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"ABSTRAK Latar belakang: Berdasarkan Jakarta Cancer Registry tahun 2012, kanker kolorektal merupakan kanker terbanyak keempat pada wanita dan kedua pada pria di Indonesia. Penelitian menggunakan mRNA fekal sebagai penanda kanker kolorektal bersifat non invasif namun cukup representatif menggambarkan kelainan pada usus. Tujuan: Mengevaluasi peran pemeriksaan mRNA CEA feses pada pasien terduga keganasan kolorektal menggunakan nested RT-PCR. Metode: Uji diagnostik ini melibatkan 93 pasien terduga keganasan kolorektal yang ditentukan melalui anamnesis dan pemeriksaan fisik oleh klinisi. Ekstraksi mRNA CEA fekal menggunakan metode Kanaoka dan sintesis DNA menggunakan metode cyclic temperature reverse transcription 2 CTRT-2 . Pemeriksaan mRNA CEA menggunakan metode nested RT-PCR. Hasil: mRNA CEA fekal positif ditemukan pada 22 pasien 23,7 . Penelitian ini mendapatkan sensitivitas 51,61 , spesifisitas 90,32 , nilai prediksi positif 72,73 dan nilai prediksi negatif 78,87 . Meskipun sensitivitas yang diperoleh rendah tetapi spesifisitas mRNA CEA fekal yang tinggi dapat mengkonfirmasi diagnosis lesi neoplastik pada pasien terduga keganasan kolorektal. Kesimpulan: Pemeriksaan mRNA CEA fekal tidak dapat digunakan sebagai penanda tunggal dalam skrining keganasan kolorektal. Pemeriksaan mRNA CEA fekal perlu dikombinasikan bersama penanda diagnostik lainnya agar dapat meningkatkan sensitivitas dan spesifisitas pemeriksaan. Kata kunci: carcinoembryonic antigen; penanda fekal; nested

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Background Based on the 2012 Jakarta Cancer Registry, colorectal cancer is the fourth of most common cancer in women and the second in men. Fecal carcinoembryonic antigen mRNA assay is a non invasive method, yet representatively describes abnormalities of the intestine. Objective To evaluate the role of fecal mRNA CEA assay in suspected colorectal cancer patients using nested RT PCR. Methods The diagnostic study included 93 suspected colorectal cancer patients which were determined by anamnesis and physical examination from the clinician. The fecal mRNA were extracted by Kanaoka method and cDNA were synthesized with cyclic temperature reverse transcription 2 CTRT 2 method. The fecal mRNA CEA assay used nested RT PCR method. Results Positive fecal mRNA CEA was detected in 22 patients 23.7 . Sensitivity, specificity, positive predictive value, and negative predictive value were 51.61 , 90.32 , 72.73 , and 78.87 respectively. This study had low sensitivity but with high specificity. Therefore, fecal mRNA CEA could be used as a confirmatory assay. Conclusions It was not recommended to use fecal mRNA CEA as a single marker in colorectal cancer screening. A fecal mRNA CEA assay should be combined with other diagnostic markers in order to improve the sensitivity and specificity of the assay. Keywords carcinoembryonic antigen fecal marker nested "

"Kadar elastase-1 dalam feses menggambarkan fungsi eksokrin pankreas. Beberapa laporan telah diajukan oleh peneliti-peneliti Eropa, tetapi sejauh ini belum ada laporan dari Indonesia terutama mengenai bayi. Tujuan penelitian ini ialah untuk mengetahui kadar elastase-1 feses bayi yang berumur 1-120 hari, sebagai laporan pendahuluan penelitian tentang ontogeni elastase-1 pankreas pada bayi cukup bulan dan kurang bulan. Metoda yang dipakai ialah kadar elastase-1 dalam feses diperiksa pada 28 bayi kurang bulan dan 34 bayi cukup bulan yang sehat, berumur 1-120 hari. Hasilnya ialah kadar elastase-1 feses bayi kurang dari 14 hari berkisar di bawah 200 µg/g feses. Pada hari pertama 80% bayi kurang bulan dan 60% bayi cukup bulan mempunyai kadar < 200 µg/g feses, pada umur 7 hari 50% bayi kurang bulan dan 33% bayi cukup bulan mempunyai kadar elastase-1 < 200 µg/g feses. Setelah umur 14 hari, kadar elastase-1 feses ialah > 200 µg/g feses, tidak tergantung masa gestasi. Laporan pendahuluan ini mendukung penelitian-penelitian terdahulu yaitu kadar elastase-1 feses mencapai kadar normal setelah umur 14 hari. Penelitian lebih lanjut diperlukan untuk mengetahui kadar elastase-1 feses pada bayi umur kurang dari 14 hari. (Med J Indones 2003; 12: 69-72)

