Cytokine Imprint in Preeclampsia

The hallmark of preeclampsia (PE) is a shift toward persistent inflammatory response, accompanied by endothelial dysfunction. The driving forces in PE are proinflammatory cytokine and growth factors, in parallel with reduced functionality of anti-inflammatory effectors, like regulatory T cells are observed. Unfortunately, no conclusive mechanism underlying preeclampsia has been identified. For this reason, research on preeclampsia is needed to provide a state of the art understanding of the pathophysiology, identification of new diagnostics tools and the development of targeted therapies. The 68 patients were divided into three groups: gestational hypertension (GH) group (n = 19) and PE group (n = 28) and a control group (n = 21). We have tested a set of 53 cytokines, chemokines and growth factors in preeclampsia and gestational hypertension, and then compared them with normal pregnancies. Using a diagnostic test assessment characteristic parameters (IL-22, MDC/CCL22, IL-2/IL-4 ratio) have been identified and cut-off values have been proposed to diagnose preeclampsia. All parameters had high negative or positive predictive values, above 80%. In conclusion, we have proposed a potential set of immune parameters to diagnose preeclampsia.

Diagnostic test assessment on protist misconception

One of the fatal problems emerge in educational practice is misconception as it is related to the students’ understanding. Consequently, these must be detected at the beginning of learning process. This research was conducted to construct and develop the specific diagnostic test to detect the misconception in protist material. The instrument consisted of, Evidence and Proof (EP), Structure Communication Grid (SCG), and essay. The instruments were analyzed to determine the validity, reliability, discriminatory power, and difficulty levels. As many as 351 students of grade X, XI, and XII were selected as the samples. The samples selected from three Public High Schools and three Private High Schools in Klaten Regency using stratified random sampling. The results showed that 93.10% of the columnar (EP) items, 100% of the SCG items, and 100% of the essay questions were valid; in which the all instruments were reliable. Based on discriminatory power analysis, of the three instruments developed, there was more than 50% of the items were classified as fair level. Whereas, the difficulty level of the instruments were balance. In general, the instruments can be accepted and used after revisions. These diagnostic test instruments can also be developed for another topic.

PENGEMBANGAN INSTRUMEN PENILAIAN TES DIAGNOSTIK PILIHAN GANDA DUA TINGKAT UNTUK MENGUKUR HASIL BELAJAR SISWA MATERI HIDROKARBON DI SMA 10 NEGERI PONTIANAK

ABSTRACT In general, the used evaluation form to measure the students’ abilities is evaluation form in multiple choice and essay, but this evaluation still has weaknesses which are there are possibilities that the students do not know the correct answer and it has low realibility. From the weaknesses, the researcher wanted to produce two levels multiple choice diagnostic test assessment instrument in order to find outthe passing of the students’ outcomes with 21 students for the first trial and 118 students for the main trial. This research consisted of 7 steps which were (1) Research and the collection of information, (2) Planning, (3) The development of introductory product, (4) Preliminary trial, (5) The revision on main product, (6) Field trial, and (7) The revision of product. The research result showed that the two levels multiple choice diagnostic test was feasible to be used. The test result from 118 students using the two levels multiple choice diagnostic test showed the validity value of Vainstrument was 3.97, the effectiveness value was 85.57 %, and the practical value was 78.80%. The obtained test result, before and after using the two levels multiple choice diagnostic test showed that there was improvement on students’ learning outcomes which was 59.3 %. Therefore, the two levels multiple choice diagnostic test can measure and improve the students’ learning outcomes.Keywords: Development, Two Levels Multiple Choice, Two Levels Multiple Choice DiagnosticTest

The Use of a Soft Gel Capsule as a Medium for Modified Barium Esophagogram in Detecting Esophageal Foreign Body

Objective: To test a soft gel capsule with barium sulfate as a medium for modified barium esophagogram in detecting esophageal foreign body. Methods: Study Design: Preliminary Diagnostic Test Assessment; Consecutive Convenience Sample Setting: Tertiary Government Hospital Participants, Patients or Population: Soft gel capsule with barium sulfate was pilot tested on patients with a history and diagnosis of radiolucent foreign body ingestion between June 1 and November 30, 2014. Results: Seven patients (6 males, 1 female; aged 26 – 61 years) underwent the procedure. In all seven, the enhanced capsule immediately stopped above the level of the esophageal foreign body, easily identifying the exact location of the obstruction. Foreign bodies included 1 embryonated duck-egg white “balut”, 5 chunks of pork meat and 1 claspless denture. All were successfully marked by the capsule on fluoroscopy and documented on X-ray. Esophagoscopy under general anesthesia was successfully performed after fluoroscopy in all patients. Conclusion: We were able to improvise a new medium for use in modified barium esophagograms that was easy to prepare and that rendered good radiographic imaging and localization of radiolucent foreign bodies. A randomized trial in comparison to the prevailing test may confirm our findings further. Meanwhile, we recommend exploring the procedure in other hospitals as an alternative to barium-soaked cotton in the diagnosis of radiolucent esophageal foreign bodies Keywords: soft gel capsule, barium suphate, esophagogram, esophageal foreign body

Evaluation of dengue fever reports during an epidemic, Colombia

OBJECTIVE To assess the validity of dengue fever reports and how they relate to the definition of case and severity. METHODS Diagnostic test assessment was conducted using cross-sectional sampling from a universe of 13,873 patients treated during the fifth epidemiological period in health institutions from 11 Colombian departments in 2013. The test under analyses was the reporting to the National Public Health Surveillance System, and the reference standard was the review of histories identified by active institutional search. We reviewed all histories of patients diagnosed with dengue fever, as well as a random sample of patients with febrile syndromes. The specificity and sensitivity of reports were estimated for this purpose, considering the inverse of the probability of being selected for weighting. The concordance between reporting and the findings of the active institutional search was calculated using Kappa statistics. RESULTS We included 4,359 febrile patients, and 31.7% were classified as compatible with dengue fever (17 with severe dengue fever; 461 with dengue fever and warning signs; 904 with dengue fever and no warning signs). The global sensitivity of reports was 13.2% (95%CI 10.9;15.4) and specificity was 98.4% (95%CI 97.9;98.9). Sensitivity varied according to severity: 12.1% (95%CI 9.3;14.8) for patients presenting dengue fever with no warning signs; 14.5% (95%CI 10.6;18.4) for those presenting dengue fever with warning signs, and 40.0% (95%CI 9.6;70.4) for those with severe dengue fever. Concordance between reporting and the findings of the active institutional search resulted in a Kappa of 10.1%. CONCLUSIONS Low concordance was observed between reporting and the review of clinical histories, which was associated with the low reporting of dengue fever compatible cases, especially milder cases.