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"Obstructive: jaundice represents the most common complication of biliary tract Malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients. The present study was designed to determine levels of tumor necrosis factor alpha (TNF-alfa) and interleukin 6 (IL-6) in preprocedure of either endoscopic retrograde cholangio pancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Method: The study method was before-and-after case study design with consecutive sampling. Blood was collected five days prior to either endoscopic retrograde cholangio pancreatography (ERCP) procedure or percutaneus transhepatic biliary drainage (PTBD) procedure and five days after either of them. Enzyme linked immunosorbed assay (ELISA) was used to determine TNF-alfa and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The age was 55.3 (SD 13.7) years old. According to the results of imaging and endoscopy procedure, twenty-two people were diagnosed cholangicarcinoma, ten people were diagnosed ampulla vateri and eigth people were diagnosed pancreatic tumor. In preprocedure, the TNF-alfa concentration was 4.81 (SD 2.91) pg/mL, the IL-6 concentration was 7.79 (SD 1.57) pg/mL and the bilirubin concentration was 15.5 (SD 6,9) mg%. In postprocedure, the TNF-alfa concentration was 8.05 (SD 6.7) pg/mL, there was a significant increase in TNF-alfa concentration (p = 0.02). However, IL-6 concentration was 7.75 (SD 1.76) pg/mL, there was not any significant chance in IL-6 concentration (p = 0.52). The bilirubin concentration was 11.3 (SD 6,5) mg%.Conclusion: There was a significant increase in mean concentration value of TNF-alfa after biliary drainage procedure. On the other hand there was not any significant decrease in the mean concentration value of IL-6 after biliary drainage procedure"

"Latar Belakang: Ikterus obstruktif merupakan salah satu komplikasi tersering keganasan sistem bilier. Keadaan ini akan memicu pelepasan sitokin proinflamasi. Terdapat kontroversi mengenai pengaruh drainase bilier terhadap perubahan kadar sitokin proinflamasi pada penderita kanker pankreatobilier.Tujuan: Untuk mengetahui kadar Tumor Necrosis Faktor alfa (TNF-alfa) dan Interleukin 6 (IL6) sebelum dan sesudah Endoscopic Retrograde Cholangio Pancreatography (ERCP) atau Percutaneus Transhepatic Biliary Drainage (PTBD) pada penderita ikterus obstruksi etiologi kanker pankreatobilier.Metode: Desain penelitian adalah one group before after study. Pemilihan sampel secara consecutive sampling. Sampel darah diambil sebelum dan lima hari sesudah ERCP atau PTBD. Pengukuran kadar TNF-alfa dan IL-6 dengan cara Enzyme Linked Immunosorbed Assay (ELISA).Hasil: Terdapat 40 orang responden yang diikutsertakan dalam penelitian ini, 22 laki laki dan 18 perempuan dengan usia rata rata 55,3 tahun. Berdasarkan imaging dan endoskopi, ditegakkan diagnosis kolangiokarsinoma sebanyak 22 orang, tumor ampula Vateri 10 orang, dan tumor pankreas 8 orang. Kadar rata-rata TNF- alfa sebelum tindakan 4,81 (2,91) pg/ml dan sesudah tindakan 8,05 (6,7) pg/ml, terdapat peningkatan yang bermakna setelah tindakan drainase bilier (p:0,02). Kadar rata-rata IL-6 sebelum tindakan 7,79 (1,57) pg/ml dan sesudah tindakan 7,75 (1,76) pg/ml, tidak terdapat perbedaan yang bermakna setelah tindakan drainase bilier (p:0.52). Kadar rata-rata bilirubin sebelum tindakan 15,5 mg% dan sesudah tindakan 11,3 mg%.Simpulan: Terjadi peningkatan kadar rata-rata TNF-alfa secara bermakna setelah drainase. Tidak ada penurunan yang bermakna kadar rata-rata IL-6.

