bluuebunny/crossref_metadata_2025 huggingface dataset:
A Synthesis of Current Surveillance Planning Methods for the Sequential Monitoring
of Drug and Vaccine Adverse Effects Using Electronic Health Care Data
Authors: Nelson Jennifer C. , Wellman Robert , Yu Onchee , Cook Andrea J. , Maro Judith C. , Ouellet-Hellstrom Rita , Boudreau Denise , Floyd James S. , Heckbert Susan R. , Pinheiro Simone , Reichman Marsha , Shoaibi Azadeh
Published: September 2016

Introduction: The large-scale assembly of electronic health care data combined
with the use of sequential monitoring has made proactive postmarket drug- and
vaccine-safety surveillance possible. Although sequential designs have been used
extensively in randomized trials, less attention has been given to methods for applying
them in observational electronic health care database settings.Existing Methods: We
review current sequential-surveillance planning methods from randomized trials, and the
Vaccine Safety Datalink (VSD) and Mini-Sentinel Pilot projects—two national
observational electronic health care database safety monitoring programs.Future
Surveillance Planning: Based on this examination, we suggest three steps for future
surveillance planning in health care databases: (1) prespecify the sequential design and
analysis plan, using available feasibility data to reduce assumptions and minimize later
changes to initial plans; (2) assess existing drug or vaccine uptake, to determine if
there is adequate information to proceed with surveillance, before conducting more
resource-intensive planning; and (3) statistically evaluate and clearly communicate the
sequential design with all those designing and interpreting the safety-surveillance
results prior to implementation. Plans should also be flexible enough to accommodate
dynamic and often unpredictable changes to the database information made by the health
plans for administrative purposes.Conclusions: This paper is intended to encourage
dialogue about establishing a more systematic, scalable, and transparent sequential
design-planning process for medical-product safety-surveillance systems utilizing
observational electronic health care databases. Creating such a framework could yield
improvements over existing practices, such as designs with increased power to assess
serious adverse events.
High dose methotrexate in the treatment of children with acute lymphoblastic leukemia
Authors: Lukito Johannes Bondan
Published: September 2016

Background It has been claimed that around 70% of childhoodacute lymphoblastic leukemia (ALL) can be cured. One of theimportant role is high dose methotrexate (HDMTX) administrationduring the consolidation therapy.Objective To determine the safety and effectiveness of HDMTXin children with ALL.Methods We reviewed patients with ALL in Pantai Indah KapukHospital, Jakarta during the period August 2000 through July 2005with observation time run through September 2006. Only patientswith normal kidney function were allowed to have HDMTX. Besidesgood hydration and alkalinization, patients were supported with goodhygiene (mouth, skin and anal area). MTX was given in loadingdose of 10% from the total dose in ½ hour and the rest 23½ hours for90%. Leucovorin rescue was started 12 hours after discontinuationof 24 hour MTX IV infusion. Leucovorin was given until the MTXconcentration reached 0.1 uM/L. Patients were stratified to low,intermediate and high risk groups; 2 gram/m 2 was given to low riskgroup and 5 gram/m2 to intermediate and high risk groups.Results There were 20 patients eligible for study. All methotrexatesteady-state plasma concentrations (MTX Cp ss ) were above 16 uM/L, and steady state concentration in CSF was always below 0.5 uM/L for 2 gram/m 2 and above 0.5 uM/L for 5 gram/m 2 doses. All 20cases went through the procedure with only mild side effects i. e,mild mucositis, anal furuncle and diarrhea, which recovered 2 weekslater. Only 1 high risk case with initial WBC 612X10 9 /L, succumbedafter he went through the HDMTX program smoothly and relapsedsubsequently during reinduction phase.Conclusion HDMTX can be given safely to ALL patients with normalkidney function with good supportive care. Five gram/m 2 HDMTXeffectively treat the minor disease and/or prevent CNS and testicularleukemia. This study has also given an impression that HDMTXmay increase event-free survival.
Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial
Authors: Karyadiguna Nugroho , Soetjiningsih Soetjiningsih , Retayasa W. , Kardana M.
Published: September 2016

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infant’s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infant’s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.
The efficacy of trimethoprim-sulfamethoxazole treatment in children with acute bloody diarrhea
Authors: Nafianti Selvi , Ramayani Oke R. , Daulay Dedy G. , Supriatmo Supriatmo , Hasibuan Berlian , Sinuhaji Atan B.
Published: September 2016

Background The etiologies of bloody diarrhea are shigella,amoeba, enterocolitis, trichuriasis, and other causes i.e, EIEC,Campylobacter jejuni or rotavirus. In developing countries,trimetroprim-sulfamethoxazole (TMP-SMP) is effective in 80%of children with bloody diarrhea.Objective To determine the efficacy of trimethoprim-sulfa-methoxazole (TMP-SMX) treatment in children with acute bloodydiarrhea.Methods A randomized double blind clinical trial was conductedin Adam Malik Hospital and Dr. Pirngadi Hospital Medan duringSeptember 2003-March 2004. Children aged 2-24 months oldwith diagnosis of acute bloody diarrhea were randomized into twogroups to either receive TMP-SMX or placebo for 5 days.Microscopic fecal analysis was performed on the first, second,fifth and twelfth day, and the results were compared.Results A total of 68 children consisted of 48 (71%) boys and 20(29%) girls were enrolled. Each group had 34 participants.Analysis of the first day showed leukocyte and erythrocyte in thestool specimens, which were all absent on the twelfth day in bothgroups. There was no difference in stool analysis between TMP-SMX and placebo group in day two (P=0.758), day five (P=0.341)and day twelve. Diarrhea duration in TMP-SMX and placebogroup was 7.18 days and 6.65 days, respectively. This differentwas statistically not significant (P=0.385).Conclusion There is no difference in the efficacy of trimethoprim-sulfamethoxazole treatment compared to placebo in children withacute bloody diarrhea.
Pattern and influencing factors of breastfeeding of working mothers in several areas in Jakarta
Authors: Fauzie Rifan , Suradi Rulina , Hadinegoro Sri Rezeki S.
Published: September 2016

