bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Maintenance Practices Among Nurses of a Tertiary Level Hospital of Nepal
Authors: Shrestha Shovana , Thakuri Aastha Singh , Devkota Rashmi
Published: July 2018

ABSTRACTBackground: Health maintenance practices are those activities that preserve a person’s current state of health and that prevents future diseases or injuries from occurring. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. A healthy nurse can deliver quality care to the patients to the optimal level. However, there are no studies that explored the health maintenance practices among nurses, here in Nepal. This study was therefore conducted to assess the health maintenancepractices among nurses. Materials and Methods: A total of 197 out of 208 nurses from Nepal MedicalCollege Teaching Hospital (NMCTH) were enrolled in the study using purposive sampling method. Pretested questionnaire was used as a tool for data collection. SPSS version 16 was applied for data entry and analysis. Descriptive statistics (Percentage, frequency, mean, standard deviation) were used for data analysis. Results: Among 208 nurses only 197 responded yielding a response rate of 94.7%. The findings suggest that nurses did not have a good screening, dietary, exercise and vaccination practices. Lack of time, work overload, psychological stress from work were the main barriers pointed out by the nurses that hinder them to maintain their health status. Conclusion: Nurses did not have good health maintenance practices which could directly influence on the quality of care they provided. Thus it is very necessary to initiate program that promotes health of nurses.Keywords: health maintenance practice; Nepal; nurses; self care.
Study of outcome of patients sustaining depressed skull fracture following blunt head trauma
Authors: KC Bidur , Shakya Bikram , Thapa Amit
Published: July 2018

ABSTRACTBackground: One of the common neurosurgical conditions is depressed skull fracture. It could be simple or compound type. This study aims to assess the outcome of the patients with depressed skull fracture.Material and Methods: Retrospective cohort study of the patients admitted with depressed skull fracture after sustaining blunt head trauma was done. Data were collected with regard to age, sex, mode of injury, time delay, Glasgow coma scale (GCS), epilepsy, focal neurological deficit, CT scan findings, treatment given, infection and Glasgow outcome scale (GOS). Results: Total of 50 patients were included, of which 68% were male and 32% were female with mean age of 21.02 ± 18.78 years. Fall was the commonest mode of injury constituting 60% of patients, 80% of the patients presented within 12 hours of injury and 86% of them sustained mild head injury. Fracture was of compound type in 56% and simple type in 44%. Wound debridement and suturing was performed in 26% and Craniotomy and elevation was done in 42%. Dural tear was observed in 47% who were operated. Early epilepsy was seen in 4% and late epilepsy in 2% and infection rate of 2%. Outcome was Favorable in 98% patients. Significant correlation noted between admission GCS with GOS (p=0.006) whereas no correlation was seen between time of presentation with infection (p=0.09).Conclusion: Mild head injury was the commonest form of presentation. Most of the patients have unfavorable outcome and with low risk of infection and epilepsy. Good admission GCS correlated with favorable outcome.Keywords: blunt head trauma; depressed skull fracture; epilepsy; infection; outcome.
Echocardiographic assessment of suspicious clinical and electrocardiogram findings of healthy young male military aspirants: a cross sectional observational study
Authors: Paudel Navaraj , Alurkar Vijay Madhav
Published: July 2018

ABSTRACTBackground: Heavy exercise is associated with multiple physiological changes in cardiovascular system. Individuals who otherwise are healthy and asymptomatic are also found to have cardiac abnormalities. The aim of study is to find prevalance of structural abnormalities in apparently healthy males who are found to have abnormal/ suspicious clinical/electrogram findings during routine screening. Materials and Methods:A cross-sectional study was done in the department of cardiology within Manipal Teaching Hospital, Pokhara over a period of 3 years (December 2013 to December 2016). The study population included all the participants who were apparently healthy young males competing for military recruitment. After the initial screening, those who had abnormal/suspicious findings in the physical examination or in ECG were subjected for trans-thoracic echocardiogram to assess for any structural abnormality Results: Out of 1950 individuals, who underwent physical examination and ECG, 165 had abnormal physical findings and 261 had abnormal ECG findings (21.84% of total had any form of abnormality). 72 (43%) had grade 2 short systolic murmur in the pulmonary area followed by pansystolic murmur in apex. Only 1.8% had diastolic murmur in aortic area. Most common ECG abnormality found was LVH followed by sinus bradycardia and Tinversion in III . Almost 7% of individuals with abnormal ECG findings. Only 16 (0.82% of the total screened/ 4.38% of suspicious findings) had structural abnormalities in echocardiography: 12 had RHD (MR-7, AR-3, R+AS+MR=2); 1 had ASD, 1 had VSD, 1 had Ebstein’s anomaly and 1 had mild valvular pulmonary stenosis (congenital). Conclusion: Individuals who are otherwise healthy and asymptomatic were found to have cardiac abnormality (almost 1.7% had serious electrical or structural abnormality). Cardiovascular screening of all the individuals seeking jobs requiring intense physical exertion is essential to prevent serious cardiovascular outcomes.Keywords: echocardiography; electrocardiography; intense exercise; physical cardiac findings.
Panoramic Radiographic Assessment of Status of Impacted Mandibular Third Molars: A Tertiary Care Centre Based Study in Eastern Nepal
Authors: Regmee Pragya , Rimal Jyotsna , Maharjan Iccha Kumar , Niraula Surya Raj
Published: July 2018

