bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabidiol restores intestinal barrier dysfunction and inhibits the apoptotic process induced by Clostridium difficile toxin A in Caco‐2 cells
Authors: Gigli Stefano , Seguella Luisa , Pesce Marcella , Bruzzese Eugenia , D’Alessandro Alessandra , Cuomo Rosario , Steardo Luca , Sarnelli Giovanni , Esposito Giuseppe
Published: March 2017

Background

Clostridium difficile toxin A is responsible for colonic damage observed in infected patients. Drugs able to restore Clostridium difficile toxin A‐induced toxicity have the potential to improve the recovery of infected patients. Cannabidiol is a non‐psychotropic component of Cannabis sativa, which has been demonstrated to protect enterocytes against chemical and/or inflammatory damage and to restore intestinal mucosa integrity.

Objective

The purpose of this study was to evaluate (a) the anti‐apoptotic effect and (b) the mechanisms by which cannabidiol protects mucosal integrity in Caco‐2 cells exposed to Clostridium difficile toxin A.

Methods

Caco‐2 cells were exposed to Clostridium difficile toxin A (30 ng/ml), with or without cannabidiol (10−7 –10−9  M), in the presence of the specific antagonist AM251 (10−7  M). Cytotoxicity assay, transepithelial electrical resistence measurements, immunofluorescence analysis and immunoblot analysis were performed in the different experimental conditions.

Results

Clostridium difficile toxin A significantly decreased Caco‐2 cells’ viability and reduced transepithelial electrical resistence values and RhoA guanosine triphosphate (GTP), bax, zonula occludens‐1 and occludin protein expression, respectively. All these effects were significantly and concentration‐dependently inhibited by cannabidiol, whose effects were completely abolished in the presence of the cannabinoid receptor type 1 (CB1) antagonist, AM251.

Conclusions

Cannabidiol improved Clostridium difficile toxin A‐induced damage in Caco‐2 cells, by inhibiting the apoptotic process and restoring the intestinal barrier integrity, through the involvement of the CB1 receptor.
Maniben Sita: South Africa’s Anti-apartheid Heroine
Authors: Naidoo Muthal
Published: March 2017

This is a portrait of the anti-apartheid struggle for freedom in South Africa by Maniben Sita, a follower of Gandhi, who adopted satyagraha to oppose injustice. In 1946–47, Maniben organised a women’s contingent to demonstrate against the restrictive laws that were being promulgated to curb Indians’ access to land and trading rights. As executive member of the Transvaal Indian Congress and later in the Defiance Campaign of the 1950s she continued her advocacy of justice for all. She was sent to prison several times during her long involvement in the anti-apartheid struggle. She is recognised as one of South Africa’s heroines and her portrait hangs in the Apartheid Museum in Johannesburg.
The crystal structure of the new mineral dyrnaesite-(La),Na8CeIVREE2(PO4)6
Authors: Balić-Žunić Tonči
Published: March 2017

Dyrnaesite-(La), Na7.89(Ce0.94Ca0.06)∑1.00(La1.14Ce0.40Pr0.10Nd0.24Ca0.12)∑2.00(PO4)6is orthorhombic,Pnma,a= 18.4662(7),b= 16.0106(5),c= 7.0274(2) Å,V= 2077.7(1) Å3,Z= 4. The crystal structure is related to the group of Na3REE(XO4)2compounds (with X = P, V, As), based on the aphthitalite/glaserite structural type. Dyrnaesite is distinct in having ordered Na vacancies, and a rare-earth element (REE) site occupied preferentially by Ce4+. This also distinguishes it from closely related vitusite-(Ce) [Na3REE(PO4)2]. The relation of their unit cells is:ad=bv,bd= 3av,cd= 1/2cv. The distinct Ce4+site in dyrnaesite-(La) has smaller coordination with shorter bond lengths than the otherREEsite in the same structure or theREEsites in vitusite-(Ce). It is adjacent to the predominately vacant Na site, which in its turn has the largest coordination of all Na sites in the structure.REEsites, or Na sites in a [010] row (similar to [100] in vitusite(Ce)) assume two types of coordinations with and without mirror symmetry and two different configurations of surrounding PO4tetrahedra. This summarizes the topological difference to vitusite-(Ce) where the corresponding coordinations are similar in the same row and intermediate in character to the two types in dyrnaesite-(La).
A new method for continental shale oil enrichment evaluation
Authors: Su Siyuan , Jiang Zhenxue , Gao Zhiye , Ning Chuanxiang , Wang Zhi , Li Zheng , Zhu Rifang
Published: March 2017

We have evaluated continental shale oil enrichment via experiments. Rock pyrolysis, nuclear magnetic resonance, and pulse permeability tests were conducted to establish the pore saturation index (PSI), which comprehensively evaluates the enrichment of shale oil features using the characteristics of self-generation and self-preservation, the parameters of which include the pyrolysis-free hydrocarbon ([Formula: see text]) and total organic carbon of source rocks as well as the porosity and permeability of reservoir rocks. The correlation of the oil content ([Formula: see text]) and PSI values indicated that PSI values greater than 50 generally indicate good oil enrichment plays, whereas those smaller than 50 imply poor conditions for oil enrichment. This conclusion was successfully applied to the Zhanhua Sag with shale oil plays in the Jiyang Depression, Bohai Bay Basin, China. In addition, the shale oil plays of the Dongying Sag in the Jiyang Depression were investigated to verify the effectiveness and reliability of the new method.
Introduction: “Narrative against Data”
Authors: Rosenthal Jesse
Published: March 2017

