , Voloshin S.V. , Hadzhidis A.K. , Chechetkin A.V.
Published: October 2017

Background. New medications, thrombopoietin mimetics which were recently introduced into clinical practice allowed to achieve clinical response in patients with chronic glucocorticoid-resistant idiopathic thrombocytopenic purpura (ITP). However, the high cost and the need for long-term administration necessitate a pharmacoeconomic analysis of the use of thrombopoietin receptors agonists in the treatment of ITP. Aim. To assess the cost-effectiveness of the use of thrombopoietin mimetics (romiplostim and eltrombopag) and immunosuppressive therapy in the treatment of chronic glucocorticoid-resistant ITP. Materials & Methods. The Markov modelling of diagnosis and treatment of ITP was conducted in accordance with the National guidelines for diagnosis and treatment of primary ITP. The cost-benefit analysis of the use of thrombopoietin receptors agonists (romiplostim and eltrombopag) and immunosuppressive therapy was performed. The time period (horizon) of the study was 5 years. Results. The therapy with thrombopoietin mimetics had higher costs but was shown to be more effective compared to immunosuppressive therapy. The cost-effectiveness for achieving 1 QALY in the treatment was 1.33 million rubles with eltrombopag, 4.2 million rubles with romiplostim, and 0.17 million rubles with immunosuppressive therapy. The lowest additional costs compared to immunosuppressive therapy had eltrombopag treatment, whereas romiplostim treatment doubled the additional costs. The threshold values of the ratio of thrombopoietin receptors agonists costs were determined for the cost-benefit analysis. The use of romiplostim is cost-effective at a price for 1 vial of 15-18 % less than for 1 package of eltrombopag. The total cumulative burden of treatment of chronic ITP for 5 years may be 7.18 billion rubles with the use of eltrombopag, 23.23 billion rubles with romiplostim, and 0.91 billion rubles with immunosuppressive therapy only. The results confirm the need for budgeting the diagnosis and treatment of ITP not as a part of general approach, but to consider ITP as an orphan disease. Conclusion. The developed pharmacoeconomic model can be used as an assessment tool of the costs of new diagnostic approaches and treatment strategies and optimizing budget expenditures.
First-Line Therapy for Patients with Advanced Hodgkin’s Lymphoma: Efficacy and Toxicity of Intensive ЕАСОРР-14 Program (NN Blokhin National Medical Cancer Research Center Data)
Authors: Demina Elena Andreevna , Leont'eva A.A. , Tumyan G.S. , Ryabukhina Yu.E. , Trofimova O.P. , Volkova N.V. , Pryamikova YU.L. , Sotnikov V.M. , Larionova V.B. , Medvedovskaya E.G. , Paramonova E.V. , Manzyuk L.V. , Probatova N.A. , Kokosadze N.V. , Osmanov E.A.
Published: October 2017

Aim. To assess the efficacy and toxicity of intensive 6 courses EACOPP-14 treatment with or without radiotherapy (RT) for advanced stages of Hodgkin's lymphoma (HL). Materials & Methods. From November 2009 to February 2015, 95 patients with advanced stages of HL (IIX-IIE, III-IV) aged between 17 and 50 years (median 29 years) were selected for the participation in the protocol ЛХМосква1-3. The study population consisted of 46.3 % men and 53.7 % women. The results of the treatment were assessed in 91 patients who have received more than 2 courses of EACOPP-14. The follow up period was at least 3 months after the receiving the therapy. Consolidation RT with a total dose of 30 Gy for residual tumor lesions and/or initially large tumors was performed after the chemotherapy. Results. Complete remission was achieved in 82 (90.1 %) patients, partial remission in 2 (2.2 %), and the progression was observed in 7 (7.7 %) patients. The overall 4-year survival rate was 90.8 %, the progression-free survival was 88.2 %. The toxicity of the ЕАСОРР-14 program was slightly lower than that of 8 courses of ВЕАСОРРesc, and was comparable to the toxicity of other modifications of intensified ВЕАСОРР scheme. Hematological toxicity grade 3 and 4 was most commonly observed: leukopenia was observed after 64.9 % of courses, anemia - after 24 % of courses, thrombocytopenia - after 3.8 % of courses. The rate of infections did not singificantly differ and accounted for 24 %. The most frequent non-infectious complications were mucositis (21.1 %) and polyneuropathy (11.7 %). Complications resulted in the change of treatment in only 3 (3.01 %) of patients. The exclusion of bleomycine from the ЕАСОРР-14 program reduced the frequency of RT complications. Grade 3 pulmonitis developed in 4.5 % of cases, while radiation-induce pulmonary fibrosis verified by CT developed in 15.2 % of cases. The ЕАСОРР-14 6 courses program showed its high efficacy both with and without RT, high tolerance and the possibility of full administration for the majority of patients with the various stages of HL. Conclusion. Current research showed the efficacy of treatment without RT for patients with advanced stages of HL with negative PET results and small (< 2.5 cm) residual tumors after intensive ЕАСОРР-14 program. This approach allowed to avoid a number of late treatment complications.
The Comparison of De Novo Grade 3 Follicular Lymphoma and Transformed Grade 3 Follicular Lymphoma: Own Data
Authors: Plastinina Lyubov' Vasil'evna , Kovrigina A.M. , Obukhova T.N. , Nesterova E.S. , Magomedova A.U. , Mangasarova Ya.K. , Misyurina A.E. , Babaeva F.E. , Kulikov S.M. , Vorob'ev A.I. , Kravchenko S.K.
Published: October 2017