Background Breast milk contains many essential nutrition factorsbest for babies. The 1997 Indonesian Health Demography foundthat the proportion of exclusive breastfeeding was still low (52%)and increased to 55.1% in 2002. Due to increasing number ofworking mothers, promoting breast feeding among them should beperformed properly. There are no data on exclusive breastfeedingrate and pattern among working mothers in Indonesia.Objective To describe exclusive breastfeeding rate and patternamong working mothers in several areas in Jakarta and the influ-encing factors.Methods A descriptive study using a questionnaire was conductedfrom October 2005 to February 2006. Subjects were workingmothers who had 6 to 12 month old baby and breastfed and thebaby had no congenital or chronic disease.Results Among 290 mothers interviewed, 40% worked at banksor insurance business, 34% were private employees, 25% medicalstaffs, and 2% were teachers. Almost 80% have exclusivelybreastfed for less than 4 months, 17% for 4 months, and only 4%for 6 months. Maternal leave, family support, mothers’ knowl-edge, facilities at workplace, media influences, and working hoursseemed to have no relations to breastfeeding rate. There were122 (42%) mothers who had good knowledge about physiologyof lactation, 155 of them (53%) had fair knowledge, and only45% of them had poor knowledge.Conclusions The proportion of working mothers in several areasin Jakarta who have exclusively breastfed for 4 months is 17%, andonly 4% of subjects do exclusive breastfeeding for 6 months. Mostsubjects have a good to fair knowledge about the physiology oflactation but it does not seem to influence the decision to exclu-sively breastfed their babies.
Shigellosis in children less than five years in urban slum area: a study at primary health care in Jakarta
Authors: Elvira Junita , Firmansyah Agus , Akib Arwin A. P.
Published: September 2016

Background Shigellosis has a global distribution especially incountries with poor hygiene and sanitation. The most commonmanifestation of shigellosis in children is diarrhea with broadspectrum manifestations from watery diarrhea to classicaldysentery. Appropriate antibiotic management is important toeradicate Shigella spp.Objective To find out shigellosis prevalence and manifestationsand also Shigella spp. resistance pattern in children less than 5years with acute diarrhea in certain district urban slum areas inJakarta.Methods This cross sectional study involved 475 outpatients ofless than 5 years old with acute diarrhea who visited primary healthcares in Jakarta from July– October 2005. Stool for culture andantibiotic resistance test was taken with single rectal swab.Results Shigella spp. was found only in 3 (0.6%) patients. Thesubjects were between 6 to 24 months. Watery diarrhea was foundin 1 subject and so was the classical dysentery manifestation offever and bloody diarrhea. Two strains were found, 2 cases of S.sonnei and 1 case of S. flexneri. They were resistance tocotrimoxazole, tetracycline, and colistine.Conclusion Shigella spp. was not the main cause of acute diarrheain children less than 5 years old. Due to the small number ofcases, we could not find the most common manifestation andresistance pattern of shigellosis in these children.
Clinical risk factors for dengue shock syndrome in children
Authors: Junia Jujun , Garna Herry , Setiabudi Djatnika
Published: September 2016

Background Dengue shock syndrome (DSS) is a seriouscomplication of dengue hemorrhagic fever (DHF) which maycause death in more than 50% cases if not treated properly andpromptly. Clinical, viral, and epidemiological risk factorsdetermine the occurrence of DSS. Identifying risk factors for thedevelopment of shock in patients with DHF can increase theawareness of clinicians to perform a close monitoring.Objective To determine the clinical risk factors for DSS.Methods This case control study was conducted on DHF andDSS patients admitted to the Department of Child Health,Medical School, University of Padjadjaran, Dr. Hasan SadikinHospital Bandung from January 2004 to December 2005. Thesubjects were patients aged less than 14 years who fulfilled WHOcriteria (1997). The exclusion criteria were history of asthma,diabetes mellitus, sickle cell anemia, typhoid, sepsis, and measles.The risk factors for DSS were analyzed using chi-square test,calculation of odds ratio, and logistic regression analysis.Results Of 1,404 patients with suspected DHF, 600 met the studycriteria; 200 patients of DSS and 400 patients of DHF as controlgroup were identified. Univariate analysis showed that there wasassociation between DSS and age 5-9 years (OR=1.67, 95%CI1.08;2.58), overweight (OR=1.88, 95%CI 1.22;2.90), vomiting(OR=1.44, 95%CI 1.02;2.04), abdominal pain (OR=2.07,95%CI 1.46;2.92), and severe bleeding (OR=13.6, 95%CI5.96;31.03). By logistic regression analysis, it was found that age5-9 years (OR=1.62, 95%CI=1.03–2.53), overweight (OR=1.97,95%CI=1.29–3.08), and persistent abdominal pain (OR=2.08,95%CI =1.44–2.99) were independent risk factors for DSS.Conclusion Age 5-9 years, overweight, and persistent abdominalpain are the risk factors for DSS.
The association between fever in the first year of life and atopy in children with or without family history of atopic disease
Authors: Wihadi Susy P. , Setiabudiawan Budi , Kartasasmita Cissy B.
Published: September 2016

