Articles de revues : « Terapia CAR-T »

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Gómez-De León, Andrés, Dalila M. Alvarado-Navarro, Anna C. Rodríguez-Zúñiga et Edgar U. Coronado-Alejandro. « Perspectivas sobre la terapia CAR-T en México ». Revista Mexicana de Medicina Transfusional 14, S1 (2022) : s107–110. http://dx.doi.org/10.35366/107039.

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Souza, T. F., M. C. S. C. Ramos, M. P. M. Porthun, H. R. D. Santos, T. S. Band, V. E. F. Filho, F. T. H. Queiroz et P. H. S. Lopes. « TERAPIA CAR-T NO TRATAMENTO DO MIELOMA MÚLTIPLO ». Hematology, Transfusion and Cell Therapy 42 (novembre 2020) : 424. http://dx.doi.org/10.1016/j.htct.2020.10.713.

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De Almeida, Anne Vitória Nogueira. « MODIFICAÇÃO PROGNÓSTICA DE CÂNCERES HEMATOLÓGICOS ATRAVÉS DO TRATAMENTO COM CÉLULAS CAR-T ». Brazilian Journal of Case Reports 2, Suppl.6 (1 décembre 2022) : 26. http://dx.doi.org/10.52600/2763-583x.bjcr.2022.2.suppl.6.26.

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Introdução: A imunoterapia contra o câncer fundamentada no uso do receptor de antígeno quimérico CAR-T reflete uma nova perspectiva para a cura e melhora clínica de múltiplos tumores malignos, especialmente neoplasias hematológicas. Objetivos: Elucidar a influência que a terapia com células CAR-T pode acarretar no prognóstico de cânceres hematológicos. Metodologia: Trata-se de uma revisão de literatura, onde para a seleção de artigos realizou-se pesquisas a partir das bases de dados US National Library of Medicine/Medical Literature Online (PUBMED/MEDLINE) e Literatura Latino-Americana e do Caribe de Informação em Ciências da Saúde (LILACS), entre os anos de 2021 e 2022, utilizando os descritores: Terapia CAR com células T, hematologia, prognóstico e evolução clínica. Revisão de Literatura: Apesar de inúmeros avanços em imunoterapia, a mortalidade por doença neoplásica hematológica ainda é relevante, sendo a maioria dos óbitos relacionados à refratariedade da doença. O primeiro produto comercial de células CAR-T foi aprovado pela agência regulatória norte-americana Food and Drug Administration (FDA) em 2017 e desde então busca-se melhores resultados prognósticos. O que se sabe é que remissões prolongadas foram observadas em subgrupos específicos de pacientes acometidos por Linfoma não Hodgkin (LNH), Leucemia Linfocítica Aguda de células B recidivante e/ou refratária (LLA-B/RR) e mieloma múltiplo (MM). Estudos pré-clínicos indicaram sinergia potencial entre o tratamento radioterápico e a terapia com células CAR-T, apontando que combinações terapêuticas podem aumentar a imunidade específica contra o tumor e consequentemente, interferir de forma positiva no prognóstico. No entanto, terapias com células CAR-T exigem uma estrutura complexa para desenvolvimento, sendo seu principal problema, o alto custo. Conclusão: A terapia com células CAR-T demonstrou respostas nunca antes alcançadas na oncologia devido sua atividade antitumoral direta, tornando-se uma estratégia ímpar de tratamento remissivo e curativo para pacientes com cânceres hematológicos avançados. No entanto, para maior cobertura clínica com tal terapêutica, faz-se necessário estudos que visem a redução de custos em sua produção.

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Burgaleta Alonso de Ozalla, Carmen. « Visión actual de la terapia con células CAR-T ». Revista de Investigación y Educación en Ciencias de la Salud (RIECS) 7, n^o 1 (30 mai 2022) : 83–90. http://dx.doi.org/10.37536/riecs.2022.7.1.312.

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La terapia con células T portadoras de antígeno quimérico (CAR), es una forma de inmunoterapia adoptiva para neoplasias. Los resultados obtenidos con formas refractarias de Leucemia Aguda Linfoblástica (LLA) y Linfoma no Hodgkin han permitido confirmar esta modalidad terapéutica en neoplasias hematológicas mediante CAR dirigidas al CD19 y se prevé la ampliación de su uso tanto en onco-hematología como en tumores sólidos con el desarrollo de nuevos CAR. Las limitaciones del tratamiento son la toxicidad asociada a un síndrome de liberación de citoquinas y neurotoxicidad y la limitación de la duración de la respuesta. En la actualidad se está a la búsqueda de estrategias que mejoren los resultados actuales, disminuyendo las complicaciones y prolongando la duración de SLE.

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Vázquez Rodríguez, Adrián, et Jorge Flavio Mendoza-Rincón. « Células asesinas naturales con el receptor de antígeno quimérico (CAR-NK) ». Nova 19, n^o 37 (23 décembre 2021) : 11–24. http://dx.doi.org/10.22490/24629448.5472.

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Una de las herramientas más novedosas en inmunoterapias adoptivas contra leucemias y tumores malignos es el uso del receptor de antígeno quimérico “CAR”. El receptor CAR ha sido ampliamente utilizada en células T (células CAR-T) potenciando su eficacia en el reconocimiento y eliminación de tumores, obteniéndose a la fecha terapias basadas en esta tecnología. No obstante, las células CAR-T llegan a repercutir negativamente en la salud del paciente, presentando el síndrome neurológico de efecto inmune asociado a células (ICANS) y el síndrome de lanzamiento de citocinas (SLC). Como consecuencia, el paciente necesita ser hospitalizado durante la terapia. Además, el coste de manufactura y terapia es elevado, siendo una tecnología limitada a un sector muy bajo de la población. En este trabajo, mencionamos el empleo de una terapia emergente de células asesinas naturales (NK) con el receptor CAR (CAR-NK), que cuentan con muchas ventajas por encima de las células CAR-T. Las células CAR-NK conservan su capacidad citotóxica en contra de tumores gracias a su acción dependiente de receptores activadores e inhibidores, por lo que el receptor CAR, solo estimula sus habilidades y persistencia. Sumado a esto, el coste de una terapia de células CAR-NK podría resultar redituable debido a la capacidad de las células CAR-NK de eliminar múltiples células tumorales sin generar daño colateral en el paciente. Aquí analizamos las características de los múltiples receptores CAR y los fenotipos de células NK que han sido utilizados durante múltiples ensayos (NK-92, células NK de sangre cordal y periférica, y células NK iPSC).

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Zaragoza García, Francisco. « El Plan Profarma y las células CAR-T ». Revista de Investigación y Educación en Ciencias de la Salud (RIECS) 5, n^o 2 (30 novembre 2020) : 116–21. http://dx.doi.org/10.37536/riecs.2020.5.2.233.

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El Plan Profarma fue diseñado fundamentalmente por los Ministerios de Industria y de Sanidad y tiene como objetivo incentivar a la industria farmacéutica establecida en España, tanto nacional como multinacional, con el fin de que las compañías farmacéuticas realicen investigación en materia de medicamentos y sean competitivas. Esta I+D puede ser realizada de forma contratada con organismos públicos o privados, como las universidades, lo que brinda unas excelentes posibilidades a los grupos de investigación. Las células CAR-T constituyen una auténtica revolución en terapia cancerosa, por sus excelentes resultados. Una parte de los estudios conducentes a su autorización, fueron presentados para la evaluación de las empresas fabricantes en el Plan Profarma. Eventualmente, los fármacos que se utilizan para contrarrestar sus efectos adversos, son unos buenos candidatos en terapia anti-COVID-19.

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Kierasińska, Amelia, Damian Ciunowicz, Marta Węgierska, Ewelina Stoczyńska-Fidelus et Piotr Rieske. « CAR-T therapy in oncology and other fields of medicine ». Alergologia Polska - Polish Journal of Allergology 8, n^o 2 (2021) : 77–91. http://dx.doi.org/10.5114/pja.2021.106685.

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Souza, Vinícius Gonçalves, Bianca Dantas Vieira, Lucas Ribeiro Tavares, Mariana Severo Takatsu, Nátaly Caroline Silva Souza, Paula Fernanda Freitas Lima, Taís Coelho de Moraes Ponte et Ludimila Paula Vaz Cardoso. « Terapia genética com células CAR-T para leucemia linfocítica aguda ». Brazilian Journal of Health Review 3, n^o 3 (2020) : 5982–85. http://dx.doi.org/10.34119/bjhrv3n3-156.

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Karwicka, Katarzyna, Joanna Wawer, Olga Czabak, Janusz Kocki et Marek Hus. « Innowacyjna terapia CAR-T w leczeniu nowotworów hematologicznych — wybrane aspekty genetyczne i immunologiczne ». Hematologia 11, n^o 3 (27 décembre 2020) : 166–82. http://dx.doi.org/10.5603/hem.a2020.0025.

