bluuebunny/crossref_metadata_2025 huggingface dataset:
Computational vectorelectrocardiography: comparison of representations according to McPhee-Parungao and Frank
Authors: Drozdov D. V. , Kozlovskaya I. L. , Kozhemyakina E. Sh. , Sobolev A. V.
Published: August 2024

Aim: to compare amplitude-temporal and vectorcardiographic (VCG) parameters calculated through most commonly used matrix transformations.

Materials and methods. Preliminary literature search revealed Kors and inverse Dower transformation to be the most commonly used matrices for converting ECG‑12 into Frank VCG. Trunov-Aidu matrix appeared to be the only one for deriving VCG in the McFee-Parungao lead system.The study included 1250 ECGs of patients at the National Medical Research Center of Cardiology with various cardiovascular diseases: arterial hypertension, coronary heart disease, post-infarction cardiosclerosis, aortic stenosis. For each patient, using the above transformations, three VCGs with an intact and three VCGs with an inverted direction of the Z axis (according to Ozol) were obtained. The comparison was carried out based on the main amplitude-temporal indicators of P-QRS-T, as well as on VCG parameters: spatial QRS-T angle, QRS loop area, QRS integral vector, fractional integrals P and QRS. A total of 9 pairwise comparisons of 134 indicators were carried out for each synthesized VCG

Results. The strongest (r > 0.9 or r < -0.9) significant (p < 0.001) linear correlation was found between the spatial metrics: P, QRS, T wave loop lengths, QRS loop area, QRS-T angle, ventricular gradient, and QRS shared integrals. Significant relationship between projection parameters and P-QRS-T amplitude and duration was observed in some cases. The largest number of correlations was noted between parameters calculated in McFee-Parungao and Frank lead system derived by Kors.

Conclusions. Strong linear relationship was found between the VCG parameters determined through Kors, Dower and Trunov-Aidu matrix transformations, which indicates the equivalence of the results obtained through these matrices.
Assessment of hemodynamic disturbance in connective tissue dysplasia syndrome of extracerebral and cerebral vessels in children
Authors: Abramova M. F. , Pikov M. I.
Published: August 2024

Syndrome of dysplasia connective tissue are recorded as cerebrovascular structural abnormalities of the vascular system include (deformations of vessels) and they are predisposing factors of dyscirculatory hemodynamic cerebrovascular disturbances.

The studying of clinical and ultrasonic data of extra cranial part of brachiocephalic vessels at children allows to reveal the structural peculiarities and direction of internal carotid artery (deformations), its interrelation with cerebrovascular hemodynamic infringements.

Early revealing of vessels’ structural abnormalities allow to carry out in due time diagnostics and cerebrovascular pathology preventive maintenance at children’s age. The ultrasound methods are one of the key non-invasive methods in management algorithm of patients with cerebrovascular disturbances
ERITEMA MULTIFORME PASCA-VARISELA
Authors: Wijaya Lorettha , Veronica Veronica
Published: August 2024

Eritema multiforme (EM) adalah erupsi kutan atau mukokutan yang jarang ditemukan, ditandai oleh lesi target. Eritema multiforme biasanya disebabkan oleh reaksi hipersensitivitas terhadap infeksi (misalnya varisela) dan obat-obatan (antara lain asetaminofen).
Pasien perempuan, 23 tahun, datang dengan lesi target khas EM. Keluhan didahului oleh varisela 6 hari sebelumnya. Lesi varisela mengering dengan terapi valasiklovir, asetaminofen, dan multivitamin. Pada hari ke-4 varisela timbul urtikaria dan pada hari ke-6 muncul lesi EM. Pemeriksaan darah lengkap dalam batas normal, kecuali eosinofil sedikit meningkat. Pasien didiagnosis sebagai EM minor akibat erupsi obat dengan diagnosis banding EM minor akibat varisela dan penyakit Degos. Perbaikan terjadi setelah terapi metilprednisolon, desloratadin, dan losio pelembap.
Eritema multiforme terjadi 6 hari sesudah pasien mengalami varisela dan mengonsumsi obat. Penyebab EM pada kasus ini diduga akibat obat karena lesi varisela membaik dengan terapi valasiklovir serta ada lesi urtikaria sebelum lesi target muncul. Di antara obat-obat yang digunakan pasien, asetaminofen diduga sebagai penyebabnya. Pemeriksaan serologis untuk varisela dan uji tempel atau provokasi oral untuk alergi obat perlu dipertimbangkan untuk menegakkan diagnosis pasti.
LIKEN AMILOIDOSIS DENGAN TERAPI TOPIKAL KOMBINASI
Authors: Pramita Nyoman Yoga Maya , Adiguna Made Swastika , Suryawati Nyoman
Published: August 2024

Liken amiloidosis merupakan subtipe dari amiloidosis kutaneus lokalisata primer yang terjadi akibat penumpukan massa amiloid dalam papila dermis tanpa deposit amiloid pada organ lain. Gejala klinis liken amiloidosis berupa papul hiperpigmentasi yang tersebar diskret disertai rasa gatal. Kasus seorang perempuan berusia 35 tahun dengan keluhan papul hiperpigmentasi, hiperkeratotik yang tersebar diskret pada tungkai kanan dan kiri, dan gatal. Keluhan ini diderita pasien sejak 5 tahun yang lalu. Pemeriksaan histopatologi telah dilakukan dengan hasil sesuai dengan liken amiloidosis. Penatalaksanan yang diberikan berupa terapi topikal kombinasi dan didapatkan hasil yang memuaskan. Liken amiloidosis merupakan kasus yang jarang, dan pengobatan pada pada kondisi ini masih menjadi tantangan bagi para klinisi oleh karena sifatnya yang persisten, menetap beberapa tahun dan dapat terjadi kekambuhan. Kombinasi terapi tersebut berupa kortikosteroid poten topikal dan asam salisilat 6% yang dicampur dengan spiritus dilitus yang diaplikasikan 2 kali dalam sehari. Pasca 3 bulan terapi kombinasi topikal didapatkan hasil yang memuaskan. Terapi tersebut merupakan pengobatan yang cukup efisien untuk menipiskan dan menghilangkan lesi.
PATOGENESIS DAN PENDEKATAN DIAGNOSTIK SINDROM NETHERTON
Authors: Purnawan Shafira Anindya , Novianto Endi , Menaldi Sri Linuwih , Rihatmadja Rahadi
Published: August 2024