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Background: Obstructive jaundice represents the most common complication of biliary tract malignancy. Obstructive jaundice causes releases of proinflammatory cytokine. There has been controversy about effect of biliary drainage on the change in proinflammatory cytokine level in pancreatobiliary cancer patients.Objective: The present study was designed to determine levels of Tumor Necrosis Factor Alpha (TNF-Alpha) and Interleukin 6 (IL-6) in preprocedure of either Endoscopic Retrograde Cholangio Pancreatography (ERCP) or Percutaneus Transhepatic Biliary Drainage (PTBD) and postprocedure of them in obstructive jaundice patient caused by pancreatobiliary cancer.Methods : The study method is before- and- after case study design with consecutive sampling. Blood was collected five days prior to either Endoscopic Retrograde Cholangio Pancreatography (ERCP) procedure or Percutaneus Transhepatic Biliary Drainage (PTBD) procedure and five days after either of them. Enzyme Linked Immunosorbed Assay (ELISA) was used to determine TNF-Alpha and IL-6.Results: Forty subjects were included in this study which consisted of 22 men and 18 women. The mean age was 55.3 years old. According to the results of imaging and endoscopy procedure, twenty two (22) people were diagnosed cholangi carcinoma, ten (10) people were diagnosed ampulla varteri and eigth (8) people were diagnosed pancreatic tumor. In preprocedure, the mean of TNF-Alpha concentration was 4.81 (2.91) pg/mL, the mean of IL-6 concentration was 7.79 (1.57) pg/mL and the mean of bilirubin concentration was 15.5 mg%. In postprocedure, the mean of TNF-Alpha concentration was 8.05 (6.7) pg/mL, there was significant increase in TNF-Alpha concentration (p:0.02). However, the mean of IL-6 concentration was 7.75 (1.76) pg/mL, there was not any significant chance in IL-6 concentration (p:0.52). The mean of bilirubin concentration was 11.3 mg%.Conclusions: On one hand, there was significant increase in mean concentration value of TNF-Alpha after biliary drainage procedure. On the other hand there was not any significant decrease in mean concentration value of IL-6 after biliary drainage procedure."

"Meningkatnya penggunaan narkoba (narkotika, psikotropika dan berbahaya lainnya) di dunia, berdampak pada penyalahgunaan Methamphetamin (METH) khususnya di Indonesia. Efek METH dapat menginduksi neurotoksik, dimana terjadi kerusakan pada saraf terminal dopaminergik, serotonergik, apoptosis neuron, astroglia dan aktivasi mikroglia yang mengarah pada respon peradangan saraf di dalam otak. Studi menunjukkan efek NAC yang signifikan dalam memperbaiki TNF-α dan IL-6 pada fase infeksi akut atau kronis memotivasi pelaksanaan penelitian untuk mengevaluasi perubahan kadar IL-6 dan TNF-α pada pasien ketergantungan METH yang mengalami withdrawal pada kelompok yang mendapatkan terapi N- asetilsistein.Penelitian ini menggunakan bahan biologis tersimpan (serum), untuk mengetahui kadar IL-6 dan kadar TNF-α sebagai indikator neuroinflamasi pada pasien dengan ketergantungan METH yang mendapatkan terapi NAC (n=30) atau Placebo (n=30) selama 30 hari (cross-sectional). Penelitian dilakukan di Laboratorium Farmakologi Kinetik FKUI Salemba, Jakarta Pusat dan waktu penelitian pada bulan Agustus 2022 sampai bulan November 2022 dengan menggunakan metode ELISA. Hasil penelitian didapatkan 15 sampel yang terukur dan hanya 7 sampel yang dapat dianalisis (NAC-Placebo, Pre-Post Intervensi). Hasil mean TNF-α (Pre NAC) = 78.403 (pg/ml) ± 108,02, dan mean TNF-α (Post NAC) = 55,3176 (pg/ml) ± 75,15. Hasil IL-6 didapatkan pre NAC= 13,52 pg/ml, dan post NAC= 7,57 pg/ml. Kesimpulan penelitian adalah kadar IL-6 pada kelompok yang mendapatkan NAC mengalami penurunan dan kadar TNF-α pada kelompok yang mendapat NAC mengalami penurunan. Saran untuk penelitian selanjutnya diperlukan sampel baru dengan subyek yang lebih banyak dengan parameter inflamasi lainnya, dan kit-reader yang sensitif untuk mendapatkan efek potensial anti-inflamasi NAC pada subyek ketergantungan METH.

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The increasing use of drugs (narcotics, psychotropics and other dangerous drugs) in the world has had an impact on the abuse of Methamphetamine (METH), especially in Indonesia. The effects of METH can induce neurotoxicity, where there is damage to dopaminergic, serotonergic nerve terminals, neuronal apoptosis, astroglia and activation of microglia which leads to a neuroinflammatory response in the brain. The study shows the significant effect of NAC in improving TNF-α and IL-6 in the acute or chronic phase of infection motivating the implementation of research to evaluate changes in IL-6 and TNF-α levels in METH-dependent patients experiencing withdrawal in the group receiving N-acetylcysteine ​​therapy .