Background The role of repeated infection in early life in thedevelopment of childhood atopy is still controversy. Fever in thefirst year of life which is frequently associated with infections mightdecrease atopy.Objective The aim of this study was to investigate the associationbetween fever in the first year of life and atopy in children.Methods This was an observational clinical epidemiology studyperformed at Puskesmas Garuda, Padasuka, and Babakan Sari,Bandung, from January to March 2006. From 749 children, werandomly chose 150 subjects each from group with and withoutfamily history of atopic disease. Skin prick test and measurementof total serum immunoglobulin (Ig) E were performed on eachchildren. Atopy was defined as the skin prick test result waspositive to >1 allergen. The number of fever episodes in the firstyear of life was based on parents report. The relationship betweenfever and atopy was analyzed using Mantel Haenszel.Results From 284 subjects, atopy was found in 28.2% of children,of which 32.4% with and 23.9% without a family history of atopicdisease. Generally there was no significant association betweenfever and atopy. There was only decreased odds ratio withincreased fever episodes and trend analysis showed this decreasewas significant (P=0.01). The significant association betweenfever and atopy were found only in group without family historyof atopic disease (P=0.03, OR=0.43, CI 95% 0.18;1.01).Conclusion There is a relationship between fever and atopy inchildren without family history of atopic disease.
Circumcision in boys with mild Hemophilia A – the Yogyakarta experience
Authors: Widjajanto Pudjo Hagung , Sugiarto Ridwan Tjandra , Sutaryo Sutaryo , Ali Kaiser
Published: September 2016

Background In boys with hemophilia, there is a risk ofhemorrhage resulting from circumcision. There has been nostandardised management in Indonesia. We report our experiencewith 4 hemophiliac boys who underwent circumcision at Dr.Sardjito General Hospital, Yogyakarta, in south-central Java.Objective To develop a safe, practical and accessible method toprevent bleeding in boys with hemophilia undergoing circumcisionin Indonesia.Methods Written informed consent was obtained from parentsrequesting the procedure. All boys had mild Hemophilia A (VIII:C level >7.8 U/ml) diagnosed at a median age of 4.4 years (range0.75–9 years). Median age at time of circumcision was 7.5 years(range 0.8–12 years).Results There were no intraoperative or post-circumcisionbleeding problem encountered in any of the patients, who weredischarged from hospital three days post-surgery. On follow upeight days and 12 days post-circumcision, they remained free ofcomplications.Conclusion Circumcision can be safely performed in boys withmild Hemophilia A following adequate pre-operative planningand prophylactic therapy. A standardised protocol for theYogyakarta Bleeding Disorders Program. evolving from thisexperience, is being planned.
Soy protein sensitization in cow’s milk allergy patients
Authors: Muktiarti Dina , Munasir Zakiudin , Tumbelaka Alan R.
Published: September 2016

Background The management of cow’s milk allergy (CMA) isavoidance of cow’s milk as strictly as possible. Extensive hydrolyzedprotein and amino acid based formulas are recommended dietaryproducts for treatment of CMA. However, they have somedisadvantages, such as bitter taste and high cost. Alternativeprotein sources from vegetable proteins, such as soy, can be usedas milk-substitute. Previous studies showed the prevalence of soyallergy in CMA patients in Western countries ranged between 0to 63%, but the prevalence in Asia was not greater than 20% andno data about this prevalence in Indonesia.Objectives To determine the proportion of soy proteinsensitization in CMA patients and characteristics of CMA patientswho were sensitized to soy protein.Methods Fifty seven CMA patients who consumed soy proteinwere taken their blood sample to examine the soy-specific IgE.Results From 57 CMA patients, we found only 18% of patientswho were sensitized to soy protein. Seven out of ten CMA patientswho were sensitized to soy protein were under 12 months old.Atopic dermatitis was the most frequent clinical manifestation(8/10) and all of them had family history of atopic diseases. Soysensitization in IgE-mediated and non-IgE mediated CMA were6/10 and 4/10, respectively.Conclusions Proportion of soy sensitization in CMA patients inthis study was 18%. Soy protein can be used as an alternative forcow’s milk substitute in CMA patients.
The benefit of co-trimoxazole treatment in the management of acute watery diarrhea caused by invasive bacterial infection
Authors: Dharmawan Bobby Setiadi , Firmansyah Agus , Chair Imral
Published: September 2016

