Hasil Pencarian  ::  Simpan CSV :: Kembali

"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.

---

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."

"ABSTRAKInflammatory Bowel Disease (IBD) adalah penyakit yang semakin meningkatprevalensinya selama dua dekade terakhir. Baku emas diagnosis IBD adalah kolonoskopidan histopatologi. Calprotectin feses merupakan salah satu pemeriksaan yang banyakdiminta untuk menapis pasien terduga IBD agar mengurangi kolonoskopi yang tidakperlu. Metode pemeriksaan calprotectin yang banyak digunakan sekarang adalah ELISA,tetapi saat ini terdapat metode baru yaitu CLIA. Penelitian ini bertujuan membandingkancalprotectin feses antara kedua metode tersebut, melakukan uji diagnostik denganperbandingan baku emas, dan membandingkan calprotectin pada kelompok IBD dan non-IBD. Penelitian dilakukan secara potong lintang dan data disajikan secara deskriptifanalitik dengan melibatkan 50 pasien dewasa. Uji korelasi antara kedua metodemenemukan hubungan kuat dan bermakna (r=0,865, p<0,001), tetapi persamaan regresiPassing-Bablok mendapatkan perbedaan konstan dan proporsional. Uji Bland-Altmanmendapatkan kesesuaian 92% dengan rerata selisih 76,2 μg/g feses dan batas kesesuaian-964,3-1116,7 μg/g feses. Uji diagnostik calprotectin feses metode ELISA menemukantitik potong optimal adalah 194 μg/g dengan sensitivitas 55,6%, spesifisitas 56,5%, NPP60%, dan NPN 48%. Apabila menggunakan titik potong pabrik 50 μg/g, maka didapatkansensitivitas 88,9%, spesifisitas 13%, NPP 54,5%, dan NPN 50%. Uji diagnostikcalprotectin feses metode CLIA menemukan titik potong optimal adalah 90,5 μg/gdengan sensitivitas 51,9%, spesifisitas 52,2%, NPP 56%, dan NPN 48%. Apabilamenggunakan titik potong pabrik yaitu 50 μg/g, maka diperoleh sensitivitas 70,4%,spesifisitas 43,5%, NPP 59,4%, dan NPN 55,6%. Perbandingan calprotectin feses metodeELISA antara kelompok IBD dan non-IBD menemukan perbedaan rerata yang tidakbermakna secara statistik, begitu juga dengan perbandingan kelompok IBD dan non-IBDpada calprotectin feses metode CLIA. Penelitian ini menemukan bahwa kedua kitpemeriksaan tidak dapat saling menggantikan dan uji diagnostik menemukan akurasidiagnostik yang buruk. Penelitian selanjutnya harus mengeksklusi kolitis infektif untukmempertajam diagnosis terduga IBD dan menemukan pasien IBS dengan melibatkanrumah sakit lain.

---

ABSTRACTInflammatory Bowel Disease (IBD) prevalence has been increasing since last twodecades. Gold standard to diagnose IBD is colonoscopy and histopathology. Fecalcalprotectin is frequently ordered test for screening of patient with suspect IBD sounnecessary colonoscopy can be reduced. Method often used today is ELISA, but CLIAmethod is available nowadays. This study was aimed to compare fecal calprotectin testbetween this two method, to perform diagnostic test with gold standard, and compare thelevel of fecal calpoctin between IBD and non-IBD group. Study design was crosssectional and was presented as descriptive-analytic data, involving 50 subjects.Correlation between two method is strong and statistically significant (r=0,865, p<0,001),but Passing-Bablok regression test found constant and proportional difference. Bland-Altman test found agreement was 92% with mean difference 76,2 μg/g faeces and borderof agreement -964,3-1116,7 μg/g faeces. Diagnostic test with ELISA method foundoptimal cut-off was 194 μg/g with sensitivity 55,6%, specificity 56,5%, PPV 60%, andNPV 48%. If cut-off from manufacturer was used (50 μg/g), sensitivity 88,9%, specificity13%, PPV 54,5%, and NPV 50%. Diagnostic test with CLIA method found optimal cutoffwas 90,5 μg/g with sensitivity 51,9%, specificity 52,2%, PPV 56%, and NPV 48%. Ifcut-off from manufacturer was used (50 μg/g), sensitivity 70,4%, specificity 43,5%, PPV59,4%, and NPV 55,6% . Difference level of fecal calprotectin between IBD and non-IBD group is not statistically significant, both with ELISA and CLIA method. This studyfound that these two fecal calprotectin is not interchangeable and diagnostic test foundpoor result. Future study should give more restriction to diagnose suspect IBD byexclusion of infective colitis and found IBS cases by involving other hospital."