This introduction frames the principal questions of this special issue: the nature of data in criticism and the relation between data-driven literary criticism and more traditional forms of criticism. The suggestion throughout is that the current tension in critical practice can be better understood by turning to nineteenth-century narratives and their fraught attempts at encapsulating and representing data. Particular attention is paid to the means of representing data in literary criticism, particularly through visualizations. The essays in this special issue are then discussed, with emphasis on the possibilities and conceptual difficulties that come with the representation of large aggregates in novel form.
Women-Identified Women
Authors: Heaney Emma
Published: March 2017

This essay argues that retrieval of the archive of trans women's engagement with women's liberation corrects a historical focus on the virulent trans misogyny that targeted trans women for exclusion from feminist milieus and projects beginning in 1973. This essay follows the arguments for trans exclusion into their contemporary iterations and proposes the archive of trans women's feminist work as a theoretical and political resource for countering trans misogyny.
Reading Trans Biology as a Feminist Sociologist
Authors: Lane Riki
Published: March 2017

Feminist analysis has often rejected ideas that biology influences gender development as inherently reactionary. However, some trans people have found personal and political utility in making the argument that they were “born this way.” This essay argues for an understanding of nature and culture that aims to supersede a division of bodies as authentic and real versus constructed and mutable—reappraising scientific understandings of sex and gender can overcome this false dichotomy. Recent biological and neurological research has shifted from linear determinism toward ideas of nonlinearity, contingency, self-organization, and open-endedness. Feminist and trans studies engagement with such research offers ways around theoretical impasses and can assist struggles for social and political change.
Radical Inclusion
Authors: Williams Cristan
Published: March 2017

This article reviews the ways in which radical feminism has been and continues to be trans inclusive. Trans inclusive radical feminist opinion leaders, groups, and events are reviewed and contrasted against a popular media narrative that asserts that radical feminism takes issue with trans people. Reviewed are historical instances in which radical feminists braved violence to ensure their feminism was trans inclusive.
Radical Queen
Authors: Stryker Susan
Published: March 2017

Tommi Avicolli Mecca, born in Philadelphia in 1951, moved to San Francisco in 1991 and quickly established himself as a leading queer performance artist, playwright, and newspaper columnist as well as a leading housing rights and antigentrification activist. This interview is excerpted from an interview initially conducted by Susan Stryker, general coeditor of TSQ: Transgender Studies Quarterly, for the GLBT Historical Society on November 19, 1998, and edited in consultation with Mecca for publication in TSQ, to highlight content related to the interrelationships between feminism, drag culture, and gay liberation politics in Philadelphia in the 1970s. In what follows, Mecca discusses his early involvement with radical sexuality and gender politics with the Gay Liberation Front (GLF) at Temple University, his later involvement in the more assimilationist Gay Activist Alliance (GAA), the formation of the Radical Queens collective, and his alliance with the separatist lesbian feminist group DYKETACTICS.
Efficient Ranking and Selection in Parallel Computing Environments
Authors: Ni Eric C. , Ciocan Dragos F. , Henderson Shane G. , Hunter Susan R.
Published: March 2017

The goal of ranking and selection (R&S) procedures is to identify the best stochastic system from among a finite set of competing alternatives. Such procedures require constructing estimates of each system’s performance, which can be obtained simultaneously by running multiple independent replications on a parallel computing platform. Nontrivial statistical and implementation issues arise when designing R&S procedures for a parallel computing environment. We propose several design principles for parallel R&S procedures that preserve statistical validity and maximize core utilization, especially when large numbers of alternatives or cores are involved. These principles are followed closely by our parallel Good Selection Procedure (GSP), which, under the assumption of normally distributed output, (i) guarantees to select a system in the indifference zone with high probability, (ii) in tests on up to 1,024 parallel cores runs efficiently, and (iii) in an example uses smaller sample sizes compared to existing parallel procedures, particularly for large problems (over 106 alternatives). In our computational study we discuss three methods for implementing GSP on parallel computers, namely the Message-Passing Interface (MPI), Hadoop MapReduce, and Spark, and show that Spark provides a good compromise between the efficiency of MPI and robustness to core failures.

