bluuebunny/crossref_metadata_2025 huggingface dataset:
Fracturas graves del cuello del astrágalo. Análisis del tratamiento en 20 casos
Authors: Macklin Vadell Alberto , Sperone Enzo , Bigatti Andrés , Iglesias Matías , Atilmis Yanser , Rofrano Martín , Torterola Iván , Ortega Galvis José
Published: February 2022

Introducción: Las fracturas del cuello del astrágalo son infrecuentes, pero la tasa de complicaciones y reintervenciones es alta. El objetivo de este estudio fue analizar y describir las complicaciones a mediano y largo plazo en 20 pacientes con fractura del cuello del astrágalo. Nuestra hipótesis fue que, en las lesiones graves, la reducción abierta y fijación interna genera una tasa alta de complicaciones que requerirán de nuevas intervenciones quirúrgicas.
Materiales y Métodos: Se evaluó a 20 pacientes con fractura del cuello del astrágalo: 6 Hawkins II (29%), 11 Hawkins III (52%) y 3 Hawkins IV (19%). El seguimiento promedio fue de 11 años. Se analizaron el tipo de fractura (simple o conminuta), las lesiones asociadas, las complicaciones y la necesidad o no de un nuevo procedimiento quirúrgico.
Resultados: Once pacientes (55%) tenían lesiones asociadas y 14 (70%), conminución en el trazo de fractura. Quince (75%) sufrieron complicaciones. Nueve (45%) requirieron una segunda intervención para tratar la complicación.
Conclusiones: Los factores más relacionados con el desarrollo de complicaciones y la necesidad de una nueva intervención son: conminución en el trazo de fractura, lesiones asociadas en el miembro inferior homolateral, fracturas tipos III y IV de Hawkins, y fracturas expuestas. Creemos que, en las lesiones graves del cuello del astrágalo (tipos III y IV de Hawkins) con uno o más de estos factores, la artrodesis primaria podría disminuir el riesgo de complicaciones y de nuevas cirugías, y acortar el tiempo de recuperación de los pacientes.
Fracturas intertrocantéricas en adultos mayores: análisis de los factores de riesgo asociados con falla en la osteosíntesis con clavo cefalomedular
Authors: Cangiano Lucía Verónica , Yapur Pablo Miguel , Talamo Francisco
Published: February 2022

Objetivos: Las fracturas intertrocantéricas son cada vez más frecuentes debido al envejecimiento de la población. La osteosíntesis con clavo cefalomedular se utiliza ampliamente para tratar estas fracturas. El objetivo de este estudio fue analizar la tasa de fallas en la osteosíntesis con clavo cefalomedular y sus factores de riesgo.

Materiales y Métodos: Se evaluó retrospectivamente a pacientes >75 años con fracturas intertrocantéricas tratados con clavo cefalomedular, en nuestro Centro, entre enero de 2016 y diciembre de 2019. Se analizó el ángulo cervicodiafisario de la cadera operada en el posoperatorio inmediato, la distancia puntaápice y la posición del tornillo deslizante en la cabeza femoral.

Resultados: Se incluyó a 66 pacientes. Hubo 8 casos de fallas en la osteosíntesis (12,12%). Se comprobó que ciertos factores ya establecidos (distancia punta-ápice >25 mm y reducción en varo) también fueron factores de riesgo significativos para falla en la osteosíntesis, en nuestra cohorte. La posición inadecuada del tornillo deslizante fue un factor de riesgo con significación estadística en el análisis univariado, pero no en el multivariado.

Conclusiones: Al tratar las fracturas intertrocantéricas con un clavo cefalomedular, la reducción en neutro o ligero valgo, apuntando a una distancia punta-ápice ≤25 mm redujo significativamente el riesgo de falla en la osteosíntesis. Hallamos que una localización superior o posterior del tornillo deslizante aumenta el riesgo de falla en la fijación, si bien la localización del tornillo no fue un factor de riesgo significativo en el análisis multivariado.
Seudoaneurisma de la arteria femoral lateral: revisión sistemática a propósito de una complicación infrecuente en pacientes con fracturas pertrocantéricas
Authors: Royo Agustín María , Castro Sauras Ángel , Urgel Granados Alejandro César , García Fuentes Jorge , Ibarra Reyes Leticia , Ranera García Miguel
Published: February 2022

Introducción: Se presenta un caso clínico de seudoaneurisma de la arteria femoral circunfleja lateral secundario a una fractura pertrocantérica de cadera.

Materiales y Métodos: Como el cuadro y su localización son infrecuentes, se llevó a cabo una revisión bibliográfica sistematizada que incluyó todos los casos publicados sobre esta enfermedad (n = 40) en los últimos 15 años.

Resultados: No se hallaron asociaciones estadísticamente significativas entre ninguna de las variables estudiadas. Sin embargo, parece existir cierto consenso en mantener una alta sospecha clínica para una intervención precoz y así obtener mejores resultados. Tanto su etiología como su localización se relacionan con la morfología de la fractura, el gesto quirúrgico y el material de osteosíntesis. Asimismo, hay una tendencia mayor a utilizar la angiotomografía para el diagnóstico y la localización del seudoaneurisma.

