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"Anak sakit kritis terutama sepsis mengalami degradasi protein yang tinggi, yang memperburuk luaran bila masukan nutrisi tidak adekuat. Kiraan jumlah kebutuhan protein yang ada saat ini ternyata dalam praktiknya kurang dari 90 memenuhi target kebutuhan. Di lain sisi, variasi genetik individu juga memengaruhi luaran. Polimorfisme gen TNF?-308 berhubungan dengan luaran yang buruk berbagai penyakit infeksi dan inflamasi, walaupun hasil yang diperoleh berbeda-beda.Penelitian ini bertujuan mengetahui hubungan nutrisi tinggi protein terhadap prognosis pasien sepsis skor PELOD , lama rawat dan lama pemakaian ventilator, serta menganalisis peran pelbagai faktor yang berperan terhadap skor PELOD, termasuk polimorfisme gen TNF?-308.Penelitian ini merupakan uji klinis randomisasi pada 80 anak sepsis di 4 rumah sakit. Intervensi diberikan asam amino parenteral, yaitu Aminosteril infant 6 untuk usia < 1 tahun dan Aminofusin pediatric 5 untuk usia ge; 1 tahun. Kelompok eksperimental diberikan asam amino 4 g/KgBB/hari, sedangkan kelompok kontrol menerima 2 g/KgBB/hari selama tiga hari, kemudian dilakukan pencatatan skor PELOD pada hari ke-1,2 dan 3, lama hari rawat dan lama pemakaian ventilator. Dilakukan pemeriksaan keseimbangan nitrogen selama tiga hari, pemeriksaan kadar prealbumin hari ke-1 dan ke-3, pemeriksaan kadar TNF-? dan IL-10. Pemeriksaan polimorfisme dengan metode PCR polymerase chain reaction ndash; RFLP restriction fragment length polymorphism . Pada kelompok kontrol, diperoleh rerata skor PELOD pada hari ke-1 20,5 10,6 , hari ke-2 19,8 13,8 dan hari ke-3 19,8 15,4 ; median lama rawat 7 hari 3 ndash;19 dan median lama pemakaian ventilator 5 hari 1 ndash;14 . Pada kelompok eksperimental, diperoleh rerata skor PELOD berturut-turut 22,4 10,8 ; 20,5 13,9 ; 18,8 14,5 ; median lama rawat 7 hari 4 ndash;27 dan median lama pemakaian ventilator 4 hari 1 ndash;27 . Tidak ditemukan perbedaan bermakna skor PELOD, lama rawat dan lama pemakaian ventilator antara 2 kelompok. Diperoleh perbedaan bermakna secara statistik pada keseimbangan nitrogen baik hari ke-1,2, dan 3 p = 0,003; p = 0,016; p = 0,046 . Dari 80 subjek, 6 subjek 7,5 dengan polimorfisme gen TNF?-308 G/A atau heterozigot dan tidak ditemukan homozigot.Tidak ditemukan peran usia, jenis kelamin, status gizi, pemberian nutrisi tinggi protein dan polimorfisme gen TNF?-308 terhadap skor PELOD. Kata kunci: polimorfisme gen TNF?-308, protein tinggi, sepsis