ABSTRACTBackground: Mandibular third molar (M3M) is the most posterior of the three molars present in each quadrant. Racial variation, genetic inheritance etc can affect the jaw size, size of tooth and ultimately the eruption state of M3M. So, studies of impacted M3Ms have been carried out in various populations. But data relating to these are not evident from most of the parts of Nepal. Hence, this study was done to assess the status of impacted M3Ms in a tertiary care center in eastern Nepal. Materials & Methods: Total of 220 patients’ M3Ms (i.e 440 sites of M3Ms) were assessed with Panoramic Radiographs, in Department of Oral Medicine and Radiology. The impaction status was divided as class of impaction (I, II, III), level of eruption (A, B, C) and angulation (mesioangular, vertical, distoangular and horizontal). Data were entered in Microsoft excel sheet and analyzed using SPSS software version 11.5. Results: Class II impaction state wasmost commonly present in this population group, in 345 sites (85.18%) while none of the patients had class III impaction. Level A eruption was most prevalent, 315 sites (77.78%). The least prevalent was level C eruption, 14 sites (3.46%). Majority 18 sites (46.67%) had vertical inclination while only 32 sites (7.9%) had horizontal inclination. Conclusion: The most prevalent impaction state of M3M in this populationgroup is Class II, Level A with vertical angulation. Keywords: impacted teeth; mandible; panoramic radiography; third molar.
Survey of current materials and impression techniques for Complete Dentures among Nepalese Prosthodontists
Authors: Bhochhibhoya Amar , Acharya Binod , Rana Samskar Bickram , Sharma Rinu , Acharya Jemish , Maskey Brijesh
Published: July 2018

ABSTRACTBackground: Impression making is one of the critical factors in determining success or failure of complete denture therapy. The precise reproduction of edentulous foundation is essential for retention, stability, and support of the removable prosthesis. Evidence suggests that there is variability in materials and techniques regarding impressions making for complete dentures. There is little published information on studies conducted among Nepalese Prosthodontists. The purpose of this study was to evaluate current materials andmethods for impressions for complete denture prosthodontics in Nepal. Materials & Methods: A questionnaire based survey was conducted among Nepalese Prosthodontists. Ethical approval for the beginning of the study was obtained via Institutional Review Committee, Nepal Medical College. A self-administered anonymous questionnaire was distributed to the participants. Data were analyzed by using frequency distribution.Results: Majority of responses indicated use of irreversible hydrocolloid in stock metal tray for making the preliminary impression. The selective pressure was the predominantly used impression philosophy (78.3%). The most common material for the fabrication of custom trays was autopolymerizing acrylic resin (96.7%). All respondents border molded the custom tray prior to making the final impression. The final impression materials used were zinc oxide eugenol impression paste (73.3%), polyvinylsiloxane (11.7%), polyether (11.7%) and polysulphide (3.3%). Conclusion: Although there is variability in impression materials andtechniques used by Prosthodontists in Nepal for the fabrication of complete dentures, the results showed interesting trends. Most practitioners followed the traditional techniques of complete denture impression procedures.Keywords: complete denture; custom tray; edentulism; impression.
Pediatric brain abscess clinical profile, management and outcome at tertiary care centre in Nepal
Authors: Kafle Prakash , Sharma Mohan Raj , Shilpakar Sushil Krishna , Sedain Gopal , Pradhanang Amit , Shrestha Ram Kumar , Bhandari Binod Raj , Khanal Babita
Published: July 2018

ABSTRACTBackground: Brain abscess in pediatric population is serious life threatening problem. Many risk factors are associated with this entity like congenital heart disease, ear infection and immunocompromised state. Early diagnosis and treatment with minimal invasive procedure has good outcome. Materials and Methods: This is a hospital based cross-sectional study conducted at institute of Medicine (IOM), Tribhuvan University Teaching Hospital Kathmandu, Nepal over the period of 3 years between September 2014 to August 2017. Clinical profile, management and outcome were analyzed. Results: A total of 27 cases were taken for the surgical management in the present study. There were 18 male and 9 female with the male to female ratio of 2:1. Mean age of the study population was 7.08 years. Otogenic Abscess was the most common 37.03% (n=10) and the temporal lobe was the most common site (37.5%). Headache was the most common clinical presentation seen in 74.07 %. All the cases were initially managed with the burrhole and aspiration. Only 14.8 %( n=4) of cases subsequently required surgical excision of the abscess wall. Only18.5 %( n=5) of the cases required multiple session aspiration. Positive culture was seen in 25.9% (n=7). Pseudomonas aeruginosa and E.coli were the commonest organisms grown. Mortality rate was 3.7%.Conclusion: Modern advances in radio imaging and multidisciplinary team involvement has decreased the morbidity and mortality.Keywords: otogenic brain abscess; pediatric brain abscess; tubercular abscess.
Analisis Pelaksanaan Bimbingan Belajar dalam Mengatasi Kesulitan Belajar Siswa
Authors: Rozak Abdul , Fathurrochman Irwan , Ristianti Dina Hajja
Published: July 2018

This study aims to determine the description of the Planning program preparation of counseling program especially PKO Services with the field of Tutoring and to know the extent to which the implementation of Tutoring Teachers Teachers in overcoming students' learning difficulties in SMA Simpang Semambang. The subjects of this study are teachers, principals and students. This type of research is field research (field research), with qualitative descriptive approach. Data collection techniques by observation, documentation, interview and distribution of KPMP data. Data analysis technique used qualitative descriptive analysis. The results of research and data analysis have concluded that Program Guidance and Counseling Service (Tutoring) in Simpang Semambang State Senior High School has been planned and made in accordance with the needs of schools and guidelines. In fact the implementation of tutoring in SMA Simpang Semambang sometimes not fully able to solve every problem of student learning difficulties that occur due to the service process or guidance is implemented minimal intensity and minimal continuity, it could be from other factors that influence it. The services are done with classical format that is in the classroom as for the service materials only in the form of advice and motivation, while the service with the field of tutoring is still minimal.