The e-companion is available at https://doi.org/10.1287/opre.2016.1577 .
Solutions to five common challenges
Authors: Sobel Daniel
Published: March 2017

In the last edition, inclusion expert Daniel Sobel described the five challenges that he often sees in vulnerable schools. He now attempts to offer some advice on tackling these key issues…
Avoid getting caught out
Authors: Lepkowska Dorothy
Published: March 2017

Busy headteachers are often warned against the dangers of signing up to procurement contracts without proper caution. Dorothy Lepkowska seeks some advice on avoiding common pitfalls
The ideological challenge for the regional press; reappraising the community value of local newspapers
Authors: Matthews Rachel
Published: March 2017

Existing for the good the community has been an established claim to legitimacy for the English regional press since the nineteenth century. Expressed varying as a localized version of the fourth estate or ‘parish pump patriotism’, this article understands this notion as a discursive position which underwrites claims by the local newspaper to act as a watchdog on behalf of those readers it seeks to serve. As such it serves an ideological function and justifies the normative practices of the industry. However, interviews with newspaper workers suggest that while the good of the community remains a key professional value, increasingly they feel compromised in their ability to uphold it due to the economic environment in which they are operating. It concludes with the proposition that the political economy of the local newspaper needs to invest in real terms in the good of the community if its normative function is to be retained.
Moments of (aha!) walking and encounter: Fluid intersections with place
Authors: Burke Geraldine , Lasczik Cutcher Alexandra , Peterken Corinna , Potts Miriam
Published: March 2017

In contemporary art, research and art education, the concepts of walking and mapping in singular and collaborative encounters with place are established as a generative learning, creative and research event. In this iteration of walking and encounter, four arts academics sought to extend and engage the practice of itinerant drift, collaboratively and discretely, mapping manifestations and then responding with an artful riposte in relation to educational practice. Using the provocation of playfulness, the methodology was inspired by the concept of the dérive and stimulated by Dada, Surrealist and Fluxus legacies. This visual essay portrays the assemblage of walking and encounter at the Peninsula campus site at Monash University through visual poetics, which aims to arouse continuing dialogue around place, learning, encounter, chance and disruption.
Sustaining Huaco making in Perú: A decolonizing study with a native knowledge bearer
Authors: Alexander Amanda
Published: March 2017

This article investigates the extensive knowledge and experience of a traditional Peruvian huaco maker named Lorenzo Cabrera Abanto. Huaco is a pre-Columbian pottery form that western museums and literature identify as a portrait jar or vessel. Lorenzo is discussed as a living repository of ancient heritage and Andean art making for those unfamiliar with its expressions. Due to globalization and changing dynamics in Peruvian culture and economy, huaco making as an expression of Peruvian heritage is threatened. Examining huaco making and history through a decolonizing lens, Lorenzo’s life and work as a native knowledge bearer is considered in light of globalization, the demands of the capitalist markets, theoretical premises of critical pedagogues, and concerns of an art educator. Confronting cultural interactions and shifting global paradigms, the arts education field can productively draw on critical art pedagogy that is informed by diverse discourses and reveres Native wisdom and knowledge of living art forms such as those sustained by Lorenzo.
The Silver Voices: A possible model for senior singing
Authors: Balsnes Anne Haugland
Published: March 2017

Every Tuesday morning, 150 people from the age of 62 and above gather to sing in Kilden Performing Arts Centre, Kristiansand, Norway. A case study of this choir, The Silver Voices, was conducted. The aim of the study was to understand the practice and how an art institution can play a role in developing such an activity. As a point of departure the following questions were formulated: What is going on in the choir? Why and how is the activity organized? What is the meaning of the participation for the singers? The collection techniques utilized were participant observation, semi-structured interviews and document analysis. Perspectives from the fields of music education, community music and music and health will illuminate the analysis. The study shows that a musical activity such as The Silver Voices transcends distinctions between disciplinary fields.
Empire Cinema: Propaganda and censorship in colonial films during the Portuguese Estado Novo
Authors: Piçarra Maria do Carmo
Published: March 2017

Aiming to provide a critical analysis of the filmic memorial of Portuguese colonialism I consider two alternative ‘visions of cinema’: the official version presented in Estado Novo propaganda newsreels, and, in ‘reverse shot’, the disruptive gaze found in censored auteur fiction films – Faria de Almeida’s Catembe (1965), Lopes Barbosa’s Deixem-me ao Menos Subir às Palmeiras… (1972) and António de Sousa’s Esplendor Selvagem (1972). Portuguese colonies were seldom depicted on film, and only the ‘right kind’ of images – specifically those presented in propaganda newsreels – tended to be approved by the censorship committees. Faria de Almeida received government support to film everyday life in Mozambique’s capital, in 1964. After the first version of the film was censored – with 103 cuts, a Guinness world record – projection of Catembe was banned.1 In 1972, Barbosa made a film about abuses of power in colonial farms in Mozambique. The film was banned. Sousa recorded initiation rituals and rites of passage in different Angolan ethnic groups. The documentary was considered ‘anti-political’. Until conducting this research, the films remained deposited at the Portuguese Cinema Museum, largely unknown to audiences and researchers. What are the limitations of the history of cinema – and of the knowledge of the ‘imagined man’ – as long as the perspectives provided in such censored colonial films remain unanalysed?
Film Review
Authors: Petty Sheila
Published: March 2017

FI RASSI ROND-POINT (DANS MA TÊTE UN ROND-POINT) (A ROUNDABOUT IN MY HEAD), HASSEN FERHANI (DIR.) (2015) 100 mins, Arabic, Centrale Electrique/Allers Retours Films Algeria/France/Qatar/Netherlands/Lebanon
Cronenberg’s debt to Kafka: An analysis of A Country Doctor (1917) and Videodrome (1983)
Authors: Moody Paul
Published: March 2017

