A Potential Differentiation of Adipose and Hair Follicle-derived Mesenchymal Stem Cells to Generate Neurons Induced with EGF, FGF, PDGF and Forskolin.

Human Adipose Derived Mesenchymal Stem Cells (HADMSCs) and Human Hair Follicle Derived Mesenchymal Stem Cells (HHFDMSCs) have attracted great interest because of their multilineage differentiation potential, selfrenewal properties, and their possible use of cell and gene therapies. This present study to investigate the neurogenic differentiation ability of hADMSCs and hHFDMSCs induced by Epidermal Growth Factors (EGF), Fibroblast Growth Factor (FGF), Platelet Derived Growth Factor (PDGF) and Forskolin. This study was true experimental with longitudinal study design. The sample size determined with minimal sample size formula and it was randomly chosen. These studies employed an in vitro design for the expansion and proliferation of Mesenchymal Stem Cells (MSCs) and examined the heterogeneity of these cells using the markers CD105, CD90, OCT4, and SOX2. MSCs from adipose tissue and hair follicles were induced with EGF, FGF, PDGF and Forskolin to differentiate and generate neurons. The capacity of MSCs to generate neurons were verified using glial fibrillary acidic protein, nestin, and β-tubulin III . The expression of neural markers and morphological changes in Mesenchymal stem cells from hADMSCs and hHFDMSCs were confirmed. hADMSCs and hHFDMSCs share a similar capacity to differentiate and generate neurons, which is beneficial for the development of neuronal restoration for future therapies for patients suffering from neurological diseases

Pengembangan ICU Card Talk sebagai Alat Bantu Komunikasi bagi Pasien dengan Ventilasi Mekanik

This study aims to develop ICU Card Talk as a communication tool for mechanically ventilated patients. The method used in this study was a Research and Development approach with data collection stages through literature studies, interviews, and observations to formulate strategic issues and design ICU Card Talk content designs through focus group discussions based on strategic issues. The results of this study are color graphic communication cards equipped with writing according to the patient's basic needs and patient complaints measuring 10x15 cm using a glossy paper. The results of the content validity test by assessing the I-CVI showed that the ICU Card Talk content was valid with a value of 1.0, and the reliability value obtained a reliability coefficient > 0.6 which stated that the ICU Card Talk content was reliable. In conclusion, ICU Card Talk can be used as a communication tool that is easy to use as a means of interaction between patients with mechanical ventilation and medical staff so that patient communication needs can be met. This will indirectly reduce the patient's stress level, which will affect the patient's recovery. Keywords: Intensive Care, Communication, Mechanical Ventilatio

The effect of pectointercostal fascial block on stress response in open heart surgery

Background: Activation of the hypothalamus–pituitary–adrenal (HPA) axis and inflammatory processes are common forms of stress response. The increased stress response is associated with a higher chance of complications. Open hearth surgery is one of the procedures with a high-stress response. Pectointercostal fascial block (PIFB), as a new pain management option in sternotomy, has the potential to modulate the stress response. Objective: To determine the effect of PIFB on stress response in open heart surgery. Methods: This study was a Randomized Controlled Trial on 40 open heart surgery. Patients were divided into two groups, control (20 patients) and PIFB (20 patients). Primary parameters included basal and postoperative TNF-α, basal and post sternotomy ACTH, and basal, 0, and 24 hours postoperative NLR. Secondary parameters include the amount of opioid use, length of the post-operative ventilator, length of ICU stay, and Numeric Rating Scale (NRS) 6, 12, 24, and 48 hours postoperative. Results: The PIFB group had a decrease in ACTH levels with an average change that was not significantly different from the control group (−57.71 ± 68.03 vs. −129.78 ± 140.98). The PIFB group had an average change in TNFα levels and an average increase in NLR 0 hours postoperative that was not significantly lower than the control group (TNFα: −0.52 ± 1.31 vs. 0.54 ± 1.76; NLR: 12.80 ± 3.51 vs. 14.82 ± 4.23). PIFB significantly reduced the amount of opioid use during surgery, NRS at 6, 12, and 24 hours, and the length of post-operative ventilator use (P < 0.05, CI: 95%). Conclusion: PIFB has a good role in reducing the stress response of open heart surgery and producing good clinical outcomes

Acute kidney injury after a coronary artery bypass graft surgery

Abstract Background— Acute kidney injury (AKI) is a common complication after coronary artery bypass grafting (CABG) and is associated with adverse outcomes. However, the relationship between AKI after CABG and the long-term risk of end-stage renal disease (ESRD) is unknown. Methods and Results— This study included 29 330 patients who underwent primary isolated CABG in Sweden between 2000 and 2008. AKI was classified according to the Acute Kidney Injury Network (AKIN) classification: stage 1, >0.3 mg/dL (>26 μmol/L) or 50% to 100% increase; stage 2, 100% to 200% increase; and stage 3, >200% increase from the preoperative to postoperative serum creatinine level. Cox proportional hazards regression analysis was used to calculate hazard ratios with 95% confidence intervals for ESRD in AKIN stage 1 and stage 2 to 3. Postoperative AKI occurred in 13% of patients. During a mean follow-up of 4.3±2.4 years, 123 patients (0.4%) developed ESRD, including 50 (1.6%) in AKIN stage 1, 29 (5.2%) in AKIN stage 2 to 3, and 44 (0.2%) without AKI after CABG. After multivariable adjustment, the hazard ratio for ESRD was 2.92 (95% confidence interval, 1.87–4.55) for AKIN stage 1 and 3.81 (95% confidence interval, 2.14–6.79) for AKIN stage 2 to 3. Conclusions— This nationwide study of patients who underwent CABG found that a small increase in the postoperative serum creatinine level was associated with an almost 3-fold increase in the long-term risk of ESRD after adjustment for a number of confounders, including preoperative renal functio

A Potential Differentiation of Adipose and Hair Follicle-derived Mesenchymal Stem Cells to Generate Neurons Induced with EGF, FGF, PDGF and Forskolin

Human Adipose Derived Mesenchymal Stem Cells (HADMSCs) and Human Hair Follicle Derived Mesenchymal Stem Cells (HHFDMSCs) have attracted great interest because of their multilineage differentiation potential, self-renewal properties, and their possible use of cell and gene therapies. This present study to investigate the neurogenic differentiation ability of hADMSCs and hHFDMSCs induced by Epidermal Growth Factors (EGF), Fibroblast Growth Factor (FGF), Platelet Derived Growth Factor (PDGF) and Forskolin. This study was true experimental with longitudinal study design. The sample size determined with minimal sample size formula and it was randomly chosen. These studies employed an in vitro design for the expansion and proliferation of Mesenchymal Stem Cells (MSCs) and examined the heterogeneity of these cells using the markers CD105, CD90, OCT4, and SOX2. MSCs from adipose tissue and hair follicles were induced with EGF, FGF, PDGF and Forskolin to differentiate and generate neurons. The capacity of MSCs to generate neurons were verified using glial fibrillary acidic protein, nestin, and ß-tubulin III . The expression of neural markers and morphological changes in Mesenchymal stem cells from hADMSCs and hHFDMSCs were confirmed. hADMSCs and hHFDMSCs share a similar capacity to differentiate and generate neurons, which is beneficial for the development of neuronal restoration for future therapies for patients suffering from neurological diseases