Keywords: Implementation of Tutoring Program, Learning Difficulty
Kesulitan Siswa dalam Menyelesaikan Soal Fisika pada Materi Suhu dan Kalor di Kelas X SMA Ar-Risalah Lubuklinggau Tahun Pelajaran 2016/2017
Authors: Charli Leo , Amin Ahmad , Agustina Desi
Published: July 2018

The purpose of this study is to determine the type of difficulty, causal factors, and provide solutions to overcome the difficulties in solving materials physics matter temperature and heat.Techniques of collecting data using tests, questionnaires, and interviews.The subjects of class X High School Ar-Risalah Lubuklinggau.From the analysis of the test data found the difficulty proportion of 80.3% problem, the difficulty of using symbols 76.2%, difficulty using the formula of 84%, difficulty analyzing the graph of 65% and 90% difficulty count.Based on the results of interviews and questionnaires, the factors that cause students to have difficulty understanding the problem is that students do not understand the purpose and purpose of the problem, the lack of students' understanding of the material, the students rarely repeat the material that has been studied at home and students lazy exercise to do the question.The cause of the difficulty of using symbols is that students forget the physical symbol and students remember the symbol by memorizing not understanding it.The cause of difficulty using the formula is the students are not interested and feel complicated with the matter that there is a formula and students do not master the concept of the material well.The cause of the difficulty of analyzing the graph is the students do not understand the purpose of the graph, the students feel complicated and not interested in the matter of the graph.The cause of the difficulty of counting is the students are less interested in the matter of the count, the students are not careful in calculating, the students have difficulty performing the count operation, and the teacher rarely gives a varied problem.

Keywords:Difficulty, Problem Solving, Temperature and Heat
Implementasi Pendekatan Floor Time untuk Mengatasi Anak Lambat Bicara Usia 3-4 Tahun
Authors: Zusfindhana Inna Hamida
Published: July 2018

This research is motivated by the objective condition of children with speech delay. Floor time is one way of therapy used to overcome speech delay. The purpose of this study is to improve the speech development of children aged 3 to 4 years. The method used in this research is qualitative method using observation and interview to collected the data of children with speech delay. Research subject is children with speech delay talk 3 to 4 years age. The result showed that the ability of children is in the fourth stage of complex communication, where children begin to show the phase of lalling.

Keywords : floortime, speech delay, age 3 to 4 years
Upaya Meningkatan Kemampuan Menentukan Unsur Unsur Intrinsik Cerita Rakyat Siswa Kelas III SD Negeri 25 Lubuklinggau Melalui Model Pembelajaran Kooperatif Tipe Think Pair And Share (TPS)
Authors: Zubaidah Siti
Published: July 2018

The purpose of this research is to prove that through cooperative learning model of Think Pair and Share (TPS) type can improve the ability of third grade students of SD Negeri 25 Lubuklinggau in determining the intrinsic elements of folklore. The method used in this research is Classroom Action Research method (PTK) which is preceded by pratindakan data and twice the implementation of the research cycle. Results of test data on pratindakan of 36 students, students who scored 65 or have completed as many as 21 people or 58.33 percent of the number of students. While students who scored less than 65 or not completed as many as 15 people or 41.67 percent, with an average grade grade of 61.25. In the first cycle there is an increase in value gains. Students who have completed as many as 26 students or 72.22 percent while unfinished as many as 10 people or 27.78 percent with an average score of 66.53. This is an increase of 5.28 or 8.62 percent. Cycle II also increased, from 36 students who have completed as many as 33 students or 91.67 percent and unfinished as many as 3 students or 8.33 percent with an average value of 75.69. If the calculated increase from the pre-action value until the second cycle there is an increase of 16.1 percent. Thus, the hypothesis that is found in this research is proved, that with the implementation of cooperative learning model Think Pair and Share (TPS) can improve the ability to determine the intrinsic elements in folklore students III SD Negeri 25 Lubuklinggau.

Keywords: Cooperative Model, Think Pair and Share, Intrinsic Elements.
Upaya Meningkatkan Kemampuan Membuat Kalimat Tanya Melalui Metode Tutor Sebaya di Kelas I Sekolah Dasar Negeri 25 Lubuklinggau
Authors: Sumarni Sumarni
Published: July 2018

The purpose of this research is to know the application of peer tutor method can improve the ability of second grade students of SD Negeri 25 Lubuklinggau in making a question word. The method used in this research is using the Class Action Research approach (PTK) which is preceded by pratindakan data and twice the implementation of the research cycle. The results of test data on pratindakan of 24 students, students who scored 65 or have completed as many as 14 people or 58.33 percent of the number of students. While students who scored less than 65 or not completed as many as 10 people or 41.67 percent, with an average grade of 63.75. In the first cycle there is an increase in value gains. Students who have completed as many as 17 students or 70.83 percent while unfinished as many as 7 people or 29.17 percent with an average value of 67.08. This is an increase of 3.33 or 5.23 percent. Cycle II also increased, from 24 students who have completed as many as 22 students or 91.67 percent and who have not completed as many as 2 students or 8.33 percent with an average value of 75.21. If the calculated increase of pratindakan value until cycle II there is an increase of 11.61 percent. Based on these data the hypothesis that was found in this study proved, that with the application of peer tutor method can improve the ability to make sentences asked students of class I SD Negeri 25 Lubukkinggau.

