Solitary cerebellar metastasis from bladder cancer

Pośród pacjentów z rakiem pęcherza moczowego przerzuty do mózgu są rzadko spotykane i dotyczą około 1–7% chorych z naciekającym rakiem pęcherza. W większości przypadków przerzuty mózgowe są wtórne do obecnych już przerzutów w narządach trzewnych i węzłach chłonnych. Pierwotna manifestacja raka przejściowokomórkowego (<i>transitional cell carcinoma</i> – TCC) jako pojedynczy przerzut móżdżkowy została opisana w pojedynczych artykułach. Mężczyzna 55-letni zgłosił się do szpitala z powodu uporczywych dolegliwości bólowych głowy z towarzyszącymi nudnościami. Objawom towarzyszyły zaburzenia równowagi. Tomografia komputerowa (TK) głowy wykazała obecność zmiany guzowatej o wymiarach 28 x 24 x 22 mm w górnej części robaka móżdżku. Badanie TK klatki piersiowej, jamy brzusznej i miednicy małej uwidoczniło zmianę guzowatą w obrębie pęcherza moczowego z poszerzeniem układu kielichowo-miedniczkowego nerki prawej. Nie stwierdzono powiększonych węzłów chłonnych ani cech innych przerzutów. Wykonano kraniotomię i zewnętrzny drenaż komór mózgu, usuwając guz. Pacjenta zakwalifikowano do przezcewkowej elektroresekcji zmiany guzowatej w obrębie pęcherza. Guz obejmował część trójkąta pęcherza moczowego wraz z ujściem prawego moczowodu i większą część prawej ściany pęcherza. Badania histopatologiczne i immunohistochemiczne obu tkanek guzowatych (móżdżku i pęcherza) potwierdziły obecność komórek raka przejściowokomórkowego o wysokim stopniu złośliwości (<i>high grade</i> – HG) z inwazją mięśniową w obrębie wypieracza pęcherza (T2, HG). Na tej podstawie u chorego rozpoznano naciekającego raka pęcherza z przerzutem do móżdżku. Pacjent nie wyraził zgody na cystektomię i został przekazany na oddział onkologii, gdzie zakwalifikowano go do radioterapii głowy i miednicy oraz następowej chemioterapii. W pracy opisano przypadek rozległego guza pęcherza moczowego T2, który rozwinął się bez typowych objawów urologicznych.

Perencanaan Tempat Evakuasi Sementara Untuk Bencana Tsunami di Kelurahan Pasir Nan Tigo Kota Padang

Pasir Nan Tigo merupakan salah satu dari 104 kelurahan yang ada di Kota Padang yang merupakan bagian dari Kecamatan Koto Tangah. Kelurahan ini terletak di sebelah Utara dan di pesisir pantai Kota Padang. Berdasarkan Peta Evakuasi Tsunami Kota Padang, seluruh daerah kelurahan ini berada pada daerah genangan atau zona merah namun masih belum memiliki Tempat Evakuasi Sementara (TES) untuk bencana tsunami untuk itu dilakukan perencanaan gedung TES. Perencanaan yang digunakan dalam mendesain gedung ini adalah dengan mengumpulkan data pengamatan dan pengukuran pada gedung TES yang telah ada di kota padang serta memperhatikan Pedoman Teknik Perencanaan Tempat Evakuasi Sementara (TES) Tsunami oleh Pusat Penelitian Mitigasi Bencana Institut Teknologi Bandung yang mengacu kepada peraturan perundang-undangan dan FEMA-USA (P646-2012). Berdasarkan hasil perencanaan, didapatkan gedung TES multifungsi yang berlokasi di Jalan Pasir Jambak, Kelurahan Pasir Nan Tigo, Kecamatan Koto Tangah, Kota Padang dengan koordinat 0°51’00”S - 100°19’35”E. Gedung TES ini memiliki luas 42 x 24 m dan ketinggian 5 lantai yang dapat menampung hingga 3.024 jiwa dengan lantai 3 s/d 5 yang difungsikan sebagai area evakuasi.

Large Perpendicular Exchange Energy in TbxCo100−x/Cu(t)/[Co/Pt]2 Heterostructures

In order to realize a perpendicular exchange bias for applications, a robust and tunable exchange bias is required for spintronic applications. Here, we show the perpendicular exchange energy (PEE) in the TbxCo100−x/Cu/[Co/Pt]2 heterostructures. The structure consists of amorphous ferrimagnetic Tb–Co alloy films and ferromagnetic Co/Pt multilayers. The dependence of the PEE on the interlayer thickness of Cu and the composition of Tb–Co were analyzed. We demonstrate that the PEE can be controlled by changing the Cu interlayer thickness of 0.2 < tCu < 0.3 (nm). We found that PEE reaches a maximum value (σPw = 1 erg/cm2) at around x = 24%. We, therefore, realize the mechanism of PEE in the TbxCo100−x/Cu/[Co/Pt]2 heterostructures. We observe two competing mechanisms—one leading to an increase and the other to a decrease—which corresponds to the effect of Tb content on saturation magnetization and the coercivity of heterostructures. Sequentially, our findings show possibilities for both pinned layers in spintronics and memory device applications by producing large PEE and controlled PEE by Cu thickness, based on TbxCo100−x/Cu/[Co/Pt]2 heterostructures.

