Jumper’s fracture of the sacrum: a novel and reproducible way for successful reduction and fixation

Purpose Surgical treatment of jumper’s fractures is a highly demanding situation for the surgeon due to its rareness and frequent association with severe concomitant injuries. There is no current consensus regarding a standard treatment approach, thus reducing quality of care. Our objectives were to describe, apply and assess a novel surgical technic. Methods The presented research is an observational retrospective study of patients who underwent the described novel surgical intervention in a level 1 trauma center. We conducted analyses of the patient cohort using patient-related outcome measures at least 1 year after surgery, as well as investigating pain, quality of life and the clinical effectiveness of the procedure. Results A total of 24 patients (17 male and 7 female) with an average age 47 ± 16.3 years were included. ISS scores ranged from 9 to 66 with a mean ISS of 40 ± 15. Clinical scores exist of 15 out of 24 patients (62.5%). The mean VAS score was 53.7 ± 12.9. The mean EQ-5D index was 0.68 ± 0.22. Significant negative correlation existed between the ISS value and the EQ-5D index (r = − 0.704; p < 0.005) and EQ-5D VAS (r = − 0.809; p < 0.001). Anatomical reduction was achieved in all patients (n = 24). Radiological follow-up was performed in 58%. Conclusion We present one of the largest studies with operatively treated jumper’s fractures of the sacrum. The technique is capable of reproducibly restoring the physiological anatomy of the patient and allows pain-adapted mobilization.

EP.TH.267Gastroesophageal Reflux Disease after sleeve gastrectomy

Aim A prominent complication of a sleeve gastrectomy is gastroesophageal disease (GERD). Symptoms include chest pain, dysphagia, heartburn, regurgitation, chronic cough, and laryngitis. With the rise in obesity, and the already high prevalence of GERD in these populations, this is a significant cause of morbidity in western populations and is likely set to worsen. Method The literature search was carried out using Ovid MEDLINE and PubMed databases to search for keywords and MeSH terms including “bariatric surgery”, “sleeve gastrectomy”, “complications”, “gastroesophageal reflux disease”, “GERD”, “GORD”, and “obesity”. Result Approximately 20% of patients who undergo SG will develop de-novo GERD whilst 19% will have an increase in reflux symptoms. The exact mechanism of GERD in both obesity and post-operatively following SG is unclear. However, it can involve several different mechanisms. This includes poor surgical technique, disruption to physiological anatomy, increase in gastric pressure, increased risk of hiatus hernia, and disruption to normal hormonal balance. An effective approach to treat GERD includes the Stretta procedure with studies showing 72% of patients being symptom-free after 10 years. If this fails, conversion of SG to Roux-en-Y is effective but there is an increased risk of gastro-jejunal anastomotic leak (3% vs 1%). Alternatively, addition of hiatoplasty and 180° cardioplication can also be effective. Conclusion More evidence and international collaborations would help determine which patient groups require counselling and will benefit from novel management to minimise complications.