Conclusiones: Nuestra paciente es el primer caso de resolución espontánea. Es fundamental conocer estacomplicación tan poco frecuente para optimizar los resultados terapéuticos. Esta revisión, la más reciente sobre el tema, es muy útil para enumerar y subrayar los aspectos más importantes sobre el manejo y la prevención de los seudoaneurismas secundarios a una fractura de cadera.
Revisión de la literatura en diseño de servicios y experiencias para la humanización en hospitales
Authors: Sierra Pérez María Alejandra
Published: February 2022

El propósito de este artículo es examinar las bases teóricas recientes relacionadas con el diseño de experiencias y el diseño de servicios para la humanización en los hospitales desde el año 2014. Además, examinar las temáticas principales más relevantes en esta área. La revisión sistemática se dividió en dos fases. La primera fase consistió en encontrar los términos adecuados de búsqueda en cuatro idiomas diferentes: inglés, francés, italiano y español. La segunda fase comprendió la búsqueda en las bases de datos Scopus, Web of Science, Ebscohost, dependiendo de la cantidad de términos y aplicando filtros entre el año 2014 a 2020, revistas científicas y acceso abierto. El análisis de resultados muestra una serie hallazgos comprendidos en la cantidad de estudios publicados anualmente, por continente y por términos esenciales (innovación-tecnología, significación, empatía, cocreación e interacción) para la investigación en el diseño de servicios y experiencias para servicios de salud. Además, este estudio permite una comprensión para visualizar, de manera holística, los sistemas de servicios de salud teniendo en cuenta aspectos relacionados entre la humanización y la investigación en diseño.
Estrategias de diseño de producto para una economía circular
Authors: Reyes Forero Iris Andrea
Published: February 2022

La necesidad de habitar en un planeta cuyos recursos son limitados ha llevado a que se desarrollen estrategias desde todos los campos del conocimiento para cumplir con el objetivo de evitar la destrucción total de los recursos naturales.

El concepto de economía circular comenzó a vislumbrarse en la década de los 70, sin embargo, actualmente sigue siendo un tema nuevo para muchos. Este artículo tiene como objetivo revisar e identificar los trabajos centrados en las estrategias de diseño de producto que han surgido para la economía circular, con el fin de servir como guía en las barreras, indicadores y herramientas que resultan útiles para personas interesadas en procesos de diseño con un enfoque en la sostenibilidad. Los criterios para delimitar la búsqueda, selección, codificación y síntesis de los 50 artículos científicos originales que formaron parte de la revisión fueron los siguientes: incluir estudios publicados desde 2013 hasta el 2019, publicados en el continente europeo, en lengua inglesa y española, por medio de palabras clave en bases de datos y en citas bibliográficas. La información obtenida mediante los artículos seleccionados demostró que, a cualquier disciplina relacionada con el desarrollo de bienes y servicios, le compete aplicar, o al menos conocer, modelos acordes con la economía circular, concepto que ha nacido para disociar el crecimiento económico con la explotación de recursos.
Analysis of the goodness of fit of the San model for the calculation of the removal percentage of flocculent particles with low initial turbidity values in the problem water
Authors: Pulgarin M. Diego Alejandro , De Plaza Juan Sebastián , Ruge C. Juan Carlos , De Albuquerque Paulo J.R.
Published: February 2022

In this study, the degree of goodness of fit presented by the San model is determined to calculate the percentage of removal of flocculent particles, when the initial turbidity in the problem water is low. For this, the frequency analysis of the historical turbidity data that enters four drinking water treatment plants located in the department of Cundinamarca (Colombia) is made, which show values that range between 0.60 and 15.08 NTU (Nephelometric Turbidity Units). The water coagulation was done using type A aluminum sulfate and the sedimentation test was carried out in a sedimentation tower in order to determine the remaining turbidity in the water, which allows calculating the percentage of removal for different sedimentation times and at different depths. The values of the constants of the San model were determined through a multiple linear regression and the goodness of fit test was performed by calculating the coefficient of determination R2 for the different initial turbidity values in the test water.
Experimental and economic assessment of alkaline electrolyzer for dual-fuel operation in low-displacement diesel engines
Authors: Maestre-Cambronel Daniel , Hernández Brando , Duarte Forero Jorge
Published: February 2022

This investigation evaluated the integration of an alkaline electrolyzer for dual-fuel operation in an experimental test bench of a diesel engine from a techno-economic viewpoint. The characterization of the electrolyzer operation indicated that higher electrolyte (KOH) concentrations (30 – 40% w/w) improve the overall performance since less voltage is required for electrolysis, thus featuring higher efficiencies (50 – 60%) and hydrogen production (4 – 6 LPM). The economic analysis demonstrated that hydrogen cost remains competitive (4.3 - 5.6 USD/kg), and it is greatly dependent on the electrolyte concentration. Additionally, the operation of the engine with hydrogen injection at 20 LPM and a palm biodiesel blend reduced the fuel consumption rate between 10 – 31% depending on the load rate when compared to pure diesel. In contrast, dual-fuel operation generated a minor reduction in fuel conversion efficiency (< 5%), which reflects on the power output. Overall, this technology stands as a promising avenue to improve the fuel utilization ratio.
Aprendizaje del uso terapéutico de fármacos a partir de la información espacial tridimensional de su estructura molecular con redes neuronales convolucionales
Authors: Martinez Conde Jorge Mario , Patiño-Vanegas Alberto
Published: February 2022