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Critically ill children, particularly with sepsis, have high protein degradation which worsens outcome if nutritional intake are inadequate. Currently, the estimated protein requirement is less than 90 target requirement. In addition, individual genetic variation also affects the outcome of these population. Tumor necrosis factor TNF 308 gene polymorphism is associated with poorer outcome of several infectious disease and inflammation, although the results are conflicting.This study aimed to determine the association between high protein nutrition intervention with prognosis of sepsis which is measured by PELOD score, length of stay, and duration of mechanical ventilation use. We also analyze the role of TNF 308 gene polymorphism which contribute to PELOD score.This was a randomized clinical trial in 80 children with sepsis in four hospitals. The interventions were parenteral amino acid, which includes Aminosteril infant 6 for subjects aged below one year and Aminofusin pediatric 5 for subjects aged above one year. Subjects in the experimental group were provided with amino acid 4 g KgBW day while those in the control group were provided with amino acid 2 g KgBW day for three consecutive days. PELOD scores in day 1, 2, 3, length of stay, and duration of mechanical ventilation use, were recorded. Nitrogen balance was measured for three days and prealbumin levels were measured in day 1 and 3. TNF and IL 10 levels were also measured. Polymorphism was measured using polymerase chain reaction PCR ndash restriction fragment length polymorphism RFLP .In the control group, the mean PELOD score on day 1, 2, 3 were 20.5 10.6 , 19.8 13.8 , and 19.8 15.4 , respectively. Median length of stay was 7 3 ndash 19 days and median duration of mechanical ventilation was 5 1 ndash 14 days. In the experimental group, obtained mean PELOD score was 22.4 10.8 20.5 13.9 18.8 14.5 consecutively median length of stay was 7 days 4 ndash 27 and median duration of ventilator use was 4 days 1 ndash 27 . There was no significant difference in PELOD score, length of stay, and duration of mechanical ventilation use between both groups. There was a significant difference in nitrogen balance on day 1, 2, and 3 p 0.003, p 0.016, and p 0.046, respectively . Of the 80 subjects, 6 7.5 subjects with TNF 308 G A gene polymorphism or heterozygotes, and no homozygote was found.Age, gender, nutritional status, provision of high protein nutrients, and TNF 308 gene polymorphism have no significant role in PELOD score. Keywords high protein, sepsis, TNF 308 gene polymorphism."

"Endometriosis merupakan penyakit ginekologi umum yang dipicu terjadinya peradangan kronis yang ditandai dengan produksi beberapa sitokin pro-inflamasi, salah satu yang terbanyak yaitu TNF-α. Di sisi lain, sitokin anti-inflamasi, seperti IL-10, dapat mengakhiri proses inflamasi berlanjut ini. Propolis adalah bahan bioaktif alami produk lebah, sebagai imunomodulator dan efek anti-inflamasi yang dapat menekan proliferasi sel-sel patologis. Penelitian ini bertujuan untuk menentukan pengaruh pemberian propolis terhadap tumor necrosis factor alpha dan interleukin 10. Penelitian ini menggunakan desain uji klinis dengan alokasi acak dan double-blinded. 24 wanita dengan terapi Levonorgestrel (LNG) karena endometriosis secara acak ditugaskan untuk menerima propolis yang mengandung 17,5 mg flavonoid per tetes atau plasebo. Intervensi diberikan dua kali sehari, pada pagi dan malam hari, dengan dosis 1 tetes/10 kg berat badan (kgBB) per kali. Sampel darah dan penilaian gizi diambil pada kunjungan pertama dan 30 hari setelahnya. Hasil penelitian menunjukkan bahwa kadar tumor necrosis factor alpha dan interleukin 10 tidak memiliki perbedaan yang signifikan antara kedua kelompok (p>0,05). Kadar tumor necrosis factor alpha mengalami penurunan yang lebih besar pada kelompok propolis sebesar 4,17 (44,36-50,05) pg/mL dibandingkan dengan kelompok plasebo. Kadar IL-10 menunjukkan peningkatan sebesar 344,94 setelah 30 hari diberikan intervensi. Pemberian flavonoid dalam propolis tidak menghasilkan perubahan yang signifikan dalam kadar Tumor Necrosis Factor Αlpha dan Interleukin 10 selama periode intervensi 30 hari.

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Endometriosis is a common gynecological disease triggered by chronic inflammation characterized by the production of several pro-inflammatory cytokines, one of which is TNF-α. On the other hand, anti-inflammatory cytokines, such as IL-10, can end this ongoing inflammatory process. Propolis are natural bioactive ingredients contained in bee products, as immunomodulators and anti-inflammatory effects that can suppress the proliferation of pathological cells. This study aimed to determine the effect of propolis supplementation on tumor necrosis factor alpha and interleukin 10. This study used clinical trial design with random allocation and double- blinded. 24 women with Levonorgestrel (LNG) therapy due to endometriosis were randomly assigned to receive propolis-contained 17.5 mg of flavonoids per drop or placebo. The intervention given two times a day,in the morning and at night, with a dose of 1 drop /10 kg body weight (kgBW) per time. Blood samples and nutritional assessment were taken at the first time of visit and 30 days thereafter. The results showed that the levels of tumor necrosis factor alpha and interleukin 10 did not differ significantly between the two groups (p>0.05). Tumor necrosis factor alpha levels experienced a greater decrease in the propolis group by 4.17 (44.36-50.05) pg/mL compared to the placebo group. IL-10 levels showed an increase of 344.94 after 30 days of intervention. The administration of propolis supplementation did not result in significant changes in the levels of Tumor Necrosis Factor Αlpha and Interleukin 10 during the 30- day intervention period."