Keywords: Ability, Peer Tutor, Sentence Question
Upaya Meningkatkan Hasil Belajar Siswa Kelas III SD Negeri 39 Lubuklinggau dalam Pembelajaran IPA tentang Gerak Benda melalui Metode Demonstrasi
Authors: Susilawati Susilawati
Published: July 2018

The purpose of this study was to determine the effort to improve the learning outcomes of third grade students of SD Negeri 39 Lubuklinggau in science learning about the motion of objects through demonstration methods. This classroom action research consists of three cycles. The preliminary research was conducted on April 3, 2015, cycle 1 on April 10, 2015 and cycle II on April 17, 2015 with the following results; 1) student activity from prasiklus, cycles 1, and cycle 2 increased by 24.14 on prasiklus, 51.72 in cycle I and 86.21 in cycle II, 2) individual completeness also increased, 53.45 percent in prasiklus, and 64.48 percent in cycles I and 75.35 in cycle II, 3) classical completeness also increased, ie 37.24 percent in prasiklus, and 62.07 percent in cycles I and 82.76 in cycle II. Conclusion in the research is the implementation of demonstration method can increase student's learning interest, thus encouraging student learning outcomes in Class III State Elementary School 39 Lubuklinggau

Keywords: Learning Outcome, Demonstration Method, Science Lesson
Upaya Meningkatkan Hasil Belajar Siswa pada Materi Pembentukan Tanah Karena Pelapukan Batuan dengan Model Kooperatif Tipe Two Stay Two Stray di Kelas VI SD Negeri 39 Lubuklinggau
Authors: Nurbayati Nurbayati
Published: July 2018

The low level of activity of grade 6 students of SD Negeri 39 Lubuklinggau in science lesson, and the learning model used is less varied resulting in low student learning outcomes in science lesson, therefore the researcher intends to improve learning by conducting classroom action research consisting of three cycles by using Model Cooperative Type Two Stay Two Stray. The study was conducted on February 2, 2015, cycle 1 on February 9, 2015, and cycle of 10 February 2015 with the following results: first activity of students from prasiklus, cycle 1 and cycle 2 progressed on prasiklus 56.67 percent, students active in cycle 1 increased to 70 percent and cycle 2 to 86.67 percent of active students. Both the average test held in each cycle also experienced a significant increase of average prasiklus only 51.83, in cycle 1 increased to 62.5 and in cycle 2 to 80.83. Completeness also experienced an increase in prasiklus only 43.33 percent, cycle 1 increased to 66.67 percent, and in cycle 2 reached 93.33 percent. So it can be concluded the use of cooperative model type Two Stay Two Stray managed to improve the ability to encourage student achievement, especially Class VI SD Negeri 39 Lubuklinggau.

Keywords: Learning Outcomes, TSTS Model
Pengaruh Model Pembelajaran Berbasis Masalah terhadap Kemampuan Pemecahan Masalah Matematika Siswa Kelas XI IPA MA Negeri 1 Lubuklinggau
Authors: Luthfiana Maria , Yuliansyah Yuliansyah , Fauziah Anna
Published: July 2018

This research issue is whether there is influence of problem-based learning model for mathematical problem solving ability of students grade XI IPA MA Negeri 1 Lubuklinggau ?. The method used is a true experimental design were carried out with the comparison group. The study population  was all students in grade XI IPA MA Negeri 1 Lubuklinggau, which consists of 113 students. As an experimental class is a class XI IPA 3 as many as 36 students and a control class is the class XI IPA 2 were 38 students randomly selected. Data collected by the testing techniques in narrative form. Data were analyzed using t-test. Based on the results of t-test analysis on the level of significance α = 0.05, obtained t_hitung (6.80) > t_tabel (1.671), so that it can be concluded there is the influence of problem-based learning model for mathematical problem solving ability of students grade XI IPA MA Negeri 1 Lubuklinggau.

Keywords: Problem Based Learning, Problem Solving Ability Mathematics
Pengaruh Strategi Think Talk Write (TTW) terhadap Pemahaman Konsep Matematika Siswa Kelas VIII SMP Negeri 2 Lubuklinggau
Authors: Fitriyana Nur , Asnurida Rani
Published: July 2018

This research aims to determine the influence of Think Talk Write (TTW) strategy to understand of mathematical concept students class VIII SMP Negeri 2 Lubuklinggau. The method used in this research is pure experiment. The population is the entire class VIII SMP Negeri 2 Lubuklinggau academic year 2016/2017 which amounts to 444 students, as the sample is class VIII.9 as experimental class and class VIII.7 as a control class taken at random. Data collection is done by test technique. Collected data was analyzed using t-test at significant level α = 0,05, obtained tcount > ttable that is 3,48 > 1.67, so it can be concluded that there is significant influence of Think Talk Write (TTW) strategy to understanding of mathematical concepts student class VIII SMP Negeri 2 Lubuklinggau. The average score of students' understanding of mathematical concepts in the final test of the experimental class is 25.23 and the control class is 17.44.

Keywords: Think Talk Write strategy (TTW), Understanding of Mathematical Concepts.
Peningkatan Ketuntasan Hasil Belajar Matematika Menggunakan Model Cooperative Learning Tipe STAD melalui Pemanfaatan Alat Peraga
Authors: Winarto Bambang
Published: July 2018

The aim of this research is to improve students' learning mastery. This research uses qualitative and quantitative descriptive approach and this type of research is classroom action research. Methods of data collection using observation, test and documentation. The results obtained in this study is the result of student learning. This shows that in teaching and learning activities with contextual learning the students become very active. While student's learning completeness classically in cycle I reach 77,5% increase in cycle II to 90% so that only some student who have not finished their study. This suggests that STAD type cooperative learning can be considered as a learning model used by teachers. The conclusion that can be drawn from the data analysis and discussion is by applying STAD type cooperative learning can improve student learning outcomes. Based on the results of data analysis and discussion of the results of research on the application of STAD learning on student learning outcomes, it can be concluded the application of these methods can attract students to follow the teaching and learning activities to the end of the lesson with a pleasant learning environment that can lead to increased student learning outcomes.