Sindrom Netherton merupakan genodermatosis autosomal resesif karena mutasi gen serine peptidase inhibitor Kazal type 5 (SPINK5) yang mengkode lymphoepithelial Kazal-type inhibitor (LEKTI). Defisiensi LEKTI menyebabkan berbagai perubahan fisiologis yang mengakibatkan kerusakan sawar kulit. Peningkatan kallikrein (KLK) khususnya KLK 5, 7, dan 14 akan mendegradasi desmosom dan korneodesmosom sehingga stratum korneum terlepas. Peningkatan elastase (ELA) 2 menyebabkan degradasi filaggrin dan abnormalitas lipid sehingga sawar kulit terganggu. Aktivasi PAR-2 dan peran katelisidin mencetuskan reaksi alergi dan inflamasi. Sindrom Netherton memiliki gejala klinis yang mirip beberapa dermatosis lain sehingga kadang tidak terdiagnosis. Diagnosis ditegakkan dengan pendekatan klinis yang komprehensif, pemeriksaan laboratorium, histopatologi, serta pewarnaan imunohistokimia. Pemeriksaan rambut dapat menggunakan trikoskopi, mikroskop cahaya, atau mikroskop elektron. Pemeriksaan genetik molekular dengan DNA sequencing dapat mengonfirmasi diagnosis dan memungkinkan konseling genetik yang lebih tepat.
DAMPAK PRE-EXPROSURE PROPHYLAXIS ANTIRETROVIRAL ORAL TERHADAP INFEKSI MENULAR SEKSUAL
Authors: Kamila Noer , Irawan Yudo , Nilasari Hanny
Published: August 2024

World Health Organization menganjurkan penggunaan Pre-exposure prophylaxis (PrEP) pada pasien HIV negatif sejak tahun 2015. Terapi PrEP menggunakan obat antiretroviral (ARV) diberikan pada kelompok yang memiliki risiko tinggi dengan dosis tunggal harian atau dosis intermiten. Rekomendasi WHO penggunaan PrEP secara spesifik harus menggunakan Tenofovir tunggal atau dapat dikombinasikan dengan obat ARV lainnya. Pada beberapa penelitian efektivitas PrEP mampu menurunkan insiden kasus baru HIV hingga 92%. Terdapat potensi yang perlu diperhatikan mengenai pemberian PrEP, yaitu peningkatan perilaku seksual yang tidak aman, peningkatan insiden infeksi menular seksual (IMS), potensi resistensi virus, dan kecenderungan untuk melakukan hubungan aktifitas seksual berisiko lebih sering. Hal tersebut ditunjang oleh beberapa studi yang melaporkan peningkatan insiden IMS setelah era PrEP pada kelompok berisiko dan penurunan penggunaan kondom pada kelompok PrEP. Peningkatan kasus terjadi hampir di seluruh penyakit IMS yang disebabkan oleh bakteri sedangkan untuk penyakit IMS yang disebabkan oleh virus relatif menetap. Pemberian PrEP harus disertai dengan konseling dan pemeriksaan kesehatan berkala khususnya terkait infeksi menular seksual. Tinjauan pustaka ini disusun untuk memahami dampak pemberian PrEP terhadap angka kejadian IMS.
Kata kunci: IMS, perilaku seksual, Preexposure prophylaxis (PrEP)
HUBUNGAN MELASMA DENGAN WARNA KULIT, PORI, DAN KERUT
Authors: , SpKK(K) Irma Bernadette Sihotang , Rahman Yusnita , Krisanti Roro Inge Ade , Wisnu Wismandari
Published: August 2024

Melasma merupakan kelainan hiperpigmentasi didapat, umumnya terdapat pada wajah. Manifestasi klinis dari melasma dapat dinilai menggunakan Modified Melasma Area and Severity Index (mMASI). Penentuan lesi melasma juga dapat dilakukan dengan menggunakan alat ukur Janus II facial analysis system.
Tujuan penelitian ini untuk mengetahui hubungan antara mMASI dengan warna kulit, pori, dan kerut pada wajah dengan menggunakan Janus II facial analysis system. Penelitian ini bersifat deskriptif dengan desain potong lintang pada subjek berusia 20-50 tahun, dengan lesi melasma pada daerah wajah. Pengukuran derajat keparahan menggunakan skor mMASI dan Janus II facial analysis system. Hubungan antara melasma berdasarkan mMASI dengan warna kulit, pori, dan kerut wajah dinilai dengan korelasi bivariat. 
Pada penelitian ini, mMASI memiliki korelasi yang lemah terhadap pori (r=0,377) dan kerut (r=0,323) dan keduanya signifikan secara statistik (p=0,008 dan p=0,025 secara berurutan). mMASI memiliki korelasi yang sangat lemah terhadap warna kulit dan tidak signifikan secara statistik (r=0,045, p=0,761)
Penilaian melasma dengan skor mMASI memiliki korelasi bermakna terhadap pori dan kerut. Walaupun korelasi lemah, namun hal ini menunjukkan signifikan secara statistik
PENDEKATAN DIAGNOSTIK LUPUS VULGARIS PADA RUMAH SAKITPERIFER
Authors: Hoshea Felicia Emiliana , Lumban Gaol Evangelina
Published: August 2024

Indonesia termasuk dalam lima negara dengan insiden kasus tuberkulosis (TB) tertinggi
di dunia. Sebesar 1-2% dari kasus TB merupakan TB kutis. Lupus vulgaris (LV)
merupakan salah satu bentuk infeksi TB kutis pausibasiler yang bersifat kronis dan
progresif. Gambaran klinis LV dapat menyerupai berbagai kelainan kulit lainnya,
seperti lupus eritematosus diskoid dan sarkoidosis. Pada laporan kasus ini, seorang
perempuan, 59 tahun, mengalami keluhan bercak kemerahan yang tidak nyeri pada
wajah sejak 6 bulan sebelum datang ke rumah sakit. Pasien memiliki riwayat TB paru
dan telah menyelesaikan pengobatan tiga bulan sebelum munculnya bercak. Pada
pemeriksaan, ditemukan lesi plak atrofik eritematosa berbatas tegas yang dikelilingi
nodulus eritema multipel. Pemeriksaan histopatologis mendukung diagnosis LV. Terapi
dengan obat anti tuberkulosis (OAT) menghasilkan perbaikan pada lesi. Mengingat LV
memiliki kemiripan dengan berbagai entitas penyakit lainnya, diagnosis dini yang
cermat pada pasien diperlukan agar pengobatan yang adekuat dapat segera terlaksana. Pemeriksaan histopatologis merupakan pemeriksaan yang relatif mudah dilakukan pada area perifer, dan sangat berperan dalam diagnosis TB kutis.
PIODERMA GANGRENOSUM MULTIPEL DAN BERULANG
Authors: Widiawaty Alida , Yasmin Farah Asyuri , Romus Ilhami
Published: August 2024