Background. Grade 3 follicular lymphoma (FL) is a heterogenetic group of tumors. The selections of patients with similar characteristics of the tumor process is important for classification 3 grade forms of FL and risk stratification, as well as for the development of new therapeutic approaches. Different morphological, immunohistochemical and cytogenetical characteristics of the tumor result in different clinical forms of the disease. Aim. To describe the clinical, morphological, immunohistochemical and cytogenetical characteristics of grade 3 FL and evaluate their prognostic value for R-CHOP-21 chemotherapy. Materials & Methods. We performed retrospective and prospective analysis of morphological, immunohistochemical and genetical characteristics of 93 primary patients with grade 3 FL (21-78 years, median 53 years, women to men - 1:1.4) admitted to National Medical Hematology Research Center from years 2001 to 2016. Morphological and immunohistochemical assessment of the affected lymph nodes and bone marrow biopsy material was performed. Data obtained from the standard cytogenetic and FISH assessment were compared to identify the BCL2 rearrangement. Results. We proposed an algorithm for differential diagnosis of the 2 types of grade 3 FL: de novo FL (n = 22) and transformed FL (n = 21). De novo grade 3 FL had the immunophenotype of CD10- in 19 (86 %) cases, MUM1++ (monomorphically) in 19 (90 %), and BCL-2 in 5 (22 %). It was characterized by the absence of the BCL2 rearrangement (n = 22, 100 %) and bone marrow involvement (n = 14, 67 %) and/or bone marrow involvement (n = 7, 100 %). Third grade FL transformed from grades 1 or 2 had was CD10+ (n = 19, 90 %), MUM1+ (heterogeneously, n = 16, 76 %) or MUM1-(n = 4, 19 %), BCL-2+ (n = 20, 95 %) and had BCL2 rearrangement (n = 19, 90 %). Small cell bone marrow involvement was observed in 71 % of cases, whereas large cell involvement was seen predominantly in de novo FL (p = 0.06). The analysis showed that 5-year relapse-free survival in patients with grade 3 de novo FL after R-CHOP-21 therapy was 87 % compared to 16 % with transformed FL (p = 0.06) for the median 41 months of follow up. Conclusion. We described the morphological, immunohistochemical and cytogenetical characteristics of grade 3 de novo FL and grade 3 FL, transformed from grades 1 or 2. The described variants show different sensitivity to immunochemotherapy.
Targeted Therapy of Myelofibrosis
Authors: Vinogradova Ol'ga Yur'evna , Shuvaev V.A. , Martynkevich I.S. , Pankrashkina M.M. , Fominykh M.S. , Efremova E.V. , Krutikova K.Yu. , Polushkina L.B. , Sharkunov N.N. , Voloshin S.V. , Chechetkin A.V.
Published: October 2017

Background. Myelofibrosis (primary myelofibrosis, postessential trombocythemia myelofibrosis, post-polycythemia myelofibrosis) is the most complex and pressing problem among all Ph-negative myeloproliferative diseases. The present article summarizes the author's experience of using new Janus kinase inhibitors in routine clinical practice, and compares the data with the results of other clinical research. Aim. To evaluate the use of ruxolitinib in patients with myelofibrosis. Materials & Methods. Our analysis includes 48 patients (21 men and 27 women) with histologically verified myelofibrosis (primary myelofibrosis in 36 cases, post-essential trombocythemia myelofibrosis in 10 cases, and post-polycythemia myelofibrosis in 2 cases) in a chronic stage. All patients received ruxolitinib. Median age at the start of therapy was 60 years (range from 35 to 79). Massive splenomegaly (> 10 cm below the costal margin) was found in 34 (71 %) of 48 patients. The initial dose of ruxolitinib was determined by the platelet level. The efficacy of the therapy was evaluated in accordance with ELN 2013 criteria. Results. Median duration of treatment was 18 months (range from 1 to 50 months). Symptoms of intoxication were relieved in 33 of 37 patients (89 %). The spleen size decreased in 64 % of patients. In 33 % of cases spleen size did not change, whereas an increase was observed in 3 % of patients. In the majority of patients hemoglobin level remained stable through the course of treatment. Three of 14 transfusion dependent patients did not require blood transfusions after 3 months of therapy. In patients with high thrombocyte levels prior to ruxolitinib therapy the mean level was approaching normal by the end of the 1st month of treatment. The median JAK2V617F mutant allele burden at the beginning treatment was 56.5 % (n = 20; 22.5-126.1 %). After 6 moths of treatment it accounted for 62.3 % (n = 11; 25.4-79.7 %) and in 12 months accounted for 47.4 % (n = 12; 14.2-102.2 %). By the time of the analysis 42 of 48 patients continued the ruxolitinib treatment (88 %). Death occurred in 4 patients. Overall 1-year (92 %) and 2-year (87 %) survival corresponds to the data of COMFORT-I, COMFORT-II and JUMP clinical trials. Conclusion. Ruxolitinib showed to be an effective treatment for myelofibrosis. The most pronounced and rapid effect ruxolitinib had on the spleen size and the symptoms of intoxication. The tolerability of ruxolitinib was satisfactory in the majority of patients. According to the author's data, ruxolitinib had a small impact on the JAK2V617F mutant allele burden. The overall survival rate in patients with myelofibrosis, receiving ruxolitinib in the clinical setting was similar to that of in the clinical trials.
Proand Antifibrotic Factors in the Serum of Patients with Chronic Myeloproliferative Disorders
Authors: Silyutina A.A. , Matyukhina N.M. , Lisina E.G. , Khvan V.I. , Leleko S.N. , Siordiya N.T. , Sirotkina O.V. , Butylin Pavel Andreevich
Published: October 2017

