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"ABSTRAKPenyakit ginjal kronik (PGK) telah menjadi penyakit epidemik global dan prevalensinya di Indonesia terus meningkat. Hemodialisis (HD) merupakan terapi pengganti ginjal yang paling sering dilakukan pada pasien PGK stadium akhir. Pasien PGK yang menjalani HD rutin rentan mengalami protein energy wasting (PEW) sehingga memengaruhi status gizi. Lingkar otot lengan atas (LOLA) merupakan indeks yang dapat menggambarkan total protein tubuh dan massa otot. Terapi medik gizi komprehensif diperlukan untuk menghindarkan pasien dari PEW dan memperbaiki kualitas hidup pasien. Pemantauan terhadap empat pasien berusia 32-61 tahun dengan proporsi jenis kelamin sama, didiagnosis PGK stadium akhir dan menjalani HD rutin. Berdasarkan kriteria The American Society for Parenteral and Enteral Nutrition seluruh pasien mengalami malnutrisi. Dua pasien telah menderita PEW, dua lainnya berisiko PEW. Terapi medik gizi diberikan sesuai dengan keadaan klinis pasien dengan target protein yaitu 1,1-1,4 g/kgBB/hari. Asupan energi dan protein pada dua pasien telah lebih dari 35 kkal/kgBB/hari dan 1,2 kkal/kgBB/hari sejak awal, sedangkan dua pasien lainnya rendah pada awal pengkajian namun mengalami peningkatan di akhir pemantauan. Seluruh pasien memiliki nilai LOLA yang rendah dan diduga mengalami deplesi otot, namun dua pasien mengalami peningkatan LOLA di akhir pemantauan.

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ABSTRACTChronic kidney disease has become a global epidemic disease and the prevalence is increasing in Indonesia. Hemodialysis (HD) is the most common treatment for end stage renal disease (ESRD) patients. Patients who undergoing HD routinely are vulnerable to increase protein energy wasting (PEW) so nutritional status must be monitored closely. Mid upper arm muscle circumference (MUAMC) can be use to show total body protein and muscle mass. Medical nutrition therapy is needed to prevent patients from PEW and improve the quality of life. Four patients age range 32-61 years and same sex ratio, diagnosed with ESRD undergoing HD. Based on The American Society for Parenteral and Enteral Nutrition s criteria all patients were malnutrition. Two patients experienced PEW and the other had risk of PEW. Medical nutritional therapy is given according to clinical condition of each patient with target protein from 1.1-1.4 g/kgBW/day. Energy and protein intake in two patients was more than 35 kcal/kgBW/day and 1.2 kcal/kgBW/day at first assessment. Unfortunately the others patient intake were low at the first assessment but incresed at the end of monitoring. All patients had low MUAMC scores which indicate muscle depletion. Two patients had increased MUAMC at the end of monitoring."

"Proses inflamasi pada kanker kepala dan leher menyebabkan peningkatan sitokin proinflamasi dan sintesis protein fase akut c-reactive protein, CRP yang kemudian menyebabkan perubahan metabolisme dan anoreksia pada penderitanya. Seng merupakan zat gizi yang memiliki peran penting dalam menekan inflamasi, namun dilaporkan sekitar 65 pasien kanker kepala dan leher mengalami kekurangan seng. Penelitian potong lintang ini bertujuan mengetahui korelasi antara asupan seng dan kadar seng serum dengan kadar c-reactive protein CRP sebagai upaya menekan inflamasi sehingga dapat mengurangi morbiditas dan mortalitas pasien kanker kepala leher. Dari 49 subyek yang dikumpulkan secara konsekutif di Poliklinik Onkologi RS Kanker Dharmais, 67,3 adalah laki-laki, rentang usia subyek 46 ndash;65 tahun. Frekuensi terbanyak 65,3 adalah kanker nasofaring dan 69,4 berada pada stadium IV. Seratus persen subyek memiliki asupan seng dibawah nilai angka kecukupan gizi. Rerata kadar seng serum subyek adalah 9,83 2,62 mol/L. Sebanyak 51 subyek memiliki kadar CRP yang meningkat. Terdapat korelasi negatif yang lemah antara kadar seng dengan kadar CRP subyek r =-0,292, p =0,042, namun tidak terdapat korelasi antara asupan seng dengan kadar CRP subyek p =0,86.

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The inflammatory process of head and neck cancer leads to increase the proinflammatory cytokines and the synthesis of c reactive protein CRP , which then causes metabolic alteration and anorexia in the patients. Zinc is one of nutrient that has an important role in suppressing inflammation. It is reported that about 65 of head and neck cancer patients have zinc deficiency. The aim of this cross sectional study is to determine the correlation between zinc intake and serum zinc levels with CRP level as an effort to reduce inflammation to reduce the morbidity and mortality of head and neck cancer patients. Subjects were collected by consecutive sampling in the Oncology Polyclinic Dharmais Cancer Hospital, from 49 subjects 67,3 were men, most subjects were in the age range between 46 ndash 65 years. The highest frequency 65,3 is nasopharyngeal cancer and 69,4 are already in stage IV. All subjects in this study have a zinc intake below the recommended dietary allowance RDA in Indonesia. The mean serum zinc level of the subjects was 9.83 2.62 mol L. Most subjects have elevated CRP levels. There was a weak significant negative correlation between zinc concentration and CRP levels of subjects r 0.292, p 0.042, but there was no correlation between zinc intake and CRP levels of subjects p 0.86. "