Cardioembolic stroke in patients with atrial fibrillation

Stroke is a neurological emergency in the form of disturbances in brain function that occur suddenly, it can be focal or global, which lasts for 24 hours or more and even causes death, with no other obvious cause other than vascular disorders. Strokes are generally divided into two main categories: ischemic stroke and hemorrhagic stroke. Atrial fibrillation (AF) is a cardiac arrhythmia and is often associated with stroke, dementia, and death.  In our case, an 81-year-old woman came to the ED complaining of sudden loss of consciousness with GCS E2V1M5.  A non-contrast CT scan of the head revealed cerebral atrophy and senile cerebellum accompanied by suspicion of infarction in the left globus pallidus.  The ECG results showed an irregular rhythm (irregular P-P) leading to AF.  AF is a high-risk factor for stroke because of impaired blood pumping, so the risk of clots forming which can then escape and flow to the brain causes blockage of blood flow to the brain and stroke occurs.  It is therefore important for routine treatment and control of high-risk patients with heart rhythm disorders such as AF to prevent embolic strokes

Faktor-faktor yang Mempengaruhi Permintaan Daging Ayam Kampung

Alexander Sinaga (070304020) dengan judul skripsi “Faktor-Faktor yang Mempengaruhi Permintaan Daging Ayam Kampung di Kecamatan Siantar Barat, Kota pematang Siantar” dibawah bimbingan Ibu Dr.Ir.Salmiah, MS sebagai ketua pembimbing dan Bapak Ir.Sinar Indra Kesuma, MSi sebagai anggota pembimbing. Penelitian ini bertujuan untuk mengidentifikasi faktor-faktor yang mempengaruhi permintaan daging ayam kampung dan mengetahui hubungan karakteristik umur, pekerjaan dan tingkat pendidikan dengan perilaku konsumen dalam membeli daging ayam kampung. Untuk mengidentifikasi faktor-faktor yang mempengaruhi permintaan daging ayam kampung digunakan analisis regresi linier berganda dimana faktor-faktor yang mempengaruhi permintaan daging ayam kampung adalah harga daging ayam kampung, pendapatan per bulan, jumlah tanggungan dan harga daging ayam potong. Untuk mengetahui hubungan karakteristik umur, pekerjaan dan tingkat pendidikan digunakan analisis koefisien Rank Spearman. Hasil penelitian menunjukkan bahwa faktor-faktor yang mempengaruhi permintaan daging ayam kampung di daerah penelitian adalah pendapatan per bulan sedangkan harga daging ayam kampung, jumlah tanggungan dan harga daging ayam potong tidak mempengaruhi. Hasil penelitian juga menunjukkan tidak terdapat hubungan antara karakteristik umur, pekerjaan dan tingkat pendidikan dengan perilaku konsumen dalam membeli daging ayam kampung

Analisis Framing Konstruksi Media Terhadap Pemberitaan Calon Gubernur dan Calon Wakil Gubernur Sumatera Barat dalam Pilkada 2015 di Harian Umum Singgalang dan Harian Pagi Padang Ekspres

Pemilihan kepala daerah di Sumatera Barat khususnya Gubernur dan Wakil Gubernur mengalami perubahan atas putusan Mahkamah Konstitusi terhadap bakal calon Gubernur. Bakal calon Gubernur yang semulanya ada 7 bakal calon Gubernur di Sumatera Barat. Kini hanya menyisakan 2 pasang calon Gubernur dan Wakil Gubernur, yaitu Irwan Prayitno dan Nasril Abit (IP-NA), dan Muslim Kasim dan Fauzi Bahar (MK-FB). Hal ini membuat peneliti tertarik meneliti bagaimana media massa melakukan pemberitaannya, khususnya Harian Umum Singgalang dan Harian Pagi Padang Ekspres. Bingkai pemberitaan Harian Umum Singgalang dan Harian Pagi Padang Ekspres dianalisis dan dilihat dari sudut pandang konstruktivisme dengan memakai metode analisis framing, berlandaskan pada teori framing Robert N. Entman. Proses analisis ditinjau dari elemen framing Robert N. Entman yang terdiri define problems, diagnose cause, make moral judgement, dan treatment recommendation. Untuk mempertajam analisis penelitian, peneliti menggunakan teori hirarki pengaruh isi media dari Shoemaker dan D. Reese. Hasil penelitian menunjukkan ada perbedaan framing pada masing-masing media. Pemberitaan Harian Umum Singgalang dan Harian Pagi Padang Ekspres terhadap pasangan calon Gubernur Sumatera Barat memiliki framing yang terpihak pada salah satu pasangan calon Gubernur. Singgalang lebih menekankan dukungan pada IP-NA sementara itu Padang Ekspres MK-FB. Hal ini dapat diidentifikasi dari penggunaan kata, frasa, dan kalimat pada teks berita, serta pemilihan narasumber yang berbeda-beda pada masing-masing media. Kata Kunci : Pilkada, framing media, berita, Sumatera Barat, Singgalang, Padang Ekspre