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Souza, Karolayne Silva, Milena Roberta Freire da Silva, Flávia Steffany Leite Miranda, Kaleen Massari Leite, Jaqueline dos Santos Silva, Rute Medeiros de Sousa, Leandro Paes de Brito et al. « Imunoterapia dirigida com células T-CAR para tratamento de leucemia linfoide aguda ». Research, Society and Development 9, n^o 11 (2 décembre 2020) : e72891110372. http://dx.doi.org/10.33448/rsd-v9i11.10372.

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Introdução: A imunoterapia com células T-CAR tem sido utilizada como um método alternativo de tratamento da Leucemia Linfóide Aguda (LLA). A LLA é uma patologia na qual há o aumento exacerbado de células jovens imaturas, visto que seus precursores celulares mais afetados são as células T e, na maioria das vezes, células B. O objetivo deste artigo foi explanar sobre a técnica de imunoterapia com células T-CAR, assim como o seu funcionamento. Metodologia: Trata-se de uma revisão bibliográfica de abordagem qualitativa do tipo exploratória, dos quais, foram realizadas buscas nas principais bases eletrônicas nacionais e internacionais: Pubmed, Eletronic Library On-line (SCIELO) Biblioteca virtual de saúde (Bvs), Cell, Science, Nature e Scholar Google no período de 2007 a 2018. Resultados: A LLA é uma patologia que acomete a produção de células sanguíneas como eritrócitos, megacariócitos e granulócitos, isso se deve devido à propagação elevada de blastos na medula óssea. Esta doença tem como tratamento convencional principalmente a quimioterapia e a radioterapia, como também o transplante de células tronco, entretanto esses métodos podem vir a causar diversas complicações ao paciente. A terapia com células T-CAR tem como alvo a destruição de células B do indivíduo, através do reconhecimento de antígenos específicos dessas células (CD19). Conclusão: O tratamento com as células T-CAR demonstra efeitos adversos de baixa gravidade comparado às terapias convencionais (quimioterapia e radioterapia). Portanto, essa imunoterapia pode favorecer no futuro um elevado número de pacientes no combate não apenas a LLA, mas também a diversas outras doenças.

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Wills Sanín, Beatriz, et Alexandra Gómez Arteaga. « Historia del tratamiento de las neoplasias hematolinfoides desde la quimioterapia al trasplante y terapia celular ». Medicina 43, n^o 1 (20 avril 2021) : 160–75. http://dx.doi.org/10.56050/01205498.1592.

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Algunos de los avances más importantes en el campo de la hematología maligna incluyen el desarrollo de la quimioterapia, el trasplante de médula ósea y la introducción de la terapia celular. En conjunto, estas terapias han mejorado significativamente el pronóstico de pacientes con enfermedades hematolinfoides. Inicialmente el trasplante de células madre hematopoyéticas (TCMH) fue recibido con una mezcla de escepticismo, entusiasmo y decepciones. Inicialmente fue necesario superar distintas barreras, incluyendo las diferencias inherentes entre la inmunología de animales y humanos, el rechazo del injerto y la enfermedad de injerto contra huésped (EICH). Los desenlaces médicos y las altas tasas de mortalidad por recaída en los primeros trasplantes frenaron, en primera instancia, la investigación del TCMH. Sin embargo, gracias a la determinación de diferentes pioneros, el TCMH pasó de ser una opción experimental con disponibilidad limitada a ser una terapia que hoy en día beneficia aproximadamente 50.000 pacientes anualmente con distintos desórdenes hematológicos que de otro modo serían fatales. En la actualidad el TCMH tiene una variedad de aplicaciones médicas más allá de las neoplasias hematológicas, incluyendo síndromes de falla medular, tratamiento de tumores sólidos, hemoglobinopatías, enfermedades autoinmunes, trastornos hereditarios del metabolismo e incluso enfermedades infecciosas como el virus de inmunodeficiencia humano (VIH)(1). Además la terapia celular, específicamente las células T con receptores de antígeno quimérico (CAR- T) es uno de los avances más importantes del tratamiento de las enfermedades neoplásicas hematológica. Este artículo revisará la perspectiva histórica del tratamiento de las neoplasias hematolinfoides desde la quimioterapia, TCMH y la terapia celular.

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Vergara, B., B. Herrero et L. Madero. « Anti-CD19 CAR-T cell theraphy in pediatric patients with relapsed/refractory acute lymphoblastic leukemia. Experience at Hospital Infantil Universitario Niño Jesús ». ANALES RANM 138, n^o 138(02) (31 août 2021) : 157–67. http://dx.doi.org/10.32440/ar.2021.138.02.rev07.

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Acute lymphoblastic leukemia (ALL) continues to be the most frequent neoplasm in childhood, with a 5-year survival rate ranging from 78 to 91%. The increase in the survival rate in the last 40 years has been 30 to 80%, with no comparable improvement in the case of relapsed or refractory ALL. It is for this very reason that there is currently research into innovative treatments, such as CAR-T cell therapy. This treatment involves the ex vivo genetic modification of the patient’s own T cells, enhancing their specificity and cytotoxicity against antigens present in the majority of blasts, such as CD19. In clinical trials carried out worldwide, positive results have been obtained in patients with refractory or relapsed ALL treated with CAR-T 19 therapy, with disease-free survival at one year in up to 50% of patients, and overall survival at one year of 76%. The first published report in Spain with respect to this treatment reproduces the results obtained in clinical trials. The results were reported in HNJS in 2020 involving 8 patients treated with CAR-T 19. Complete remission was observed in 87.5% of patients one month after infusion followed by an overall survival of 75% at the time of analysis (7.6 months mean follow-up duration across all the patients). To date, the most frequent side effects described with the use of this therapy in the short term are cytokine release syndrome and neurotoxicity. This innovative therapy, therefore, represents a paradigm shift in the survival of pediatric patients with relapsed or refractory ALL. Further studies and evidence of its effectiveness and the long-term follow-up of patients treated with this therapy are still needed, but the results to date are encouraging.

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Zanella, C., VO Camandoni, M. Lemos, PM Melo, RC Cezar et ICR Machado. « ESTRUTURAÇÃO DO CENTRO DE PROCESSAMENTO CELULAR DO HOSPITAL AC CAMARGO CANCER CENTER PARA IMPLANTAÇÃO DA TERAPIA CAR-T. » Hematology, Transfusion and Cell Therapy 44 (octobre 2022) : S300. http://dx.doi.org/10.1016/j.htct.2022.09.508.

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Catalá, Eva, Gloria Iacoboni et Pere Barba. « Terapia con linfocitos T con receptor de antígeno quimérico (CAR-T) en pacientes con linfoma de célula B agresivo. Perspectiva actual tras una década de tratamiento ». Medicina Clínica 158, n^o 7 (avril 2022) : 327–32. http://dx.doi.org/10.1016/j.medcli.2021.10.005.

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Maiolino, Angelo, Luciano J. Costa, Marcelo Pasquini, Edvan de Queiroz Crusoe, Afonso Celso Vigorito, Marco Aurélio Salvino, Fernanda Salles Seguro, Jayr Schmidt Filho et Vania Tietsche de Moraes Hungria. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. IV : CAR-T cell therapy for multiple myeloma patients ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S30—S34. http://dx.doi.org/10.1016/j.htct.2021.09.004.

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Picanço-Castro, Virginia, Martín Hernan Bonamino, Rodrigo Nalio Ramos, Renato L. Guerino-Cunha, Theo Gremen M. Oliveira et Eduardo M. Rego. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. VIII : CAR-T cells : preclinical development - Safety and efficacy evaluation ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S54—S63. http://dx.doi.org/10.1016/j.htct.2021.09.008.

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De Santis, Gil Cunha. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. Special article : compassionate use and clinical trial on CAR-T cells ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S64—S67. http://dx.doi.org/10.1016/j.htct.2021.09.009.

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Seber, Adriana, Claudio Galvão de Castro Junior, Lucila N. Kerbauy, Alexandre V. Hirayama, Carmem Bonfim, Juliana Folloni Fernandes, Mair Souza et al. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. II : CAR-T cell therapy for patients with CD19+ acute lymphoblastic leukemia ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S13—S21. http://dx.doi.org/10.1016/j.htct.2021.09.002.

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Alencar, Alvaro J., Alexandre V. Hirayama, Diego V. Clé, Marco Aurélio Salvino, Guilherme Perini, Celso Arrais, Otávio Baiocchi et al. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. III : anti-CD19 CAR-T cell therapy for patients with non-Hodgkin lymphoma ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S22—S29. http://dx.doi.org/10.1016/j.htct.2021.09.003.

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Clé, Diego V., Alexandre V. Hirayama, Alvaro J. Alencar, Luciano J. Costa, João V. P. Feliciano, Ederson R. Mattos, Ana C. Cordeiro et al. « Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular Consensus on genetically modified cells. I : Structuring centers for the multidisciplinary clinical administration and management of CAR-T cell therapy patients ». Hematology, Transfusion and Cell Therapy 43 (novembre 2021) : S3—S12. http://dx.doi.org/10.1016/j.htct.2021.09.001.

