Infeksi Nosokomial Saluran Kencing (Insk) di Rumah Sakit Khusus Penyakit Menular, Jakarta

A prospective survey to establish the incidence of urinary tract nosocomial infection (UTNI) was conducted at the Infectious Diseases Hospital of Jakarta for one year duration in 1982-1983. The study was done by taking random samples from patients hospitalized for longer than 2 days through urine cultures on day 1, 3 and 7 and other necessary examination. From 2288 patients hospitalized during that period, 723 patients (aged 2 months-70 years) met the requirement to be included in the study, and 115 (15.9%) of them met the criteria for UTNI. Female patients had higher rate of UTNI compared to male patients (19.8% vs 12.4%). The age group with highest rate of UTNI was children with < 1 year of age and the rate of UTNI decreased as the age of patients increased. Febrile patients had significantly higher rate of UTNI compared to diarrhea patients (33.4% vs 2,4%, p < 0.001). Patients who had catheterization had significantly higher rate of UTNI compared to patients without catheter placement (85.7% vs 12.3% p <0.05). Antibiotics treatment prior to hospitalization was associated with higher rate of UTNI compared to patients without it (22.8% vs 12.6% p < 0.01) as it was also observed with hospitalization for 7 days or longer (15.8% vs 11.9%) of it is compared to shorter duration of hospitalization. Gram negative bacterias were the most commonly recovered from the urine cultures compared to gram positive (89.8% vs 10.2%) with E. coli (24.2%) as the leading organism. Other recovered organism, Proteus spp and Citrobacter bacilli showed high resistancy toward antibiotics commonly used in the hospital. Average duration of hospitalization for patients with UTNI (9.6 days) was longer compared to average duration for patients without UTNI (4.4 days). Six out of 115 patients with UTNI died (5.2%) compared to only 1.3% mortality in patients without UTNI. No single factor was significantly shown to be responsible for higher mortality rate of patients with UTNI, possibly was due to more severe condition of underlying disease of patients with UTNI

Infeksi Komunitas (Ik)/infeksi Luar Rumah Sakit (Ilrs) (Community Acquired Infection) di Rumah Sakit Khusus Penyakit Menular, Jakarta

A one year prospective study was conducted at the Infectious Diseases Hospital (IDH) of Jakarta in 1982-1983 to survey the rate of community acquired infection (CAI). Blood culture, rectal swab, urine culture and in some patients cerebro spinal fluid culture were obtained randomly from hospitalized patient at the time of admission. From 723 patients with age 2 months-70 years, who were examined and fulfilled the study criteria, 504 (69,7%) patients were positive for CAI resulted in total of 611 CAIs. Based on anatomical location, this number consists of 53.5% CAI of GI Tract, 20.9% CAI of Urinary Tract, 9.5% CAI bacteremia and 0.6% CAI involving central nervous system. Incidence rate was significantly higher in female (74.1%) compared to male (65.7%) (p12 years patients (73.9%) compared to children <12 years (p<0,01). Diarrhea patients had significantly higher CAI (77.4%) compared to febrile patients (55.2%) (p<0,01). Patients who had not received antibiotic prior to admission had higher rate of CAI (70.9%) compared to who received it prior to admission (67.1%) Etiologic agents most commonly recovered were gram negative bacterias (94.9%) with Vibrio cholerae (48.6%) as the leading cause, and only 5.1% were gram positive. Some of bacteria found as the etiologic agent of CAI, were Salmonella group D, Salmonella group E4, Proteus vulgaris and ruttgerii, Klebsiella pneumoniae, Mima polymorpha, Alkaligenes sp showed high rate of resistancy to commonly used antibiotics. (Ampicillin, Tetracycline, Chloramphenicol and Trimethoprim + Sulfamethoxazole). Average duration of hospitalization for CAI cases (6,4 days) was longer than in cases without CAI (4,3 days). There were 11 deaths (2.2%) in cases with CAI and 2 deaths (1.4%) in patients without CAI, with death rate was higher in males (2.4%) compared to female (1.9%), and highest was in less than 1 year old age group patient (13.6%), also significantly higher in febrile patients compared to diarrhea patients (7.2% vs 0.3%, p< 0.001). The higher mortality rate in CAI is due to more severe condition of underlying disease of patients who had CAI

