Saturday, October 22, 2011

[sehat] Digest Number 16311

Messages In This Digest (25 Messages)

1a.
Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1 From: Inta
1b.
Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1 From: ursula_maniez@yahoo.com
2a.
Re: Maap, oTt banget From: baretaramadhani@gmail.com
3.
Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1[banned] From: alifah.davida@gmail.com
4a.
compressor Nebulizer From: goofypinkku83@yahoo.com
4b.
Re: compressor Nebulizer From: umialiyah_dzatil@yahoo.co.id
4c.
Re: compressor Nebulizer From: angel.encis@gmail.com
4d.
Re: compressor Nebulizer From: goofypinkku83@yahoo.com
4e.
Re: compressor Nebulizer From: Inta
5.
Bls: Re: [Sehat] Maap, oTt banget From: 'Ita' Elisabeth Dianita
6a.
Re: Imunisasi Rotavirus dan PVC From: wrdolphin@gmail.com
6b.
Re: Imunisasi Rotavirus dan PVC From: F.B.Monika
7a.
Re: (Tanya) Beda Pink Eye (Conjunctivitis) viral or bacterial infect From: Khonic
7b.
Re: (Tanya) Beda Pink Eye (Conjunctivitis) viral or bacterial infect From: Khonic
8a.
Re: OOT Sex Edukasi u Anak From: Khonic
8b.
Re: OOT Sex Edukasi u Anak From: yolani_r@yahoo.com
8c.
Re: OOT Sex Edukasi u Anak From: Khonic
8d.
Re: OOT Sex Edukasi u Anak From: Muhammad Arief Budiman
9a.
Re: [Need Advice] Zat besi pencegah anemia From: sophia_hcl
10a.
Re: (sehat) tanya : dokter atau bidan? From: siti amatullah mutmainah
11a.
a vaccine for malaria From: alifah.davida@gmail.com
11b.
Re: a vaccine for malaria From: Inta
12.
hasil USG: lambung janin 17 minggu terlihat besar From: roma shintauli
13a.
Re: Berita duka, salah satu dari Fantastic 4 meninggal dunia From: F.B.Monika
14.
Re: [tanya] Proses Menyapih? From: heidy_jo@yahoo.com

Messages

1a.

Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1

Posted by: "Inta" dini.maesarinta@gmail.com

Fri Oct 21, 2011 6:37 pm (PDT)



Jualan yah, siap2 aja yaaah bawa koper...pulang.

Cheers, Inta
@Intamaesarinta
terkirim dari henponkuh

1b.

Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1

Posted by: "ursula_maniez@yahoo.com" ursula_maniez@yahoo.com   ursula_maniez

Fri Oct 21, 2011 7:14 pm (PDT)



Hahahaha
Ampe ngakak bacax.
Kirain serius ternyata jualan.
Hedeeewwww

Ursula - binun penyakit non medis? Glek!
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2a.

Re: Maap, oTt banget

Posted by: "baretaramadhani@gmail.com" baretaramadhani@gmail.com

Fri Oct 21, 2011 6:49 pm (PDT)



Nambahin utk pelanggan INDOSAT..

Utk Teman pemakai INDOSAT yg msh jd korban CP/Sms Premium. Silahkan tekan *726# utk cek status layanan sms. kemudian pilih 1 (satu) utk menghentikan (unreg) seluruh layanan CP/SP. dan tekan 2 utk mengetahui status layanan Sms yg msh aktif. Selamat Mencoba, dan Layanan ini Free/gratis.