Background. The study of pro- and antifibrotic factors in the serum of patients with Ph-negative chronic myeloproliferative disorders (CMPDs) will allow to understand better the mechanisms of myelofibrosis development, as well as to identify new diagnostic markers. Aim. To assess the correlation between the levels of classic (TGF-ß, bFGF, MMP-2, -9, -13 and VEGF) and new proin-flammatory serum factors (galectin-3), involved into development of myelofibrosis in different Ph-negative forms of CMPDs and genetic abnormalities. Materials & Methods. The research included 55 CMPD patients (13 with polycythemia vera, 17 with essential thrombocythemia, 25 with primary myelofibrosis) and 8 healthy controls. Whole blood genomic DNA extraction was used to evaluate mutations JAK2V617F, CALR (deletions and insertions), MPLW515L, and MPLW515K. Antibody-immobilized ELISA was used to evaluate the levels of galectin-3, TGF-ß, bFGF, VEGF, MMP-2, MMP-9 and MMP-13. Results. The analysis showed the differences in serum MMP-9, VEGF, TGF-ß and galectin-3 levels in patients with different CMPDs. A tendency towards the decrease of serum MMP-9 levels in patients with CALR mutations was shown. Conclusion. The shown differences between patients with different CMPDs may serve as a basis for improving diagnostic protocols in challenging differential diagnosis of CMPDs.
Classification of Conditioning Regimens for Bone Marrow Transplantation: Historical Background and Current Perspectives
Authors: Melkova Kapitolina Nikolaevna , Petrova G.D. , Gorbunova N.V. , Chernyavskaya T.Z. , Trofimova O.P.
Published: October 2017

Hematopoietic stem cells transplantation is a current standard treatment for many oncohematological diseases. The milestone of any type of transplantation is the choice of conditioning regimen. This article presents the principles of classification of conditioning regimens in terms of myeloablativity and discusses the concepts of “autologous transplantation”, “high-dose chemotherapy supported by hematopoietic stem cells”, “allogeneic transplantation” and “immunotherapy”. Up-to-date uniform classification of conditioning regimens may serve an important prognostic component in assessing both the risks and efficacy of hematopoietic stem cells transplantation.
Remineralization Strategies in Oral Hygiene: A Position Paper of Italian Society of Oral Hygiene Sciences-S.I.S.I.O. Working Group
Authors: Sanavia Consuelo , Tatullo Marco , Bassignani Jessica , Cotellessa Silvia , Fantozzi Giulia , Acito Giovanna , Iommiello Alessia , Chiavistelli Lorella , Sabatini Silvia , Nardi Gianna Maria
Published: October 2017

Background/Objective:

The clinical conditions that lead to an alteration of the enamel structure are numerous. The diet high in sugars and acidifying substances, psychological stress that triggers parafunctional behaviors, the reduced intake of fiber-rich foods or alkalizing substances, together with other factors, contribute to demineralization of the tooth enamel. Dental mineralizing products on the current market are distinguished according to the dosage form, the active ingredient, the release technology, clinical indications and patient choice. Currently, it is necessary to propose to oral health professionals a guide to orient themselves in this chaotic choice, in order to prefer the most effective product for their own clinical target.

Methods:

Italian Society of Oral Hygiene Sciences-S.I.S.I.O. is one of the leading scientific Italian societies representing those dental hygienists working with high-quality standards and in agreement with scientific evidence: in the last year, the SISIO working group has carried out a study focused on remineralizing agents in dentistry, in order to give an authoritative point of view to indicate a guideline in the decision process of the choice of a remineralizing agent. We will report the results pointed out from the last consensus meeting in 2017.

Results:

We have reported the good the bad and the ugly have been discussed in a critical discussion of such topic.

Conclusion:

The SISIO experience has been reported in this position paper with the aim to serve as a useful aid in the daily choice of the clinical steps to perform, when dental professionals need to treat demineralized teeth.
Oral Manifestations in Pediatric Patients with Coeliac Disease – A Review Article
Authors: Macho Viviana Marisa Pereira , Coelho Ana Sofia , Veloso e Silva Diana Maria , Andrade David José Casimiro de
Published: October 2017

Background:

Coeliac disease is a chronic enteropathy that remains a challenge for the clinician, due to its atypical manifestations and etiopathogenic complexity.

Objective:

This article intends to describe the oral characteristics of Coeliac Disease in children in order to facilitate their management in the dental office.

Methods:

A review of the literature was performed electronically in PubMed (PubMed Central, and MEDLINE) for articles published in English from 2000 to April of 2017. The article is also based on the authors' clinical experience with children with coeliac disease. The searched keywords were “coeliac disease “,”oral manifestations “, “dental enamel defects”, “recurrent aphthous stomatitis” and “oral aphthous ulcers”.

Results:

There are some oral manifestations which are strictly related to coeliac disease: dental enamel defects, recurrent aphthous stomatitis, delayed tooth eruption, multiple caries, angular cheilitis, atrophic glossitis, dry mouth and burning tongue.

Conclusion:

The complete knowledge of the oral manifestations of coeliac disease can trigger an effective change in the quality of life of the patients with this disease.
Dose Escalation and Co-therapy Intensification Between Etanercept, Adalimumab, and Infliximab: The CADURA Study
Authors: Thorne Carter , Boire Gilles , Chow Andrew , Garces Kirsten , Liu Fang , Poulin-Costello Melanie , Walker Valery , Haraoui Boulos
Published: October 2017

Objective:

To compare anti-TNF dose escalation, DMARD and/or glucocorticoid intensification, switches to another biologic, and drug and drug-related costs over 12 and 18 months for rheumatoid arthritis (RA) patients initiating etanercept (ETN), adalimumab (ADA), or infliximab (IFX) in routine clinical practice across Canada.

