HEADACHE PROFILE OF BRAIN TUMOR PATIENTS IN MOHAMMAD HOESIN HOSPITAL PALEMBANG

Background: Headache is one of the most common complaint in population while a serious causative of underlying disease is very rare. Although headaches are rarely the result of a brain tumor, brain tumors are frequently associated with headaches. The challenges to the physician are to determine the specific feature of headache related to brain tumor.Methods: This is cross sectional study involved primary and metastatic brain tumor patient admitted in neurology ward of Mohammad Hoesin hospital from April 2018 to June 2019. The inclusion criteria including age > 18 years old and there was symptom of headache based on anamnesis. All were interviewed about their personal details (age, gender). The characteristic of headache was obtained based on questionnaire designed in our department. Various neurological symptoms related to the tumor were also recorded. Information of the tumor was obtained from the patient’s chart (histopathology of the tumor) and from characteristic of neuroradiological finding (magnetic resonance imaging or computed tomography). Headache and tumor characteristics were compared between primary and metastatic tumor by contrasting frequencies. We also analysed the correlation between tumor characteristics (location, hidrocephalus, vasogenic edema and tumor type) with headache intensity.Results: A total of 95 of 199 patients (48%) with headache symptom were studied in this series. Most patients were complained of chronic headache. Headache was mostly throbbing in both primary and metastatic brain tumors.  Progressively headache was dominant in this study and more than half patients report the quality of headache as moderate at the onset. In 35,8% patients, headache was the patient’s first complaint.  Headache as the isolated symptom of brain tumor was found in only 3,2% and only 28,4% of patients ful?lled the three ‘classic criteria’ of the brain tumor headache. A great localizing value of the headache was found in 63 cases of 95 patients. Of the 61 patients with single tumor and unilateral side, the unilateral headache was on 48 cases (78,8%). Of the 26 patients with strictly bilateral headache, 10 cases (38,5%) had bilateral sided tumors. Conclusion: The incidence of brain tumor headache in this study is similar to previous reports although the classic brain tumor headache features was found in a small portion of the patients.

PAIN CHARACTERISTICS OF CENTRAL NERVOUS SYSTEM TUMOR IN MOHAMMAD HOESIN GENERAL HOSPITAL

Pain is one of the cardinal symptom in tumor patient, especially in Central Nervous System (CNS) tumor. It often impacts patient’s quality of life. The incidence and characteristic of pain have rarely been reported in Palembang, Indonesia. This observational study was planned to investigate the clinical presentation and epidemiology of CNS tumor firstly diagnosed in ward throughout July to December 2018. 99 patients recently diagnosed with CNS tumor were enrolled. From 99 patients, we found 34 patients with tumor associated pain. We further evaluated the information of pain linked with brain tumors via questionnaire and medical record. Of all 34 subjects, the age ranged from 43 to 79 years old with female : male ratio 3:1. Pain was present 100% in spinal tumor and 54% in brain tumor. Clinical characteristics of pain found in brain tumor were typically in ipsilateral lesion (92%), pulsating (76%), moderate intensity (60%), recurrent (84%), not radiating (80%), with frequency of 3-4 times in a week (48%). On the other hand, pain in spinal tumor was generally felt on the site of the lesion (100%), radiating (77.8%), electrical type of pain (44.4%), high intensity (77.8), and constant (88.9%). From this study we conclude that tumor locations can show some different pain characteristics. Therefore careful pain assessment is compulsory to have better understanding and more appropriate management

Sharing Leadership through Digital Collaborative Objects

This paper contributes to the understanding of the role of collaborative tools and objects in the emergence and support of shared leadership, which has been associated with positive team dy-namics and innovative outcomes. We draw on ideas from the recent discourse on viewing lead-ership as a practice that involves human actors and material or technological tools to provide the first analysis of the features of collaborative tools that can support shared leadership. We present our early findings and insights from a multiple case study of ten innovation teams in their interaction with a collaborative tool that is particularly designed for coordination. We suggest that collaborative tools can contribute to shared leadership through two facilitating fea-tures: shared problem space and shared visualisation. Through our findings, we highlight the role of collaborative tools in supporting teams in sharing leadership for the purpose of joint in-novation

