UPAYA MASYARAKAT TIONGHOA DALAM MELESTARIKAN TRADISI KEBUDAYAANNYA DI LANGSA

Studi ini membahas tentang upaya masyarakat Tionghoa di Langsa dalam melestarikan tradisi kebudayaannya pada masa puncak konflik Aceh (1998-2005). Pertanyaan pokok yang ingin dijawab adalah gambaran masyarakat Tionghoa di Langsa dan bagaimana upaya masyarakat Tionghoa dalam melestarikan tradisi kebudayaannya. Tujuan penelitian yang penulis lakukan dalam penulisan skripsi ini adalah untuk memberikan gambaran masyarakat Tionghoa di Langsa dan upaya masyarakat Tionghoa dalam melestarikan tradisi kebudayaannya. Penelitian ini menyimpulkan bahwa masyarakat Tionghoa merupakan minoritas di Langsa terbukti dari jumlah keseluruhan masyarakat di Langsa adalah 148.945 orang sedangkan masyarakat Tionghoa hanya 684 orang atau hanya sekitar 4,6% dari penduduk Langsa keseluruhan. Masyarakat Tionghoa mayoritas memeluk Agama Buddha. Mata pencaharian masyarakat Tionghoa di Langsa adalah berdagang. Masyarakat Tionghoa di Langsa melestarikan tradisi kebudayaan mereka melalui pendidikan dalam keluarga. Mereka mengajarkan tradisi kebudayaan mereka sejak anak-anak mereka kecil

Randomized, open-label, phase 1/2a study to determine the maximum tolerated dose of intraventricular sustained release nimodipine for subarachnoid hemorrhage (NEWTON [Nimodipine Microparticles to Enhance Recovery While Reducing Toxicity After Subarachnoid Hemorrhage])

BACKGROUND AND PURPOSE—: We conducted a randomized, open-label, phase 1/2a, dose-escalation study of intraventricular sustained-release nimodipine (EG-1962) to determine safety, tolerability, pharmacokinetics, and clinical effects in aneurysmal subarachnoid hemorrhage. METHODS—: Subjects with aneurysmal subarachnoid hemorrhage repaired by clipping or coiling were randomized to EG-1962 or enteral nimodipine. Subjects were World Federation of Neurological Surgeons grade 2 to 4 and had an external ventricular drain. Cohorts of 12 subjects received 100 to 1200 mg EG-1962 (9 per cohort) or enteral nimodipine (3 per cohort). The primary objective was to determine the maximum tolerated dose. RESULTS—: Fifty-four subjects in North America were randomized to EG-1962, and 18 subjects were randomized to enteral nimodipine. The maximum tolerated dose was 800 mg. One serious adverse event related to EG-1962 (400 mg) and 2 EG-1962 dose-limiting toxicities were without clinical sequelae. There was no EG-1962-related hypotension compared with 17% (3/18) with enteral nimodipine. Favorable outcome at 90 days on the extended Glasgow outcome scale occurred in 27/45 (60%, 95% confidence interval 46%–74%) EG-1962 subjects (5/9 with 100, 6/9 with 200, 7/9 with 400, 4/9 with 600, and 5/9 with 800 mg) and 5/18 (28%, 95% confidence interval 7%–48%, relative risk reduction of unfavorable outcome; 1.45, 95% confidence interval 1.04–2.03; P=0.027) enteral nimodipine subjects. EG-1962 reduced delayed cerebral ischemia (14/45 [31%] EG-1962 versus 11/18 [61%] enteral nimodipine) and rescue therapy (11/45 [24%] versus 10/18 [56%]). CONCLUSIONS—: EG-1962 was safe and tolerable to 800 mg, and in this, aneurysmal subarachnoid hemorrhage population was associated with reduced delayed cerebral ischemia and rescue therapy. Overall, the rate of favorable clinical outcome was greater in the EG-1962-treated group. CLINICAL TRIAL REGISTRATION—: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01893190

SDF1-A Facilitates Lin−/Sca1+ Cell Homing following Murine Experimental Cerebral Ischemia