Pengabdian Kepada Masyarakat Bantuan Hidup Dasar Pada Santri

ABSTRAK Angka kejadian henti jantung atau cardiac arrest ini berkisar 10 dari 100.000 orang normal yang berusia dibawah 35 tahun dan per tahunnya mencapai sekitar 300.000-350.000 kejadian. Pertolongan pertama yang tepat pada kasus henti jantung adalah bantuan hidup dasar (BHD). Tindakan yang bisa dilakukan adalah resusitasi jantung paru (RJP). Tujuan dari resusitasi jantung paru adalah mengembalikan sirkulasi spontan serta mempertahankan fungsi organ vital pada henti jantung dan henti nafas dengan melakukan kompresi dada dan bantuan nafas. Tujuan setelah dilakukan pelatihan ini diharapkan santri dapat berperan aktif dan dapat memberikan pertolongan pertama henti jantung dan henti nafas secara tepat serta mampu melakukan RJP. Kegiatan ini dilakukan dengan metode pemaparan teori tentang anatomi fisiologi sistem respirasi dan sistem sirkulasi, dampak dari henti nafas dan henti jantung, bantuan hidup dasar dan pada hari kedua dilanjutkan dengan praktik RJP melalui manekin. Hasil yang didapatkan sebagian besar santri (80%) memahami dan mengerti tentang bantuan hidup dasar dan mampu mempraktekkan RJP kepada manekin meskipun masih butuh pendampingan. Kata Kunci : bantuan hidup dasar, santri, pondok pesantren ABSTRACT The incidence of cardiac arrest or cardiac arrest ranges from 10 out of 100,000 ordinary people aged under 35 years and annually reaches around 300,000-350,000 events. Appropriate first aid in cases of cardiac arrest is basic life support (BLS). Action that can be done is cardiopulmonary resuscitation (CPR). Cardiopulmonary resuscitation aims to restore spontaneous circulation and maintain vital organ function in cardiac arrest and stop breathing by performing chest compressions and breath support. After this training, the goal is that students will be able to play an active role and be able to provide first aid for cardiac arrest and stopping breathing appropriately and be able to perform CPR. This activity was carried out using the method of presenting theories on the respiratory system's physiological anatomy and the circulatory system, the impact of respiratory and cardiac arrest, basic life support, and on the second day, continued with the practice of CPR through mannequins. The results obtained were most of the students (80%) understood and understood basic life support and were able to practice CPR to the mannequins even though they still needed assistance. Keyword: basic life support, student, Islamic boarding school

The First 24 Hours Post Partum Mother’s Breast Milk Production at Hospital

Breast milk is ideal baby food, various kinds of breast milk content are needed by the baby. Factors affecting breastmilk production among others: mother's food intake, mind, physiological anatomy, baby suction factors, rest factors and drug factors. The purpose of this study was to determine the production of postpartum mother milk in the first 24 hours. The research was conducted in descriptive quantitative with a time-series approach. The research subjects were obtained through consecutive sampling. Data were obtained at 2 hours postpartum, 16 hours postpartum and 24 hours postpartum using measuring cups and observation sheets. The subjects of this study were 21 normal postpartum mothers. The research data were analyzed using univariate analysis. The study was conducted in July 2020 at Ungaran Hospital. Respondents have explained the study. Researchers guarantee the confidentiality of respondents from the beginning to the end of the study. The results showed parity of postpartum multiparous mothers was 52.4%, primiparous 47.6%. Postpartum mothers with the early adult category were 66.7%. Postpartum mother breastmilk production at 2 hours with an average ± 0.155 cc, the mother experienced an increase in the amount of milk production at 16 hours postpartum by an average of ± 1.272 ml and at 24 hours postpartum experienced an increase in the amount of mother's milk production on average ± 1.369 ml. It can be concluded that physiologically normal post-partum mother milk production has increased gradually, the increase is because the more often the mother empties the breast, the more breast milk production.

The implementation and Perception of Pharmacy Students About Blended Learning On Course of Anatomy Human Physiology at The Pandemic Covid-19

Blended learning is a learning model which combines various forms of delivery, teaching model, and learning style, which make it easier for students to receive material that is given by their teachers. These blended learning type of course in this research took advantage of the Kulon of online application portal e-learning developed by the muhammadiyah pharmaceutical high school, as an online learning effort during the covid-19 outbreak. The study aims to learn the application of e-learning Kulon to the subjects of human physiological anatomy of pharmaceutical students and a pharmaceutical student's perception of online learning. This research method employs qualitative descriptive research methods. Research instruments used in questioner and online interviews were given to 40 people of pharmaceutical students who take a course in the anatomy of human physiology. Data collected from observation during college and from student response questionnaires to the application of blended learning. Analysis shows that the Kulon portal system and students are ready for the implementation of online learning. With clear instruction, students can perform good and independent learning. A questionnaire's data analysis showed the students braver to asking and answering questions during learning at the Kulon portal rather than in a manual class can conclude that the application of e-learning, a blended type of learning, using the Kulon's portal e-learning during the covid-19 outbreak was good and effective

The tragedy of the emeritus and the fates of anatomical collections: Alfred Benninghoff's memoir of Ferdinand Count Spee

