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Abstrak :
Latar Belakang: Bertambahnya jumlah penderita miopia di dunia menyebabkan terjadinya peningkatan jumlah pengguna Lensa Kontak Lunak (LKL). Di Indonesia, prevalensi miopia sebesar 26.1% pada tahun 2002 dan diperkirakan akan meningkat setiap tahunnya. Pemaikaian LKL memiliki efek samping berupa terjadinya inflamasi pada kornea dan konjungtiva, yang ditandai oleh peningkatan kadar Interleukin-6 (IL-6) pada air mata. Tujuan: Mengevaluasi peningkatan kadar IL-6 pada air mata pada pengguna LKL harian tipe hidrogel konvensional dan LKL mingguan tipe silikon hidrogel serta meninjau korelasinya dengan tingkat inflamasi konjungtiva. Metodologi (Method): Penelitian ini merupakan suatu uji eksperimental randomisasi acak terkontrol dengan desain dua kelompok paralel, yaitu satu subjek miopia yang diterapi menggunakan LKL Hydrogel Nefilcon-A harian di satu mata, dan menggunakan LKL Silicone Hydrogel Lotrafilcon-B mingguan di mata lainnya, selama 14 hari. Tindakan foto konjungtiva, dan pengambilan sampel air mata untuk IL-6 dilakukan sesaat sebelum pemakaian LKL dan 14 hari setelah pemakaian LKL. Hasil: Seratus mata dari 50 pasien dilibatkan dalam penelitian ini. Dari seluruh subjek tersebut, 80,8% adalah perempuan dan 18,2% laki-laki dengan usia rata-rata 22,18±1,79 tahun. Median delta IL-6 sebelum dan setelah penggunaan LKL adalah 6,37 (0,05 — 1115,80) pg / mL untuk silikon hidrogel dan 4,46 (0,01 - 685,40) pg / mL untuk hidrogel konvensional. Tidak didapatkan perbedaan bermakna antara kadar IL-6 pra dan pasca LKL pada kedua grup (p=0,117). Kesimpulan: Kadar IL-6 pada air mata mengalami peningkatan signifikan setelah 14 hari penggunaan LKL pada kedua kelompok. Tetapi peningkatan kadar IL-6 pada air mata tersebut tidak disertai dengan peningkatan hiperemia konjungtiva. ......Background: The increasing number of myopia patient in the world, causes growth in Soft Contact Lenses (SCL) users. In Indonesia, the prevalence of myopia was 26.1% in 2002 and is expected to increase every year. SCL usage has proven to increase cytokine production, especially Interleukin-6 (IL-6) which accompanied by inflammation of the ocular surface such as conjunctival hyperemia. Objective: Comparing IL-6 tear levels and their correlation with conjunctival inflammation scale between overnight wear silicone hydrogel SCL and daily wear hydrogel SCL. Methods: This study is a randomized controlled trial between two parallel groups. A myopia subject, who has never used SCL before, being treated using daily Hydrogel (Nefilcon-A) SCL in one eye, and overnight Silicone Hydrogel (Lotrafilcon-B) SCL in the other eye, for 14 days. The slit lamp examination, conjunctival photographs, and tear sampling for IL-6 were done before and 14 days after SCL usage. Results: One hundred eyes from 50 patients were included in this study. Of those patients, 80,8% were female and 18,2% male with mean age 22,18±1,79 years old. Median of IL-6 delta (pre-post) SCL usage was 6,37 (0,05 — 1115,80) pg / mL for silicon hydrogel and 4,46 (0,01 - 685,40) pg / mL for conventional hydrogel (p = 0,117). There were no significant difference between the initial and final conjunctival hyperemia scales in both groups (p=1,000). The correlation between IL-6 tear levels and conjunctival hyperemia was not significant (p = 0.234). Conclusion: There were a significant increase of IL-6 tear levels after 14 days of SCL usage in both groups. But the marked escalation of tear IL-6 levels was not accompanied by increasing scales of azconjunctival hyperemia.