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Fecal elastase-1 concentration reflects exocrine pancreatic function. There have been some reports from Europe, but so far there has not been a report of fecal elastase-1 concentration in Indonesia, especially concerning infants. The aim of this study is to know the concentration of elastase-1 in feces of infants aged 1-120 days as a preliminary report of the study of the ontogeny of pancreatic elastase-1 in term and preterm infants. Fecal elastase-1 were measured from feces of 28 healthy preterm and 34 healthy term infants up to 120 days (4 month) of age. Elastase-1 concentration in infants less than 14 days of age fluctuated below 200 µg/gram feces. At the first day of life 80% preterm and 60% term infants had elastase-1 concentration less than 200 µg/gram feces, and by the age of 7 days 50% preterm and 33% term infants had elastase-1 concentration less than 200 µg/gram feces. After 14 days of age its concentration was more than 200 µg/gram feces, regardless of gestational age. This preliminary study corroborates supported the previous studies that the level of fecal elastase-1 reached normal level after 14 days. Future longitudinal study is needed to know elastase-1 concentration in infants less than 14 days. (Med J Indones 2003; 12: 69-72)"

"ABSTRAKLatar Belakang : Diagnosis Inflammatory Bowel Disease (IBD) masih didasarkan pada pemeriksaan invasif (endoskopi dan histopatologi). Fecal calprotectin merupakan petanda inflamasi intestinal non invasif yang dapat digunakan untuk membedakan IBD dengan penyakit intestinal non inflamasi, namun studi-studi yang ada masih memberikan perbedaan nilai diagnostik dan hubungannya dengan derajat IBD.Tujuan : Membuktikan bahwa pemeriksaan fecal calprotectin memiliki nilai diagnostik yang tinggi untuk mendiagnosis IBD serta berhubungan dengan derajat IBD. Metode : Penelitian ini adalah studi potong lintang untuk melakukan uji diagnostik. Penelitian dilakukan di beberapa rumah sakit di Jakarta mulai bulan September 2014 sampai Februari 2015. Kurva ROC dibuat untuk mendapatkan nilai diagnostik fecal calprotectin dan uji Krusskal Wallis untuk menilai perbedaan kadar fecal calprotectin menurut derajat IBD.Hasil : Terdapat 71 pasien IBD berdasarkan pemeriksaan kolonoskopi diikutkan dalam penelitian. Dari pasien tersebut didapatkan sebanyak 57 pasien ditetapkan definite IBD berdasarkan pemeriksaan histopatologi. Kadar fecal calprotectin lebih tinggi bermakna pada pasien IBD dibanding yang bukan IBD (553,8 μg/g vs 76,95 μg/g, p < 0,001). Didapatkan nilai titik potong 179,3 μg/g dengan sensitivitas 96% (IK 95% 0,88-0,99), spesifisitas 93% (IK 95% 0,69-0,99) dan Area Under Curve (AUC) 99,5% (IK 95% 0,98-1,00). Didapatkan perbedaan bermakna kadar fecal calprotectin pada masing-masing derajat IBD (p < 0,001).Kesimpulan : Pemeriksaan fecal calprotectin memiliki nilai diagnostik yang tinggi untuk mendiagnosis IBD serta berhubungan dengan derajat IBD.

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ABSTRACT

Background : Diagnosis of inflammatory bowel disease (IBD) is still based on invasive examination such as endoscopy and biopsy. Fecal calprotectin as a intestinal inflammation marker can used for diagnosis, but studies still had different diagnostic value and it?s correlation with grading of IBD.

Objective : Proving that fecal calprotectin have a high diagnostic value for IBD and correlation with grading of IBD. Methods : A cross sectional study for diagnostic of IBD. This study was conducted at several Hospitals in Jakarta from September 2014 until February 2015. A curve of ROC to determined diagnostic value of fecal calprotectin and Krusskal Wallis analysis to assessed of different value of fecal calprotectin according grade of IBD were made.