Mudah2an bermanfaat :) (maapp, oot)

-bareta
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT

-----Original Message-----
From: "aina" <aina.anwar@yahoo.com>
Sender: sehat@yahoogroups.com
Date: Sat, 15 Oct 2011 11:56:31
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: [Sehat] Maap, oTt banget

Bagi Pelanggan Telkomsel , silakan tekan *111# untuk (kartuHALO) dan *116# untuk (simPATI/As) tekan 3 untuk cek konten SMS Premium yang aktif. Apabila ingin berhenti berlangganan tekan Angka 2.
Bagi pengguna XL, untuk program yg memotong pulsa cek saja di *123*572# dan bisa juga untuk off-kan layanan ybs. Dan anda akan terbebas dari sms 'siluman' yg mungkin menyedot pulsa anda. Tks

Td uda coba..ada 3 siluman ...


merci beaucoup
wassalamu'alaikum wr wb,


aina f.



[Non-text portions of this message have been removed]

3.

Re: CIRI-CIRI PENYAKIT PEMBUNUH NO. 1[banned]

Posted by: "alifah.davida@gmail.com" alifah.davida@gmail.com   alifah_davida

Fri Oct 21, 2011 6:50 pm (PDT)





Regards,
-Alifah-
Challenge yourself, being smart never hurts

4a.

compressor Nebulizer

Posted by: "goofypinkku83@yahoo.com" goofypinkku83@yahoo.com   goofypinkku83

Fri Oct 21, 2011 7:00 pm (PDT)



Dear Sp's and doctors,

Saya sudah cukup paham mengenai batuk pilek yg berasal dr virus oleh karenanya banyak minum APH adalah rahasianya.

Tp bagaimana dengan dahak dahak nya ya? Apakah dahak tersebut juga akan larut dengan banyaknya APH yg diminum? Karena jaman saya belum kenal RUM dan milis ini, saya sering membawa anak saya ke dsa nya kalo batuk pilek, dan seringkali selain obat2an anak saya juga di suruh fisiotherapy dan nebulizer dengan alesan supaya obatnya lebih bekerja dg baik dan dahaknya keluar melalui p*p nya.

Mohon penjelasan. Karena kakak saya berniiat membeli compresor nebulizer utk sedia di rumah.

Terima kasih.

Bunda Qinan.
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4b.

Re: compressor Nebulizer

Posted by: "umialiyah_dzatil@yahoo.co.id" umialiyah_dzatil@yahoo.co.id   umialiyah_dzatil

Fri Oct 21, 2011 7:14 pm (PDT)



Saya sudah cukup paham mengenai batuk pilek yg berasal dr virus oleh karenanya banyak minum APH adalah rahasianya.

=> maaf, APH apaan sich?

Tp bagaimana dengan dahak dahak nya ya?

=> banyak minum bisa bantu menggelontor si dahak... Batuk juga membantu ngeluarin si dahak.

Karena jaman saya belum kenal RUM dan milis ini, saya sering membawa anak saya ke dsa nya kalo batuk pilek, dan seringkali selain obat2an anak saya juga di suruh fisiotherapy dan nebulizer dengan alesan supaya obatnya lebih bekerja dg baik dan dahaknya keluar melalui p*p nya.

=> kalo nebulizer biasanya digunakan untuk ASMA, jadi kalo cuma batpil biasa ga btuh nebulizer, itu malah jadi overtreated - CMIIW.
Kebetulan nyimpen side effec nebulizer, silakan dibaca2... Hth:

A nebulizer is a machine that delivers medication to your lungs. Most of the time, nebulizers are used by people with asthma, bronchitis, or other lung diseases or conditions. The side effects that you may experience when using a nebulizer are caused by the medications used,
not the nebulizer itself. Side effects from asthma medications can range from mild to very serious.

Anaphylaxis
Rarely, the medications used in nebulizers can cause a severe allergic reaction called anaphylaxis. Symptoms of anaphylaxis include swelling or tingling of the lips, tongue, or throat; wheezing; and trouble swallowing. This is a medical emergency. Call 911 or seek emergency care immediately if you experience any of these symptoms.

Nervousness
Some of the medications used in nebulizers, such as albuterol, can cause nervousness, a rapid heartbeat, dizziness and shakiness. Let your doctor know if these side effects are bothering you, as your medication or dosage may need to be changed.

