HASIL KAS ANALISA JURNAL INTERNASIONAL

Oleh:

DIMAS JAMALIA SAFIQRI

NIM. 019 STYC 16

YAYASAN RUMAH SAKIT ISLAM NUSA TENGGARA BARAT

SEKOLAH TINGGI ILMU KESEHATAN YARSI MATARAM
PROGRAM STUDI ILMU KEPERAWATAN JENJANG S.1
MATARAM
2020
 Analisa Jurnal Internasional
 Jurnal 1
 Judul jurnal
CADASIL syndrome (cerebral autosomal dominant arteriopathy with subcortical
infarcts and leukoencephalopathy) presenting as psychosis
 Kata Kunci
CADASIL syndrome
 Penulis Jurnal dan tahun jurnal
Tahun jurnal 2018
1. Dheerendra Kumar Mishra
2. Aman Kishore
3. Vijay Niranjan
 Ringkasan Jurnal
CADASIL is a rare genetic disorder, and the prevalence of CADASIL is unknown,
but worldwide, pproximately 400 affected families have been reported. Notch protein
family is composed of cell surface receptors that transduce signals between neighbouring
cells. Notch3 is predominantly expressed in adult arterial smooth muscle cells in human
and plays a critical role in maintaining the phenotypic stability of vascular smooth
muscle cells. Common presentation is silent or clinically evident ischaemic strokes,
migraine, seizure and cognitive impairment as described earlier. Neurotic symptoms are
reported to be mainly associated with this syndrome. The exact pathophysiological
mechanism underlying the association of psychotic symptoms with CADASIL syndrome
is not clearly understood. One possible explanation is that multiple white matter infarcts
particularly in the frontal region result in disruption of cortical–subcortical network
which results in altered reality monitoring and genesis of psychotic symptoms. NNotch
signalling pathways have a crucial role in neurodevelopment and altered Notch
signalling is reported in schizophrenia, hence this may be a common dysfunction
pathway between schizophrenia and CADASIL syndrome. Therefore, we want to make
readers aware of this unique presentation of psychotic behavioural symptoms associated
with CADASIL syndrome. A high index of suspicion is required when associated
neurological features are found alongside unusual behavioural symptoms with
inadequate response to management as usual. The targeted investigation is helpful for
identifying this syndrome. Neuroimaging is helpful for identification of suggestible
 features. Although genetic testing is definitive for confirmation of diagnosis, as per
previous literature skin biopsy yields high results with high sensitivity and specificity
 Pembahasan jurnal
CADASIL is a rare genetic disorder, and the prevalence of CADASIL is
unknown, but worldwide, pproximately 400 affected families have been reported.
Notch protein family is composed of cell surface receptors that transduce signals
between neighbouring cells. Notch3 is predominantly expressed in adult arterial
smooth muscle cells in human and plays a critical role in maintaining the
phenotypic stability of vascular smooth muscle cells. Common presentation is
silent or clinically evident ischaemic strokes, migraine, seizure and cognitive
impairment as described earlier. Neurotic symptoms are reported to be mainly
associated with this syndrome. The exact pathophysiological mechanism
underlying the association of psychotic symptoms with CADASIL syndrome is
not clearly understood. One possible explanation is that multiple white matter
infarcts particularly in the frontal region result in disruption of cortical–subcortical
network which results in altered reality monitoring and genesis of psychotic
symptoms. NNotch signalling pathways have a crucial role in neurodevelopment
and altered Notch signalling is reported in schizophrenia, hence this may be a
common dysfunction pathway between schizophrenia and CADASIL syndrome.
Therefore, we want to make readers aware of this unique presentation of psychotic
behavioural symptoms associated with CADASIL syndrome. A high index of
suspicion is required when associated neurological features are found alongside
unusual behavioural symptoms with inadequate response to management as usual.
The targeted investigation is helpful for identifying this syndrome. Neuroimaging
is helpful for identification of suggestible features. Although genetic testing is
definitive for confirmation of diagnosis, as per previous literature skin biopsy
yields high results with high sensitivity and specificity.
A 32-year-old man presented with suspiciousness, fearfulness, odd ritualistic
behaviour, decline in academic performance, self-care and social functioning and
occasionally complaint of urinary and faecal incontinence, with symptoms starting
from 14 years of age and being gradually progressive in the course. He had a
history of seizure episodes at the age of 8. For this reason he took antiepileptic
medication for 4 years and since then there has been no recurrence of seizures
Futhermore, there was a family history of stroke in his father. The patient was
 treated with second-generation antipsychotics earlier, but there was no significant
improvement in symptoms and also there was a history of developing
extrapyramidal side effects with typical antipsychotics. His mental status
examination revealed odd mannerisms, increased reaction time, retarded speech,
shallow affect with decreased reactivity and delusion of persecution against the
family member, with complete denial of illness by the patient. In addition, his
neurological examination revealed ataxic gait while other parameters of physical
examination were unremarkable. MRI brain imaging revealed confluent and
discrete, fairly symmetric T2 hyperintense foci in the deep and subcortical white
matter of the cerebral hemispheres, bilateral basal ganglia, brainstem, thalami and
the subcortical white matter, suggesting the possibility of CADASIL syndrome.
Thus, for confirmation, skin biopsy was performed which revealed granular
osmophilic deposits in the basal lamina of a small blood vessel with degeneration
and loss of smooth muscle cells under the electron microscope, as genetic testing
was unavailable at our centre. The patient was given clozapine in view of his
treatment history, which resulted in partial improvement of symptoms.

