bluuebunny/crossref_metadata_2025 huggingface dataset:
MOTIVASI, PERAN TUTOR DAN KEJENUHAN PADA MAHASISWA KEPERAWATAN STIKes KUNINGAN DENGAN PENERAPAN KURIKULUM BERBASIS KOMPETENSI
Authors: Mulyati Lia , Sofia Nisa
Published: May 2017

Kejenuhan merupakan permasalahan tersendiri baik bagi mahasiswa maupun tutor, karena hal tersebut berpengaruh terhadap optimalisasi pencapaian learning objective pembelajaran. Metode belajar Problem Base Learning (PBL) yang diterapkan pada kurikulum berbasis kompetensi (KBK) seharusnya dapat meningkatkan gairah belajar dan optimalisasi ketercapaian tujuan pembelajaran di bandingkan dengan metode konvensional yang cenderung monoton, namun pada kenyataannnya penerapan PBL banyak menemukan kendala di antaranya adalah kejenuhan yang di alami oleh mahasiswa. Penelitian ini bertujuan untuk mengetahui hubungan motivasi dan peran tutor terhadap tingkat kejenuhan mahasiswa Program Studi Keperawatan di Sekolah Tinggi Ilmu Kesehatan Kuningan dengan penerapan KBK. Jumlah responden pada penelitian ini 186 orang dan uji analisis yang digunakan adalah Rank Spearman.

Hasil penelitian diketahui terdapat hubungan yang bermakna antara motivasi dengan tingkat kejenuhan mahasiswa dengan nilai p 0.018 dan tidak terdapat hubungan yang bermakna antara peran tutor dengan tingkat kejenuhan mahasiswa dengan nilai p 0.203 > α 0.05. Walaupun peran tutor tidak berhubungan langsung dengan tingkat kejenuhan mahasiswa, namun peran tutor mempunyai hubungan yang bermakna dengan motivasi mahasiswa dengan nilai p 0.023.

Kesimpulan; Motivasi merupakan penangkal kejenuhan mahasiswa, oleh karena itu tutor perlu memiiki kemampuan dalam membangun, meningkatkan dan mempertahankan motivasi mahasiswa selama proses pembelajaran. Pembentukan peer tutor, adanya training formal untuk meningkatkan kemampuan tutor tentang pembelajaran pedagogic, pemahaman terhadap tugas dan tanggung jawab tutor serta tata kelola pembelajaran tutorial serta pengembangan shoftskill mahasiswa merupakan upaya yang dapat meningkatkan optimalisasi pencapaian tujuan belajar dengan metode tutorial.

Kata Kunci: Kejenuhan, Problem Based Learning, Tutorial
HOME CARE DALAM PERAWATAN ULKUS DIABETIKUM DI KOTA SEMARANG
Authors: Kusyanti Eni Kusyanti
Published: May 2017

Pendahuluan. Meningkatnya jumlah penderita Diabetes Mellitus menyebabkan peningkatan kejadian komplikasi diabetes, diantaranya luka pada kaki. Praktek keperawatan dapat berupa klinik ataupun perawatan dirumah (homecare). Tujuan penelitian adalah memperoleh gambaran keputusan memilih perawat praktek mandiri melalui home care dalam perawatan ulcus diabeticum di kota Semarang.  Metode. Metode penelitian kualitatif dilakukan pada 6 orang penderita Ulkus Diabetikum sebagai responden primer menggunakan  Focus Group Discussion. Partisipan dipilih secara purposive sampling. Triangulasi sumber oleh praktisi praktek mandiri perawat dan ketua PPNI. Analisis data menggunakan content analysis thematic. Hasil. Hasil penelitian penyebab terjadinya luka juga menentukan waktu penyembuhan, perawatan luka yang baik dipahami lebih kearah prosedur dan sifat empati yang menonjol dari perawat, partisipan mengetahui adanya praktek mandiri perawat dari membaca informasi papan praktek yang terpasang dan informasi dari orang lain, home care dipahami dari arti kalimat saja, sedangkan alasan dan keputusan menggunakan jasa home care karena banyak keuntungan yang diperoleh. Diskusi. Tanggapan yang positif dari masyarakat pengguna pelayanan home care karena perawat memiliki pengetahuan, keterampilan dan sikap yang sesuai dengan kebutuhan stake holder serta melakukan pelayanan secara komprehensif.  Kata kunci: Perawat praktek mandiri, Home care, Ulcus diabeticum
IMPROVING SELF-CARE INDEPENDENCY OF TYPE 2 DM PATIENTS BASED ON LASALLIAN EDUCATION MODEL
Authors: Lamonge Annastasia Sintia , Langelo Wahyuny , Rakinaung Natalia
Published: May 2017

AbstractThe specific objectives of this study were: (1) Analyze the effectiveness of Lasallian health education in order to increased knowledge and attitude. (2) Analyze the effectiveness of Lasallian health education in order to increase the self-care independency of people with type 2 diabetes mellitus (DM). Research design of this study was  Pre-Experiment with target population patients with type 2 DM. 12 participants were recruited in the study with  purposive sampling technique. Bivariate test results of knowledge and attitudes before and after giving the Lasallian health education showed significant results with ρ-value of 0.016 (p-value <ά 0.05). Research result of self-care independency of type 2 diabetic patients in before and after giving Lasallian health education show significant result with ρ-value of 0.001 (p-value <ά 0:01). Transformation of people behavior or habit by a health education program should have three important determinant, there are cognitive,  affective and psychomotor aspects of participants to motivate and increase self-awareness, and adherence of self-care management and improving of quality of life.Keywords: Type 2 DM, Lasallian Health Education, Knowledge, Attitude, Self-care independency.
RIGHT MEDICATION RELATED TO DRUG CENTRALIZED IN RSUD SIDOARJO
Authors: Aprilia Aprilia , Nursalam Nursalam , Asmoro Candra Panji
Published: May 2017