Background Hematopoietic stem cells mobilize to the peripheral circulation in response to stroke. However, the mechanism by which the brain initiates this mobilization is uncharacterized. Methods Animals underwent a murine intraluminal filament model of focal cerebral ischemia and the SDF1-A pathway was evaluated in a blinded manner via serum and brain SDF1-A level assessment, Lin−/Sca1+ cell mobilization quantification, and exogenous cell migration confirmation; all with or without SDF1-A blockade. Results Bone marrow demonstrated a significant increase in Lin−/Sca1+ cell counts at 24 hrs (272±60%; P<0.05 vs sham). Mobilization of Lin−/Sca1+ cells to blood was significantly elevated at 24 hrs (607±159%; P<0.05). Serum SDF1-A levels were significant at 24 hrs (Sham (103±14), 4 hrs (94±20%, p = NS) and 24 hrs (130±17; p<0.05)). Brain SDF1-A levels were significantly elevated at both 4 hrs and 24 hrs (113±7 pg/ml and 112±10 pg/ml, respectively; p<0.05 versus sham 76±11 pg/ml). Following administration of an SDF1-A antibody, Lin−/Sca1+ cells failed to mobilize to peripheral blood following stroke, despite continued up regulation in bone marrow (stroke bone marrow cell count: 536±65, blood cell count: 127±24; p<0.05 versus placebo). Exogenously administered Lin−/Sca1+ cells resulted in a significant reduction in infarct volume: 42±5% (stroke alone), versus 21±15% (Stroke+Lin−/Sca1+ cells), and administration of an SDF1-A antibody concomitant to exogenous administration of the Lin−/Sca1+ cells prevented this reduction. Following stroke, exogenously administered Lin−/Sca1+ FISH positive cells were significantly reduced when administered concomitant to an SDF1-A antibody as compared to without SDF1-A antibody (10±4 vs 0.7±1, p<0.05). Conclusions SDF1-A appears to play a critical role in modulating Lin−/Sca1+ cell migration to ischemic brain

Complement activation and its prognostic role in post-cardiac arrest patients

Cardiac arrest causes generalized ischemia/hypoxia, and subsequent resuscitation inflicts reperfusion injury, the pathology of which is not fully understood. Moreover, predicting the prognosis of comatose, post-cardiac-arrest patients is a complex clinical challenge. We hypothesized that the extent of complement activation might be a reliable predictor of mortality in this population. Forty-six comatose cardiac arrest patients were enrolled into our prospective cohort study, conducted in a tertiary care university clinic. All subjects were cooled to 32-34 degrees C body temperature for 24 hours and then, allowed to rewarm to normothermia. All patients underwent diagnostic coronary angiography. On admission, at 6 and at 24 hrs, blood samples were taken from the arterial catheter. In these, complement products (C3a, C3, C4d, C4, SC5b9, and Bb) were measured by ELISA in blood samples. Patients were followed-up for 30 days; 22 patients (47.8%) died by the end of this period. We observed that complement activation (determined as the C3a to C3 ratio) was higher in non-survivors than in survivors at each time point. In the multivariate Cox regression analysis, the C3a/C3 ratio determined 24 hours after the initiation of therapeutic hypothermia predicted 30-day mortality regardless of age, sex, and the APACHE II score. Complement activation occurs in post-cardiac arrest patients, and its extent correlates with 30-day survival. The C3a/C3 ratio might prove useful for estimating the prognosis of comatose post-cardiac-arrest patients. This article is protected by copyright. All rights reserved

Endovascular Treatment for Acute Stroke Patients With a Pre-stroke Disability: An International Survey

Background: It is unclear what factors clinicians consider when deciding about endovascular thrombectomy (EVT) in acute ischemic stroke patients with a pre-existing disability. We aimed to explore international practice patterns and preferences for EVT in patients with a pre-stroke disability, defined as a modified Rankin score (mRS) ≥ 2. Methods: Electronic survey link was sent to principal investigators of five major EVT trials and members of a professional interventional neurology society. Results: Of the 81 survey-responding clinicians, 57% were neuro-interventionalists and 33% were non-interventional stroke clinicians. Overall, 64.2% would never or almost never consider EVT for a patient with pre-stroke mRS of 4-5, and 49.3% would always or almost always offer EVT for a patient with pre-stroke mRS 2-3. Perceived benefit of EVT (89%) and severity of baseline disability (83.5%) were identified as the most important clinician-level and patient-level factors that influence EVT decisions in these patients. Conclusion: In this survey of 80 respondents, we found that EVT practice for patients with pre-stroke disability across the world is heterogenous and depends upon patient characteristics. Individual clinician opinions substantially alter EVT decisions in pre-stroke disabled patients

Endovascular Therapy vs Medical Management for Patients With Acute Stroke With Medium Vessel Occlusion in the Anterior Circulation