Skin Manifestations of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a disease that affects the intestinal tract via an inflammatory process. Patients who suffer from IBD often have diseases that affect multiple other organ systems as well. These are called extraintestinal manifestations and can be just as, if not more debilitating than the intestinal inflammation itself. The skin is one of the most commonly affected organ systems in patients who suffer from IBD. The scientific literature suggests that a disturbance of the equilibrium between host defense and tolerance, and the subsequent over-activity of certain immune pathways are responsible for the cutaneous disorders seen so frequently in IBD patients. The purpose of this review article is to give an overview of the types of skin diseases that are typically seen with IBD and their respective pathogenesis, proposed mechanisms, and treatments. These cutaneous disorders can manifest as metastatic lesions, reactive processes to the intestinal inflammation, complications of IBD itself, or side effects from IBD treatments; these can be associated with IBD via genetic linkage, common autoimmune processes, or other mechanisms that will be discussed in this article. Ultimately, it is important for healthcare providers to understand that skin manifestations should always be checked and evaluated for in patients with IBD. Furthermore, skin disorders can predate gastrointestinal symptoms and thus may serve as important clinical indicators leading physicians to earlier diagnosis of IBD

Coronary Stenosis and Cardiogenic Shock Secondary to Aortitis Following Aortic Root Support Procedure

A woman with recent personalized external aortic root support implant presented in cardiogenic shock with bilateral coronary ostial occlusion and aortic inflammation requiring emergency coronary angioplasty. Subsequent computed tomography with positron emission tomography scanning demonstrated aortitis with extensive inflammation adjacent to the personalized external aortic root support mesh, the first report of this important complication

Tourism film and its influence on destination image and intentions for Indonesian tourist visits to South Korea Film tourism dan pengaruhnya terhadap citra destinasi dan niat berkunjung wisatawan Indonesia ke Korea Selatan

Film tourism is a tourist trip to a destination that is a location in a film or television drama. This study aims to examine the influence of film tourism elements consisting of place, personality, and performance on the destination image and on film tourism visit intention and to determine the effect of destination image in mediating the influence of film tourism elements on film tourism visit intention. The online survey was distributed to 183 respondents who like South Korean films or dramas. This study uses SEM-PLS for primary data processing. The results showed that the three elements of South Korean film tourism had a positive and significant effect on the destination image formation of South Korea among Indonesian tourists. Destination image has a positive and significant effect on Indonesian tourists� intention to undertake film tourism in South Korea. Destination image has been shown to significantly mediate the influence of film tourism elements on Indonesian tourists� visit intention to involve in film tourism in South Korea

Cancer prevention and therapy through the modulation of the tumor microenvironment

Cancer arises in the context of an in vivo tumor microenvironment. This microenvironment is both a cause and consequence of tumorigenesis. Tumor and host cells co-evolve dynamically through indirect and direct cellular interactions, eliciting multiscale effects on many biological programs, including cellular proliferation, growth, and metabolism, as well as angiogenesis and hypoxia and innate and adaptive immunity. Here we highlight specific biological processes that could be exploited as targets for the prevention and therapy of cancer. Specifically, we describe how inhibition of targets such as cholesterol synthesis and metabolites, reactive oxygen species and hypoxia, macrophage activation and conversion, indoleamine 2,3-dioxygenase regulation of dendritic cells, vascular endothelial growth factor regulation of angiogenesis, fibrosis inhibition, endoglin, and Janus kinase signaling emerge as examples of important potential nexuses in the regulation of tumorigenesis and the tumor microenvironment that can be targeted. We have also identified therapeutic agents as approaches, in particular natural products such as berberine, resveratrol, onionin A, epigallocatechin gallate, genistein, curcumin, naringenin, desoxyrhapontigenin, piperine, and zerumbone, that may warrant further investigation to target the tumor microenvironment for the treatment and/or prevention of cancer