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Coimbra, Shirlene Aparecida Lopes. « A inﬂuência da equoterapia no equilíbrio estático e dinâmico : apresentação de caso clínico de encefalopatia não progressiva crônica do tipo diparético espástico ». Fisioterapia Brasil 7, n^o 5 (20 mars 2018) : 391. http://dx.doi.org/10.33233/fb.v7i5.1938.

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A proposta deste estudo consiste em uma análise da interferência da Equoterapia no equilíbrio estático e dinâmico em um paciente portador de Encefalopatia Não Progressiva Crônica (ENPC) do tipo diparético espástico com 5 anos de idade. Para a análise em questão, foram utilizadas duas escalas de avaliação, a Gross Motor Function Measure (GMFM) e a de Tinetti, totalizando 15 sessões de terapia com duração de 60 minutos (30 minutos a cavalo e 30 minutos para avaliação pré e pós-atendimentos). Findo o período de estudo, houve considerável diminuição da disfunção motora grossa do praticante em todos os itens, principalmente no item D (ﬁ car em pé), com aumento de 23,08% em relação ao escore inicial. Não houve, porém, alteração no item A (deitar e rolar). Nas análises semanais através da escala de Tinetti (pré e pós-montaria), onde foi utilizado o teste T-Student, os resultados obtidos apresentaram médias signiﬁ cativas para o estudo, no valor de 4,4, sendo p < 0,05. Os dados coletados permitem concluir que uma sessão semanal de 30 minutos com o animal a passo inﬂ uencia positivamente o equilíbrio estático e dinâmico da criança, aprimorando, desta forma, suas habilidades motoras e contribuindo para o prognóstico de marcha. Palavras-chave: encefalopatia, equoterapia, equilíbrio, cavalo, paralisia cerebral

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Čemusová, B. « Cytokine release syndrome after CAR T-cell therapy : a review of the literature and our experience ». Anesteziologie a intenzivní medicína 33, n^o 2 (12 mai 2022) : 90–96. http://dx.doi.org/10.36290/aim.2022.013.

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Rodríguez Quezada, Federico. « Terapias novedosas : CAR-T aspectos prácticos y aplicación clínica ». Revista Mexicana de Medicina Transfusional 14, S1 (2022) : s43–46. http://dx.doi.org/10.35366/107020.

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Kwiatkowska, Jowita, Piotr Wawrzyniak et Agnieszka Knopik-Skrocka. « CAR-T cell i nanotechnologia – najnowsze narzędzia terapii przeciwnowotworowej ». Tutoring Gedanensis 6, n^o 3 (1 décembre 2021) : 42–54. http://dx.doi.org/10.26881/tutg.2021.3.04.

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Rajčević, Uroš. « Adoptivna celična terapija in limfociti T z izraženimi himernimi antigenskimi receptorji ». Slovenian Medical Journal 89, n^o 7-8 (7 septembre 2020) : 398–407. http://dx.doi.org/10.6016/zdravvestn.3006.

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Pri zdravljenju raka se trenutno uporabljajo pristopi kirurškega zdravljenja, radio- in kemoterapije ter različne kombinacije teh pristopov. Kot 'četrti steber' onkološkega zdravljenja se razvija imunoterapija. Revija Science je imunoterapijo raka že leta 2013 razglasila za 'preboj leta'. Terapije s protitelesi in citokini se uporabljajo že dlje, celična imunoterapija pa pridobiva na pomenu šele v zadnjih letih, še posebej po zaslugi adoptivne T-celične terapije (ATC). Terapije z adoptivnimi limfociti T, kar obravnava prispevek, delimo predvsem na terapije s tumor infiltrirajočimi limfociti (TIL) in terapije z limfociti T, ki so gensko spremenjeni bodisi s transgenimi T-limfocitnimi receptorji (angl. T-cell receptor, TCR) ali pa s himernimi antigenskimi receptorji (CAR). Vse te terapije so izrazito personalizirane in trenutno temeljijo na presaditvi avtolognih, t.j. bolnikovih lastnih celic. Terapevtiki se pripravijo za vsakega bolnika posebej, kar zelo vpliva na procese razvoja in izdelave ter tako na logistiko in stroške, ki so povezani s tem. Nov način terapij s CAR-T, ki je za določene bolezni trenutno tudi edini registrirani način ATC, povzroča revolucionarne premike pri razvoju takih naprednih terapevtikov, s tem pa tudi v klinični onkologiji. Terapija s CAR-T dosega izredne uspehe v klinični praksi zlasti v boju proti hematološkim oblikam raka, medtem ko pri zdravljenju bolnikov s solidnimi tumorji še ne. Hkrati pa zaradi velike kompleksnosti terapije težavo pri zdravljenju s CAR-T povzročajo pogosti, težki stranski učinki, ki lahko vodijo tudi v bolnikovo smrt. Z ustreznimi ukrepi lahko stranske učinke nadzorujemo in delno ublažimo. Terapija s CAR-T vstopa v Slovenijo s komercialno dostopnimi terapevtiki te vrste, na možnost ostalih adoptivnih celičnih terapij pa bo potrebno še počakati. V Sloveniji pa na tem področju razvijamo tudi lastno znanje in tehnologijo, zato upamo, da bodo novi učinkoviti načini zdravljenja čim prej dostopni čim širšemu krogu bolnikov.

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Habibi, Ali, Siti Zulaikha Risqiyani et Dwi Ari Santi Putri. « Potensi Chimeric Antigen Receptor T Cell (CAR-T Cell) dengan Target Prostate-Specific Membrane Antigen (PSMA) Termodifikasi CRISPR/Cas9 sebagai Terapi Kanker Prostat ». JIMKI : Jurnal Ilmiah Mahasiswa Kedokteran Indonesia 9, n^o 1 (12 juillet 2021) : 23–37. http://dx.doi.org/10.53366/jimki.v9i1.321.

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ABSTRAK Pendahuluan : Kanker prostat merupakan keganasan sel-sel prostat yang menjadi salah satu keganasan tersering pada pria dengan prevalensi 137,9 kasus baru per 100.000 pria tiap tahunnya. Salah satu pekerjaan yang memiliki risiko tinggi terhadap kejadian kanker prostat adalah petani, karena diakibatkan pajanan pestisida dan zat berbahaya lainnya. Saat ini, Androgen Deprivation Therapy (ADT) masih menjadi terapi yang banyak digunakan. Namun, ADT dapat menurunkan libido, impotensi, hot flashes, dan peningkatan risiko patah tulang. Karena beberapa kelemahan dari terapi ADT, maka diperlukan inovasi terapi untuk kanker prostat. Metode : PRISMA yang didasarkan fakta-fakta dan pengambilan data secara random dengan memasukan kata kunci yang telah ditentukan. Dari 94 jurnal yang telah ditelaah, 64 jurnal diantaranya dianggap sesuai dengan topik bahasan dan digunakan sebagai referensi. Hasil dan Pembahasan : CAR-T Cell termodifikasi CRISPR/Cas9 diinjeksikan ke mencit terbukti efisien dan efektif meningkatkan fungsi CAR-T Cell. Mekanisme imunosupresif yang diakibatkan oleh ikatan PD-1 dengan PD-L1 dapat dituntaskan dengan menggunakan metode CRISPR/Cas9-mediated anti PD-1, sehingga yang dapat mempertahankan aktivasi CAR-T Cell. Dibuktikan dengan peningkatan degranulasi CAR-T Cell dan clearance tumor pada uji in vivo. Kesimpulan : Chimeric Antigen Receptor T Cell (CAR-T Cell) dengan target Prostate-Specific Membrane Antigen (PSMA) termodifikasi CRISPR/Cas9 berpotensi sebagai inovasi terapi yang efektif pada kanker prostat.

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Hermansyah, Imam, et Eddy Zulfikar. « CAR-T-ICI : Kombinasi chimeric antigen receptor T-cell dengan immune checkpoint inhibitor anti PD-1 selaku pilihan terapi terbaru kanker kolorektal ». JIMKI : Jurnal Ilmiah Mahasiswa Kedokteran Indonesia 9, n^o 1 (12 juillet 2021) : 56–68. http://dx.doi.org/10.53366/jimki.v9i1.339.