El desarrollo de nuevas moléculas es un proceso que requiere de múltiples etapas y los ensayos clínicos para verificar su eficacia cuesta miles de millones de dólares cada año. El aprendizaje automático es una herramienta que está avanzando rápidamente en el reconocimiento de imágenes, voz y texto, y trabajar In silico aumentaría la capacidad de predecir y priorizar la función de un medicamento. En esta investigación nos preguntamos si la función de los medicamentos de uso terapéutico se puede predecir a partir de la configuración estereoquímica de la molécula. Nosotros usamos redes neuronales convolucionales para predecir el uso terapéutico de fármacos, entrenadas tanto con información bidimensional como con información tridimensional de su estructura química. El modelo entrenado solamente con seis vistas de la información 3D de la estructura molecular mejoró la exactitud en un 10 respecto al modelo entrenado con la información 2D.
Numerical analysis of aircraft flow exhaust gases to design a curved deflector for Mexico City international airport
Authors: Garrido-Téllez Jorge Luis , Hernandez Martinez Eusebio Eduardo , Jiménez-Escalona José Carlos
Published: February 2022

The numerical simulation results of the flow exhaust gases emitted by different aircraft engines are presented in this work. These results permitted the design of the most appropriate circular arc for a curved deflector to correctly direct the flow at the time planes are taking-off on the left runway number five of Mexico City International Airport (AICM) and not to affect the operability and route of the inter-terminal train, called as “Aerotren”. This train has four carriages of 25 passengers each and transports users of Mexico City International Airport from terminal T-1 to terminal T-2 and vice versa. For the numerical simulation, several engine models of different aircraft were used, including the Boeing 747-400, the Boeing 777-200LR/-300ER, the Airbus A340-600, and the McDonnell Douglas MD11. The results presented here are those from the McDonnell Douglas MD11 airplane, which is the most critical case since it has an engine in the rear part of the fuselage on the vertical empennage, and this causes the flow of exhaust gases to arrive in a direction from top to bottom on the upper part of the Aerotren, which for safety should not exceed 15.0 m/s (54 km/hr). The impact of the explosion of these engine models was used to choose the most appropriate deflector curvature angle in the take-off area. The numerical simulation was carried out through the Fluent CFD program, solving the Navier-Stokes equations, the standard model, turbulence, and atmospheric conditions in Mexico City. An experimental stage and the visualization of the behavior of the flow of exhaust gases within a wind tunnel are also presented. A 1: 125 scale model was used for both the deflectors with the radius of curvature obtained and the train car, in an area of one square meter and a grid background screen
Effect of the liquid-to-powder ratio on physicochemical properties of calcium phosphate cements and of these properties over Biofilm thickness of adhered Staphylococcus Aureus
Authors: Moreno Duarte Daniel , Vargas Galvis Fabio , López Gómez María Esperanza
Published: February 2022

Tricalcium phosphate (TCP) synthetized by high temperature solid state reaction at 1400°C and three derived calcium phosphate cements (CPCs) prepared at liquid to powder (L/P) ratios of 0.33, 0.44 and 0.55 ml/g, respectively, were physicochemically characterized. Calcium deficient hydroxyapatite crystals were identified by scanning electron microscopy on CPC, and differences in crystal sizes were observed at different L/P ratios. Also, the biofilm thickness of two Staphylococcus Aureus (S.aureus) strains grown for 24 hours on the three CPC are reported. A dependence of the biofilm thickness with the specific surface area (SSA) of CPC was identified. They are directly proportional for non-extracellular polysaccharide substances (EPS) producing S.aureus and inversely proportional for EPS producing S.aureus. Non-proportional behavior between the SSA and mechanical strength of the CPC was observed as L/P ratio increases.
Using Arduino sensors to monitor vacuum gauge and soil water moisture
Authors: Duarte Thiago Franco , Araújo Silva Tonny José , Bonfim-SIlva Edna Maria , Koetz Márcio
Published: February 2022

Sensors associated with the Arduino board can be an alternative to traditional sensors. The objective of this study was to calibrate a capacitive sensor to measure soil moisture and determine the soil water retention curve (< 100 kPa) using the MPX5100DP pressure transducer in conjunction with capacitive sensor measurements. The soil used was Red Oxisol, which had a clay texture and a bulk density of 1.20 Mg m−3. The model 𝑦𝑦=𝑎𝑎−𝑏𝑏𝑐𝑐𝑥𝑥 was fitted to the capacitive sensor data, which had the following statistical parameters: 9% (MAPE, mean absolute percentage error), 0.025 (RMSE, root-mean-square error), 0.97 (d), and 0.93 (𝑅𝑅2). In general, the error for the retention curves obtained with the capacitive sensor and that obtained by weighing was 0.025 (RMSE). Despite the slight tendency of the capacitive sensor to underestimate the highest values of soil moisture, these sensors can be used as an alternative for measuring soil moisture and water tension.
Landscape visual quality influence on noise pollution propagation in urban green areas
Authors: Dias de Oliveira Jefferson , Biondi Daniela , Nunho dos Reis Allan Rodrigo , Viezzer Jennifer
Published: February 2022

The objective was to evaluate the influence of noise pollution on both visual and sound landscapes at the Botanical Garden and the São Lourenço Park in Curitiba, Brazil. Data were collected in three transects (A, B, and C), representing different vegetation densities. Landscape visual quality was characterized through a direct method for valuing landscape elements. The visual quality was classified as Good, Mean, or Bad. For the sound analysis, two INSTRUTHERM decibel meters, model DEC-470, with 1.5-decibel precision, were used. The landscapes evaluated at site C showed variation in the quality of the landscape from 1 to 21.57, with the best visual and noise attenuation qualities. Correlation analysis between the visual quality of the landscape and the amount of blocked noise showed a strong correlation coefficient (0.65; p = 0.0001). Landscapes with better visual quality result in a greater amount of attenuated noise, mainly due to the presence of vegetation.
Diseñando un sistema de microtránsito con vehículos eléctricos usando simulación de eventos discretos: caso de un campus universitario
Authors: Apolo Matamoros Edison Oswaldo , Guerrero William Javier
Published: February 2022