Introduction. Centralized drug is a management of the entire drug which is entirely done by nurses to administration to patients. Right medication is the process of right drug administration which is done by nurses based on 6 rights of medication, and wary of side effects. The purpose of this study was to analyze the corelation between centralized drug, team leadership, and nurse`s knowledge with right medication among nurses. Methods.The design of the study was descriptive corelational with cross-sectional approach. The population was inpatient nurses in RSUD Sidoarjo. Total sample was 114 respondents was selected by purposive sampling. The independent variables in this study: centralized drug, team leadership, and nurse`s knowledge. The dependent variable was right medication. Data were collected by using questionnares for independent variables and dependent variable. Data were analyzed by using Binary Logistic Regression with degree of significance α>0,05. Results. Binary Logistic Regression test showed non significance level between centralized drug with right medication (P=0.501), team leadership with right medication (P=0.874), and nurses`s knowledge with right medication (P=0.243). Discussion. This study concluded centralized drug, team leadership, and nurse`s knowledge were good. But, there are nurses that have negative value at right medication, however right medication in RSUD Sidoarjo has majority positive value. Keywords: centralized drug, right medication
THE CARING BEHAVIOR OF VOLUNTARY NURSES TO THE CLIENT IN PADANGSIDIMPUAN GENERAL HOSPITAL
Authors: Siregar Hotma Royani , Antoni Adi
Published: May 2017

Voluntary nurses is the nurses who provide health care voluntarily without expecting any fee. Caring behavior of voluntary nurses is the skill of voluntary nurses giving attention, empaty,and helping clients to fullfil their daily needs as long as voluntary nurses giving nursing care in hospital. The objective of the research was to explore deeply caring behavior of voluntary nurses to the client in Padangsidimpuan General Hospital. The research used phenomenological design. The data were gathered by conducting in-depth interviews. Purposive sampling technique was used to select the participants who had met the criteria. They consisted of 6 voluntary nursesin Padangsidimpuan General Hospital. The result of the interviews was recorded and analyzed by using content analysis. The result of the research showed that there were 4 themes which reflected the research phenomena. They were Voluntary Nurses care to the clients, Voluntary nurses doing holistic nursing care, Voluntary nurses respect clients, and The effects of caring behavior of voluntary nurses. It is recommended that the Voluntary nerses alwaysapply caring behavior to the client even though without recieve any fee. Keywords: Behavior, Caring, Voluntary Nurses, Client
FEEDING PATTERN TOWARD THE INCREASING OF NUTRITIONAL STATUS IN CHILDREN AGED 1–3 YEARS
Authors: Subarkah Toni , Nursalam Nursalam , Rachmawati Praba Diyan
Published: May 2017

Introduction: The prevalence of nutritional status problems with underweight in Indonesia at the moments is (19,6%). Data showed that children with less nutritional status aged 1-3 years in Kalijudan, Surabaya are existed. Provide feeding pattern properly is one effort to improve the nutritional status by fulfilling the needs of the child nutrition. The purpose of this study was to explain the relationship of feeding pattern and nutritional status in children aged 1-3 years in the Kalijudan district, Surabaya. Methods: The research design used was cross-sectional study with dietary habit as the independent variable and nutritional status as dependent variable. The sample was taken from 154 mothers and children. Consecutive sampling was deployed. Data collection by questionnaires, and then data analysis using the Spearman’s Rho in level  of significance α≤0.05. Result and Analysis: There was strong relationship between feeding pattern and nutritional status (r=0.640). The result showed that inappropriate feeding patterns with nutritional status is very thin (44.4%) a proper feeding patterns with normal nutritional status (89.7%).  Discussion and Conclussion: The efforts to improve nutritional status of children aged 1-3 years related to feeding patterns should be improved in order to achieve a normal nutritional status. Further research may explore on the feeding patterns based on dietary allowances.Keywords: feeding pattern, nutritional status, 1-3 years old children
Tomato-rich (Mediterranean) diet does not modify inflammatory markers
Authors: Blum Arnon , Monir Merei , Khazim Khalid , Peleg Aviva , Blum Nava
Published: May 2017

Background: The Mediterranean diet is rich in lycopene and has been reported to reduce cardiovascular events. The mechanism of prevention of cardiovascular events has not been clearly established. Our aim was to study the effects of a tomatoes-rich diet on markers of vascular inflammation.

Methods: Plasma concentrations of E-selectin, intercellular adhesion molecule 1 (ICAM-1), and high sensitivity C-reactive protein (hs-CRP) were determined by ELISA in 103 apparently healthy volunteers. Volunteers were randomly assigned to two groups: 50 participants ate 300 g tomatoes daily for 1 month, and 53 participants ate their usual diet with tomatoes prohibited during that period. Markers of inflammation were measured before enrollment and 1 month after their assigned diet.

Results: The two diet groups had similar baseline clinical characteristics and similar baseline levels of inflammatory markers. After 30 days of assigned diet concentrations of hs-CRP, E-selectin and ICAM-1 were unchanged compared with baseline in the tomato-rich diet. However, ICAM-1 concentraion was increased in the regular diet group from 247.55±55ng/ml to 264.71±60.42ng/ml (P=0.01).

Conclusions: The mechanisms of benefit of the tomato-rich diet are not directly related to inhibition of markers of vascular inflammation.
32. Relearning in military surgery: The contributions of Princess Vera Gedroits
Authors: Wilson B.
Published: May 2017

It is a well known truth that knowledge is often forgotten and has to be relearned. In medicine, this unfortunate trend is especially prevalent in the history of military surgery. The story of a Russian Princess, military surgeon, and poet, Dr. Vera Gedroits is one such forgotten story. Dr. Gedroits’ largely unrecognized contribution to military surgery was the adoption of laparotomy for penetrating abdominal wounds (PAWs).