Infeksi Nosokomial Saluran Nafas Bawah (Insnb) di Rumah Sakit Khusus Penyakit Menular, Jakarta

A prospective study to determine the incidence of lower respiratory tract nosocomial infection (LRNI) was conducted at the Infectious Diseases Hospital of Jakarta (IDH) in 1982-1983 for one year duration. Samples were taken randomly from 2 group of hospitalized patients: diarrheal and febrile patients. The criteria for development of lower respiratory infection were based on history, physical examination and chest x-ray examination, which was done only Li some of the patients those with duration of hospitalization &gt;2 days. From 2288 patients hospitalized during that period,723 (31.6%) patients fulfilled the criteria to be included in the nosocomial study, and from this group 34 (4.7%) of them met the criteria for LRNI. The LRNI was observed in almost similar percentage in both sexes of patients (4.5% in males and 4.9% in females). Comparison of different age group of patients showed that 5-11 years old children had highest rate of LRNI (14,5%) and significantly (p&lt;0,01) compare to &gt; 12 years old followed by children 1-4 year old (7,1%), while children &lt;1 year had 5.9%, and the lowest rate was in &gt; 12 years group with 2.7% Febrile patients had significantly higher rate of LRNI compared to diarrhea patients (11.6% vs 1.1%; p&lt; 0,001). Patients who received oxygen and bronchial mucus suction had significantly higher rate of LRNI (27.4%) vs 3.1%; p&lt;0,001) compared to those who did not (3,1%, p&lt; 0,001). Average duration of hospitalization for patients with LRNI was longer than for patients without it (11.1 vs 5.1 days). Case fatality rate in patients with LRNI was also higher 17.7%, compared only 1.2% in patients without LRNI. Factors involved in CFR was mostly due to severity of underlying disease and respiratory failure due to pneumonia in patients who developed LRNI

Pencemaran Kuman di Lingkungan Rumah Sakit Khusus Penyakit Menular, Jakarta

A survey to establish environmental contamination was conducted at the Infectious Diseases Hospital (IDH) of Jakarta by taking swabs from 90 hospital personnels who are directly involved in patients care. These swabs were taken from their hands, nails, throat and rectum. Swabs and cultures were also obtained from 167 equipments, solid and liquid material, food from the hospital, and the air in the hospital wards. From total of 437 specimen obtained, 73.7% showed presence contaminated result. There was 100% positive culture result noted in hands and nails swabs, 94.8% culture positive for any microorganism result was obtained from throat swabs while rectal swab indicated only 4.4% rate of contamination. Results of 167 swabs from material/equipments in the hospital, showed that 85.1% of them were not sterile, this included 59.1% of 54 liquid material, 37.3% from 35 liquid material which were supposed to be sterile, 100% positive culture of 17 liquid material specimen that were supposed to be clean. From solid materials 66.7% of 51 specimen were not sterile. This included 76.2% from 21 specimen that were supposed to be sterile, and 100% from 7 specimen that supposed to be clean. Also 100% non sterility was obtained from 23 other material and 62 equipment. Recovered bacterias consisted of both gram positive and negative bacterias and almost all of them represented normal human flora. Some of them potentially could became pathogen including pathogen for nosocomial infection. From the hospital personnels hand swabs, 25.4% were spore-forming bacteria and from the throat swabs 46.7% yielded Streptococcus ~ hemolyticus, and 4.4% were positive for coliform bacteria from rectal swabs. Results of material and equipment showed majority of aerobic rods (31.5%). Some of the bacteria recovered, including Pseudomonas aeruginosa and Enterobacter aerogenes were resistant to commonly used antibiotics in the hospital (Ampicillin, Tetracycline and Chloramphenicol)

AN OVERVIEW OF OBSERVATIONAL SLEEP RESEARCH WITH APPLICATION TO SLEEP STAGE TRANSITIONING

In this manuscript we give an overview of observational sleep research with a particular emphasis on sleep stage transitions. Sleep states represent a categorization of sleep electroencephalogram behavior over the night. We postulate that the rate of transitioning between sleep states is an important predictor of health. This claim is evaluated by comparing subjects with sleep disordered breathing to matched controls

Polarisation observables in lepton antilepton to proton antiproton reactions including lepton mass