Importance Randomized clinical trials have shown the efficacy of endovascular therapy (EVT) for acute large vessel occlusion strokes. The benefit of EVT in acute stroke with distal, medium vessel occlusion (DMVO) remains unclear. Objective To examine the efficacy and safety outcomes associated with EVT in patients with primary DMVO stroke when compared with a control cohort treated with medical management (MM) alone. Design, Setting, and Participants This multicenter, retrospective cohort study pooled data from patients who had an acute stroke and a primary anterior circulation emergency DMVO, defined as any segment of the anterior cerebral artery (ACA) or distal middle cerebral artery, between January 1, 2015, and December 31, 2019. Those with a concomitant proximal occlusion were excluded. Outcomes were compared between the 2 treatment groups using propensity score methods. Data analysis was performed from March to June 2021. Exposures Patients were divided into EVT and MM groups. Main Outcomes and Measures Main efficacy outcomes included 3-month functional independence (modified Rankin Scale [mRS] scores, 0-2) and 3-month excellent outcome (mRS scores, 0-1). Safety outcomes included 3-month mortality and symptomatic intracranial hemorrhage. Results A total of 286 patients with DMVO were evaluated, including 156 treated with EVT (mean [SD] age, 66.7 [13.7] years; 90 men [57.6%]; median National Institute of Health Stroke Scale [NIHSS] score, 13.5 [IQR, 8.5-18.5]; intravenous tissue plasminogen activator [IV tPA] use, 75 [49.7%]; ACA involvement, 49 [31.4%]) and 130 treated with medical management (mean [SD] age, 69.8 [14.9] years; 62 men [47.7%]; median NIHSS score, 7.0 [IQR, 4.0-14.0], IV tPA use, 58 [44.6%]; ACA involvement, 31 [24.0%]). There was no difference in the unadjusted rate of 3-month functional independence in the EVT vs MM groups (151 [51.7%] vs 124 [50.0%]; P = .78), excellent outcome (151 [38.4%] vs 123 [31.7%]; P = .25), or mortality (139 [18.7%] vs 106 [11.3%]; P = .15). The rate of symptomatic intracranial hemorrhage was similar in the EVT vs MM groups (weighted: 4.0% vs 3.1%; P = .90). In inverse probability of treatment weighting propensity analyses, there was no significant difference between groups for functional independence (adjusted odds ratio [aOR], 1.36; 95% CI, 0.84-2.19; P = .20) or mortality (aOR, 1.24; 95% CI, 0.63-2.43; P = .53), whereas the EVT group had higher odds of an excellent outcome (mRS scores, 0-1) at 3 months (aOR, 1.71; 95% CI, 1.02-2.87; P = .04). Conclusions and Relevance The findings of this multicenter cohort study suggest that EVT may be considered for selected patients with ACA or distal middle cerebral artery strokes. Further larger randomized investigation regarding the risk-benefit ratio for DMVO treatment is indicated

The family caregiver’s discourse on the hospitalization of the elderly with Alzheimer’s disease O discurso do cuidador familiar sobre a hospitalização do idoso com doença de Alzheimer

ResumoObjetivo: Conhecer a percepção do cuidador sobre a hospitalização do idoso com Doença de Alzheimer. Método: Trata-se de um estudo descritivo, exploratório, de natureza qualitativa, realizado com onze cuidadores familiares de idosos com doença de Alzheimer. Os dados foram coletados no período de Abril a Junho de 2013 por meio de entrevista semiestruturada. A análise dos dados foi pautada no Discurso do Sujeito Coletivo. Resultados: Emergiram duas ideias centrais síntese: piora da função cognitiva do idoso com doença de Alzheimer durante o processo de hospitalização e o despreparo da equipe de saúde para cuidar de um idoso com demência.Conclusão: De acordo com os resultados obtidos, urge a necessidade de capacitação e/ou especialização dos profissionais de saúde para atender o idoso com demência e sua família. A família é parte integrante do cuidado a esse idoso, sendo fundamental compreendê-la e assisti-la como uma unidade social complexa.Descritores: Cuidadores, Doença de Alzheimer, Idoso, Hospitalização. AbstractObjective: To investigate the perception of the caregiver about the hospitalization of the elderly with Alzheimer disease. Method: This is a descriptive study, exploratory and qualitative in nature, performed with 11 family caregivers of elderly with Alzheimer disease. The data were collected during the period from April to June 2013 through semi-structured interview. The data analysis was based on the Collective Discourse of the Subjects. Results: Two summary central ideas emerged: worsening of cognitive function in the elderly with Alzheimer disease during the process of hospitalization and the lack of health staff to take care of an elderly with dementia. Conclusion: According to the results obtained, there is urgent need for training and/or specialization of health professionals to meet the elderly with dementia and their families. The family is an integral part of the care that elderly, being critical to understand it and watched it as a social unit complex.Descriptors: Caregivers, Alzheimer Disease, Elderly, Hospitalization. ResumenObjetivo: Investigar la percepción del cuidador acerca de la hospitalización de las personas mayores con la enfermedad de Alzheimer. Método: Este es un estudio descriptivo, exploratorio y de naturaleza cualitativa, realizado con 11 cuidadores familiares de ancianos con enfermedad de Alzheimer. Los datos fueron recolectados durante el periodo de abril a junio de 2013 a través de la entrevista semi-estructurada. El análisis de los datos se basa en el discurso de los sujetos colectivos. Resultados: Surgieron dos ideas centrales resumen: empeoramiento de la función cognoscitiva en los ancianos con enfermedad de Alzheimer durante el proceso de hospitalización y la Falta de personal sanitario a cuidar de un anciano con demencia. Conclusión: De acuerdo a los resultados obtenidos, existe la urgente necesidad de formación y/o especialización de los profesionales de la salud para atender a los ancianos con demencia y sus familias. La familia es una parte integral de la atención que los ancianos, siendo fundamental para entenderla y verla como una unidad social compleja.Descriptores: Cuidadores, Enfermedad de Alzheimer, Ancianos, Hospitalización