In the latter half of the 19th Century, the treatment of PAWs was controversial. However, the results of the Spanish-American (1898) and Boer (1899-1902) Wars and the outspoken opinions of prominent experts unified medical opinion; conservative treatment was clearly established as the treatment paradigm for PAWs at the birth of the 20th Century. Indeed, conservative treatment was officially adopted by the Russians at the outset of the Russo-Japanese War (1904-1905).

During this war, the bold surgical practices of Dr. Gedroits would seriously challenge this standard of care. Dr. Gedroits performed operations in a converted railway car in a Red Cross hospital train. Despite these suboptimal conditions, she performed laparotomies on victims of PAWs with unprecedented success. These results, which were largely due to strict surgical indications and technical skill, effectively demonstrated the importance of laparotomy in the treatment of such wounds. As a result, the Russians adopted operative treatment as the new standard of care. Interestingly however, no other countries seemed to take any notice. Dr. Gedroits’ results were barely remarked upon and quickly forgotten. Indeed, contemporary Western observers of the Russian medical outfit, and historians since, have interpreted the surgical results of the war to support conservative management. It was not until WWI, ten years later, that surgeons relearned the utility of laparotomy. The story of Dr. Gedroits, both before and after her innovative treatment in the Russo-Japanese war, deserves remembering.

Bennett J. Princess Vera Gedroits: military surgeon, poet, and author. British Medical Journal 1992; 305(6868):1532-1534.

Harvard V, Hoff J. Reports of Military Observers Attached to the Armies in Manchuria during the Russo-Japanese War. London: HMSO, 1908.

Wallace C. War surgery of the abdomen. Lancet 1917; 189(4885):561-5568.
In vitro validation of a 3-dimensional transrectal ultrasound system for prostate biopsiess
Authors: Cool Derek , Sherebrin Shi , Izawa Jonathan , Chin Joseph , Fenster Aaron
Published: May 2017

Introduction: Transrectal ultrasound (TRUS) prostate biopsy (Bx) is currently confined to 2D information to both target and record 3D Bx locations. Accurate placement of Bx needles cannot be verified without 3D information, and recording Bx sites in 2D does not provide sufficient information to accurately guide the high incidence of repeat Bx. We have designed a 3D TRUS prostate Bx system that augments the current 2D TRUS system and provides tools for biopsy-planning, needle guidance, and recording of the biopsy core locations entirely in 3D.

Methods: Our Bx system displays a 3D model of the patient’s prostate, which is generated intra-procedure from a collection of 2D TRUS images, representative of the particular prostate shape. Bx targets are selected, needle guidance is facilitated, and 3D Bx sites are recorded within the 3D context of the prostate model. The complete 3D Bx system was validated, in vitro, by performing standard ten-core Bx on anatomical phantoms of two patient’s prostates. The accuracy of the needle-guidance, Bx location recording, and 3D model volume and surface topology were validated against a CT gold standard.

Results: The Bx system successfully reconstructed the 3D patient prostate models with a mean volume error of 3.2 ± 7.6%. Using the 3D system, needles were accurately guided to the pre-determined targets with a mean error of 2.26 ± 1.03 mm and the 3D locations of the Bx cores were accurately recorded with a mean distance error of 1.47 ± 0.79 mm.

Conclusion: We have successfully developed a 3D TRUS prostate biopsy system and validated the system in vitro. A pilot study has been initiated to apply the system clinically.
The contribution of omental adipose tissue to adipokine concentrations in patients with the metabolic syndrome
Authors: Tarantino Giovanni , Lobello Roberto , Scopacasa Francesco , Contaldo Franco , Pasanisi Fabrizio , Cirillo Michele , De Caterina Maurizio , Conca Paolo , Terracciano Daniela , Gennarelli Nicola , Ariello Manuela , Mazzarella Claudia , Grimaldi Ernesto , Macchia Vincenzo
Published: May 2017

Purpose: To examine differences in peripheral vascular endothelial growth factor (VEGF), interleukin-6 (IL6) and cortisol concentrations between patients with both visceral obesity and metabolic syndrome, and lean controls. In a subsample of metabolic patients underwent abdominal surgery, the adipokine concentrations were measured in venous blood from the omentum to determine information on some processes of synthesis.

Methods: Forty-two healthy lean controls and 46 overweight-obese patients with central adiposity and stigmata of metabolic syndrome were studied. In a subsample of 11 metabolic patients undergoing non-bariatric surgery, blood samples from omental and peripheral veins were taken intraoperatively to determine VEGF, IL6 and cortisol concentrations.

Results: Median levels (range) of peripheral VEGF and IL6 were higher in patients than in controls [31.5 (3-112) pg/mL vs 21.35 (9-41.9) pg/mL (P < 0.05) and 5.50 (1.40-13) pg/mL vs 1.15 (0.3-1) pg/mL (P < 0.0001)]. On the other hand, concentrations of VEGF and IL6 from the omental and peripheral veins were similar in the surgery sub-group. Peripheral cortisol concentrations were not higher in patients than in controls, nor were omental concentrations different from the peripheral. Omental and peripheral VEGF and cortisol values were correlated, whereas no association was found between omental and peripheral IL6.