"Inflammatory bowel disease (IBD) merupakan penyakit kronik dan relapsing yang mempengaruhi kualitas hidup pasien. Hingga saat ini penegakkan diagnosis IBD masih menjadi persoalan. Calprotectin merupakan biomarker yang dapat dideteksi di jaringan (intramukosal) dan dinilai memiliki potensi dalam membantu penegakkan diagnosis IBD. Penelitian ini bertujuan untuk menilai ekspresi calprotectin intramukosal pada IBD, kolitis non-IBD dan kontrol. Penelitian bersifat retrospektif analitik. Pengambilan sampel dilakukan secara konsekutif pada sediaan biopsi kolorektal yang didiagnosis IBD, kolitis non-IBD, serta sediaan reseksi dengan bagian kolon tanpa kelainan patologik bermakna dari arsip Departemen Patologi Anatomik FKUI/RSCM tahun 2017-2020. Dilakukan pulasan imunohistokimia untuk menilai ekspresi calprotectin (rerata jumlah sel/LPB) pada tiap kelompok. Dari 45 sampel IBD dan 45 sampel non-IBD, sebagian besar menunjukkan peradangan aktif, derajat keaktifan ringan. Ekspresi calprotectin intramukosal pada kelompok IBD dan non-IBD lebih tinggi dibandingkan dengan kelompok kontrol (p<0,001). Kasus dengan peradangan aktif memiliki ekspresi calprotectin yang lebih tinggi dibandingkan pada peradangan inaktif (p<0,001). Peningkatan ekspresi calprotectin memiliki hubungan bermakna dengan adanya peradangan namun belum dapat direkomendasikan untuk menjadi dasar penentuan etiologi IBD dan non-IBD.

---

Inflammatory bowel disease is a chronic relapsing disease affecting patients’ quality of life. To date, IBD diagnosis remains a challenge. Calprotectin is a biomarker that can be detected in tissue (intramucosal) and is considered as a potential marker of IBD. This study aims to determine intramucosal calprotectin expression in IBD, non-IBD colitis and control. Analytic retrospective study including consecutively sampled colorectal biopsy specimens diagnosed as IBD, non-IBD colitis and resection specimens with normal colon mucosa recorded in archives of Anatomical Pathology Department, FKUI/RSCM in 2017-2020. Calprotectin expression (cell/HPF) was detected by immunostaining and evaluated for every group. Most of the samples from IBD and non-IBD group (45 samples each) showed mild active inflammation, with higher mucosal calprotectin expression than that of control group (p<0.001). Subjects with active inflammation showed higher calprotectin expression compared to those with inactive inflammation (p<0.001). The increase of calprotectin expression showed significant association with the presence of inflammation, with higher expression found in active inflammatory conditions. However, the use of calprotectin to determine inflammatory etiology (IBD vs non-IBD) has yet to be recommended."