Background World Health Organization (WHO) states thatantimicrobials are reliably helpful only for children with bloodydiarrhea (probable shigellosis), suspected cholera with severedehydration, and symptomatic infection caused by Giardia lamblia.The benefit of antimicrobial treatment in management of acutewatery diarrhea caused by invasive bacterial infection is still debated.Objective To prove the benefit of co-trimoxazole treatment inthe management of acute watery diarrhea caused by invasivebacterial infection in patients age 2–24 months.Methods This was a randomized, double blind clinical trialinvolving infants and children aged 2–24 months with acutewatery diarrhea caused by invasive bacterial infection withoutco-morbidity or complications. Invasive bacterial infection wasdefined by fecal leukocytes greater than ten cells (+2) per highpower field on stool. Subjects were assigned to receive either co-trimoxazole or placebo. The duration and frequency of diarrheabetween two groups were compared.Result Of 70 patients (co-trimoxazole, n=35; placebo, n=35),42 (60%) were children aged 12–24 months, of whom 61% wereundernourished. Males were affected 1.2 times as much as females.The clinical manifestations were mild-moderate dehydration(64%), mucus in the stool (100%), fever (24%), vomiting (10%),fever with vomiting (56%) and lactose malabsorption (53%).Duration of diarrhea in placebo group (mean 117.0 [SD 28.1]hours) was not significantly different (P=0.43) compared to thatin co-trimoxazole group (mean 122.5 [SD 30.1] hours). Frequencyof diarrhea per day in placebo group (mean 5.23 [SD 1.48] times)was not significantly different either (P=0.37) compared to thatin co-trimoxazole group (mean 5.64 [SD 2.20] times).Conclusion It is concluded that co-trimoxazole therapy providesno benefit to patients with acute watery diarrhea caused byinvasive bacterial infection. This disorder seems to be self-limited.
Effect of oral vitamin K prophylaxis on prothrombine time and activated partial thromboplastin time: a randomized controlled comparison with an intramuscular vitamin K in infants
Authors: Limantara V. Lily , S. Sudaryat , Mudita I. B. , Retayasa W. , Kardana M.
Published: September 2016

Background Low plasma concentration of vitamin K in thenewborn accounts for serious bleeding in the neonatal period andearly infancy. The aim of prophylactic vitamin K is to preventbleeding. Oral prophylaxis is preferable to intramuscular (IM)administration because oral administration is less expensive andless traumatic.Objective To compare oral vs. intramuscular vitamin K onprothrombine time (PT) and activated partial thromboplastin time(APTT) during the first 60 days of life.Methods We randomized newborn infants to either receive oralvitamin K 2 mg at birth and repeated at 7 and 30 days of life orthe 1 mg intramuscular vitamin K. PT and APTT were monitoredat 0, 15, and 45 days of age. Independent t-test, repeatedmeasurement, and regression analysis were used for statisticalanalyses and comparison of the results.Results Fifty infants were assigned into the oral group and 50 tothe IM group. All participants completed 60 days of study. BothPT and APTT decreased after administration of oral or IM vitaminK, and the values did not differ significantly at any time pointand through the period of investigation. Using regression analysisit was shown that only vitamin K administration was correlatedwith PT and APTT with P value were 0.044 and 0.036,respectively. During 60 days of study, there was no hemorrhagicdiathesis in both groups.Conclusions Through the first 60 days of life, 3 doses of oralvitamin K maintain hemostasis by decreasing PT and APTT ininfants at values equal to those achieved by the intramuscularpreparation. Diathesis hemorrhagic event did not occur in bothgroups.
Efficacy of dexamethasone for lung maturity in preterm delivery in association with lamellar bodies count
Authors: Sumiartini Ni Made , Santoso Hendra , Retayasa Wayan , Kardana Made
Published: September 2016

Background Organ immaturities in preterm infants may result inperinatal death. One of the diseases is respiratory distress syndrome(RDS) which is caused by lung immaturity. Dexamethasone is oftenused to accelerate maturity of infant lungs.Objective To determine the efficacy of dexamethasone on lungmaturity measured by lamellar bodies count.Methods A quasi experimental study was done at PerinatologyDivision, Department of Child Health, Medical School, UdayanaUniversity, Sanglah Hospital, Denpasar. We recruited 72 subjects;36 subjects were given four times intramuscular dexamethasone5 mg every twelve hours before delivery. Thirty six subjects whodid not receive dexamethasone belonged to control group. Infants’lungs maturity assessment was performed using lamellar bodiescount taken from amniontic fluid.Results The gestational age ranged between 28 to 36 weeks, withthe mean gestational age in dexamethasone group was 32.2 (SD1.76) weeks and that in control group was 31.7 (SD 2.65) weeks.The efficacy of dexamethasone therapy on lung maturity wassignificant with Fisher’s exact test P<0.0001, 95%CI 2.546;11.173. Using multivariate logistic regression analysis, there wassignificant correlation between dexamethasone and lung maturitymeasured by lamellar bodies count [OR=239.39; P<0.0001,95%CI 22.12;526.53].Conclusion Administration of dexamethasone in pregnantwomen during preterm delivery significantly improves lungmaturity measured by lamellar bodies count.
Comparison of serial blood lactate level between dengue shock syndrome and dengue hemorrhagic fever (evaluation of prognostic value)
Authors: Puspanjono M. Tatang , Latief Abdul , Tumbelaka Alan R. , Sastroasmoro Sudigdo , Gunardi Hartono
Published: September 2016

