Comatose after Fourth Cycle of 5-Fluorouracil: A Report of Toxic Leukoencephalopathy

Abstrak: Penelitian ini dilakukan melalui penelitian tindakan kelas dengan melibatkan subjek sebanyak 39 orang mahasiswa jurusan Pendidikan Tenik Elektro Fakultas Teknik Unimed, menyangkut permasalahahan implementasi contextual teaching-learning melalui riset mini dalam perkuliahan metode penelitian pengajaran. Masalahnya adalah apakah implementasi kontekstual teaching learning melalui riset mini dapat meningkatkan kompetensi mahasiswa dalam membangun proposal penelitian?. Penelitian dilakukan dalam 5 siklus dengan target capaian yaitu 85% mahasiswa mencapai skor ≥ 80. Hasil yang diperoleh yaitu ada peningkatan dari siklus ke siklus berikutnya, yaitu pada siklus I ada 12 orang mahasiswa (30,76%) mencapai target; pada siklus II ada 19 orang mahasiswa (48,71%) mencapai target; Pada siklus III ada 24 orang mahasiswa (61,53%) mencapai target; Pada siklus IV terdapat sejumlah 28 orang mahasiswa (71,79%) yang mencapai target; dan pada siklus V terdapat 34 orang mahasiswa (87,17%) sudah mencapai target. Berdasarkan temuan penelitian disimpulkan bahwa implementasi contextual teaching learning melalui riset mini dapat meningkatkan kompetensi mahasiswa dalam membangun proposal penelitian. Kata Kunci: Implementasi kontekstual teaching learning Abstract: The research was conducted through action research involving subjects as many as 39 students of electrical education department of technical faculty Unimed, concerning the problems of contextual teaching learning implementation through mini rsearch in education research method course. The formulation of this researh problem is “whether the implementation of contextual teaching learning through mini research can improve students' competencies in building research proposal?. The study was conducted in 5 cycles with a target achievement of 85% of students achieving a score of ≥ 80. The results are an increase of the cycle to the next cycle, the first cycle, there were 12 students (30.76%) targets; in the second cycle there are 19 students (48.71%) targets; In the third cycle there were 24 students (61.53%) targets; in the fourth cycle there are a number of 28 students (71.79%) to reach the target, and the cycle of V contained 34 students (87.17%) has reached the target. Based on the findings of the study concluded that the implementation of contextual teaching learning through mini research can improve the competence of students in developing research proposals. Keywords: Contextual teaching learning implementation

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Toxic leukoencephalopathy with extrapyramidal dysfunction due to synthetic cannabinoids

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2018.10.022 ◽

2018 ◽

Vol 58 ◽

pp. 213-214 ◽

Cited By ~ 1

Author(s):

Jordan Yardain Amar ◽

Jeffrey Ruta ◽

David Rahimian ◽

Rachel Leah Dillinger ◽

Paul Katz

Keyword(s):

Synthetic Cannabinoids ◽

Toxic Leukoencephalopathy

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Methadone-Induced Toxic Leukoencephalopathy: Diagnosis and Follow-up by Magnetic Resonance Imaging Including Diffusion-Weighted Imaging and Apparent Diffusion Coefficient Maps

Journal of Neuroimaging ◽

10.1111/j.1552-6569.2010.00530.x ◽

2010 ◽

Vol 21 (3) ◽

pp. 283-286 ◽

Cited By ~ 13

Author(s):

Alfonso Cerase ◽

Sara Leonini ◽

Matteo Bellini ◽

Giuseppe Chianese ◽

Carlo Venturi

Keyword(s):

Magnetic Resonance Imaging ◽

Diffusion Coefficient ◽

Magnetic Resonance ◽

Apparent Diffusion Coefficient ◽

Diffusion Weighted Imaging ◽

Resonance Imaging ◽

Toxic Leukoencephalopathy ◽

Apparent Diffusion ◽

Apparent Diffusion Coefficient Maps

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Stroke-Like Presentation of Toxic Leukoencephalopathy as the Initial Manifestation of HIV Infection

Case Reports in Neurology ◽

10.1159/000346033 ◽

2012 ◽

Vol 4 (3) ◽

pp. 231-235

Author(s):

Björn Reuter ◽

Marc E. Wolf ◽

Alex Förster ◽

Kira Kalvin ◽

Kristina Szabo ◽

...