"Latar Belakang. Vitamin D merupakan salah satu komponen regulator yang berperan dalam respons imun humoral maupun adaptif yang memiliki peranan patogenesis dalam berbagai kondisi autoimun termasuk IBD. Defisiensi vitamin D diketahui dapat mempengaruhi derajat aktivitas pada pasien dengan IBD. Beberapa studi menunjukkan terdapat peran vitamin D dalam meningkatkan angka remisi pada pasien dengan IBD. Namun studi lain menunjukkan tidak ada hubungan yang signifikan terhadap aktivitas klinis IBD dengan defisiensi vitamin D. Belum ada studi di Indonesia yang menilai hubungan kadar vitamin D dengan aktivitas klinis pada IBD.Tujuan. Mengetahui prevalensi defisiensi vitamin D pada pasien dengan IBD dan menilai perbedaan rerata kadar 25-OH D pada subjek dengan IBD aktif dengan remisi.Metode. Penelitian ini merupakan studi dengan desain potong lintang yang dilakukan di Rumah Sakit Cipto Mangunkusumo. Pasien dengan IBD yang datang ke Poliklinik Gastroenterologi dan dilakukan pemeriksaan kadar 25-OH-D. Subjek dengan kolitis ulseratif dinilai aktivitas klinisnya dengan menggunakan instrumen Simple Clinical Colitis Activity Index (SCCAI) dimana nilai <2 dikategorikan sebagai remisi, sedangkan subjek dengan penyakit Crohn dinilai aktivitas klinisnya dengan menggunakan instrumen Crohn’s Disease Activity Index (CDAI) dengan nilai <150 dikategorikan sebagai remisi. Dilakukan analisis perbedaan rerata kadar 25-OH-D antara subjek remisi dibandingkan aktif baik pada subjek dengan kolitis ulseratif dan penyakit Crohn.Hasil. Sebanyak 76 subjek memenuhi kriteria inklusi dan eksklusi, 48 subjek termasuk ke dalam kolitis ulseratif dan 28 lainnya penyakit Crohn. Sebanyak 65,3% subjek perempuan dengan rerata usia subjek adalah 46,39 (SB 16,25). Prevalensi defisiensi vitamin D pada pasien IBD adalah sebesar 46,1% dengan 32,1% pada penyakit Crohn dan 54,2% pada kolitis ulseratif. Tidak didapatkan adanya perbedaan median yang signifikan antara subjek dengan penyakit Crohn pada remisi (20,7 (12,25 – 32,55) ng/ml) dan aktif (15,7 (12,03 – 28,6) ng/ml) (p = 0,832), maupun subjek dengan kolitis ulseratif pada remisi (26,05 (19,33 – 30,73) ng/ml) dan aktif (25,05 (14,43 – 33,37) ng/ml) (p = 0,301).Kesimpulan. Prevalensi defisiensi vitamin D pada IBD adalah sebesar 46,1%. Tidak terdapat adanya perbedaan yang signifikan terhadap kadar 25-OH-D pada pasien dengan IBD yang aktif dibandingkan dengan remisi.

---

Background. Vitamin D is one of the regulatory components that play a role in humoral and adaptive immune responses that have a pathogenesis role in various autoimmune conditions including IBD. Vitamin D deficiency is known to affect activity levels in patients with IBD. Several studies have shown that there is a role for vitamin D in increasing remission rates in patients with IBD. However, other studies have shown that there is no significant relationship between clinical activity of IBD and vitamin D deficiency. There are no studies in Indonesia that have assessed the relationship between vitamin D levels and clinical activity in IBD.

Aim. To determine the prevalence of vitamin D deficiency in patients with IBD and to assess the difference in mean 25-OH D levels in subjects with clinically active and remission.

Method. This is a cross-sectional study conducted at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Patients with IBD who came to the Gastroenterology Polyclinic and have their 25-OH-D levels checked. Subjects with ulcerative colitis were assessed for clinical activity using the Simple Clinical Colitis Activity Index (SCCAI) instrument where a value <2 was categorized as remission, while subjects with Crohn's disease were assessed for clinical activity using the Crohn's Disease Activity Index (CDAI) instrument with a value <150 categorized as remission. An analysis of the difference in mean 25-OH-D levels between remission versus active subjects was performed both in subjects with ulcerative colitis and Crohn's disease.