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ABSTRAK Pendahuluan: Kanker kolorektal selaku keganasan ketiga tersering di dunia umumnya ditangani dengan operasi, radioterapi, maupun kemoterapi berdasarkan stadium penyakitnya. Namun, akibat prosedur invasif dan efek samping yang ditimbulkan oleh terapi tersebut, Chimeric Antigen Receptor (CAR) T-cell hadir sebagai pilihan terapi terbaru yang bersifat lebih spesifik terhadap sel tumor. Efektivitas CAR T-cell untuk mengobati tumor padat masih terbatas oleh karena molekul imun inhibitorik, Programmed Cell Death-1 (PD-1) yang memiliki efek imunosupresif terhadap sel T. Oleh karena itu, penyusunan literature review ini bertujuan untuk mengkaji potensi terapi kombinasi imunoterapi CAR-T cell dengan anti PD-1 dalam pengobatan kanker kolorektal stadium lanjut. Metode: Literature review ini disusun menggunakan metode studi pustaka dengan strategi pencarian jurnal ilmiah PubMed yang kemudian dianalisis secara sistematis. Pembahasan: Berdasarkan studi sebelumnya, ekspresi EpCAM dalam jumlah tinggi ditemukan pada sel kanker kolorektal. Sekresi IFN-γ dan TNF-α dalam jumlah yang tinggi ditemukan pada sel tumor EpCAM positif menunjukkan bahwa EpCAM-CAR-T cell memiliki efek sitotoksik spesifik terhadap sel tumor target. Rata-rata volume tumor kolorektal pada kelompok EpCAM CAR-T cell lebih rendah dibanding kontrol, menunjukkan EpCAM-CAR-T cell mampu menghambat pembentukan dan pertumbuhan sel tumor. Di sisi lain, 35,8% pasien kanker kolorektal metastasis diketahui memiliki objective response rate dan 73,6% diantaranya tercatat memiliki disease control rate ≥12 minggu setelah terapi anti PD-1 nivolumab, menunjukkan efektivitas nivolumab dalam pengendalian penyakit jangka panjang dengan masa survival yang lebih lama pada pasien kanker kolorektal metastasis. Simpulan: Kombinasi imunoterapi EpCAM CAR-T cell dengan anti PD-1 memiliki potensi sebagai pengobatan terbaru yang efektif untuk kanker kolorektal stadium lanjut. Kata kunci: Anti PD-1, CAR-T cell, imunoterapi, kanker kolorektal

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Martyniak, Ewa, Julia Wyszomirska, Marek Krzystanek, Katarzyna Piekarska-Bugiel et Aleksander Stolarczyk. « Can`t get enough. Addiction to physical exercises : phenomenon, diagnostic criteria, etiology, therapy and research challenges. » Psychiatria Polska 55, n^o 6 (31 décembre 2021) : 1357–72. http://dx.doi.org/10.12740/pp/127499.

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Khoiruddin, Muhammad AH, Yusi Windya Febriyanti et Nafia Amalia. « POTENSI SEL T MOBIL HER2 SPESIFIK MODIFIKASI CRISPR / CAS9 PD-1 / PD-L1 PEMBLOKIRAN SEBAGAI INOVASI TERAPI UVEAL MELANOMA ». Al-Iqra Medical Journal : Jurnal Berkala Ilmiah Kedokteran 2, n^o 1 (17 novembre 2019) : 01–11. http://dx.doi.org/10.26618/aimj.v3i1.2745.

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Uveal Melanoma (UM) is the primary intraocular tumor most commonly found in adults. The combination of therapy, Brachytherapy, surgery, Tranpupillary Thermal Therapy (TTT), Proton Beam Theraphy has not produced satisfactory results. The discovery of HER2 receptors expressed by UM cells can be used as a specific antigen target for the treatment of CAR T-celss. However, the effectiveness of CAR T-cell immunotherapy in tumors results in immunosuppressive T cells caused by an increase in Programmed cell Death Ligand-1 (PD-L1). This literature review demonstrates the success of HER2-specific CART T Cells as UM therapeutic efforts capable of eliminating tumor cells. In addition, CRSPR / Cas9 PD-1 / PD-L1-blocking modified HER2-specific CAR T cells can be a gene innovation in UM sufferers. Further clinical trials are needed to prove the effectiveness of CRISPR / Cas9 PD-1 / PD-L1-Blocking modified HER2-specific CAR T Cells in the treatment of UM patients.Keywords: Uveal melanoma, CAR T cell, reseptor HER

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Padilha, Marcos Daniel Mendes, Sérgio Augusto Antunes Ramos, Alice Carters Duarte, Raissa Melo de Sousa, Oscar David Albito Balcazar, Camila Lorena Rodrigues Machado, Clebson Pantoja Pimentel, Kelly Emi Hirai, Gleyciane Machado da Costa et Gustavo Moraes Holanda. « Imunomodulação de células cancerosas por imunoterapias CAR-T, mAbs, CTLA-4 e neoantígenos direcionados ». Revista Eletrônica Acervo Saúde 15, n^o 3 (24 mars 2022) : e9959. http://dx.doi.org/10.25248/reas.e9959.2022.

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Objetivo: Elucidar o perfil imunomodulador e farmacocinético de terapias com CAR-T, CTLA-4, mAbs com adjuvantes e combinadas para uso clínico em células humanas. Métodos: Trata-se de um estudo de revisão integrativa com análise sistemática, as bases de dados consultadas foram o NCBI, BVS, Scielo, Pubmed, Periódicos Capes e LILACS. 162 artigos foram identificados e apenas 37 selecionados para a revisão, as palavras chaves foram padronizadas de acordo com os Descritores em Ciências da Saúde (DeCs) e os artigos categorizados na íntegra. Resultados: Os achados reforçam o perfil molecular de CAR-T como alternativas para depleção de células cancerosas, mAbs são estratégias que já possuem uso clínico e aprovado, potencializando sua combinação com CTLA-4 responsivo a ativação gênica gerou respostas anticancerosas mais robustas. Neoantígenos são estratégias promissoras e possuem capacidade de modular respostas específicas para células T e podem ser utilizados como futuros alvos para produção de vacinas anticâncer. Considerações finais: As estratégias atuais de imunoterapia estão potencializando uma cura para o câncer, entretanto outros mecanismos precisam ser mais investigados como no caso de tumores sólidos o que torna uma limitação.

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Ribera, Josep-Maria, Mireia Morgades, Rosa Coll, Jose Luis Lopez Lorenzo, Pau Montesinos, Rosario Varela, Mónica Cabrero et al. « Frequency, Clinical Characteristics and Outcome of Adult Patients with Acute Lymphoblastic Leukemia (ALL) and COVID-19 in Spain : Results of a Survey from Pethema and Geth Groups ». Blood 136, Supplement 1 (5 novembre 2020) : 19. http://dx.doi.org/10.1182/blood-2020-134296.

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Introduction and objective. SARS-CoV-2 pandemic has deeply impacted in Spain. In cancer patients (pts) the lethality has been higher than in normal population, but, little is known on the impact in adults with ALL. Our objective was to analyze the frequency, clinical characteristics and outcome of adult ALL patients infected by SARS-CoV-2. Methods. Between March 1, 2020 and May 31, 2020 (the period of the peak of COVID-19 infection in Spain) two registries from the PETHEMA (Programa Español de Tratamientos en Hematologia) and GETH (Grupo Español de Trasplante Hematopoyético y Terapia Celular) groups were activated to recruit adult patients with ALL and COVID-19 infection confirmed by PCR. The PETHEMA registry was based on ASH proposal (www.ashresearchcollaborative.org/covid-19-registry) and the GETH registry was specifically performed for hematological diseases and COVID-19 infection. Both registries were merged for this study. Eighty-four Spanish centers were contacted and weekly reminds were sent until May 19, 2020. The demographic and clinical characteristics of ALL and COVID-19 infection, the comorbidities, the treatment and outcome were collected. The study was closed for follow in July 10, 2020. Results. Fifty-six of 84 centers answered the survey and 28 patients with ALL and COVID-19 infection were identified in 17 of them, especially on March (n=11) and April (n=15). Median age was 46 (range 20-78) yrs. and 19 were aged over 40 yrs. Fifteen pts were male, 1 was active smoker and 9 showed one or more comorbidities (chronic liver disease [n=2] diabetes [n=1], hypertension [n=5], cardiopathy [n=2], prior malignancy [n=1] and hypogammaglobulinemia [n=1]). ALL was of B-cell precursors in 18 pts (Ph+ in 6) and T in 10. Twenty-six pts were on treatment of LAL (induction [n=10], consolidation [n=3], maintenance [n=1], HSCT [n=5], rescue [n=6], and palliative [n=1]). Eight patients were previously submitted to allogeneic HSCT, CAR T [n=1] or immunotherapy with monoclonal antibodies (inotuzumab, n=4) and 21 were receiving immunosuppressive drugs (corticosteroids in 11, fludarabine in 4, among others). Eleven pts showed neutropenia <0.5x109/L and 18 lymphocytopenia <0.5x109/L. Median value of C reactive protein was 28.7 mg/L (0.9-311.7) and D-dimer 690 ng/mL (120-31,200). The main clinical characteristics of COVID-19 infection were: fever (n=18), cough (n=16), shortness of breath (n=9) and asthenia (n=11) and 5 pts were asymptomatic. The most frequency therapies were hydroxychloroquine/chloroquine (n=23), combined or not with lopinavir/ritonavir. Tocilizumab was given to 8 pts. Twelve pts required oxygen supply and 7 required ICU support (median stay 16 [1-47] days). COVID-19 was solved in 18 pts, although 5 pts showed PCR+ persistence (median 25 [16-91] days) after resolution of symptoms. The treatment of ALL was stopped/modified in 11 pts. Nine pts dead (COVID-19 [n=6], COVID-19 and ALL progression [n=2] and COVID-19 andPseudomonassepsis [n=1]). A trend for higher mortality was observed in patients with neutropenia <0.5x109/L and in those with lymphocytopenia <0.5x109/L. Conclusion. The frequency of adult patients with ALL and COVID-19 infection can be considered high, given the low incidence of adult ALL. COVID-19 infection was frequent in patients with advanced age and on ALL therapy. The frequency of severe COVID-19 infection and the mortality were high. Supported in part by 2017 SGR288 (GRC) Generalitat de Catalunya and "la Caixa" Foundation. Disclosures Ribera: Pfizer, Amgen, Ariad, Novartis:Consultancy, Speakers Bureau;Pfizer, Amgen:Research Funding.Barba:Amgen, Celgene, Novartis, Pfizer:Speakers Bureau;Amgen, Celgene, Gilead, Jazz Pharmaceuticals, Novartis, Pfizer, Shire:Consultancy.