David Cronenberg has often been regarded as a literary director, who draws on a well-versed knowledge of literature for his film projects. This is most evident in his adaptations of authors often thought to exert the greatest influence on his work, from Burroughs (Naked Lunch) to Ballard (Crash). Yet there is another author with an equally potent, if mostly unacknowledged, impact on Cronenberg’s output – Franz Kafka. Cronenberg has never directly adapted a Kafka story, yet elements of the ‘Kafkaesque’ permeate Cronenberg’s oeuvre, none more so than in his 1983 film, Videodrome. Drawing on Mark Browning’s work, I argue that the similarities between Videodrome and the short story A Country Doctor (1917) are so stark, that Cronenberg’s film should be considered as an adaptation of Kafka’s composition, and that further connections between the two artists become apparent in light of this association.
Music technology, composition teaching and employability skills
Authors: Otondo Felipe
Published: March 2017

This article explores the relationship between the creative skills taught as part of the music technology BA course at Lancaster University and the skills valued by graduates and employers in the creative industries. The study investigated ways of enhancing specific and generic employability skills intrinsic to music technology teaching while working in close collaboration with industry partners and Lancaster University graduates. A survey of students, graduates and industry experts showed that generic and discipline-based skills linked to music technology composition teaching, such as communication, planning and organizing and critical listening, are highly valued by both recruiting professionals and students. These results are in line with findings from an earlier project that showed the importance of non-disciplinary knowledge shared among students from different backgrounds for the design and implementation of successful interdisciplinary collaborations. Future developments of the project will investigate ways of enhancing generic and specific employability skills within interdisciplinary learning environments for art and science students.
Remixing dub reggae in the music classroom: A practice-based case study on the educational value of music production for listening skills and stylistic analysis
Authors: Herbst Jan-Peter
Published: March 2017

This article examines learning opportunities of music production tasks by an exemplary unit on dub reggae following an action research approach. It addresses the educational areas of sound design, musical knowledge, analysis and listening skills, taking the sound of dub reggae as starting point for learner-centred activity. The main premise is to advocate music production technology as an effective tool for music learning allowing students to experience techniques of music production first hand, vividly illustrating creative approaches of remote musical cultures, their successive influence on popular music, and aesthetic experiences special to technologically created sound. The overall goal is to facilitate a higher awareness and a more detailed understanding of produced sound, and practical competences of integrating technological sound into musical action. The study took place within two vocational college courses for social and health (N = 10; 7 women, 3 men; average age 21 years) and art and design (N = 9; 5 women, 4 men; average age 18.3 years), and aimed to investigate the methodical practicability and the success of the suggested educational approach. It provides preliminary insights along with recommendations for improvements and further applications.
Maschine-itivity: How I found my creativity using a digital sampling device to compose music
Authors: Kladder Jonathan
Published: March 2017

The ubiquity of digital music technology has prompted researchers and scholars to examine how music educators might support music learning that encourages creativity through the use of these mediums. Infusing technology into current curricular offerings offers one avenue in fostering a diversity of music learning experiences for students when teachers are interested in developing creativity in their students. Research examining current practising teachers and their experiences with digital sampling and beat making technology is limited. The purpose of this research was to offer my experiences learning, writing and sharing music using a sampling and beat-making device called the Maschine. This auto-ethnography uses Sawyer’s eight stages of the creative process as the theoretical framework to guide analysis of my creativity. The aims of this research were to: (1) reflect on the creative process involved in making music on a digital sampling and beat-making device; (2) provide a contextual understanding of my challenges and successes along the way; and (3) suggest implications for both current and future music teachers interested in learning to use this type of technology in their music teaching to provide contemporary music making experiences for their students. Results suggest that vernacular and informal music learning strategies were common over the 14-week semester, as YouTube tutorials supported my learning. My creativity occurred in small incremental steps and yielded three completed compositions at the culmination of the project. A conceptual model of the creative process is proposed, outlining the non-linearity of my creative process. Implications for music education are offered in conclusion.
Drawing the pathetic parent creature: Aline Kominsky Crumb in conversation with Sarah Lightman
Authors: Lightman Sarah
Published: March 2017

In this abridged and edited transcription of ‘“Arnie’s Air Conditioner” and other fond memories: Aline Crumb in conversation with Sarah Lightman’, held on 15 April 2016 at The House of Illustration, Kominsky Crumb talks through her role in the history of autobiographical comics, and discusses comics that reflect on her childhood experiences. She also describes how she deliberately approached parenting her daughter, Sophie, differently and how this is reflected in her works.
Drugs, earthquakes and high-school girls: An interview with Reiko Momochi
Authors: Rabone Emily
Published: March 2017

This is an interview with Reiko Momochi, a Japanese shojo manga artist best known for producing the Confidential Confessions (2003) series. The interview was carried out with the aim to gain an insight into the manga industry in Japan, with a particular focus on the matter of gender.
Blood lipid of preadolescent boys of well-to-do families
Authors: Munir Muzief , Darmoprawiro Sudiro
Published: March 2017