The family caregiver’s discourse on the hospitalization of the elderly with Alzheimer’s disease O discurso do cuidador familiar sobre a hospitalização do idoso com doença de Alzheimer

Resumo Objetivo: Conhecer a percepção do cuidador sobre a hospitalização do idoso com Doença de Alzheimer. Método: Trata-se de um estudo descritivo, exploratório, de natureza qualitativa, realizado com onze cuidadores familiares de idosos com doença de Alzheimer. Os dados foram coletados no período de Abril a Junho de 2013 por meio de entrevista semiestruturada. A análise dos dados foi pautada no Discurso do Sujeito Coletivo. Resultados: Emergiram duas ideias centrais síntese: piora da função cognitiva do idoso com doença de Alzheimer durante o processo de hospitalização e o despreparo da equipe de saúde para cuidar de um idoso com demência. Conclusão: De acordo com os resultados obtidos, urge a necessidade de capacitação e/ou especialização dos profissionais de saúde para atender o idoso com demência e sua família. A família é parte integrante do cuidado a esse idoso, sendo fundamental compreendê-la e assisti-la como uma unidade social complexa. Descritores: Cuidadores, Doença de Alzheimer, Idoso, Hospitalização.   Abstract Objective: To investigate the perception of the caregiver about the hospitalization of the elderly with Alzheimer disease. Method: This is a descriptive study, exploratory and qualitative in nature, performed with 11 family caregivers of elderly with Alzheimer disease. The data were collected during the period from April to June 2013 through semi-structured interview. The data analysis was based on the Collective Discourse of the Subjects. Results: Two summary central ideas emerged: worsening of cognitive function in the elderly with Alzheimer disease during the process of hospitalization and the lack of health staff to take care of an elderly with dementia. Conclusion: According to the results obtained, there is urgent need for training and/or specialization of health professionals to meet the elderly with dementia and their families. The family is an integral part of the care that elderly, being critical to understand it and watched it as a social unit complex. Descriptors: Caregivers, Alzheimer Disease, Elderly, Hospitalization.   Resumen Objetivo: Investigar la percepción del cuidador acerca de la hospitalización de las personas mayores con la enfermedad de Alzheimer. Método: Este es un estudio descriptivo, exploratorio y de naturaleza cualitativa, realizado con 11 cuidadores familiares de ancianos con enfermedad de Alzheimer. Los datos fueron recolectados durante el periodo de abril a junio de 2013 a través de la entrevista semi-estructurada. El análisis de los datos se basa en el discurso de los sujetos colectivos. Resultados: Surgieron dos ideas centrales resumen: empeoramiento de la función cognoscitiva en los ancianos con enfermedad de Alzheimer durante el proceso de hospitalización y la Falta de personal sanitario a cuidar de un anciano con demencia. Conclusión: De acuerdo a los resultados obtenidos, existe la urgente necesidad de formación y/o especialización de los profesionales de la salud para atender a los ancianos con demencia y sus familias. La familia es una parte integral de la atención que los ancianos, siendo fundamental para entenderla y verla como una unidad social compleja. Descriptores: Cuidadores, Enfermedad de Alzheimer, Ancianos, Hospitalización