Pioderma gangrenosum termasuk dalam penyakit inflamasi kulit noninfeksi yang jarang ditemukan. Sampai saat ini, belum ada kriteria diagnosis yang spesifik maupun pedoman tatalaksana untuk kasus pioderma gangrenosum. Kasus seorang laki-laki 73 tahun, dikonsul dari Bedah dengan luka borok di tungkai bawah kiri dan lengan kanan atas yang sangat nyeri dan meluas dengan cepat. Diagnosis awal adalah ulkus bakterial sehingga dilakukan debridement dan diberi antibiotik. Setelah debridement, ulkus bertambah luas dan semakin nyeri. Pada pemeriksaan histopatologi ditemukan sebukan sel radang padat yang terdiri atas PMN (dominan), limfosit, dan sel plasma sampai ke jaringan subkutis, sesuai dengan gambaran pioderma gangrenosum. Pasien mendapat terapi metilprednisolon 1 x 31.25 mg intravena dan krim mometason furoat 0.1%. Perbaikan klinis mulai tampak 2 minggu setelah terapi. Dua tahun kemudian, muncul lesi serupa di tungkai kanan, diawali trauma, dan juga memberi respon yang baik dengan kortikosteroid. Diagnosis pioderma gangrenosum perlu dipertimbangkan bila menemukan lesi nekrotik dengan progresivitas cepat, sangat nyeri, dan tidak merespons dengan antibiotik. Pemeriksaan histopatologi dapat digunakan untuk menyingkirkan penyebab ulkus yang lainnya. Prinsip tatalaksana adalah menekan proses inflamasi. Keterlambatan dalam diagnosis, pemilihan terapi yang tidak tepat, serta kekambuhan lesi merupakan masalah yang sering dijumpai.
KERATOAKANTOMA : DIAGNOSIS DAN TATALAKSANA
Authors: Pratama Nevristia , Winaya Ketut Kwartantaya , Zella Nandya Dwi
Published: August 2024

Keratoakantoma merupakan tumor kulit berasal dari folikel rambut dan dapat juga terjadi pada area tidak berambut, dengan memiliki pertumbuhan cepat dan regresi spontan. Insiden KA lebih sering terjadi pada populasi kulit putih dan cenderung lebih tinggi pada laki-laki. Etiologi terjadinya KA dikaitkan oleh beberapa faktor, faktor paparan ultraviolet merupakan faktor risiko utama terjadinya KA. Dalam mediagnosa KA didasarkan 3 prinsip, antara lain adanya manifestasi klinis khas dari tumor crateriform, pertumbuhan cepat dengan perjalanan trifasik dan pemeriksaan histopatologi. Secara garis besar KA memiliki beberapa varian klinis, yakni KA soliter dan KA multiple. Gambaran klinis dan histopatologis dari KA juga bervariasi, sesuai dengan tahapan yang terjadi yaitu tahap proliferasi, tahap berkembang sempurna, dan tahap regresi, sedangkan untuk gambaran dermoskopi dari KA ditandai dengan massa keratin tidak berstruktur berwarna putih-kekuningan di bagian tengah, dan dikelilingi oleh pembuluh darah dengan berbagai bentuk dan lingkaran putih (whitish halo). Pada sebgaian besar kasus KA terjadi regresi spontan sehingga pada beberapa kasus dapat dilakukan strategi berupa pemantauan/watchful-waiting. Keratoakantoma seringkali sulit dibedakan dengan KSS, sehingga baku emas untuk tatalaksana KA dengan bedah eksisi dan dilanjutkan untuk pemeriksaan specimen serta terdapat beberapa terapi alternatif lain yang dapat dilakukan untuk KA.
MUKORMIKOSIS KUTAN PADA ANAK: TINJAUAN PUSTAKA
Authors: Febriani Dina , Widhiati Suci
Published: August 2024

Mukormikosiskutanpadaanakadalahinfeksijamur Mucor sp. yangdapatmenyebabkanbeberapa
komplikasi dan kematian dengan angka morbiditas dan mortalitas yang cukup tinggi.Tinjauan pustaka ini
bertujuanuntukmengenaldanmemahamigambaranklinisbeberapakelainankulitakibatmukormikosis
kutanpadaanak,melakukanpenegakandiagnosissertamemberikantatalaksanayangtepat.Pencarian
literaturmenggunakanpedoman Preferred reporting items for systemic reviews and meta analyses
(PRISMA)melaluibasisdata PubMed dan Science Direct padabulanApril2020.Sejumlah15artikel
termasukdalamtinjauanpustakaini.Mukormikosiskutanpadaanakadalahsuatuinfeksijamur
oportunistikyangdisebabkanolehjamurMucor sp.,penyakitinidapatmenjadiinfeksiprimeratau
sebuahmanifestasiklinissebagaico-infection pada underlying disease lainnya. Ujud kelainankulit pada
mukormikosis kutan memiliki kesamaan padainfeksi jamurlainnya, sehinggaperlu dilakukan
pemeriksaan kultur danhistopatologi sebagaibaku emas untukmenegakkandiagnosis.Manifestasi klinis
kelainankulitdapatsalingtumpangtindihdenganbeberapainfeksikulityangdisebabkanolehjamur,
namunpadamukormikosiskutanmemilikigejalayangkhas.Padapasienanak-anak,perludilakukan
pemeriksaansecaraintensifdanmenyeluruh,anamnesisgejalapenyakitdanriwayatpenyakityangdapat
menjadi underlying disease yang dapat menyebabkan terjadinya mukormikosis kutan.
Kata Kunci: manifestasi kulit, mukormikosis kutan.
CHRONIC BULLOUS DISEASE OF CHILDHOOD: TINJAUAN KLINIS, HISTOPATOLOGI, DAN DIRECT IMMUNOFLOURESCENCE PADA PENEGAKAN DIAGNOSIS
Authors: Sulistianingrum Nita Damayanti , Irmawati Yulia Eka , Radiono Sunardi , Widodo Yohanes , Dwianingsih Ery Kus
Published: August 2024