Este trabajo presenta una metodología flexible para diseñar un sistema de microtránsito usando vehículos eléctricos. La metodología propuesta está constituida por cinco etapas. Primero, la estimación de la demanda de la población objetivo realizada por medio de encuestas. Segundo, se caracterizan y comparan las capacidades tecnológicas de los medios de transporte potenciales. Tercero, se caracterizan las distintas posibles rutas para el microtránsito para cada opción tecnológica y se escoge la mejor, tomando en cuenta las necesidades del usuario. Esto se logra por medio de herramientas de toma de decisiones y simulación por medio de eventos discretos que representa el funcionamiento del sistema. Finalmente, evaluamos el impacto ambiental que se genera al implementar este nuevo medio de transporte en una ruta de microtránsito. La metodología propuesta es flexible y puede ser aplicada tanto en sistemas de microtransito público como privado. Presentamos un caso de estudio para validar los resultados de la metodología en un campus universitario en Colombia.
Heinz Schilling. 1517: Weltgeschichte eines Jahres [Historia mundial de un año]
Authors: Suárez-Sánchez Fernando
Published: February 2022

Reseña del número 42 Heinz Schilling. 1517: Weltgeschichte eines Jahres [Historia mundial de un año]. Múnich: C. H. Beck, 2017. 364 pp.
Dr Beneficios del intercalamiento de canavalia inoculada con hongos micorrízicos y Rhizobium en Coffea canephora
Authors: Bustamante-González Carlos Alberto , Ferrás-Negrín Yusdel , Hernández-Forte Ionel , Rivera-Espinosa Ramón
Published: February 2022

Introducción. La caficultura requiere de tecnologías que incrementen los rendimientos, la eficiencia del uso de los fertilizantes, promuevan el uso de fuentes locales de nutrientes y aprovechen los beneficios de los microorganismos. Objetivo. Establecer la factibilidad del intercalamiento de la canavalia inoculada con rizobios y hongos micorrízicos arbusculares en cafetos y su relación con la fertilización nitrogenada. Materiales y métodos. El estudio se realizó entre los años 2008 y 2012 en el Instituto de Investigaciones Agro-Forestales, en Santiago de Cuba, Cuba. Se utilizó un diseño de bloques al azar con arreglo factorial. Se estudiaron cinco sistemas de fertilización nitrogenada, con y sin intercalamiento de canavalia inoculada en una plantación de cafetos podados y cultivados en suelo Cambisol. Las plantas de canavalia se mantuvieron en las calles del cafeto durante la época lluviosa, en ciclos de crecimiento de 90 a 120 días, corte, arrope y posterior siembra. Las semillas de canavalia se recubrieron con inoculantes micorrízicos y Rhizobium y se sembraron a 25 cm x 25 cm en la entrecalle de los cafetos. Se evaluó la biomasa, el crecimiento de la leguminosa, el rendimiento del cafeto y la eficiencia agronómica de la fertilización nitrogenada. Resultados. Con la canavalia inoculada con Rhizobium y hongos micorrízicos se incorporaron 205,9 kg de N ha-1 en tres años y se incrementó el rendimiento de los cafetos en 17 % y 16 % en el primer y segundo año, respectivamente. Con el sistema de fertilización N4 + canavalia se obtuvo un rendimiento promedio anual de 1,69 t ha-1 de café oro. Conclusiones. El intercalamiento de la canavalia con el cafeto incrementó la eficiencia de la fertilización nitrogenada. Fue efectivo el intercalar la canavalia inoculada con Rhizobium y hongos micorrízicos en el manejo de C. canephora durante los primeros dos años a partir de la poda baja del cafeto.
Venezuela en los estertores del dominio español y su relación con las Antillas Extranjeras, 1820-1823
Authors: Pita Pico Roger
Published: February 2022

El eje central de este artículo apunta a abordar la relación de las autoridades políticas y militares españolas asentadas en Venezuela con las Colonias extranjeras en el Caribe en la etapa culminante de la lucha independentista. Bajo el ambiente de tensión e incertidumbre por causa de la guerra, fue clave el despliegue diplomático del gobierno español asentado en Venezuela, no solo en su acercamiento con los gobiernos de aquellas islas sino con las potencias de las cuales dependían. Aún con todas las dificultades, fue valioso el auxilio de estas colonias extranjeras al agónico gobierno de Venezuela aunque no fue suficiente para evitar que sucumbiera frente a la ofensiva  de los republicanos quienes de manera creciente recurrieron también el apoyo político, económico y militar de las posesiones insulares en el Caribe.
La construcción sociohistórica de la noción de “riesgo social”. Intervención, legislación e instituciones en Costa Rica (1821-1880)
Authors: Izquierdo Vázquez Carlos
Published: February 2022