Conclusions: In the presence of abdominal obesity, VEGF and IL6 concentrations are increased in the systemic circulation. The contribution of visceral adipose tissue to circulating levels of VEGF and IL6 was modest.
Multidisciplinarity, interdisciplinarity, and transdisciplinarity in health research, services, education and policy: 2. Promotors, barriers, and strategies of enhancement
Authors: Choi Bernard C. K. , Pak Anita W. P.
Published: May 2017

Background/Purpose. Multidisciplinary, interdisciplinary and transdisciplinary teams are increasingly encouraged in health research, services, education and policy. This paper is the second in a series. The first discussed the definitions, objectives, and evidence of effectiveness of multiple disciplinary teamwork. This paper continues to examine the promotors, barriers, and ways to enhance such teamwork.

Methods. The paper is a literature review based on Google and MEDLINE (1982-2007) searches. “Multidisciplinarity”, “interdisciplinarity”, “transdisciplinarity” and “definition” were used as keywords to identify the pertinent literature.

Results. The promotors of teamwork success include: good selection of team members, good team leaders, maturity and flexibility of team members, personal commitment, physical proximity of team members, the Internet and email as a supporting platform, incentives, institutional support and changes in the workplace, a common goal and shared vision, clarity and rotation of roles, communication, and constructive comments among team members.

The barriers, in general, reflect the situation in which the promotors are lacking. They include: poor selection of the disciplines and team members, poor process of team functioning, lack of proper measures to evaluate success of interdisciplinary work, lack of guidelines for multiple authorship in research publications, language problems, insufficient time or funding for the project, institutional constraints, discipline conflicts, team conflicts, lack of communication between disciplines, and unequal power among disciplines.

Conclusion. Not every health project needs to involve multiple disciplines. Several questions can help in deciding whether a multiple disciplinary approach is required. If multiple disciplinarity is called for, eight strategies to enhance multiple disciplinary teamwork are proposed. They can be summarised in the acronym TEAMWORK - Team, Enthusiasm, Accessibility, Motivation, Workplace, Objectives, Role, Kinship.
Does the energy expenditure status in obstructive sleep apnea favour a positive energy balance?
Authors: Major Genevieve C. , Series Frederic , Tremblay Angelo
Published: May 2017

Purpose: The effect of the obstructive sleep apnea syndrome on energy expenditure is controversial. The objective of this study was to assess the relationship between 24-hr energy expenditure or sleeping metabolic rate and features of the obstructive sleep apnea.

Methods: Twenty-four apneic men took part in this cross-sectional study and were classified in quartiles of nocturnal desaturation severity, i.e. of percentage total sleep time with SaO2 < 90% determined with polysomnography. 24-hr energy expenditure and sleeping metabolic rate were measured with a whole body indirect calorimetry (respiratory chamber), and body composition by hydrodensitometry. During the stay in the respiratory chamber, urine was collected to assess catecholamine concentration and percentage recording time with SaO2 < 90% (%TRT SaO2 < 90%) was measured with nocturnal oximetry.

Results: Mean fat free mass and fat mass were greater in quartile 4 than in quartile 1 (P < 0.05). %TRT SaO2 < 90% was higher in quartile 4 than in other quartiles (P < 0.0001). 24-hr energy expenditure and sleeping metabolic rate were similar among quartiles. However, when expressed on a per kg body weight basis (kcal/kg), these variables were negatively correlated with the %TRT SaO2 < 90% in the whole group (r = -0.46 and -0.48, respectively, P < 0.05). %TRT SaO2 < 90% was found to be a predictor of sleeping metabolic rate which explained, together with fat mass and fat free mass, 86% of this variance (P < 0.05).

Conclusion: In apneic men energy expenditure relative to body weight decreases with increasing severity of oxygen desaturation which could favour a positive energy balance.
The effects of renal replacement therapy on plasma, asymmetric dimethylarginine, nitric oxide and C-reactive protein levels
Authors: Uzun Halfize , Konukoglu Dildar , Besler Mine , Erdenen Fusun , Sezgin Can , Muderrisoglu Cuneyt
Published: May 2017

Purpose: Asymmetric dimethylarginine (ADMA), nitric oxide (NOx), and C-reactive protein (CRP) are important risk factors for endothelial dysfunction and mortality in the end stage renal diseases population. The aim of the study was to investigate the relationship between renal replacement therapy and endothelial dysfunction.

Methods: Plasma NOx, ADMA and CRP levels were examined in randomized selected 30 patients with chronic kidney diseases (CKD), 28 patients receiving continuous ambulatory peritoneal dialysis (PD) and 30 patients receiving regular hemodialysis (HD) and age-matched 20 healthy controls. The duration of dialysis was from 4, 5 to 11, and 6 years, respectively.

Results: CKD patients had higher plasma ADMA (1.26±0.53?mol/L) and CRP levels (1.02±025mg/L) and lower NOx levels (28.6±5.4?mol/L) than controls (0.45±0.20; 0.65± 0.45; 32.5±37 respectively, P < 0.001).Plasma NOx and CRP levels were higher in HD patients (32.9±5.5?mol/L, P < 0.05 and 4.59±3.18mg/L, P < 0.001) and plasma ADMA and CRP levels were higher in PD patients (1.82±0.98?mol/L, P < 0.001 and 2.40±1.53mg/L, P < 0.001) than in CKD patients. PD patients had higher plasma ADMA levels (P < 0.05) and lower plasma NOx and CRP levels than HD patients (P < 0.001 and P < 0.001). Plasma ADMA levels were negatively correlated with NOx levels in all patient groups (P < 0.001). Plasma CRP levels in CKD and HD patients were positively correlated with plasma urea levels (r:0,437, P < 0,001) and duration of dialysis (r:0,370, P < 0.01), respectively.

