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Pengaruh Penggunaan Antibiotika Terhadap Lama Hari Sakit Dan Lama Kehilangan Hari Kerja Pada Pasien Infeksi Pernapasan Akut Bagian Atas Pada Pelayanan Kesehatan Primer, Gunawan Gunawan, Suhendro Suwarto, Cleopas Martin Rumende, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Pendahuluan: Prevalensi infeksi saluran pernapasan bagian atas akut (ISPA) di komunitas masih tinggi dan menyebabkan morbiditas dan penurunan kualitas hidup masyarakat secara luas. Etiologi tersering dari infeksi pernapasan akut di luar negeri adalah virus, selain itu terdapat etiologi bakteri yang memerlukan terapi antibiotika yang spesifik. Penggunaan antibiotika untuk infeksi pernapasan akut berlebihan, dan hal ini menyebabkan peningkatan resistensi bakteri terhadap antibiotika. Penelitian ini bertujuan untuk mengetahui pola etiologi infeksi pernapasan akut, kesesuaian pemberian antibiotika dan perbedaan rerata lama sakit dan lama kehilangan hari kerja.

Metode: Penelitian ini merupakan penelitian observasional analitik dengan pengambilan data secara potong lintang dan …

Metastatic Angiosarcoma And Kasabach-Merritt Syndrome, Suleiman Massarweh, Aun Munis, Rouzan Karabakhtsian, Edward Romond, Jessica Moss

Internal Medicine Faculty Publications

Angiosarcomas are exceedingly rare tumors that are often difficult to diagnose. Exceptionally unusual is the presentation of these tumors with Kasabach-Merritt Syndrome, a curious form of intratumoral coagulation that can be impossible to distinguish from intravascular coagulation, which is more common. Instant recognition of this clinical association can help making a prompt diagnosis and timely initiation of therapy.

Mechanical Thrombectomy Versus Intrasinus Thrombolysis For Cerebral Venous Sinus Thrombosis: A Non-Randomized Comparison., Fazeel M. Siddiqui, Chirantan Banerje, Susanna M. Zuurbier, Qing Hao, Chul Ahn, Glenn L. Prid, Mohammad Wasay, Charles B.L.M. . Majoie, David Liebeskind, ,Mark Johnson, Jan Stam

Department of Medicine

Small retrospective studies have shown the benefit of endovascular treatment with intrasinus thrombolysis (IST) or mechanical thrombectomy (MT) with/without IST (MT ± IST) in cases of multifocal cerebral venous thrombosis (CVT). Our study compares the mortality, functional outcome and periprocedural complications among patients treated with MT ± IST versus IST alone. We reviewed clinical and angiographic findings of 63 patients with CVT who received endovascular treatment at three tertiary care centers. Primary outcome variables were discharge mortality and neurological dysfunction, and intermediate (three months) and long-term (>six months) morbidity. The modified Rankin scale (mRS) was used to assess morbidity. …

Relationship Between Alcohol Use Categories And Noninvasive Markers Of Advanced Hepatic Fibrosis In Hiv-Infected, Chronic Hepatitis C Virus-Infected, And Uninfected Patients, J. K. Lim, J. P. Tate, S. L. Fultz, J. L. Goulet, J. Conigliaro, K. J. Bryant, A. J. Gordon, C. Gibert, D. Rimland, V. Lo Re, +4 Additional Authors

Journal Articles

Background. It is unclear if the risk of liver disease associated with different levels of alcohol consumption is higher for patients infected with human immunodeficiency virus (HIV) or chronic hepatitis C virus (HCV). We evaluated associations between alcohol use categories and advanced hepatic fibrosis, by HIV and chronic HCV status. Methods. We performed a cross-sectional study among participants in the Veterans Aging Cohort Study who reported alcohol consumption at enrollment (701 HIV/HCV-coinfected; 1410 HIV-monoinfected; 296 HCV-monoinfected; 1158 HIV/HCV-uninfected). Alcohol use category was determined by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire and alcohol-related diagnoses and was classified as nonhazardous …

Reply: To Pmid 23929808, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. L. Schilsky, W. M. Lee, R. S., Jr. Brown

Journal Articles

No abstract provided.