El artículo analiza cómo se desarrolló la atención hacia diversos sectores pobres en Costa Rica. A través de la revisión de leyes, decretos y circulares oficiales, se demuestra que el Estado practicó diversas medidas de protección a través de la institucionalización temprana de la caridad, la exoneración parcial o total de ciertos cobros, la repartición de tierras y el fomento de la salud pública a través de la medicina y de los hospitales. Diversos actores fueron clave en su desarrollo, como la ciudadanía, la Iglesia Católica y algunos integrantes de las elites. Sus propósitos también fueron el fortalecimiento del capitalismo, el fomento de la producción agrícola y la lucha contra la vagancia. Se concluye que el Estado fue institucionalizando la caridad y la salud pública hacia las poblaciones pobres a través del financiamiento y la fiscalización de diversos actores.
Secondary syphilis with HIV infection in men who have sex with men (MSM) patient treated with azithromycin and doxycycline: a case report
Authors: Lusyana Hani , Walujo Agus , Damayanti Lina
Published: February 2022

Introduction: Syphilis frequently presents in tandem with conditions such as HIV, and the prevalence is increasing, particularly in men who have sex with men (MSM). The most common and recognizable manifestations are usually the secondary stage, characterized with or without constitutional symptoms. Choosing the first line or alternative therapy was based on patient condition and the availability of the medicine.Case report: It was reported a 22-year-old man with secondary syphilis and HIV infection. The diagnosis was established based on erythema and hyperpigmented maculopapular lesions with the scale on the forearms, palms, back, feet, and soles without pruritic sensation, a history of the same-sex sexual partners and the titer of VDRL 1:64, TPHA 1:2560. The patient also has a low CD4 level, and HIV-1 RNA was detected on a blood test. Patients received azithromycin 2 grams orally and continued by doxycycline twice a day for 30 days and also treated for the HIV Infection.Conclusion: Skin disorders have improved rapidly and significantly, accompanied by decreased VDRL titer.
Steroid-induced diabetes mellitus in pemphigus vulgaris patient at Bali Mandara Hospital: a case report
Authors: Aviana Felicia , Birawan I Made
Published: February 2022

Background: Pemphigus vulgaris (PV) is a blistering autoimmune disease of the skin and mucous membranes defined histologically by intraepidermal blister due to acantholysis. Systemic corticosteroids and immunosuppressive agents had greatly improved the prognosis of pemphigus. However, steroid use often leads to metabolic complications, such as diabetes mellitus. This case report describes steroid-induced diabetes mellitus in PV, where the side effect of long-term high dosages steroid used and the method to manage it can be used as a study case.Case report: A 31-year-old man complained of new blisters from almost the entire body. He had a history of PV 1 year ago and no history of diabetes mellitus in the patient or family. He had a medication history of methylprednisolone 8 mg every 8 hours. Dermatological status showed erythema macules, extensive erosion almost on the entire body, the Nikolsky sign (+), and the Asboe-Hansen sign (+). Blood laboratory result: random blood glucose 451 mg/dl, HbA1c 12.3%.  Histopathological examination: suprabasal blister, in which the basal cells still attached to the basement membrane show a “tombstone” appearance. The diagnosis was steroid-induced diabetes in pemphigus vulgaris. He was treated with steroids and insulin.Conclusion: Steroid use in PV treatment can lead to metabolic complications, such as diabetes mellitus. Regularly monitoring is needed to prevent complications due to steroid use.
Dermoscopy in superficial fungal infection
Authors: Sawitri Putu Dyah , Karmila I Gusti Ayu Agung Dwi , Sadeli Marrietta Sugiarti
Published: February 2022

Superficial fungal infections are one of the most common skin infection infections. It is caused by fungal pathogens and are limited to the outer layer of the skin, hair, and nails. Superficial fungal infections include dermatophytosis, superficial candidiasis, and diseases caused by Malassezia spp. Most physicians diagnose and treat superficial fungal infections based solely on clinical appearance. But unfortunately, there are many other infectious and non-infectious diseases that have similar clinical appearance.Dermoscopy is a practical and noninvasive imaging method that allows magnifying clinical surface images that are normally invisible under a magnifying lens. In diagnosing superficial mycosis, dermoscopy was found to have a higher sensitivity and specifity compared to pottasium chloride (KOH) and fungal culture.More understanding is needed about the use of dermoscopy in diagnosing superficial fungal infections in the hope of being able to provide an overview of superficial fungal infections and dermoscopy, as well as dermoscopy features in some superficial fungal infections. In this article, the author describe dermoscopic findings in various superficial fungal infections on the skin, hair, and nails.
Does a higher degree of education affect the performance of healthcare leaders? A systematic review
Authors: Prasetyo Awal , Budiman Jethro , Isa Muzakar
Published: February 2022

Introduction: Healthcare leaders must have management skills, administrative competency, and leadership roles to fulfill the market demands, patient satisfaction, health policy, and complexity of the healthcare environment. Healthcare leader is expected to improve the competency through educational and professional program attainment to maximize measurable performance outcome for the hospital. The study aimed to systematically review the existing literature and carefully examine the findings to investigate the relationship between higher education and the performance of healthcare leaders.Methods: Three independent reviewers conducted a literature search in electronic databases for publications that met the inclusion and exclusion criteria. Each of the included studies' risk of bias was independently evaluated by the lead author, who then discussed their findings with the other two authors to reach a consensus. Five papers out of 529 found by database searching met the requirements for this study.Results: The Majority of the study designs were cross-sectional (4 of 5). Most of the studies discussed the outcome of the higher degree of education in healthcare leaders.Conclusion: Higher and advanced degrees of education affect the better leadership role, administrative competence, and patient experience. Top healthcare leaders mostly have higher degrees of education focused on healthcare.
The ethanol extract of Garcinia mangostana L peel reduces the isoniazid-induced liver damage in rats
Authors: Pramana Triyanta Yuli , Wasita Brian , Widyaningsih Vitri , Cilmiaty Risya , Suroto Suroto , Mudigdo Ambar , Purwanto Bambang
Published: February 2022