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Carborxymethyl lysine dalam makanan (dCML), CML plasma (pCML), dan tumor necrosis alpha plasma (pTNF-α) mungkin dapat memengaruhi obesitas. Namun database kandungan CML makanan di Indonesia dan penelitian tentang pengaruh asupan CML terhadap obesitas pada wanita Asia belum pernah dilaporkan sebelumnya.

Penelitian ini bertujuan untuk mendapatkan database CML makanan Indonesia dan menilai efek mediator dCML, pCML, dan pTNF-α terhadap lingkar pinggang (WC), rasio lingkar pinggang terhadap tinggi badan (WHtR), dan indeks masa tubuh (IMT).

Penelitian potong lintang dilakukan terhadap 235 wanita sehat berusia 19-50 tahun, yang bertempat tinggal di daerah pesisir pantai dan pegunungan di Sumatra Barat dan Jawa Barat. Database CML dibuat berdasarkan estimasi dari database CML yang telah dipublikasi dan pemeriksaan secara langsung pada makanan yang diambil dari kedua provinsi tersebut, dengan menggunakan metode liquid chromatography-tandem mass spectrometry. Asupan CML, pCML, dan pTNF-α didapatkan berturut-turut dari 2x24 jam recalls, ultra-performance liquid chromatography-tandem mass spectrometry, and enzyme-linked immunosorbent assay. Perbedaan di antara kelompok dianalisis dengan menggunakan Chi-square atau t-test tidak berpasangan, efek mediator dianalisis dengan structural equation modelling, dan untuk perilaku makan dilakukan dengan wawancara mendalam dan observasi.

Terdapat 161 dari 252 jenis makanan dalam database CML yang telah diidentifikasi kandungan CMLnya secara langsung. Kelompok daging dan kacang-kacangan memiliki nilai rerata kandungan CML tertinggi pertama dan kedua. Geometric means ± SD dari dCML, pCML, dan pTNF-α berturut-turut sebesar 1.7±0.8 mgCML/hari, 22.3±7.9 ng/mL, dan 0.68 ± 0.38 IU/mL. Asupan CML berhubungan langsung dan positif terhadap pCML (β= 0.99 [95%CI: 0.53, 1.78]) demikian pula pCML terhadap pTNF-α (β= 0.12 [95%CI: 0.28, 0.49]). Plasma CML dan pTNF-α berhubungan secara langsung dan positif terhadap WC (β= 0.21 [95%CI: 0.08, 0.33] dengan β= 0.23 [95%CI: 0.11, 0.35]) dan juga terhadap WHtR (β= 0.18 [95%CI: 0.06, 0.31] dengan β= 0.23 [95%CI: 0.11, 0.35]). Pada wawancara mendalam didapatkan bahwa kelompok suku Sunda lebih banyak mengosumsi makanan yang diproses seperti ikan peda goreng, ikan asin goreng dan bakso dibandingkan kelompok suku Minangkabau.

Simpulan: Asupan CML, pCML, dan pTNF-α tampaknya lebih berperan sebagai mediator terhadap WC dan WHtR, dibandingkan terhadap BMI. Pembatasan asupan CML diperlukan untuk menurunkan risiko obesitas sentral pada populasi ini.

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Carborxymethyl lysine in foods (dCML), plasma CML (pCML), and plasma tumor necrosis alpha (pTNF-α) may have an influence on obesity. However, there have been no reports on databases of CML content in Indonesian foods and on studies of the influence of CML intake on obesity in Asian women.

This study aims to develop a database of CML content in Minangkabau and Sundanese foods and to evaluate the mediator effects of dCML, pCML, and pTNF-α on waist circumference (WC), waist to height ratio (WHtR), and body mass index (BMI).

A cross-sectional study was conducted in 235 healthy women aged 19-50 years, who resided in coastal and mountainous areas of West Sumatra and West Java. The CML database was developed based on an estimate from published database and direct measurement of foods obtained from these two provinces, using liquid chromatography-tandem mass spectrometry. The dCML, pCML, and pTNF-α concentrations were obtained from 2x24 hour recalls, ultra-performance liquid chromatography-tandem mass spectrometry, and enzyme-linked immunosorbent assay, respectively. Between-group differences were analyzed by chi-square test or unpaired t-test, the mediator effects by structural equation modelling, and eating behavior by in-depth interviews and observations.

