Present study aimed to estimate the incidence of recurrent SARS-CoV-2 RNA positivity after recovery from COVID-19 and to determine the factors associated with recurrent positivity. We searched the PubMed, MedRxiv, BioRxiv, the Cochrane Library, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry for studies published to June 12, 2020. Studies were reviewed to determine the risk of bias. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Fourteen studies of 2568 individuals were included. The incidence of recurrent SARS-CoV-2 positivity was 14.8% (95% confidence interval [CI] 11.44–18.19%). The pooled estimate of the interval from disease onset to recurrence was 35.4 days (95% CI 32.65–38.24 days), and from the last negative to the recurrent positive result was 9.8 days (95% CI 7.31–12.22 days). Patients with younger age and a longer initial illness were more likely to experience recurrent SARS-CoV-2 positivity, while patients with diabetes, severe disease, and a low lymphocyte count were less likely to experience. Present study concluded that the incidence of recurrent SARS-CoV-2 positivity was 14.8% suggesting further studies must be conducted to elucidate the possibility of infectious individuals with prolonged or recurrent RNA positivity.

Background: One of the components of blood cells are often used for transfusions is Packed Red Cell (PRC). Blood components transfusion may continues with rapid or delayed transfusion ractions. The most transfusion reactions was fever (55%) or febrile non haemolytic transfusion reaction (FNHTRs). The cause of these events is associated with allogenic leucocytes (the ability to differentiate self cells and non-self cells based on the human leukocyte antigen (HLA) on the cell surface) and release of proinflammatory cytokines such as IL-1, IL-6, IL-8, TNFα, Cell-free DNA (cfDNA), histone and the duration of blood storage. Methods: Cross-sectional study on 41.177 patients who received a PRC transfusion with the FNHTR transfusion reaction in Hospital Blood Bank Dr. Kariadi Semarang, during January 2017 to July Pendahuluan: Salah satu komponen sel darah yang sering digunakan untuk transfusi adalah Packed Red Cell (PRC). Pemberian transfusi dapat disertai dengan reaksi transfusi baik reaksi transfusi cepat atau lambat. Reaksi transfusi sebagian besar (55%) berupa demam atau febrile non haemolytic transfusion reaction (FNHTR). Penyebab dari FNHTR dikaitkan dengan adanya allogenic leucocytes (kemampuan untuk membedakan antara sel-sel tubuh sendiri dan sel asing berdasarkan protein human leukocyte antigen (HLA) yang ada pada membran sel), pelepasan sitokin proinflamasi seperti IL-1, IL-6, IL-8, TNFα, Cell-free DNA (cfDNA), histone serta lama masa simpan darah. Metode: Sebuah studi cross-sectional pada 41.177 pasien yang mendapat transfusi PRC yang mengalami reaksi transfusi FNHTR di Bank Darah RSUP Dr. Kariadi Semarang selama bulan Januari 2018. Pearson Chi Square test for expected frequency more than 5. The Kolmogorov smirnov and Shapiro-wilk test were used to evaluate normality of the data. Mann-Whitney test to analyze the difference, p < 0,05 was considered as significant. Results: The incidence of FNHTR was lower in patients who received leukodepleted PRC (11 patients) than non leukodepleted PRC (124 patients). There were differences in body temperature in the incidence of FNHTR between the two groups 38.1 0 C (38-39) VS 38.4 0 C (38-39.2) with p = 0,046. Conclusions: There were relationship between the incidence of FNHTR with the transfusion with leukodepleted PRC and non leukodepleted PRC.

BACKGROUND: Serum levels of 25-hydroxyvitamin D (25(OH)D), prostaglandin E2 (PGE2), and cyclooxygenase 2 (COX2) expression differ between breast cancer stages. Since, previous studies showed mixed results, in this study, we aimed to analyze vitamin D levels related to breast cancer stages and serum levels of COX2 and PGE2 in Indonesia.METHODS: This was a cross sectional study involving 75 breast cancer patients. Subjects were divided into 3 groups, namely operable early stage (K1), locally advanced stage (K2), and advanced stage (K3). Venous blood samples were taken from each subject, then were analyzed for the 25(OH)D, COX2, and PGE2 serum levels by enzyme-linked immunosorbent assay (ELISA) method.RESULTS: There were significant differences in 25(OH)D among groups (p=0.012); between K1 and K2 (p=0.009) and between K1 and K3 (p=0.023). However, there was no significant difference in serum COX2 level (p=0.328). There were significant differences of PGE2 among groups (p=0.002); between K1 and K2 (p=0.036) and between K1 and K3 (p=0.001). Correlation test showed that there were differences between 25(OH)D serum levels and PGE2 serum level (r=0.306, p=0.008) and also between 25(OH)D serum level and breast cancer stage (r=-0.229; p=0.048).CONCLUSION: There were differences in serum Vitamin D and PGE2 levels at various stages of breast cancer. Serum 25(OH)D levels had weak correlation with breast cancer stage and PGE2 serum level. Serum vitamin D level in advanced breast cancer were lower than early stage breast cancer and indicate a poor prognosis.KEYWORDS: breast cancer, 25-hydroxyvitamin D, cyclooxygenase 2, prostaglandin E2

Latar belakang : Systemic Lupus Erythematosus adalah penyakit kronik inflamatif autoimun dengan manifestasi multiorgan. Pemeriksaan bone marrow punction  mengkonfirmasi gangguan hematologi. Imunoassai ANA, anti-dsDNA dan anti Sm mengkonfirmasi imunopatogenesis. Tujuan studi kasus ini adalah untuk menganalisis aspek laboratorium dalam diagnosis dan tatalaksana nefritis Lupus kelas IV dan neuropsikiatri lupus dengan Sindroma Mielodisplasia. Kasus : Seorang wanita 35 tahun mengeluh lemas. Pemeriksaan fisik : hipertensi, konjungtiva palbebra pucat, ulkus dimulut, echimosis dikulit, pleural friction rub paru kanan, edema pitting ekstremitas. Pemeriksaan laboratorium : peningkatan LDH, hiperlipidemia, hipofibrinogenemia, peningkatan D-dimer, proteinuria, hematuria dan silinderuria. Pemeriksaan ANA dan Sel LE positif. Pansitopenia darah tepi dikonfirmasi pemeriksaan BMP didapatkan gambaran MDS. Pasien mengalami kejang, dikonfirmasi MSCT kepala terdapat infark serebri multipel. Anti ds-DNA positif moderate, C3/C4 rendah namun anti Sm negatif. Kesimpulan : Berdasarkan data klinis dan laboratoris pasien ini didiagnosis  SLE derajat berat, nefritis lupus kelas IV, sindroma mielodisplasia dan neuropsikiatrilupus. Anti Sm negatif kemungkinan disebabkan  fenomena “cross reactivity” atau “Hook Effect” sehingga menyebabkan interferensi hasil negatif palsu. Anti Sm negatif tidak dapat menyingkirkan diagnosis SLE