Methods:

A retrospective chart review of biologic-naïve adult RA patients newly initiating ADA, ETN, or IFX between January 01, 2006 and December 31, 2012 from 11 practices across Canada.

Results:

There were 314 patients in the 12-month analysis and 217 in the 18-month analysis. No dose escalation occurred with ETN over 12 and 18 months versus 38% and 32% for IFX (p<0.001) and 2% and 2% for ADA (p=0.199, p=0.218). Over 18 months, dose escalation and/or DMARD and/or glucocorticoid intensification was less frequent among ETN (16%) versus IFX (44%, p=0.005) and ADA (34%, p=0.004). By 18 months, 22% of patients initiating ADA had switched to another biologic compared with 6% of ETN patients (p=0.001).

Patients initiating ETN had lower total (drug and drug-related) costs over 12 and 18 months compared to IFX, and no difference compared to ADA when adjusted for potential confounders. Patients with dose escalation had higher costs compared to those with no dose escalation.

Conclusion:

Physicians were more likely to escalate the dose of IFX, but optimize co-therapy with ADA and ETN. ETN patients had no dose escalation and were less likely to have DMARD and/or glucocorticoid intensification than ADA patients. ETN-treated patients had lower costs compared to IFX patients.
A Home-Based Couple Management Guide for Couples Affected by Dementia (DemPower): A Protocol (Preprint)
Authors: Lasrado Reena , Bielsten Therése , Hann Mark , Davies Linda , Schumm James , Reilly Siobhan , Swarbrick Caroline , Keady John , Hellström Ingrid
Published: October 2017

BACKGROUND

The increasing rate of dementia and high health and social care costs call for effective measures to improve public health and enhance the wellbeing of people living with dementia and their relational networks. Most post diagnostic services focus on the condition and the person with dementia with limited attention to the caring spouse/partner. The key focus of the study is to develop a guide for couples where one partner has a diagnosis of dementia. This couple-management guide is delivered in the form of an app, ‘DemPower’.

OBJECTIVE

The study aims to investigate the feasibility and acceptability of DemPower and assess the criteria for a full-integrated clinical and economic randomised control trial.

METHODS

DemPower couple-management app will be introduced to couples where one partner has dementia. The study will recruit 25 couples in the UK and 25 couples in Sweden. Couples will be given three months to engage with the app and the amount of time taken to complete the guide (it may be <3 months as well as >3) will be reviewed. A set of outcome measures will be obtained at baseline and post intervention stages.

RESULTS

The proposed study is at recruitment phase. The DemPower app is being introduced to couples from consultation groups at a pre-trial phase for identification of bugs and explore if any navigation challenges exist. The feasibility testing will begin in April 2018.

CONCLUSIONS

The study will determine how much support couples need to engage with DemPower and whether or not they make use of it in their everyday lives. If there is support for app use, a future study will assess whether it is superior to ‘usual care’.

CLINICALTRIAL

ISRCTN10122979
ANALYSIS ON THE INHIBITION OF AGGREGATIBACTER ACTINOMYCETEMCOMITANS BY STREPTOCOCCUS SALIVARIUS ISOLATED FROM SALIVA AND TONGUE DORSUM OF ADULTS
Authors: Vaniabella Regina , Joenoes Hedijanti , Bachtiar Boy M
Published: October 2017

Objective: To analyze the inhibitory potential of S. salivarius isolated from saliva and the dorsum of the tongue, and the protein it produces, ininhibiting the growth of Aggregatibacter actinomycetemcomitans.Methods: Examine the inhibition zone of A. actinomycetemcomitans formed by the treatment of S. salivarius isolated from saliva and the tonguedorsum, along with the protein produced, in 10 participants using a deferred antagonism test with well-diffused gelatin.Results: The inhibitory zone of S. salivarius isolated from saliva and the tongue against A. actinomycetemcomitans is insignificantly different (p=0.05).There is no inhibition of the growth of A. actinomycetemcomitans shown by whole-cell and spent medium proteins of S. salivarius.Conclusion: S. salivarius isolated from both saliva and the tongue dorsum is able to inhibit the growth of A. actinomycetemcomitans, but not theprotein they produce.
ANTIOXIDANT ACTIVITY AND INHIBITION OF LIPOXYGENASE ACTIVITY ETHANOL EXTRACT OF ENDOSPERM ARENGA PINNATA (WURMB) MERR.
Authors: Elya Berna , Puspitasari Nuraini , Sudarmin Annisa Chairani
Published: October 2017

Objective: The purpose of this study is to determine the antioxidant activity and the potential inhibition of lipoxygenase activity from sugar palm fruit.Methods: Antioxidant activity was evaluated by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) methods. Inhibition of lipoxygenase activity was performed in vitro. Sugar palm fruit was macerated with 95% ethanol.Results: The results showed that sugar palm fruit ethanol extract has antioxidant activity when using DPPH method with EC50 of 141.3929 μg/mL and the FRAP method with EC50 of 60.2083 μg/mL. Inhibition test of lipoxygenase activity showed inhibitory concentration 50% value of 71.376 μg/mL.Conclusions: Ethanol extract of endosperm Arenga pinnata has antioxidant activity, as determined using the DPPH method with EC50of 141.3929 μg/mL and the FRAP method with EC50 of 60.2083 μg/mL.
ANTIBACTERIAL ACTIVITY OF FRACTIONS OF ETHYL ACETATE EXTRACT OF GARCINIA LATTISSIMA MIQ. FRUITS
Authors: Ambarwati Nenengsiti Silfi , Malik Amarila , Listari Ageng Tri , Nirwana Nirwana , Elya Berna , Hanafi Muhammad
Published: October 2017