Background Dengue shock syndrome (DSS) mortality is still high.Monitoring of blood lactate level is important to evaluate shock.Objectives The study were to review the difference between bloodlactate level of DSS and that of dengue hemorrhagic fever (DHF),to correlate blood lactate level with hypoxia state as shock riskfactors (PaO 2 , oxygen saturation, and anion gap) and to determinethe cut-off point of blood lactate level to predict shock.Methods The study was carried out at the Department of ChildHealth, Medical School, University of Indonesia, CiptoMangunkusumo Hospital, Jakarta, from January until July 2006.Three mL venous blood specimen was collected from all subjectsfor peripheral blood, blood gasses, serology, and blood lactateexaminations. This study consisted of a retrospective cohort anda cross sectional method. Data were analyzed with Chi-squaretest. Continous data tested using Mann-Whitney method. Toknow the correlation between blood lactate level and shock riskfactors we use logistic regression test.Results In DSS group, 73% shows hyperlactatemia (lactate =2mmol/L). Conversion of lactate means between two groups issignificantly different from day one to day two and three. Therewas a negative correlation between lactate level and pO 2 andoxygen saturation. Oxygen saturation is the only value that hasclinical correlation. Regressions analysis can be applied using Y= 7.05–0.05 X equation. The cut-off point of lactate level asmarker for shock by using ROC curve is 32.015 mmol/L with 70%sensitivity and 83.3% specificity.Conclusions Hyperlactatemia in DSS can be considered as a signfor unappropriate treatment of shock. Blood lactate level can beused as a biochemical marker for tissue hypoxia, to assess severityof the disease, as monitoring of treatment, and has prognosticvalue of DHF cases.
Effect of subdural hemorrhage on term infants development - a prospective study
Authors: Ariawati Ketut , Soetjiningsih Soetjiningsih , Kari I. K.
Published: September 2016

Background Subdural haemorrhage (SDH) is a common problemin infants under 6 months of age and it has a risk to develop intodevelopmental delay.Objective To evaluate adverse effects of SDH on the developmentof term infants.Methods It was a prospective cohort study carried out on infantsbelow six months of age admitted to Sanglah Hospital due toSDH. Control was healthy term infants born in Sanglah Hospital.Mullen Scales test was performed at the age of 6 and 12 months.Multivariate analysis was conducted to examine the relationshipbetween several independent variabels and developmentaloutcome.Results Sixty six infants were enrolled in this study (33 infantswith SDH and 33 infants without SDH), 52 (79%) were maleand 14 (21%) were female. Mean age was 1.53 (SD 0.75) monthsvs 1.70 (SD 0.73) months. The result of Mullen Scales test at theage of 6 and 12 months showed that very low category was higherin infants with the history of SDH than that in control group.Multivariate logistic regression analysis showed that only SDHcorrelated with Gross Motor and Cognitive Scale delay at theage of 6 months and 12 months (Gross motor 6 months: P=0.01;OR 13.07; 95%CI 2.04;83.84; Gross motor 12 months: P=0.00;OR 23.58; 95%CI 2.87;193.84); (Cognitive 6 months: P=0.00;OR 12.11; 95%CI 2.44;59.90; Cognitive 12 months: P=0.00; OR26.67; 95%CI 3.25;218.86).Conclusion Term infants with history of subdural haemorrhageare associated with increased Gross Motor and Cognitive Scaledelay at the age of 6 and 12 months.
Some factors related to lipid profile in obese children at junior high schools in Manado
Authors: Tangkilisan Anneke Helena , Akune Kartin
Published: September 2016

Background Factors related to lipid profile in obese children arecalorie intake, fast food consuming habit, gender, physical activity,television (TV) watching, sleep duration, and visceral fat distribution.Objective To determine factors related to lipid profile in obesechildren at junior high school.Methods We studied obese children aged 11-<15 years fromNovember 2004 to February 2005 at junior high school in Manadocity. One hundred and seven junior high school children aged 11-<15years were enrolled in this study, excluding children with acute disease,having hypothyroidism, diabetes mellitus, chronic renal disease, liverdisease, and using corticosteroid. The rsik factors considered werecalorie intake, fast food consuming habit, gender, physical activity, TVwatching, sleep duration, and waist circumference. The outcomemeasures were total cholesterol, LDL, HDL, non-HDL cholesterol,and triglyceride. Data was analyzed using X 2 , fisher exact test, Spearman’srho and multiple linear regression analysis with stepwise procedure.Results The prevalence of increased total cholesterol was 28%,LDL 44%, triglyceride 16.8%, low HDL cholesterol 6.5%, and non-HDL was 23.3%. There were statistically significant relationshipbetween gender, calorie intake, fast food consuming habit, physicalactivity, TV watching, sleep duration, and total cholesterol. Therewere also statistically significant relationship between calorie intake,habit of consuming fast food, physical activity, TV watching, sleepduration, and LDL cholesterol. Fast food consuming habit and TVwatching also had statistically significant relationship with HDLcholesterol. There were statistically significant relationship betweencalorie intake, physical activity, TV watching, and sleep durationwith non-HDL cholesterol.Conclusion Duration of TV watching, sleep duration, less physicalactivity and waist circumference >98 percentile are correlatedwith hyperlipidemia in obese children.
Comparison of cardiac dysfunction in thalassemia major patients using deferoxamine or deferiprone as an iron-chelating agent
Authors: Josep Rosalina , Wahidiiyat Pustika Amalia , Trihono Partini , Yanuarso Piprim
Published: September 2016

