Pengaruh Penggunaan Antibiotik Eritromisin Dengan Terapi Calcium-channel Blocker Terhadap Gagal Ginjal Akut

Calsium-Channel Blocker (CCB) seperti amlodipin, felodipin, nifedipin, diltiazem, dan verapamil dimetabolisme oleh enzim CYP3A4. Kadar CCB dalam darah dapat meningkat ke level yang berbahaya jika enzim tersebut dihambat. Eritromisin (antibiotik makrolida) merupakan inhibitor CYP3A4, penggunaan bersamaan CCB dan makrolida diasosiasikan dengan peningkatan risiko rawat inap akibat gagal ginjal akut. Tujuan penelitian ini untuk mengetahui pengaruh yang ditimbulkan oleh penggunaan CCB dan eritromisin terhadap fungsi ginjal pada pasien rawat inap poliklinik penyakit dalam RS Dr. Moewardi. Penelitian dilakukan secara deskriptif dengan pendekatan pengambilan data secara retrospektif. Data diperoleh dari hasil observasi catatan rekam medik pasien selama menjalani perawatan di rumah sakit (rawat inap). Hasil dari 4 pasien diketahui masing-masing pasien mengalami peningkatan kadar kreatinin dan ureum dengan rata-rata kenaikan kreatinin 34,8% dan ureum 36,6%. Hal ini kemungkinan disebabkan adanya interaksi makrolida dan CCB yang mengakibatkan kenaikan kadar CCB dalam darah sehingga menyebabkan hipotensi. Keadaan hipotensi dapat menyebabkan hipoperfusi ginjal yang berpotensi terjadinya gagal ginjal akut, dimana ditandai dengan meningkatnya kadar ureum dan kreatinin

A Structured Framework and Resources to Use to Get Your Medical Education Work Published.

IntroductionMedical educators often have great ideas for medical education scholarship but have difficulty converting their educational abstract or project into a published manuscript.MethodsDuring this workshop, participants addressed common challenges in developing an educational manuscript. In small-group case scenarios, participants discovered the importance of the "So what?" in making the case for their project. Incorporating conceptual frameworks, participants chose appropriate outcome metrics, discussed how to frame the discussion section, and ensured appropriate journal fit. After each small-group exercise, large-group discussions allowed the small groups to report back so that facilitators could highlight and reinforce key learning points. At the conclusion of the workshop, participants left with a checklist for creating an educational manuscript and an additional resources document to assist them in avoiding common pitfalls when turning their educational abstract/project into a publishable manuscript.ResultsThis workshop was presented in 2016 and 2017. Presenter evaluations were completed by 33 participants; 11 completed conference evaluations. The mean overall rating on presenter evaluations was 4.55 out of 5, while the conference evaluations mean was 3.73 out of 4. Comments provided on both evaluation tools highlighted the perceived effectiveness of the delivery and content. More than 50% of respondents stated that they planned to incorporate the use of conceptual frameworks in future work.DiscussionThis workshop helped participants address common challenges by providing opportunities for hands-on practice as well as tips and resources for use when submitting a medical education manuscript for publication

Quantum and Classical in Adiabatic Computation

Adiabatic transport provides a powerful way to manipulate quantum states. By preparing a system in a readily initialised state and then slowly changing its Hamiltonian, one may achieve quantum states that would otherwise be inaccessible. Moreover, a judicious choice of final Hamiltonian whose groundstate encodes the solution to a problem allows adiabatic transport to be used for universal quantum computation. However, the dephasing effects of the environment limit the quantum correlations that an open system can support and degrade the power of such adiabatic computation. We quantify this effect by allowing the system to evolve over a restricted set of quantum states, providing a link between physically inspired classical optimisation algorithms and quantum adiabatic optimisation. This new perspective allows us to develop benchmarks to bound the quantum correlations harnessed by an adiabatic computation. We apply these to the D-Wave Vesuvius machine with revealing - though inconclusive - results

Type I Non-Abelian Superconductors in Supersymmetric Gauge Theories

Non-BPS non-Abelian vortices with CP^1 internal moduli space are studied in an N=2 supersymmetric U(1) x SU(2) gauge theory with softly breaking adjoint mass terms. For generic internal orientations the classical force between two vortices can be attractive or repulsive. On the other hand, the mass of the scalars in the theory is always less than that of the vector bosons; also, the force between two vortices with the same CP^1 orientation is always attractive: for these reasons we interpret our model as a non-Abelian generalization of type I superconductors. We compute the effective potential in the limit of two well separated vortices. It is a function of the distance and of the relative colour-flavour orientation of the two vortices; in this limit we find an effective description in terms of two interacting CP^1 sigma models. In the limit of two coincident vortices we find two different solutions with the same topological winding and, for generic values of the parameters, different tensions. One of the two solutions is described by a CP^1 effective sigma model, while the other is just an Abelian vortex without internal degrees of freedom. For generic values of the parameters, one of the two solutions is metastable, while there are evidences that the other one is truly stable.Comment: 35 pages, 8 figures. v2: fixed typos and added small comments, v3 removed an unecessary figur

Cognitive Impairment and Age-Related Vision Disorders: Their Possible Relationship and the Evaluation of the Use of Aspirin and Statins in a 65 Years-and-Over Sardinian Population