Coronary heart disease is presently one of the leading causes of death In adults in many countries, including in Indonesia. It is well known that elevated levels of cholesterol in children are closely associated with hypercholesterolemia and coronary heart disease in adult life. This study was conducted in an attempt to find a preliminary insight of the magnitude of the problem of hypercholesterolemia In children In Indonesia as a developing country. The blood lipid levels of 54 preadolescent boys from well-Io-do families were analyzed. Two-third of those children were shown to have elevated blood cholesterol level, and even one third or 16 out of 54 preadolescents boys investigated suffered from hypercholesterolemia. We conclude that elevated blood cholesterol level is frequently found among large-framed and obese Indonesian children.
Relationship between the general condition of acute lymphoblastic leukemia patients with remission rate and convulsion as an adverse effect chemotherapy
Authors: Andid Rusdi , Nurdiani Nurdiani , Lubis Bidasari , Sutjipto Adi
Published: March 2017

A retrospective study on the relationship between the general condition of acute lymphoblastic leukemia patients with remission rale and convulsion as an adverse effect of chemotherapy was conducted in leukemia patients of the hematology-oncology subdivision, Departmenl of Child Health, Medical School, University of North Sumatra, Medan. Of 114 children with acute lymphoblastic leukemia, 81 (71.05%) received chemotherapy, 31 patients among them was in good general condition. Remission rate of the 31 patients was 80.6% (25 children). Whereas in the remaining 50 patients, the remission rate among them was 84% (42 patients). There was no significant relationship between their general condition to the recurrence rate of acute lymphoblastic leukemia patients who had been administered chemotherapy during induction phase. Convulsion was found In 2 cases, due to CNS leukemia.
Evaluation of cardiac murmurs in 8647 children at primary school-age children in the Province of Malatya, Eastern Turkiye
Authors: Pac Feyza Aysenur , Karabiber Hamza , Kilic Ayhan , Kutlu Onur , Yakinci Cengiz , Egri Mucahit
Published: March 2017

We assessed prospectively the prevalence 01 pathologic and Innocent murmurs in childhood, to determine the efficacy of clinical evaluation, to compare the results of physical examinations performed by pediatricians and pediatric cardiologists and echocardiographic evaluations, and to contribute to the determination of the limits of echocardiography indications in children with murmurs. A number of 8647 children, aged 6.5-15 years, 4092 females, 4455 males in ten different primary schools belonging to different socioeconomic levels in Malatya, Eastern Turkey. Those children with a murmur were evaluated by a pediatric cardiologist. Chest X-ray, electrocardiography, and echocardlography were obtained in all subjects having a murmur. The results of physical examinations performed by the pediatricians and the pediatric cardiologist were compared, and the final diagnoses were reached by evaluation of chest X-ray, ECG and chocardiography. The incidence of Innocent murmurs was found to be 3.4% and that of pathological murmurs 0.54% In the population eximaned. The statistical comparison of the results revealed that pediatricians have a tendency toward Innocent murmurs in the interpretation of murmurs (p<0.05). There was not a statistically significant difference between the results of physical examinations of the pediatric cardiologist and the results of echocardlographic examination. Pediatricians can diagnose pathologic cases with a sensitivity of 63.8% whereas pediatric cardiologist could diagnose those cases with a sensitivity of 95.7% and specificity of 99.7%. Our findings support the policy that children with a cardiac murmur should be referred to a pediatric cardiologist, in order to verify clinical diagnosis.
Pulmonary tuberculosis in childhood nephrotic syndrome (A cross sectional study)
Authors: Tambunan Taralan , Dewanti Attila , Madiyono Bambang , Rahayoe Nastiti N
Published: March 2017

Childhood tuberculosis persists as an important global health problem. Tuberculosis is one of the commonestimportant complications in children with nephrotic syndrome. Tuberculosis may interfere with the response to steroid therapyand is still being the commonest morbidity cause in children with nephrotic syndrome. To find out the prevalence, clinicalfeatures, and the impact of tuberculosis in children with nephrotic syndrome, a cross sectional study was conducted on 100nephrotic children consisted of 63 males and 37 females at the Cipto Mangunkusumo Hospital from April 1st to October 30th,1999. Pulmonary tuberculosis was detected on 15 cases ( 95% CI : 8% - 22% ) , consisted of 8 boys and 7 girls. Most of themaged 10 – 16 years old (66,6%) and 86,7% were undernourished. The combination of clinical judgement, chest X-ray andMantoux test were helpful in establishing the diagnosis. The majority of tuberculosis cases (80%) were detected on frequentrelapsers and steroid dependent groups of the nephrotic syndrome. A significant correlation were noted in tuberculosis withundernutrition and unfavorable response to steroid (frequent relapser and steroid dependent cases).
Immunopathogenesis of cow’s milk allergy
Authors: Harsono Ariyanto
Published: March 2017