There were 161 of 252 food items of which the CML content was determined. The group of meats and the group of legumes had the highest and second highest mean CML content, respectively. The Geometric means ± SD of dCML, pCML, and pTNF-α were 1.7±0.8 mgCML/day, 22.3±7.9 ng/mL, and 0.68 ± 0.38 IU/mL, respectively. There was a direct positive association between dCML and pCML (β= 0.99 [95%CI: 0.53, 1.78]) and between pCML and pTNF-α (β= 0.12 [95%CI: 0.28, 0.49]). Plasma CML and pTNF-α were directly and positively associated with WC (β= 0.21 [95%CI: 0.08, 0.33] and β= 0.23 [95%CI: 0.11, 0.35]) and WHtR (β= 0.18 [95%CI: 0.06, 0.31] and β= 0.23 [95%CI: 0.11, 0.35]). In eating behavior, it was seen that the Sundanese women consumed more CML from processed foods such as fried fermented fish (ikan peda goreng), fried salted fish (ikan asin goreng) and meatballs (bakso) than Minangkabau women.

Conclusion: Dietary CML, pCML, and pTNF-α apparently had a greater role as mediators in the path from ethnicity to WC and WHtR, than in the path from ethnicity to BMI. Limitation of CML intake is necessary to reduce the risk of central obesity in this population

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"Latar belakang: Kolesteatoma merupakan penyakit yang menyebabkan destruksi tulang dan komplikasi yang berbahaya. Tumor Necrosis Factor Alpha (TNF-∝) merupakan sitokin utama yang terlibat dalam proses tersebut. Tujuan: Mengetahui hubungan ekpresi TNF-a dengan destruksi tulang akibat kolesteatoma pada penderita Otitis Media Supuratif Kronis (OMSK) tipe bahaya. Metode: Penelitian ini merupakan penelitian analitik dengan menggunakan cross sectional design. Pemeriksaan imunohistokimia dilakukan untuk menilai ekspresi TNF-∝ pada kolesteatoma. Hasil: Ekspresi TNF-a yang positif/overexpressionlebihbanyakpada kelompok destruksi tulang derajat sedang yaitu sebanyak 57,9%. Terdapat hubungan yang bermakna antara ekspresi TNF-∝ dengan derajat destruksi tulang (p=0,001).Kesimpulan: Terdapat hubungan antara ekspresi TNF-∝ dengan destruksi tulang akibat kolesteatoma pada penderita OMSK tipe bahaya."

"ABSTRAKLatar Belakang: Puasa selama bulan Ramadhan adalah perubahan dalam gaya hidup untuk periode sebulan penuh yang rutin tiap tahunnya. Sejumlah penelitian menunjukkan terjadinya perubahan biokimia tubuh saat berpuasa baik pada pasien diabetes dan juga nondiabetes yang dapat mempengaruhi metabolisme glukosa dan sensitivitas insulin.Tujuan: Menilai pengaruh berpuasa selama Ramadhan terhadap perubahan kontrol glikemia, kadar Fetuin A, dan TNF-α dibandingkan sebelum dan sesudah puasa RamadhanMetode: Penelitian prospektif terhadap dua kelompok (diabetes dan non diabetes). Parameter kontrol glikemik, Fetuin A, dan TNF-α diukur 2-4 minggu sebelum berpuasa Ramadhan, minimal 14 hari puasa Ramadhan dan 4 minggu setelah puasa Ramadhan.Hasil: Puasa Ramadhan menurunkan glukosa darah puasa (GDP) secara signifikan pada kelompok Diabetes (D) (p=0,013) dan pada kelompok Non Diabetes (ND) (p=0,047), sedangkan serum Fetuin A turun tidak signifikan pada kelompok D (p=0,217) dan secara signifikan pada kelompok ND (p=0,009). Dan tidak ada perubahan yang signifikan kadar TNF-α pada kedua kelompok dibandingkan sebelum puasa Ramadhan (p=0,248, p=0,789). Pada 4 minggu setelah puasa Ramadhan,GDP kembali ke nilai yang tidak berbeda dari nilai dasar pada kedua kelompok, sementara Fetuin A secara signifikan lebih rendah pada kelompok diabetes (p=0,039) dan TNF-α lebih rendah secara signifikan pada kelompok ND (p=0,042) dari dari nilai dasar.Kesimpulan: Puasa selama Ramadahan memperbaiki kontrol glikemia pada kedua kelompok. Puasa Ramadhan juga mampu menurunkan nilai Fetuin A pada kedua kelompok, dan TNF-α pada kelompok ND