Conclusion: CRP and ADMA may be emerging as important risk factors for atherosclerosis in dialysis patients. Reduced NO elaboration secondary to accumulation of ADMA and elevated inflammation may be important pathogenic factors for endothelial dysfunction in both dialysis treatment strategies.
Levels of pregnancy-associated plasma protein A in patients with coronary artery disease
Authors: Liu Zhi-Yuan , Zhang Jin-Ying , Sun Tong-Wen , Zhang Yan-Jun , Zhang Li , Wang Le-Xin
Published: May 2017

Purpose: To investigate the levels of pregnancy-associated plasma protein A (PAPP-A) or insulin-like growth factor -1 (IGF-1) in patients with acute coronary syndrome.

Methods: Serum PAPP-A and IGF-1 was measured with biotin–tyramide-amplified enzyme immunoassay and Enzyme Linked Immuoserbent Assay, respectively, in patients with ST elevation acute myocardial infarction (STEMI, n=12), unstable angina (UAP, n=15), and stable angina (n=15). PAPP-A and IGF-1 was also measured in 16 healthy subjects (control group).

Results: The serum levels of PAPP-A in the STEMI (16.9±10.3 mIU/L) and UAP group (15.2±10.5 mIU/L) were higher than in the stable angina (8.5±3.1 mIU/L) or control group (8.4±2.0 mIU/L, P < 0.01). The serum levels of IGF-1 in the STEMI (132.3±40.9 µg/L) and UAP group (127.3±36.0 µg/L) were also higher than in the stable angina (44.9±18.5 µg/L) or control group (67.7±24.5µg/L, P < 0.01). There were no differences in serum levels of PAPP-A or IGF-1 among the single, double and three vessel lesion groups. The serum levels of PAPP-A (19.9±10.1 mIU/L) and IGF-1 (153.2±52.4 µg/L) after PCI were higher than those before PCI (15.1±10.0 mIU/L and 91.4±51.0 µg/L, respectively, P < 0.01). A positive correlation was found between PAPP-A and IGF-1 levels in the STEMI and UAP group before PCI (r=0.48?P < 0.01).

Conclusion: PAPP-A and IGF-1 are elevated in patients with acute coronary syndrome. They may be used as biomarkers for vulnerable plaques in patients with coronary artery disease. Whether post-PCI elevation of IGF-1 can be used to predict restenosis of coronary arteries remains to be seen.
Effects of adrenomedullin on the cell numbers and apoptosis of endothelial progenitor cells
Authors: Kong Xiang-Quan , Wang Le-Xin , Yang Chuan-Sheng , Chen Shuang-Feng , Xue Yu-Zeng , Liu Yi-Hua
Published: May 2017

Purpose: To investigate the effect of adrenomedullin on the cell numbers and apoptosis of endothelial progenitor cells (EPCs).

Methods: Mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation. The cells were stimulated with adrenomedullin, before and after the treatment of adrenomedullin-receptor antagonist, adrenomedullin 22-52, or a PI3K inhibitor LY294002.

Results: Adrenomedullin dose-dependently increased the number of EPCs (P < 0.05). Adrenomedullin also significantly decreased apoptosis rate of EPCs in a concentration-dependent manner (P < 0.05). In the isolated human mononuclear cells pretreated with adrenomedullin 22-52 or LY294002, adrenomedullin failed to increase the number of EPCs or to reduce the level of apoptosis.

Conclusions: Adrenomedullin increases the number of EPCs and decreases their apoptosis. These actions are likely mediated by PI3K signaling pathways. The clinical importance of these favourable effects on EPCs remains to be determined.
Effect of a seashell protein Haishengsu on cell growth and expression of apoptosis genes in leukemia K562 cells
Authors: Li Guang-Yao , Liu Ji-Zhu , Yu Xiao-Min , Chen Shuang-Feng , Zhang Bin , Zhang Wei-Feng , Xiao Tai-Wu , Wang Chun-Bo , Wang Le-Xin
Published: May 2017

Objectives: To investigate the effect of a seashell protein Haishengsu (HSS), an extract from a shellfish Tegillarca granosa, on cell growth and the expression of apoptosis genes in leukemia K562 cells.

Methods: Cultured K562 cells were treated with HSS at various concentrations (10-40mg/L). The cell cycle, cell growth and the expression of apoptosis suppressor gene bcl-2 and apoptosis promoting gene bax were evaluated.

Results: HSS, 20mg/L, inhibited cell cycle in the G0/G1 and S phases. HSS, 20mg/L, also inhibited the growth of K562 cells over time. Expression of bcl-2 gene in the HSS 20mg/L (58.8%±4.7%) and HSS 40mg/L group (26.6%±2.1%) were lower than in the control group (91.0±8.7%, P < 0.01). Expression of bax gene in the HSS 20mg/L (77.7±3.6%) and 40mg/L group (90.6±3.7%) were higher than in the control group (10.9±6.6%, P < 0.01).

Conclusion: HSS suppresses leukemia K562 cell growth by inhibiting the G0/G1 and S phases of the cell cycle. It also induces apoptosis in these leukemia cells by reducing the expression of apoptosis suppressor gene bcl-2, and increasing the expression of apoptosis promoting gene bax. Further studies are required to investigate the clinical efficacy of HSS in leukemia.
Effect of tanshinone on the levels of nitric oxide synthase and acetylcholinesterase in the brain of alzheimer’s disease rat model
Authors: Yin You , Huang Liuqing , Liu Yan , Huang Shaqi , Zhuang JianHua , Zhuang Xiaoyan , Wu Huijuan , Shao Fuyuan , Zhao Zhongxin
Published: May 2017

Purpose: To determine the influence of tanshinone on the levels of nitric oxide synthase (NOS) and acetylcholinesterase (AChE) in the brain of an Altzheimer Disease (AD) rat model and on its potential therapeutic mechanism.

