CNS infection is a life-threatening condition in developing countries and Streptococcus pneumoniae has been reported as the most common cause of bacterial meningitis; however, there is limited data on pneumococcal meningitis in Indonesia. This cross-sectional study aimed to isolate and identity S. pneumoniae strains from cerebrospinal fluid (CSF) specimens collected as part of routine testing from patients with clinically diagnosed central nervous system infection at a national referral hospital in Jakarta, Indonesia in 2017. S. pneumoniae isolation and identification were performed using conventional culture and molecular tools. Antibiotic susceptibility patterns were monitored through minimum inhibitory concentration testing. From 147 CSF specimens, one S. pneumoniae strain was identified from a patient with bacterial meningitis symptoms. The isolate was serotype 6B (ST5661) and susceptible to 18 antimicrobial agents tested, including penicillin, tetracycline, and the macrolide group. Our data provide insights into the epidemiology of invasive pneumococcal disease in Indonesia.
IntroductionAtopic dermatitis (AD) is the most common skin disorder in young children worldwide, with a high impact on morbidity and quality of life. To date, no prospective study has been published on the incidence and potential predictors of AD in South East Asian populations. The Indonesian Prospective Study of Atopic Dermatitis in Infants (ISADI) will address the genetic, metabolic and dietary characteristics of mothers and their offspring, as well as potential determinants of AD within the first year of infant life.Methods and analysisThis prospective study will be undertaken in about 400 infants to investigate the direct and indirect effects of filaggrin (FLG) gene mutations, the genetic variants of FADS1, FADS2 and FADS3 and the role of long-chain polyunsaturated fatty acids (LCPUFA) on the development of AD. We will use standardised protocols for subject recruitment, umbilical artery plasma analysis, buccal cell sampling for genotyping, fatty acid analysis, physical exams, 3-day food-intake recall of mothers and children, as well as comprehensive questionnaires on environmental, socioeconomic and AD-related factors, including family history. Monthly monitoring by telephone and physical exams every 3 months will be carried out to assess participants' anthropometry, medical history and incidence of AD diagnosis during the first year of life. Hypotheses-driven analyses of quality-controlled dietary, genetic and metabolic data will be performed with state-of-the-art statistical methods (eg, AD-event history, haplotype, dietary or metabolic factor analysis). Direct and indirect effects of genetics and LCPUFA in buccal cell and cord plasma glycerophospholipids as potential mediators of inflammation on AD development will be evaluated by path analysis.Ethics and disseminationThe Permanent Medical Research Ethics Committee in Medicine and Health/Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital (No. 47/H2.F1/ETIK/2014) approved the study protocol (extended by the letter no. 148/UN2.F1/ETIK/2015). We aim to disseminate our findings via publication in an international journal with high impact factor.
Apo E alleles might influence improvement in lipid profiles after diet and exercise interventions. These results could inform personalized dyslipidemia management in obese adolescents, to determine which subjects would benefit from blood lipid-lowering drugs.
BackgroundAdequate availability of long-chain polyunsaturated fatty acids (LC-PUFAs) is important for human health from pregnancy to adulthood. Previous studies on fatty acid desaturase (FADS) gene single-nucleotide polymorphisms (SNPs) have been performed predominantly in Western populations and showed that FADS SNPs had a marked impact on LC-PUFA composition in blood and tissues.ObjectivesWe aimed to investigate the influence of fetal FADS genotypes on LC-PUFA composition in umbilical artery plasma lipids in Indonesian infants.DesignWe performed a cross-sectional study to assess for these associations.ResultsA total of 12 cord plasma n–6 (ω-6) and n–3 (ω-3) fatty acids were analyzed for associations with 18 FADS gene cluster SNPs from 390 women with single parturition from the Indonesian Prospective Study of Atopic Dermatitis in Infants (ISADI). Fetal FADS genotypes influenced cord plasma LC-PUFA composition, but, in contrast to previous studies from Western populations, the quantitatively predominant SNPs were associated with lower LC-PUFA content.ConclusionTo our knowledge, this study was the first in South East Asia on FADS genotypes and arterial cord blood fatty acids to show an association between fetal LC-PUFA composition and fetal FADS SNPs. The FADS genotype distribution differs markedly between different geographical populations. This trial was registered at clinicaltrials.gov as NCT02401178.
Latar belakang: Gagal jantung kronik merupakan penyakit progresif lambat dengan morbiditas serta mortalitas yang tinggi; penggunaan obat-obatan seringkali tidak berhasil memperbaiki hasil keluaran. Enhanced external counterpulsation (EECP) bersifat non-invasive dan merupakan alternatif terapi dalam penanganan gagal jantung. Penelitian ini bertujuan menilai pengaruh EECP terhadap myeloperoksidase (MPO) sebagai penanda inflamasi, dan pada keluaran klinis. Metode: Penelitian ini menggunakan desain uji klinik terkontrol secara randomisasi terbuka terhadap 66 penderita gagal jantung kronik pada Januari-Desember 2012. Pasien dibagi dalam dua kelompok: kelompok yang menjalani terapi EECP (n = 33) dan yang tidak menjalani terapi (non-EECP) (n = 33). Pemeriksaan MPO dilakukan pada awal dan setelah 6 bulan pengamatan. Selain itu juga dinilai kejadian kardiovaskular. Uji t tidak berpasangan digunakan untuk membandingkan kadar MPO dan uji chi-kuadrat untuk analisis kejadian kardiovaskular.
