PENERAPAN BRAIN GYM PADA ASUHAN KEPERAWATAN LANSIA DEMENSIA DI PSTW BUDI LUHUR KASONGAN BANTUL YOGYAKARTA

Populasi lansia di Indonesia yang terus meningkat dapat menjadi aset bangsa apabila sehat dan produktif. Agar hidup produktif kesehatan lansia perlu diprogramkan yaitu dengan kegiatan stimulasi otak untuk meminimalisir penurunan fungsi kognitif yang menyebabkan demensia. Stimulasi otak salah satu kegiatannya adalah brain gym. Menurut penelitian sebelumnya ada pengaruh penurunan tingkat demensia pada lansia brain gym yang dilakukan selama 10-15 menit setiap pagi sebanyak 5x/minggu selama 4 minggu. Peneliti akan menerapkan brain gym pada asuhan keperawatan lansia demesia di PSTW Budi Luhur. Tujuan studi kasus ini menerapkan brain gym pada asuhan keperawatan lansia demensia, mengetahui tingkat demensia sebelum dan setelah dilakukan brain gym. Metode dalam studi kasus ini yaitu observasi, wawancara, dan studi dokumentasi pada dua lansia yang hasilnya dianalisis dan dibandingkan perbedaan responnya. Lokasi studi kasus ini di PSTW Budi Luhur Kasongan Bantul Yogyakarta. Subyek studi kasus ini adalah dua orang lansia sesuai kriteria yang telah ditetukan. Hasil studi kasus ini kedua subyek dapat melakukan semua gerakan brain gym. Penilaian menggunakan MMSE klien I pre test 17 dan post test 19 poin. Untuk klien II pre test 20 poin dan post test 23 poin. Kesimpulan studi kasus ini penerapan terapi brain gym pada asuhan keperawatan lansia demensia dapat dilakukan pada kedua klien. Hasil penilaian MMSE pada kedua klien ada kenaikan. Kata Kunci : tingkat demensia, brain gym, penilaian MMS

Balloon cells promote immune system activation in focal cortical dysplasia type 2b

AIMS: Focal cortical dysplasia (FCD) type 2 is an epileptogenic malformation of the neocortex associated with somatic mutations in the mammalian target of rapamycin (mTOR) pathway. Histopathologically, FCD 2 is subdivided into FCD 2a and FCD 2b, the only discriminator being the presence of balloon cells (BCs) in FCD 2b. While pro‐epileptogenic immune system activation and inflammatory responses are commonly detected in both subtypes, it is unknown what contextual role BCs play. METHODS: The present study employed RNA sequencing of surgically resected brain tissue from FCD 2a (n = 11) and FCD 2b (n = 20) patients compared to autopsy control (n = 9) focusing on three immune system processes: adaptive immunity, innate immunity and cytokine production. This analysis was followed by immunohistochemistry on a clinically well‐characterised FCD 2 cohort. RESULTS: Differential expression analysis revealed stronger expression of components of innate immunity, adaptive immunity and cytokine production in FCD 2b than in FCD 2a, particularly complement activation and antigen presentation. Immunohistochemical analysis confirmed these findings, with strong expression of leukocyte antigen I and II in FCD 2b as compared to FCD 2a. Moreover, T‐lymphocyte tissue infiltration was elevated in FCD 2b. Expression of markers of immune system activation in FCD 2b was concentrated in subcortical white matter. Lastly, antigen presentation was strongly correlated with BC load in FCD 2b lesions. CONCLUSION: We conclude that, next to mutation‐driven mTOR activation and seizure activity, BCs are crucial drivers of inflammation in FCD 2b. Our findings indicate that therapies targeting inflammation may be beneficial in FCD 2b

Evidence for mTOR pathway activation in a spectrum of epilepsy-associated pathologies

Activation of the mTOR pathway has been linked to the cytopathology and epileptogenicity of malformations, specifically Focal Cortical Dysplasia (FCD) and Tuberous Sclerosis (TSC). Experimental and clinical trials have shown than mTOR inhibitors have anti-epileptogenic effects in TS. Dysmorphic neurones and balloon cells are hallmarks of FCDIIb and TSC, but similar cells are also occasionally observed in other acquired epileptogenic pathologies, including hippocampal sclerosis (HS) and Rasmussen's encephalitis (RE). Our aim was to explore mTOR pathway activation in a range of epilepsy-associated pathologies and in lesion-negative cases