This study used stored biological material (serum), to determine IL-6 levels and TNF-α levels as indicators of neuroinflammation in patients with METH dependence who received NAC therapy (n=30) or Placebo (n=30) for 30 days (cross -sectional). The research was conducted at the Kinetic Pharmacology Laboratory, FKUI Salemba, Central Jakarta and the research period was from August 2022 to November 2022 using the ELISA method.

The research results showed that 15 samples were measurable and only 7 samples could be analyzed (NAC-Placebo, Pre-Post Intervention). Results mean TNF-α (Pre NAC) = 78.403 (pg/ml) ± 108.02, and mean TNF-α (Post NAC) = 55.3176 (pg/ml) ± 75.15. IL-6 results showed that pre NAC= 13.52 pg/ml, and post NAC= 7.57 pg/ml. The conclusion of the study was that IL-6 levels in the group that received NAC decreased and TNF-α levels in the group that received NAC decreased. Suggestions for further research require new samples with more subjects with other inflammatory parameters, and sensitive kit-readers to obtain the potential anti-inflammatory effect of NAC in METH-dependent subjects."

"We reported here a rare case of a 62 year old male patient with obstructive jaundice due to bile duct tumor. The main clinical features were yellowish eye and skin, followed by pruritus and clay-colored stool. Ultrasonography showed common bile duct dilatation and without evidence of stones. Computed Tomography Scan of upper abdomen showed a mass which were thought of head of pancreas origin. Endoscopic Retrograde Cholangio Pancreatograph revealed tight narrowing of the distal bile duct to a malignant tumor. A stent was inserted to allow biliary drainage, A surgical plan for billio digestive anastomosis was rejected by the patient and family."

"Pembedahan masih menjadi standar emas terapi kuratif untuk obstruksi saluran empedu maligna, namun hanya 10-20% kasus yang dianggap dapat dioperasi. Oleh karena itu, terapi paliatif untuk menghilangkan rasa sakit, kolestasis, dan obstruksi saluran empedu, merupakan pengobatan utama bagi sebagian besar pasien. Perkembangan drainase bilier transhepatik perkutan dan drainase bilier endoskopi telah menghasilkan pengobatan invasif minimal untuk obstruksi bilier ganas, yang memiliki morbiditas dan mortalitas lebih rendah dibandingkan drainase bedah. Pilihan teknik drainase tergantung pada jenis tumor, lokasi obstruksi, serta ketersediaan tenaga ahli dan instrumentasi.

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Surgery is still the golden standard of curative therapy for malignant biliary obstruction, but only 10-20% of cases considered resectable. Therefore, palliative therapy to relieve pain, cholestasis, and biliary obstruction, is the main treatment for most patients. The development of percutaneous transhepatic biliary drainage and endoscopic biliary drainage had brought about minimally invasive treatment for malignant biliary obstruction, which had lower morbidity and mortality than surgical drainage. The choice of drainage technique depends on type of tumor , site of obstruction, also the available expert and instrumentation."

"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."

"Latar Belakang: Periodontitis merupakan penyakit keradangan kronis yang ditandai dengan adanya kerusakan jaringan periodontal. Seiring bertambahnya usia, terdapat perubahan respon inflamasi tubuh, yaitu meningkatnya aktivitas mediator proinflamasi. Salah satu penyakit kronis yang paling sering ditemui pada lansia adalah diabetes melitus (DM). Diabetes melitus memiliki hubungan dua arah dengan penyakit periodontal. Salah satu yang berperan dalam proses proinflamasi ini adalah tumor necrosis factor alpha (TNF-α). Tujuan: Untuk memperoleh perbedaan kadar TNF-α dan parameter klinis pada pasien periodontitis lanjut usia antara DM dan non-DM. Metode: Subjek terdiri dari 49 pasien periodontitis usia lanjut dengan DM dan non-DM. Data klinis (kedalaman poket, indeks pendarahan, kehilangan perlekatan klinis, dan OHI) dicatat dan sampel cairan krevikular gingiva serta sampel darah diambil. ELISA kit digunakan untuk menganalisa kadar TNF-α. Hasil: Terdapat perbedaan signifikan pada kedalaman poket, OHI, dan kadar TNF-α antara pasien periodontitis lanjut usia dengan DM dan non-DM (p ≥ 0.05). Kesimpulan: Pasien DM memiliki kadar TNF-α lebih tinggi secara signifikan dibandingkan non-DM, sehingga penggunaan TNF-α sebagai biomarker memiliki potensial besar.