Steroid Use In Acute Liver Failure, J. Karkhanis, E. C. Verna, M. S. Chang, R. T. Stravitz, M. Schilsky, W. M. Lee, R. S., Jr. Brown

Journal Articles

Drug-induced and indeterminate acute liver failure (ALF) might be due to an autoimmune-like hepatitis that is responsive to corticosteroid therapy. The aim of this study was to evaluate whether corticosteroids improve survival in fulminant autoimmune hepatitis, drug-induced, or indeterminate ALF, and whether this benefit varies according to the severity of illness. We conducted a retrospective analysis of autoimmune, indeterminate, and drug-induced ALF patients in the Acute Liver Failure Study Group from 1998-2007. The primary endpoints were overall and spontaneous survival (SS, survival without transplant). In all, 361 ALF patients were studied, 66 with autoimmune (25 steroids, 41 no steroids), 164 …

Brief Motivational Enhancement Intervention To Prevent Or Reduce Postpartum Alcohol Use: A Single-Blinded, Randomized Controlled Effectiveness Trial, D. M. Rubio, N. L. Day, J. Conigliaro, B. H. Hanusa, C. Larkby, M. Mcneil, E. Cohen, B. Jones, M. Watt-Morse, K. L. Kraemer, +2 Additional Authors

Journal Articles

AIMS: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DESIGN: This study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum. SETTING: The setting is in a large, urban, obstetrics clinic. PARTICIPANTS: Participants were women who were >/= 18 years old,gestation, and consumed alcohol during pregnancy. Of 3438 women screened, …

D-Dimer And Risk Of Thromboembolic And Bleeding Events In Patients With Atrial Fibrillation - Observations From The Aristotle Trial, C. Christersson, L. Wallentin, U. Andersson, J. H. Alexander, J. Ansell, R. De Caterina, B. J. Gersh, C. B. Granger, M. Hanna, A. Siegbahn, +5 Additional Authors

Journal Articles

BackgroundD-dimer is related to adverse outcomes in arterial and venous thromboembolic diseases. ObjectivesTo evaluate the predictive value of D-dimer level for stroke, other cardiovascular events, and bleeds, in patients with atrial fibrillation (AF) treated with oral anticoagulation with apixaban or warfarin; and to evaluate the relationship between the D-dimer levels at baseline and the treatment effect of apixaban vs. warfarin. MethodsIn the ARISTOTLE trial, 18201 patients with AF were randomized to apixaban or warfarin. D-dimer was analyzed in 14878 patients at randomization. The cohort was separated into two groups; not receiving vitaminK antagonist (VKA) treatment and receiving VKA treatment at …

Direct Oral Anticoagulants New Drugs And New Concepts, J. H. Levy, A. C. Spyropoulos, C. M. Samama, J. Douketis

Journal Articles

Direct oral anticoagulants (DOACs) are approved for multiple thromboembolic disorders and provide advantages over existing agents. As with all anticoagulants, management protocols for the eventuality of bleeding are important. Randomized phase III studies generally show that DOACs have a similar risk of clinically relevant bleeding compared with standard anticoagulants, with reductions in major bleeding in some cases. This may be particularly important in patients with atrial fibrillation, for whom the rate of intracranial hemorrhage was approximately halved with DOACs compared with warfarin. Conversely, the risk of gastrointestinal bleeding may be increased. Specific patient characteristics, such as renal impairment, comedications, and …

Factors Associated With Inconsistent Condom Use In Adolescents With Negative Or Unknown Hiv Status In Northwest Cameroon, L. Morris, F. Kouya, R. Kwalar, M. Pilapil, K. Saito, N. Palmer, R. Posada, P. M. Tih, T. Welty, J. Jao

Journal Articles

The purpose of this study is to evaluate the association between utilization of HIV testing and condom use amongst Cameroonian youths/adolescents who are not known to be HIV-infected. Worldwide, HIV is spreading most quickly amongst youths/adolescents. Between 44% and 82% of sexually active youths in Cameroon report inconsistent condom use. Data regarding utilization of HIV testing and condom use are lacking. A cross-sectional survey was administered to 431 youths ages 12-26 years in Cameroon from September 2011 to December 2011. Data on sociodemographics, sexual risk behaviors, self-reported HIV status, and condom use were collected. We compared rates of inconsistent condom …