Chronic bullous disease of childhood (CBDC) adalah penyakit autoimun bulosa
yang jarang, non herediter, dan biasa muncul pada dekade pertama kehidupan.
Gambaran klinis berupa bula tegang berisi cairan jernih atau hemoragik yang
membentuk cluster of jewels, rosette atau string of pearls. Fitur histopatologi berupa
celah subepidermal dengan neutrofil atau eosinofil di sepanjang membran basalis.
Pemeriksaan direct immunofluoroscence (DIF) didapatkan deposisi linear homogen
immunoglobulin (Ig) A pada area membran basalis. Deposit tambahan imunoreaktan
lain, tersering IgG dan bisa juga komplemen ketiga (C3), juga ditemukan pada sebagian
kecil pasien CBDC. Tujuan penulisan laporan ini adalah meningkatkan pemahaman
klinisi tentang penegakan diagnosis CBDC secara klinis serta variasi temuan
histopatologi dan DIF. Seorang anak perempuan usia 4 tahun 9 bulan mengalami lepuh
pada kulit disertai rasa gatal, namun tanpa keluhan sistemik sejak 2 bulan lalu. Status
dermatovenereologis tampak bula dinding tegang multipel berkelompok dengan pola
rosette. Pemeriksaan histopatologi tampak celah subepidermal dengan sedikit sebukan
1 sel polimorfonuklear. Pemeriksaan DIF pada kulit peri-lesi terdapat deposisi IgG, IgA

dan C3 pada membran basalis dengan pola linier. Diagnosis CBDC ditegakkan
berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan histopatologi berupa
gambaran celah subepidermal serta imunopatologi DIF berupa deposisi linier IgG, IgA
dan C3 pada membran basalis.
PATOGENESIS DAN TATA LAKSANA DERMATITIS ATOPIK TERKINI
Authors: Manurung Teguh Hopkop Putera , Fitri Eyleny Meisyah , Budianti Windy Keumala , Sirait Sondang P , Miranda Eliza
Published: August 2024

Dermatitis atopik (DA) merupakan salah satu dermatosis kronik yang ditandai dengan eksema berulang yang disertai dengan rasa gatal yang tidak tertahankan dan dapat mengakibatkan gangguan kualitas hidup yang bermakna. Studi terdahulu melaporkan faktor genetik, sawar kulit, disregulasi sistem imun, dan faktor eksternal saling memengaruhi dalam menimbulkan penyakit. Meskipun gambaran klinis DA pada tiap pasien relatif sama, studi terkini menyatakan tiap pasien memiliki perbedaan dalam komponen yang dominan berperan dalam patogenesis penyakit. Terapi standar DA saat ini meliputi kortikosteroid, inhibitor kalsineurin, dan pelembap. Pemahaman mengenai patogenesis DA penting untuk mengembangkan modalitas terapi DA yang baru. Uji klinis obat terhadap sitokin (dupilumab, tralokinumab, dan lebrikizumab), molekul kecil (apremilast, crisaborol, tofacitinib, dan baricitinib), reseptor (tapinarof), dan mikrobiom yang terlibat pada DA telah banyak dilakukan dan diharapkan dapat memberi solusi pada tata laksana DA. Tinjauan pustaka ini bertujuan untuk memaparkan studi terkini mengenai patogenesis dan berbagai modalitas terapi yang telah dikembangkan untuk tata laksana DA.
EFEK TERAPI PURIFIED PROTEIN DERIVATIVE TERHADAP KADAR INTERLEUKIN-12 SERUM PASIEN KUTIL ANOGENITAL
Authors: Suwarsa Oki , Achdiat Pati Aji , Rowawi Rasmia , Hidayat Yudi Mulyana , Shafiee Muhammad Nasir , Gunawan Hendra , Dwiyana Reiva Farah , Johan Reyshiani
Published: August 2024

Kutil anogenital (KAG) merupakan proliferasi jinak epitel kulit/mukosa yang disebabkan oleh infeksi human papillomavirus (HPV),dengan gambaran klinis berupa kutil di daerah genital/perianal. Imunitas seluler yang berperan dalam eliminasi virus HPV ditandai dengan ekspresi sitokin selThelper (Th)-1, yaitu interleukin (IL)-12 yang akan meningkatkan proliferasi dan diferensiasi sel T menjadi sel Th-1, mengeluarkan sitokin pro-inflamasi, serta menginduksi proliferasi sel natural killerdan mensekresi sitokin pro-inflamasi untuk meningkatkan sitotoksisitas. Pada penelitian in vitro,injeksi purified protein derivative(PPD) intralesimeningkatkan ekspresi IL-12 pada serum pasien veruka vulgaris (p<0,05) dibanding pasien kontrol. Penelitian mengenai kadar IL-12 pada serum pasien KAG yang mendapat injeksi PPD intralesi di Indonesia belum pernah dilakukan, sehingga menjadi tujuan penelitian ini. Penelitian ini merupakan one grouppre- and post-designberdasarkan studi analitik eksperimental. Subjek penelitian berupa 14 serum pasien KAG sebelum dan setelah mendapat terapi PPD. Pengukurankadar IL-12 dalam serum menggunakan metode enzyme linked immunosorbent assay.Hasil penelitian didapatkan rerata kadar IL-12 serum sebelum mendapat terapi 45.73Â±53.186pg/ml. Setelah mendapat terapi PPD, didapatkan peningkatan kadar IL-12 serum sebesar rerata 45.9pg/ml menjadi rerata 91.68Â±79.321pg/ml (p=0,158). Simpulan penelitian ini adalah kadar IL-12 dalam serum penderita KAG tidak mengalami peningkatan setelah mendapat terapi PPD.
TATA LAKSANA TERKINI PENYAKIT SINDROM STEVENS-JOHNSON (SSJ)/ NEKROLISIS EPIDERMAL TOKSIK (NET)
Authors: Kusumawardhani Dina , Fitri Eyleny Meisyah , Budianti Windy Keumala , Novianto Endi , Effendi Evita Halim
Published: August 2024

Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksik (NET) merupakan penyakit yang mengancam nyawa, ditandai oleh adanya ruam dan lepuh yang nyeri, disertai lepasnya lapisan epidermis, atau ulkus pada mukosa mulut, mata, dan genital. SSJ/NET merupakan spektrum terberat dari reaksi efek simpang obat yang dimediasi imun, terutama oleh sel T, dan termasuk reaksi hipersensitivitas tipe IVc. SSJ dan NET adalah penyakit yang sama, dibedakan berdasarkan persentase permukaan kulit yang terlibat yaitu SSJ (<10%), SSJ/NET overlap (10%-30%), dan NET (>30%). SSJ/NET sering disertai keterlibatan multiorgan dengan rerata mortalitas 1-5% pada SSJ dan 25-35% pada NET. Tata laksana optimal SSJ/NET meliputi diagnosis dini, identifikasi dan penghentian obat tersangka, mempertimbangkan kemungkinan adanya infeksi sebagai pencetus, serta terapi suportif sedini mungkin. Terapi suportif yang dilakukan oleh tim multidisipilin merupakan tata laksana utama. Terapi suportif yang baik terbukti dapat memperbaiki kondisi klinis pasien. Rekomendasi penggunaan terapi sistemik berupa kortikosteroid, siklosporin, intravenous immunoglobulin (IVIg), plasmaferesis, dan terapi target, hingga saat ini sangat bervariasi karena belum terdapat bukti efikasi berdasarkan penelitian randomized controlled trial.
PRIMARY CUTANEOUS AGGRESSIVE EPIDERMOTROPISM CD8+ CYTOTOXIC T-CELL LYMPHOMA: SEBUAH KASUS SULIT
Authors: Hamada Nizami , Suwarsa Oki
Published: August 2024

Pendahuluan: Primary cutaneous aggressive epidermotropism CD8+ cytotoxic t-cell lymphoma (PCAE-CD8+ CTCL) merupakan varian cutaneous T-cell lymphoma agresif dengan prognosis yang buruk. Variasi gambaran klinis dan histopatologis, serta belum terdapatnya kriteria diagnosis, membuat penegakan diagnosis PCAE-CD8+ CTCL menjadi tantangan.  Kasus: Dilaporkan satu kasus PCAE-CD8+ CTCL pada seorang laki-laki berusia 67 tahun dengan gambaran histopatologis awal mendukung parapsoriasis. Pada pemeriksaan fisis di hampir seluruh tubuh terdapat lesi multipel yang sebagian besar berupa plak eritem disertai ulkus dangkal tertutup krusta, dengan perjalanan penyakit yang kronis. Pada pasien dilakukan pemeriksaan histopatologis ulang dan didapatkan gambaran epidermotropisme serta infiltrat limfosit atipik dan pleomorfik pada epidermis dan dermis. Pemeriksaan imunohistokimia menunjukkan hasil positif terhadap CD8, CD4, Granzyme, CD3, dan Ki-67, sehingga disimpulkan sebagai PCAE-CD8+ CTCL. Diskusi: Manifestasi klinis PCAE-CD8+ CTCL yang bervariasi dan tidak khas dapat membuat penegakan diagnosisnya menjadi terlambat. Pemeriksaan penunjang dengan pemeriksaan histopatologis dan imunohistokimia perlu dilakukan untuk membantu penegakan diagnosis PCAE-CD8+ CTCL. Kesimpulan:  Pengetahuan mengenai variasi dan perjalanan klinis PCAE-CD8+ CTCL perlu dipahami dengan baik, agar penegakan diagnosis dapat dilakukan dengan cepat dan akurat, untuk meningkatkan angka harapan hidup pasien.
EKSPRESI RESEPTOR VITAMIN D PADA LESI DAN PERILESI KULIT PASIEN VITILIGO BERDASARKAN PEMERIKSAAN
Authors: Karisa Nadila Ayu , Dwiyana Reiva Farah , Sutedja Eva Krishna , Sutedja Endang , Suwarsa Oki , Gunawan Hendra , Hernowo Bethy , Usman Hermin Aminah
Published: August 2024

Pendahuluan: Vitamin D diketahui memiliki banyak fungsi dalam tubuh, salah satunya berperan sebagai imunomodulator. Vitamin ini bekerja melalui transkripsi gen sel-sel tertentu yang mengekspresikan reseptor vitamin D (RVD) Tujuan: Untuk lebih memahami peran vitamin D pada pasien vitiligo berdasarkan RVD di jaringan kulit. Metode: Penelitian ini menggunakan studi observasional analitik dengan metode potong lintang. Kelompok kasus merupakan pasien vitiligo yang diambil kulitnya pada area lesi dan perilesi melalui prosedur biopsi plong dan disimpan sebagai bahan biologik tersimpan sedangkan kelompok kontrol adalah pasien luka bakar dan luka kronis dari Poliklinik Bedah Plastik, yang diambil kulit sehatnya dengan prosedur split-thickness skin graft. Ekspresi RVD dilakukan dengan pemeriksaan imunohistokimia menggunakan antibodi monoklonal dan dinilai oleh dua orang ahli patologi. Hasil: Rerata histoskor RVD pada lesi kulit pasien vitiligo (4.96Â±1.852) lebih tinggi daripada kontrol (2.47Â±0.405). Rerata perilesi kulit pasien vitiligo (5.07Â±1.321) lebih tinggi daripada kontrol (2.47Â±0.405). Rerata histoskor lesi lebih rendah (4.96Â±1.852), tetapi tidak bermakna secara statistik dibandingkan perilesi pasien vitiligo (5.07Â±1.321).Kesimpulan: Ekspresi RVD perilesi pasien vitiligo lebih tinggi dibandingkan lesi, tetapi ekspresi RVD pasien vitiligo tidak lebih rendah dibandingkan kontrol. Hal ini menunjukkan bahwa RVD tidak banyak berperan dalam patogenesis vitiligo.
Atividade física: jogos e brincadeiras na educação infantil
Authors: Rossi Miriam
Published: August 2024