Results : Based on colonoscopy, 71 patient IBD were participated in this study. There were 57 patient diagnosis as definite IBD based on histopathology examination. Value of fecal calprotectin for IBD patient was higher than non IBD (553.8 μg/g vs 76.95 μg/g, p < 0,001). Value of fecal calprotectin was 179.3 μg/g as a new cutoff value with sensitivity 96% (CI 95% 0.88-0.99), specificity 93% (CI 95% 0.69-0.99) and Area Under Curve (AUC) 99.5% (CI 95% 0.98- 1.00) for diagnostic IBD. There was significant differences value of fecal calprotectin according every grade of IBD ( p < 0.001 ).

Conclusion : Fecal calprotectin has a high diagnostic value for IBD and correlated with grading of IBD."

"[ABSTRAKLatar Belakang : Pada kanker pankreas dapat terjadi obstruksi pada duktus pankreatikus yang menghambat transfer enzim dan bikarbonat ke duodenum yang menyebabkan aktifitas enzim tidak cukup adekuat untuk mempertahankan proses pencernaan secara normal yang disebut sebagai pancreatic exocrine insufficiency (PEI), yang dapat dideteksi dengan pemeriksaan kadar fecal elastase 1.Tujuan : Mengetahui proporsi dan derajat PEI, proporsi steatore pada kanker pankreas, perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable dan perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas.Metode : Penelitian ini adalah studi potong lintang untuk menentukan perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable. Penelitian ini dilakukan di Rumah Sakit Cipto Mangunkusumo, beberapa rumah sakit jejaring RSCM, dan RS Wahidin Sudirohusodo Makasar dari bulan November 2014 sampai dengan Mei 2015. Uji statistik yang digunakan untuk menilai perbedaan kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable adalah Mann Whitney dan untuk menilai perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas adalah Kruskal Wallis.Hasil : Sebanyak 48 subyek kanker pankreas diikutkan dalam penelitian, dengan kategori resectable sebanyak 19(39,6%) subyek, dan 29(60,4%) subyek yang unresectable. Proporsi pasien kanker pankreas yang mengalami PEI sebanyak 75% (IK 95% 0,63-0,87) dan proporsi pasien kanker pankreas yang memberikan gejala steatore sebanyak 68,8% (IK 95% 0,557-0,819). Tidak ada perbedaan kadar fecal elastase 1 yang bermakna (P=0,738) antara kelompok resectable dan unresectable dengan nilai median pada kelompok resectable adalah 38,0(15-500) μg/g dan pada kelompok unresectable adalah 35,0(15-500) μg/g. Tidak ada perbedaan bermakna (p=0,767) kadar fecal elastase 1 berdasarkan stadium kanker pankreas dengan nilai median(rentang) pada stadium IB 36(15-100) μg/g, stadium IIA 62(15-500) μg/g, stadium III 15(15-500) μg/g, dan stadium IV 36(15-500) μg/g.Kesimpulan : Pada penelitian ini didapatkan proporsi PEI dan steatore yang tinggi pada kanker pankreas. Tidak ditemukan perbedaan bermakna kadar fecal elastase 1 antara kanker pankreas yang resectable dan unresectable. Tidak terdapat perbedaan rerata kadar fecal elastase 1 berdasarkan stadium kanker pankreas.