Hla-Drb1-Associated Rheumatoid Arthritis Risk At Multiple Levels In African Americans Hierarchical Classification Systems, Amino Acid Positions, And Residues, R. J. Reynolds, A. F. Ahmed, M. I. Danila, L. B. Hughes, P. K. Gregersen, S. Raychaudhuri, R. M. Plenge, S. L. Bridges, Af Consortium Longitudinal Evaluat

Journal Articles

Objective. To evaluate HLA-DRB1 genetic risk of rheumatoid arthritis (RA) in African Americans by 3 validated allele classification systems and by amino acid position and residue, and to compare genetic risk between African American and European ancestries. Methods. Four-digit HLA-DRB1 genotyping was performed on 561 autoantibody-positive African American cases and 776 African American controls. Associa-tion analysis was performed on Tezenas du Montcel (TdM), de Vries (DV), and Mattey classification system alleles and separately by amino acid position and individual residues. Results. TdM S2 and S3P alleles were associated with RA (odds ratio [95% confidence interval] 2.8 [2.0-3.9] and 2.1 [1.7-2.7], …

The Influence Of Polygenic Risk Scores On Heritability Of Anti-Ccp Level In Ra, J. Cui, K. E. Taylor, Y. C. Lee, H. Kallberg, M. E. Weinblatt, J. S. Coblyn, L. Klareskog, L. A. Criswell, P. K. Gregersen, E. W. Karlson, +2 Additional Authors

Journal Articles

The objective of this study was to study genetic factors that influence quantitative anticyclic citrullinated peptide (anti-CCP) antibody levels in RA patients. We carried out a genome-wide association study (GWAS) meta-analysis using 1975 anti-CCP + RA patients from three large cohorts, the Brigham Rheumatoid Arthritis Sequential Study (BRASS), North American Rheumatoid Arthritis Consortium (NARAC) and the Epidemiological Investigation of RA (EIRA). We also carried out a genome-wide complex trait analysis (GCTA) to estimate the heritability of anti-CCP levels. GWAS-meta-analysis showed that anti-CCP levels were most strongly associated with the human leukocyte antigen (HLA) region with a P-value of 2 x …

Lymphoma Risk In Systemic Lupus: Effects Of Disease Activity Versus Treatment, S. Bernatsky, R. Ramsey-Goldman, L. Joseph, J. F. Boivin, K. H. Costenbader, M. B. Urowitz, D. D. Gladman, P. R. Fortin, C. Aranow, A. E. Clarke, +27 Additional Authors

Journal Articles

Objective To examine disease activity versus treatment as lymphoma risk factors in systemic lupus erythematosus (SLE). Methods We performed case-cohort analyses within a multisite SLE cohort. Cancers were ascertained by regional registry linkages. Adjusted HRs for lymphoma were generated in regression models, for time-dependent exposures to immunomodulators (cyclophosphamide, azathioprine, methotrexate, mycophenolate, antimalarial drugs, glucocorticoids) demographics, calendar year, Sjogren's syndrome, SLE duration and disease activity. We used adjusted mean SLE Disease Activity Index scores (SLEDAI-2K) over time, and drugs were treated both categorically (ever/never) and as estimated cumulative doses. Results We studied 75 patients with lymphoma (72 non-Hodgkin, three Hodgkin) and …

Mhc Associations With Clinical And Autoantibody Manifestations In European Sle, D. L. Morris, M. M. A. Fernando, K. E. Taylor, S. A. Chung, J. Nititham, M. E. Alarcon-Riquelme, L. F. Barcelloss, T. W. Behrens, P. K. Gregersen, Con Syst Lupus Erythematosus Genet, +13 Additional Authors

Journal Articles

Systemic lupus erythematosus (SLE) is a clinically heterogeneous disease affecting multiple organ systems and characterized by autoantibody formation to nuclear components. Although genetic variation within the major histocompatibility complex (MHC) is associated with SLE, its role in the development of clinical manifestations and autoantibody production is not well defined. We conducted a meta-analysis- of four independent European SLE case collections for associations between SLE sub-phenotypes and MHC single-nucleotide polymorphism genotypes, human leukocyte antigen (HLA) alleles and variant HLA amino acids. Of the 11 American College of Rheumatology criteria and 7 autoantibody sub-phenotypes examined, anti-Ro/SSA and anti-La/SSB antibody subsets exhibited the …