Background: The long-term use of Isoniazid (INH) as the Tuberculosis (TB) treatment increases the risk of possible liver damage. The peel from Garcinia Mangostana L. has been shown to reduce hepatotoxicity in the rat model. However, the molecular mechanism of this effect is not well-understoodObjective: This study aims to investigate the effect of the ethanol extract of the peel of Garcinia Mangostana L or mangosteen in preventing INH-induced liver damage at the cellular and molecular levels.Methods: A total of 32 male Wistar rats (Rattus Norvegicus) three to four months old with bodyweight between 170 and 200 grams are randomly enrolled into the negative control (NC), Positive control (PC), Treatment 1, and treatment 2 groups. The rats in the positive control (PC) and the treatment groups (T1, T2) were injected with 80 mg INH per kilogram body weight to induce liver fibrosis at the beginning of the study. The rats in the negative control group (NC) are injected with normal saline. The T1 and T2 groups are given 250 mg and 500 mg per kilogram body weight of mangosteen peel ethanol extract, respectively. After 35-days of treatment, blood samples were drawn from the rats, and the SGPT level was measured. Following the sacrifice, the liver tissues were prepared into slides and immunohistochemically stained and the TGF-Î²1 expression and fibrosis level were examined.Results: The expression of TGF-Î²1 is significantly higher in the PC and T1 groups than in the NC group (p-value <0.05). Compared with the NC groups, the SGPT level is significantly higher in the PC, T1, and T2 groups with a p-value less than 0.05. The fibrosis scoring in the T2 group is statistically lower than the PC group. (p-value <0.05)Conclusion: The ethanol extract of Garcinia mangostana L peel at a dose of 500 mg/kg of body weight shows a significant difference in the fibrosis score between the treatment group and the positive control group.
The role of cholelithiasis risk factors in stone types in cholelithiasis patients at Universitas Sumatera Utara Hospital
Authors: Siregar Denny Rifsal , Muhar Adi Muradi , Pohan Doddy Prabisma
Published: February 2022

Introduction: Cholelithiasis is the most common disease in the biliary tract. Several risk factors have been known as risk factors of cholelithiasis, such as obesity and female gender. Meanwhile, only few studies evaluate correlation between clinical characteristics and stone type in cholelithiasis. The study aims to evaluate correlation between clinical characteristics and stone type in cholelithiasis patients at Universitas Sumatera Utara Hospital.Method: The study design was cross sectional. The sample of this study was 35 people with cholelithiasis patients who underwent cholecystectomy either by open or laparoscopic cholecystectomy at Universitas Sumatera Utara Hospital. Gallstones will be examined by a laboratory. Risk factors assessed were age, gender, body mass index, hemoglobin bilirubin, cholesterol levels. Data analysis will use the Kruskal Wallis test.Result: From 35 study samples was found the most types of stones were mixed stones with 17 (48.6%). Based on the Kruskal Wallis test found a significant relationship between the type of stone with gender, body mass index, total bilirubin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).Conclusion: Factors related to the type of cholelithiasis stone are gender, body mass index, bilirubin levels, total cholesterol levels, HDL-C, and LDL-C.
Relationship between IL-6, IL-1Î², and vitamin D on frailty status in elderly women
Authors: Ngestiningsih Dwi , Dayanti Jessa Kris , Batubara Lusiana
Published: February 2022

Background: The aging process is associated with an increase in proinflammatory markers' serum levels, indicating that a chronic inflammatory process is correlated with an increase in disability, mortality, and frailty. Pro-inflammatory cytokines that increase with the incidence of frailty syndrome are IL-6, IL-1Î² and TNF-Î±. 25-hydroxyvitamin D (25 (OH) D) deficiency is also a potential risk factor for frailty, especially in the elderly. Vitamin D deficiency is associated with a risk of falling, which can speed up the frailty process. The aim of the study is to determine the relationship between IL-6, IL-1Î² and Vitamin D on frailty status in elderly women in elderly integrated health services (posyandu lansia), Semarang City.Methods: This study used a cross sectional design with a consecutive sampling method of 27 subjects. Subjects measured vital signs, weight and height measurements. The study subjects were then taken venous blood to measure the levels of IL-6, IL-1Î² and vitamin D in blood serum and assessed their frailty status. Data analysis using SPSS 25 with Spearman correlation test.Results: There were 27 elderly women who followed this study with an average age of 67.93 years. There are 16 people with pre-frail status and 3 people with frail status. There is a significant relationship between vitamin D levels in serum and frailty status (p = 0.008; r = 0.497). Variables IL-6 (p=0.328) and IL-1Î² (p=0.095) had no significant relationship with frailty status.Conclusion: Most of the elderly women have a pre-frailty status, namely as much as 59.3%. Vitamin D levels in the body have a significant and unidirectional relationship with frailty status in elderly women.
COVID-19 vaccination in patients with cancer: Position paper from the Indonesian Society of Hematology and Medical Oncology (ISHMO) of Semarang
Authors: Pangarsa Eko Adhi , Setiawan Budi , Santosa Santosa , Naibaho Ridho Monotoc , Rizky Daniel , Suyono Suyono , Tobing Mika Lumban , Sofro Muchlis Achsan Udji , Suharti Catharina
Published: February 2022