 Jurnal 2
 Judul jurnal
Complement factor H contributes to mortality in humans and mice with bacterial
meningitis
 Kata Kunci
Bacterial meningitis, Pneumococcal meningitis, Complement system, Complement
factor H, Anti-inflammatory therapy, Animal models
 Penulis Jurnal dan tahun jurnal
Tahun jurnal 2019
1. E. Soemirien Kasanmoentalib
2. Mercedes Valls Serón
3. Joo Yeon Engelen Lee
4. Michael W. Tanck
5. Richard B. Pouw
6. Gerard van Mierlo
7. Diana Wouters
8. Matthew C. Pickering
9. Arie van der Ende
 10. Taco W. Kuijpers
11. Matthijs C. Brouwer
12. Diederik van de Beek
 Ringkasan Jurnal
Despite the introduction of effective vaccines and antibiotic treatment
pneumococcal meningitis is the most common and severe form of bacterial meningitis
and is associated with mortality rates of 18 to 37% and neurological sequelae in about
50% of survivors. Due to serotype replacement reducing vaccine effectiveness and the
growing emergence of antibiotic resistance new treatment strategies are needed .
Experimental bacterial meningitis animal models have shown that outcome is related to
the severity of inflammation in the subarachnoid space and that the outcome can be
improved by modulation of this inflammatory response. The introduction of
dexamethasone, an anti-inflammatory drug, has improved outcomes in patients in high-
income countries although the burden of disease remains substantial . Other adjunctive
therapies are needed to further improve the prognosis of pneumococcal meningitis
patients.
In conclusion, we show FH has an important role in the pathophysiology of
bacterial meningitis and genetic variation influences severity of the disease. Our mouse
model shows that treatment with hFH inhibits complement activation during
pneumococcal meningitis but did not influence outcome due to detrimental and
beneficial effects.