Keywords: Cooperative Learning, TYPE STAD, Learning Outcomes.
Antifungal, Anti-aflatoxigenic, Antioxidant Activity and in vivo Efficacy of Essential Oil of the Aerial Parts of Thymus capitatus (L.) Hoffmanns & Link
Authors: Ben Miri Y. , Djenane D.
Published: July 2018

Aspergillus flavus has been reported to be the most common fungus used as food by human beings. This fungus may have the potential to produce aflatoxin B1 (AFB1), which is reported as being the most hepatotoxic, teratogenic, mutagenic, and immunosuppressive to humans and other livestock. Therefore, the objective of this work was to study the chemical profile of Thymus capitatus essential oil (EO) and the inhibition of growth of Aspergillus flavus E73 and AFB1 production by the EO. The antioxidant activity and phytotoxicity were also evaluated. The gas chromatography– mass spectrometry (GC–MS) analysis showed that the major components of Thymus capitatus EO were thymol (25.82%), linalool (23.40%), geraniol (14.22%), pcymen- 3-ol (8.93%), and p-cymene (6.76%). The results showed that the EO could inhibit the growth of Aspergillus flavus E73 in the range of 40.72 to 87.00%. The minimal inhibitory concentration (MIC) of Thymus capitatus EO against Aspergillus flavus E73 was found to be at 1.00 mg/ml. The oil revealed complete inhibition of dry mycelium weight and AFB1 production at 1.00 mg/ml. The EO revealed a broad spectrum of fungitoxicity against some fungi. The antioxidant activity was also assessed where IC50 (when initial concentration is reduced to half) and β- carotene/linoleic acid inhibition percentage of Thymus capitatus EO were 619.16 ± 3.94 μg/ml and 65.55%, respectively, while the total phenolic content was 21.45 μg/mg. The EO showed non-phytotoxicity on two varieties of wheat seeds. These findings demonstrated that EO could be good alternative to protect food.
Toxicité rénale des immunoglobulines intraveineuses
Authors: Luque Y.
Published: July 2018

Les immunoglobulines intraveineuses (IgIV) sont largement prescrites de nos jours à visée substitutive ou à visée immunomodulatrice. Les IgIV sont prescrites à faible dose (environ 200 mg/kg) dans les déficits immunitaires afin de substituer les IgIV endogènes manquantes ou à forte dose (1 à 2 g/kg et par cure) à visée immunomodulatrice dans diverses pathologies inflammatoires ou auto-immunes. Ces produits, fabriqués à partir de plasmas de donneurs sains, peuvent s’accompagner d’une toxicité rénale décrite dès les années 1990. Il s’agit d’une toxicité tubulaire pouvant aboutir à des insuffisances rénales aiguës sévères. L’analyse des biopsies rénales révèle des vacuolisations des cytoplasmes tubulaires et des lésions de nécrose tubulaire aiguë. Les excipients glucidiques et en particulier le saccharose sont les principaux facteurs favorisant cette néphrotoxicité. L’utilisation d’IgIV sans saccharose a permis de diminuer nettement les cas d’insuffisance rénale aiguë et doit être préférée chez les patients ayant une insuffisance rénale préalable ou à risque d’en développer (patients âgés, diabétiques, obèses, hypovolémiques ou transplantés rénaux).
SmtDNA: A Geant4-DNA user application for evaluating radiation-induced damage in supercoiled mitochondrial DNA
Authors: Tavakoli M B , Moradi H , Khanahmad H , Hosseini M , Rahimmanesh I
Published: July 2018

Background: There is no geometrical nucleotide resolution model which can be used in numerical simulations of the interaction between radiation and supercoiled mt-DNA to perform realistic evaluations of DNA–free radical reactions.Objectives: A new geometrical model of mitochondrial DNA (mt-DNA) is developed in Geant 4-DNA to investigate the radiation-induced damage on mt-DNA. The presented application can be used to modify both geometrical parameters and structural elements, and to evaluate the damage induced on the mt-DNA molecule by ionizing particles.Methods: Our model covers the organisation of a supercoiled human mitochondrial genetic system. The current model includes all 16,659 base pairs of human mitochondrial DNA. This new mtDNA model has been preliminarily tested in this work by determining SSB and DSB DNA damage yields and site-hit probabilities due to the impact of proton particles.Results: Determination of single-strand (SSBs) and double-strand breaks (DSBs) is designed using the locations of all hit sites. Estimation of single-strand breaks and double strand breaks yielded similar results with the increment of incident particle LET. The output results contain the information about the energy transfers in the backbone region of DNA double helix.Conclusions: Considerations seem to be consistent with the corresponding experimental determinations. This application can be used for the investigation of radiation-induced damage to the mitochondrial genome and in any problems that require a supercoiled geometrical model. This work is going to be extended to circular conformation in a parallel project in the near future.
Efficacy and Safety of CalliSpheres® Drug-Eluting Beads Transarterial Chemoembolization in Barcelona Clinic Liver Cancer Stage C Patients
Authors: Liu Yaohong , Huang Wensou , He Mingji , Lian Hui , Guo Yongjian , Huang Jingjun , Zhou Jingwen , Zhu Kangshun
Published: July 2018