Patients with active cancer (cancer on treatment, those planning to start treatment, and those immediately post-treatment) consider getting the COVID-19 vaccine, like the other vulnerable populations, to reduce the severe risk of SARS-CoV-2 infection. We suggest patients with cancer should be vaccinated with a non-lived COVID-19 vaccine. Specific consideration belongs to the type of cancer, current treatment, phase of disease along the cancer continuum, and optimal timing for vaccination; they should talk to their hematologist-medical oncologist. Vaccination with the live-attenuated and replicating-vector vaccine is strongly discouraged in patients with active cancer receiving chemotherapy and during other immunocompromising therapies. For patients those receiving intensive chemotherapy (e.g., induction or consolidation therapy in acute leukemia), anti-B-cell antibodies, hematopoietic stem cell transplantation (HSCT), and other immunocompromised conditions, we suggest postponing SARS-CoV-2 vaccination until reaching stable lymphocyte counts due to the risk of vaccine infectivity. Cancer survivors are considered to have the same risk as other persons with matched aged and other risk factors. They also should be vaccinated as early as possible. There are various other risk factors for cancer patients which must consider related to complications of COVID-19, such as age, other comorbid diseases, demographic and social factors. All of these factors should be judged as a comprehensive evaluation of an individual patient. The use of masks, physical distancing, hygienic activities such as washing hands with soap and hand sanitizers are still needed during this pandemic. Caregivers and households should certainly be included in the vaccination strategies.
The correlation TNF-Î± gene promoter region -238G, -308G, -857, and -1031 polymorphism with psoriasis vulgaris
Authors: Meher Cashtri , Iswara R. Lia Kusumawati , Roesyanto-Mahadi Irma D
Published: February 2022

Background: Psoriasis vulgaris is a recurrent chronic skin disorder signed by hyperproliferation and epidermal inflammation. One of the etiology of psoriasis is genetic factors related to genetic polymorphism as disease susceptibility markers. This study was aimed to analyze the correlation of TNF-Î± gene promoter region polymorphism with psoriasis vulgaris.Â Methods: An analytical observational study with cross-sectional design to identify correlation TNF-region promoter polymorphisms with psoriasis vulgaris. This study included 45 psoriasis vulgaris patients and 45 non-psoriasis vulgaris patients from April to October 2016 at Immuno-dermatology Polyclinic of Dermatology and Venereology/Haji Adam Malik Hospital, Medan. We isolated DNA from the blood sample then ran into the PCR process with specific primers. PCR results were examined by electrophoresis with 2% agarose. Chi-Square test was used to test the hypothesis of a relationship between the TNF-Î± promoter region and psoriasis vulgaris at a significance of P <0.05.Â Result: Analysis by Chi-Square test found a significant correlation of polymorphism in TNF-Î± gene promoter region with psoriasis vulgaris in -308G (p=0,001) and 1031 (p=0,002) loci.Conclusion: TNF-Î± gene promoter region polymorphism TNF-Î± gene -1031 was more frequent in the case group, -308G was commonly found in the control group. Both of them were significantly correlated with psoriasis vulgaris.
Perspectives on hand hygiene practices in response to the current COVID-19 pandemic: Possible impacts on the homeostasis of cutaneous microbiome
Authors: Ramadhani Mahayu Firsty , Nirwati Hera , Danarti Retno , Susilowati Rina
Published: February 2022

During the current Coronavirus Disease 19 (COVID-19) pandemic, regular handwashing and other hand hygiene practices as the primary infection prevention program are highly encouraged. Notwithstanding the noticeable benefits in combating viral infection, hand hygiene practice potentially promotes dysbiosis of the skin microbiome. This review aimed to summarize the possible impacts of hand hygiene practices using soap products and alcohol-based hand rubs (ABHR) on the homeostasis of human skin microbiota. We discuss recent findings to provide evidence of the effectiveness of hand hygiene practices in viral infection control, the role of the skin microbiome in human health and the effects of hand hygiene practice on the homeostasis of the skin microbiome. Finally, this review also suggests improving research and practice of hand hygiene in response to the ongoing COVID-19 pandemic.
Melatonin prevented the elevation of leukocyte count and the decreased of hematocrit levels in burn-induced Wistar Rats
Authors: Kurniawan Muhammad Farhan , Utami Sulistiyati Bayu , Fulyani Faizah , Kresnoadi Erwin , Wicaksono Satrio Adi
Published: February 2022