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Savitri, Wenny, Nani Fidayanti et Paulus Subiyanto. « TERAPI MUSIK DAN TINGKAT KECEMASAN PASIEN PREOPERASI ». MEDIA ILMU KESEHATAN 5, n^o 1 (9 novembre 2019) : 1–6. http://dx.doi.org/10.30989/mik.v5i1.138.

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Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= -1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: Anxiety, preoperative, music therapy

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Savitri, Wenny, Nani Fidayanti et Paulus Subiyanto. « TERAPI MUSIK DAN TINGKAT KECEMASAN PASIEN PREOPERASI ». Media Ilmu Kesehatan 5, n^o 1 (4 avril 2016) : 1–6. http://dx.doi.org/10.30989/mik.v5i1.44.

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Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= - 1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: anxiety, preoperative, music therapy

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Susanti, Dewi, et Mohamad Hasinuddin. « Perbedaan Kecemasan Ibu Hamil Trimester III yang Diberi Terapi Musik Mozart dan Terapi Murrotal Al-Qur’an ». SAKTI BIDADARI (Satuan Bakti Bidan Untuk Negeri) 4, n^o 2 (13 septembre 2021) : 37–44. http://dx.doi.org/10.31102/bidadari.2021.4.2.37-44.

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Anxiety is a natural disorder of feeling characterized by a feeling of deep and sustained fear or concern. The results of preliminary studies that had been done in Polindes Pademawu Timur, there were 10 pregnant women experience anxiety. The purpose of this study was to analyze the differences between Mozart and murottal Al-qur'an music on the anxiety of pregnant women in the third trimester in the face of labor. This research used quasy experiment design. This design used a pretest and posttest design approach. The independent variables were mozart music therapy and murottal therapy of the Qur'an. The dependent variable was anxiety. The population is the third trimester pregnant women who got experience anxiety. The sample was taken as many as 18 pregnant women who were divided into mozart music therapy group and murottal Al-Qur'an therapy group. The instrument used was the questionnaire of hamilton rating scale for anxiety (HRSA). The results were analyzed using paired t-test on mozart music therapy and murottal therapy Al-Qur'an with value α = 0,05. The result of statistical test by used paired t-test in mozart music therapy group (ρ = 0,006). The result of statistic test using paired t-test in murottal therapy group of Al-Qur'an is (ρ = 0,000) meaning there was difference of pre patient's anxiety surgery between before and after mozart music therapy and murottal therapy of the Qur'an. The independent t-test showed the significance value ρ = 0.228. So it can be concluded that there was no difference in decreased anxiety of third trimester pregnant women between given mozart music therapy and murottal therapy Al-Qur'an. The results of this study is expected to get the experience of respondents and the application of mozart music therapy and murottal therapy Al-Qur'an in reducing anxiety in third trimester pregnant women.

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Tsalouchos, Aris, et Maurizio Salvadori. « La terapia immunosoppressiva nel trapianto di rene ». Giornale di Clinica Nefrologica e Dialisi 31, n^o 3 (16 septembre 2019) : 192–96. http://dx.doi.org/10.33393/gcnd.2019.529.

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Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

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Tsalouchos, Aris, et Maurizio Salvadori. « La terapia immunosoppressiva nel trapianto di rene ». Giornale di Tecniche Nefrologiche e Dialitiche 31, n^o 3 (septembre 2019) : 192–96. http://dx.doi.org/10.1177/0394936219875392.

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Immunosuppressive therapy in renal transplantation Immunosuppressive therapy in renal transplantation can be distinguished in induction therapy and maintenance therapy. Induction therapy is an intense immunosuppressive therapy administered at the time of kidney transplantation to reduce the risk of acute allograft rejection. In general, the induction immunosuppressive strategies used at kidney transplant centers fall into one of these two categories. One strategy relies upon high doses of conventional immunosuppressive agents, while the other utilizes antibodies directed against T-cell antigens in combination with lower doses of conventional agents. Maintenance immunosuppressive therapy is administered to almost all kidney transplant recipients to help prevent acute rejection and loss of the renal allograft. Although an adequate level of immunosuppression is required to dampen the immune response to the allograft, the level of chronic immunosuppression is decreased over time (as the risk of acute rejection decreases) to help lower the overall risk of infection and malignancy; these risks directly correlate with the degree of overall immunosuppression. The optimal maintenance immunosuppressive therapy in kidney transplantation is not established. The major immunosuppressive agents that are available in various combination regimens are glucocorticoids (primarily oral prednisone), azathioprine, mycophenolate mofetil (MMF), enteric-coated mycophenolate sodium (EC-MPS), cyclosporine (in non-modified or modified [microemulsion] form), Tacrolimus, everolimus, rapamycin (sirolimus), and Belatacept.

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Yulendasari, Rika, et Djunizar Djamaludin. « Pengaruh pemberian teknik relaksasi Benson terhadap tekanan darah pada penderita hipertensi ». Holistik Jurnal Kesehatan 15, n^o 2 (17 juillet 2021) : 187–96. http://dx.doi.org/10.33024/hjk.v15i2.4393.

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Effect of Benson relaxation technique on blood pressure in patients with hypertensionBackground: Hypertension management is classified into non-pharmacological and pharmacological therapy. Non-pharmacological therapy is believed to be safer and has a positive effect. The technique is Benson relaxation, this technique focuses more attention. So it can create a calm environment and can control blood pressure.Purpose: To know effect of Benson's relaxation technique on blood pressure in patients with hypertension at Poncowati Health Center, Central Lampung. Method: Quantitative research with the research design "Quasy Experimental” with using Nonequivalent control group design/non randomized control group pretest posttest design. The research subjects were 32 respondents who were divided into two groups. Data analysis used parametric statistical paired T test and unpaired T test (Independent T Test).Results: There is an effect of Benson relaxation therapy on reducing blood pressure in patients with hypertension, where the average difference in systolic blood pressure between the intervention group and the control group is 8.063 (p-value 0.000) and diastolic blood pressure of 4.188 (p-value 0.003).Conclusion: There is an effect of Benson relaxation therapy on reducing blood pressure in hypertensive patients.Keywords: Benson relaxation; Blood pressure; Patient; HypertensionPendahuluan: Penatalaksanaan hipertensi dikelompokkan menjadi terapi nonfarmakologi dan terapi farmakologi. Terapi nonfarmakologi diyakini lebih aman dan memberikan efek positif. Salah satu tekniknya yaitu relaksasi benson, teknik ini lebih memusatkan perhatian. Sehingga dapat menciptakan lingkungan yang tenang dan dapat mengontrol tekanan darah.Tujuan: Untuk mengetahui pengaruh terapi relaksasi Benson terhadap penurunan tekanan darah penderita hipertensi di Puskesmas Poncowati Lampung Tengah.Metode: Eksperimen semu (quasi experiment design) dengan bentuk Nonequivalent control group design/non randomized control group pretest postest design. Subjek penelitian sebanyak 32 responden yang dibagi menjadi dua kelompok. Analisa data menggunakan statistik parametrik uji T berpasangan (Paired T Test) dan uji T tidak berpasangan (Independent T Test).Hasil: Pengaruh terapi relaksasi Benson terhadap penurunan tekanan darah penderita hipertensi dengan selisih rata-rata tekanan darah sistolik antara kelompok intervensi dengan kelompok kontrol adalah sebesar 8,063 (p-value 0,000) dan diastolik sebesar 4,188 (p-value 0,003).Simpulan: Adanya pengaruh terapi relaksasi Benson terhadap penurunan tekanan darah penderita hipertensi.