Mouth Problems
The act of inhaling the medication through a nebulizer can cause dry mouth, sore throat, a bad taste in the mouth or hoarseness.

Sometimes, nebulizers can cause thrush, which is a yeast infection in the mouth. Symptoms of thrush include white spots in the mouth, bleeding and pain. Tell your doctor if these effects are occurring.

Worsening of Asthma Symptoms
Sometimes asthma medications can cause a worsening of your asthma symptoms. If you find yourself needing your nebulizer more often, or if you are experiencing increased shortness of breath, wheezing or coughing, contact your doctor right away.

http://www.livestrong.com/article/23178-side-effects-nebulizer-use/

ada yg menarik buat saya disini. meskipun GINA merekomendasikan nebulizer sbg bagian/ guidelines terapi asthma, namun ERC/European Respiratory Society meragukan bukti ilmiahnya
disini :

Boe, J; J H Dennis, B R O'Driscoll, T T Bauer, M Carone, B Dautzenberg, P Diot, K Heslop, L Lannefors (2001-07). "European Respiratory Society Guidelines on the use of nebulizers". /The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology/ *18* (1): 228-242

http://www.worldcat.org/title/european-respiratory-journal/oclc/42897227

Atun

Sent from my BlackBerry® smartphone from Sinyal Bagus XL, Nyambung Teruuusss...!
4c.

Re: compressor Nebulizer

Posted by: "angel.encis@gmail.com" angel.encis@gmail.com   indahlife

Fri Oct 21, 2011 7:15 pm (PDT)



Dahaknya kan jadi encer kalo banyak asupan APHnya.trus masuk ke saluran pencernaan kluar deh di PUP.alat nebul untuk apa ya?kalo untuk biar obatnya manjur mah aku rasa ga perlu.kan batpil ga ada obatnya.

Angel
Emaknya encis n twinnies inside

4d.

Re: compressor Nebulizer

Posted by: "goofypinkku83@yahoo.com" goofypinkku83@yahoo.com   goofypinkku83

Fri Oct 21, 2011 7:21 pm (PDT)



Yak ampun kok tega2nya yah DSA sekarang.. Anak2 temen saya yg belum kenal RUM pun sampai sekarang masih dan selalu nebu kalo batpil, buat ngeluarin dahak. Bahkan mereka sedia sendiri dirumah. APH itu air putih hangat mbak.
Terimakasih rujukannya.
*elus dada

Bunda Qinan.
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-----Original Message-----
From: umialiyah_dzatil@yahoo.co.id
Sender: sehat@yahoogroups.com
Date: Sat, 22 Oct 2011 02:19:20
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [Sehat] compressor Nebulizer

Saya sudah cukup paham mengenai batuk pilek yg berasal dr virus oleh karenanya banyak minum APH adalah rahasianya.

=> maaf, APH apaan sich?

Tp bagaimana dengan dahak dahak nya ya?

=> banyak minum bisa bantu menggelontor si dahak... Batuk juga membantu ngeluarin si dahak.

Karena jaman saya belum kenal RUM dan milis ini, saya sering membawa anak saya ke dsa nya kalo batuk pilek, dan seringkali selain obat2an anak saya juga di suruh fisiotherapy dan nebulizer dengan alesan supaya obatnya lebih bekerja dg baik dan dahaknya keluar melalui p*p nya.

=> kalo nebulizer biasanya digunakan untuk ASMA, jadi kalo cuma batpil biasa ga btuh nebulizer, itu malah jadi overtreated - CMIIW.
Kebetulan nyimpen side effec nebulizer, silakan dibaca2... Hth:

A nebulizer is a machine that delivers medication to your lungs. Most of the time, nebulizers are used by people with asthma, bronchitis, or other lung diseases or conditions. The side effects that you may experience when using a nebulizer are caused by the medications used,
not the nebulizer itself. Side effects from asthma medications can range from mild to very serious.