Keyword(s):

Hiv Infection ◽

Initial Manifestation ◽

Toxic Leukoencephalopathy

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SEVEN The Fourth Cycle (1980–1990): The Post-Network Era

10.7560/781757-008 ◽

2002 ◽

pp. 111-146

Keyword(s):

Fourth Cycle ◽

Network Era

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Acute Toxic Leukoencephalopathy: Etiologies, Imaging Findings, and Outcomes in 101 Patients

American Journal of Neuroradiology ◽

10.3174/ajnr.a5947 ◽

2019 ◽

Vol 40 (2) ◽

pp. 267-275 ◽

Cited By ~ 9

Author(s):

C. Özütemiz ◽

S.K. Roshan ◽

N.J. Kroll ◽

J.C. Benson ◽

J.B. Rykken ◽

...

Keyword(s):

Imaging Findings ◽

Toxic Leukoencephalopathy ◽

Acute Toxic Leukoencephalopathy ◽

Acute Toxic

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Malignant cerebellar edema in three-year-old girl following accidental opioid ingestion and fentanyl administration

The Neuroradiology Journal ◽

10.1177/1971400919863713 ◽

2019 ◽

Vol 32 (5) ◽

pp. 386-391 ◽

Cited By ~ 4

Author(s):

Cathy H Chen ◽

Alexander J Mullen ◽

Dustin Hofstede ◽

Tanvir Rizvi

Keyword(s):

Computed Tomography ◽

Case Reports ◽

External Ventricular Drain ◽

Opioid Analgesics ◽

Gas Chromatography Mass Spectrometry ◽

Motor Deficits ◽

Acute Hypertension ◽

Toxic Leukoencephalopathy ◽

Hospital Days ◽

Fentanyl Administration

A three-year-old girl was found altered with an unknown timeline. Gas chromatography mass spectrometry was positive for hydromorphone, dihydrocodeine, and hydrocodone. Initial computed tomography and magnetic resonance imaging suggested a malignant cerebellar edema not confined to a vascular distribution. She received fentanyl boluses on hospital days 0 and 1 before receiving a continuous infusion on day 1. On day 3, she had an episode of acute hypertension and bradycardia. Emergent computed tomography showed an evolving hydrocephalus and similar diffuse edema throughout both cerebellar hemispheres. External ventricular drain was placed to relieve the increased intracranial pressure. Following drain placement and fentanyl discontinuation, the patient recovered, though not without fine- and gross-motor deficits at the four-month follow-up. Our case adds to a handful of case reports of opioid toxicity in pediatric patients that present as toxic leukoencephalopathy. Though the mechanism is poorly understood, it has been suggested to be a consequence of the neurotoxic effects of the drug, which has particular affinity for µ opioid receptors—the primary opioid receptor found in the cerebellum. Clinicians would do well to recognize that this syndrome is primarily caused by direct toxicity rather than ischemia. This case adds insight by suggesting that lipophilic opioid analgesics may worsen this neurotoxicity. When intervening with mechanical ventilation, clinicians should consider avoiding lipophilic opioid drugs for analgesia until the pathogenesis of cerebellar edema is better understood.

