Hasil Pencarian  ::  Simpan CSV :: Kembali

"In the past couple of years, several studies have demonstrated that T- helper cells play an important role in the induction and reaction process of allergy. The T-helper cell (T-h) is a kind of T lymphocyte. At first, in the year 1921 Praustniz and Kustner, as quoted by Romagnani, stated the concept that allergy is an interaction between allergens and the IgE (Immunoglobulin E) specific antibody that is attached to IgE receptors on mast cells or mastocytes, which would then release its mediators. Other factors that also play a role in the development of allergy is lymphokine, produced by T-cells, which regulate IgE antibody production by the B-cell.1 Lymphokine or cytokine is a hormone-like substance released by T-cells, B-cells, or other cells, that function as intercellular signaling substances in the regulation of immune responses towards outside stimuli.'"

"A 31-year-old patient came to visit the outpatient clinic at the hospital for his routine twice-weekly hemodialyis (HD) session. During HD, the patient suddenly developed a fever with shivering. At that time, a diagnosis of catheter-related blood stream infection (CR-BSI) was developed, HD catheter or the catheter double lumen (CDL) was uninstalled and the patient was hospitalized. Results of culture withdrawn through the tip of catheter lumen and peripheral blood revealed identical microorganism, i.e. the Enterobacter cloacae. Diagnosis of CR-BSI in the present case was made based on the 2009 Infectious Disease Society of America (IDSA) criteria. In general, prevention measures for CR-BSI should be taken into account including education for patient, awareness of the health care providers who install the CDL, implementation of procedure for appropriate skin aseptic technique and best practice for HD catheter care, particularly on the exit site of the CDL to prevent the development of CR-BSI.

---

Seorang pasien pria usia 31 tahun, datang berobat jalan ke rumah sakit untuk hemodialisis (HD) rutin 2 kali dalam seminggu. Saat dilakukan tindakan HD mendadak pasien demam dan menggigil, saat itu ditegakkan diagnosis catheter-related blood stream infection (CR-BSI), dilakukan pencabutan catheter double lumen (CDL) dan pasien kemudian dirawat. Hasil kultur tip CDL dan kultur darah perifer didapatkan kuman yang sama yaitu Enterobacter cloacae. Diagnosis CR-BSI pada kasus ini ditegakkan berdasarkan kriteria Infectious Disease Society of America (IDSA) tahun 2009. Secara keseluruhan harus diperhatikan langkah pencegahan CR-BSI berupa edukasi pasien dan petugas yang memasang CDL, penerapan prosedur tindakan aseptik kulit yang benar serta perawatan exit site CDL, untuk mencegah terjadinya CR-BSI."

"A 46-year-old man was admitted to ICU with a diagnosis at the time of admission of Guillain Barre Syndrome (GBS) and sepsis due to suspected Ventilator-Associated Pneumoniae (VAP). Specimens for the following laboratory workup were inquired, i.e. complete blood count, culture and resistance workup using specimens obtained from the tip of suction pipe, urinalysis and urine culture, blood culture and resistance, procalcitonin and lactate levels. Neutrophilia was found along with increased procalcitonin and lactate levels, which supported the sepsis diagnosis. Moreover, the result of culture from suction pipe demonstrated colonies of Pseudomonas luteola MDRO, which might be originated from the oropharyngeal colonization of the patients due to poor oral hygiene and ineffective oral hygiene nursing; therefore, the colonies of the microorganism were swabbed away when obtaining the specimens. Ineffective oral hygiene nursing may have a potency to cause VAP and recurrent VAP.

---

Seorang pria usia 46 tahun, dari ICU dengan diagnosis saat masuk Guillain-Barre syndrome (GBS) + sepsis ec suspek ventilator associated pneumoniae (VAP), dimintakan bahan pemeriksaan laboratorium: darah lengkap, kultur, resistensi ujung selang suction, urinalisis dan kultur urin, kultur darah dan resistensi, procalcitonin dan laktat. Didapatkan neutrofilia, peningkatan procalcitonin dan laktat sesuai diagnosis sepsis, dan pada hasil kultur selang suction didapatkan kuman Pseudomonas luteola MDRO yang kemungkinan berasal dari kolonisasi pada oropharynx pasien, akibat higiene oral pasien yang buruk dan tindakan perawatan higiene oral oleh perawat yang kurang efektif, sehingga kuman yang berkolonisasi tersebut terbawa saat pengambilan sampel. Perawatan higiene oral yang tidak efektif potensial untuk terjadinya VAP dan VAP berulang."