O presente trabalho tem por objetivo mostrar a importância dos jogos e brincadeiras para a Educação Infantil, tais atividades são imprencindiveis para o desenvolvimento global das crianças, brincar é mais do que uma atividade sem consequência para a criança. Brincando, ela não apenas se diverte, mas recria e interpreta o mundo em que vive, se relaciona, interage, socializa, contribui para o desenvolvimento social. Brincando, a criança aprende. Por isso, cada vez mais os educadores recomendam que os jogos e as brincadeiras ocupem um lugar de destaque no programa escolar desde a Educação Infantil, fase em que esses conteúdos fazem total diferença no desenvolvimento integral da criança. Neste trabalho teremos acesso as Teorias de três grandes estudiosos que defendem a importância dos Jogos e das Brincadeiras para o desenvolvimento da criança, o primeiro, Piaget, o segundo, Vigotski e o terceiro, Wallon. Será realizada uma pesquisa bibliográfica, onde será buscado em materiais já existentes sobre o tema da atual pesquisa.
Os efeitos no processo de emagrecimentos para pessoas com obesidade: uma avaliação sobre os benefícios em realizar atividade física regulamente
Authors: Silveira Pedro
Published: August 2024

Objetivo do presente trabalho é analisar os efeitos e avaliar a importância da realização de atividade física e seus benefícios para o processo de emagrecimento para pessoa com obesidade. Justificativa: O trabalho realizado contribui no processo de conhecimento sobre os problemas que a sociedade brasileira enfrenta com a ausência em realizar atividade física, uma vez que auxilia no entendimento a respeito dos efeitos causados no emagrecimento para pessoas com obesidade e colabora com o desenvolvimento da conscientização da sociedade brasileira para realizar atividade física. Método:Este estudo é uma revisão bibliográfica, acerca dos efeitos no processo de emagrecimento para pessoas com obesidade: uma avaliação sobre os benefícios em realizar atividade física regulamente, realizada através de pesquisas nas bases de dados Public Medline (PUBMED), Scientific Eletronic Library Online (SCIELO), Medical Literature Analysis and Retrieval System Online (MEDLINE) e Google Acadêmico Foram utilizados os seguintes descritores em inglês e português: emagrecimento, obesidade, atividade física e benefícios. Foram selecionados estudos que utilizaram atividade física para o processo de emagrecimento para pessoas com obesidade. Conclusões: Os resultados apontaram que a prática de exercícios físicos mostraram ser importante componente no processo de emagrecimentos para a obesidade, pois melhora o quadro de saúde física.
Recombinant fibrous protein biomaterials meet skin tissue engineering
Authors: Li Dipeng , Wang Yirong , Zhu Shan , Hu Xuezhong , Liang Renjie
Published: August 2024

Natural biomaterials, particularly fibrous proteins, are extensively utilized in skin tissue engineering. However, their application is impeded by batch-to-batch variance, limited chemical or physical versatility, and environmental concerns. Recent advancements in gene editing and fermentation technology have catalyzed the emergence of recombinant fibrous protein biomaterials, which are gaining traction in skin tissue engineering. The modular and highly customizable nature of recombinant synthesis enables precise control over biomaterial design, facilitating the incorporation of multiple functional motifs. Additionally, recombinant synthesis allows for a transition from animal-derived sources to microbial sources, thereby reducing endotoxin content and rendering recombinant fibrous protein biomaterials more amenable to scalable production and clinical use. In this review, we provide an overview of prevalent recombinant fibrous protein biomaterials (collagens, elastin, silk proteins and their chimeric derivatives) used in skin tissue engineering (STE) and compare them with their animal-derived counterparts. Furthermore, we discuss their applications in STE, along with the associated challenges and future prospects.
Preservation of vision by transpalpebral electrical stimulation in mice with inherited retinal degeneration
Authors: Gunes Kasim , Chang Karen , Lennikov Anton , Tai Wai Lydia , Chen Julie , ElZaridi Farris , Cho Kin-Sang , Utheim Tor Paaske , Dong Feng Chen
Published: August 2024

Introduction

The potential neuroprotective and regenerative properties of electrical stimulation (ES) were studied in rhodopsin knockout mice (Rho−/−), a murine model of inherited retinal degeneration. The study focused on assessing the impact of varying ES frequencies on visual functions and photoreceptor cell survival in Rho−/− mice.

Methods

To elucidate the impact of electrical stimulation on cone survival, Rho−/− mice received either sham or transpalpebral ES using biphasic ramp or rectangular waveforms at 100 µA amplitude, starting at six weeks of age. The treatment duration spanned from one to three weeks. The optimal treatment frequency of ES sessions was determined by applying ES every one, two, or three days in three separate groups of Rho−/− mice. The sham group received daily treatments without the application of ES.

Results

Our study revealed significant improvement of visual function in Rho−/− mice following daily or every-other-day noninvasive transpalpebral ES, as evidenced by electroretinogram and optomotor response-based visual behavior assays. Concurrently, assessment of outer nuclear thickness and immunohistochemistry for the cone photoreceptor cell marker PNA demonstrated pronounced increases in the survival of rods and cones and improvement in the morphology of the inner and outer segments.

Discussion

This study underscores the protective effect of non-invasive ES in rhodopsin knockout-induced retinal degenerative disorders, providing a foundation for developing targeted therapeutic interventions for retinitis pigmentosa.
Clinical features and prognostic factors of cryptococcal infections in HIV-infected patients: a 10-year study from an infectious disease specialist hospital
Authors: Dai Fang-Fang , Lou Jin-Li , Yu Yan-Hua , Chen Ming , Lu Xin-Xin
Published: August 2024

Background

Cryptococcosis is an invasive infection that commonly affects immunosuppressed individuals, especially patients with HIV infection. Cryptococcal infection in HIV-infected patients should be considered a major health concern because it is associated with high morbidity and mortality rates. In this study, we aimed to evaluate the clinical characteristics and prognostic factors of cryptococcal infections in human immunodeficiency virus (HIV)-infected patients to facilitate effective clinical management and improve patient outcomes.