Objectives: The emergence of new infections and increase in bacterial drug resistance has created a serious need for the expansion of new antibacterial agents from natural sources. The study was carried out to evaluate the antibacterial activity of fractions of ethyl acetate extract of Garcinia latissima Miq. fruits.Methods: The fractionation was done using a silica gel column and organic solvents as the eluent, i.e., n-hexane, ethyl acetate, and methanol. All fractions were assayed for antibacterial activity, which was done by performing disc diffusion for growth inhibition against Bacillus subtilis and Pseudomonas aeruginosa. In addition, the growth inhibition activity was also examined by performing bioautography assay using pre-coated silica gel 60 GF 254 plates as the stationary phase. Fractions A-F were eluted using n-hexane:chloroform (1:4), while Fractions G-K were used ethyl acetate:dichloromethane (4:1) as the mobile phase. The plate was visualized by ultraviolet at λ 254 nm and 366 nm, while the other one was contacted with the inoculated agar medium to observe zone inhibition. Further, the minimum inhibitory concentration (MIC) value was determined by performing microdilution.Results: The result showed that the antibacterial activity of all fractions was more active at inhibiting the growth of B. subtilis than P. aeruginosa, mainly for Fractions H and J. However, the strongest antibacterial activity was showed by Fractions H and J against B. subtilis, MIC 312.5 μg/mL (lower than reference, which is erythromycin antibiotic (25 μg/mL), followed by Fraction D against B. subtilis MIC 625 μg/mL, Fraction K against P. aeruginosa MIC 625 μg/mL, whereas Fractions C, E, and G against B. subtilis, and Fraction E against P. aeruginosa also showed low MIC values (1.250 μg/mL).Conclusions: The results indicated that fractions of G. latissima Miq. fruit ethyl acetate extracts possessed antibacterial activity. The most active fraction that inhibited the growth of B. subtilis was shown by Fractions H and J; these fractions have the potential to be developed as new antibacterial agents.
TYROSINASE INHIBITION, 2,2-DIPHENYL-1-PICRYLHYDRAZYL RADICAL SCAVENGING ACTIVITY, AND PHYTOCHEMICAL SCREENING OF FRACTIONS AND ETHANOL EXTRACT FROM LEAVES AND STEM BARK OF MATOA (POMETIA PINNATA)
Authors: Sauriasari Rani , Azizah Nur , Basah Katrin
Published: October 2017

Objective: This study aims to investigate the potency of matoa as a tyrosinase inhibitor and antioxidant and also to identify the chemical compounds in the most active fraction and an ethanol extract from the leaves and stem bark of matoa.Methods: The extracts were tested for their tyrosinase inhibitory activity by evaluating the formation of L-dopachrome at 490 nm. Antioxidant activity was tested using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method. The most active extract from liquid-liquid partition analysis was fractionated, and then, the assays were performed.Results: The ethanol extract of leaves and stem bark of matoa showed weak anti-tyrosinase activity (percent inhibition was 24.54±0.22% and 21.93±0.57%, respectively, final concentration 200 μg/mL), but they showed strong DPPH radical scavenging activity (IC50 values were 6.11 μg/mL and 5.47 μg/mL, respectively). The ethyl acetate fraction was the most active fraction with an IC50 value of 5.38 μg/mL. Ethanol extract from the leaves and stem bark of matoa and the ethyl acetate fraction contains flavonoids, tannins, saponins, triterpenoids, and glycosides.Conclusion: Matoa does not have potency as a tyrosinase inhibitor, but it has good antioxidant activity, although still lower than that of quercetin.
COMPARISON OF ZIDOVUDINE COMBINATION AND TENOFOVIR COMBINATION ON THE EFFECTIVENESS OF THERAPY AND SIDE EFFECTS IN HIV/AIDS PATIENTS IN RSAL MINTOHARDJO
Authors: Insaniputri Phihaniar , Supardi Sudibyo , Andrajati Retnosari
Published: October 2017

Objectives: Tenofovir-based therapy is a newly adopted first-line HIV/AIDS therapy regimen in Indonesia that is replacing the stavudine-based regimen. However, zidovudine-based regimens remain the first-line therapy for patients with HIV/AIDS. This study aimed to compare the effectiveness and incidence of adverse effects with hemoglobin (Hb) in both zidovudine- and tenofovir-based regimens in HIV/AIDS patients at Mintohardjo Hospital. Methods: We used a cross-sectional comparative research design. The data analyzed were medical records of all HIV/AIDS patients treated through 2015. Results: The sample included 75 patients in the zidovudine group and 53 patients in the tenofovir group. Wilcoxon signed-rank tests indicated that both combinations of therapy were effective in improving CD4+ cells. Initial CD4+ cell counts ≤ 200 cells/mm3 were 4.55 times better at increasing CD4+ cell counts when compared with an initial CD4+ > 200 cells/mm3. Chi-square results showed that both treatment combinations affected the decrease in Hb. Patients using the zidovudine combination had 4.59 times greater risk for a Hb decrease compared with the tenofovir combination. Conclusions: Zidovudine- and tenofovir-based regimens had similar effectiveness in increasing CD4+ cell counts, but the tendency to cause anemia in tenofovir-based regimens was less than that of the zidovudine-based regimens.
ROLE OF PHARMACISTS IN REDUCING DRUG-RELATED PROBLEMS IN HEMODIALYSIS OUTPATIENTS
Authors: Lumbantobing Romauli , Sauriasari Rani , Andrajati Retnosari
Published: October 2017

