De betekenis van A. Kuypers gemene gratie - leer voor vandag

This article explores the meaning of Kuyper's doctrine of general grace for today, starting off with a consideration of grace and culture from the perspective of three possibilities: grace residing in opposition to, next to or within culture. Calvinism is posited as accepting the last view. The author explores Kuyper's harking back to predestination for a founding of general grace. This bestows meaning on everything, and the author subsequently explores this in more detail, looking at both main trends and by ways, and linking specific racial culture (according to Kuyper) very definitely with development. This leads to a consideration of Christendom and technology. This is followed by a critical evaluation of Kuyper’s doctrine, in the course of which it is delegated to a nine­ teenth century vision (in view of subsequent developments), more espe­ cially in view of the increasing secularization of the West, in contradistinction to Kuyper's earlier expectations of Calvinist expansion. This is also evident in Kuyper's views of the historical supremacy of the White races. It remains important, however, for the Calvinist to remain within culture, although in the final analysis the first priority should be the gospel of Christ and not the culture of people

Describing out-of-hospital cardiac arrest to improve recognition: An analysis of online cardiac arrest videos

Introductions   Out-of-hospital cardiac arrests (OOHCA) often go untreated by lay-rescuers. One barrier to response is poor recognition. This study’s purpose is to describe OOHCA using publicly available videos.   Materials and Methods   26 of the internet’s most popular video-hosting and social media platforms were consecutively searched in English and Chinese August 3rd to January 20th, 2018 until each site returned 100 consecutive unrelated videos.   Video inclusion required: i) medium to high definition video quality (>360p and >10 frames per second), ii) that cardiac arrest be confirmed from two sources (i.e. news, social media, etc.), iii) 100% reviewer agreement on pre-arrest and post-arrest signs, and iv) arrest have non-traumatic etiology.   Results   821 videos were identified; 165 videos met inclusion criteria and underwent content analysis. 68, victims (41%) exhibited pre-arrest signs: 34 (21%) had unsteady gait; 42 (26%) touched their head or neck; and 33 (20%) hip-flexed or squatted prior to collapse. After collapse, 97 (59%) exhibited signs of life such as agonal breathing (71, 43%) or posturing/convulsions (39, 24%).   Most common lay-responses were: 38 (28%) victims were shaken, 28 (17%) received chest compression(s), 18 (11%) had their head held, 17 (10%) were unsuccessfully lifted to a standing position, 9 (5%) had their legs raised, and 5 (3%) had an AED applied.   Discussion   Analysis suggests three times as many victims of cardiac arrest show some signs of life compared to no signs of life, and that bystander response is poor. Publicly available videos offer rich examples of what OOCHA collapse and resuscitation look like and could inform training

Palliative care in Dutch hospitals: A rapid increase in the number of expert teams, a limited number of referrals

Background: Palliative care expert teams in hospitals have positive effects on the quality of life and satisfaction with care of patients with advanced disease. Involvement of these teams in medical care is also associated with substantial cost savings. In the Netherlands, professional standards state that each hospital should have a palliative care team by 2017. We studied the number of hospitals that have a palliative care team and the characteristics of these teams. Methods: In April 2015, questionnaires were mailed to key palliative care professionals in all general, teaching and academic hospitals in the Netherlands. Out of 92 hospitals, 74 responded (80 %). Results: Seventy-seven percent of all participating hospitals had a palliative care team. Other services, such as outpatient clinics (22 %), palliative care inpatient units (7 %), and palliative day care facilities (4 %) were relatively scarce. The mean number of disciplines that were represented in the teams was 6,5. The most common disciplines were nurses (72 %) and nurse practitioners (54 %), physicians specialized in internal medicine (90 %) or anaesthesiology (75 %), and spiritual caregivers (65 %). In most cases, the physicians did not have labeled hours available for their work as palliative care consultant, whereas nurses and nurse practitioners did. Most teams (77 %) were only available during office hours. Twenty-six percent of the teams could not only be consulted by healthcare professionals but also by patients or relatives. The annual number of consultations for inpatients per year ranged from 2 to 680 (median: 77). On average, teams were consulted for 0.6 % of all patients admitted to the hospitals. Conclusion: The number of Dutch hospitals with a palliative care team is rapidly increasing. There are substantial differences between teams regarding the disciplines represented in the teams, the procedures and the number of consultations. The development of quality standards and adequate staffing of the teams could improve the quality and effectiveness of the teams

Chloroquine Administration in Breastfeeding Mothers Associates with Increased HIV-1 Plasma Viral Loads