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ABSTRACTBackground: Fasting during Ramadan is a anually change in lifestyle for the period of a lunar month. Numerous studies have mentioned the biochemical alterations while fasting among both in nondiabetic patients and diabetic patients which can affect glucose metabolism and insulin sensitivity.Objective: to assess the impact of fasting during Ramadan on glycemic control, Fetuin A l, and TNF-a compared to before and after Ramadhan fastingMethods: Prospective Study of diabetic patients (D group) and non-diabetic subjects (ND group). Parameters of glycemic control, Fetuin A, and TNF-a were measured 2-4 weeks before Ramadan fasting, at least 14 days of Ramadan fasting and 4 weeks after Ramadan fasting.Results: Ramadan fasting reduced fasting blood glucose (FBG) significantly in D groups (p=0,013) and in the (ND) groups (p=0,047) , respectively, serum Fetuin A were lowered insignificantly in D groups (p=0,217) dan significantly in ND groups (p=0,009). And no significant differences of TNF-α level ini both group compared to before Ramadhan fasting (p=0,248, p=0,789). At 4 weeks post-Ramadhan fasting FBG returned to levels indistinguishable from their baseline values in both groups, while Fetuin A was maintained significantly lower in D groups (p=0,039) and TNF-α significantly lower in ND groups (p=0,042) from their baseline.Conclusions: Fasting during Ramadan improves glycemic control in both groups, Ramadan fasting was also able to reduce Fetuin A level in both groups, and TNF-α in the ND group."

"ABSTRAK Latar Belakang: Pengaruh metastasis sebagai penyebab peningkatan procalcitonin(PCT) pada pasien tumor padat nonsepsis masih belum jelas. Studi-studisebelumnya memberikan hasil yang tidak konklusif. Nilai titik potong PCT untukdiagnosis sepsis pada tumor padat metastasis juga belum diketahui. Tujuan: Mengetahui peran PCT dalam diagnosis sepsis pada pasien tumor padatdengan metastasis. Metode: Studi potong lintang terhadap pasien tumor padat yang berobat di RSCMSeptember-Desember 2015. Pada pasien ditentukan ada tidaknya sepsismenggunakan kriteria sepsis ACCP/SCCM 2001, dilakukan pemeriksaan darahperifer, serta PCT. Dilakukan analisis untuk mengetahui perbedaan kadar PCTpasien tumor padat metastasis dan tanpa metastasis yang tidak sepsis. Selain itu,dilakukan pula pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasientumor padat metastasis dengan menggunakan ROC. Hasil dan Pembahasan: Didapatkan 112 pasien tumor padat, pria sebanyak 51%,dengan rerata usia 47,9 ±12,47 tahun. Sebanyak 71 (63,4%) pasien sudahdidapatkan metastasis, 36 (32,1%) diantaranya sepsis, dan 6 (5,3%) mengalamiSIRS. Dari 41 (36,6%) pasien tanpa metastasis, 9 (8%) mengalami sepsis, dan 5(4,4%) SIRS. Terdapat perbedaan bermakna kadar PCT pada pasien tumor padatmetastasis dibandingkan tanpa metastasis pada kondisi nonsepsis [0,25 ng/mL(0,07-1,76) vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Pasien tumor padat metastasisyang mengalami sepsis memiliki kadar PCT lebih tinggi dibandingkan nonsepsis[3,5 ng/mL (0,66-189,4) vs. 0,25 ng/mL (0,07-1,76); p<0,001]. Dari kurva ROCkadar PCT pada tumor padat metastasis, didapatkan AUC [0,956, IK 0,916-0,996]untuk mendiagnosis sepsis. Nilai titik potong PCT untuk diagnosis sepsis padapasien tumor padat metastasis adalah 1,14 ng/mL dengan sensitivitas 86% danspesifisitas 88%. Kesimpulan: Pada kondisi nonsepsis, kadar PCT pasien tumor padat metastasislebih tinggi dibandingkan pasien tanpa metastasis. Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis adalah 1,14 ng/mL. ABSTRACT Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)in patients with solid tumors without sepsis remains unclear. Previous studies didnot provide conclusive results. Cut off point of PCT for sepsis diagnosis inmetastatic solid tumors is also unknown. Objective: To determine the role of PCT in the diagnosis of sepsis towardmetastatic solid tumors patients. Methods: A cross sectional study was conducted in solid tumor patients who wereadmitted to Cipto Mangunkusumo, Jakarta between September 2015 and December2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS inpatients. Procalcitonin level, as well as routine blood examination, was performedto determine the differences of PCT level among solid tumor patients with andwithout metastasis. Cut off point of PCT for diagnosing sepsis in patients withmetastatic solid tumors was determined using ROC curve. Results and Discussion: There were 112 patients with solid tumors, 51% male,with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. Inthe absence of sepsis, the PCT level was significantly higher in patients withmetastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsishad PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsisin metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCTfor sepsis in patients with metastatic solid tumors was 1.14 ng / mL with asensitivity of 86% and specificity of 88%. Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solidtumors is higher than patients without metastasis. Cut off point of PCT for sepsisdiagnosis in metastatic solid tumors was 1,14 ng / mL. "