Objectives: Hemodialysis outpatients have a higher risk of developing drug-related problems. Pharmacists play a key role in identifying and preventing these drug-related problems. This study aimed to assess the effect of pharmacist intervention on the number and types of drug-related problems in outpatients undergoing hemodialysis at Indonesia Christian University Hospital.Methods: This pre- and post-prospective study was conducted from January 2013 to June 2013. We evaluated 86 patients who were prescribed 804 drugs.Results: A total of 337 drug-related problems were identified (41.86% of the total drugs prescribed). The types of drug-related problems identified were as follows: Failed therapy (18.69%); sub-optimal therapy (52.23%); indication of non-administration of therapy (2.37%); and non-allergic adverse drug effects (26.71%). The physicians received 59 recommendations, and the patients received 278 recommendations. These recommendations resulted in a decrease in ineffective drug therapy or therapeutic failure (18.69-0%), sub-optimal therapy (52.23-21.36%), indications of non-administration of drug (2.37-2.08%), and non-allergic adverse drug effects (26.71-9.20%). The factors that significantly affected the occurrence of drug-related problems were hemodialysis frequency, number of comorbidities, and number of drugs prescribed. Patients undergoing hemodialysis 3 times a week were more likely to experience a decrease in drug-related problems than those undergoing hemodialysis twice a week (odds ratio 26.33, 95% confidence interval 2.710-255.884).Conclusions: Pharmacist intervention could decrease drug-related problems in hemodialysis patients.
THE RISKS OF USING TRANEXAMIC ACID AND VITAMIN K FOR DECREASING PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME VALUES IN INTRACRANIAL HEMORRHAGIC PATIENTS AT RUMAH SAKIT UMUM PUSAT FATMAWATI JAKARTA
Authors: Azkiyah Siti Zamilatul , Supardi Sudibyo , Andrajati Retnosari
Published: October 2017

Objective: Intracranial hemorrhaging is a life-threatening condition that requires intensive treatment. Such hemorrhaging can happen spontaneously and may be caused by vascular malformations, trauma, or the administration of anticoagulant medications. The purpose of this study was to evaluate the risks of using tranexamic acid and Vitamin K for decreasing prothrombin time (PT) and activated partial thromboplastin time (aPTT) values in intracranial hemorrhagic patients.Methods: This study used a retrospective cohort design, and data were taken from patients’ medical records at the medical record installation of Rumah Sakit Umum Pusat Fatmawati in Jakarta. A total of 125 medical records were selected based on the inclusion criteria. The first group included patients receiving only tranexamic acid, and the second group consisted of patients receiving both tranexamic acid and Vitamin K.Results: Statistical analysis using Chi-squared testing for the first group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), but there was no significant decrease in PT values, with p=0.314 (p<0.05). Statistical analysis using Chi-squared testing in the second group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), and a significant decrease in PT values, with p=0.034 (p<0.05). Patients that used tranexamic acid and Vitamin K decreased the PT and aPTT values 2.7 times and 1, 6 times greater than patients without tranexamic acid and Vitamin K. Patients that used tranexamic acid decreased the PT and aPTT values 2.5 times and 1.2 times greater than patients without tranexamic acid.Conclusions: The combination of tranexamic acid and Vitamin K is potentially more effective in decreasing of hemorrhaging.
DATABASE COMPILATION AND VIRTUAL SCREENING OF SECONDARY METABOLITES DERIVED FROM MARINE FUNGI AS EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE ABSTRACT KINASE INHIBITORS
Authors: Watty Mega , Syahdi Rezi Riadhi , Yanuar Arry
Published: October 2017

Objective: Epidermal growth factor receptor (EGFR), a transmembrane protein with cytoplasmic kinase activity, transduces growth factor signaling from the extracellular space to the cell. EGFR downstream signaling increases proliferation and reduces apoptosis. Agents that are targeted at intracellular tyrosine kinase are tyrosine kinase inhibitor small molecules, which have a mechanism of action that affects adenosine triphosphate binding to the receptor. The exploration of bioactive compounds from marine materials, including marine fungi, has become a major interest lately for anticancer treatment.Methods: In this research, a database was created and in silico screening was conducted using AutoDock and Vina to obtain potential marine fungi bioactive compounds as EGFR-tyrosine kinase (EGFR-TK) inhibitors, which act as antiproliferative agents on tumor cell growth.Results: This research has concluded that the three marine fungi compounds with the lowest binding free energy, FU0015, FU0051, and FU0202, have great potential as inhibitors of EGFR-TK. Conclusions: Three active compounds were identified as inhibitors of EGFR-TK, which were Fiscalin A, derived from Neosartorya paulistensis KUFC 7897 (FU0015); Aspergiolide B, derived from Aspergillus flavus (FU0051); and Sporothrix A, derived from Sporothrix sp. (FU0202).
ANTIOXIDANT ACTIVITY AND LIPOXYGENASE INHIBITORY ASSAY WITH TOTAL FLAVONOID CONTENT OF GARCINIA LATERIFLORA BLUME LEAVES EXTRACT
Authors: Avelia Sismita , Mauldina Marista Gilang , Elya Berna
Published: October 2017