PENGARUH PEMBERIAN VASCULAR ENDOTHELIAL GROWTH FACTOR 121 REKOMBINAN TERHADAP EKSPRESI SEL NATURAL KILLER DESIDUA PADA MENCIT (MUS MUSCULUS) MODEL PREEKLAMPSIA

ABSTRACT Preeclampsia is a disease in pregnancy that still one of the main causes of maternal and infant mortality. The incidence is 3% worldwide. One of preeclampsia theory is implantation failure caused by maternal maladaptation immun system decidual Natural Killer cells (dNK cells). dNK cells also known as a producers of proangiogenik Vascular Endothelial Growth Factor VEGF in early implantation period. Several studies shown the incerase of dNK cells and lower VEGF expression in the preeclamptic women. Administration of recombinant VEGF121 expected to improve the levels of VEGF and so dNK cells. This study is an experimental analytic study with randomized control trial (RCT) design, aimed to determine the effect of external VEGF, recombinant VEGF121, to the improvement of dNK cells expressions in preeclampsia. The samples collect from 30 pregnant mice (n=10) which divided into three groups: normal pregnant mice group, group of preeclamptic pregnant mice model without recombinant VEGF121 administration and group of preeclamptic pregnant mice models with recombinant VEGF121 administration. The recombinant VEGF121 administration was perform on the -12 to -15 of mice gestation day by intravenous injection 125 mg/kg/day, continued with sampling on day -16. Examination of dNK cells using immunohistochemical staining anti CD56 antibody for CD56. Data analysis using Kruskal Wallis Test and Mann Whitney Test with SPSS (Software Package for Social Science). From examination we found significant decrease of CD56 in the group of preeclamptic pregnant mice models with administration of recombinant VEGF121 compared to the group of preeclamptic pregnant mice model without recombinant VEGF121 administration (p = 0.023; <0.05). So the conclusion is the administration of recombinant VEGF121 will decreased decidual NK cells expression in preeclamptic mice model. Keywords: Preeclampsia, decidual NK cells, recombinant VEGF121, mice

Pelaksanaan Jasa Audit dan Accounting Service Di Kantor Akuntan Publik Herman Dody Tanumihardja Dan Rekan

The Internship was conducted at Herman Dody Tanumihardja and Partner Public Accounting Firm taking the position in auditing division as a junior auditor. During the internship period, the author was given task which is corresponding with auditing process and therre are also several other task whick corresponding with the administration of the public accounting firm. The tas which the author has done during the internship are review financial statement, revising financial statement, stock opname and special audit. There were some constraints which the author face during the internship period, found difference between physical calculation and computer during stock opname, wrong method on cash flow, difficult to collect information about inventory and unussual financial statement structure. The solution of these problems were recalculating the stock in warehouse with the head warehouse and different staff, asking the senior about the method of cash flow and recalculating with manual, add more auditor during special audit and add some reference about non-profit organisation