This study aimed to investigate the efficacy and safety of drug-eluting beads transarterial chemoembolization (DEB-TACE) treatment in Barcelona Clinic Liver Cancer (BCLC) stage C liver cancer patients. In 39 patients with BCLC stage C liver cancer, after the first cycle of DEB-TACE,
2 (5.1%) and 24 (61.5%) patients achieved complete response (CR) and partial response (PR) to give an overall objective response rate (ORR) of 66.7%. With respect to the second cycle of therapy, the ORR was higher in patients receiving DEB-TACE compared with those receiving cTACE (57.1% vs.
11.1%). After the first cycle of DEB-TACE treatment, the percentages of abnormal albumin (ALB), total protein (TP), total bilirubin (TBIL), and alanine aminotransferase (ALT) worsened at 1 week and recovered at 1 month. The number of patients with abnormal aspartate aminotransferase (AST)
did not increase at 1 week but elevated at 1 month. After the second cycle of DEB-TACE or cTACE treatment, no difference was observed between cTACE and DEB-TACE in terms of all adverse events (AEs) at all visits, and most of the AEs did not change after the second cycle in both groups. The
most common AEs after the first and second treatment cycles were pain, fever, and nausea/vomiting. These results demonstrate that DEB-TACE offers patients with BCLC stage C liver cancer a clinically active short-term treatment that is safe and relatively well tolerated.
Characteristics and Outcomes of Patients with Systemic Lupus Erythematosus–associated Thrombotic Microangiopathy, and Their Acquired ADAMTS13 Inhibitor Profiles
Authors: Yue Cai , Su Jian , Gao Ruitong , Wen Yubing , Li Chao , Chen Gang , Zhang Xuan , Li Xuemei
Published: July 2018

Objective.

To investigate the characteristics and outcomes of patients with systemic lupus erythematosus (SLE)–associated thrombotic microangiopathy (TMA) based on their ADAMTS13 inhibitor profiles.

Methods.

The medical data of 31 SLE patients with clinically diagnosed TMA were analyzed. ADAMTS13 activity and ADAMTS13 inhibitor were measured in all patients.

Results.

TMA was attributable to active SLE in 19 patients. ADAMTS13 inhibitor and severe ADAMTS13 deficiency were detected in 6 of them. Patients with ADAMTS13 inhibitor (n = 6) exhibited a lower platelet count (7.3 ± 5.1 vs 25.0 ± 17.8 × 109/l, p = 0.005) and more prevalent central nervous system (CNS) involvement (100.0% vs 23.1%, p = 0.003) than patients without ADAMTS13 inhibitor (n = 13). Patients with ADAMTS13 inhibitor also had mild renal involvement characterized by a higher estimated glomerular filtration rate (112.7 ± 18.0 vs 21.6 ± 12.0, p < 0.001), lower proteinuria level [0.6 (0.2–2.5) vs 8.1 (5.2–14.0) g/d, p = 0.011], and lower mean arterial pressure (95.3 ± 13.6 vs 117.5 ± 13.1 mmHg, p = 0.008) than was observed in patients without ADAMTS13 inhibitor. All patients with ADAMTS13 inhibitor achieved complete remission within 18.6 ± 8.7 days, while 3 patients (23.1%) without ADAMTS13 inhibitor achieved complete remission during a median followup of 5.0 months, even though more patients in this group received therapeutic apheresis (100.0% vs 50.0%, p = 0.021). The chance of complete remission increased by 10.8-fold (HR 10.8, 95% CI 1.8–65.5, p < 0.001) when ADAMTS13 inhibitor was present in SLE-associated TMA.

Conclusion.

Acquired ADAMTS13 deficiency is associated with more severe thrombocytopenia and CNS involvement, mild renal involvement, rapid resolution, and relatively good treatment response in SLE-associated TMA.
Monitoring of Systemic Lupus Erythematosus Pregnancies: A Systematic Literature Review
Authors: McDonald Emily G. , Bissonette Lyne , Ensworth Stephanie , Dayan Natalie , Clarke Ann E. , Keeling Stephanie , Bernatsky Sasha , Vinet Evelyne
Published: July 2018

Objective.

Few data exist to guide the frequency and type of monitoring in systemic lupus erythematosus (SLE) pregnancies. A systematic literature review was performed to address this gap in the literature.

Methods.

A systematic review of original articles (1975–2015) was performed using Medline, Embase, and Cochrane Library. We included search terms for SLE, pregnancy, and monitoring. We also hand-searched reference lists, review articles, and grey literature for additional relevant articles.

Results.

The search yielded a total of 1106 articles. After removing 117 duplicates, 929 articles that were evidently unrelated to our topic based on title and/or abstract, and 7 that were in a language other than English or French, 53 articles were included for full-text review. Following a more in-depth review, 15 were excluded: 6 did not use any measure of SLE activity and 6 did not specifically address SLE monitoring in pregnancy; 1 case series, 1 review, and 1 metaanalysis were removed. Among the 38 included studies, presence of active disease, antiphospholipid (aPL) antibodies positivity, and abnormal uterine and umbilical artery Doppler studies predicted poor pregnancy outcomes. No studies evaluated an evidence-based approach to the frequency of monitoring.

Conclusion.

Few existing studies address monitoring for optimal care during SLE pregnancies. The available data imply roles for aPL antibodies measurement (prior to pregnancy and/or during the first trimester), uterine and umbilical artery Doppler studies in the second trimester, and following disease activity. Optimal frequency of monitoring is not addressed in the existing literature.
Psoriatic Arthritis Sonographic Enthesitis Instruments: A Systematic Review of the Literature
Authors: Elalouf Ofir , Bakirci Ureyen Sibel , Touma Zahi , Anderson Melanie , Kaeley Gurjit S. , Aydin Sibel Z. , Eder Lihi
Published: July 2018

Objective.