Background In thalassemia major (TM) patients, major mortalityis due to cardiac hemosiderosis. Several types of iron chelatingagent available recently are given to overcome this problemObjective To compare cardiac dysfunction in thalassemia majorpatients who used subcutaneous deferoxamine (DFO) to thosewho used oral deferiprone (DFP) as an iron􀁆chelating agent.Methods This cross􀁆sectional study was held at the ThalassemiaCenter, Department of Child Health􀁆Cipto MangunkusumoHospital (DCH􀁆CMH), Jakarta. We included TM patients aged1O􀁆18 years Mth a mean pre􀁆transfused hemoglobin level of 2:.7g/dL in the prior year, and who had used DFO or DFP for atleast 1 year v.ith good compliance, at a standard dose of DFO at40-60 mg/kg/day for 5 days a week or DFP at 50-100 mg/kg/day.We excluded TM patients v.ith congenital heart disease or overtheart failure. Trans􀁆thoracal echocardiography was performed atthe Integrated Cardiac Service, CMH by a pediatric cardiologistusing the conventional method and tissue Doppler imaging (TD I)consecutively, and within 2 weeks of the subject's receiving apacked red blood cell (PREC) transfusion. The 57 TM subjectsconsisted of 19 DFO users and 38 DFP users.Results In our subjects, diastolic dysfunction was more commonlyseen than systolic dysfunction, especially moderate diastolicdysfunction. In the DFO group, diastolic dysfunction only wasdetected in 3/19 subjects, systolic dysfunction only in 1/19 subjects,and both diastolic and systolic dysfunction in 15/19 subjects. Noneof the DFO users had normal cardiac function. In the DFP group,diastolic dysfunction only was seen in 6/38 subjects, and bothdiastolic and systolic dysfunction in 30/38 subjects, while 2/38subjects had normal cardiac function.Conclusion Diastolic and/or systolic dysfunction was detected inthe majority of subjects, but with preserved global cardiac function.We found that cardiac dysfunction was not significantly different inthe two iron chelator groups. For all subjects, diastolic dysfunction was seen in 89% of cases, while systolic dysfunction was detectedin 77% of cases. [Paediatr Indones. 2012;52:272,9].
Congenital malformations in the neonatal unit of Arifin Achmad Hospital, Pekanbaru: occurrence and trends
Authors: Wisnumurti Dewi Anggraini
Published: September 2016

Background Congenital malformations are a global and continualissue, contributing to neonatal mortality. The incidence andprevalence, as well as distribution of congenital malformationsvary among countries.Objective To determine the 'prevalence, distribution, and trendsin congenital malformations which are important to develop plansto cope Mth the problem.Methods We reviewed all cases of congenital malformationsadmitted to the Neonatal Unit, Department of Child Health,Arifin Ahmad Hospital from 2008 to 2010. Data were collectedfrom medical records. Diagnoses of congenital malformationswere established by history-taking, physical examination,and specific laboratory tests. Trends in the distribution ofcongenital malformation types, as well as clinical outcomes werehighlighted.Results During the study period there were 2,317 infants admit-ted to the Neonatal Unit, 724 in 2008, 772 in 2009, and 821 in2010. Most patients were referred by other hospitals, at the ageof 0-3 days. Most patients had normal birth weight and were de-livered vaginally. Of the 2,317 infants, 302 were diagnosed withcongenital malformations; the most common congenital malfor-mations were of the digestive tract. The distribution of anomalytypes was relatively constant over time, but the proportion ofpatients Mth congenital malformations discharged alive increasedin the latter two years of the 3-year period studied.Conclusion Most infants in our study had congenital malforma-tions involving the gastrointestinal tract. Distribution trendswere constant over time. Further efforts should be made to bettermanage future cases. [Paediatr lndones. 2012;52:284,8].
CERPEN FARUK “BUS KOTA” DALAM SEMIOTIK ROLAND BARTHES
Authors: Widyatwati Ken
Published: September 2016

Literature called beautiful if it contains the mandate, message, ideas and meanings that are useful for the readers. Short story “Bus Kota” (City Bus) containing the mandate, message, ideas and meanings that are useful to the reader. The mandate will be revealed by Roland Barthes' semiotic theory in the book S/Z. Literature has its own allure and text have accrued but not due to independence because of the difference in quality. Texts merge into a unity, or restore any text not as an individual but as a form of plurality. Literature as part of a social system is an expression of the author's sense of the outpouring of public life. Literary works can express themselves in the author's view the social and cultural changes in society because of the development of information technology and rapid. Technological developments and socio-cultural information can change in society so as to affect the psychology of the people. Society must have a thickness of faith not only for themselves, but to be able to maintain equanimity in the life of a pluralistic society
DIGITALISASI ARSIP FOTO UNIVERSITAS DIPONEGORO SEBAGAI LANDASAN IMPLEMENTASI KEBIJAKAN KETERBUKAAN INFORMASI PUBLIK
Authors: Handayani Tri , Kurniawan Amin Taufiq
Published: September 2016

This paper focuses on digitalization archival photo Diponegoro University, as the basis for Diponegoro University towards the era of public information openness. This basis can be realized among others bythe publication digital photo archives of the three traditional missions of academic institutions (tridharma perguruan tinggi)  and  digital photo archive of administrative activity of Head of the University of Diponegoro through the website of Khazanah Arsip Foto Undip (Collection of Undip Photo Archive). As a conclusion, Khazanah Arsip Foto Undip were digitalized and uploaded to the Undip website were information to the public about the achievements of the University of Diponegoro in organizing the three traditional missions of academic institutions activities, and the information to the public about the achievements of the Head of Diponegoro University policy.
Braudel in Algier. Die kolonialen Wurzeln der „Méditerranée“ und der „spatial turn“
Authors: Borutta Manuel
Published: September 2016