Methods: 100 Male Sprague Dawley rats were divided into three groups: control group, model group and tanshinone treatment group. 10µg A?1-42 was injected bilaterally into the dorsal lateral region of the dentate gyrus in the hippocampus of rats in the model and tanshinone treatment groups to prepare the AD models. 24h after modeling, tanshinone, 50mg/kg, was administered by gastric perfusion to rats in the tanshinone treatment group. Later, immunohistochemical assay and Western blot analysis were used to detect expression of neuronal NOS (nNOS) and inducible NOS (iNOS) in the rat hippocampus. Activity of AChE in each subregion (CA1~CA4) of rats’ hippocampus was determined by a histochemical technique.

Results: Expression of nNOS in the model group was down-regulated whereas iNOS was up-regulated. After A?1-42 injection, the number of AChE positive fibers in each subregion (CA1~CA4) of the hippocampus was decreased compared with controls. With tanshinone administration, the changes were improved to varying degrees.

Conclusion: Tanshinone modulates AChE and NOS proteins concentrations in the hippocampus of AD rats. This may have therapeutic potential in AD rats.
Protective effect of estrogen on apoptosis in a cell culture model of Parkinson's disease
Authors: Li Xue-Li , Cheng Wei-Dong , Li Juan , Guo Xian-Ling , Guo Cun-Ju , Meng Xian-hui , Sun Sheng-Gang , Wang Le-Xin
Published: May 2017

Objectives: The protective effect of estrogen on the neurons in Parkinson’s disease (PD) is unclear. The present study aimed to investigate the effect of estrogen on the apoptosis and dopaminergic function on a cultured cell model of PD.

Methods: The PD model was established by addition of 1-methyl-4-phenylpyridinium (MPP+) to PC12 cell culture. Estrogen was added to cell groups with MPP+ (Estrogen+MPP+), and without MPP+ (Estrogen only group). Cell viability, content of tyrosine hydroxylase (TH), apoptosis ratio, expression of apoptosis-suppression protein Bcl-x and apoptosis-acceleration protein IL-1 beta converting enzyme (ICE) were measured.

Results: Cell viability in the Estrogen+MPP+ group was similar to the control group but was higher than in the MPP+ group (P < 0.05). The apoptosis ratios in the Estrogen+MPP+ group (33.6%), and the control group (31.3%), were also similar, but it was lower than in the MPP+ group (63.5%, P < 0.05). Concentrations of Bcl-x were higher in the Estrogen+MPP+ group, whereas ICE concentrations were lower than in the MPP+ group (P < 0.05).

Conclusions: Estrogen suppresses apoptosis and improves cell viability in MPP+ induced injuries in the PC12 cells. The beneficial effects of estrogen on the PD model are due to the suppression of pro-apoptotic protein ICE, and stimulation of anti-apoptotic protein Bcl-x.
Reduction of cerebrospinal fluid and plasma serotonin in patients with post-stroke depression: A preliminary report
Authors: Gao Heng-qiang , Zhu Hai-yan , Zhang Yan-qiang , Wang Le-xin
Published: May 2017

Objective: To investigate the plasma and cerebrospinal fluid (CSF) concentrations of serotonin in patients with post-stroke depression (PSD).

Methods: Serotonin was measured in 30 PSD patients and 30 controls on day 15 and day 30 following stroke.

Result: There was a good correlation between the plasma and the CSF serotonin concentrations in both PSD (r = 0.641, P = 0.001) and control patients (0.852, P = 0.001) 30 days following the stroke. The average plasma and CSF serotonin concentrations in the PSD patients were lower than in the control group on day 15 (CSF: 0.24±0.27 vs 0.82±0.48 µmol/L, P < 0.01; plasma, 0.32±0.25 vs 0.83±0.45µmol/L, P < 0.01) and day 30 (CSF: 0.29±0.23 vs 0.78±0.47 µmol/L, P < 0.01; plasma, 0.31±0.33 vs 0.89±0.67 µmol/L, P < 0.01). Reduction of plasma serotonin was found in 90.0% of the PSD group and 13.3% of the control group patients (P < 0.01). Reduction in CSF serotonin in the PSD and control group was 80.0% and 6.7% respectively (P < 0.01%).

Conclusion: Plasma serotonin levels may be used to represent the CSF serotonin levels in depressed and non-depressed patients following stroke. There is a reduction in the plasma or CSF serotonin concentrations in patients with PSD. Serotonin deficiency may be one of the factors leading to depression following stroke.
The relationship of inflammatory cytokines with asthma and obesity
Authors: Canöz M , Erdenen F , Uzun H , Müderrisoglu C , Aydin S
Published: May 2017

Objectives: Obesity is considered a risk factor for asthma. However, the mechanism that connects the two is not well understood. In this study we investigated the relationship between inflammatory cytokines and acute phase reactants in obesity, and asthma.

Method: Asthmatic and control subjects were divided into 2 sub-groups: obese and non-obese. Anthropomorphic parameters, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leptin, tumour necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) were compared between obese, asthmatics and control subjects of normal weight. Respiratory function tests and allergy skin tests were also performed in the patients with asthma.

Results: ESR, CRP, TNF-α, IL-6, and leptin levels in obese asthma patients were higher than in the healthy controls (P < 0.01). TNF-α, IL-6, and leptin levels were higher in obese asthma patients than in non-obese asthma patients (P < 0.01). Inflammatory markers were related to parameters of obesity. No association was found between allergy test results and obesity (P > 0.05).

