Asuhan Keperawatan Pada Ny. W dengan Gangguan Sistem Neurologi: Stroke Non Hemoragik di Bangsal Anggrek-Bougenvile RSUD Pandanarang Boyolali

Latar Belakang : Kesehatan merupakan salah satu kebutuhan utama manusia karena setiap manusia berhak untuk memiliki kesehatan. Kenyataannya tidak semua orang dapat memiliki kesehatan yang optimal disebabkan oleh lingkungan yang buruk, sosial ekonomi yang rendah, gaya hidup yang tidak sehat mulai dari makanan, kebiasaan, maupun lingkungan sekitarnya. Hal ini yang memicu berbagai macam penyakit diantaranya adalah stroke Tujuan : Untuk mengetahui asuhan keperawatan pada pasien dengan stroke non hemoragik yang meliputi pengkajian, intervensi, implementasi dan evaluasi keperawatan. Metode : Metode yang digunakan adalah dengan melakukan asuhan keperawatan pada pasien stroke non gemoragik Hasil : Setelah dilakukan asuahan keperwatan selama 3x24 jam didapatkan perfusi jaringan serebral belum berfungsi secara optimal, tidak mampu berkomunikasi dengan lancar, pasien sudah bisa tirah baring di tempat tidur meskipun terbatas , dan tidak mampu melakukan perawatan diri sendiri Kesimpulan : Satu masalah keperawatan berupa hambatan mobilitas fisik sudah teratasi sebagian sehingga membutuhkan perawatan lebih lanjut. Dan belum ada masalah keperawatan yang sudah teratasi, sehingga memerlukan tindakan keperawatan yang lebih lanjut

Molecular Aggregation of L-isoleucine in Aqueous Solution and its Impact on the Determination of Solubility and Nucleation Kinetics

Comparison between the solubility of L-Isoleucine as measured using gravimetric and dissolution methods reveals significant differences which is consistent with the presence of solute aggregation in solution. Calculation of the critical aggregation concentration confirms this analysis revealing this concentration to lie between the two measured solubility values suggesting the existence of a stability zone roughly defined by the temperature/concentration range of 40°C/33g/L to 75°C/42g/L in which a mixture of free and aggregated molecules under the slurried conditions appear to exist. Dynamic light scattering result reveals that the aggregate size lies within the range of 40-170 nm. The potential impact of relying on the measurement of solubility using gravimetric data based on solution isolation of the slurried state for such systems is highlighted through a comparison of the values of representative crystallization parameters such as metastable zone width (MSZW) and nucleation kinetics as determined using solubilities derived from both methodologies. Reduction in solution pH in the aggregated molecular state is consistent with the aggregates being formed from neutral species suggesting, in turn, that this compound might crystallize via a 2-step nucleation process. This research suggests that caution should be exercised when using solubility data derived from gravimetric measurements particularly for amphiphilic molecules where solute ordering in solution might be expected

NRP/Optineurin Cooperates with TAX1BP1 to Potentiate the Activation of NF-κB by Human T-Lymphotropic Virus Type 1 Tax Protein

Nuclear factor (NF)-κB is a major survival pathway engaged by the Human T-Lymphotropic Virus type 1 (HTLV-1) Tax protein. Tax1 activation of NF-κB occurs predominantly in the cytoplasm, where Tax1 binds NF-κB Essential Modulator (NEMO/IKKγ) and triggers the activation of IκB kinases. Several independent studies have shown that Tax1-mediated NF-κB activation is dependent on Tax1 ubiquitination. Here, we identify by co-immunoprecipitation assays NEMO-Related Protein (NRP/Optineurin) as a binding partner for Tax1 in HTLV-1 infected and Tax1/NRP co-expressing cells. Immunofluorescence studies reveal that Tax1, NRP and NEMO colocalize in Golgi-associated structures. The interaction between Tax1 and NRP requires the ubiquitin-binding activity of NRP and the ubiquitination sites of Tax1. In addition, we observe that NRP increases the ubiquitination of Tax1 along with Tax1-dependent NF-κB signaling. Surprisingly, we find that in addition to Tax1, NRP interacts cooperatively with the Tax1 binding protein TAX1BP1, and that NRP and TAX1BP1 cooperate to modulate Tax1 ubiquitination and NF-κB activation. Our data strongly suggest for the first time that NRP is a critical adaptor that regulates the assembly of TAX1BP1 and post-translationally modified forms of Tax1, leading to sustained NF-κB activation

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Does the Quality of Life in Operated Patients with Adolescent Idiopathic Scoliosis correspond with the Radiographic Parameters?

Objectives: Traditionally, scoliosis surgery is aimed at attaining a fused, balanced and painless spine. With improvement in surgical and instrumentation techniques, spine surgeons strive to achieve higher degree of Cobb’s angle and rib hump correction with the idea of greater patient satisfaction. The aim of this study was to determine the patients’ satisfaction using SRS-22 questionnaire and their correlations with the radiographic changes. Materials and methods: A prospective study was conducted in a tertiary referral centre using the Scoliosis Research Society-22 (SRS-22) questionnaire during the patients’ annual follow up, between February to April 2014. Thirtyseven patients who met the inclusion criteria were enrolled. Results: The mean pre-operative Cobb’s angles were 57.8o ±12.7o and mean post-operative angle of 20.0o ± 10.4o, resulting in average correction of 65.9 ± 14.4%. Mean preoperative rib hump was 61.1 ± 15.4 mm with mean postoperative rib hump of 15.8 ± 17.8 mm, resulting in average reduction of 77.7 ± 23.7%. Mean of post-operative total SRS score was 4.1 ± 0.5. Using Spearman rank correlation, the percentage of Cobb’s angle correction versus the SRS-22 score showed correlation of 0.17 (P=0.33) while the percentage of rib hump reduction versus SRS-22 score showed a correlation of 0.11 (P=0.53). Conclusion: In this study, the average total SRS-22 score was 4.1 ± 0.5 (range, 3.1-4.9) post-operatively indicating very high satisfaction rate overall. Despite attempts at greater curve correction and rib hump reduction, there is no direct correlation between patient satisfaction and radiographic parameters