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ABSTRACTBackground : In the pancreatic cancer can occur obstruction of the pancreatic duct that inhibit the enzyme transfer and bicarbonate into the duodenum which causes the enzyme activity is not quite adequate to maintain normal digestive process referred to as pancreatic exocrine insufficiency (PEI) that can be detected by measurement of fecal elastase 1 level.Objective : Knowing the proportion and the degree of PEI, the steatore proportion in pancreatic cancer, the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer and differences between the mean levels of fecal elastase 1 based on the stage of pancreatic cancer.Methods : A cross-sectional study to determine the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer. This research was conducted at Cipto Mangunkusumo hospital, some satellite of Cipto Mangunkusumo hospital, and Wahidin Sudirohusodo Makasar hospital at November 2014 until May 2015. The statistical test used to assess differences in the levels of fecal elastase 1 between resectable and unresectable pancreatic cancer is Mann Whitney and to assess the differences between the mean levels of fecal elastase 1 based on staging pancreatic cancer is the Kruskal Wallis.Results : A total of 48 subjects with pancreatic cancer were participated in this study, with resectable category were 19 (39.6%) subjects, and 29 (60.4%) subjects who unresectable. The proportion of patients with pancreatic cancer that experienced PEI are 75% (CI 95% 0.63 - 0.87) and the proportion of patients with pancreatic cancer which provide steatore symptoms are 68.8% (CI 95% 0.557 - 0.819). There is no significant difference levels of fecal elastase 1 (P = 0.738) between the resectable and unresectable where the resectable group median value is 38.0 (15-500) μg / g and in unresectable group was 35.0 (15-500) μg / g. There is no significant difference (p = 0.767) levels of fecal elastase 1 based on the stage of pancreatic cancer with median (range) in stage IB 36 (15-100) pg / g, stage IIA 62 (15-500) pg / g, stage III 15 (15-500) μg / g, and stage IV 36 (15-500) μg / g.Conclusion : This study found a high proportion of PEI and steatore in pancreatic cancer. there is no significant difference fecal elastase 1 levels between the resectable and unresectable pancreatic cancer. There is no significant difference between mean levels of fecal elastase 1 based on the stage of pancreatic cancer., Background : In the pancreatic cancer can occur obstruction of the pancreatic duct that inhibit the enzyme transfer and bicarbonate into the duodenum which causes the enzyme activity is not quite adequate to maintain normal digestive process referred to as pancreatic exocrine insufficiency (PEI) that can be detected by measurement of fecal elastase 1 level.Objective : Knowing the proportion and the degree of PEI, the steatore proportion in pancreatic cancer, the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer and differences between the mean levels of fecal elastase 1 based on the stage of pancreatic cancer.Methods : A cross-sectional study to determine the difference levels of fecal elastase 1 between resectable and unresectable pancreatic cancer. This research was conducted at Cipto Mangunkusumo hospital, some satellite of Cipto Mangunkusumo hospital, and Wahidin Sudirohusodo Makasar hospital at November 2014 until May 2015. The statistical test used to assess differences in the levels of fecal elastase 1 between resectable and unresectable pancreatic cancer is Mann Whitney and to assess the differences between the mean levels of fecal elastase 1 based on staging pancreatic cancer is the Kruskal Wallis.Results : A total of 48 subjects with pancreatic cancer were participated in this study, with resectable category were 19 (39.6%) subjects, and 29 (60.4%) subjects who unresectable. The proportion of patients with pancreatic cancer that experienced PEI are 75% (CI 95% 0.63 - 0.87) and the proportion of patients with pancreatic cancer which provide steatore symptoms are 68.8% (CI 95% 0.557 - 0.819). There is no significant difference levels of fecal elastase 1 (P = 0.738) between the resectable and unresectable where the resectable group median value is 38.0 (15-500) μg / g and in unresectable group was 35.0 (15-500) μg / g. There is no significant difference (p = 0.767) levels of fecal elastase 1 based on the stage of pancreatic cancer with median (range) in stage IB 36 (15-100) pg / g, stage IIA 62 (15-500) pg / g, stage III 15 (15-500) μg / g, and stage IV 36 (15-500) μg / g.Conclusion : This study found a high proportion of PEI and steatore in pancreatic cancer. there is no significant difference fecal elastase 1 levels between the resectable and unresectable pancreatic cancer. There is no significant difference between mean levels of fecal elastase 1 based on the stage of pancreatic cancer.]"

"Kurangnya penelitian mengenai transisi pada pola asupan dan marker inflamasi usus pada anak gemuk. Studi ini bertujuan untuk melihat hubungan anatara pola asupan dan fecal calprotectin pada anak prasekolah.Studi potong lintang ini dilakukan pada 101 anak dengan BMI Z score > 1 SD dengan median 2.26 (1.61, 3.43) SD serta menggunakan semiquantitative food frequency questionnaires yang telah divalidasi dimana, pola asupan diperoleh dengan menggunakan principal component analysis. Hasil studi menunjukkan 66% anak mempunyai kadar fecal calprotectin > 50 µg/g dan berhubungan dengan BMI Z score (p=0.05, r=1.89). Pola asupan (healthy pattern p=0.132, western pattern p=0.555, staple pattern p=0.541 and milk pattern p=0.534) ditemukan tidak berhubungan dengan inflamasi saluran cerna. Penelitian lebih lanjut dibutuhkan untuk mengkonfirmasi hasil studi ini dengan menggunakan pendekatan lain dan kombinasi antar marker inflamasi usus.