Results. A total of 76 subjects met the inclusion and exclusion criteria, 48 subjects had ulcerative colitis and 28 had Crohn's disease. A total of 65,3% of female subjects with the mean age of the subject was 46,39 (SB 16,25). The prevalence of vitamin D deficiency in IBD patients was 46,1% with 32,1% in Crohn's disease and 54,2% in ulcerative colitis. There was no significant median difference between subjects with Crohn's disease in remission (20,7 (12,25 – 32,55) ng/ml) and active (15,7 (12,03 – 28,6) ng/ml) (p = 0,832), as well as subjects with ulcerative colitis in remission (26,05 (19,33 – 30,73) ng/ml) and active (25,05 (14,43 – 33,37) ng/ml) (p = 0,301).

Conclusion. Prevalence of vitamin D deficiency in IBD is 46,1%. There was no significant difference in 25-OH-D levels in patients with active IBD compared with remission."

"Inflammatory bowel disease (IBD) merupakan penyakit kronis saluran cerna dengan siklus eksaserbasi-remisi. Masih terdapat tantangan dalam mempertahankan remisi dan menunda flare pada pasien IBD. Asupan gizi tertentu dapat memodifikasi mediator inflamasi pada saluran gastrointestinal sementara aktivitas fisik dapat mempengaruhi kadar sitokin sehingga keduanya dapat mempengaruhi perjalanan IBD. Penelitian ini bertujuan untuk menganalisis hubungan antara potensi inflamasi diet dan aktivitas fisik dengan aktivitas penyakit IBD.Metode: Penelitian ini menggunakan desain potong lintang pada pasien IBD yang melakukan kontrol di Poliklinik Gastroenterologi Rumah Sakit Cipto Mangunkusumo (RSCM) selama periode Juli–September 2022. Pengambilan data mengenai potensi inflamasi diet berdasarkan skor Dietary Inflammatory Index (DII) dan aktivitas fisik berdasarkan skor International Physical Activity Questionnaire (IPAQ). Derajat aktivitas penyakit IBD diperoleh berdasarkan kuesioner Indeks Harvey-Bradshaw (HBI) untuk Penyakit Crohn (PC) dan Simple Colitis Clinical Activity Index (SCCAI) untuk Kolitis Ulseratif (KU). Analisis statistik dengan menggunakan uji KruskalWallis, Spearman, dan Regresi linear multipel.Hasil: Sebanyak 100 subjek penelitian didapatkan rerata skor DII pada kelompok PC adalah 0,22± 2,20 dengan tren rerata yang meningkat signifikan seiring dengan keparahan PC: -0,13 ± 2,3 (remisi), 0,17 ± 2,51 (ringan), 0,65 ± 2,11 (sedang), 0,68 ± 1,60 (berat); p=0,02. Rerata skor DII pada kelompok KU adalah 0,11 ± 2,45 dan tidak ditemukan perbedaan bermakna antar subgrup keparahan. Rerata skor aktivitas fisik pada kelompok PC dan KU berturut-turut adalah 5097,4 ± 2955,7 dan 6023,7 ± 4869,4. Tidak ditemukan perbedaan bermakna antara tingkat aktivitas fisik dan derajat aktivitas penyakit IBD. Skor DII secara independen dapat mempengaruhi aktivitas penyakit PC dari analisis multivariat (koefisien Î² 0,370; p= 0,006). Kesimpulan: Terdapat hubungan signifikan antara potensi inflamasi diet dengan derajat aktivitas penyakit PC. Tidak terdapat hubungan antara potensi inflamasi diet dengan derajat aktivitas penyakit KU maupun antara aktivitas fisik dengan derajat aktivitas penyakit IBD.

---

Background: inflammatory bowel disease (IBD) is a chronic gastrointestinal disease with exacerbation-remission cycles. There are still challenges in maintaining remission and preventing flares in IBD patients. Intake of certain nutrients can modify inflammatory mediators of the gastrointestinal tract while physical activity may affect cytokine levels, therefore both can influence the course of  IBD. This study aims to analyze the association between inflammatory potential of diet and physical activity with IBD disease activity.