 Pembahasan jurnal
Despite the introduction of effective vaccines and antibiotic treatment
pneumococcal meningitis is the most common and severe form of bacterial meningitis
and is associated with mortality rates of 18 to 37% and neurological sequelae in about
50% of survivors. Due to serotype replacement reducing vaccine effectiveness and the
growing emergence of antibiotic resistance new treatment strategies are needed .
Experimental bacterial meningitis animal models have shown that outcome is related to
the severity of inflammation in the subarachnoid space and that the outcome can be
improved by modulation of this inflammatory response. The introduction of
dexamethasone, an anti-inflammatory drug, has improved outcomes in patients in high-
income countries although the burden of disease remains substantial . Other adjunctive
 therapies are needed to further improve the prognosis of pneumococcal meningitis
patients.
However, treatment with C5 antibodies blocks the terminal complement pathway
impairing the killing of Neisseria meningitidis, the second most common cause of
bacterial meningitis . Moreover, intervening in the complement system upstream in one
of the three activation pathways could be more beneficial as it also reduces early
anaphylatoxin formation. The classical, lectin, and alternative pathway of complement
all lead to the formation of the opsonin C3b, which also induces the formation of C3 and
C5 convertase when binding to other complement components. The alternative pathway
is activated by spontaneous hydrolysis of C3, resulting in the formation of a solvent-
based C3 convertase followed by the deposition of C3b on cell surfaces. Once C3b has
been formed, by one of the three pathways, the alternative pathway amplification loop
can rapidly increase C3b production

 Jurnal 3
 Judul jurnal
Bone Fracture Acute Phase Response—A Unifying Theory of Fracture Repair: Clinical
and Scientific Implications

 Kata Kunci
Fracture repair . Fracture vascularity . Strain . Acute phase response . Endochondral
ossification . Non-union