Abstrak :
Latar belakang: Lupus eritrematosus sistemik (LES) adalah penyakit yang kompleks dengan manifestasi yang bervariasi. Interleukin-6 (IL-6) merupakan sitokin pleitropik yang mempunyai aktivitas biologis dengan rentang luas yang berperan penting pada regulasi imun dan inflamasi. Saat ini belum ada biomarker yang dapat membedakan kondisi remisi total dengan aktivitas penyakit ringan. Interleukin-6 diharapkan dapat digunakan sebagai parameter aktivitas penyakit terutama pada kasus-kasus dimana antara manifestasi klinis dan skor SLEDAI tidak sesuai yaitu pada pasien LES dengan aktivits ringan dan remisi total. Tujuan: Mengetahui karakteristik IL-6 pada LES anak dengan berbagai aktivitas ringan dan remisi total. Metode: Penelitian kasus kontrol dilakukan di poli rawat jalan Alergi-Imunologi Departemen Ilmu Kesehatan Anak RSUPN dr. Cipto Mangunkusumo, Jakarta dan RSUP Dr. Sardjito, Yogyakarta mulai Mei hingga Juni 2019. Pasien anak usia 1-18 tahun dengan diagnosis LES dinilai kadar IL-6 dan aktivitas penyakit yang dinilai dengan skor SLEDAI. Uji korelasi chi square dilakukan untuk mengetahui hubungan variabel bebas dan luaran. Analisis data dilakukan dengan program SPSS for Window ver 20,0 Hasil: Dari 60 subjek penelitian yang terdiri dari 30 pasien LES aktivitas ringan dan 30 remisi total. tidak ada perbedaan kadar IL-6 tinggi pada kelompok kasus dibanding kelompok kontrol dengan p=0,500, OR= 0,483 (95% IK: 0,041-5,628). Terdapat 2 subyek dengan kadar IL-6 tinggi menderita infeksi saluran kencing. Simpulan: Tidak ada perbedaan aktivitas penyakit pada pasien LES anak dengan aktivitas ringan dibanding remisi total. ......Background: Systemic Lupus Erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities that plays an important role in immune regulation and inflammation. Recently, there is no other biomarker that could differentiate total remission condition and mild disease activity in juvenile SLE. Interleukin-6 may be used as a parameter of disease activity, especially in the cases with different clinical manifestations and SLEDAI scores among SLE patients with mild activities and total remissions. Aim: To indentify the characterictics of serum IL-6 concentration in juvenile systemic lupus erythematosus with mild activities and total remissions. Methods: Case control study was performed at outpatient clinic of allergy-immunology, department of child health dr. Cipto Mangunkusumo hospital, Jakarta and dr. Sardjito hospital, Yogyakarta during May-June 2019. Serum IL-6 consentration and disease activity were assessed in all juvenile SLE patients aged 1-18 year. SLE disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme linked immunosorbent assay. Chi square correlation analysis was used to determine the correlation of serum IL-6 concentration with disease activity in juvenile SLE patients. Analyses of data were performed using the SPSS statistical software for windows version 20,0. Results: Among 60 subjects included in this study, 30 subjects with mild activities in the case group and 30 subjects with total remissions in the control group. There was no differences of serum IL-6 concentration between case and control group (p=0,500, OR= 0,483 (95% IK: 0,041-5,628)). In this study, we found 2 subjects with urinary tract infection have high serum IL-6 concentration. Conclusion: There was no differences of serum IL-6 concentration between juvenile SLE patients with mild activities compared with total remissions.

