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"Tujuan : Mengetahui pengaruh pemberian nutrisi enteral tinggi protein pada status protein penderita stroke akutTempat : Ruang rawat IRNA B, bagian Neurologi Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Jakarta.Metodologi : Penelitian adalah suatu uji klinik paralel yang telah disetujui oleh panitia tetap penilai etik penelitian Fakultas Kedokteran Universitas Indonesia. Sebanyak 36 subyek penelitian stroke hemoragik dan iskemik akut yang memenuhi kriteria dibagi dalam dua kelompok secara randomisasi blok. Sebanyak 18 orang kelompok perlakuan mendapat nutrisi enteral tinggi protein (NETP), sedangkan 18 orang kelompok kontrol mendapat makanan cair racikan rumah sakit. Pengukuran berat badan dan tinggi badar dilakukan pada hari 1. Pemeriksaan albumin dan prealbumin serum dilakukan pada hari ke 1 dan Pemeriksaan NUU dan kreatinin urin dari urin tampung 24 jam pada hari 1, dan 7. Imbang nitrogen diperoleh dengan menghitung asupan nitrogen dan NUU 24 jam Uji statistik yang digunakan adalah uji t untuk data yang berdistribusi normal, dan uji Mann Whitney untuk data yang berdistribusi tidak normal. Batas kemaknaan yang digunakan sebesar 5%.Hasil : Pada kelompok perlakuan didapatkan sedikit peningkatan ni1ai prealbumin yang belum bermakna, yaitu 0,161 (0,104-0,303) menjadi 0,163 (0,043 0,276) g/L, sedangkan pada kelompok kontrol didapatkan penurunan yang bermakna yaitu 0,181 (0,093-0,267) menjadi 0,138 (0,066-0,280). Didapatkan penurunan nilai albumin pada kedua kelompok. Penurunan nilai albumin pada kelompok perlakuan lebih sedikit dibandingkan kontrol, masing-masing yaitu - 0,35 dan - 0,60 g/dL.Pemberia NETP dapat menurunkan ekskresi kreatinin urin secara bermakna, yaitu dari 1019 (300-1530) menjadi 791,50 (246-1524) mg/24 jam), tetapi belum memperbaiki NUU dari imbang nitrogenKesimpulan : Pemberian NETP pada pasien stroke akut cenderung dapat meningkatkan status protein, walaupun belum dapat dibuktikan secara statistik.

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Effects High Protein Enteral Nutrition on Protein Status in Acute Stroke PatientsObjective To investigate the effects of high protein enteral nutrition on protein status in acute stroke.

Location: IRNA B, Cipto Mangunkusumo General Hospital, Jakarta

Subjects and Methods : The study was a parallel clinical trial, which was alread} certified by the Ethical Clearance Research Committee of Faculty of Medicine Universit of Indonesia. Thirty six subjects with acute hemorhagic and ischemic stroke wen selected using certain criteria. The subjects were divided into two groups using blocs randomization. Eighteen subjects in treatment group received high protein entera nutrition (HPEN), and the control group received enteral hospital diet. Body weight an( height were assessed on the la day of admission. Albumin and prealbumin were assessed on day 1 and 7. Urinary urea nitrogen (UUN) and urinary creatinine were assessed on da: 1, 4, and 7 using 24-hour urine collection. Nitrogen balance was calculated b: substracting nitrogen intake with urinary urea nitrogen. Statistical analysis was performe+ using t-test for normal distributed and Mann Whitney test for not normal distributed data The level of significance was 5%.

Results : In the treatment group, there was a slingtly increased in prealbumin level, bi: not yet significantly : 0,161 (0,104-0,303) to 0,163 (0,043-0,276) g,/L, while in the contra group markedly decreased : 0,181 0,093-0,267) to 0,138 (0,066-0,280) gIL, The albumi level decreased in both groups. Albumin level in the trreatment group decreased less tha the control group, respectively - 0,35 (-1,20-0,60) and - 0,60 (-1,40-0,00). The HPE] decreased urinary creatinine excretion significantly : 1019 (307-15310) to 791,50 (24( 1524), however UUN and nitrogen balance did not show any improvement

Conclusion : HPEN tend to be able to increase the protein status although has ni statistically been proven yet."