Methods

We reviewed and analyzed the clinical data and relevant laboratory test results of HIV-infected patients with positive cryptococcal cultures and reserved strains between 2013 and 2023 from Beijing Youan Hospital affiliated to Capital Medical University. The clinical characteristics and laboratory test results of the patients were compared, and the correlation between parameters and the prognoses of the patients at different observation timepoints (3, 6, 9, and 12 months) was analyzed.

Results

A total of 76 patients (70 males and six females; median age, 37 years) were included in this study. The results indicated that the later the initiation of antiretroviral therapy (ART) after the diagnosis of HIV infection (> 6 months), the higher the probability of death. Analysis of the correlation between the time of ART initiation and the timing of treatment for cryptococcal infections showed that the time of ART initiation was strongly related to survival at different timepoints. Initiation of ART time within 0-4 weeks, 4-6 weeks and more than 6weeks of starting treatment for Cryptococcus infection was associated with a lower mortality rate at 12-month, the 3-month, 6- and 9-month follow-up timepoint separately.

Conclusions

Although cryptococcal infection in HIV-infected patients continues to be a challenging and intricate issue, ART is a key factor that affects its prognosis. The later ART is started, the worse the prognosis of the infection. The time of ART initiation and the timing of treatment for cryptococcal infections should be further refined and balanced based on different clinical courses. Thus, clinicians should pay closer attention to cryptococcal infections in patients with HIV infection and initiate ART based on the patient’s clinical condition.
Understandability of passive smoking prevention leaflets in Japan
Authors: Iso Tomoya , Ishikawa Yoshihiro , Kobashi Yurie , Nollet Kenneth , Yokokawa Hirohide , Goto Aya
Published: August 2024

Purpose

There are few studies in Japan evaluating informational materials about passive smoking prevention with respect to health literacy. This study applied a range of health literacy assessment tools to assess the understandability of public-sector leaflets about passive smoking prevention.

Methods

We collected 26 anti-passive smoking leaflets published online by Japanese prefectural governments. We used three internationally recognized health literacy assessment tools to evaluate their understandability: the Clear Communication Index (CCI), the Suitability Assessment of Materials (SAM), and the Patient Education Materials Assessment Tool (PEMAT, further divided into scales for understandability and actionability).

Results

Although none of the assessed materials met the CCI's scoring threshold for “easy to understand,” the highest-scoring leaflet, which received a top-two ranking in three of the four scales (excluding the PEMAT understandability scale), was characterized by its conciseness and its easy-to-understand structure, including the use of checklists and flowcharts to engage reader interest. There was a significant correlation between CCI and SAM, and between SAM and the PEMAT understandability scale. However, the PEMAT actionability scale did not significantly associate with the other assessment scales.

Conclusions

The understandability of written informational materials about passive smoking prevention in Japan could be improved by referring to multiple assessment scales.
Concurrent and longitudinal associations between touchscreen use and executive functions at preschool-age
Authors: Mortimer Alicia , Fiske Abigail , Biggs Bethany , Bedford Rachael , Hendry Alexandra , Holmboe Karla
Published: August 2024

Introduction

The prevalence of touchscreen devices has recently risen amongst young children. Some evidence suggests that increased touchscreen use may be negatively related to preschool-age children's executive functions (EFs). However, it has been argued that actively interacting with touchscreen devices (e.g., via creative apps for drawing) could better support EF development compared to passive use (e.g., watching videos). There is a pressing need to understand whether the type of use can explain potential associations between touchscreen use and EF.

Methods

By following up longitudinally on an infant sample, now aged 42-months (N = 101), the current study investigates the relative contributions of passive and active touchscreen use, measured concurrently at 42-months and longitudinally from 10-to-42-months, on parent-reported EFs.

Results

A multivariate multiple regression found no significant negative associations between touchscreen use and preschool EF. There was a significant positive association between active touchscreen use at 42-months and the BRIEF-P Flexibility Index.

Discussion

The lack of significant negative associations found is consistent with an earlier study's findings in the same sample at infancy, suggesting that the moderate levels of early touchscreen use in this sample are not significantly associated with poorer EF, at least up to preschool-age.
Monopile-induced turbulence and sediment redistribution form visible wakes in offshore wind farms
Authors: Bailey Lewis P. , Dorrell Robert M. , Kostakis Ina , McKee David , Parsons Dan , Rees Jon , Strong James , Simmons Stephen , Forster Rodney
Published: August 2024

Offshore wind farms are becoming an increasingly common feature in the marine environment as a renewable energy source. There is a growing body of evidence on the effects of wind farms on the seabed and its organisms. However, an important and understudied aspect of site development is the interaction of turbine foundations on the surrounding marine environment. Structures exert significant disturbance on tides, waves and currents; these are visible as optically-distinct, elongate wakes at the sea surface with elevated suspended particulate matter. Despite this, there is uncertainty on the mechanisms that lead to the visible manifestation of wakes at turbine foundations, primarily due to a lack of direct measurements. Here, in situ measurements along with a 15-year time series of satellite images of the Thanet offshore wind farm, located within the Thames Estuary, were used to investigate the formation of visible monopile wakes, and the effects these have on the surrounding water column. We show the optically distinct wakes are near-constant at Thanet; visible in >90% of all satellite images, yet no regional change in sea surface turbidity could be attributed to wind farm construction or operation. Monopile wake in situ water samples and acoustic Doppler current profiler (ADCP) backscatter measurements demonstrated colour change related to elevated sea surface sediment concentration. However, averaged water column measurements of suspended sediment within wakes, and upstream of monopiles, remained consistent. These measurements demonstrate that sediment was redistributed towards surface waters, rather than additional sediment becoming suspended in the wake. ADCP velocity measurements supported a mechanism of sediment lofting towards the surface, with enhanced vertically upwards flow recorded in wakes.
Male infertility risk and plasma lipidome: a Mendelian randomization study
Authors: Yang Yang , Xue Xinyu , Zhou Jun , Qiu Zerui , Wang Biao , Ou Guangyang , Zhou Qing
Published: August 2024

Background

In recent years, the decline in sperm quality in men has become a global trend. There is a close relationship between sperm quality and pregnancy outcome. There is a large body of literature supporting the role of plasma lipidome in male infertility, while the complex mechanisms between them and male infertility are still less clear. Systematic study of the causal relationship between plasma lipidome and MI can help to provide new therapeutic ideas and targets for male infertility.

