Viruses and Gram-negative bacilli are dominant causes of CAP in this region, more so than S. pneumoniae. Most of the bacteria have wild type susceptibility to antimicrobial agents. Patients with severe disease and those with unknown etiology have a higher mortality risk.

Latar belakang. Infeksi dengue merupakan infeksi virus tropis yang paling penting saat ini. Pleural effusionindex (PEI) digunakan sebagai prediktor derajat DBD, berperan dalam menentukan skor kebocoran vaskular(SKV), dan merupakan faktor risiko terjadinya mortalitas pada DSS. Melalui pemeriksaan foto toraks RLD,pengukuran PEI menimbulkan efek radiasi dan sulit dilakukan pada pasien yang tidak dapat dimobilisasi.Pemeriksaan ultrasonografi toraks tidak menimbulkan efek radiasi dan dapat mengetahui estimasi volumeefusi pleura dengan mengukur jarak interpleura pada posisi supine.Tujuan. Menganalisis korelasi pleural effusion index dengan jarak interpleura secara ultrasonografi padademam berdarah dengue anak.Metode. Desain penelitian belah lintang menggunakan 14 pasien DBD anak selama bulan Juli sampaidengan November 2014, dilakukan di RSUD Dr. Kariadi Semarang, dan subjek berusia 10 bulan-12 tahun.Pada hari kelima demam dilakukan pemeriksaan foto toraks RLD, dilanjutkan pemeriksaan ultrasonografitoraks.Hasil. Uji korelasi Rank Spearman memperlihatkan PEI berkorelasi positif sedang dengan jarak interpleurasecara sonografi (p=0,014; rho=0,639).Kesimpulan.Terdapat korelasi bermakna antara nilai PEI dengan jarak interpleura secara sonografi padapasien DBD anak.

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Background: Pulmonary hypertension is a condition which there is an increase in mean pulmonary artery pressure measured at ≥25 mmHg. The gold standard in diagnosing this condition is right heart catheterization. Enlargement of right descending pulmonary artery on chest radiographs is a sign of pulmonary hypertension. However, the value of radiographic measurements reported was diverse. The study analyzes the correlation between the right descending pulmonary artery (RDPA) diameter on chest radiographs and means pulmonary artery pressure on right heart catheterization to understand whether RDPA diameter on chest X-ray could be a predictor in determining the severity of pulmonary hypertension.Methods: Thirty-five subjects were reviewed to compare RDPA diameter from a chest X-ray on posteroanterior projection and mPAP value from the right heart catheterization. The correlation between them was analyzed using Pearson's correlation test.  RDPA diameter cut-off point was defined using the ROC curve.Result: RDPA diameter and mPAP revealed a high positive correlation (p<0.001; r=0.824). The cut-off value of the RDPA diameter was 21.8 mm (sensitivity 81% and specificity 85.7%; AUC =0.9)Conclusion: The measurement of right descending pulmonary artery diameter on chest x-ray positively correlates with mean pulmonary artery pressure. Therefore, the diameter of the right pulmonary artery on the chest x-ray can predict the severity of pulmonary hypertension.

Previous study using thoracic phantom for estimating fluid volume has been obtained which represents the case of pleural effusion based on the size of the x-ray radiograph. The models are obtained in the form of three equations, the pleural effusion volume as a function of height, length times the height, and area of the radiograph image. The three models of estimation have high linearity with ratio value more than 0.988, higher than the modeling measurement using ultrasonography modality. The modeling is expected to give a contribution on developing method for helping clinicians estimate the pleural effusion volume as a basic for performing fluid aspiration and to monitor the therapy. However, because modeling is developed using phantoms, then to be applied clinically, further research is needed for its application to patients. The height function model yields correlation value of 0.966 and paired T-test value of 0.892. The height times length function model yields correlation value of 0.982 and paired Ttest value of 0.611. The area function model yields correlation value of 0.997 and paired T test value of 0.647. From-the three equations, measurement of estimated pleural effusion volume using area function on chest x-ray lateral decubitus position is the most appropriate equation. Corresponding to the results of the measurement of gold standard using a CT scan. Height measurement is the measurement that is the fastest and easiest in the application. The three equations can not be applied to patients with condition such as post lung surgery, massive pleural effusion, and anatomical abnormalities of thoracic cavity.