Objective: Garcinia lateriflora Blume has been reported to have antioxidant activity using the 2,2-diphenyl-1-picrylhydrazyl method with methanol, ethyl acetate, and n-hexane leaves extract inhibitory concentration 50% (IC50) levels of 6.18, 8.03, and 156.8 μg/mL, respectively. Meanwhile, there has been no literature regarding G. lateriflora Blume’s lipoxygenase inhibition activity. The aim of this study was to determine the potential antioxidant activity and lipoxygenase inhibition activity of three leaf extracts of G. lateriflora Blume. Methods: These study test methods involved an assessment of antioxidant activity using the ferric reducing antioxidant power method, an assessment of lipoxygenase inhibition activity through the in vitro method, and a qualitative analysis of flavonoid and total flavonoid content using thin-layer chromatography and the AlCl3 colorimetric method to reveal the most active extract.Results: Based on the assessment for methanol, ethyl acetate, and n-hexane, the results showed that the effective concentration 50% levels of the antioxidant activity of G. lateriflora Blume leaves extract were 9.567, 16.555, and 50.550 μg/mL, respectively. Furthermore, the IC50 levels of the lipoxygenase inhibition activity were 0.693, 0.793, and 1.316 μg/mL, respectively. The most active extract for both of the tests was methanol extract, which has a total flavonoid content of 6.298 mg quercetin equivalents/g.Conclusions: Based on the test results, it can be concluded that G. lateriflora Blume leaves extracts exhibit antioxidant and lipoxygenase inhibition activities, with methanol extract as the most active extract, containing more flavonoid than the other two extracts.
ASSOCIATION BETWEEN KNOWLEDGE AND COMPLIANCE OF TAKING IRON/FOLIC ACID SUPPLEMENTS DURING PREGNANCY
Authors: Titaley Christiana R , Rahayu Enrika , Damayanti Rita , Dachlia Dini , Sartika Ratu Ayudewi , Ismail Amry , Sanjaya Adhi , Karyadi Elvina
Published: October 2017

Objective: In Indonesia, pregnant women are recommended to take a minimum of 90 tablets of iron/folic acid (IFA), to prevent iron deficiency anemia. Our analysis aimed at examining the extent to which improved knowledge on IFA supplementation is associated with women’s compliance with taking a minimum of 90 IFA tablets during their last pregnancy in four districts in Indonesia.Methods: Data were derived from a cross-sectional study conducted in four districts, that is, Lebak and Pandeglang District (Banten Province) as well as Purwakarta and Subang District of West Java Province, Indonesia on June 2014. We used information from 436 mothers who delivered their baby in the last 6 months from the time of the survey and received at least 90 IFA tablets during her last pregnancy. Logistic regression analysis was used to examine the role of knowledge after controlling for confounders and other significant predictor on compliance with taking a minimum of 90 IFA tablets during pregnancy.Result: Significant association was found between knowledge of IFA supplements and compliance. Compared to women with poor knowledge of IFA supplementation, the odds of taking a minimum of 90 IFA tables increased by almost 100% in women with moderate knowledge (adjusted odd ratio [aOR]=1.96, 95% confidence interval [CI]: 1.17-3.30, p=0.011); and by more than four times (aOR=5.42, 95% CI: 1.76-16.68, p=0.003) in women with good knowledge of IFA supplementation. Other factors associated with compliance was attendance in at least four antenatal services (aOR=5.71, 95% CI: 1.28-25.53, p=0.023) and pregnant women experience of no side effects resulting from taking IFA tablets during pregnancy (aOR=2.70, 95% CI: 1.63-4.46, p<0.001).Conclusions: Efforts to increase women’s knowledge on IFA supplementation through community-based education will increase women’s compliance of taking IFA supplements. Strengthening counseling services on potential side effects of IFA supplementation and ways to manage them will also help to improve compliance.
Graphs with two main and two plain eigenvalues
Authors: Hayat Sakander , Javaid Muhammad , Koolen Jack
Published: October 2017

In this note, we study graphs with two main and two plain eigenvalues.
Besides some other characterization results, we characterize the disconnected
graphs with two main and two plain eigenvalues. Moreover, we provide several
families of examples of such graphs.
Locating eigenvalues of unicyclic graphs
Authors: Braga Rodrigo , Rodrigues Virgínia , Trevisan Vilmar
Published: October 2017

We present a linear time algorithm that computes the number of eigenvalues of
a unicyclic graph in a given real interval. It operates directly on the
graph, so that the matrix is not needed explicitly. The algorithm is applied
to study the multiplicities of eigenvalues of closed caterpillars, obtain the
spectrum of balanced closed caterpillars and give sufficient conditions for
these graphs to be non-integral. We also use our method to study the
distribution of eigenvalues of unicyclic graphs formed by adding a fixed
number of copies of a path to each node in a cycle. We show that they are not
integral graphs.
Higher order bell polynomials and the relevant integer sequences
Authors: Natalini Pierpaolo , Ricci Paolo
Published: October 2017

The recurrence relation for the coefficients of higher order Bell polynomials,
i.e. of the Bell polynomials relevant to nth derivative of a multiple composite function, is proved. Therefore, starting from this recurrence
relation and by using the computer algebra program Mathematica?, some
tables for complete higher order Bell polynomials and the relevant numbers
are derived.
Subperiodic trigonometric subsampling: A numerical approach
Authors: Sommariva Alvise , Vianello Marco
Published: October 2017

We show that Gauss-Legendre quadrature applied to trigonometric polynomials
on subintervals of the period can be competitive with subperiodic
trigonometric Gaussian quadrature. For example with intervals corresponding to few angular degrees, relevant for regional scale models on the earth
surface, we see a subsampling ratio of one order of magnitude already at
moderate trigonometric degrees.
Modulation of the laser power to prevent hot cracking during laser welding of tempered steel
Authors: Schaefer Marcel , Kessler Steffen , Scheible Philipp , Graf Thomas
Published: October 2017

It is shown that a temporal modulation of the laser power can prevent the formation of hot cracks during deep-penetration laser welding of tempered steel. For this purpose, the influence of the modulated laser power on the cumulated length of the hot cracks in the weld seams was quantified. Varying amplitude and frequency of the modulation significantly changes the pattern and length of the hot cracks. Moreover, hot cracks can be prevented entirely in a specific range of the modulation frequency that depends on the welding speed. Our results indicate that the reduction of hot cracks might be related to a change of the fluctuating length of the weld pool, which was detected by means of thermographic imaging.
Lama-ajan joutilas mies ja homososiaalinen yhteisö Pekko Aikamiespoika -elokuvissa 1993‒1997
Authors: Kallioniemi Noora , Karvo Elina
Published: October 2017