 Penulis Jurnal dan tahun jurnal

Tahun jurnal 2018
1. Courtney E. Baker
2. Stephanie N. Moore-Lotridge
3. Alexander A. Hysong
4. Samuel L. Posey
5. J. Patton Robinette
6. Deke M. Blum
7. Michael A. Benvenuti
8. Heather A. Cole
9. Satoru Egawa
10. Atsushi Okawa
11. Masanori Saito
 12. Jason R. McCarthy
13. Jeffry S. Nyman
14. Masato Yuasa
15. Jonathan G. Schoenecker
 Ringkasan Jurnal
Bone fractures create five problems that must be resolved: bleeding, risk of
infection, hypoxia, disproportionate strain, and inability to bear weight. There have
been enormous advancements in our understanding of the molecular mechanisms that
resolve these problems after fractures, and in best clinical practices of repairing
fractures.We put forth a modern, comprehensive model of fracture repair that
synthesizes the literature on the biology and biomechanics of fracture repair to address
the primary problems of fractures. This updated model is a framework for both
fracture management and future studies aimed at understanding and treating this
complex process. This model is based upon the fracture acute phase response (APR),
which encompasses the molecular mechanisms that respond to injury. The APR is
divided into sequential stages of “survival” and “repair.” Early in convalescence,
during “survival,” bleeding and infection are resolved by collaborative efforts of the
hemostatic and inflammatory pathways. Later, in “repair,” avascular and
biomechanically insufficient bone is replaced by a variable combination of
intramembranous and endochondral ossification. Progression to repair cannot occur
until survival has been ensured. A disproportionate APR—either insufficient or
exuberant—leads to complications of survival (hemorrhage, thrombosis, systemic
inflammatory response syndrome, infection, death) and/or repair (delayed- or non-
union). The type of ossification utilized for fracture repair is dependent on the relative
amounts of strain and vascularity in the fracture microenvironment, but any failure
along this process can disrupt or delay fracture healing and result in a similar non-
union. Therefore, incomplete understanding of the principles herein can result in
mismanagement of fracture care or application of hardware that interferes with
fracture repair. This unifying model of fracture repair not only informs clinicians how
their interventions fit within the framework of normal biological healing but also
instructs investigators about the critical variables and outputs to assess during a study
of fracture repair.
 Pembahasan jurna
 Fractures create five primary problems: bleeding, susceptibility to infection,
disproportionate interfragmentary strain, bone hypoxia, and an inability to bear weight
. First, bleeding occurs due to bone’s open vascular system, which makes rapid
hemostasis a challenge following a fracture. Second, infection is a common concern
as fractures disrupt the body’s protective anatomical compartments. Third, strain,
defined as the change in length of a fracture gap upon loading relative to its overall
length when unloaded, can be detrimental to fracture healing if it is disproportionate
to the intended ossification process. Fourth, bone hypoxia occurs as fractures result in
both bony and vascular discontinuity, resulting in a large area of under-perfused,
hypoxic bone tissue. Finally, the inability to bear a load must be resolved before a
fracture is considered healed. After achieving vascular and bone union, the bone
begins the long process of remodeling to a structurally and energetically efficient
construct. In order to return to preinjury function, a bone must not only physically
bridge the fracture gap, but also be able to transmit force across it, ideally without
altered joint mechanics. Acute Phase Response—The “Heroes” In order to address the
five primary problems created by fractures, the body utilizes the APR, a complex
hormonal system for surviving injury and repairing damaged tissues following any
trauma, including fractures (Fig. 1a). The APR occurs in an orderly fashion and is
divided into two distinct phases— termed “survival” and “repair.” The “survival”
phase functions to contain the injury by utilizing coagulation and inflammation to
achieve hemostasis and prevent infection. These are the most immediate, lethal threats
of a fracture and must be addressed quickly. Once the body has survived these
problems, it then proceeds to the “repair” phase, which aims to recreate functional
anatomy by minimizing excessive strain at the fracture site, restoring vascular unity,
and repairing bony anatomy to restore load-bearing ability.
Bone fractures create five problems that must be resolved: bleeding, risk of
infection, hypoxia, disproportionate strain, and inability to bear weight. There have
been enormous advancements in our understanding of the molecular mechanisms that
resolve these problems after fractures, and in best clinical practices of repairing
fractures.We put forth a modern, comprehensive model of fracture repair that
synthesizes the literature on the biology and biomechanics of fracture repair to address
the primary problems of fractures. This updated model is a framework for both
fracture management and future studies aimed at understanding and treating this
complex process. This model is based upon the fracture acute phase response (APR),
 which encompasses the molecular mechanisms that respond to injury. The APR is
divided into sequential stages of “survival” and “repair.” Early in convalescence,
during “survival,” bleeding and infection are resolved by collaborative efforts of the
hemostatic and inflammatory pathways. Later, in “repair,” avascular and
biomechanically insufficient bone is replaced by a variable combination of
intramembranous and endochondral ossification. Progression to repair cannot occur
until survival has been ensured. A disproportionate APR—either insufficient or
exuberant—leads to complications of survival (hemorrhage, thrombosis, systemic
inflammatory response syndrome, infection, death) and/or repair (delayed- or non-
union). The type of ossification utilized for fracture repair is dependent on the relative
amounts of strain and vascularity in the fracture microenvironment, but any failure
along this process can disrupt or delay fracture healing and result in a similar non-
union. Therefore, incomplete understanding of the principles herein can result in
mismanagement of fracture care or application of hardware that interferes with
fracture repair. This unifying model of fracture repair not only informs clinicians how
their interventions fit within the framework of normal biological healing but also
instructs investigators about the critical variables and outputs to assess during a study
of fracture repair.

 Jurnal 4

 Judul jurnal
The national and subnational prevalence of cataract and cataract blindness in China: a
systematic review and meta-analysis

 Kata Kunci
subnational prevalence of cataract and cataract blindness in China

 Penulis Jurnal dan tahun jurnal

Tahun jurnal 2018
1. Peige Song
2. He Wang
3. Evropi Theodoratou
4. Kit Yee Chan
5. Igor Rudan

 Ringkasan Jurnal
 Cataract is the second leading cause of visual impairment and the first of
blindness globally. However, for the most populous country, China, much remains to
be understood about the scale of cataract and cataract blindness. We aimed to
investigate the prevalence of cataract and cataract blindness in China at both the
national and subnational levels, with projections till 2050. the first and most
comprehensive estimates of the prevalence of cataract and cataract blindness in China
were provided in this study, at both the national and subnational levels. The
prevalence of cataract varied considerably among different demographic and
geographic groups. In the coming decades, cataract and cataract blindness will
continue to be a leading public-health issue in China. Future work should be
prioritized on the promotion of high-quality epidemiological studies on cataract.

