Pengaruh Bap Dan Naa Terhadap Induksi Kalus Dan Kandungan Artemisinin Dari Artemisia Annua L. [the Effect of Bap and Naa on Callus Induction and Artemisinin Content of Artemisia Annua L.]

Malaria is a global health problem that threatens 300-500 million people and kills more than one million people annually.Artemisinin, a sesquiterpen secondary plant metabolite extracted from Artemisia annua L., is a promising and potent antimalarial drug which has a remarkable activity against chloroquine resistant to Plasmodium falciparum. To counter the present low content(0.01-0.5%) of artemisinin in A. annua L.is a limitation to commercial production of the drug and uneconomical chemical synthesis. A research was conducted to induce callus production by using Murashige-Skoog (MS) medium added with NAA (0, 0.5 and 1 mg/1) and BAP (0, 0.5 dan 1 mg/1) and also to produce artemisinin from the calli. Complete Randomized Design was used in the research. Callus cultures were induced from leaf explants of A. annua. The research reports succesful approach for production of artemisinin by callus cultures of A. Annua. Medium formulation of MS basal media added with plant growth regulators BAP 0.5 mg/1 and NAA 0.5 mg/1 give the best result for callus induction than others, with callus fresh weight 844,4 mg, artemisinin content 0.73%, dry weight 216.6 mg and total weight of artemisinin 1.58 mg

Understanding concepts of generalism and specialism amongst medical students at a research-intensive London Medical School

Background Many prominent UK medical organisations have identified a need for more generalist clinicians to address the complex requirements of an aging society. We sought to clarify attitudes towards “Specialists” and “Generalists” amongst medical students and junior doctors at Imperial College School of Medicine. Methods A survey exploring medical students’ beliefs was followed up by qualitative analysis of focus groups of medical students and Imperial-graduate foundation year doctors. Results First year medical students associated specialists with academia and higher income, and generalists with ease of training and job availability. Senior (Years 5/6) medical students associated specialists even more firmly with broader influence and academic work, whilst generalists were assigned lower prestige but the same workload as specialists. The medical student focus group discussed concepts of Generalism pertaining only to Primary Care. In contrast, the foundation year doctor focus group revealed that Generalism was now seen to include some hospital care, and the perception that generalists sat lower in a knowledge hierarchy had been challenged. Conclusion Perceptions that Generalism is associated with lower prestige in the medical profession are already present at the very start of medical school and seem to be reinforced during undergraduate training. In early postgraduate clinical practice, the perceived knowledge and prestige hierarchy lessens. These findings can help inform curriculum redesign and the promotion of Generalism as a rewarding career aspiration

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

New data regarding hypogeous mushrooms of Romania

New research results regarding hypogeous mushrooms collected in Transylvania (Romania), especially in Harghita district are presented. From the 40 species and 4 varieties recorded in this paper 19 species and 3 varieties are new for the country; 24 species belong to Basidiomycetes, 15 species to Ascomycetes and 1 to Zygomycetes. In these classes the species and the variabilities belonging to different families are presented alphabetically

Transitions in the Prophylaxis, Treatment and Care of Patients with Venous Thromboembolism

INTRODUCTION: Patients experience numerous transitions, including changes in clinical status, pharmacologic treatment and prophylaxis, and progression through the physical locations of their healthcare setting as they advance through a venous thromboembolism (VTE) clinical experience. This review provides an overview of these transitions and highlights how they can impact clinical care. METHODS: Major public resources (PubMed, MEDLINE, and Google Scholar) were searched using various combinations of the terms: “venous thromboembolism”, “deep vein thromboses”, “pulmonary embolism”, “transitions in care”, and “hospital protocols” to identify narrative reviews, professional guidelines, or primary manuscripts reporting protocol development strategies and/or clinical data, published in English from 2010 through January 2015. The studies included in this review were selected on the basis of extensive reading of the literature and the author’s clinical expertise. RESULTS: VTE treatment and prophylaxis is a dynamic process requiring ongoing patient assessments and adjustments to therapeutic strategies as the patient progresses through various hospital and outpatient settings. Throughout these transitions in care, physicians need to be vigilant of any changes in the patient’s clinical condition which may impact the patient’s risk of VTE, and re-evaluate the intervention(s) employed when such changes occur. A standardized, interdisciplinary VTE clinical pathway developed for medical patients with acute VTE resulted in decreased utilization of hospital resources and healthcare costs, suggesting that further research is warranted in this area. CONCLUSION: The prevention and management of VTE can be optimized by the development and local implementation of standardized evidence-based clinical pathways. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12325-015-0271-8) contains supplementary material, which is available to authorized users