General expressions, including the lepton mass, for the spin averaged differential cross section for the annihilation reaction lepton antilepton to proton antiproton are given, as well as general formulae for the single and double spin asymmetries in the centre of mass frame. In particular we discuss the single spin asymmetry, normal to the scattering plane, which measures the relative phase difference between nucleon electromagnetic form factors $G_E$ and $G_M$. Recent experimental investigations of these form factors in the space and time like region are reviewed. It is thought that measurements of the phase of these form factors will provide fundamental information on the internal nucleon structure. The phases between $G_E$ and $G_M$ are accessible through polarisation observables measured in the antiproton proton to lepton antilepton reaction, or in its time reversed process.Comment: 14 pages, to be submitted to EPJ

Procalcitonin decrease over 72 hours in US critical care units predicts fatal outcome in sepsis patients

Introduction: Close monitoring and repeated risk assessment of sepsis patients in the intensive care unit (ICU) is important for decisions regarding care intensification or early discharge to the ward. We studied whether considering plasma kinetics of procalcitonin, a biomarker of systemic bacterial infection, over the first 72 critical care hours improved mortality prognostication of septic patients from two US settings. Methods: This retrospective analysis included consecutively treated eligible adults with a diagnosis of sepsis from critical care units in two independent institutions in Clearwater, FL and Chicago, IL. Cohorts were used for derivation or validation to study the association between procalcitonin change over the first 72 critical care hours and mortality. Results: ICU/in-hospital mortality rates were 29.2%/31.8% in the derivation cohort (n = 154) and 17.6%/29.4% in the validation cohort (n = 102). In logistic regression analysis of both cohorts, procalcitonin change was strongly associated with ICU and in-hospital mortality independent of clinical risk scores (Acute Physiology, Age and Chronic Health Evaluation IV or Simplified Acute Physiology Score II), with area under the curve (AUC) from 0.67 to 0.71. When procalcitonin decreased by at least 80%, the negative predictive value for ICU/in-hospital mortality was 90%/90% in the derivation cohort, and 91%/79% in the validation cohort. When procalcitonin showed no decrease or increased, the respective positive predictive values were 48%/48% and 36%/52%. Discussion In septic patients, procalcitonin kinetics over the first 72 critical care hours provide prognostic information beyond that available from clinical risk scores. If these observations are confirmed, procalcitonin monitoring may assist physician decision-making regarding care intensification or early transfer from the ICU to the floor

20 Years of Progress in Intestinal Parasitic Diseases Research

Since 1968 investigators from U.S. Naval Medical Research Unit No. 2 Detachment (NAMRU-2) and the National Institute of Health Research and Development (NIHRD) have conducted parasitological/biomedical surveys in every major island in the Indonesian archipelago. Even smaller islands such as Nasi and Beras off of Sumatra and Beeuw off of Irian Jaya are represented in these studies. These activities were aimed to update and provide new information on the prevalence and distribution of intestinal parasites as well as other infectious agents. These surveys were done in collaboration with the Directorate General of Communicable Disease Control and Environmental Health (CDC&amp;EH), universities and other health institutions such as the Indonesian Armed Forces Health Services, Provincial Health Services, and others. Stool specimens, blood smears, and venous blood examined in these studies showed that most of the population surveyed were infected with one to 7 different species of parasites. Between 50% to 95% of the population had multiple infections

Digital communication platforms in cardiothoracic surgery during COVID-19 pandemic: keeping us connected or isolated?

During the COVID-19 pandemic, performing a surgeon’s duties has become challenging while adhering to social distancing mandates. To aid in the continuity of healthcare services, rapid implementation of digital communication tools became a necessity. This is an account of experiences using digital communication platforms, namely Microsoft Teams and Zoom, for clinical and educative purposes in the field of Cardiothoracic Surgery in the UK. While enabling ongoing virtual clinical meetings, conferences and learning opportunities for residents with little face-to-face contact, are these digital communication platforms keeping us connected or isolated

Determination of two-photon exchange amplitudes from elastic electron-proton scattering data

Using the available cross section and polarization data for elastic electron-proton scattering, we provide an extraction of the two-photon exchange amplitudes at a common value of four-momentum transfer, around Q^2 = 2.5 GeV^2. This analysis also predicts the e^+ p / e^- p elastic scattering cross section ratio, which will be measured by forthcoming experiments.Comment: 4 pages, 5 figures, updated error analysi