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      • Slide Session : OS-IFD-08 ; Infectious Disease : West Nile Virus (WNV) as a Potential New Threat to HIV/AIDS Patients in Indonesia

        ( Nasronudin ),( Bimo Aksono ),( Bimo D Lukito ),( Brian E Rachman ),( Noordiansyah ),( Retno Indrawati ),( Retno P Rahayu ),( M Inge Lusida ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        NASRONUDIN1, Bimo AKSONO1, Bimo D LUKITO4, Brian E RACHMAN2, NOORDIANSYAH7, Retno INDRAWATI1, Retno P RAHAYU1, M Inge LUSIDA1 Institute of Tropical Disease, Airlangga University, Indonesia1, Medical Faculty Airlangga University - Dr Soetomo Hospital, Indonesia2, Medical Faculty Airlangga University - Dr Soetomo Hospital, Indonesia3, Medical Faculty Airlangga University - Dr Soetomo Hospital, Indonesia4, Faculty of Dentistry, Airlangga University, Indonesia5, Faculty of Dentistry, Airlangga University, Indonesia6, Airlangga University Hospital, Indonesia7 Background: WNV is a mosquito-borne zoonotic arbovirus, belongs to the genus Flavivirus in the family Flaviviridae. Although WNV infection in human has been reported for decades in several parts of the world, but it was diagnosed recently in 2014 in Indonesia. Approximately 80% of WNV infections in humans do not develop any symptoms. Elderly or those with immunosuppression, such as HIV/AIDS, are at greater risk for serious illness. Phylogenetic analysis has divided WNV into mainly Lineage 1(L1) and Lineage 2 (L2), which is geographically specifi c. Aims: To determine and phylogenetic analyse of WNV on HIV/AIDS Patients. Methods: The subjects were HIV/AIDS patients in Airlangga University Hospital. Examination of blood samples were performed in Institute of Tropical Disease Airlangga University. This study has been approved by Ethical Committee. A total of 30 HIV/ AIDS patients were enroled after obtainined informed consent, and examined for WNV RNA using RT-PCR in the envelope region (408 bps). Results: The results showed that 8 (25.81%) of 30 HIV/AIDS patients were WNV positive. The phylogenetic of one WNV strain in this study showed that it belongs to the L2. Only recently were those strains of L2 identifi ed outside of Africa. Conclusions: We found WNV as one of the potential coinfections in HIV/AIDS patients in Indonesia, and therefore it may in other countries too. Phylogenetic analysis of one strain revealed that the virus clustered in the lineage 2.

      • Slide Session : OS-IFD-05 ; Infectious Disease : Displacement of the Predominant Dengue Virus from Type 2 to Type 1 in Surabaya, Indonesia Within March 2012 - April 2013

        ( Brian Eka Rachman ),( Maria I Lusida ),( E Bimo Aksono ),( Siswanto Siswanto ),( Musofa Rusli ),( Bramantono ),( Nasronudin ),( Umar F Achmadi ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Indonesia is a country with high endemicity of dengue (haemorrhagic) fever (DF/ DHF). It was reported that dengue virus type 2 (DENV2) was the predominant circulating virus in 2003-2005 in Surabaya, Indonesia, while Yamanaka et al., 2011 reported shifting of DENV serotypes between 2008 - 2010 in three times survey. This study was part of the clinical trial phase three of antivirus against dengue, held in year 2012-2013. Methods: A total of 317 serum samples were collected from patients with fever on day-1 or day-2, suspected dengue infection according to WHO criteria, showed positive result either by NS-1, and or IgM - IgG within March 2012 - April 2013. After an RNA extraction, a multiplex DEN 1-4 quantitative Real-Time PCR was applied to each sample. Results: Sixty three (90%) of 70 PCR positive sera collected within March 2012 and May 2012 showed DENV2, then 5(7.2%) DENV1, 1(1.4%) DENV3, and 1mixed of DENV1+3. Surprisingly, it was totally different for those collected since June 2012 until April 2013. Fifty three (50%) of 106 positive samples were DENV1, 5 (4.7%) DENV2, 35 (33%) DENV3, 7 (6.6%) DEN4, and 2, 2, 1 mixed type of DENV 1+3, DENV1+4, DENV 3+4 respectively. Conclusions: There was a displacement of the predominant type of dengue virus circulating in Surabaya within March 2012 - April 2013. Such kind of predominant DENV shifting from type 2 to type 1 has occurred between October and November 2008. This indicates the need for continuous surveillance of the circulating viruses, which may predict the risk of severe DHF and mild DF as reported previously.

      • Poster Session : PS 0421 ; Infectious Disease ; Demographic and Seroepidemiologic Patterns of Dengue Infection in Surabaya, Indonesia

        ( M Atoillah Isfandiari ),( M Inge Lusida ),( E Bimo Aksono ),( Brian E Rachman ),( Rahayu Anggraini ),( Musofa Rusli ),( M Vitanata Arfijanto ),( Nasronudin ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: Dengue infection cases in Surabaya, contributed to more than 25% of cases in the East Java province during 2012-2013. This study was held to determine the patterns of dengue infection in Surabaya based on patient demographic and types of the virus prior to a clinical trial study of herbal medicine for the treatment of dengue infection Methods: A total of 460 patients with dengue infection diagnosed by specific non-structural 1 (NS1) antigen and or IgM/IgG examination, with fi rst or second day of fever, distributed in 10 hospitals and 15 health centers, obtained during January 2012 to November 2013, were included in this cross-sectional study. Strain identifi cation was based on multiplex RT-PCR for DEN1 to DEN4. The level of CD4 molecules on T-Lymphocytes were also quantitatively determined by ELISA Results: Around one third of the patients (34.6%) were aged between 21-60 y.o, with the rests were under 21 y.o. The dengue type was identifi ed in 209 patients. Among them, 77% were single type infection and 19% were double or more type infection, with DEN1 (34,9%) to be the most prevalent. The average level of CD4 molecules among patients was moderate (5.86±9,1 ng/mL), with no signifi cant difference level among each age group. During the two-year of study, the number of incidence per month fi uctuated between 1 to 80 cases, but tended not to follow general seasonal pattern. Conclusions: In Surabaya, Dengue infections are likely to be found widely among adults, with the pattern of incidence per month tend not to follow regular seasonal pattern. Among all strains, DEN 1 was most widely identifi ed, either as single or double infection with other strains during the period of study. Healthcare preparedness to care dengue infection patients should be conducted throughout the year.

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