Pengetahuan mengenai manfaat klinis kadar magnesium serum baru dimulai akhir-akhir ini seiring dengan adanya analisis dan penemuan bahwa kadar magnesium abnormal pada gangguan kardiovaskuler, metabolik dan neuromuskuler. Meskipun kadarnya di serum tidak menggambarkan kadar magnesium tubuh, tetapi saat ini yang dikenal luas penggunaannya hanya pemeriksaan kadar magnesium serum. Magnesium eritrosit saat ini dinilai lebih sensitif dari pada magnesium serum, karena magnesium eritrosit dapat mewakili penilaian status magnesium intrasel. Menurut NCCLS (National Committee for Clinical Laboratory Standards) setiap laboratorium dianjurkan memiliki nilai rujukan sendiri untuk pemeriksaan yang dikerjakannya, termasuk juga pemeriksaan magnesium. Nilai rujukan yang didapat sesuai dengan populasi dan dipengaruhi oleh metode serta teknik pemeriksaan. Penelitian ini bertujuan untuk mendapatkan nilai rujukan magnesium dalam serum dan plasma serta mendapatkan nilai rujukan magnesium intrasel yaitu magnesium eritrosit dengan metode pemeriksaan langsung dan mengetahui perbandingan hasil pemeriksaan antara magnesium serum dengan plasma. Bahan darah diambil dari 114 peserta donor darah di Unit Transfusi Darah Daerah (UTDD) Budhyarto PMI DKI Jakarta, terdiri dari 57 orang pria dan 57 orang wanita berusia antara 17-65 tahun, secara klinis sehat menurut kriteria donor darah PMI. Darah diambil dari selang blood set, langsung dimasukkan 4 mL ke dalam tabung vakum tanpa antikoagulan untuk pemeriksaan magnesium serum dan 3 mL kedalam tabung vakum dengan antikoagulan lithium heparin untuk pemeriksaan magnesium eritrosit dan plasma. Penetapan kadar magnesium dilakukan dengan alat kimia klinis otomatis Hitachi 912 dengan metode Xylidil Blue dengan prinsip kolorimetri.Pada penelitian ini didapatkan tidak ada perbedaan bermakna untuk hasil pemeriksaan magnesium ekstrasel memakai bahan serum maupun plasma heparin. Nilai rujukan untuk magnesium serum atau plasma adalah 1.30-2.00 mEq/L dan magnesium eritrosit adalah 4.46-7.10 mEq/L.
Evaluation of the in vitro interaction of doripenem and amikacin against Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae was done by classifying them into four groups: doripenem and amikacin sensitive (DOR-S/AMK-S), doripenem sensitive and amikacin resistant (DOR-S/AMK-R), doripenem resistant and amikacin sensitive (DOR-R/AMK-S), and both doripenem and amikacin resistant (DOR-R/AMK-R). The MIC of each antibiotic and their combination was obtained using the Etest method. The fractional inhibitory concentration index was calculated to classify the results as synergistic, additive, indifferent, or antagonistic interaction. In the DOR-S/AMK-S class, 1 isolate of A. baumannii showed synergy and the other 5 showed additive results, 5 isolates of P. aeruginosa showed additive and 1 isolate showed indifferent result, and 2 isolates of K. pneumoniae showed additive and the other 4 showed indifferent results. In the DOR-S/AMK-R class, 3 isolates of A. baumannii showed additive and the other 3 showed indifferent results, 2 isolates of P. aeruginosa showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. In the DOR-R/AMK-S class, 1 isolate of A. baumannii showed additive and the other 5 showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 4 isolates of K. pneumoniae showed additive and the other 2 showed indifferent results. In the DOR-R/AMK-R class, 6 isolates of A. baumannii showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. Synergy occurred in only 1 (1.5%) isolate. Additive interaction occurred in 24 (35.3%) isolates, and indifferent interaction occurred in 43 (63.2%) isolates. Doripenem sensitive combined with amikacin sensitive reduced MIC significantly in all bacterial isolates when compared to single MIC of each antibiotic.
Background:Helicobacter pylori (H. pylori) causes continuous inflammation of the stomach. It is suspected that H. pylori infection is associated with an inflammatory response in acute myocardial infarction (AMI). This research was aimed at analyzing the association of Helicobacter pylori infection and the degree of reduction in left ventricular ejection fraction (LVEF) in patients with AMI, the number of coronary heart disease (CHD) risk factors with H. pylori on AMI incident, and association of type of AMI and H. pylori on AMI incident. Method: This is a prospective cohort study with observational-analytic method in AMI patients at ICCU of Prof. Dr. R. D. Kandou General Hospital Manado in 2015-2016. Data retrieval was done by filling out questionnaires, examination of blood samples, serology test to examine the presence of H. pylori, and echocardiography examination in patients with AMI. Results: Statistical analysis showed no significant association between H. pylori with the degree of reduction in LVEF in AMI patients (p=0.713), and the number of CHD risk factors (p=0.087). There was a significant association between H. pylori and types of IMA (p=0.017). There were more ST-Elevation Myocardial Infarction (STEMI) patients infected with H. pylori. Conclusion: There is no significant association between H. pylori infection and the degree of reduction in LVEF in AMI patients, and also the number of CHD risk factors. However, there is a significant association between AMI type and H. pylori on AMI, to wit there are more STEMI patients with H. pylori infections.
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