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Mulia, Madepan. « PENGARUH TERAPI KOGNITIF DAN TERAPI PSIKOEDUKASI KELUARGA TERHADAP TINGKAT ANSIETAS KLIEN KANKER ». Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) 7, n^o 1 (29 mars 2021) : 24–28. http://dx.doi.org/10.33023/jikep.v7i1.700.

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Introduction: Cancer is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells that can lead to death. The physical impact caused by cancer will affect a person's psychological condition, causing psychosocial problems. Purpose: This study aims to determine the effect of cognitive therapy and family psychoeducation therapy on the anxiety level of cancer clients at the Regional General Hospital (RSUD) Dr. Hi. Abdul Moeloek, Lampung Province. Methods: This study used a quasi-experimental design with pre-post test control group with a total sample of 35 people for each group. The instrument used was hamilton anxiety rating scale (HARS). The analytical test used was repeated ANOVA test and independent t-test. Results: The results showed that cancer client anxiety decreased significantly (p value <0.05) after receiving nurse nursing action, but after being given cognitive therapy and family psychoeducation therapy, it decreased significantly than after receiving nurse nursing action. Conclusion: The implication of this research is that cognitive therapy and family psychoeducation therapy reduce the anxiety level of cancer clients, so that the hospital can add interventions related to psychosocial problems, especially for cancer clients who experience anxiety at the Regional General Hospital (RSUD) Dr. Hi. Abdul Moeloek, Lampung Province.

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Arikhman, Nova. « Penurunan Intensitas Nyeri Persalinan Fase Aktif Kala I Melalui Terapi Musik Instrumental ». Jurnal Keperawatan Indonesia 13, n^o 1 (24 mars 2010) : 32–36. http://dx.doi.org/10.7454/jki.v13i1.228.

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AbstrakIntensitas nyeri selama persalinan yang berlebihan dapat merugikan ibu dan janin. Terapi musik instrumental sebagai teknik nonfarmakologi, berguna menimbulkan efek distraksi dan relaksasi. Tujuan penelitian ini mengetahui pengaruh terapi music instrumental terhadap intensitas nyeri saat persalinan. Penelitian metode kuasi-eksperimen dengan pre post-test desain ini dilakukan pada 18 ibu multipara yang mengalami persalinan kala I di ruang bersalin kebidanan rumah sakit X. Pengambilan sampel melalui metode consecutive sampling. Data dianalisa melalui uji Paired t-test dan Wilcoxon sign rank test. Hasil penelitian menunjukkan bahwa perlakuan terapi musik instrumental berpengaruh signifikan terhadap penurunan intensitas nyeri (p= 0.017, α= 0,05). Penelitian ini merekomendasikan agar terapi musik instrumental sebagai salah satu terapi nonfarmakologis digunakan dalam menurunkan persepsi intensitas nyeri pada ibu multipara yang mengalami persalinan fisiologis kala I. AbsractSeverity of labor pain may damage mother and infant. Therefore, instrumental music therapy as non-pharmacology technique can be used for distraction and relaxation. This research aims to study about the effect of instrumental music therapy to severity of labor pain. Method of this research is quasi-experiment with pre post-test design, involving 18 multiparous mothers who experienced stage I labor in labor room of X hospital. Samples are selected through consecutive sampling. Data was analyzed by paired t-test and Wilcoxon sign rank test.The research shown that instrumental music therapy significantly relieved the severity of pain labor (p= 0.017, α= 0,05). The research recommended that instrumental music therapy can be used as non- pharmacological therapy to relieve the severity of labor pain for multiparous mothers who experience stage I labor.

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Tambunan, Marcelina Boru, Linda Suwarni, Linda Setiawati et Mardjan Mardjan. « EFT (Emotional Freedom Technique) As An Alternative Therapy To Reduce Anxiety Disorders and Depression in People Who Are Positive Covid-19 ». Psikostudia : Jurnal Psikologi 11, n^o 1 (12 mars 2022) : 59. http://dx.doi.org/10.30872/psikostudia.v11i1.7104.

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The increasing number of deaths from Covid-19 is in line with anxiety disorders and depression in people who are positive for Covid-19. The emotional Freedom Technique (EFT) is known as an effective therapy to reduce mental health disorders in certain patients but has never been applied to people who are confirmed positive for Covid-19. This study aims to analyze the effectiveness of EFT as an alternative therapy in reducing anxiety and depression in people who are positive for Covid-19. This research design uses a quasi-experimental approach with a one-group pretest and posttest approach. A total of 22 people were isolated in the Health Training Unit (UPELKES) provided by the Pontianak Government in June 2021. The data analysis technique used paired t-test (95% CI). There was a significant decrease in anxiety (t value = 6,738) and depression scores (t value = 2,585) after EFT therapy was given (p-value < 0.05). Thus, EFT can be an alternative therapy in overcoming anxiety and depression disorders in people who are confirmed positive for Covid-19.Meningkatnya angka kematian akibat Covid-19 seiring dengan gangguan kecemasan dan depresi pada orang yang positif Covid-19. Emotional Freedom Technique (EFT) dikenal sebagai terapi yang efektif menurunkan gangguan kesehatan mental pada pasien tertentu, namun belum pernah diaplikasikan pada orang yang terkonfirmasi positif Covid-19. Penelitian ini bertujuan untuk menganalisis efektivitas EFT sebagai terapi alternatif dalam menurunkan gangguan kecemasan dan depresi pada orang yang positif Covid-19. Desain penelitian ini menggunakan quasy experimental dengan pendekatan one group pretest and posttest. Sebanyak 22 orang yang diisolasi di Unit Pelatihan Kesehatan (UPELKES) yang disediakan Pemerintah Pontianak pada bulan Juni 2021. Teknik analisis data menggunakan paired t test (95% CI). Terdapat penurunan skor gangguan kecemasan (nilai t = 6,738) dan depresi (nilai t = 2,585) yang signifikan setelah diberikan terapi EFT (p value < 0,05). Dengan demikian, EFT dapat menjadi terapi alternatif dalam mengatasi gangguan kecemasan dan depresi pada orang yang terkonfirmasi positif Covid-19.

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Satriyawati, Arisda Candra, Syaifurrahman Hidayat, Yulia Wardita et Nor Arifah. « Terapi Dzikir Jahar Mengurangi Kecemasan Pada Ibu Pre Operasi Sectio Caecarea ». Wiraraja Medika : Jurnal Kesehatan 11, n^o 1 (3 août 2021) : 36–40. http://dx.doi.org/10.24929/fik.v11i1.1477.

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Dhikr Jahar Therapy Reduces Anxiety in Pre-Operative Sectio Caesarea Mothers. Mothers often experience anxiety before cesarean section surgery. Non-pharmacological therapy with dhikr Jahar can be a complementary therapy option to reduce anxiety. This study aimed to explain the effect of dhikr therapy on reducing maternal anxiety levels before SC surgery. The research method uses Quasy Experiment with Pre-Post Test With Control Group Design. The respondents' determination was carried out by total sampling, namely pre-cesarean section surgery pregnant women in March-June 2019 at Garam Islamic Hospital, Kalianget (n=24). Statistical test using Paired T-Test, Wilcoxon Test, and Independent T-Test. The results of the Paired T-Test showed that there were differences in the level of anxiety of patients before SC before and before being given dhikr therapy in the intervention group (p = 0.000); there was an average decrease of 9.917. The Wilcoxon test results showed no difference (change) in the level of anxiety of patients before and before being given therapeutic communication in the control group the value (p = 0.636); the decrease that occurred was 0.83. In the Independent T-Test results, there was no difference in the level of anxiety before SC before and before being given treatment in the intervention group and the control group (p = 0.211). There is an effect of providing dhikr Jahar therapy to reduce maternal anxiety levels before SC surgery.

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Satriyawati, Arisda Candra, Syaifurrahman Hidayat, Yulia Wardita et Nor Arifah. « Terapi Dzikir Jahar Mengurangi Kecemasan Pada Ibu Pre Operasi Sectio Caecarea ». Wiraraja Medika : Jurnal Kesehatan 11, n^o 1 (3 août 2021) : 36–40. http://dx.doi.org/10.24929/fik.v11i1.1477.

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Dhikr Jahar Therapy Reduces Anxiety in Pre-Operative Sectio Caesarea Mothers. Mothers often experience anxiety before cesarean section surgery. Non-pharmacological therapy with dhikr Jahar can be a complementary therapy option to reduce anxiety. This study aimed to explain the effect of dhikr therapy on reducing maternal anxiety levels before SC surgery. The research method uses Quasy Experiment with Pre-Post Test With Control Group Design. The respondents' determination was carried out by total sampling, namely pre-cesarean section surgery pregnant women in March-June 2019 at Garam Islamic Hospital, Kalianget (n=24). Statistical test using Paired T-Test, Wilcoxon Test, and Independent T-Test. The results of the Paired T-Test showed that there were differences in the level of anxiety of patients before SC before and before being given dhikr therapy in the intervention group (p = 0.000); there was an average decrease of 9.917. The Wilcoxon test results showed no difference (change) in the level of anxiety of patients before and before being given therapeutic communication in the control group the value (p = 0.636); the decrease that occurred was 0.83. In the Independent T-Test results, there was no difference in the level of anxiety before SC before and before being given treatment in the intervention group and the control group (p = 0.211). There is an effect of providing dhikr Jahar therapy to reduce maternal anxiety levels before SC surgery.