Acute Mesenteric Ischemia: A Sequela Of Abdominal Aortography, S. Kedia, V. R. Bhatt, A. Koirala, S. Murukutla, J. Rijal, S. Pant, M. A. Wrzolek, A. Gottesman

Journal Articles

The use of abdominal angiography and transcatheter embolization has increased rapidly in the last few decades. Although improvement in angiographic techniques has made the procedure safe, ischemic colitis is a rare but potentially dreadful complication. We report a case of a 51-year-old woman who developed ischemic colitis following aortography, demonstrating that such angiographic studies may produce substantial morbidity.

Acute St-Segment Elevation Myocardial Infarction In A Young Patient With Essential Thrombocythemia: A Case With Long-Term Follow-Up Report, T. Bhat, M. Ahmed, H. Baydoun, Z. Ghandour, A. Bhat, D. Mccord

Journal Articles

Essential thrombocythemia (ET) is a neoplastic proliferation of mature myeloid cells - in particular, megakaryocytes - leading to persistently elevated platelet count. Usual clinical presentation is related to an increase in the risk of hemorrhage and/or thrombosis. Management of ET consists of antiplatelet therapies - mainly aspirin and cytoreductive therapies. Coronary involvement in patients with ET is rare. The optimal treatment strategies for ET patients presenting with acute myocardial infarction remains unclear. Acute interventions like intracoronary thrombolytic therapy, angioplasty, and coronary-artery bypass grafting have been reported in such patients. However, several questions remain unanswered about the acute and long-term management …

Angiopoietin-2: A Key To Understanding Sepsis And Its Pulmonary Sequelae?, J. Y. Lee, E. J. Miller

Journal Articles

No abstract provided.

B-1a Cell Diversity: Nontemplated Addition In B-1a Cell Ig Is Determined By Progenitor Population And Developmental Location, N. E. Holodick, T. Vizconde, T. L. Rothstein

Journal Articles

Natural Abs produced by B-1a cells are required for immediate protection against infection. The protective capacity of natural Abs is attributed to germline-like structure, which includes the relative absence of N-region addition. Previous studies have shown B-1a cell Ig from aged mice contains abundant nontemplated (N)-additions. B-1a cells have been shown to derive from a specific lineage-negative (Lin(-)) CD45R(low/-) CD19(+) progenitor found both in fetal liver and adult bone marrow. In this study, we report identification of a fetal liver population characterized phenotypically as Lin(-)CD45R(-)CD19(-), which gives rise to IgM(+)IgD(low)CD45R(low)CD5(+)Mac-1(+)CD19(high)CD43(+)CD23(low) B-1a cells upon adoptive transfer to SCID recipients. These B-1a …

Breast Cancer And Aging: Results Of The U13 Conference Breast Cancer Panel, M. F. Barginear, H. Muss, G. Kimmick, C. Owusu, E. Mrozek, A. Shahrokni, K. Ballman, A. Hurria

Journal Articles

Breast cancer is predominantly a disease of older women, yet there is a knowledge gap due to the persisting misalignment between the age distribution of women with breast cancer and the age distribution of participants in clinical trials. The purpose of this report is to state the U13 conference breast cancer panel's recommendations regarding therapeutic clinical trials that will fill gaps in knowledge regarding the care of older patients with breast cancer. The U13 conference was a collaboration between the Cancer and Aging Research Group and the National Institute on Aging and the National Cancer Institute (NCI). Clinical trials should …

C1q-Mediated Repression Of Human Monocytes Is Regulated By Lair-1, M. Son, B. Diamond

Journal Articles

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by abnormal function of both the innate and the adaptive immune system, leading to a loss of tolerance to self-antigens. Monocytes are a key component of the innate immune system and are efficient producers of multiple cytokines. In SLE, inappropriate activation of monocytes is thought to contribute to the loss of self-tolerance. In this study, we demonstrate that type 1 interferon (IFN) production by CpG-challenged monocytes can be suppressed by C1q through activate leukocyte-associated Ig-like receptor-1 (LAIR-1), which contains ITIM motifs. The phosphorylation of LAIR-1 and the interaction of LAIR-1 …