Anaphylaxis
Rarely, the medications used in nebulizers can cause a severe allergic reaction called anaphylaxis. Symptoms of anaphylaxis include swelling or tingling of the lips, tongue, or throat; wheezing; and trouble swallowing. This is a medical emergency. Call 911 or seek emergency care immediately if you experience any of these symptoms.

Nervousness
Some of the medications used in nebulizers, such as albuterol, can cause nervousness, a rapid heartbeat, dizziness and shakiness. Let your doctor know if these side effects are bothering you, as your medication or dosage may need to be changed.

Mouth Problems
The act of inhaling the medication through a nebulizer can cause dry mouth, sore throat, a bad taste in the mouth or hoarseness.

Sometimes, nebulizers can cause thrush, which is a yeast infection in the mouth. Symptoms of thrush include white spots in the mouth, bleeding and pain. Tell your doctor if these effects are occurring.

Worsening of Asthma Symptoms
Sometimes asthma medications can cause a worsening of your asthma symptoms. If you find yourself needing your nebulizer more often, or if you are experiencing increased shortness of breath, wheezing or coughing, contact your doctor right away.

http://www.livestrong.com/article/23178-side-effects-nebulizer-use/

ada yg menarik buat saya disini. meskipun GINA merekomendasikan nebulizer sbg bagian/ guidelines terapi asthma, namun ERC/European Respiratory Society meragukan bukti ilmiahnya
disini :

Boe, J; J H Dennis, B R O'Driscoll, T T Bauer, M Carone, B Dautzenberg, P Diot, K Heslop, L Lannefors (2001-07). "European Respiratory Society Guidelines on the use of nebulizers". /The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology/ *18* (1): 228-242

http://www.worldcat.org/title/european-respiratory-journal/oclc/42897227

Atun

Sent from my BlackBerry® smartphone from Sinyal Bagus XL, Nyambung Teruuusss...!

------------------------------------

Milis SEHAT mengucapkan terimakasih kepada:
- Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
- PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

"Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
=================================================================
Milis Sehat thanks to:
- AIA Insurance as sponsor for PESAT Bali 2011
- PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.

Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.

Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================Yahoo! Groups Links

4e.

Re: compressor Nebulizer

Posted by: "Inta" dini.maesarinta@gmail.com

Fri Oct 21, 2011 8:36 pm (PDT)



Mba,

Batuk itu sendiri kan mekanisme membuang dahak dari saluran pernafasan ke pencernaan. Jadi dahak dibuang melalui muntah atau feses.

Cheers, Inta
@Intamaesarinta
terkirim dari henponkuh

5.

Bls: Re: [Sehat] Maap, oTt banget

Posted by: "'Ita' Elisabeth Dianita" ita_sehat@yahoo.com   ita_sehat

Fri Oct 21, 2011 7:01 pm (PDT)



Haduh... Makasih yaaa infonya..
SOL


salam sehat,
ita (ibuke Saka & Ambar)
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6a.

Re: Imunisasi Rotavirus dan PVC

Posted by: "wrdolphin@gmail.com" wrdolphin@gmail.com   wr_dolphin

Fri Oct 21, 2011 7:34 pm (PDT)



Dear SPs n Docs

Maaf nich kl pertanyaannya agak2 bodoh
Imunisasi rotavirus dan PVC ini sama dengan IPD ga yah? Anak pertama udh divaksin IPD ini, tp baru denger ãÏ'ã imunisasi rotavirus (ketinggalan banget dech). Kl emang berbeda rotavirus dan PVC dgn IPD, pertanyaan berikutnya usia brp hrs vaksin rotavirus n PVC ini? Anakku 3thn

Terima kasih
Windy
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6b.