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Melentijević, Dragana, et Teodora Beljić-Živković. « The etiology, treatment and outcome of diabetic ketoacidosis and hyperosmolar coma ». Medicinska istrazivanja 49, n^o 3 (2015) : 1–11. http://dx.doi.org/10.5937/medist1501001m.

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Diabetic ketoacidosis (DKA) and nonketotic hyperosmolar hyperglycemic state (NHOK) are acute complications of diabetes mellitus (DM). The aim was to investigate precipitating factors, therapy and the result of the treatment of DKA and NHOK. The study included all the people who were admitted to the Clinical Department of Endocrinology, Diabetes and metabolism disease KBC "Zvezdara" in the state of DKA and NHOK between 2007 and 2010. During this period we treated 56 people, aged 51.8 ± 18.8 years. DKA was diagnosed in 54 patients, whereas NHOK was diagnosed in two patients. Type 1 DM was present in 26 (46.42%) patients and type 2 in 30 (53.57%) patients. In DKA average values of glucose were 32±8,85mmol / l, HbA1c-11.6±2,52%, pH 6.89±0,17, HCO3-7.40±5,03. In patients with NHOK average glucose was 60.35±15,14mmol / l, HbA1c-11.2±1,7%,pH 7.43±0,1, HCO3-19, 8±5,23. There was a significant difference in the glucose level (t(54) =6.03,p<0.01) as well as in bicarbonate level (t(54)=3.72,p=0.01) between DKA and NHOK. The most common precipitating factors were: infection in 26 (46.42%) cases, inadequate therapy in 24 (42.85%) cases, myocardial infarction and cerebral stroke in 2 (3.57%) cases. All the patients with NHOK and 16 with DKA had previously been on oral antihy-perglycemic drugs, while 29 patients with DKA had previously been on insulin therapy. Upon admission, the previous therapy was not in relation with the level of glucose and pH. Bicarbonate level was significantly higher in the group treated with oral therapy (t (43) = 2.16,p <0.05). The therapy was considered because of rehydration, fractionally giving boluses HM insulin, potassium compensation and treatment precipitating factors. Rehydration was achieved with an average of 5.6±1,65 liters on the first day,4.08±0,87l on the second day, and 3±0,01 liters on the third day of infusion solutions. The total daily dosage of insulin bolus HM on the first day was 81.04±27,97i.j, 59.64±17,60i.j. on the second day and 58.06±19,70i.j. on the third day. Maximum daily supplementation of potassium in the form of 7.4% KCL solution was 61±18,70mmol / l. Upon the end of the treatment, the total of 26 (46.42%) was discharged on basal-bolus human insulin therapy, 18 (32.14%) on the treatment of basal-bolus analogues, 11 (19.64%) on therapy insulin premix and metformin, while two (3.57%) were discharged on oral antihyperglycemic medications. The treatment outcome was successful in 50 people (89.3%), while death occurred in 6 (10.7%) cases. The most common complication was hypokalemia, present in 29 (51.78%) patients. Other complications were acute renal failure (3 people), acute respiratory distress syndrome (2 people), pulmonary edema (2 people) and gastrointestinal bleeding (1 person). Despite education and available medications for diabetes, acute complications of diabetes can still occur and are sometimes accompanied by dangerous complications.

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S.A.M, Rahmadevita, Yeni Rustina et Elfi Syahreni. « Memperbaiki Saturasi Oksigen, Frekuensi Denyut Jantung, dan Pernafasan Neonatus yang Menggunakan Ventilasi Mekanik Dengan Terapi Musik ». Jurnal Keperawatan Indonesia 16, n^o 3 (15 novembre 2013) : 154–60. http://dx.doi.org/10.7454/jki.v16i3.324.

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AbstrakNeonatus yang menggunakan ventilasi mekanik akibat gangguan pernapasan mengalami masalah oksigenisasi dan frekuensi denyut jantung. Berbagai upaya perlu dilakukan agar neonates tenang sehingga kebutuhan oksigen dapat diminimalkan, salah satu upaya tersebut adalah terapi musik. Penelitian ini bertujuan untuk menguji pengaruh terapi musik terhadap saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan neonatus yang menggunakan ventilasi mekanik. Penelitian kuasi eksperimen dengan rancangan pretest-posttest without control meibatkan 13 neonatus yang dipilih secara konsekutif. Intervensi yang diberikan adalah terapi musik dengan Brahm’s Lullaby selama 30 menit dengan headphone. Pengumpulan data menggunakan observasi dan dianalisis dengan Paired t test. Hasil penelitian menunjukkan adanya perbedaan bermakna antara rerata saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan sebelum dan setelah pemberian terapi musik. Pada saturasi oksigen terjadi peningkatan, sedangkan pada frekuensi denyut jantung dan pernapasan mengalami penurunan. Terapi musik dapat digunakan sebagai pendamping terapi medis untuk memperbaiki oksigenisasi pada neonatus yang menggunakan ventilasi mekanik.Kata kunci: denyut jantung neonatus, pernapasan, saturasi oksigen, terapi musik, ventilasi mekanikAbstractImproving Oxygen Saturation, Heart Rate, and Respiratory Rate of Neonates Using Mechanical Ventilation with Music Therapy. Neonates using mechanical ventilation cause of respiratory disorder experience oxygenation and heart rate problems. Interventions should be made in order to calm neonates so that the need of oxygen can be minimized, one of these interventions is music therapy. This study aimed to identify the effect of music therapy on oxygen saturation, heart rate and respiratory rate of neonates using mechanical ventilation. This quasi experiment study with a pretest-posttest design without control involved 13 neonates selected by consecutive sampling. Data collected through observation and analyzed by paired t test. There was a significant difference on the average of oxygen saturation, heart rate and respiratory rate of infants using mechanical ventilation before and after music therapy (p value <0,05). Music therapy can be used as a complementary medical therapies to improve oxygenation in neonates using mechanical ventilation.Key words: heart rate, mechanical ventilation, music therapy, neonate, oxygen saturation, respiratory rate

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Muhith, Abdul, Teguh Herlambang, Atika Fatmawati, Dyah Siwi Hety et I. Wayan Surya Merta. « PENGARUH TERAPI RELAKSASI OTOT PROGRESIF TERHADAP KEKUATAN OTOT DAN KUALITAS TIDUR LANJUT USIA ». Care : Jurnal Ilmiah Ilmu Kesehatan 8, n^o 2 (4 juillet 2020) : 306. http://dx.doi.org/10.33366/jc.v8i2.1792.

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Physiological changes in the elderly can cause a change in the neural system that is a disorder towards sleep quality while changes in the musculoskeletal system are the occurrence of muscle strength decline. Progressive Muscle Relaxation Therapy is a therapy which can improve sleep quality and muscle strength. The purpose of this research is to analyze the effect of progressive muscle relaxation therapy towards muscle strength and sleep quality of the elderly at House Technical Implementation. The research type used is quasi-experiment design with pretest and posttest nonequivalent control group design. The population in this research were all elderly as many as 40 elderly people. The sampling technique used was Total Sampling which was then divided into intervention group which consists of 20 respondents and control group which consists of 20 respondents. The measurement tool used was PSQI (Pittsburgh Sleep Quality Index) questionnaire for sleep quality and the MMT (Manual Muscle Testing) observation sheet for muscle strength. The data were analyzed using Paired T-test and Independent T-test. Based on Paired T-test, it was obtained that p value = 0.000 (p

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Simanullang, Ester, Linda Linda et Kamelia Sinaga. « Pengaruh Aroma Terapi Mawar Terhadap Tingkat Kecemasan Ibu Bersalin Kala I ». Indonesian Health Issue 1, n^o 1 (19 février 2022) : 90–97. http://dx.doi.org/10.47134/inhis.v1i1.16.