Conclusion: We identified a relationship between acute phase reactants and inflammatory cytokines, and the criteria for obesity in obese asthma patients. Inflammation markers were at their highest levels in obese asthma patients. Leptin levels were considerably higher in obese patients than in normal weight controls. Like obesity, leptin is suggested to play a role in the pathogenesis of asthma.
Influence of obesity on the prevalence and clinical features of asthma
Authors: Boulet Louis-Philippe
Published: May 2017

Obesity has been associated with an increased prevalence of asthma and poorer control of this disease. However, the mechanisms by which obesity can influence airway function and make asthma more difficult to control remain uncertain. The physiological changes associated with obesity can contribute to respiratory symptoms and these should be differentiated from those caused by asthma. Obesity can possibly influence the development of asthma through genetic, developmental, hormonal, neurogenic or mechanical influences. Breathing at low lung volumes and changes in the pattern of breathing in obese subjects may alter airway smooth muscle plasticity and airway function. The release by adipocytes of various cytokines and mediators such as Interleukin-6, TNF-α, eotaxin, and leptin, and the reduction of anti-inflammatory adipokines in obese subjects may possibly contribute to the development or increased clinical expression of asthma in promoting airway inflammation. Reduced asthma control and impaired response to asthma therapy have been reported in obese patients. Obesity-related co-morbidities such as Sleep Apnea and Gastro-esophageal reflux may also contribute to this poor control. Weight loss improves asthma control and reduces medication needs. Research is needed to better define the optimal management of obese asthmatic patients.
Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in western region of Turkey
Authors: Tamer Gulden Sonmez , Dundar Deyrim , Caliskan Eray
Published: May 2017

Purpose: Prenatal screening for antibodies to Toxoplasma gondii (T. gondii), rubella virus and cytomegalovirus (CMV) infectious agents is an important tool in this process. The aim of this study was to determine the seroprevalence of these infections through antenatal screening in Kocaeli region.

Material and Methods: 1972 samples of sera were tested for antibodies to TORCH agents known to cause serious congenital infections: T. gondii, rubella, CMV. Anti-Toxoplasma, anti-rubella and anti-CMV IgM and IgG antibodies were assayed by ELISA method using Abbott kits (Axsym, Abbott, USA) according to the manufacturer’s instructions.

Results: Of 1972 pregnant women, seropositivity for anti-toxoplasma IgG antibody was found in 952 (48.3%), while 8 (0.4%) of the subjects tested were positive for the anti-Toxoplasma IgM antibody only, and 31 (1.6%) of the subjects tested were positive for anti-Toxoplasma IgG+IgM antibodies together. The seropositivities for anti-rubella IgG, IgM and IgG+IgM together were found in 1896 (96.1%), 4 (0.2%) and 35 (1.8%) of the pregnant women, respectively. The seropositivities for anti-CMV IgG, IgM and IgG+IgM together were found in 1900 (96.4%), 13 (0.7%) and 37 (1.9%) of the pregnant women, respectively. Conclusion: Widespread population screening may contribute to the prevention of congenital infections due to TORCH agents. Because of the high seropositivity of T. gondii, rubella and CMV in pregnant women, preventive measures should be taken.
Methicillin-resistant S. aureus colonization in Mexican children attending day care centres
Authors: Velázquez-Guadarrama Norma , Martinez-Aguilar Gerardo , Galindo José Arellano , Zuñiga Gerardo , Arbo-Sosa Antonio
Published: May 2017

Purpose: To determine MRSA carriage rates and genetic relationships of S. aureus strains in children attending day care centres in 14 cities from three geographic regions in Mexico.

Materials and methods: Cross-Sectional Study performed in apparently healthy children aged from 6 mo to 6 yr attending day care centres (DCCs). From September 2002 To January 2003, 2345 nasopharyngeal specimens from a similar number of children were collected. Nasopharyngeal samples for bacterial isolation were obtained by standard methods. Antimicrobial susceptibility was determined and genetic relatedness of all MRSA isolates was determined by pulsed field gel electrophoresis (PFGE).

Results: S. aureus was identified in 237 children (10.1%), twenty-two children had MSRA for an overall prevalence of MRSA carriage of 0.93%. Children attending DCCs from cities located in the north and south of Mexico showed higher prevalence than children from DCCs in the central region; 1.75%, and 1.71 vs. 0.08%, respectively (P < 0.05). PFGE demonstrated six different restriction profiles of MRSA with a predominant pattern.

Conclusions: We documented the presence of MRSA strain colonizing children attending DCCs in Mexico, mainly in the south and north regions of the country. Clone A and B which are closely related represented 45 % of the total of MRSA isolates. We found both, SCCmec type II and type IV strains in the three regions.
Thyroid arterial embolization for the treatment of hyperthyroidism in a patient with thyrotoxic crisis
Authors: Zhao Wei , Gao Bu-Lang , Yi Gen-Fa , Yang Hui-Ying , Li Hong
Published: May 2017

Purpose: We report a case of hyperthyroidism in a young woman caused by Graves’ disease that was successfully treated with thyroid arterial embolization.

Clinical details: A 35 year-old woman with a history of thyrotoxic crises was admitted after the last thyroid crisis. Thyroid arterial embolization was used to treat the hyperthyroidism after it had been controlled. Immediately after embolization, the enlarged thyroid gland shrank and vascular murmurs disappeared. Serum thyroid hormones increased on day 3 following embolization but decreased gradually. Thyroid hormone returned to normal 2 months after embolization and remained normal at three years.

Conclusion: Thyroid arterial embolization is an effective means to treat refractory hyperthyroidism.
Expression of Ezrin correlates with lung metastasis in Chinese patients with osteosarcoma
Authors: Xu-dong Shen , Zan Shen , Shui-er Zheng , Li-na Tang , Wen-xi Yu , Feng Lin , Yang Yao
Published: May 2017

Purpose: To determine the prognostic value of the expression of Ezrin, CD44 and Six1 genes in osteosarcoma tissues of Chinese patients.