"Pendahuluan: Saat ini, dunia secara global termasuk Indonesia tengah mengalami tren pesat peningkatan populasi lansia. Hal ini dapat menjadi tantangan kesehatan besar karena penuaan meningkatkan kerentanan terjadinya penyakit degeneratif. Sayangnya, agen antipenuaan seperti suplemen vitamin masih sulit terjangkau secara biaya atau diperoleh secara luas. Centella asiatica L. (CA) adalah tanaman herbal tradisional yang dilaporkan memiliki efek antiinflamasi dan antioksidan poten dalam banyak studi. Namun, studi yang meneliti efek CA dalam konteks penuaan masih sangat terbatas. Tujuan: Studi ini meneliti efek pemberian ekstrak etanol CA terhadap kadar TNF-α pada jantung dan ginjal tikus Sprague-Dawley tua Metode: Tikus Sprague Dawley jantan usia 8-12 minggu dan 20-24 bulan dibagi menjadi empat kelompok uji: kontrol positif (vitamin E 6 IU), kontrol negatif (air ad libitum), CA 300 (CA 300 mg/kgBB), dan kontrol muda (tikus usia 8-12 minggu dengan air ad libitum). Setelah 28 hari perlakuan, tikus diterminasi. Organ jantung dan ginjal setiap tikus diambil dan melewati pengukuran kadar TNF-α dengan metode enzyme-linked immunosorbent assay (ELISA). Hasil: Pada kelompok CA 300, terdapat penurunan kadar TNF-α jantung secara signifikan (p = 0,023) disertai penurunan kadar TNF-α ginjal secara tidak signifikan (p = 0,574). Namun, kadar TNF-α ginjal pada kelompok yang diberikan CA tetap paling rendah dibandingkan kelompok lainnya. Kesimpulan: Pemberian ekstrak etanol CA menurunkan kadar TNF- α jantung secara signifikan pada tikus Sprague-Dawley tua namun tidak berpengaruh terhadap kadar TNF-α ginjal. Diperlukan penelitian lebih lanjut untuk menyelidiki efek CA sebagai agen antipenuaan.

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Introduction: Currently, the world including Indonesia are experiencing a trend of rapid growth in aging population. This poses a major challenge to healthcare due to increasing incidence of degenerative diseases. In spite of this, preventive antiaging agents such as vitamin supplements are not widely available nor affordable. Centella asiatica L. (CA), a traditional herbal plant native to Southeast Asia, has been widely studied and demonstrated potent anti-inflammatory and antioxidant effects in clinical studies. However, studies examining effects of CA in aging population are very limited. Objective: This study investigates effects of CA treatment on aged Sprague-Dawley rats. Methods: Male Sprague-Dawley rats aged 8-12 weeks and 20-24 months were split into four experimental groups: positive control (vitamin E 6 IU), negative control (water ad libitum), CA 300 (CA 300 mg/kgBW), and young control (young rats given water ad libitum). After 28 days of treatment, the rats underwent termination with kidneys and hearts harvested. TNF-α concentration were determined using enzyme-linked immunosorbent assay (ELISA) method. Results: In the CA 300 group, there was a significant decrease in heart TNF-α levels (p = 0,023) accompanied by an insignificant decrease in kidney TNF-α levels (p = 0,574). However, renal TNF-α levels in the group given with CA is still the lowest among all groups. Conclusion: The administration of CA ethanolic extract on aged Sprague-Dawley rats significantly reduced heart TNF-α level and had no effect on the kidney TNF-α level. Further research and exploration needs to be made to investigate the effects of CA as an antiaging agent"