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Latar Belakang: Kecemasan bersalin merupakan penyebab kematian Ibu dan Bayi. Kecemasan bersalin dapat dikurangi dengan beberapa terapi penurunan kecemasan yaitu terapi farmakologi dan nonfarmakologi. Salah satu solusi penurunan kecemasan masa bersalin adalah aroma terapi mawar.Tujuan: untuk mengetahui pengruh aromaterapi mawar terhadap tingkat kecemasan pada ibu persalinan kala I. Metode: . Penelitian ini menggunakan pendekatan rancangan non equivalent control group yang menggunakan kelompok perlakuan dan kelompok control sebanyak 30 orang ibu bersalin, tehnik pengambilan data random sampling waktu penelitian April-Mei 2021 dan analisis untuk komparatif menarik berpasangan dua kelompok adalah Uji T berpasangan. Hasil: Adanya pengaruh aroma terapi mawar terhadap kecemasan ibu bersalin Kala I sebelum dan sesudah terapi aroma mawar P value (0.000) < α (0,05). Kesimpulan: Terdapat pengaruh aroma terapi mawar terhadap kecemasan ibu bersalin Kala I. Background: Maternity anxiety is a cause of maternal and infant mortality. Maternity anxiety can be reduced by several anxiety-reducing therapies, namely pharmacological and non-pharmacological therapies. One solution to reduce anxiety during childbirth is aromatherapy roses. Objective: To determine the effect of aromatherapy roses on anxiety levels in the first stage of labor. Method:This study uses a non-equivalent control group design approach that uses a treatment group and a control group of 30 maternity mothers, the technique of data collection is random sampling during the April-May 2021 study and the analysis for comparatively interesting pairs of two groups is the paired T-test. Result: The effect of rose aroma therapy on maternal anxiety in the first stage before and after rose aroma therapy P value (0.000) < (0.05). Conclusion: There is an effect of rose aroma therapy on the anxiety of maternity mothers in fisrt stage.

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Afghedara, Tifaldha, Miskanik Miskanik et Fajar Bilqis. « Pengaruh terapi musik dalam mengatasi stres siswa pada masa pandemi ». Orien : Cakrawala Ilmiah Mahasiswa 2, n^o 2 (3 novembre 2022) : 77–84. http://dx.doi.org/10.30998/ocim.v2i2.6924.

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this study aims to determine the effect of music therapy in dealing with student stress at Malahayati Islamic Vocational School during the pandemic. The research method used in this research is quantitative research with quasi-experimental, and this research model uses nonequivalent control group design. Sampling used purposive sampling technique with a sample size of 60 respondents (30 students in the treatment group and 30 students in the control group). Student stress was measured by giving a questionnaire in the form of a questionnaire about student stress. The data analysis of this research used t-test to determine the difference between the effect of music therapy on the treatment group and the control group on student stress. The results of the t-test analysis shown that there was a significant difference in music therapy between the treatment group and the control group on student stress at Malahayati Islamic Vocational School during the pandemic. This study concluded that music therapy can have an effect on dealing with student stress at the Malahayati Islamic Vocational School during the pandemic.

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Ajmala, Indana Eva, et Laksmi Wulandari. « Terapi ARV pada Penderita Ko-Infeksi TB-HIV ». Jurnal Respirasi 1, n^o 1 (1 avril 2019) : 22. http://dx.doi.org/10.20473/jr.v1-i.1.2015.22-28.

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TB and HIV have a very close relationship since the development of AIDS. Through a significant reduction in cellular immunity, HIV affects the pathogenesis of tuberculosis, thereby increasing the risk of TB in HIV co-infected individuals. In 2006, there were an estimated 9.2 million new TB cases worldwide, there were 710.00 in patients with HIV and 500,000 cases with MDR-TB. Sensitivity to TB associated with cytokine production by T lymphocytes (IFN gamma and TNF are like alpha). During HIV infection, IFN gamma production declined dramatically in line with the decrease in CD4 T lymphocytes This leads to an increased risk of developing reactivation or reinfection Mycobacterium tuberculosis. Clinical symptoms of pulmonary TB in people living with HIV are often non-specific. Clinical symptoms often found are fever and significant weight loss. The other symptoms usually associated with extrapulmonary TB. Antiretrovirals are drugs that inhibit HIV replication. The main priority in patients co-infected with TB-HIV is a start of TB therapy, followed by cotrimoxazole and ARV. ARV treatment recommendation on co-infection tuberculosis is starting ARV therapy to all people living with HIV with active TB, regardless of CD4 cell count. Antiretroviral therapy start as soon as possible after TB treatment can be tolerated, as soon as 2 weeks and no more than 8 weeks. Regimen set by WHO for first-line regimen containing two nucleoside reverse transcriptase inhibitors (NRTIs) plus one non-nucleoside reverse transcriptase inhibitors (NNRTIs). In the co-infection of TB-HIV nucleoside was elected WHO recommended Zidovudine (AZT) or tenofovir disoproxil fumarate (TDF), in combination with lamivudine (3TC) or emricitabine (FTC). For NNRTI, WHO recommends efavirenz (EFV) or nevirapine (NVP).

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Sulistyawati, Henny. « Pengaruh Terapi Musik Klasik Terhadap Lama Persalinan Kala I ». J-HESTECH (Journal Of Health Educational Science And Technology) 3, n^o 2 (31 décembre 2020) : 129. http://dx.doi.org/10.25139/htc.v3i2.3225.

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ABSTRAKPersalinan normal adalah proses persalinan yang melalui kejadian secara alami dengan adanya kontraksi rahim ibu dan dilalui dengan pembukaan untuk mengeluarkan bayi. Penelitian yang bertautan dengan partus lama, ditemukan 65 % penyebabnya adalah kontraksi uterus yang tidak berkontraksi dengan baik. Apabila kemajuan persalinan terhambat dan tidak segera di tangani oleh tenaga kesehatan maka akan berakibat buruk terhadap kelancaran dan kemajuan persalinan. Maka dari itu, bila persalinan lancar diperlukan cara untuk mempercepat proses persalinan dengan cara pemberian musik klasik.Tujuan dari penelitian ini yaitu untuk mengetahui ada dan tidaknya pengaruh musik klasik terhadap kemajuan persalinan kala I di BPM Lilis Suryawati Jombang Tahun 2019.Rancangan penelitian ini memakai pra eksperimen static group comparison, Yaitu ada kelompok yang dikasih musik klasik dan ada yang tidak dikasih musik klasik. Pengumpulan sampel dilakukan secara accidental sampling sebanyak 24 responden. Penelitian ini memakai Uji T dua sampel bebas. Hasil Analisis statistik uji T dua sampel bebas didapatkan tingkat signifikan (ρ) kemajuan persalinan sebanyak 0,033 uji dipakai pada tingkat kesalahan sebesar (α) 5% atau 0,05. Sehingga didapatkan sig(ρ) < α ) maka Ho ditolak dan ada pengaruh musik klasik terhadap kemajuan persalinan kala I di BPM Lilis Suryawati Jombang. Besarnya pengaruh yang diberi music klasik sebesar 33%.Berdasarkan hasil penelitian diatas, maka sebaiknya petugas kesehatan menolong persalinan dengan menggunakan musik klasik saat proses kelahiran, karena musik klasik bisa membuat ibu rileks dan juga bisa mempercepat proses kemajuan persalinan. Kata Kunci : Pengaruh, musik klasik, kemajuan persalinan, Kala I ABSTRACTLabor is the process of movement of the fetus, placenta, and membranes out of the womb through the escape route. Research related to the incidence of prolonged labor, 65% is due to inefficient uterine contractions. If the progress of labor is hampered and not handled properly can adversely affect the smooth delivery. For that we need a way to accelerate the delivery of one of them by giving the classical music. The purpose of this study to determine whether there is influence of classical music on the progress of labor stage I in BPM Lilis Suryawati Jombang Year 2019.The design of this study used pre experiments with static group comparison design, where there are groups that are given classical music and which are not given classical music. Sampling by accidental sampling amounted to 22 people. This study used a free two-T test. The result of T test statistic analysis of two free samples obtained significant level (ρ) for the progress of labor of 0.033 testing was done at the error rate of (α) 5% or 0.05. Then obtained sig (ρ) <α) then Ho is rejected and there is an influence of classical music on the progress of labor stage I in BPM Lilis Suryawati Jombang. The magnitude of the influence that was given classical music by 33%.Based on the results of the above research, should as a health officer using classical music in the process of childbirth, because the classical music in addition to making the mother relaxed music can also accelerate the progress of labor.Keywords: Influence, classical music, progress of labor, Kala I

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Parra López, Carlos Alberto. « La implementación de las vacunas basadas en neoantígenos tumorales : un desafío para la medicina de precisión en oncología ». Revista Colombiana de Cancerología 24, n^o 4 (30 novembre 2020) : 154–56. http://dx.doi.org/10.35509/01239015.713.

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En el año 2002 el grupo de Rosenberg en el Instituto Nacional de Cáncer en Estados Unidos demostró por primera vez que los linfocitos T pueden mediar regresiones tumorales notables, incluida la curación completa de pacientes con cáncer metastásico (1). Estos resultados logrados con la transferencia adoptiva de linfocitos T infiltrantes de tumor amplificados in vitro y luego restituidos al paciente, fue seguido de la implementación exitosa de terapias celulares con células CAR-T y el uso de anticuerpos anti-punto de control para el tratamiento de los tumores, con lo cual la Inmunoterapia junto a la Cirugía, la Quimioterapia y la Radioterapia se ha posicionado como el cuarto pilar de tratamiento del cáncer.

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