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Lack of study confirmed the relationship between transition of diets and gut inflammation marker in obese children. Our study aimed to investigate the association between dietary pattern and fecal calprotectin level in preschool children. A cross sectional study was conducted in 101 children with body mass index (BMI) Z-score > 1 SD and median 2.26 (1.61, 3.43) SD using validated semi quantitative food frequency questionnaires whereas dietary patterns were revealed by principal component analysis. We found 66% children had fecal calprotectin levels > 50 µg/g. The fecal calprotectin level correlated with BMI Z score (p=0.05, r=1.89). Major dietary patterns were revealed: healthy pattern (p=0.132), western pattern (p=0.555), staple pattern (p=0.541) and milk pattern (p=0.534) and multivariate analysis showed no significant association with fecal calprotectin even after full adjustment for age, sex, sedentary physical activity, BMI Z score, fat intake and total fibre intake. Our findings acknowledged the insignificant association diet with gut inflammation marker had been observed due the baseline characteristic BMIZ score of the children more contribute to the elevated of fecal calprotectin level. Further investigations are warranted with a specific inflammatory food approach using a combination of marker gut inflammation."

"ABSTRAKPenelitian ini dilakukan untuk mengetahui kadar fecal calprotectin (FC) pada anak dengan BB normal, BB lebih termasuk obesitas akibat inflamasi dan disfungsi saluran cerna serta faktor risiko apa saja pada awal kehidupan yang dapat menyebabkan terjadinya obesitas usia pra sekolah. Penelitian ini merupakan studi kasus-kontrol, subyek penelitian terdiri dari 58 anak kelompok kasus (BB lebih atau obesitas) dan 58 anak kelompok kontrol (BB normal) yang dipasangkandengan jenis kelamin, usia, dan sekolah. Hasil penelitian didapatkan median IMT z-zcore 2,05 (-1,86?6,78) SD, rerata asupan energi total sebesar 1541,66 + 389,69 kkal dan asupan lemak 54,92 + 17,48 gram. Didapatkan hubungan bermakna asupan energi total dan lemak pada kelompok kasus dan kontrol (p=0,040 danp=0.022). Tidak ditemukan hubungan bermakna kadar FC antara kelompok kasusdan kontrol (p=0,454). Dilakukan analisis multivariat terhadap faktor risiko awalkehidupan dengan status gizi lebih lebih dan kadar FC diaatas normal, tidakdidapatkan hubungan. Namun setelah dihubungkan dengan faktor penggangu,didapatkan kecendrungan kenaikan nilai OR dan penurunan p-value. Hal inimenunjukkan bahwa ada hubungan antara kejadian obesitas dan peningkatankadar FC pada anak pra sekolah dengan faktor risiko awal kehidupan

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ABSTRACTThis study was conducted to determine levels of fecal calprotectin (FC) inchildren that have normal weight, overweight (OW) including obesity due toinflammation and dysfunction of the gastrointestinal tract and any risk factors inearly life can lead to obesity preschool children. This study was a case-controlstudy, subjects consisted of 58 children in group cases (OW or obese) and 58controls group (normal weight) were matched by sex, age, and school. The resultsshowed a median BMI z-zcore 2.05 (-1,86-6,78) SD. Mean total energy intake andfat intake were 1541.66+389.69 kcal and 54.92+17.48 grams. We foundsignificant relationship between subject cases and control for total energy intakeand fat intake (p=0,040 and p=0.022). And no significant value of FC betweencase and control (p=0,454). Multivariate analysis of the early life risk factors withnutritional status and levels of FC, no significant. However, after adjusted with adisturbance factor, obtained trend increase the value of OR and decrease p-value.This suggests that there is a relationship between the incidence of obesity in preschoolchildren and increased value of FC with risk factors early in life"

"Background: One of the causes of chronic diarrhea is pancreatic exocrine insufficiency. Chronic diarrhea cases are commonly encountered in Indonesia.Materials & Methods: All patients with chronic diarrhea at hospitals in Jakarta were included in this study and dyspeptic patients were used as control subjects. The study and control subjects must submit their stool for fecal pancreatic elastase-1 examination at a private laboratory in Jakarta. Mild/moderate pancreatic exocrine insufficiency was defined if the concentration was between 100 - 200 [ig El/g stool. Severe pancreatic exocrine insufficiency was defined if the concentration was below 100 [ig El/g stool. The data was analyzed using Fisher or Kruskal-Wallis tests.Results: There were 32 chronic diarrhea patients with a male to female ratio of 19/13 (59.38%/40.62%). The most frequent age range was 50-59 years old (39.5%). The characteristics (sex, age and race) of chronic diarrhea patients were matched with the characteristics of dyspeptic patients as control subjects (p > 0.05). The fecal elastase-1 results in chronic diarrhea displayed greater pancreatic exocrine insufficiency (< 200 fig El/g stool) than in dyspepsia (control) (>_ 200 fj,g El/g stool, p < 0.001). The mean fecal elastase-1 result in chronic diarrhea and in dyspepsia were 316.29 ±_ 195.44 vs. 475.93 +. 65.33 fig El/g stool (p < 0.001). Six patients (18.74%) were established as having severe pancreatic exocrine insufficiency. Seven patients (21.88%) were found with mild/moderate pancreatic exocrine insufficiency.Conclusion: Pancreatic exocrine insufficiency was found frequently in chronic diarrhea."