"Latar Belakang : Terjadinya peningkatan biomarker inflamasi akibat penyelaman dekompresi merupakan salah satu faktor yang dapat menyebabkan terjadinya penyakit dekompresi, hal ini telah dibuktikan dengan terjadinya peningkatan ekspresi TNF? akibat penyelaman dekompresi tunggal. Pencegahan peningkatan biomarker inflamasi dapat dilakukan dengan memberikan perlakuan sebelum penyelaman dekompresi, sesuai dengan preconditioning theory, yang salah satunya adalah pemberian latihan fisik sebelum penyelaman yang dapat mengurangi ukuran dan jumlah gas bubble akibat penyelaman. Pengaruh latihan fisik sebelum penyelaman terhadap kadar biomarker inflamasi TNF? sesudah penyelaman belum pernah diteliti. Penelitian ini bertujuan untuk membuktikan bahwa latihan fisik sebelum penyelaman dekompresi dapat mencegah terjadinya peningkatan kadar biomarker inflamasi TNF?. Metode : Penelitian ini menggunakan desain studi eksperimental murni dengan seluruh subjek penelitian adalah penyelam laki-laki terlatih, terbagi secara random kedalam dua kelompok, yaitu perlakuan dan kontrol, di mana kelompok perlakuan mendapatkan latihan fisik submaksimal dengan intensitas 70 frekuensi jantung maksimal menggunakan cycle ergometer dengan 60 kayuhan permenit, 24 jam sebelum penyelaman dekompresi 280 kPa bottom time 80 menit, pada kelompok kontrol tidak diberikan latihan fisik submaksimal. Ekspresi biomarker diperiksa sebanyak tiga kali, awal penelitian, sebelum penyelaman dan sesudah penyelaman. Hasil : Pada kelompok perlakuan tidak terjadi peningkatan, bahkan terjadi penurunan eskpresi TNF? yang tidak bermakna, dari 7.06 1.85 pg/ml menjadi 6,75 1,81 pg/ml, sedangkan kelompok kontrol mengalami peningkatan ekspresi TNF? yang bermakna, dari 8,22 1,45-13,11 pg/ml menjadi 8,39 1,73-12,18 pg/ml, dan terdapat perbedaan selisih rerata yang signifikan antara kelompok yang mendapatkan latihan fisik sebelum penyelaman dan kelompok yang tidak mendapatkan latihan fisik sebelum penyelaman dengan perbedaan rerata -024 -2.74 - 1.67 pg/ml dan 0.45 -0.94 ndash; 0.95 pg/ml. Kesimpulan dan Saran : Latihan fisik submaksimal akut dapat mencegah terjadinya peningkatan kadar TNF? akibat penyelaman dekompresi tunggal.

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Background : The increase of Inflammatory biomarkers due to decompression dive is one of the factors that could cause decompression sickness, which has been proven by the increased expression of TNF due to a single decompression dive. According to the preconditioning theory, physical exercise before the dive, can reduce the size and the amount of gas bubble caused by the dive, but no research has been done on the influence of physical exercise before diving to the expression of inflammatory biomarkers like TNF. This study aims to prove that physical exercise before diving can prevent increase of the inflammatory biomarker TNF.

Methods : This study used an experimental study design with trained male divers as a subjects, who are divided randomly into two groups, treatment and control. The treatment group got submaximal physical exercise with 70 maximal cardia rate intensity, using cycle ergometer 24 hours before decompression diving 280 kPa bottom time 80 minute, whereas the control group did not get physical exercise. Biomarker expression was checked three times, at beginning of the study, before the dive and after the dive.