Given the public’s increasing awareness of cow’smilk allergy and their frequent misperception thatvarious illness is caused by cow’s milk-induced aller-gic reactions, the physician must retain some skepti-cism throughout the evaluation and rely on objectivemeasures to arrive at the final diagnosis. Over diag-nosis of cow’s milk allergy has led to malnutrition,eating disorders, and psychosocial problems, as wellas family disruption, whereas under diagnosis leavesthe patient suffering unnecessarily and may result ingrowth failure and permanent physical impairments.The following discussion provides an immunologicalbasis of cow’s milk allergy in an attempt to improveour understanding in clinical manifestations, diagno-sis and management of the disease.
Seroconversion and adverse reaction of live-attenuated (OKA strain) varicella vaccine
Authors: Ramli Yulchair , A Sri Rezeki H , Akib Arwin P
Published: March 2017

Background Live-attenuated varicella vaccine was used to pre-vent Shingle disease.Objective The aim of this study was to find out seroconversionrate and safety of this vaccine.Methods An open clinical trial was conducted on 313 children atCipto Mangunkusumo Hospital, Jakarta between March and Octo-ber 1998. The data were analyzed to distribution frequency andtables.Results Only 43 out of 356 (12.1%) children had positiveantivaricella antibody before vaccination. Seroconversion exami-nation by indirect immunoflouresence method was done only onrandomly 150 of 313 (50%) children due to financial limitation. Itwas found that 99.3% of patients had positive seroconversion.Among 298 children who were followed, the nature of symptom ofadverse reaction was mostly general than local. Only one patienthad local symptom after vaccination that appeared within 7 daysof the follow up period.Conclusion Varicella vaccine (OKA strain) gives highseroconversion rate with minimal adverse events
Correlation between leukocyte aggregation score of cerebrospinal fluid and bacterial meningitis in children
Authors: Togas Meitha PE , Masloman Nurhayati
Published: March 2017

Background Bacterial meningitis is one of life-threatening dis-eases and carries a risk of sequelae in affected children. In termsof cost and rapid differentiation between bacterial and non-bacte-rial meningitis, several tests have been proposed.Objective This study aimed to determine the use of leukocyteaggregation score (LAS) of cerebrospinal fluid (CSF) in diagnos-ing bacterial meningitis.Methods A prospective analytic study was done from October 2001to July 2002 in the Department of Child Health, Medical School,Sam Ratulangi University/ Manado General Hospital. Children pre-senting with symptoms of meningitis, aged between 28 days and13 years were enrolled. LAS was counted in percentage. Regres-sion analysis was used to determine the correlation between LASand diagnosis of bacterial meningitis.Results CSF examinations were done on 35 meningitis patients.Three patients were excluded. The remaining 32 patients com-prised of 11 with bacterial meningitis and the other 21 with non-bacterial meningitis. The mean of LAS in bacterial meningitis wassignificantly higher than that of non-bacterial meningitis (p<0.001).The cut off value of LAS to diagnose bacterial meningitis was12.35%.Conclusion LAS may be used as a fast and simple alternativediagnostic tool to confirm the diagnosis of bacterial meningitis
D+ hemolytic uremic syndrome
Authors: Sumiartini Ni Made , Lila I Nyoman , Suarta I Ketut
Published: March 2017

Hemolytic uremic syndrome (HUS) is characterized by anemia microangiopathy, thrombocytopenia, and acute renalfailure, predominantly occurs in childrenyounger than 4 years of age. It is the most commoncause of acute renal failure in children.1,2 HUS is dividedinto two categories, the epidemic type which isaccompanied by enteritis (D+HUS) and the sporadictype which is not accompanied by enteritis (D-HUS).The pathogenesis is unknown, but available evidencestrongly suggests endothelial cell damage in the organs.
Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta
Authors: Deselina Benita , Putra Sukman Tulus , Suradi Rulina
Published: March 2017

Background Patent ductus arterious (PDA) is one of the mostcommon congenital heart diseases encountered in preterm infants.The lower the birth weight and gestational age are, the higher theincidence of PDA is.Objectives To investigate the incidence of PDA in premature infantshospitalized in the neonatal wards of Cipto Mangunkusumo Hospitalusing echocardiography.Methods Preterm infants born between August and October 2003were included in this study. Clinical features were retrieved from medicalcharts. The first echocardiography was conducted on all of the preterminfants at the chronological age of 3 days. If PDA was detected,echocardiography was repeated at the chronological age of 6 days.Results During the 3-month period, sixty-five preterm infantsparticipated in this study and underwent echocardiography. In thefirst echocardiogram, the incidence rate of PDA was 32%. Atgestational age of less than 28 weeks, 1 of 2 infants had PDA. Of 3infants with birth weight of more than 1000 grams, 2 had PDA. Onthe second echocardiography, the incidence rate of PDA was 14%and mostly found in infants at gestational age of less than 28 weeks(8/9) and in those with birth weight of less than 1000 grams (7/9).All infants with RDS whose PDA was identified in the firstechocardiography proved to maintain their PDA in the secondechocardiography.Conclusion The incidence rate of PDA in preterm infants was14%. The lower the birth weight, the higher the incidence rate ofPDA. The presence of RDS is related to the delay in the closing ofthe arterial duct
A study on the antibiotic resistance of Shigella
Authors: Dwipoerwantoro Pramita G , Pulungsih Sri P , Susanti Nuraini I , Sadikin Hartaniah , Firmansyah Agus
Published: March 2017