"Latar belakang: Diare merupakan masalah kesehatan paling sering pada anak.Berbagai penyebab diare dapat menyebabkan diare berlangsung lama dan bisa menjadi malnutrisi (gizi buruk).Penyebab diare bisa disebabkan oleh infeksi bakteri dan membutuhkan antibiotik sehingga diperlukan deteksi sedini mungkin. Pemeriksaan soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) dapat menduga adanya infeksi bakteri pada anak dengan diare akut. Tujuan :Mengetahui seberapa besar nilai diagnostik peningkatan leukosit dalam tinja dibandingkan dengan sTREM-1. Metode :studi potong lintang terhadap anak usia 6-60 bulan dengan diare akut tanpa komplikasi dan penyerta penyakit lain. Pada subyek dilakukan anamnesis gambaran klinis (demam, muntah, sakit perut), pemeriksaan leukosit dalam tinja dan pemeriksaan sTREM-1 sebagai referensi standard. Hasil : Anak dengan diare akut oleh karena infeksi bakteri usia 6-60 bulan dengan sTREM-1>470 pg/mL sebanyak 2 dari 64 subyek penelitian dan leukosit tinja > 10 / LPB sebanyak 14 dari 64 subyek penelitian, terbanyak lelaki, status nutrisi normal dan memiliki gambaran klinis demam, muntah dan tanpa sakit perut. Peningkatan leukosit tinja > 10 / LPB memiliki sensitifitas 50 %, spesifisitas 79,1 %, nilai prediksi positif 7,1 %, nilai prediksi negatif 98 %, akurasi 78 %, nilai rasio likelihood positif 2,18 dan nilai rasio likelihood negatif 0,63. Simpulan :Peningkatan leukosit tinja > 10 / LPB sebagai konfirmasi diagnostik kurangbaik dalam mendiagnosis diare akut oleh karena infeksi bakteri.

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Background: Diarrhea is a health problem most often occurs in children. Various etiology of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. Objective: toknow how much the diagnostic value of fecal leukocytes test compared to sTREM-1. Methods: cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Results : Children, aged 6-60 months with acute diarrhea due to bacterial infections

with sTREM-1> 470 pg / mL as many as 2 of 64 subjects and fecal leukocytes > 10 / HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical

manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0, 63. Conclusion: Fecal leukocyte test > 10 / HPF as a diagnostic confirmation is not good in

diagnosing acute diarrhea due to bacterial infection."

"Wilayah hunian dapat dengan bebas memanfaatkan air tanahsementara peraturan tentang jarak sumber air bersih dan pembuangankotoran manusia yang merupakan salah satu sumber pencemar tidakdiindahkan akibatnya pertumbuhan penduduk yang diiringi denganmerapatnya jarak antar rumah memicu penurunan kualitas air tanah dangkal.Berkaitan dengan hal tersebut, maka permasalahan yang dikemukan adalahbagaimana kualitas air tanah dangkal pada musim hujan dan kemarau dalamkaitannya dengan kerapatan rumah dan jarak dari sungai di DKI Jakarta? Caramendapatkanya adalah dengan analisis korelasi peta (overlay) dan korelasistatistik (pearson product moment) untuk melihat korelasi (kaitan) antarvariabel. Hasilnya kerapatan rumah berkorelasi (berhubungan) dengankualitas air (parameter bakteri Fecal coli), jadi semakin rapat rumah makakualitas air tanah dangkal semakin buruk. Sedangkan jarak sumber air dengansungai tidak terbukti berpengaruh terhadap kualitas air.Kata Kunci : Air tanah dangkal, kualitas air, Fecal coliform, deterjen.viii+78 halaman+32 tabel+6 grafik+2 gambar+5 lampiran+12 petaBibliografi : 19 (1989-2006)"