Clostridium difficile ribotypes in Austria: a multicenter, hospital-based survey

A prospective, noninterventional survey was conducted among Clostridium difficile positive patients identified in the time period of July until October 2012 in 18 hospitals distributed across all nine Austrian provinces. Participating hospitals were asked to send stool samples or isolates from ten successive patients with C.difficile infection to the National Clostridium difficile Reference Laboratory at the Austrian Agency for Health and Food Safety for PCR-ribotyping and in vitro susceptibility testing. A total of 171 eligible patients were identified, including 73 patients with toxin-positive stool specimens and 98 patients from which C. difficile isolates were provided. Of the 159 patients with known age, 127 (74.3 %) were 65 years or older, the median age was 76 years (range: 9–97 years), and the male to female ratio 2.2. Among these patients, 73 % had health care-associated and 20 % community-acquired C. difficile infection (indeterminable 7 %). The all-cause, 30-day mortality was 8.8 % (15/171). Stool samples yielded 46 different PCR-ribotypes, of which ribotypes 027 (20 %), 014 (15.8 %), 053 (10.5 %), 078 (5.3 %), and 002 (4.7 %) were the five most prevalent. Ribotype 027 was found only in the provinces Vienna, Burgenland, and Lower Austria. Severe outcome of C. difficile infection was found to be associated with ribotype 053 (prevalence ratio: 3.04; 95 % CI: 1.24, 7.44), not with the so-called hypervirulent ribotypes 027 and 078. All 027 and 053 isolates exhibited in vitro resistance against moxifloxacin. Fluoroquinolone use in the health care setting must be considered as a factor favoring the spread of these fluoroquinolone resistant C. difficile clones

Testing for aerobic heterotrophic bacteria allows no prediction of contamination with potentially pathogenic bacteria in the output water of dental chair units

Background: Currently, to our knowledge, quality of output water of dental chair units is not covered by specific regulations in the European Union, and national recommendations are heterogeneous. In Germany, water used in dental chair units must follow drinking water quality. In the United States of America, testing for aerobic heterotrophic bacteria is recommended. The present study was performed to evaluate whether the counts of aerobic heterotrophic bacteria correlate with the presence of potentially pathogenic bacteria such as Legionella spp. or Pseudomonas aeruginosa

The time consuming nature of phenylketonuria: A cross-sectional study investigating time burden and costs of phenylketonuria in the Netherlands

Abstract Background Phenylketonuria (PKU) is a rare inborn error of metabolism that affects the ability of patients to metabolise phenylalanine (Phe). Lifelong management of blood Phe levels is required in order to avoid the complications associated with PKU. This constitutes a severely protein restricted diet, and regular monitoring of Phe levels. Management of PKU may be costly and time-consuming for adult patients or caregivers of PKU-affected children. A cross-sectional study was performed with patients or their caregivers in the Netherlands to gain insight into the personal time burden and cost of living with PKU. Methods A systematic literature review was performed to identify all aspects of PKU management that may pose a financial or time burden on patients or caregivers. Findings were confirmed through interviews with PKU experts and feedback from patients and caregivers, and consolidated into a questionnaire that aimed to evaluate the impact of each of these factors. Early and continuously treated adult patients and caregivers from seven metabolic centres were recruited to complete the questionnaire online. Results 22 adult patients and 24 caregivers participated in the study. Managing a Phe-restricted diet represented an extra time burden of 1 h and 24 min for caregivers and 30 min for adult patients per day. Caregivers reported a significantly higher time burden than adult patients. The median total out-of-pocket cost (OOPC) for patients was €604 annually, with 99% of expenditure on low-protein food products. Greater disease severity was significantly associated with increased OOPC and time burden for both adult patients and caregivers. Conclusions Management of PKU is associated with a considerable time burden for both caregivers of children with PKU and adult patients. Caregivers of PKU-affected children reported a significantly higher time burden than adult patients. The OOPC of caregivers and patients was mainly driven by the expenditure on low protein food

Mechanisms behind variation in the Clostridium difficile 16S–23S rRNA intergenic spacer region

Clostridium difficile infection is an increasing problem in hospitals worldwide, mainly due to the recent emergence of a hypervirulent C. difficile strain. C. difficile PCR ribotyping, based on size variation of the 16S–23S rRNA intergenic spacer region (16S–23S ISR), is widely used in Europe for molecular epidemiological investigation. The mechanism underlying the 16S–23S ISR size variations in the genome of C. difficile is currently not completely understood. To elucidate this mechanism, isolates of six different PCR ribotypes were analysed by cloning and sequencing the 16S–23S ISR. A direct repeat, IB, of 9 bp was detected up to five times in the 16S–23S ISR in all 47 clones investigated. Thirty-five clones displayed differences either by ribotype or by nucleotide sequence. The sequences of the 16S–23S ISR of C. difficile showed a uniformly organized structure, composed of a tRNAAla gene and spacers of 33 and 53 bp separated by the 9 bp direct repeat IB. The results of the study support the hypothesis that this composition is responsible for the length variations seen in the 16S–23S ISR, and indicate that these length variations result from slipped-strand mispairing and intra- and possibly interchromosomal homologous recombination