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool
Cardiac arrest in a child during a combined general epidural anesthesia procedure
Authors: Soenarjo Soenarjo , Prabakti Yudhi , Siahaan Edwin MP , Soemantri A , Sidhartani M
Published: March 2017

An increased risk of perioperative cardiac arrestin children, in comparison to adults, has beenrecognized. A number of factors associatedwith perioperative cardiac arrest have been identified,including young age, comorbidities, and emergencysurgery. Since anesthesia-related cardiac arrest isuncommon, a multi-related database is required tounderstand the mechanisms of cardiac arrest and todevelop preventive strategies. Most cardiac arrestsoccur during induction (37%) or maintenance (45%)of anesthesia, usually following one or more of thefollowing antecedent events, i.e., bradycardia (54%),hypotension (49%), abnormality of oxygen saturationas measured by pulse oximetry (48%), inability tomeasure blood pressure (25%), abnormality of end-tidal CO 2 (21%), cyanosis (21%), or arrhythmia(18%). In 11% of cases, cardiac arrest occurredwithout recognized warning. There are only fewreports in the literature, and in Kariadi Hospital, nonehas ever been reported. The aim of this report is toidentify and discuss possible causes of cardiac arrestand to anticipate its complications.
The Epilepsies of Rett Syndrome in Indonesia
Authors: Herini E. S. , H Sunartini , Mangunatmadja I. , S Purboyo , Pusponegoro Hardiono D.
Published: March 2017

Objective This study aimed to evaluate various types of sei-zures, EEG findings, and last evolution of epileptic seizures foundin children with Rett Syndrome (RTT).Methods A case series of ten female subjects from Sardjito Hos-pital, Yogyakarta; Cipto Mangunkusumo Hospital, Jakarta; andHasan Sadikin Hospital, Bandung from February 2001-April 2004.Diagnosis of RTT was established using necessary and support-ive criteria by the RTT Diagnostic Criteria Work Group and epi-lepsy was diagnosed according to clinical and EEG findings.Results The age during initial diagnosis of RTT ranged from 2years 6 months - 10 years 2 months (average: 4 years 6 months).The diagnosis of epilepsy, on the other hand, was establishedfrom 2 years - 5 years 10 months (average: 3 years 8 months).All subjects (10/10) had abnormal EEG results. Eight out of tenhad epileptiform discharge; the remaining had slowing backgroundactivity. The average age of initial seizure onset was 18 months.Five were diagnosed as epileptic subjects. Febrile convulsionswere the most common initial seizure. General tonic clonic sei-zure was major type of seizure which manifested in 2 subjects.Conclusion All EEG results showed abnormality, although sei-zure did not appear. Five out of ten subjects experienced epi-lepsy
The profile of acute glomerulonephritis among Indonesian children
Authors: Albar Husein , Rauf Syarifuddin
Published: March 2017

Background Acute glomerulonephritis (AGN) is a form of glom-erulonephritis characterized by sudden and explosive onset of glom-erular injury symptom. It usually occurs after recent infection bygroup A beta-hemolytic streptococcus. AGN among Indonesianchildren seems to be less frequently reported than that among othercountries.Objective To determine the current profile of AGN among Indo-nesian children hospitalized in eleven teaching centers.Methods This was a descriptive, cross-sectional study, based ona review of the standard medical records of 509 children with AGNhospitalized in 11 teaching centers in Indonesia over a five-yearperiod (1997-2002). Data extracted from the medical records con-sisted of history of illness, clinical and laboratory findings, and chestX-rays.Results Age of the patients at the onset of AGN ranged from 2.5 to15 years, with peak age of 8.5 years. The majority (76.4%) wasabove 6 years old with male predominance (58.3%). About 68.9%and 82% of the patients came from low socioeconomic and low edu-cational status families. Antecedent upper respiratory infections wereobserved in 45.8% cases and pyoderma in 31.6%. The diseaseseemed to be more commonly elicited by streptococcal infectionthan by other infections, as proved by an elevated anti-streptolisinO (ASO) titer (66.6%) and decreased C 3 concentrations (60.4%).The frequent clinical features included periorbital edema (76.3%),hypertension (61.8%), and gross hematuria (53.6%). The most preva-lent laboratory findings were microhematuria (99.3%), proteinuria(98.5%), raised erythrocyte sedimentation rate (85.3%). The initialchest X-rays showed pleural effusion (81.6%) and cardiomegaly(80.2%), whereas echocardiogram documented pericardial effusion(81.6%). Acute pulmonary edema (11.5%), hypertensive encepha-lopathy (9.2%), and acute renal failure (10.5%) were frequent com-plications noted in our study.Conclusion Despite no adequate data on throat or skin cul-tures, AGN among Indonesian children seems mostly to bepoststreptococcal AGN as proved by the elevated ASO titerand decrease in serum C 3 concentration
Multidrug resistance in the neonatal unit and its therapeutic implications
Authors: Rohsiswatmo Rinawati
Published: March 2017