Tarkastelemme artikkelissa Pekko Aikamiespoikaa ja hänen Tyräaholla asuvia ystäviään esimerkkeinä positiivisesta joutilaisuudesta ja huolta pitävästä homososiaalisesta yhteisöstä. Pekko-elokuvien (1993‒1997) tuotannon ja tulkinnan kehys on 1990-luvun syvä lama. Ajan julkisessa keskustelussa suhde työttömiin koveni ja työvoiman ulkopuolelle jäämistä alettiin pitää yksilön henkilökohtaisena ominaisuutena. Joutilas työtön ei osallistunut tarpeeksi ahkerasti itsensä kehittämiseen ja kansakunnan talouden tasapainottamiseen. Samalla ajan miestutkimuksessa nostettiin esiin miehille asetetut epärealistiset rooliodotukset jatkuvasta selviytymisestä taloudellisesti tiukkoina aikoina. Pekko ystävineen edustaa positiivista joutilasta miestä, joka toimii aktiivisesti tärkeinä pitämiensä asioiden edistämiseksi, opiskelee haluamiaan asioita ja ennen kaikkea on arvostettu osa omaa yhteisöään. Näin hän on itse asiassa esimerkillinen innovatiivinen kansalainen, mutta hänen toimeliaisuutensa kohdistuu yhteiskunnan kannalta vääriin kohteisiin.

Timo Koivusalon Pekko on hahmona intermediaalinen ja ammentaa edeltävistä suomalaisen elokuvan lajityypeistä kuten maalaiskomedioista ja rillumarei- ja tukkilaiselokuvista. Pekko tarjoaa Uuno Turhapuron tavoin katsojalle sadunomaisen maailman, jossa arkipäivän murheet on mahdollista asettaa syrjään. Pekko-elokuvien aikalaiskritiikeissä nostettiin vahvasti esiin lama-ajan synkkien näkymien kaukaisuutta Tyräahon kylän idyllisessä maalaismaisemassa. Pekon joutilaisuus nouseekin erityiseen asemaan ristiinluettaessa elokuvien komediallista historiaa lama-ajan yhteiskunnallista kontekstia vasten.
THE CONCEPTUAL SCHEME OF INFORMATION SECURITY IN THE OBJECT PROTECTION MODEL
Authors: Popov Alexander Georgievich , Popov Georgiy Aleksandrovich , Rudenko Mikhail Fedorovich , Shishkin Nickolai Dmitrievich
Published: October 2017

This paper proposes a conceptual scheme of information security (IS) which comprises most existing IS systems. There are shown seven components describing IS process in the object protection model: requirements to IS support; the data protected; threats to the protected data; countermeasures to the threats; information system for the protected data processing; conditions facilitating or impeding IS process; object of protection. The diagram showing interrelations of the listed components has been given. The meanings of the entities "requirements", "Information system", "conditions", "object of protection" have been clarified; mechanisms for influencing IS process of such entities as "information system", "conditions", "object of protection" have been revealed. For the entity "requirements" there have been allocated seven classes of requirements to ensure information security; the main legislative and normative documents that define the content of these requirements for each class of requirements have been given. The approaches to measurability and assessment of the rate of requirements implementation have been described. It is stated that a number of elements in a wealth of elementary requirements are rather high, therefore, instead of the list of elementary requirements there are usually developed several generalized factors (probabilistic factor, time factor, expenses factor). IS systems oriented to these factors help to realize a more flexible IS technique, when cases of IS violation not leading to a substantial damage could be even neglected, and IS system will mainly focus on preventing most dangerous attempts to break IS.
Maternal and fetal effects of dexmedetomidine infusion in pregnant ewes anesthetized with sevoflurane
Authors: Lépiz Mauricio Loría , Sayre Rebecca , Sawant Onkar , Barr James , Pashmakova Medora , Washburn Kevin , Washburn Shannon
Published: October 2017

OBJECTIVE To characterize the maternal and fetal cardiopulmonary effects of a low-dose infusion of dexmedetomidine without a loading dose in pregnant ewes anesthetized with sevoflurane.

ANIMALS 11 pregnant ewes.

PROCEDURES Anesthesia was induced with propofol and maintained with sevoflurane. Ewes and fetuses were instrumented with arterial and venous catheters, and thermodilution–pulmonary arterial catheters were placed in the ewes. Baseline measurements were obtained at an end-tidal sevoflurane concentration of 3.4%, then dexmedetomidine (2 μg/kg/h, IV) was infused for 90 minutes without a loading dose. Cardiovascular and blood gas variables were measured at predetermined time points.

RESULTS Dexmedetomidine infusion resulted in approximately 30% decreases in maternal systemic vascular resistance, blood pressure, and heart rate. Maternal cardiac index, oxygenation variables, and acid-base status remained unchanged, whereas pulmonary arterial pressure, pulmonary vascular resistance, and stroke volume increased, compared with baseline values. Uterine blood flow decreased by approximately 30% to 36%. Fetal heart rate and blood pressure remained unchanged, but significant increases in fetal plasma glucose and lactate concentrations were detected.

CONCLUSIONS AND CLINICAL RELEVANCE Pregnant ewes receiving a combination of sevoflurane and an infusion of dexmedetomidine without a loading dose had cardiac index in acceptable ranges and maintained normoxia. This balanced anesthesia did not produce significant changes in fetal blood pressure or heart rate. However, the increase in fetal plasma lactate concentration and changes in maternal pulmonary vascular resistance and uterine blood flow require further investigation to better elucidate these effects.