Retirement can be a significant period in modern academic careers, and emeritus professors have shaped the fates of collections in departments and disciplines. This is evidenced by reconstructing the meanings of Alfred Benninghoff's remarkable memoir of Ferdinand Count Spee, sometime director of the anatomical institute in the University of Kiel. Thematizing the ‘tragedy’ of the emeritus, Benninghoff's 1944 article recalls his predecessor's possessive interactions with his collections as these approached assorted endings. With nostalgia and humour, it places the old aristocrat physically, intellectually and emotionally in a building that bombing would soon destroy. Benninghoff's Spee retained control over the microscope slides with which he engaged colleagues in conversations about research in embryology and physiological anatomy. He lost authority over the teaching charts and wet preparations, but still said a long farewell to these things; he tried, like a conductor alone after a concert, to recapture an experience he had once shared. The elegy is interpreted as apologetic about anatomy under National Socialism, and as offering a model of collegiality. It illustrates how collections have mediated relations between scientific generations at the end of a career.

Echocardiographic parameters and vertebral heart size (VHS) in lambs during the neonatal period

ABSTRACT: Due to cardiac immaturity, newborns have a different morphology and cardiac output when compared with adults. The purpose of this study was to describe the cardiac changes in echocardiographic characteristics and vertebral heart size (VHS) in newborn lambs during the neonatal period. Twenty-eight healthy Ile de France lambs were evaluated from birth to 35 days old. With the assistance of echocardiography, this study evaluated, both in systole and diastole, indexes related to the right and left ventricles, the aorta (Ao), the left atrium (LA), the E point to septal separation (EPSS) and the thickness of the interventricular septum (VSd, VSs). The left atrium-to-aorta ratio (LA:Ao) was analyzed and both the shortening (SF%) and ejection fractions were calculated (EF%). The VHS was obtained by measuring the heart’s long and short axes and comparing it to the thoracic vertebrae. Throughout the first 35 days, the results obtained demonstrated an increased LV:RV ratio when compared to adult lambs. The calculated indexes and the LA:Ao ratio did not present statistically significant differences. The VHS values were normally distributed, presenting a mean of 9.67 vertebrae (v) during the entire period. Both radiographic and echocardiographic parameters showed significant differences between the analyzed moments. The VHS values ranged from 8.4v at the minimum end to 11.2v at the maximum. In order to prevent these changes from being misdiagnosed as heart diseases, this study contributed to take note of neonatal physiological anatomy peculiarities and in addition, it describes the parameters for this age in Ilê de France lambs.

Construction of Biological Model of Human Lumbar and Analysis of its Mechanical Properties

In this paper, combined with physiological anatomy knowledge, the complete finite element model of L3–L4 lumbosacral segment of human lumbar was established by using the 3D graphic of human spine L3–L4 segment, which is obtained by image diagnosis technique (CT scan). This model includes the sections of the bones, the intervertebral disc and the anterior ligament, the posterior ligament, the ligamentum flavum, the fibrous ring and other major spine attached soft tissue. Then the finite element model meshing and the material properties of the corresponding part setting were done on the constructed model, and different loads and boundary conditions were imposed to simulate the displacement and stress and strain nephogram of the normal model and intervertebral disc herniation, senile degeneration and other models in different movement states. And the effectiveness of model data is verified by analyzing its biomechanical properties. The biomechanical properties of the spine obtained by the finite element method can be used to provide biomechanical basis for the diagnosis and treatment of intervertebral disc herniation and degeneration.