Methods

In this study, we used a two-sample Mendelian randomization analysis based on Genome-wide association studies pooled data of 179 causal relationships between plasma lipidome and male infertility. We used employed the inverse variance weighted method as the main analysis to assess causality between exposure and outcome, in addition to MR-Egger, Weighted median as complementary methods, and tests for multiplicity and heterogeneity.

Results

We identified 13 plasma lipidome comprising 4 types of plasma lipidome that were associated with male infertility. Among these, 9 plasma lipidome were found to be protective factors, while 4 were risk factors. Notably, the largest proportion of these plasma lipidome were triglyceride types, with Sphingomyelin (d40:1) exhibiting the strongest association with male infertility.

Conclusion

These findings contribute to the current better understanding of male infertility and provide new perspectives on the underlying etiology of male infertility as well as prevention and treatment strategies. In addition, clinical trial validation is needed to assess the potential of these plasma lipidome as biomarkers.
The predictive value of the triglyceride glucose index combined with cystatin C for the prognosis of patients with acute coronary syndrome
Authors: Wang Chen , Liao Pinliang , Tang Chuanqin , Chen Chunlin , Zhang Xiaoyu
Published: August 2024

Background

Recent studies have shown that the triglyceride glucose index (TyG) and cystatin C (CysC) are closely related to cardiovascular disease, but there is limited research on the prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). The aim of this study was to explore the predictive value of the combination of the TyG index and CysC in predicting major adverse cardiovascular events (MACEs) in ACS patients who underwent PCI.

Methods

This retrospective study included 319 ACS patients who underwent PCI. The clinical endpoint was the occurrence of MACEs, including all-cause mortality, heart failure, non-fatal myocardial infarction, target vessel revascularization, and angina requiring hospitalization. Patients were classified into MACEs (65 cases) and non-MACEs (254 cases) groups. Univariate factor and multivariate analysis were used to identify predictors of MACEs. The receiver operating curve (ROC) of the prediction model of MACEs was determined. Additionally, the net reclassification improvement and integrated discrimination improvement indexes were calculated to further assess the additional predictive value of the risk factors for MACEs. Subgroup and interaction analysis between the TyG index combined with CysC and MACEs were conducted in various subgroups. Patients were stratified according to the optimal cutoff point value of the TyG index and the CysC determined by ROC curve analysis. The Kaplan–Meier analysis method was used to construct a survival curve 1 year after PCI.

Results

During a median follow-up period of 14 months, 65 (20.38%) patients had experienced at least one primary endpoint event. Multivariate logistic regression analysis indicated that the TyG index and CysC were independently associated with an increased risk of MACEs after PCI (OR, 2.513, 95% CI 1.451–4.351, P= 0.001; and OR, 4.741, 95% CI 1.344–16.731, P=0.016, respectively). The addition of the TyG index and CysC to the baseline risk model had the strongest incremental effect for predicting MACEs in terms of the C-statistic from 0.789 (95% CI 0.723–0.855, P<0.001) to 0.799 (95% CI 0.733–0.865, P<0.001). Furthermore, Kaplan–Meier analysis demonstrated that a TyG index greater than 9.325 and a CysC value greater than 1.065 mg/ml were significantly associated with an increased risk of MACEs (log‐rank, all P < 0.01).

Conclusion

The TyG index predicts MACEs after PCI in patients with ASC independent of known cardiovascular risk factors. Adjustment of the CysC by the TyG index further improves the predictive ability for MACEs in patients with ACS undergoing PCI. Thus, both of them are expected to become new prognostic indicators for MACEs in patients with ACS after PCI.
Flexibility from industrial demand-side management in net-zero sector-coupled national energy systems
Authors: Mayer Patricia , Heer Mario , Shu David Yang , Zielonka Nik , Leenders Ludger , Baader Florian Joseph , Bardow André
Published: August 2024

National energy systems require flexibility to accommodate increasing amounts of variable renewable energy. This flexibility can be provided by demand-side management (DSM) from industry. However, the flexibility potential depends on the characteristics of each industrial process. The enormous diversity of industrial processes makes it challenging to evaluate the total flexibility provision from industry to sector-coupled energy systems. In this work, we quantify the maximum cost reductions due to industrial DSM in the net-zero sector-coupled Swiss energy system, and the relationship between cost reductions and various industrial process characteristics. We analyze the flexibility of industrial processes using a generic, process-agnostic model. Our results show that industrial DSM can reduce total energy system costs by up to 4.4%, corresponding to 20% of industry-related energy costs. The value of flexibility from industrial DSM depends not only on the process characteristics but also on the system’s flexibility alternatives, particularly for flexibility over seasonal time horizons. As one specific option for industrial DSM, we find that thermal energy storage (TES) technologies available today could realize between 28% and 61% of the maximum cost reductions from industrial DSM, making TES a promising DSM solution and showing that industrial DSM is an accessible and cost-effective flexibility option.
Hydraulic erosion patterns downstream of corrugated aprons: investigating free and submerged jet effects
Authors: Mumtaz Mohd Aamir , Elgamal Mohamed H. , Farouk Mohamed I. , Siddiqui Md Irfanul Haque
Published: August 2024

The experimental evaluation of the performance of a corrugated apron under free flow subcritical and submerged conditions was conducted, with a focus on scour patterns over the apron. Comparative analysis with a smooth rigid apron revealed an increase in scour depth upon the application of the corrugated apron under free and submerged jet flow conditions. The implementation of a corrugated apron resulted in a considerable reduction in scour depth and length compared to a smooth rigid apron. The maximum reduction in scour depth and length amounted to 79% and 83%, respectively, while the minimum reduction observed was 13% in scour depth and 11% in scour length. Additionally, investigations into velocity and turbulence characteristics over both smooth and corrugated aprons were conducted. It was observed that the rate of turbulence intensity increase within the scour hole due to the presence of a smooth apron surpassed that of the corrugated apron. Scour downstream of the corrugated apron exhibited distinct delineations, including regions of jet diffusion, transition, acceleration, and a recirculating zone near the bed of the scour hole.