Search

Pendahuluan: Abses serebri yang disebabkan oleh infeksi Citrobacter koseri pada orang dewasa sangat jarang ditemukan. Citrobacter koseri merupakan basil gram negatif yang menyebabkan sebagian besar meningitis dan abses serebri pada neonatus dan bayi. Laporan Kasus: Laporan ini membahas seorang laki-laki berumur 51 tahun dengan keluhan penurunan kesadaran yang dialami sejak 5 hari sebelum masuk rumah sakit, didahului dengan demam, nyeri kepala yang semakin memberat, dan muntah. Keluhan disertai dengan kelemahan anggota gerak kiri dan mulut mencong. Pasien juga memiliki riwayat infeksi telinga kanan yang sering kambuh. Pada pemeriksaan fisik didapatkan kesadaran pasien sopor dengan defisit neurologis berupa hemiparesis sinistra, paresis nervus fasialis, dan papil edema. Hasil pemeriksaan brain CT-scan tanpa kontras menggambarkan lesi abses pada lobus temporal dextra. Pasien diberikan antibiotik dan dilakukan evakuasi abses serta timpanomastoidektomi. Dari hasil kultur pus abses serebri ditemukan adanya Citrobacter koseri yang sensitif dengan sefalosporin. Kesimpulan: Terdapat perbaikan klinis setelah terapi dan tindakan bedah.

Contains fulltext : 202938.pdf (Publisher’s version ) (Closed access) BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS: We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged 18 years recruited from Peru, Romania, Indonesia and South Africa. We calculated overall agreement and individual variation (mean +/- 2 standard deviations) stratified by country, age, sex, body mass index (BMI), HbA1c level and comorbidities (anaemia, human immunodeficiency virus [HIV]). We used an error grid approach to identify disagreement that could raise significant concerns. RESULTS: Overall mean POC HbA1c values were modestly higher than laboratory HbA1c levels by 0.1% units (95%CI 0.1-0.2); however, there was a substantial discrepancy for those with severe anaemia (1.1% HbA1c, 95%CI 0.7-1.5). For 89.6% of 1942 patients, both values indicated the same DM status (no DM, HbA1c

AIMS: Diabetes mellitus (DM) is associated with worse tuberculosis (TB) treatment outcomes, especially among those with poor glycemic control. We examined whether a structured clinical algorithm could improve glycemic control in TB patients with DM. METHODS: In an open label randomized trial, TB-DM patients were randomized to scheduled counselling, glucose monitoring, and adjustment of medication using a structured clinical algorithm (intervention arm) or routine DM management (control arm), with glycated hemoglobin (HbA1c) at month 6 as the primary end point. RESULTS: We randomized 150 pulmonary TB-DM patients (92% culture positive, 51.3% male, mean age 53 years). Baseline mean HbA1c was 11.0% in the intervention arm (n=76) and 11.6% in the control arm (n=74). At 6 months, HbA1c had decreased more in the intervention arm compared with the control arm (a difference of 1.82% HbA1c, 95% CI 0.82-2.83, p

Background People with diabetes have an increased risk of developing active tuberculosis (TB) and are more likely to have poor TB-treatment outcomes, which may impact on control of TB as the prevalence of diabetes is increasing worldwide. Blood transcriptomes are altered in patients with active TB relative to healthy individuals. The effects of diabetes and intermediate hyperglycemia (IH) on this transcriptomic signature were investigated to enhance understanding of immunological susceptibility in diabetes-TB comorbidity. Methods Whole blood samples were collected from active TB patients with diabetes (glycated hemoglobin [HbA1c] ≥6.5%) or IH (HbA1c = 5.7% to, Our study shows that people with diabetes and tuberculosis have altered peripheral immune profiles compared to people with only tuberculosis, and that these differences also exist in patients with intermediate hyperglycemia.