PEMBERDAYAAN ASUHAN KEPERAWATAN DALAM UPAYA MENINGKATKAN KESEHATAN LANSIA DI WILAYAH PUSKESMAS NGALIYAN SEMARANG

Salah satu outcome atau dampak dari keberhasilan pembangunan nasional dibidang kesehatan dan kesejahteraan sosial adalah meningkatnya angka rata-rata harapan hidup (Khusaryadi, 2010). Badan Pusat Statistika (2004) menyebutkan bahwa peningkatan rata-rata harapan hidup tersebut mecerminkan bertambah panjangnya masa hidup penduduk usia lanjut (Lansia). Peningkatan proporsi jumlah lansia tersebut perlu mendapatkan perhatian dan pelayanan kesehatan dari tenaga medis karena kelompok lansia merupakan kelompok resiko tinggi yang mempunyai masalah kesehatan. Upaya peningkatan derajat kesehatan lansia perlu dilakukan guna menekan angka kesakitan pada lansia. Melalui kegiatan pengabdian masyarakat berbasis pada pelayanan dan pendampingan mahasiswa, ditujukan untuk meningkatkan derajat kesehatan lansia. Kegiatan ini mempunyai tujuan dan target yaitu mampu memberikan asuhan keperawatan pada lansia utamanya yang mengalami masalah kesehatan/kecenderungan mengalami gangguan kesehatan dan proses penyembuhan secara professional dengan menggunakan pendekatan proses keperawatan yang disesuaikan dengan kasus tertentu.Metode Pelaksanaan pengabdian dilakukan oleh mahasiswa dengan pendampingan dosen, aplikasi penerapan teori ini merupakan bentuk evaluasi dari hasil pembelajaran mahasiswa setelah mahasiswa mempelajari ilmu keperawatan gerontik. Bentuk aplikasi yang dilakukan selama Pengabdian adalah melaksanakan asuhan keperawatan pada lansia di wilayah puskesmas ngaliyan dengan melakukan kunjungan rumah. Luasnya area Pengabdian membutuhkan kemampuan dari dosen sebagai pembimbing dalam membimbing dan mengarahkan mahasiswa disaat pelaksanaan kegiatan berlangsung. Diharapkan keterampilan yang sudah dimiliki oleh mahasiswa dapat diterapkan dengan modifikasi alat dan bahan sesuai kondisi yang ada di lahan yang akan diintegrasikan dengan pemberdayaan proses keperawatan khususnya keperawatan gerontik. Pembekalan pengabdian dilaksanakan seminggu sebelum pelaksanaan dengan pihak dosen sebelumnya berkoordinasi dengan pihak puskesmas ngaliyan.Setelah diberikan penyuluhan kesehatan lansia menjadi paham tentang tanda gejala, penatalaksanaan bagaimaa cara mengatasi dan menghindari, serta bagaimana pengobatan untuk penyakit hipertensi, diabetes militus dan asam urat. Masalah kesehatan yang dialami lansia merupakan proses penuaan yang sering berakibat pada terjadinya beberapa perubahan fisiologis, anatomi, psikologis, dan sosiologis.Kesehatan lansia merupakan masalah atau tantangan yang harus disikapi dan ditangani dengan serius agar timbulnya penyakit yang menetap yang disebabkan karena bertambahnya usia pada lansia seperti Alzeimer/Dimensia, gangguan sclerosis multiple, gangguan endokrin, dan lain-lain dapat diatasi dengan baik. maka diperlukan asuhan keperawatan yang khusus pula untuk mencapai kesembuhan yang paripurna.Dengan adanya pemberdayaan asuhan keperawatan pada lansia yang dilakukan oleh mahasiswa dengan pendampingan dosen dapat membantu terwujudnya kesehatan lansia. Katakunci: Pemberdayaan, Asuhan Keperawatan, Kesehatan Lansia THE EMPOWERMENT OF NURSING CARE TO INCREASE THE HEALTH OF ELDER PEOPLE IN PUBLIC HEALTH OF NGALIYAN SEMARANGThe one of outcome or effect of the national development in healthy and social prosperity is the increase of the life expectancy ( khusaryadi ,2010). Central Bureau of Statistic(2004) stated that the increase of the life expectancy is a prove that elder people have long life.The increase of elder people have to be attended by health service of medical team because the elder people have the high risk of disease. This activity needs to do to decrease the total disease or health problem of elder people. The research objective is to give the health service for the elder people who have the health problem and help to heal the disease professionally using certain approach.The lecturer will accompany the students in practicing this activity by applying a application as the evaluation of the study result in Gerontological Nursing.The application they will do is such kind of caring service and home visiting in Public Health of Ngaliyan.After giving health counseling the elder people be more understand about the indication how to do, how to prevent and how to heal some health problem such as Hypertension, Diabetes, and Uric acid. The health problem of the elder problem is caused by aging. Sometimes it causes some changing such as physiological, anatomy, psychology and sociological.The health of elder people is a problem and challenge that should be conducted seriously so that the health problem of the elder people such as Alzaimer/ Dimensia, sclerosis multiple, endoctrin disorder, etc, can be conducted well. So, it is important to do this activity that will be conducted by the students using the certain method to get the total healing in order to make the health of the elder people be better.Key Words : The Empowerment, The care of nursing, The Health of Elder People