As part of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) ultrasound working group, we performed a systematic review of the literature to assess the evidence and knowledge gaps in scoring instruments of enthesitis in psoriatic arthritis (PsA).

Methods.

A systematic search of PubMed, EMBase, and Cochrane databases was performed. The search strategy was constructed to find original publications containing terms related to ultrasound, enthesitis, spondyloarthritis (SpA) or PsA. Data extraction focused on the properties of the sonographic enthesitis instruments used in each study following components of the Outcome Measures in Rheumatology (OMERACT) filter: feasibility, test-retest reliability, construct validity as related to clinical assessment of enthesitis, biomarkers of inflammation and imaging of enthesitis by other modalities, discriminative validity, and responsiveness to treatment.

Results.

Fifty-one of 310 identified manuscripts were included. Only 1 scoring instrument of enthesitis was specifically developed and validated in patients with PsA. Only 18 (35%) of the studies involved patients with PsA, while the remaining studies focused on SpA. In PsA, construct validity was assessed using biomarkers and clinical examination in 1 (2%) and 11 (21.5%) of the studies, respectively, whereas no studies used imaging for the same purpose. Only 2 (4%) of the studies assessed discriminative validity in PsA. Responsiveness to treatment was assessed in 7 studies, none of which included patients with PsA.

Conclusion.

Although sonographic enthesitis scoring instruments have been developed for SpA, only a few have been validated in PsA. None of them passed the OMERACT filter in patients with PsA. Additional research is required before endorsing a specific instrument for the assessment of enthesitis in patients with PsA.
Zoster after Cyclophosphamide for Systemic Lupus Erythematosus or Vasculitis: Incidence, Risk Factors, and Effect of Antiviral Prophylaxis
Authors: Garnier Camille , Ribes David , Chauveau Dominique , Huart Antoine , Pugnet Grégory , Adoue Daniel , Prevot Grégoire , Alric Laurent , Delobel Pierre , Derumeaux Hélène , Mengelle Catherine , Sailler Laurent , Moulis Guillaume
Published: July 2018

Objective.

To assess the incidence and the risk factors for zoster in patients exposed to intravenous cyclophosphamide (CYC) for systemic vasculitis or systemic lupus erythematosus (SLE), as well as the protective effect of prophylaxis by valacyclovir (VCV).

Methods.

This retrospective study included all adults treated by intravenous CYC for SLE or systemic vasculitis between 2011 and 2015 at Toulouse University Hospital, France. Zoster occurrence was recorded using medical chart review, laboratory data, and patient interviews. Univariate Cox models were computed to assess the risk factors for zoster and the protective effect of prophylaxis by VCV.

Results.

The cohort consisted of 110 patients (81 systemic vasculitis and 29 SLE). During a mean followup of 3.4 years after CYC initiation, 10 cases of zoster occurred, leading to an overall incidence of 27.9/1000 patient-years (95% CI 15.2–50.6); it was 59.4/1000 patients (95% CI 27.5–123.6) during the year after CYC initiation. Four patients experienced persistent postherpetic neuralgia. Probable risk factors were lymphopenia < 500/µl at CYC initiation (HR 5.11, 95% CI 0.94–27.93) and female sex (HR 4.36, 95% CI 0.51–37.31). The incidence was higher in patients with SLE (HR as compared with systemic vasculitis patients = 2.68, 95% CI 0.54–13.26). None of the 19 patients exposed to VCV during the followup developed zoster.

Conclusion.

The incidence of zoster is high in systemic vasculitis and in patients with SLE exposed to intravenous CYC. CYC may favor postherpetic neuralgia. Prophylaxis by VCV should be considered, particularly in cases of lymphopenia < 500/µl at CYC initiation and during the year after.
Les métamorphoses de la reconnaissance
Authors: Évrard Brigitte , Quazza Jean-Pierre
Published: July 2018

On hésite à positionner l’âge adulte, qui s’étend de la fin de l’adolescence à l’extrême vieillesse, comme une catégorie similaire à celles de l’enfance et de l’adolescence. En effet, sa durée s’étend en général sur plusieurs décennies. De plus, il n’est pas certain que l’âge adulte puisse se ranger dans des catégories comparables, ou même prendre place dans la suite des « phases » décrites ci-dessus, ne serait-ce qu’au regard des théories qui sous-tendent la division de l’enfance en diverses phases développementales. Certains considèrent d’ailleurs que le développement s’achève avec l’entrée dans cet âge, et que s’ouvre alors une période dans laquelle les choix de vie sont d’une nature différente. D’autres considèrent à l’inverse que le développement ne s’arrête pas avec l’entrée dans l’âge adulte. C’est en particulier la thèse des tenants du « potentiel humain » (mouvement dans lequel nombre des analystes transactionnels des premières générations se sont reconnus), qui se traduit par une offre et une pratique du « développement personnel » tout au long de la vie.
L’évolution des savoirs chinois sur l’Afrique : internationalisation des espaces d’apprentissage et transformation des objets de recherche
Authors: Bassan Martina , Gabas Jean-Jacques
Published: July 2018

Resumé L’intégration croissante des chercheurs chinois dans des formations et des réseaux internationaux, ainsi que la multiplication d’espaces d’études supérieures, de rencontres et de débats sur l’Afrique sont à l’origine d’échanges de savoirs et d’une diversification des contenus des productions scientifiques chinoises. Les recherches sur les questions de développement en Afrique sont particulièrement représentatives de cette tendance : à côté des sujets classiques en économie du développement (comme les analyses de filières), de nouvelles thématiques apparaissent telles que celles des politiques publiques et de la sécurité.
Des « puits burkinabè » en Haute Guinée : processus et enjeux de la circulation de savoirs techniques dans le secteur minier artisanal
Authors: Lanzano Cristiano , Arnaldi di Balme Luigi
Published: July 2018