Neurological disorders (Alzheimer’s disease, vascular and mixed dementia) and visual loss (cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy) are among the most common conditions that afflict people of at least 65 years of age. An increasing body of evidence is emerging, which demonstrates that memory and vision impairment are closely, significantly, and positively linked and that statins and aspirin may lessen the risk of developing age-related visual and neurological problems. However, clinical studies have produced contradictory results. Thus, the intent of the present study was to reliably establish whether a relationship exist between various types of dementia and age-related vision disorders, and to establish whether statins and aspirin may or may not have beneficial effects on these two types of disorders. We found that participants with dementia and/or vision problems were more likely to be depressed and displayed worse functional ability in basic and instrumental activities of daily living than controls. Mini mental state examination scores were significantly lower in patients with vision disorders compared to subjects without vision disorders. A closer association with macular degeneration was found in subjects with Alzheimer’s disease than in subjects without dementia or with vascular dementia, mixed dementia, or other types of age-related vision disorders. When we considered the associations between different types of dementia and vision disorders and the use of statins and aspirin, we found a significant positive association between Alzheimer’s disease and statins on their own or in combination with aspirin, indicating that these two drugs do not appear to reduce the risk of Alzheimer’s disease or improve its clinical evolution and may, on the contrary, favor its development. No significant association in statin use alone, aspirin use alone, or the combination of these was found in subjects without vision disorders but with dementia, and, similarly, none in subjects with vision disorders but without dementia. Overall, these results confirm the general impression so far; namely, that macular degeneration may contribute to cognitive disorders (Alzheimer’s disease in particular). In addition, they also suggest that, while statin and aspirin use may undoubtedly have some protective effects, they do not appear to be magic pills against the development of cognitive impairment or vision disorders in the elderly

Static Interactions of non-Abelian Vortices

Interactions between non-BPS non-Abelian vortices are studied in non-Abelian U(1) x SU(N) extensions of the Abelian-Higgs model in four dimensions. The distinctive feature of a non-Abelian vortex is the presence of an internal CP^{N-1} space of orientational degrees of freedom. For fine-tuned values of the couplings, the vortices are BPS and there is no net force between two static parallel vortices at arbitrary distance. On the other hand, for generic values of the couplings the interactions between two vortices depend non-trivially on their relative internal orientations. We discuss the problem both with a numerical approach (valid for small deviations from the BPS limit) and in a semi-analytical way (valid at large vortex separations). The interactions can be classified with respect to their asymptotic property at large vortex separation. In a simpler fine-tuned model, we find two regimes which are quite similar to the usual type I/II Abelian superconductors. In the generic model we find other two new regimes: type I*/II*. Unlike the type I (type II) case, where the interaction is always attractive (repulsive), the type I* and II* have both attractive and repulsive interactions depending on the relative orientation. We have found a rich variety of interactions at small vortex separations. For some values of the couplings, a bound state of two static vortices at a non-zero distance exists.Comment: 36 pages, 13 figures; v2 a small comment and a reference adde

Supersymmetry Breaking on Gauged Non-Abelian Vortices

There are a large number of systems characterized by a completely broken gauge symmetry, but with an unbroken global color-flavor diagonal symmetry, i.e., systems in the so-called color-flavor locked phase. If the gauge symmetry breaking supports vortices, the latter develop non-Abelian orientational zero-modes and become non-Abelian vortices, a subject of intense study in the last several years. In this paper we consider the effects of weakly gauging the full exact global flavor symmetry in such systems, deriving an effective description of the light excitations in the presence of a vortex. Surprising consequences are shown to follow. The fluctuations of the vortex orientational modes get diffused to bulk modes through tunneling processes. When our model is embedded in a supersymmetric theory, the vortex is still 1/2 BPS saturated, but the vortex effective action breaks supersymmetry spontaneously.Comment: Latex, 24 pages, 1 figur

Histone H3.3 mutations drive pediatric glioblastoma through upregulation of MYCN

Children and young adults with glioblastoma (GBM) have a median survival rate of only 12 to 15 months, and these GBMs are clinically and biologically distinct from histologically similar cancers in older adults. They are defined by highly specific mutations in the gene encoding the histone H3.3 variant H3F3A, occurring either at or close to key residues marked by methylation for regulation of transcription-K27 and G34. Here, we show that the cerebral hemisphere-specific G34 mutation drives a distinct expression signature through differential genomic binding of the K36 trimethylation mark (H3K36me3). The transcriptional program induced recapitulates that of the developing forebrain, and involves numerous markers of stem-cell maintenance, cell-fate decisions, and self-renewal. Critically, H3F3A G34 mutations cause profound upregulation of MYCN, a potent oncogene that is causative of GBMs when expressed in the correct developmental context. This driving aberration is selectively targetable in this patient population through inhibiting kinases responsible for stabilization of the protein.The authors acknowledge NHS funding to the National Institute for Health Research Biomedical Research Centre.This work is supported by Cancer Research UK, the Wellcome Trust, the Samantha Dickson Brain Tumour Trust, and The Stravros Niarchos Foundation

Observation of collapsing radiative shocks in laboratory experiments

This article reports the observation of the dense, collapsed layer produced by a radiative shock in a laboratory experiment. The experiment uses laser irradiation to accelerate a thin layer of solid-density material to above 100 km/s100km∕s, the first to probe such high velocities in a radiative shock. The layer in turn drives a shock wave through a cylindrical volume of Xe gas (at ∼ 6 mg/cm3∼6mg∕cm3). Radiation from the shocked Xe removes enough energy that the shocked layer increases in density and collapses spatially. This type of system is relevant to a number of astrophysical contexts, providing the potential to observe phenomena of interest to astrophysics and to test astrophysical computer codes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87760/2/082901_1.pd