Results : In the treatment group there was no increase in TNF expression, and even showed an insignificant decrease, from 7.06 1.85 pg ml to 6.75 1.81 pg ml, whereas the control group showed a significant increased TNF concentration, from 8.22 1.45 to 13.11 pg ml to 8.39 1.73 to 12.18 pg ml, and significant difference was found between the mean difference of treatment and control groups from 0.24 2.74 ndash 1.67 pg ml and 0.45 0.94 ndash 0.95 pg ml.

Conclusions and Recommendations : It can be concluded that acute submaximal physical exercise prevent an increase in the expression of TNF after single dive decompression. "

"Latar Belakang: Produksi TNF-α yang berlebihan pada mukosa kolon menyebabkan gangguan homeostasis sehingga timbul reaksi peradangan kronik. Inflammatory Bowel Diseases (IBD) merupakan kondisi klinis akibat reaksi peradangan kronik. Angka kejadian kedua penyakit tersebut sangat tinggi baik secara global. Belum ada obat yang efektif menginduksi serta mempertahankan remisi IBD dengan efek samping minimal. Penelitian ini bertujuan untuk mengetahui apakah pengemasan ekstrak daun mahkota dewa dalam nanopartikel kitosan mampu menekan ekspresi TNF-α.Metode: Penelitian ini menggunakan 30 sampel jaringan kolon tersimpan dari penelitian sebelumnya yang diwarnai dengan pewarnaan imunohistokimia (IHK). Mencit dibagi dalam 6 kelompok perlakuan yaitu kelompok normal yang tidak diberikan perlakuan (N), Kelompok kontrol negatif yang hanya diberikan larutan DSS 2% b/v, ada dua Kelompok yang diberikan larutan DSS 2% b/v diikuti dengan pemberian ekstrak daun mahkota dewa dengan dosis masing-masing 25 dan 12,5 mg dalam air minumnya (EMD 25 dan EMD 12,5 mg), dan dua kelompok yang diberikan larutan DSS 2% b/v diikuti dengan pemberian ekstrak daun mahkota dewa yang terenkapsulasi dalam nanopartikel kitosan dengan dosis masing-masing 12,5 dan 6,25 mg (NPMD 12,5 dan NPMD 6,25 mg).Hasil: Indeks ekspresi TNF-α kelompok NPMD 12,5 mg dan NPMD 6,25 mg menunjukan penurunan signifikan terhadap kelompok kontrol (p<0,05), Sedangkan kelompok EMD 25 mg dan EMD 12,5 mg tidak signifikan (p>0,05) dibandingkan kelompok kontrol.Kesimpulan: Ekstrak daun mahkota dewa yang dikemas dalam nanopartikel kitosan dengan dosis 12,5 mg dan 6,25 mg dapat menekan ekspresi TNF-α pada jaringan kolon mencit yang diinduksi dengan Dextran Sodium Sulfat.

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Background: Excessive TNF-α production in colon mucosa is known to cause homeostasis disturbance, which then lead to chronic inflammation reaction. Inflammatory Bowel Diseases (IBD) is a clinical condition caused by the chronic inflammation reaction. The diseases incidence is high globally. To date, effective drug that maintain IBD remission with mild adverse effect has yet to be found. This study aims to determine whether encapsulation of mahkota dewa leaf extract in chitosan nanoparticles can suppress TNF-α expression.Methods: This study involves 30 samples colon tissue mice from previous study that has been stained using immunohistochemistry (IHC). Included mice were divided into 6 intervention groups: a group without intervention (N); a negative control group which were only given DSS 2% b/v; two groups which were given DSS 2% b/v followed by mahkota dewa leaves extract administration, with dosages of 25 and 12.5 mg (EMD 25 and 12,5mg), and two groups which were given DSS 2% b/v followed by chitosan nanoparticle-encapsulated mahkota dewa leaves extract with dosages of 12.5 and 6.25mg (NPMD 12,5 and 6,25mg).Results: TNF-α expression index of groups treated with NPMD 12.5 mg and NPMD 6.25 mg shows significant reduction (p<0.05), while the reduction in groups treated with EMD 25 mg and EMD 12.5 mg is not significant (p>0.05), both compared to control group.Conclusion: Mahkota dewa extract loaded in chitosan nanoparticles with dosage 12,5 mg and 6,25 mg can suppress TNF-α expression on colon tissue of Dextran Sodium Sulfate-Induced mice."