Resumé L’extraction artisanale de l’or en Afrique de l’Ouest mobilise des savoirs techniques et entraîne des innovations qui traversent les frontières, du fait de la mobilité des orpailleurs qui se déplacent rapidement entre les zones aurifères. Nous présentons ici le cas d’un site minier artisanal en Haute Guinée, situé dans une région où l’orpaillage a une histoire très ancienne et est régi par des institutions coutumières : l’afflux récent d’orpailleurs provenant de pays voisins – notamment le Burkina Faso – a facilité la diffusion de nouvelles techniques de creusage et de traitement du minerai. L’article traite des conséquences sociopolitiques de ces innovations : les recompositions institutionnelles, le rôle des savoirs dans la construction de l’allochtonie, et les différentes idées de « frontière » qui s’opposent face à la mobilité des orpailleurs.
L’erreur médicale comme apprentissage. Le rôle des conditions d’exercice clinique à Abidjan (Côte d’Ivoire)
Authors: Gobatto Isabelle
Published: July 2018

Resumé Où qu’il se déroule, l’exercice médical prend appui sur des savoirs ainsi que sur des catégories du travail (des principes éthiques, des manières de penser la compétence, la responsabilité, etc.) qui constituent des soubassements collectifs transversaux aux sociétés du Nord et du Sud. Pourtant, leurs contenus n’ont rien d’universel. À partir de l’erreur médicale, problématisée dans le cadre de la prévention de la transmission du VIH de la mère à l’enfant à Abidjan, il s’agit, dans un premier temps, de renseigner les contenus émiques de cette catégorie du travail médical pour les professionnels de santé ivoiriens. La perméabilité de ces contenus à des contextes de travail marqués par la pénurie et la rareté des régulations juridiques et déontologiques est corrélativement interrogée. Enfin, il s’agit d’appréhender les processus par lesquels un lieu d’exercice singulier, matérialisé par une recherche clinique, constitue un cadre d’apprentissage de rapports renouvelés à l’erreur médicale, à la responsabilité, à la compétence, par la mise en dialogue de cultures professionnelles différenciées.
« Il tète, mais il n’y a pas de lait ». Hiérarchisation et hybridation des savoirs sur le colostrum au Cambodge
Authors: Bureau-Point Ève , Candau Joël , Sim Kruy Leang
Published: July 2018

Resumé Le terme scientifique « colostrum » correspond au lait sécrété par la mère avant et/ou après la naissance de l’enfant. Il précède le lait dit « transitionnel », puis « mature ». Au Cambodge, les mères ont longtemps jeté cette substance et donné de l’eau le temps d’avoir le lait transitionnel. Depuis les années 1990, avec le renforcement de la médicalisation de la santé maternelle et infantile dans le cadre de l’aide internationale et la libéralisation économique, les savoirs et les pratiques autour de l’allaitement se modifient. Cet article documente, à partir d’une étude ethnographique réalisée dans une maternité de Phnom Penh de septembre à décembre 2014, les savoirs en coprésence circulant sur le colostrum et les pratiques qui en découlent. Des savoirs d’origine biomédicale, sociofamiliale, expérientielle et mercantile circulent. Des mécanismes de hiérarchisation et d’hybridation se produisent, contribuant à des pratiques recomposées, inspirées par la multiplicité des savoirs en circulation.
Ketama et Amsterdam : passeurs et développeurs de savoirs dans la production de haschich
Authors: Afsahi Kenza
Published: July 2018

Resumé Cet article s’intéresse à la circulation et au développement de savoirs dans la production de cannabis. À l’affût des flux entre Ketama et Amsterdam, il met l’accent sur les spécificités des acteurs transnationaux, passeurs et développeurs de savoirs. Il montre en quoi les deux espaces de culture de cannabis, malgré leurs différences fondamentales, sont connectés. L’article s’intéresse enfin aux modes de diffusion mis en œuvre de façon visible dans un contexte de tolérance, ou sous le sceau du secret dans un climat de répression.
Embeddings of Müntz Spaces in
Authors: Al Alam Ihab , Lefèvre Pascal
Published: July 2018

In this paper, we discuss the properties of the embedding operator $i_{\unicode[STIX]{x1D707}}^{\unicode[STIX]{x1D6EC}}:M_{\unicode[STIX]{x1D6EC}}^{\infty }{\hookrightarrow}L^{\infty }(\unicode[STIX]{x1D707})$, where $\unicode[STIX]{x1D707}$ is a positive Borel measure on $[0,1]$ and $M_{\unicode[STIX]{x1D6EC}}^{\infty }$ is a Müntz space. In particular, we compute the essential norm of this embedding. As a consequence, we recover some results of the first author. We also study the compactness (resp. weak compactness) and compute the essential norm (resp. generalized essential norm) of the embedding $i_{\unicode[STIX]{x1D707}_{1},\unicode[STIX]{x1D707}_{2}}:L^{\infty }(\unicode[STIX]{x1D707}_{1}){\hookrightarrow}L^{\infty }(\unicode[STIX]{x1D707}_{2})$, where $\unicode[STIX]{x1D707}_{1}$, $\unicode[STIX]{x1D707}_{2}$ are two positive Borel measures on [0, 1] with $\unicode[STIX]{x1D707}_{2}$ absolutely continuous with respect to $\unicode[STIX]{x1D707}_{1}$.