Re: Imunisasi Rotavirus dan PVC

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Fri Oct 21, 2011 7:38 pm (PDT)



Dear Mba Windy,

Vaksinnya PCV : Pneumococcal Conjugate Vaccine untuk penyakit IPD : Invasive Pneumococcal Disease.
Rotavirus penyebab diare.
Untuk jadwal catch up :

http://www.cdc.gov/vaccines/recs/schedules/downloads/child/catchup-schedule-pr.pdf

F.B.Monika

7a.

Re: (Tanya) Beda Pink Eye (Conjunctivitis) viral or bacterial infect

Posted by: "Khonic" khonic@gmail.com   khonic_ds

Fri Oct 21, 2011 7:41 pm (PDT)



Hehehe seneng dijawab bunda..
Aku belom ke dokter, tanya2 dulu biar ada bahan diskusi..
Dsa anakku ga terlalu RUM tp masih enak buat diajak debat, jd nyiapin perlengkapan perang nih..
Menurut bunda ini virus aja ya?

Khonic
Sent from my Freegift-Berry® supported by my lovely hubby (^__^)
7b.

Re: (Tanya) Beda Pink Eye (Conjunctivitis) viral or bacterial infect

Posted by: "Khonic" khonic@gmail.com   khonic_ds

Fri Oct 21, 2011 7:43 pm (PDT)



Mba Inta, sorry emailnya ga keliatan..
Iya kayak gitu. Tp baru kali ini jd rada deg2an hihihi..
Semoga cepet sembuh baimnya
Makasih penguatannya

Hug

Khonic

Sent from my Freegift-Berry® supported by my lovely hubby (^__^)
8a.

Re: OOT Sex Edukasi u Anak

Posted by: "Khonic" khonic@gmail.com   khonic_ds

Fri Oct 21, 2011 7:46 pm (PDT)



Wah andai saja ada di Jakarta.. Hehe *iri* --> mba yola ini adanya di surabaya bukan jakarta - sol

Khonic
Sent from my Freegift-Berry® supported by my lovely hubby (^__^)
8b.

Re: OOT Sex Edukasi u Anak

Posted by: "yolani_r@yahoo.com" yolani_r@yahoo.com   yolani_r

Fri Oct 21, 2011 8:21 pm (PDT)



Iyah maksud saya andai seminarnya diadain jg di jakarta..

Hehe

Cheers,
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT
8c.

Re: OOT Sex Edukasi u Anak

Posted by: "Khonic" khonic@gmail.com   khonic_ds

Fri Oct 21, 2011 8:27 pm (PDT)



Oh salah ngerti berarti sayanya maap - sol
Sent from my Freegift-Berry® supported by my lovely hubby (^__^)
8d.

Re: OOT Sex Edukasi u Anak

Posted by: "Muhammad Arief Budiman" feira24@yahoo.com   feira24

Fri Oct 21, 2011 8:35 pm (PDT)



Buat orangtua jg perlu nih...
Sent from BlackBerry® on 3

-----Original Message-----
From: yolani_r@yahoo.com
Sender: sehat@yahoogroups.com
Date: Sat, 22 Oct 2011 03:21:54
To: <sehat@yahoogroups.com>
Reply-To: sehat@yahoogroups.com
Subject: Re: [sehat] OOT Sex Edukasi u Anak

Iyah maksud saya andai seminarnya diadain jg di jakarta..

Hehe

Cheers,
Sent from my BlackBerry®
powered by Sinyal Kuat INDOSAT

------------------------------------

Milis SEHAT mengucapkan terimakasih kepada:
- Asuransi AIA atas partisipasinya sebagai sponsor PESAT Bali 2011
- PT LG Electronics Indonesia atas partisipasinya sebagai Sponsor Tunggal FAMILY FUN DAY MILIS SEHAT 2011.

Terima kasih & penghargaan sedalam-dalamnya kepada : HBTLaw, PT.Intiland, dan PT. Permata Bank Tbk. yang telah dan konsisten mensponsori program kami, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."