Auf der Basis neuer Quellen zeigt der Aufsatz, dass Fernand Braudels „La Méditerranée et le monde méditerranéen à l'époque de Philippe II“ (1949/21966) ein Produkt kolonialer und postkolonialer Verflechtungen zwischen Frankreich und Algerien war. Zugleich wird dieser Klassiker der Geschichtsschreibung in der Debatte um den „spatial turn“ verortet. Zunächst werden die kolonialen Entstehungsbedingungen des Werks beleuchtet: Zwischen 1923 und 1932 arbeitete Braudel als Gymnasiallehrer in Algerien, wo sich seine Vision vom Mittelmeer herausbildete. Im Rückgriff auf die „Schule von Algier“ reproduzierte Braudel in „La Méditerranée“ koloniale Denkfiguren der Zwischenkriegszeit. Gleichzeitig kritisierte er darin implizit den europäischen Kolonialismus, weshalb „La Méditerranée“ zuletzt sogar als antikoloniales Werk gelesen und mit postkolonialen Theorien in Verbindung gebracht worden ist. Allerdings klammerte Braudel ausgerechnet Französisch-Algerien aus seiner Kolonialismuskritik aus. Auch nach der Dekolonisation warb er wiederholt um Verständnis für die französische Algerienpolitik. Erkläret wird diese ambivalente Haltung mit Braudels privaten Verbindungen: Ein Jahr nach seinem Aufenthalt in Nordafrika heiratete er Paule Pradel, eine Tochter europäischer Siedler aus dem algerischen Departement Oran. Ihrer Familie war Braudel eng verbunden. Auch mit seinen ehemaligen Kollegen und Schülern aus Constantine und Algier blieb er bis an sein Lebensende in Kontakt. Wie diesen pieds-noirs erschien Französisch-Algerien Braudel als ein verlorenes Paradies. Die „Méditerranée“ ist daher nicht nur ein wissenschaftliches Werk, sondern auch ein Dokument nostalgischer Erinnerung an ein untergegangenes Imperium.

Mit Blick auf die Debatte um den „spatial turn“ erinnert jedoch gerade Braudels Heroisierung des Kampfes europäischer Siedler mit der nordafrikanischen Natur in „La Méditerranée“ daran, dass Räume nicht nur soziale Konstruktionen, sondern auch physische Realitäten sind, die menschliches Handeln beeinflussen. Trotz seines kolonialen bias bleibt Braudels „La Méditerranée“ daher auch für künftige Analysen des Verhältnisses von Raum und Geschichte nützlich.
‚Sicherheit‘ im politischen Diskurs des klassischen Athen
Authors: Piepenbrink Karen
Published: September 2016

‚Sicherheit‘ als politscher Wertbegriff ist im politischen Diskurs des klassischen Athen vielfach belegt, wird hier jedoch nicht uneingeschränkt positiv konnotiert, sondern ambivalent beurteilt. Dieser Befund lässt sich durch bloßen Verweis auf allgemeine Merkmale vormoderner Gesellschaften, in denen ‚Sicherheit‘ als kollektiver Wert generell von geringerer Relevanz zu sein scheint als in modernen, nicht hinreichend interpretieren, sondern steht in unmittelbarem Kausalzusammenhang mit den Spezifika der politischen Organisationsform der attischen Demokratie.
Neostriatal GABAergic Interneurons Mediate Cholinergic Inhibition of Spiny Projection Neurons
Authors: Faust Thomas W. , Assous Maxime , Tepper James M. , Koós Tibor
Published: September 2016

Synchronous optogenetic activation of striatal cholinergic interneuronsex vivoproduces a disynaptic inhibition of spiny projection neurons composed of biophysically distinct GABAAfastand GABAAslowcomponents. This has been shown to be due, at least in part, to activation of nicotinic receptors on GABAergic NPY-neurogliaform interneurons that monosynaptically inhibit striatal spiny projection neurons. Recently, it has been proposed that a significant proportion of this inhibition is actually mediated by activation of presynaptic nicotinic receptors on nigrostriatal terminals that evoke GABA release from the terminals of the dopaminergic nigrostriatal pathway. To disambiguate these the two mechanisms, we crossed mice in which channelrhodopsin is endogenously expressed in cholinergic neurons with Htr3a-Cre mice, in which Cre is selectively targeted to several populations of striatal GABAergic interneurons, including the striatal NPY-neurogliaform interneuron. Htr3a-Cre mice were then virally transduced to express halorhodopsin to allow activation of channelrhodopsin and halorhodopsin, individually or simultaneously. Thus we were able to optogenetically disconnect the interneuron-spiny projection neuron (SPN) cell circuit on a trial-by-trial basis. As expected, optogenetic activation of cholinergic interneurons produced inhibitory currents in SPNs. During simultaneous inhibition of GABAergic interneurons with halorhodopsin, we observed a large, sometimes near complete reduction in both fast and slow components of the cholinergic-evoked inhibition, and a delay in IPSC latency. This demonstrates that the majority of cholinergic-evoked striatal GABAergic inhibition is derived from GABAergic interneurons. These results also reinforce the notion that a semiautonomous circuit of striatal GABAergic interneurons is responsible for transmitting behaviorally relevant cholinergic signals to spiny projection neurons.