Background: Burns are commonly caused by thermal injuries that are often encountered in everyday life. Burns may cause tissue damage and tissue infection. Melatonin, a hormone that acts as an antioxidant and anti-inflammatory, can be used as a supportive therapy in patients with burns by preventing excess tissue damage, decreasing inflammatory response, and preventing extreme leukocyte increase. The study aims to investigate the effects of melatonin supplementation on leukocyte count and hematocrit levels in male Wistar rats with burns injury.Method: This was an experimental animal study with randomized control group design. A total of twelve healthy male Wistar rats were randomized and divided into two groups. All Wistar rats were induced with 30% burns injuries area. The melatonin group was intraperitoneally administered with melatonin at 0, 8, and 16 hours after treatment, while the control group was administered with placebo (aquadest) with similar method. Leukocyte count and hematocrit levels were measured by taking retroorbital venous blood at 0, 3, and 24 hours after treatment. Data were analyzed with Paired t-Test, Independent t-Test, Mann-Whitney, or Wilcoxon test depend on their normality.Results: There was a higher leukocyte count in control group compared to melatonin group at 3 hours after treatment (T3) (p=0.050), but not at 0 hours after treatment (T0) and at 24 hours after treatment (T24) (p>0.05). There was increased leukocyte count in both melatonin and control groups in T3 in comparison with T0, however the increment was steeper in control group compared to melatonin group. There were no significant differences in hematocrit levels between the melatonin and control groups in T0, T3, and T24 (p>0.05). There was a steeper increased hematocrit levels in the control group than the melatonin group after T24, although it was not statistically significant.Conclusion: Melatonin might have role in preventing a steeper rise of leukocyte count and hematocrit levels in burns injury. If confirmed by further studies, melatonin might be potential for adjuvant management in burns.
The impact of basic life support training on the knowledge and skills amongst medical students in faculty of medicine, Universitas Malikussaleh: a pre-experimental study
Authors: Sayuti Muhammad , Hawari Muhammad Alief , Syahriza Muhammad , Millizia Anna
Published: February 2022

Introduction: Basic life Support (BLS) is a series of initial attempts to restore respiratory and/or circulatory functions in a person whose breathing and/or circulation stopped (cardiac or respiratory arrest). This study aimed to determine the impact of Basic Life Support (BLS) Training on the knowledge and skills amongst medical students of the Faculty of Medicine, Universitas Malikussaleh.Methods: An institution-based pre-experimental study with no control of extraneous variables in the form of a one-group pre-test-post-test design. Three steps of the study, administering a pre-test measuring the dependent variables, applying the training to the respondents, and administering a post-test. The differences attributed to the application of the BLS training were then evaluated by comparing the pre-test and post-test scores using the Wilcoxon test, and the differences were considered significant at p<0.05.Results: A total of 82 medical students were involved in this study. The overall knowledge of BLS before the training was categorized as good, adequate, and poor with 1 (1.2%), 57 (69.5%) and 24 (29.3%), respectively. While the level of BLS skills of all respondents, 82 (100%), was poor. However, the level of knowledge and skills amongst respondents after participating in BLS training categorized as adequate increased significantly to 77 (93.9%) and 48 (58.5%), respectively, and none of the respondents categorized as a poor level of knowledge even though there were 34 (41.5%) respondents still had poor level of skills. Bivariate statistical analysis using the Wilcoxon test found that the BLS training impacts knowledge and skills with a p-value of 0.000 (p< 0.05). Conclusion: This study showed that the implementation of BLS training for medical students greatly impacts knowledge and skills. The routine non-academic BLS training should be considered to increase both knowledge and skills amongst medical students.
Current concept management of talus fracture: a literature review
Authors: Soetjahjo Bintang , Arimuqti Zarkasyi
Published: February 2022

Fractures of the talus are uncommon. The relative infrequency of these injuries relates to limited guidelines to treat talus fracture. Talus fracture is always associated with high energy injury critical to the normal function of the ankle, subtalar, and transverse tarsal joints.  Outcomes vary widely and are related to the degree of initial fracture displacement. Nondisplaced fractures have a favorable outcome in most cases. Failure to recognize fracture displacement (even when minimal) can lead to undertreatment and poor outcomes. Current detailed diagnoses through Multidetector CT (MDCT) are preferred to avoid miss diagnosed in talar fracture. Although early treatment and delayed treatment did not significantly differ, multiple-choice to treat talus fracture should be known. Conservative and operative treatment can be done in accordance with clinical findings and fracture patterns. With a high risk of complication, appropriate therapy should be done. Many research and articles have been done to develop the treatment and reduce complications over talar fracture from an invasive procedure to a non-invasive procedure like arthroscopy. Therefore, we compile current treatment to give another perspective for surgeons to treat talar fracture patients
Comparison of the nutritional status and lipid profile of tuberculosis patients with and without type 2 diabetes mellitus in primary health care in Bandung
Authors: Berbudi Afiat , Camilla Chansa , Rahmadika Nofri , Cahyadi Adi Imam , Ruslami Rovina
Published: February 2022

Background: Diabetes mellitus (DM) and tuberculosis (TB) both are major global health problems. DM, primarily type 2 DM (T2DM) is often associated with obesity, hypertriglyceridemia, and high cholesterol and is a risk factor for TB. Diabetes is also associated with poor TB treatment outcomes. Since Mycobacterium tuberculosis (Mtb) relies on host nutrients, lipids, and cholesterol to survive, more knowledge about the nutritional status and lipid profile of T2DM, TB, and TB-T2DM patients is needed in order to establish novel TB management strategies for TB-T2DM patients.Methods: Cross-sectional study was conducted to compare the nutritional status and lipid profile of TB-T2DM, TB, and T2DM only patients using data collected from several Primary Health Cares in Bandung, Indonesia. In total, 77 TB-T2DM, TB only, and T2DM only patients treated at the Primary Health Care Centers in Bandung, Indonesia, were recruited.Results: BMI and the lipid profiles of the TB patients were significantly lower than those of T2DM patients (p<0.05). BMI and HDL levels were significantly lower in the TB-T2DM patients than those in T2DM patients (p<0.001 and p=0.04). Total cholesterol levels were significantly lower in TB compared to those in the TB-T2DM group (p=0.025).Conclusion: All lipid profiles showed a similar pattern with the T2DM without TB having the highest lipid levels, followed by TB-T2DM and TB patients.