"Milis SEHAT didukung oleh : CBN Net Internet Access &Website.
=================================================================
Milis Sehat thanks to:
- AIA Insurance as sponsor for PESAT Bali 2011
- PT LG Electronics Indonesia as exclusive partner of FAMILY FUN DAY MILIS SEHAT 2011.

Our biggest gratitude to: HBTLaw, PT. Intiland, and PT. Permata Bank Tbk. who have consistently sponsored our program, PESAT (Program Edukasi Kesehatan Anak Untuk Orang Tua)."
"SEHAT mailing list is supported by CBN Net for Internet Access &Website.

Kunjungi kami di (Visit us at):
Official Web : http://milissehat.web.id/
FB : http://www.facebook.com/pages/Milissehat/131922690207238
Twitter : @milissehat <http://twitter.com/milissehat/>
==================================================================
Donasi (donation):
Rekening Yayasan Orang Tua Peduli
Bank Mandiri
Cabang Kemang Raya Jakarta
Account Number: 126.000.4634514
==================================================================Yahoo! Groups Links

9a.

Re: [Need Advice] Zat besi pencegah anemia

Posted by: "sophia_hcl" staceyelizabeth11@gmail.com   sophia_hcl

Fri Oct 21, 2011 7:46 pm (PDT)





Skrining zat besi bisa dilakukan di 9 bulan ya?
Bukan baru boleh pas bayi berumur 12 bulan?

Sol

10a.

Re: (sehat) tanya : dokter atau bidan?

Posted by: "siti amatullah mutmainah" amianakbinus@yahoo.com   amianakbinus

Fri Oct 21, 2011 7:48 pm (PDT)



Dear mba pujie..
Mau bidan, mau dr.umum bisa kok ..
Kecuali ada keluhan lain yg tdk bs ditanganin keduanya silakan ke obgin ..
Mgkn tergantung kebijakan rs nya juga yah..
Spt di dkt rmh sy, ada byk rumah bersalin, baik yg bentuknya klinik biasa,rsia,rsu swasta
Meski ada obgin yg bertgs, tp tetap jika ada yg melahirkan dan ternyata partus nya spontan tdk ada mslh pasti bidan yg ambil alih ..
Hanya kan disini mmg rata2 lgsg loncat ke obgin, kyknya kurang gimanaaa gt klo ga ke obgin hehehehe..

Rgds,
Ami
*klinik bersalin markas sehat.. Hmmm ...
Bantuin modal brp yak ???




Sent from AmiBerry® via Smart 1x / EVDO Network.
11a.

a vaccine for malaria

Posted by: "alifah.davida@gmail.com" alifah.davida@gmail.com   alifah_davida

Fri Oct 21, 2011 7:51 pm (PDT)



A Vaccine for Malaria

Nicholas J. White, F.R.S.

N Engl J Med | October 18, 2011

It's been a long time coming, and indeed we are still not there yet, but it is becoming increasingly clear that we really do have the first effective vaccine against a parasitic disease in humans. If there are no unforeseen disasters, the RTS,S/AS01 Plasmodium falciparum malaria vaccine should become available in just over 3 years. The World Health Organization (WHO) has already taken the unusual step of indicating that it could recommend this first malaria vaccine for use in some African countries as early as 2015, depending on the full phase 3 trial results that will become available in 2014.1 The vaccine has been developed by a publicâ€"private partnership between GlaxoSmithKline and the Program for Appropriate Technology in Health (PATH) Malaria Vaccine Initiative, supported by the Bill and Melinda Gates Foundation, primarily for use in infants and young children in sub-Saharan Africa. RTS,S/AS01 is a hybrid construct of the hepatitis B surface antigen fused with a recombinant antigen derived from part of the circumsporozoite protein. This is the protein coat of the sporozoite, the parasite stage that is inoculated by the feeding anopheline mosquito, which then invades liver cells and multiplies there before entering the bloodstream. Keys to the success of the vaccine are the immunogenic polymeric nature of RTS,S particles and the proprietary adjuvant AS01. A large number of other potential malaria vaccines are in various stages of development, but the RTS,S/AS01 vaccine is considerably further along the path to registration and potential deployment than the others.