"Salah satu penerapan selulosa adalah untuk isolator kalor. Sudah banyak orang melakukan penelitian selulosa untuk isolator, karena merupakan issu populer penghematan energi dengan biaya penanganannya cukup murah. Untuk itu, peneliti membuat selulosa dari alang-alang jenis imperata cylindrica dengan proses ekstraksi. Hasil ekstraksi berupa serat selulosa. Serat selulosa dibuat lembaran dengan menambahkan Na-CMC (Sodium Carboksil Metyl Cellulose) sebesar 3,5%. Pembuatan lembaran dengan cara, serat diblender selama 30 menit, 45 menit dan 60 menit kemudian masing-masing dimasukkan kedalam oven pada suhu 40oC selama 36 jam. Selanjutnya, pembuatan komposit menggunakan cold-press. Pengujian dilakukan terhadap tujuh parameter yakni massa jenis, kapasitas panas, konduktivitas panas, morphologi, TGA, FTIR dan sifat-sifat mekanik yang diuji menggunakan piknometer, DSC Jade Perkin Elmer, Joulemetter, SEM, TGA Linseis STA Patinum Series 1600, FTIR Alpha Bruker, dan UTM Model UCT-5T. Hasil pengujian diperoleh massa jenis minimal 109 kg/m3 dan maksimal 455,5 kg/m3; kapasitas panas minimal 0,304 kJ/kg K dan maksimal 0.945 kJ/kg K; konduktivitas panas minimal 0,074 W/m K dan maksimal 0,153 W/m K; morfologi diperoleh hasil material yang hampir homogen; ketahanan panas minimal 195oC dan maksimal 246oC, hasil dari spektrofotometer terjadi ikatan; kekuatan tarik rata-rata minimal 9,1 MPa dan maksimal 14,2 Mpa; kekuatan tarik spesifik minimal 0,002 MPa/(kg/m3) dan maksimal 0,013 MPa/(kg/m3).

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One application of cellulose is for isolator of heat. Many researche on cellulose for isolator have been conducted due to a popular issue of energy saving with its fairly cheap treatment cost. Cellulose is produced from imperata cylindrica reed by an extraction process. The results of extraction were in a form of cellulose fibers. The cellulose fibers were made to form of sheets by adding 3.5 % Na-CMC (Sodium Carboxyl Methyl Cellulose). The sheets are produced by blending fibers for 30, 45, and 60 minutes and then put it into the oven with temperature of 40oC for 36 hours. Tests were conducted for seven parameters, namely, density, heat capacity, thermal conductivity, morphology, TGA, FTIR and Mechanical properties were evaluated by picnometer, DSC, Joulemetter, SEM, TGA from Linseis STA Patinum Series 1600, FTIR from Alpha Bruker, UCT-5T Model UTM. The test showed : minimal and maximal of densities were 109 kg/m3 and 455.5 kg/m3, respectively; minimal and maximal of heat capacity were 0,304 kJ/kg K and 0.945 kJ/kg K; minimal and maximal of thermal conductivity were 0,074 W/m K and 0,153 W/m K; morphology produce material nearly homogeneous, minimal and maximal of degradation temperature were 195oC and 246oC; result from spectrophotometer was occur a bond; minimal and maximal tensile strength were 9.1 MPa dan 14.2 MPa, respectively; and minimal and maximal specific tensile strength were 0.002 MPa/(kg/m3) and 0.013 MPa/(kg/m3)."