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Full Recovery From Cocaine-Induced Toxic Leukoencephalopathy: Emphasizing the Role of Neuroinflammation and Brain Edema

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709619868266 ◽

2019 ◽

Vol 7 ◽

pp. 232470961986826 ◽

Cited By ~ 1

Author(s):

Edward C. Mader ◽

Alexander B. Ramos ◽

Roberto A. Cruz ◽

Lionel A. Branch

Keyword(s):

White Matter ◽

Time Course ◽

Brain Mri ◽

White Matter Lesions ◽

Psychomotor Retardation ◽

Full Recovery ◽

White Matter Disease ◽

Mri Findings ◽

Prognostic Information ◽

Toxic Leukoencephalopathy

Toxic leukoencephalopathy (TL) is characterized by white matter disease on magnetic resonance imaging (MRI) and evidence of exposure to a neurotoxic agent. We describe a case of cocaine-induced TL in which extensive white matter disease did not preclude full recovery. A 57-year-old man with substance abuse disorder presented with a 5-day history of strange behavior. On admission, he was alert but had difficulty concentrating, psychomotor retardation, and diffuse hyperreflexia. Brain MRI revealed confluent subcortical white matter hyperintensities with restricted diffusion in some but not in other areas. Electroencephalography (EEG) showed mild diffuse slowing. Blood tests were normal except for mild hyperammonemia. Urine screen was positive for cocaine and benzodiazepine but quantitative analysis was significant only for cocaine. Prednisone 60-mg qd was initiated on day 4, tapered over a 5-day period, and discontinued on day 9. He was discharged after 3 weeks. Cognitive function returned to normal 2 weeks after discharge. Five months later, neurologic exam and EEG were normal and MRI showed near-100% resolution of white matter lesions. TL has been attributed to white matter ischemia/hypoxia resulting in demyelination/axonal injury. The clinical, EEG, and MRI findings and time course of recovery of our patient suggest that cocaine-induced inflammation/edema resulted in TL but not in ischemic/hypoxic injury. While inflammation/edema may have regressed when cocaine was discontinued, we cannot exclude a role for prednisone in protecting the patient from the ischemic/hypoxic sequelae of inflammation/edema. MRI is indispensable for diagnosing TL but EEG may provide additional useful diagnostic and prognostic information.

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The Influence of Constructional Parameters on Deformability of Elastic Cotton Fabrics

Journal of Engineered Fibers and Fabrics ◽

10.1177/155892501400900106 ◽

2014 ◽

Vol 9 (1) ◽

pp. 155892501400900

Author(s):

Dunja Sajn Gorjanc ◽

Matejka Bizjak

Keyword(s):

Maximum Load ◽

Cotton Fabrics ◽

Density Increase ◽

Research Results ◽

Plain Weave ◽

Weft Direction ◽

Fourth Cycle ◽

Deformation Level ◽

Twill Weave

This research is focused on the influence of constructional parameters such as the type of weave and density on deformability of pure cotton and cotton/elastane fabrics. In the research, two basic weaves were used: the plain and twill weave without (pure cotton) and with 6.2 percent of elastane in the weft direction. The density of the warp yarns was before bleaching 22yarns/cm and after end treatment (bleaching) from 24 to 31 yarns/cm. The chosen densities in the weft direction were 17 and 20 yarns/cm. The fabrics were cyclically loaded with maximum load 17.66 N. The non-recoverable deformation was measured after 30 seconds of relaxation after the fourth cycle of loading, according to ASTM D 3107–75. The research results show that elastane incorporation significantly decreased the non-recoverable deformation after loading. In the case of the twill weave, the decrease of non-recoverable deformation was from around 20% – twill without elastane to around 5% – twill with elastane – fabrics 7B and 8B. The non-recoverable deformation level decrease with fabrics in plain weave was also significant (from around 24% – plain without elastane to around 12% – plain with elastane). From the results of non-recoverable deformation, it is clearly seen that the chosen type of weave, plain and twill, significantly influenced the non-recoverable deformation level. The increase of density in the weft direction from 17 yarns/cm to 20 yarns/cm for pure cotton and cotton/elastane fabrics insignificantly influenced the non-recoverable deformation level. This means that the density increase of 3 yarns/cm is too low to significantly influence the deformability of pure cotton and cotton/elastane fabrics.

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