Background Neonatal septicemia constitutes an important causeof morbidity and mortality among neonates in Indonesia. The ex-cessive use of antibiotics may cause antibiotic resistant bacteriaand may cause neonatal fungal infection.Objective To investigate the spectrum of organisms which causeneonatal sepsis and assess their sensitivity to various groups ofdrugs in the neonatal unit.Methods A prospective study conducted on newborn babies de-livered in Cipto Mangunkusumo Hospital, Jakarta from July 2004-May 2005 who presented clinical signs of septicemia were sub-jected for blood culture. Those sensitive to antibiotics for 7 daysyet showed no clinical improvement were also cultured for fungi.Results A total of 499 blood cultures were taken, 320 were posi-tive for bacteria (positivity rate was 65.3%). There were 192 samplescultured for fungi, and the positivity rate was 64% (all for Candidasp). Acinetobacter calcoaceticus was the most common bacteriafound (35.7%), followed by Enterobacter sp (7.0%), and Staphylo-coccus sp (6.8%). Most bacteria showed high degrees of resis-tance to commonly used antibiotics (ampicillin and gentamicin).There were also high degrees of resistance to cephalosporins byboth Gram negative and Gram positive organisms. Only 61.7% ofA. calcoaceticus, and 45.7% of Enterobacter sp were sensitive toceftazidime. Gram negative organisms were also highly resistantto amikacin, but Staphylococcus sp was only moderately resis-tant. Resistance to carbapenem (meropenem and imipenem) var-ied from moderate to low. Drugs which were not used for newbornbabies (quinolones/ciprofloxacin and chloramphenicol) varied frommoderate to high resistance.Conclusion Neonatal sepsis remains one of the major causes ofmortality in our neonatal unit. Most organisms have developedmultidrug resistance, and management of patients infected withthese organisms and especially those with fungi infection are be-coming a problem in developing countries
Coagulation abnormality as a complication of L-asparaginase therapy in childhood lymphoblastic leukemia
Authors: Gatot Djajadiman , Pringgardini Keumala , Suradi Rulina
Published: March 2017

Background Bleeding, one of the most common symptoms ofacute leukemia in untreated patients, is mostly due to thrombocy-topenia as a result of myeloinvasion by leukemic cells. Neverthe-less, a further contributory factor for the additional hemorrhagiccomplication during intensive chemotherapy is the myelosuppressiveeffect of most active drugs. L-asparaginase, one of the cytostaticsused during remission induction therapy for childhood of acutelymphoblastic leukemia (ALL), is widely reported to impair the he-mostatic system.Objective To determine the influence of shorter courses of L-as-paraginase (L-Ase) on some of the hemostatic parameters in thetreatment of childhood ALL.Methods A prospective analytical study was carried out in theDepartment of Child Health, Cipto Mangunkusumo Hospital Jakartafrom July 1, 1999 to June 30, 2001 on newly diagnosed ALL pa-tients with normal liver function tests treated according to our na-tional ALL protocol which one of its composition contained 6 in-stead of 9 injections of L-asparaginase.Results All of 30 children with ALL included in the study, experi-enced prolongation of prothrombin time (PT), activated partialthromboplastin time (aPTT), and decreased fibrinogen concentra-tion, markedly during the administration of L-asparaginase. How-ever, none of the patients had additional hemorrhage or evidenceof disseminated intravascular coagulation (DIC).Conclusion The use of shorter courses of L-asparaginase, 6 in-jections, in the remission induction chemotherapy of childhood ALLin our department may reduce the blood clotting factors withoutfurther hemorrhage complication or evidence of DIC
The effect of iron versus iron plus zinc supplementation in children with malaria
Authors: Lubis Bugis Mardina , Dasraf Danny , Rosdiana Nelly , Lubis Bidasari , Lubis Munar , Pasaribu Syahril , Lubis Chairuddin P
Published: March 2017

Introduction Little is known about the potential interaction of ironand zinc given to increase hemoglobin and serum ferritin in chil-dren with malaria.Objective To study the effect of iron compared with a combination ofiron and zinc supplementation on children with falciparum malaria.Method Children with positive Plasmodium falciparum (n=86) wererandomly assigned to a daily supplementation of 6 mg iron/kg perday plus placebo or plus 10 mg zinc per day for 30 days. All childrenwere treated with the same regimen for the treatment of P. falciparum.Venous blood samples were collected at the start and end of thestudy. After 30 days of supplementation, the baseline and follow-upblood samples were analyzed.Results The increase of hemoglobin concentration in the ironplus placebo group was 0.58 g/dl, while in the iron plus zinc groupwas 0.09 g/dl (P<0.05). Serum ferritin concentration was high inboth groups before trial, yet there was no significant differenceafter iron supplementation.Conclusions Iron supplementation showed significant increasein hemoglobin concentration in children with positive P. falciparumtreated with the same regimen of treatment. Supplementation ofiron alone as well as iron plus zinc had been proven ineffective toiincrease serum ferritin in children with malaria.