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ackground: Periodontitis is a chronic inflammatory disease characterized by periodontal tissue damage. As we get older, there are changes in how our bodies response to inflammation, such as increase in activity of proinflammatory mediator. One of the most common chronic diseases found in the elderly is diabetes mellitus. Diabetes mellitus has a two-way relationship with periodontal disease. One of those involved in the proinflammatory process is tumor necrosis factor alpha (TNF-α). Objective: To obtain differences in TNF-α levels and clinical parameters in elderly periodontitis patients between diabetes mellitus and without diabetes mellitus. Methods: The subjects consisted of 49 elderly periodontitis patients with diabetes and without diabetes. Clinical data (bleeding index, clinical attachment loss, and OHI) were recorded and gingival crevicular fluid samples and blood samples were taken. ELISA kit was used to analyze TNF-α levels. Results: Significant differences in pocket depth, OHI, and TNF-α levels between elderly periodontitis patients with diabetes and without diabetes (p ≥ 0.05). Conclusion: Diabetic patients have higher TNF-α levels compared to non-diabetics, so using TNF-α as a biomarker has great potential, but further studies are needed with more samples.

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"Tujuan: mendapatkan kesintasan dan faktor-faktor yang berhubungan dengan mortalitas pada pasien ikterus obstruktif dengan etiologi maligna. Metode: penelitian kohort retrospektif dan prospektif dilakukan dengan data sekunder pasien ikterus obstruktif yang dirawat di RS. Cipto Mangunkusumo, Jakarta antara Januari 2010-Desember 2013. Faktor-faktor yang dinilai meliputi umur, jenis kelamin, sepsis, hipoalbumin, tingkat bilirubin serum, tingkat CA 19-9 serum, drainase bilier, keganasan non ca ampula Vater, dan komorbid dengan hasil keluaran berupa mortalitas pasien.Hasil: sebanyak 181 dari 402 pasien ikterus obstruktif dengan etiologi maligna memenuhi kriteria penelitian dengan proporsi laki-laki sebesar 58,6 % dengan pasien berumur ≥50 tahun sebesar 57,5%. Analisis multivariat menunjukkan bahwa sepsis, riwayat drainase bilier sebelumnya dan skor komorbid Charlson ≥4 merupakan prediktor independen terhadap mortalitas. Median kesintasan pasien dengan faktor prognosis bermakna adalah 14 hari sedangkan median kesintasan keseluruhan 26 hari. Ambang skor prognostik terbaik didapatkan pada skor ≥2 dengan sensitivitas 68% dan spesifisitas 75%. AUC pada kurva ROC 0.769.Kesimpulan: kesintasan pasien dengan faktor prognosis sepsis, drainase bilier tidak berhasil/tidak ada, dan skor indeks komorbid Charlson ≥4 lebih pendek dibandingkan kesintasan keseluruhan pasien. Skor prognostik ≥2 termasuk dalam risiko tinggi kematian dan kemampuan prediksi mortalitas dari faktor prognosis bermakna adalah 76.9%.

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Aim: to obtain survival rate and mortality-related factors of malignant obstructive jaundice patients.Methods: all medical records of obstructive jaundice inpatient at Cipto Mangunkusumo Hospital, Jakarta from January 2010 to December 2013 were reviewed retrospectively. The following factors were analyzed in terms of mortality: age, gender, sepsis, hypoalbumin, serum bilirubin level, serum CA 19-9 level, billiary drainage, non-ampulla Vateri carcinoma, and comorbid factors.Results: total 181 out of 402 patients were enrolled in this study with male proportion was 58.6%, and patients aged 50 years or above was 57.5%. Multivariate analysis showed that only sepsis, unsuccessful or no prior biliary drainage and Charlson comorbid score ≥4 were independent predictors of mortality. Patients with significant prognostic factors had median survival 14 days compared with overall median survival 26 days. Score ≥2 identified as the highest prognostic score threshold with sensitivity 68%, specificity 75%, and AUC on ROC curve 0.769.Conclusion: sepsis, unsuccessful or no prior bilirary drainage, and Charlson comorbid score ≥4 are factors significantly associated with shortened survival in malignant obstructive jaundice patients. Prognostic score ≥2 was determined to classify patients into high risk mortality group. Mortality of patients with those significant prognostic factors can be predicted in 76.9%."

"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. "