The Association Between Lentiform Nucleus Function and Cognitive Impairments in Schizophrenia

Introduction: Cognitive decline is the core schizophrenia symptom, which is now well accepted. Holding a role in various aspects of cognition, lentiform nucleus (putamen and globus pallidus) dysfunction contributes to the psychopathology of this disease. However, the effects of lentiform nucleus function on cognitive impairments in schizophrenia are yet to be investigated.Objectives: We aim to detect the fractional amplitude of low-frequency fluctuation (fALFF) alterations in patients with schizophrenia, and examine how their behavior correlates in relation to the cognitive impairments of the patients.Methods: All participants underwent magnetic resonance imaging (MRI) and cognitive assessment (digit span and digit symbol coding tests). Screening of brain regions with significant changes in fALFF values was based on analysis of the whole brain. The data were analyzed between Jun 2020 and Mar 2021. There were no interventions beyond the routine therapy determined by their clinicians on the basis of standard clinical practice.Results: There were 136 patients (75 men and 61 women, 24.1 ± 7.4 years old) and 146 healthy controls (82 men and 64 women, 24.2 ± 5.2 years old) involved in the experiments seriatim. Patients with schizophrenia exhibited decreased raw scores in cognitive tests (p &lt; 0.001) and increased fALFF in the bilateral lentiform nuclei (left: 67 voxels; x = −24, y = −6, z = 3; peak t-value = 6.90; right: 16 voxels; x = 18, y = 0, z = 3; peak t-value = 6.36). The fALFF values in the bilateral lentiform nuclei were positively correlated with digit span-backward test scores (left: r = 0.193, p = 0.027; right: r = 0.190, p = 0.030), and the right lentiform nucleus was positively correlated with digit symbol coding scores (r = 0.209, p = 0.016).Conclusion: This study demonstrates that cognitive impairments in schizophrenia are associated with lentiform nucleus function as revealed by MRI, involving working memory and processing speed.

Ventilator-Associated Pneumonia in Dr. Soetomo General Hospital Surabaya

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the intensive care unit (ICU). Mechanically, ventilated patients have a higher risk of VAP. VAP can increase morbidity, mortality, and treatment costs. However, Indonesia lacks data about VAP. The objective of this study was to find out the characteristics of VAP in Dr. Soetomo General Hospital, Surabaya, in the period of August 2017 until August 2018.Methods: This was a cross-sectional study by assessing medical records of the patients in ICU. The variables observed in this study were age, gender, outcome, length of stay in the ICU (LOSICU), and primary diagnosis. The inclusion criteria were the patients who have been using mechanical ventilation at least 2 x 24 hours in the ICU and confirmed VAP. The data were analyzed descriptively by using Microsoft Excel 2016.Results: A total of 18 VAP patients were diagnosed. VAP patients were dominated male (55.6%). The mean of LOSICU was 22.83 ± 11.24 days, and the mortality rate of VAP patients was high (55.6%). 30% of VAP patients had Guillain-Barre Syndrome (GBS) as the primary diagnosis, and 16.65% had Congenital Heart Disease (CHD).Conclusion: Most VAP patients were male and had prolonged stays. The mortality rate of VAP patients was still high. GBS was the most frequent of primary diagnoses in patients with VAP and also CHD.

Kinetics Investigation of the Formation of a Gas-Resistant Glass-Forming Layer during the Oxidation of ZrB2-MoSi2-Y2O3-Al Coatings in the Air Atmosphere

In this article, the coatings of ZrB2-xMoSi2-Y2O3-yAl (x = 24, 35, 45 wt %; y = 10, 15, 20 wt %) were applied to the surface of a carbon/carbon composite to protect against high-temperature oxidation using a multi-chamber detonation accelerator. The kinetic analysis of the formation processes of a glass-forming layer during the oxidation of the initial components of the system ZrB2-MoSi2-Y2O3-Al in an air atmosphere at a temperature of 1400 °C was carried out and the kinetically significant stages of the heterogeneous reaction were determined. It is shown that the speed and density of the formation of a glassy matrix can be adjusted by fine-tuning the ratio of components in the initial powder.