Methods: Fluorescent quantitative real-time PCR was applied to study the mRNA levels of Ezrin, CD44 and Six1 genes in 32 osteosarcoma patient samples and 10 adjacent normal tissues and MG63 osteosarcoma cell lines. The analysis of relationships between pulmonary metastasis and overall survival time were carried out based on the clinical data.

Results: mRNA levels of Ezrin and Six1 genes in osteosarcoma tissues were higher than those in adjacent normal tissues (P=0.015, 0.025). The mRNA levels of Ezrin, CD44 and Six1 genes were closely correlated with Enneking GTM clinical staging, while no correlations were demonstrated between the mRNA level of these genes with sex, age, location or pathological types. In addition, we demonstrated that the high mRNA level of Ezrin gene was related to shorter lung metastasis-free and overall survival time of the Chinese patients with osteosarcoma (P < 0.001).

Conclusion: Our data suggest that Ezrin, but not CD44 and Six1, could be a prognostic factor and a predictor of potential lung metastasis in osteosarcoma. Further large sample studies need to be done to confirm the potential value of Ezrin as a new therapeutic target.
Prevalence and duration of exercise induced albuminuria in healthy people
Authors: Heathcote Karen L , Wilson Merne P , Quest Dale W , Wilson Thomas W
Published: May 2017

Purpose: Vigorous exercise increases urine protein excretion. However, whether exercise increases urine albumin enough to reach the threshold for microalbuminuria (2.8 and 2.0 mg/mmol creatinine in women and men respectively) is uncertain. Furthermore, the duration of such albuminuria is unknown. We aimed to estimate the prevalence and duration of exercise induced microalbuminuria in normal healthy volunteers.

Methods: Thirty normal subjects provided a urine sample, then exercised to maximal heart rate, or exhaustion, using the standard Bruce Treadmill protocol. Further urine samples were collected within 15 min of completing exercise, and 24 and 48 hr later. Urine creatinine was measured by the Jaffé method and albumin via immunoturbidometry.

Results: Baseline urine albumin: creatinine ratio (A/C) was 0.5 ± 0.3 (SD) in women (n=14) and 0.4 ± 0.1 mg/mmol in men (n=16). Immediately after exercise A/C increased to 5.6 ± 9.7 (in women) and 7.6 ± 17.6 (in men). Twelve of 30 subjects reached the threshold for microalbuminuria and 2 that for macroalbuminuria. By 24 hr all had returned to baseline and there was no further change at 48 hours.

Conclusions: A short period, 15-20 min, of maximal exercise leads to A/C ratios above the microalbuminuria threshold in a substantial proportion of normal subjects. Physicians should not measure urine albumin in patients who give a history of such activity in the past 24 hr.
JOE DOUPE LECTURE: Cardiac troponin in the intensive care unit
Authors: Lim Wendy
Published: May 2017

Purpose: Cardiac troponin is specific to the myocardium and is a useful biomarker for the diagnosis of myocardial infarction. Detection of elevated blood levels of troponin indicates damage to myocardial cells, but does not indicate the mechanism. Causes other than acute coronary syndromes and myocardial infarction can result in troponin elevation and these conditions frequently occur in critically ill patients in the intensive care unit. The interpretation, clinical significance and appropriate management of an elevated troponin measurement in critically ill patients are uncertain.

Source: Studies evaluating the prevalence of troponin elevation among medical-surgical intensive care unit patients, and its prognostic significance with regards to adverse outcomes will be reviewed.

Conclusions: Cardiac troponin elevation is common and observed in 40 to 50% of critically ill medical and surgical patients. Elevated levels appear to identify patients at increased risk for death in the intensive care unit or hospital setting. This finding, and its relation to myocardial infarction and acute coronary syndromes, requires prospective study to better understand the implications for diagnosis and management.
In vitro antibacterial activity of some systemic and topical antihistaminic preparations
Authors: Gocmen Julide Sedef , Buyukkocak Unase , Caglayan Osman
Published: May 2017

Purpose: In vitro antibacterial activity of topical and systemic antihistaminic preparations containing different active substrates against the standard strains of two bacteria was evaluated.

Methods: Four topical and 3 systemic preparations containing pheniramine maleate, chlorophenoxamine hydrochloride, and diphenhydramine hydrochloride were studied. The antibacterial activities of these preparations against strains of S. aureus (American Type Culture Collection, ATCC 29213) and S. epidermidis (ATCC 25212) were tested using the disc diffusion method. In addition, the Minimal Innhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) of parenteral preparations for these two bacteria were determined.

Results: Pheniramine maleate-topical and pheniramine maleate-systemic had no activity against bacteria, but the others showed various rates of activity. Chlorophenoxamine hydrochloride-topical and chlorophenoxamine hydrochloride-systemic were the most effective (P < 0.05). Despite the same active substrate content, diphenhydramine hydrochloride-topical-1 and diphenhydramine hydrochloride-topical-2 yielded different results when they were compared with each other or with the other preparations. Diphenhydramine hydrochloride-topical-2 had a relatively higher rate of activity than diphenhydramine hydrochloride-topical-1. Inhibition zone diameters were 16.9±1.5 mm 12.3±0.5 mm for S .aureus, 17.4±1.0 mm 0 mm for S .epidermidis respectively (P < 0.05).
MIC values of parenteral preparations were equal to or above 125 ?g/ml.

Conclusion:, MIC values of parenteral preparations were higher than their blood levels in clinical use. Thus, effects of parenteral preparations may not have been reflected in routine clinical practice. However, topical forms have antibacterial activity due to additive substrates and the use of high concentration levels at the site of application. Therefore, in selection of topical forms for appropriate cases, these effects should also be taken into consideration. The antibacterial activity of topical antihistaminic preparations may be useful in certain dermatological pathology.