In this issue of the Journal, the RTS,S Clinical Trials Partnership provides an interim report of a large, multicenter phase 3 trial of this vaccine.2 A total of 15,460 children in two age categories â€" 6 to 12 weeks and 5 to 17 months â€" were enrolled. The report describes vaccine efficacy against P. falciparum malaria in the first 6000 of 8923 children in the older age category, together with an evaluation of the first 250 cases of severe malaria from the two age groups. It is not usual practice to publish the results of trials in pieces, and there does not seem to be a clear scientific reason why this trial has been reported with less than half the efficacy results available. The target population for this vaccine is young infants who would receive the malaria vaccine together with routine immunizations, but the critical efficacy results in this subgroup will not be reported for another year. Even then, only results on short-term efficacy will be available, findings that will be insufficient to assess the public health role of this vaccine.

The interim results are broadly in line with those reported previously in extended phase 2 studies.3â€"5Protective efficacy against P. falciparum malaria (55% protection against all malaria episodes) was at the upper end of expectations from earlier studies, whereas the overall reduction in severe malaria (35% protection) was slightly less than anticipated.

Trials often throw up unexpected findings. In this trial, there were significantly more cases of meningitis among children receiving the RTS,S/AS01 vaccine than among those receiving the comparator vaccines. There seems to be no plausible explanation for this, and it may well turn out to be a chance finding, but it cannot be ignored. On the other hand, the increased risk of febrile reactions or seizures among RTS,S/AS01 recipients may be real, reflecting the reactogenicity of this highly immunogenic vaccine. Such questions highlight the importance of phase 4 studies of both safety and effectiveness with active surveillance if this vaccine is deployed.

What does this vaccine mean for the future of the control and elimination of malaria? The considerable increase in global funding is paying dividends. In places where effective interventions (insecticide-treated bed nets, insecticides, and artemisinin-combination treatments) are being intensively deployed, malaria morbidity and mortality are falling. Several new, simple, affordable interventions, such as seasonal chemoprevention among young children in areas of seasonally high malaria transmission and the use of artesunate in patients with severe malaria, can also provide substantial reductions in mortality. The very low rate of death from malaria in this large trial (only 10 deaths directly attributed to malaria) testifies to the benefits of providing early diagnosis and effective antimalarial treatment. But there are real dangers ahead. How will the necessary funding be sustained in the face of a global economic downturn, along with a reduction in political pressure associated with declining mortality from malaria? In addition, artemisinin resistance in malaria parasites and pyrethroid resistance in anopheline mosquito vectors pose very serious threats.

All the investigators who have labored long and hard in the development and evaluation of this malaria vaccine deserve congratulations. It is a great achievement and an important advance, but they know that this partially protective vaccine is not the sole solution to the control and elimination of malaria. After registration, the definitive WHO guidance, expected in 2015, may recommend that the inclusion of RTS,S/AS01 in the multipronged attack against malaria is justified. The key question of how long the protection against malaria lasts, particularly in the anticipated context of declining malaria transmission, remains open. An assessment of an 18-month booster dose will not be available until 2014. Another key issue is whether efficacy varies according to the intensity of transmission. We also do not know yet how much the vaccine will cost. All these factors are essential components of the objective assessments of cost-effectiveness that should form the basis of future global and national policy decisions.

This article (10.1056/NEJMe1111777) was published on October 18, 2011, at NEJM.org.

Disclosure forms provided by the author are available with the full text of this article atNEJM.org.