BACKGROUND: Data regarding the incidence of tuberculosis (TB) among people living with diabetes (PLWD) in TB-endemic settings are scarce. We examined TB incidence among PLWD in Indonesia who had previously been screened for latent TB infection (LTBI) and TB disease. METHODS: PLWD (≥18 y of age) in an urban setting were examined a mean 3.4 y after they had been screened for active TB and LTBI. Data on subsequent TB diagnosis were collected by interview and with chest X-ray, sputum smear and Mycobacterium tuberculosis culture. TB incidence rates were stratified for baseline LTBI status, as determined by the QuantiFERON interferon-gamma release assay (IGRA). RESULTS: Of 590 PLWD, 101 had died and 163 could not be contacted or refused. Among the 326 who were re-examined, 6 (1.8%; 95% confidence interval [CI] 0.7 to 4.0) reported being diagnosed already and a further 5 were diagnosed with active TB (1.5%; 95% CI 0.50 to 3.5). The TB incidence rate was 9.85 (95% CI 4.03 to 15.68) per 1000 person-years. TB incidence was higher among PLWD with baseline LTBI (17.13; 95% CI 5.25 to 29.00/1000 person-years) compared with those without LTBI (4.79; 95% CI -0.63 to 10.21), with an incidence rate ratio of 3.57 (95% CI 0.86 to 20.92; p=0.054). CONCLUSIONS: PLWD with LTBI in Indonesia and similar settings are likely to benefit from TB preventive therapy.

Research in the wake of the problems how much influence interpersonal communication head Dikmenti field to work productivity of employees at the Education Department of West Java Province. The method used is descriptive method supported by literature study. As well as using the techniques of data collection using the questionnaire enclosed with 4 rating scale (Likert) were distributed to 49 employees especially in the field Dikmenti as samples. The problems of this study (1) how the image of interpersonal communication chief of Dikmenti Education Department of West Java Province, (2) how the employee productivity Education Department of West Java Province, (3) how much influence interpersonal communication head of Dikmenti against employee productivity Education Department of West Java Province. Based on the results of data processing which is calculated by using the technique Weight Means Scores (WMS) shows that the average general tendency for the variable X (Interpersonal Communication) obtained at 3.06 and are in very good category. As for the average general trend in Y (Work Productivity) obtained at 3.45 to be in very good category. The calculation result normality test on the distribution of the data that the variables X and Y have normal distribution. Judging from the calculation of the correlation coefficient (rhitung) using the formula obtained Perason Product Moment correlation coefficient of 0675. Thisshows that there is a strong relationship between the variables X and Y. The test results significantly with t-test obtained t is known ttabel 6.031 and 2.012 compared to 6.03˃ 2012 means that significant relationship between interpersonal communication department heads Dikmenti on productivity employee of West Java Provincial Education Office. To determinethe influence of the variables X and Y is shown from the calculation coefficient of determination (KD) of 43%. This shows that the influence of the head of the field of interpersonal communication Dikmenti against employee productivity Education Department of West Java province by 43% and the remaining 57% is influenced by other factors. Likewise, the results of the regression analysis obtained by the equation Y = 44.949 + 0.525 X means every one-unit change in the variable X will provid a change in the variable Y for 0.525.Berdasarkan the above results it can be concluded that the research hypothesis that there is positive and significant correlation between Interpersonal Communication Division leader Dikmenti the Work Productivity Employee Education Department of West Java Province. The results of this study are expected to provide a benefit both for the institution, employees and for further research that will examine communication problems on the productivity of labor.

The upcoming suite of Sentinel satellites in combination with their free and open access data policy will open new perspectives for establishing a spatially and temporally detailed monitoring of the Earth’s surface. The Sentinel fleet will provide a so-far unique coverage with Earth observation (EO) data and new possibilities with respect to the implementation of innovative methodologies, techniques and geo-information products and services. However, the capability to effectively and efficiently access, process, analyze and distribute the mass data streams from the Sentinels and high-level information products derived from them poses a key challenge. This is also true with respect to the necessity of flexibly adapting the processing and analysis procedures to new or changing user requirements and technical developments. Hence, the implementation of operational, modular and highly automated processing chains, embedded in powerful hard- and software environments and linked with effective distribution functionalities, is of central importance. This contribution introduces the TEP Urban project that aims at the utilization of modern information technology functionalities and services to bridge the gap between the technology-driven EO sector and the information needs of environmental science, planning, and policy. Key components of such a system are currently developed in the TEP Urban project. This includes the implementation of an open, web-based platform employing distributed high-level computing infrastructures (Platform as a Service – PaaS) as well as providing key functionalities for i) high-performance access to thematic data (Information as a Service – InaaS), ii) modular and generic state-of-the art pre-processing, analysis, and visualization (Software as a Service – SaaS), iii) customized development and dissemination of algorithms, products and services, and iv) networking and communication. These services and functionalities are supposed to enable any interested user to easily exploit and generate thematic information on the status and development of the environment based on EO data and technologies. The TEP Urban platform is supposed to initiate a step change in the use of EO data by providing an open and participatory platform based on modern ICT technologies and services that enables any interested user to easily exploit and generate thematic information on the status and development of the built environment.