Background: Parallel imaging is a time-reduction technique that uses phased-array coils. Phased array coils measure and process signals from a piece, then combine pieces to form an image of a larger area of anatomy. Commonly used imaging parallel technique is one of them is sensitivity encoding or SENSE. This research is the difference of image quality MRI Lumbal sequence T1WI TSE of sagittal pieces with and without the use of SENSE in the case of hernia nucleus pulposus (HNP). The aim of this research is to know the difference between SNR, anatomy information and better image quality and anatomical information. MRI Lumbal sequence T1WI TSE sagittal pieces with and without the SENSE in HNP.Methods: The type of this research is quantitative with an experimental approach, The research was conducted in RS dr. Saiful Anwar Malang. The research was taken from Lumbal MRI examination in 9 patients with predetermined exclusion and inclusion criteria of T1WI TSE sectional pieces with and without the use of SENSE in HNP. Image assessment was done by two radiologists. Analysis of data used paired T-test and Wilcoxon test with alpha 5%.Results: The results showed that there was a difference in image quality of MRI Lumbal T1WI TSE sequence of sagittal pieces with and without the use of SENSE in HNP with p-value = 0.001, and anatomic information with p-value = 0.001. Sensitivity encoding resulted in better image quality and anatomical information, with mean values at SNR 181,4333, and rank information anatomy 11,00.Conclusion: There is a difference in SNR and anatomical information between the use of SENSE andwithout the use of SENSE on sagittal lumbar MRI. The use of SENSE is capable of producing quality MRIimagery (SNR) and Anatomical Information on lumbar MRI lumbar sequences of sagittal slices.

Pendahuluan SARS-CoV-2 merupakan virus RNA yang terutama menginfeksi sel-sel pada saluran napas pelapis alveoli. Virus SARS-CoV-2 yang terhirup mengikat sel epitel di rongga hidung dan mulai bereplikasi. Virus ini menyebar serta bermigrasi ke saluran pernapasan, memicu respons imun bawaan dan pada akhirnya berkembang menjadi Acute Respiratory Distress Syndrome (ARDS). Gambaran ground glass infiltrates dapat terdeteksi pada pencitraan toraks. Pemeriksaan X-ray toraks dan MSCT toraks memegang peranan penting dalam deteksi dan follow up COVID-19. Metode dan Bahan Laporan kasus 2 pasien laki-laki yang terkonfirmasi COVID-19 umur 43 tahun dan 48 tahun dengan keluhan utama sesak napas, batuk dan demam. Pasien pertama mempunyai riwayat perjalanan ke Amerika Serikat 3 minggu sebelum masuk rumah sakit, sedangkan pasien kedua mempunyai riwayat kontak dengan pasien terkonfirmasi COVID-19. Pada pemeriksaan X-ray toraks kedua pasien menunjukkan gambaran konsolidasi disertai air bronchogram pada lapangan paru bilateral yang tampak dominan pada perifer. Berdasarkan pedoman Severe Acute Respiratory Syndrome (SARS) terdahulu, evaluasi dapat dilakukan 2 bulan dan 6 bulan setelah terinfeksi. Dua bulan setelah terinfeksi COVID-19 dilakukan pemeriksaan HRCT toraks dengan hasil normal. Kesimpulan Lesi berupa konsolidasi disertai air bronchogram dengan distribusi yang dominan pada perifer merupakan gambaran radiologis yang khas pada pasien Covid-19 seperti yang ditemukan pada kedua kasus yang dipaparkan dalam artikel ini. Evaluasi sequele dengan pemeriksaan HRCT yang dilakukan 2 bulan pasca penyembuhan menunjukkan gambaran paru paru yang normal, tidak ada infiltrat maupun fibrosis pada kedua pasien tersebut. Kata kunci X-ray toraks, konsolidasi, air bronchogram, COVID-19   Introduction SARS-CoV-2 is an RNA virus that mainly infects cells in the alveoli lining airways. The inhaled virus binds to epithelial cells in the nasal cavity then begins to replicate. This virus spreads, migrates to the respiratory tract, triggering an innate immune response, and develop to Acute Respiratory Syndrome. The ground-glass opacities can be detected in thoracic imaging eventually. Chest X-ray and CT-scan have an important role in the detection and follow-up of COVID-19. Materials and Methods The case report of 2 male patients confirmed COVID-19 aged 43 years and 48 years with major complaints of shortness of breath, coughing, and fever. The first patient had a history of raveling to the United States 3 weeks before hospitalization, while the second patient had a history of contact with a confirmed COVID-19 patient. On chest X-ray examination, both patients showed multiple consolidation with air bronchogram in bilateral lung field which appeared dominant in the periphery. According to the previous Severe Acute Respiratory Syndrome (SARS) guideline, evaluation for patients can be done in two months and six months after firstly infected. Two months after COVID-19 infection, a chest HRCT examination was performed with normal results. Conclusion Consolidation with air bronchogram which dominantly seen in peripheral distribution is a typical radiological picture in COVID-19 patients as found in two cases described in this article. Sequelae evaluation with chest HRCT conducted 2 months after healing showed normal lung appearance with no sign of infiltrates or fibrosis seen in both patients. Keywords:  Chest X-ray, consolidation, air bronchogram, COVID-19

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