Method: in this cross-sectional study, IBD patients who had regular control at the gastroenterology outpatient clinic of RSCM were recruited during the period of July–September 2022. The data of inflammatory potential of diet obtained through the dietary Inflammatory Index (DII) score and physical activity data obtained through the International Physical Activity Questionnaire (IPAQ) score. The degree of IBD disease activity based on the Harvey-Bradshaw Index (HBI) for Crohn’s Disease (CD) and the Simple Colitis Clinical Activity Index (SCCAI) for Ulcerative Colitis (UC). Statistical analysis using the Kruskal-Wallis test, Spearman test, and Multiple Linear Regression test.

Results: A total of 100 subjects obtained the mean DII score in the CD group was 0.22± 2.20 with an upward trend that increased significantly as CD disease severity progressed: -0.13 ± 2.3 (remission), 0.17 ± 2.51 (mild), 0.65 ± 2.11 (moderate), 0.68 ± 1.60 (severe); p=0,02. The mean DII score in the UC group was 0.11 ± 2.45 and there was no significant difference among severity subgroups. The mean physical activity scores in the CD and UC groups were 5097.4± 2955.7 and 6023.7 ± 4869.4 respectively. There was no significant difference of physical activity among various degrees of IBD severity. DII scores independently influenced CD disease activity based on multivariate analysis (β-coefficient 0.370; p= 0.006).

Conclusion: A significant association between the inflammatory potential of diet and CD disease activity was observed. There was no association between inflammatory potential of diet and UC disease activity, as well as between physical activity and IBD disease activity."

"Latar belakang. Kolestasis terkait sepsis (KTS) masih merupakan permasalahan medis di negara berkembang disebabkan tingginya morbiditas, mortalitas dan lama rawat. Inflamasi usus akibat disfungsi sawar usus diduga berperan dalam KTS sehingga perlu dibuktikan perannya terhadap terjadinya KTS. Inflamasi dan permeabilitas mukosa usus dapat dinilai melalui kadar kalprotektin dan alfa-1 antitripsin (AAT) pada tinja.Tujuan. Untuk mengetahui hubungan antara terjadinya KTS pada sepsis neonatorum dengan inflamasi dan gangguan permeabilitas usus yang dinilai dengan peningkatan kadar kalprotektin dan α-1-antitripsin dalam tinja. Metode. Studi kohort prospektif di ruang rawat inap Perinatologi dan Neonatal Intensive Care Unit Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangunkusumo periode Juni 2012- Oktober 2013. Delapan puluh neonatus diambil secara consecutive sampling dari 271 subjek proven sepsis yang dirawat pada periode studi ini, terbagi menjadi 2 kelompok (KTS dan sepsis tidak kolestasis) masing-masing 40 subjek. Dilakukan pemeriksaan kadar kalprotektin dan AAT tinja.Hasil penelitian. Tidak ditemukan perbedaan antara KTS dan sepsis tidak kolestasis dalam ekskresi kalprotektin tinja [KTS vs. sepsis tidak kolestasis, median (rentang) 104,4 (25 sampai 358,5) vs. 103,5 (5,4 sampai 351) μg/g; p = 0,637] dan alfa-1 antitripsin tinja [median (rentang) 28 (2 sampai 96) vs. 28 (2 sampai 120) mg/dL; p = 0,476). Tidak ditemukan peningkatan bermakna kadar kalprotektin tinja dengan nilai p = 0,63 (IK 95% 0,4 sampai 3,6) dan kadar AAT tinja dengan nilai p=0,152 (IK 95% 0,4 sampai 3,3).Simpulan. Kadar kalprotektin dan alfa-1 antitripsin tinja tidak terbukti dapat memprediksi kejadian KTS pada sepsis neonatorum. Tidak ada bukti proses inflamasi usus yang terjadi pada KTS melalui peningkatan permeabilitas paraselular usus. Perlu dilakukan penelitian lebih lanjut mengenai patogenesis inflamasi usus yang terjadi melalui peningkatan permeabilitas trans-selular dan kerusakan enterosit usus pada KTS.