SIGNIFICANCE STATEMENTThe circuitry between neurons of the striatum has been recently described to be far more complex than originally imagined. One example of this phenomenon is that striatal cholinergic interneurons have been shown to provide intrinsic nicotinic excitation of local GABAergic interneurons, which then inhibit the projection neurons of the striatum. As deficits of cholinergic interneurons are reported in patients with Tourette syndrome, the normal functions of these interneurons are of great interest. Whether this novel route of nicotinic input constitutes a major output of cholinergic interneurons remains unknown. The study addressed this question using excitatory and inhibitory optogenetic technology, so that cholinergic interneurons could be selectively activated and GABAergic interneurons selectively inhibited to determine the causal relationship in this circuit.
Hyperglycemia in Stroke Impairs Polarization of Monocytes/Macrophages to a Protective Noninflammatory Cell Type
Authors: Khan Mahtab A. , Schultz Sina , Othman Alaa , Fleming Thomas , Lebrón-Galán Rafael , Rades Dirk , Clemente Diego , Nawroth Peter P. , Schwaninger Markus
Published: September 2016

Hyperglycemia is common in patients with acute stroke, even in those without preexisting diabetes, and denotes a bad outcome. However, the mechanisms underlying the detrimental effects of hyperglycemia are largely unclear. In a mouse model of ischemic stroke, we found that hyperglycemia increased the infarct volume and decreased the number of protective noninflammatory monocytes/macrophages in the ischemic brain. Ablation of peripheral monocytes blocked the detrimental effect of hyperglycemia, suggesting that monocytes are required. In hyperglycemic mice, α-dicarbonyl glucose metabolites, the precursors for advanced glycation end products, were significantly elevated in plasma and ischemic brain tissue. The receptor of advanced glycation end products, AGER (previously known as RAGE), interfered with polarization of macrophages to a noninflammatory phenotype. WhenAgerwas deleted, hyperglycemia did not aggravate ischemic brain damage any longer. Independently of AGER, methylglyoxal reduced the release of endothelial CSF-1 (M-CSF), which stimulates polarization of macrophages to a noninflammatory phenotype in the microenvironment of the ischemic brain. In summary, our study identified α-dicarbonyls and AGER as mediators by which hyperglycemia lowers the number of protective noninflammatory macrophages and consequently increases ischemic brain damage. Modulating the metabolism of α-dicarbonyls or blocking AGER may improve the treatment of stroke patients with hyperglycemia.

SIGNIFICANCE STATEMENTAlthough glucose is the main energy substrate of the brain, hyperglycemia aggravates ischemic brain damage in acute stroke. So far, clinical trials have indicated that insulin treatment provides no solution to this common clinical problem. This study shows, in an experimental stroke model, that hyperglycemia interferes with the polarization of monocytes/macrophages to a protective cell type. Key players are α-dicarbonyls and the receptor for advanced glycation end products (AGER). Deletion of AGER normalized monocyte/macrophage polarization and reversed the detrimental effects of hyperglycemia, suggesting new avenues to treat stroke patients.
Inhibitory Gating of Basolateral Amygdala Inputs to the Prefrontal Cortex
Authors: McGarry Laura M. , Carter Adam G.
Published: September 2016

Interactions between the prefrontal cortex (PFC) and basolateral amygdala (BLA) regulate emotional behaviors. However, a circuit-level understanding of functional connections between these brain regions remains incomplete. The BLA sends prominent glutamatergic projections to the PFC, but the overall influence of these inputs is predominantly inhibitory. Here we combine targeted recordings and optogenetics to examine the synaptic underpinnings of this inhibition in the mouse infralimbic PFC. We find that BLA inputs preferentially target layer 2 corticoamygdala over neighboring corticostriatal neurons. However, these inputs make even stronger connections onto neighboring parvalbumin and somatostatin expressing interneurons. Inhibitory connections from these two populations of interneurons are also much stronger onto corticoamygdala neurons. Consequently, BLA inputs are able to drive robust feedforward inhibition via two parallel interneuron pathways. Moreover, the contributions of these interneurons shift during repetitive activity, due to differences in short-term synaptic dynamics. Thus, parvalbumin interneurons are activated at the start of stimulus trains, whereas somatostatin interneuron activation builds during these trains. Together, these results reveal how the BLA impacts the PFC through a complex interplay of direct excitation and feedforward inhibition. They also highlight the roles of targeted connections onto multiple projection neurons and interneurons in this cortical circuit. Our findings provide a mechanistic understanding for how the BLA can influence the PFC circuit, with important implications for how this circuit participates in the regulation of emotion.

SIGNIFICANCE STATEMENTThe prefrontal cortex (PFC) and basolateral amygdala (BLA) interact to control emotional behaviors. Here we show that BLA inputs elicit direct excitation and feedforward inhibition of layer 2 projection neurons in infralimbic PFC. BLA inputs are much stronger at corticoamygdala neurons compared with nearby corticostriatal neurons. However, these inputs are even more powerful at parvalbumin and somatostatin expressing interneurons. BLA inputs thus activate two parallel inhibitory networks, whose contributions change during repetitive activity. Finally, connections from these interneurons are also more powerful at corticoamygdala neurons compared with corticostriatal neurons. Together, our results demonstrate how the BLA predominantly inhibits the PFC via a complex sequence involving multiple cell-type and input-specific connections.