GAMBARAN LAMA HARI RAWAT INAP, ASUPAN ENERGI DAN PROTEIN DENGAN STATUS GIZI PASIEN YANG MENDAPATKAN POSITIVE DIET DI RSU HOLISTIC

Latar Belakang: Lama rawat inap serta asupan energi dan protein rendah dapat mempengaruhi status gizi pasien. Makanan positive diet adalah salah satu jenis terapi diet yang diberikan kepada pasien di RSU Holistic. Tujuan positive diet memberikan makanan sesuai dengan kondisi pasien untuk detoksifikasi dan mencegah serta mengurangi kerusakan jaringan tubuh. Jenis karbohidrat yang diberikan serealia organik dan umbi-umbian. Jenis protein tahu, tempe dan kacang-kacangan serta protein hewani seperti ikan kembung, ikan gindara, telur dan daging ayam kampung. Sumber lemak yang diberikan minyak zaitun dan minyak jagung. Tujuan Penelitian: Mengetahui gambaran lama hari rawat inap, asupan energi dan protein dengan status gizi pada pasien positive diet. Metode: Penelitian ini merupakan penelitian deskriptif analitik dengan desain cross sectional yang dilakukan bulan September-November 2020. Sembilan subjek yang memenuhi kriteria inklusi diambil dengan metode consecutive sampling. Data lama hari rawat inap diambil selama pasien masuk sampai keluar rumah sakit. Data asupan energi dan protein menggunakan form food recall 3 x 24 jam. Data status gizi menggunakan Indeks Massa Tubuh (IMT) diambil awal pasien masuk dan saat keluar dari rumah sakit. Hasil: Hasil penelitian ini menunjukkan sebanyak 44,4% (n=4) memiliki lama hari rawat inap panjang (8-10 hari). Sebagian besar subjek memiliki rata-rata asupan energi baik (44,4%) dan asupan protein kurang (77,8%). Status gizi awal masuk dengan kategori normal sebanyak 4 orang (44,5%), dan saat keluar dari rumah sakit 5 orang (55,6%). Simpulan: Lama hari rawat inap yang panjang pada pasien yang mendapatkan positive diet memiliki asupan energi baik, asupan protein kurang dan status gizi normal.

Uji Aktivitas Antibakteri Fraksi n-heksan dari Ekstrak Daun Meniran (phyllanthus niruri L.) Terhadap Pertumbuhan Bakteri salmonella sp.

Meniran (Phyllanthus niruri L.) adalah tumbuhan Euphorbiaceae yang banyak tumbuh liar pada daerah tropis yang mengandung senyawa bioaktif flavonoid, filantin dan hipofilantin yang mampu menghambat pertumbuhan bakteri. Penelitian ini bertujuan untuk mengetahui aktivitas antibakteri fraksi N-heksan dari ekstrak daun meniran terhadap pertumbuhan bakteri Salmonella sp. Penelitian ini adalah penelitian eksperimen pengujian efek antibakteri dengan metode ekstraksi meniran (Phyllanthus niruri L.) menggunakan pelarut non polar berupa n-heksan dengan variasi konsentrasi 0.1%, 0,5%, 1% dan 5%. Uji antimikroba ekstrak tersebut dilakukan dengan menggunakan metode difusi agar pada medium Glukosa Nutrient Agar (GNA) dengan masa inkubasi 1 x 24 jam dan 2 x 24 jam. Berdasarkan hasil penelitian, pada konsentrasi 5% dari ekstrak meniran (Phyllanthus niruri L.) fraksi n-heksan memiliki bioaktivitas terbesar terhadap Salmonella sp. dengan nilai zona hambatan sebesar 16,03 mm pada inkubasi 1 x 24 jam dan 14,03 pada inkubasi 2 x 24 jam. Dari hasil penelitian dapat disimpulkan bahwa fraksi n-heksan dari ekstrak daun meniran (Phyllanthus niruri L.) bersifat bakteriostatik terhadap pertumbuhan bakteri Salmonella sp.

Avaliação populacional do conhecimento sobre atendimento extra-hospitalar da parada cardíaca

Introdução: A morbimortalidade da parada cardiorrespiratória depende da eficácia do atendimento. O sucesso da ressuscitação aumenta se iniciada precocemente no local. Indivíduos desinformados e não capacitados podem prestar um atendimento inadequado aumentando os danos. Objetivo: avaliar se sexo, idade, escolaridade e profissão influenciam no conhecimento e nas atitudes do socorrista. Método: Pesquisa aplicada, com questionário do tipo aberto e fechado, quanti-qualitativo. Estudo transversal por amostra de conveniência, utilizada como reflexo de uma população, não probabilística. Resultado: Foram 319 questionários aplicados entre agosto e outubro de 2015. Homens 36%. Idade média 34,3+14,7 anos. Nível superior 55% e médio 40%. Homens e Mulheres dizem que sabem reconhecer um evento, mas os homens se sentem mais aptos (36% x 21,6% p=0,01), sabem o que fazer (51,2% x 38,2% p=0,02), pedem menos ajuda (27,9% x 40,4%) e checam mais sinais vitais (27,9% x 12,5%). Em relação à faixa etária aqueles entre 20 e 60 anos reconhecem menos eventos (40% x 24% p=0,02) e poucos sabiam como pedir ajuda corretamente. Pessoas com nível superior tinham maior capacidade de reconhecer uma parada (45%), mas isso não os diferenciou nos demais itens. Profissionais da área da saúde chamam menos por ajuda, e metade deles não sabe para qual número ligar. Conclusão: Homens, as pessoas mais velhas e as mais jovens estão mais bem preparados para atender uma parada, independente da escolaridade. E profissionais da área da saúde possuem um conhecimento pouco melhor que a população leiga.