---

Background. Sepsis-associated cholestasis (SAC) remain a medical problem in developing countries due to high morbidity, mortality and length of hospital. Intestinal inflammation as the causes of intestinal barrier dysfunction are suspected play a role in SAC, so it is necessary to prove its contribution to SAC. Intestinal inflammation and increased permeability were assessed through faecal calprotectin and alpha-1 antitrypsin (AAT) concentrations.Objective. To determine the association between SAC in sepsis neonatorum with intestinal inflammation and permeability were assessed through increased faecal calprotectin and AAT levels.Methods. This was cohort prospective study at Perinatologi and Neonatal Intensive Care Unit Department of Child Health Cipto Mangunkusumo Hospital during June 2012 to October 2013. Eighty neonates were obtained by consecutive sampling, of which 271 proven sepsis hospitalized in this period, devided 2 groups (SAC and non cholestasis sepsis) respectively 40 subjects. Faecal calprotectin and AAT concentrations was measured.Results. There was no significant association between SAC and faecal calprotectin excretion [SAC vs. non cholestasis sepsis, median (range) 104.4 (25 to 358,5) vs. 103.5 (5.4 to 351) μg/g; p = 0.637] and faecal AAT [median (range) 28 (2 to 96) vs. 28 (2 to 120) mg/dL; p = 0.476). Increased faecal calprotectin (CI 95% 0.4 to 3.6; p = 0,63) and AAT (CI 95% 0.4 to 3.3; p=0.152) did not differ significantly between the two groups.Conclusions. Faecal calprotectin and alpha-1 antitrypsin concentrations is not associated with SAC in sepsis neonatorum. There is no evidence of intestinal inflammation causes increased paracellular intestinal permeability in SAC. Further research is needed on the pathogenesis of intestinal inflammation in SAC which may result in increased intestinal permeability by transcellular and enterocyte damage."

"Inflammatory bowel disease (IBD) has begun to emerge in Indonesia. The disease is further classified into two types, ulcerative colitic (UC) and crohn's disease (CD). Diagnosis of IBD is initiated from symptom findings such as diarrhea, abdominal pain, bleeding diarrhea, and weight loss, and supported by physical examination and additional tests. The options for additional examinations of IBD are mainly endoscopy (esophagogastroduodenoscopy, colonoscopy, and also intestinal endoscopy), imaging the techniques and laboratory examinations either from blood or feces. The application of these modalities should be prompted by sufficient clinical suspicion to promote their efficiency as well as prevent underdiagnosis or overdiagnosis. In primary health care settings, patients with IBD are expected to be recognized for therapy or to use appropriate referral system to warrant a proper treatment."

"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.

---

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."

"The term "Inflammatory Bowel Disease" (IBD) is frequently used to denote two diseases, ulcerative colitis (UC) and Crohn's disease (CD). This condition is frequently recorded in the West, and along with development of diagnostic facilities, is beginning to be more commonly found in Indonesia.The etiology of this disease is still unclear, but it is suspected that environmental, geographic, and genetic factors are involved. Cytokines play a great role in the pathogenesis of IBD, where in IBD there is an unbalance of pro-inflammatory cytokines and inhibitor cytokines. In IBD, there is an increase in pro-inflammatory cytokines, such as IL-1, IL-2, IL-6, IL-8, and alpha TNF in the intestinal mucosa. Such increase significantly correlates with the activity of ulcerative colitis through endoscopic examination,At this moment, forms of therapy for IBD associated with cytokines are being developed, such as ways to inhibit cytokine synthesis, cytokine release, cytokine activity and the cytokine signaling pathway in the target cell."