Chloroquine (CQ) and Hydroxychloroquine (HCQ) have been proposed to be effective at treating COVID-19 patients. We, and others, have previously reported on the capacity of CQ to reduce HIV-1 replication in vitro. We tested CQ administration in post-partum mothers on influencing HIV-1 viral loads in human milk as a means of lowering mother to child transmission. A Phase I/II, randomized, placebo-controlled study to evaluate chloroquine administration to reduce HIV-1 RNA levels in human milk: the CHARGE study. Thirty HIV-1 positive pregnant Rwandese women (CQ n = 20; placebo n = 10) were enrolled in a 16-week study, with the treatment group receiving a 200 mg oral dose of CQ daily. Base-line plasma viral load (pVL) measurements and CD4 counts were determined prior to delivery, and pVL, breast milk VL (bmVL) and CQ levels measured during treatment. For women receiving treatment, CQ concentration was higher in breast milk compared to plasma (over 2.5-fold), with a positive correlation between the levels in the two compartments (P \u3c 0.003). A link between high CQ concentrations in plasma and high CD4 counts (P \u3c 0.001) was observed. Surprisingly, we found a significant increase in pVL after CQ treatment in over half of the mothers (n=11; P \u3c 0.001) and with no alteration to bmVL measurements. No specific amino acid alterations in the gp120 envelope sequences could be associated with CQ administration. CQ usage is associated with a significant increase to pVL in early breastfeeding mothers from Rwanda which cautions against the use of CQ in such individuals. Our results highlight a discrepancy between CQ effects on modulating HIV-1 replication in vitro versus in vivo and indicate caution when prescribing CQ to postpartum HIV-1 untreated mothers. This discrepancy should be taken into consideration when testing CQ or HCQ treatment in COVID-19 clinical trials, especially relating to the post-partum setting

Tyrosine hydroxylase phosphorylation is under the control of serine 40

Tyrosine hydroxylase catalyzes the initial and rate-limiting step in the biosynthesis of the neurotransmitter dopamine. The phosphorylation state of Ser40 and Ser31 is believed to exert a direct effect on the enzymatic activity of tyrosine hydroxylase. Interestingly, some studies report that Ser31 phosphorylation affects Ser40 phosphorylation, while Ser40 phosphorylation has no effect on Ser31 phosphorylation, a process named hierarchical phosphorylation. Here, we provide a detailed investigation into the signal transduction mechanisms regulating Ser40 and Ser31 phosphorylation in dopaminergic mouse MN9D and Neuro2A cells. We find that cyclic nucleotide signaling drives Ser40 phosphorylation, and that Ser31 phosphorylation is strongly regulated by ERK signaling. Inhibition of ERK1/2 with UO126 or PD98059 reduced Ser31 phosphorylation, but surprisingly had no effect on Ser40 phosphorylation, contradicting a role for Ser31 in the regulation of Ser40. Moreover, to elucidate a possible hierarchical mechanism controlling tyrosine hydroxylase phosphorylation, we introduced tyrosine hydroxylase variants in Neuro2A mouse neuroblastoma cells that mimic either phosphorylated or unphosphorylated serine residues. When we introduced a Ser40Ala tyrosine hydroxylase variant, Ser31 phosphorylation was completely absent. Additionally, neither the tyrosine hydroxylase variant Ser31Asp, nor the variant Ser31Ala had any significant effect on basal Ser40 phosphorylation levels. These results suggest that tyrosine hydroxylase is not controlled by hierarchical phosphorylation in the sense that first Ser31 has to be phosphorylated and subsequently Ser40, but, conversely, that Ser40 phosphorylation is essential for Ser31 phosphorylation. Overall our study suggests that Ser40 is the crucial residue to target so as to modulate tyrosine hydroxylase activity

Lower leukotriene C4 levels in bronchoalveolar lavage fluid of asthmatic subjects after 2.5 years of inhaled corticosteroid therapy

Long-term treatment with inhaled corticosteroids has been shown to result in improvement of symptoms and lung function in subjects with asthma. Arachidonic acid (AA) metabolites are thought to play a role in the pathophysiology of asthma. It was assessed whether differences could be found in bronchoalveolar lavage (BAL) AA metabolite levels between subjects with asthma who were treated for 2.5 years with inhaled bronchodilators alone or in combination with inhaled corticosteroids. Prostaglandin (PG)D2, PGF2α, 6-keto-PGF1α, thromboxane B2, leukotriene (LT)C4 and LTB4 levels and cell numbers were assessed in BAL fluid from 22 non-smoking asthmatic subjects. They were participating in a randomized, double-blind multicentre drug trial over a period of 2.5 years. Results of the group treated with inhaled corticosteroids (CS+: beclomethasone 200 μg four times daily) were compared with the other group (CS−) which was treated with either ipratropium bromide (40 μg four times daily) or placebo. BAL LTC4 levels of asthmatic subjects were significantly lower after 2.5 years inhaled corticosteroid therapy (CS+, 9(1–17) pg/ml vs. CS−, 16(6-53) pg/ml; p = 0.01). The same trend was observed for the PGD2 levels. The results suggest that inhaled corticosteroids may exert their beneficial effect on lung function via a mechanism in which inhibition of LTC4 synthesis in the airways is involved

Антибіотикопрофілактика в хірургії

Наук. кер.: М.Г. КононенкоГнійно-запальні післяопераційні ускладнення за останні десятиріччя набувають все більшої актуальності. Це вже стає проблемою. Такі ускладнення необхідно попереджувати. Для забезпечення тканин операційного поля антибіотиком у ефективній (бактерицидній) концентрації на весь період хірургічного втручання проводять антибіотикопрофілактику (АБП). Вона є складовою частиною комплексної профілактики гнійно-запальних ускладнень. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/2734