References

World Health Organization. Malaria. Initiative for vaccine research (IVR) (http://www.who.int/vaccine_research/Malaria/en/index.html).
The RTS,S Clinical Trials Partnership. First results of phase 3 trial of RTS,S/AS01 malaria vaccine in African children. N Engl J Med 2011. DOI: 10.1056/NEJMoa1102287.
P Bejon, J Lusingu, A Olotu, Efficacy of RTS,S/AS01E vaccine against malaria in children 5 to 17 months of age.N Engl J Med2008;359:2521-2532
KP Asante, S Abdulla, S Agnandji, Safety and efficacy of the RTS,S/AS01(E) candidate malaria vaccine given with expanded-programme-on-immunisation vaccines: 19 month follow-up of a randomised, open-label, phase 2 trial.Lancet Infect Dis2011;11:741-749
A Olotu, J Lusingu, A Leach, Efficacy of RTS,S/AS01E malaria vaccine and exploratory analysis on anti-circumsporozoite antibody titres and protection in children aged 5-17 months in Kenya and Tanzania: a randomised controlled trial.Lancet Infect Dis2011;11:102-109
Source Information

From the Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Regards,
-Alifah-
Challenge yourself, being smart never hurts

[Non-text portions of this message have been removed]

11b.

Re: a vaccine for malaria

Posted by: "Inta" dini.maesarinta@gmail.com

Fri Oct 21, 2011 8:38 pm (PDT)



Naaaaah ini yang dinanti2 suami saya. Udah masuk belum yah di sini?

Cheers, Inta-sol
@Intamaesarinta
terkirim dari henponkuh

12.

hasil USG: lambung janin 17 minggu terlihat besar

Posted by: "roma shintauli" sitompul22@gmail.com   romashintauli

Fri Oct 21, 2011 7:59 pm (PDT)



Dear Docs & SPs,

Kemarin saya kontrol kehamilan saya yang berusia 17 minggu,
dari hasil USG, dokter mengatakan bayi nya sehat (meskipun saya mengalami
flek pada hari itu).
Namun, dokter mengatakan juga kalau ukuran lambung bayi dalam kandungan saya
terlihat cukup besar
artinya tidak normal. Saya disarankan untuk USG 4D saat usia kehamilan 26
minggu nanti.
Beliau bilang itu bisa indikasi kelainan atau juga bisa disebabkan bayi
sedang banyak minum.
ini merupakan kehamilan kedua saya, saya juga tidak mengkonsumsi obat2an
selain vitamin dari dokter. (fetavita&hemobion)
namun saya memang jarang minum susu krn merasa eneg.

Kira2 ada yang punya pengalaman sama dengan yg saya alami?
saya sedikit khawatir mengenai penjelasan dokter soal kelainan.
kira2 apa dampaknya setelah lahir ya?

mohon sharingnya

Trima kasih

Salam,

roma

[Non-text portions of this message have been removed]

13a.

Re: Berita duka, salah satu dari Fantastic 4 meninggal dunia

Posted by: "F.B.Monika" f_monika_b@yahoo.com   f_monika_b

Fri Oct 21, 2011 8:06 pm (PDT)



Ikut meng Aamiin kan doa semuanya..Semoga diberi kesabaran n ketabahan

F.B.Monika

14.

Re: [tanya] Proses Menyapih?

Posted by: "heidy_jo@yahoo.com" heidy_jo@yahoo.com   heidy_jo

Fri Oct 21, 2011 8:45 pm (PDT)



Dear moms n docs,

Mau tanya donk bagaimana proses menyapih dan efeknya pada PD?

Produksi asi saya sudah menurun drastis banget shg baby harus sambung sufor. Puji Tuhan semua lancar unt baby, tidak alergi dan tdk diare.

Lalu bagaimana unt PD sendiri? Selama ini msh terus dipompa, sehari bisa 400ml. Apakah akan ada kemungkinan mastitis dsb? Lalu apakah nantinya akan sama sekali berhenti walaupun tetap dipompa?

Mohon sharingnya...

Thanks,
Erika
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