 Pembahasan jurna
Cataract, defined as any opacity of the crystalline lens in the eye that affects
clear vision, is a common condition in later life. If left untreated, cataract can
eventually progress to severe visual impairment or even blindness. Compared to the
general population, people with cataract are more likely to have substantially reduced
vision-related quality of life and increased risk of comorbidity and mortality. Surgery
is cost-effective and successful in restoring cataract-related vision loss. However, in
many resource-deprived areas, especially remote and poor areas in developing
countries, barriers in access to appropriate preventative eye care and surgical
treatments still exist, presenting an enormous problem to the society in terms of social
and economic burden. Based on aetiology, cataract can be broadly classified as age-
related, congenital, traumatic, secondary and drug-induced, etc., with age-related
cataract (ARC) being the predominant subtype.
Despite the fact that cataract can be easily, safely and cost-efficiently treated
with a standard procedure, cataract still remains the second leading cause of visual
impairment and the first of blindness globally. According to the latest estimates in
2010, 94 million people were visually impaired and 20 million were blind because of
cataract, accounting for one third (33%) of all individuals with visual impairment and
more than half (51%) of blind cases worldwide. Cataract is a multifactorial disease,
with ageing being the major risk factor by far. As people live longer, the prevalence of
cataract is expected to rise correspondingly, posing challenges for health systems.
From the public health perspective, understanding the magnitude of cataract and
cataract blindness is the first step in prevention and treatment, and can provide a basis
for evidence-based policy making and public health resources allocation . Despite
this, comprehensive review of data regarding the prevalence and burden of cataract on
a global basis has never, to the best of our knowledge, been documented previously.
This may largely due to the difficulty of combining prevalence data from different
national, regional, racial and ethnic groups, especially in cases where inconsistent
definitions of cataract were adopted and a universally recognized standardisation was
lacking.
Similarly, in the largest developing country, China, few national-representative
investigations have been conducted to provide precise estimates of the prevalence of
cataract or cataract blindness in general Chinese population. Nevertheless, a growing
number of population-based studies on the epidemiology of cataract have been
conducted across the nation during the past decades, which have reported an overall
cataract prevalence of from less than 10% to more than 50% in various samples. The
substantial variations might largely come from the disparities of cataract definitions
(eg, with reduced visual acuity or not, different cut-offs for defining reduced visual
acuity), as well as the different characteristics of individual studies (eg, the age
structure of the investigated population and the geographic location of the study sites).
Until recently, no information has been compiled for the prevalence of cataract and
cataract blindness in China, and the magnitude of the national number of people with
cataract and cataract blindness in general Chinese population remains unclear. As
Chinese population is progressively ageing, an increasing burden of cataract and
cataract blindness is also expected. If nothing else alters, the corresponding increased
demand for cataract surgery will present new challenges for the Chinese health
system.
In view of uncertainties about the prevalence of cataract and cataract blindness
in China, we conducted a comprehensive systematic review, in both Chinese and
English databases, to retrieve all population-based studies that reported the prevalence
of cataract or cataract blindness in China from 1990 onwards. By using standardized
definitions of cataract and cataract blindness, we quantitatively summarised the
prevalence of cataract and cataract blindness in China. Furthermore, the geographic
patterns and secular trend of cataract/cataract blindness prevalence were also
examined to add insights to the public health domain, assisting both researchers and
policymakers to prioritize health care resources needed. The principal aims of this
study were: 1) to determine the prevalence and number of people affected by cataract
and cataract blindness at the national level from 1990 to 2015; 2) to project the
prevalence and number of people with cataract and cataract blindness at the national
level till 2050; and 3) to examine regional differences in the prevalence of cataract
and number of affected people from 2000 to 2010.