"Latar balakang. Sekitar 75% kanker leher rahim datang ke rumah sakit dalam stadium lanjut. Terapi utama kanker serviks stadium lanjut adalah radioterapi. Kombinasi terapi radiasi dengan kemoterapi ternyata tidak menghasilkan respons terapi yang lebih baik, tetapi bahkan menimbulkan efek samping yang lebih berat dibandingkan terapi radiasi saja. Perubahan pola makan saat ini, diduga berpengaruh pada respons terapi. Rasio asupan Polyunsaturated Fatty Acids (PUFA) n-6 : n-3 sekitar 1-2 : 1 dapat melawan pertumbuhan kanker. Beberapa publikasi melaporkan bahwa PUFA n-3 (AL n-3) mempunyai efek pro-apoptosis, anti-inflamasi, anti-proliferatif dan anti-angiogenik. Penelitian ini bertujuan untuk mengetahui apakah suplementasi nutrisi tinggi PUFA bersamaan dengan terapi radiasi dapat meningkatkan respons tumor pada kanker serviks stadium lanjut. Metode. Penelitian ini merupakan Randomized Clinical Trial, double blind pada pasien kanker serviks stadium lanjut, jenis karsinoma sel skuama yang hanya mendapat terapi radiasi di Departemen Radioterapi, Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta. Subjek penelitian diambil secara konsekutif, melalui randomisasi dibagi dua kelompok, yaitu kelompok perlakuan dan kontrol. Selama radiasi subjek penelitian mendapat suplementasi nutrisi mengandung isokalori dan isoprotein dengan rasio AL n-6 : n-3 = 1,27 : 1 dan kontrol. Selama perlakuan dilakukan evaluasi setiap lima kali radiasi, meliputi BB dan efek samping radiasi akut. Parameter yang dinilai adalah respons klinis, respons histopatologis serta perubahan kadar PGE2 dan VEGF serum.Hasil. Sebanyak 31 subjek dari 45 subjek dapat menyelesaikan penelitian. Sebelum perlakuan, status sosio-demografi, pola asupan AL n-6 dan n-3, status gizi dan klinis tidak didapatkan perbedaan bermakna. Setelah perlakuan, didapatkan penurunan kadar PGE2 serum pada kelompok perlakuan, sedangkan kelompok kontrol mengalami kenaikan (p = 0,127). Penurunan kadar VEGF kelompok perlakuan lebih besar dibanding kontrol (p = 0,626). Respons klinis dan respons histopatologis kelompok perlakuan lebih baik dibanding kontrol, dengan kemaknaan masing-masing p = 0,172 dan p = 0,169. Secara statistik belum didapatkan perbedaan yang bermakna pada penurunan kadar PGE2 dan VEGF serum, respons klinis dan respons histopatologis, tetapi didapat kemaknaan klinis yang nyata pada kelompok perlakuan dibanding kontrol. Analisis statistik gabungan dari respons klinis, respons histopatologis, kadar PGE2 dan VEGF serum didapatkan respons tumor total yang bermakna (p = 0,048).Kesimpulan. Suplementasi nutrisi tinggi PUFA dengan rasio asam lemak n-6 : n- 3 = 1,27 : 1 pada kanker serviks stadium lanjut bersama terapi radiasi memberikan respons tumor total yang lebih baik.

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Background. Approximately 75% of uterine cervical cancer came to the hospital in an advanced stage. Primary therapy of advanced cervical cancer is radiotherapy. The combination of radiotherapy with chemotherapy did not give better outcomes, but even cause more severe side effects than radiotherapy. Changes in dietary intake at this time, are supposed to influence the response to therapy. The ratio of n-6 to n-3 polyunsaturated fatty acids (PUFA) about 1-2: 1 can fight cancer growth. Several publications stated that n-3 PUFA has pro- apoptotic effect, anti-inflammatory, anti-proliferative and anti-angiogenic. This study aimed to examine whether radiotherapy combined with daily nutritional supplements enriched PUFA enhance tumor response in advanced cervical cancer.

Method. This study was a double-blind Randomized Clinical Trial (RCT) in patients with advanced squamous cell cervical cancer, received radiation only as control group, and those who received nutritional supplementation containing isocaloric and isoprotein with ratio of n-6 : n-3 PUFA = 1.27: 1 as treatment group. This study was performed in the Department of Radiotherapy Dr. Cipto Mangunkusumo General Hospital (RSUPNCM), Jakarta. Evaluation was done every five times radiation, including Karnofsky Perfomance Scale, body weight and side effects of acute radiation. Parameters assessed were clinical and hematological response, histopathological response and changes in the levels of PGE2 and VEGF serum.

Results. A total of 31 subjects from 45 subjects participated the study completely. Prior to treatment, socio-demographic status, patterns of n-6 and n-3 PUFA, clinical and nutritional status were analyzed, no significant differences were noted. After treatment, a decrease in serum PGE2 levels in the treatment group was found, while in the control group increased (P = 0.127). VEGF in the treatment group declined higher than controls (P = 0.626). Treatment group showed significant better clinical response and histopathological responses compared to the control group (p = 0.172 and p = 0.169). No significant differences were found in the reduction of PGE2 and VEGF serum levels, clinical response and histopathological response, although from clinical standpoint there is a better significant response in the treatment group than the control. The combined statistical analysis of clinical response, histopathological response, PGE2 and VEGF serum levels obtained total tumor response (P = 0.048).

Conclusion. Nutritional supplementation enriched PUFA (ratio of n-6: n-3 PUFA = 1.27 : 1) in advanced cervical cancer receiving radiotherapy gives better total tumor response."