Abstrak :
ABSTRAK Hubungan antara peningkatan kadar interleukin-6 dan protein C reaktif dengan kebocoran plasma pada penderita infeksi dengue dewasa masih belum jelas. Penelitian ini dilakukan untuk mengetahui perbedaan kadar IL-6 dan protein C reaktif antara kelompok infeksi dengue dengan dan tanpa kebocoran plasma. Penelitian dilakukan secara potong lintang terhadap data sekunder dari penderita infeksi dengue dewasa yang dirawat di RSCM dan RSUP Persahabatan antara 1 Maret 2014 - 1 April 2015. Jumlah total sampel adalah 44 orang, terdiri dari 24 orang dengan kebocoran plasma dan 20 orang tanpa kebocoran plasma. Kadar IL-6 pada kelompok dengan dan tanpa kebocoran plasma masing-masing pada hari ke-3 dan ke-5 demam adalah 8,56 vs 3,80 (p = 0,069) pg/mL dan 4,30 vs 2,76 pg/mL (p = 0,025), sedangkan untuk protein C reaktif adalah 10,1 vs 6,8 mg/L (p = 0,014) dan 5,0 vs 2,9 mg/L (p = 0,048). Kadar IL-6 hari ke-3 dan ke-5 demam pada kelompok dengan kebocoran plasma adalah 8,56 vs 4,30 pg/mL (p = 0,037) dan pada kelompok tanpa kebocoran plasma adalah 3,80 vs 2,76 pg/mL (p = 0,005). Kadar protein C reaktif hari ke-3 dan ke-5 demam pada kelompok dengan kebocoran plasma adalah 10,1 vs 5,0 mg/L (p = 0,0001) dan pada kelompok tanpa kebocoran plasma adalah 6,8 vs 2,9 mg/L (p = 0,0001). Tidak ada perbedaan kadar IL-6 pada hari ke-3 demam di antara kedua kelom-pok, sedangkan pada hari ke-5 demam kadarnya lebih tinggi pada kelompok dengan kebocoran plasma. Kadar protein C reaktif hari ke-3 dan ke-5 demam lebih tinggi pada kelompok dengan kebocoran plasma. Kadar IL-6 dan protein C reaktif hari ke-3 lebih tinggi dibandingkan hari ke-5 demam pada kedua kelompok.;

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ABSTRACT There is stiil unclear association between the elevation of interleukin-6 and C-reactive protein levels with plasma leakage in adult dengue infection patients. The study aims to determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. This is a cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The total number of samples were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3rd and the 5th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3rd and the 5th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3rd and 5th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). There was no differences in levels of interleukin-6 on the 3rd day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3rd and the 5th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3rd day of fever were higher than the 5th day of fever in both groups. ;There is stiil unclear association between the elevation of interleukin-6 and C-reactive protein levels with plasma leakage in adult dengue infection patients. The study aims to determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. This is a cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The total number of samples were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3rd and the 5th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3rd and the 5th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3rd and 5th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). There was no differences in levels of interleukin-6 on the 3rd day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3rd and the 5th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3rd day of fever were higher than the 5th day of fever in both groups.;There is stiil unclear association between the elevation of interleukin-6 and C-reactive protein levels with plasma leakage in adult dengue infection patients. The study aims to determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. This is a cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The total number of samples were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3rd and the 5th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3rd and the 5th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3rd and 5th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). There was no differences in levels of interleukin-6 on the 3rd day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3rd and the 5th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3rd day of fever were higher than the 5th day of fever in both groups.;There is stiil unclear association between the elevation of interleukin-6 and C-reactive protein levels with plasma leakage in adult dengue infection patients. The study aims to determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. This is a cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The total number of samples were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3rd and the 5th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3rd and the 5th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3rd and 5th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). There was no differences in levels of interleukin-6 on the 3rd day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3rd and the 5th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3rd day of fever were higher than the 5th day of fever in both groups.;There is stiil unclear association between the elevation of interleukin-6 and C-reactive protein levels with plasma leakage in adult dengue infection patients. The study aims to determine differences in the levels of interleukin-6 and C-reactive protein among groups of dengue infection with and without plasma leakage. This is a cross-sectional study of secondary data from adult patients with dengue infection were treated at Cipto Mangunkusumo and Persahabatan Hospital between March 1, 2014 until April 1, 2015. The total number of samples were 44 people, consisting of 24 people with plasma leakage and 20 people without plasma leakage. Median levels of interleukin-6 for groups with and without plasma leakage each for the 3rd and the 5th day of fever were 8.56 vs 3.80 pg/mL(p = 0.069) and 4.30 vs 2.76 pg/mL (p = 0.025), whereas for C-reactive protein were 10.1 vs 6.8 mg/L ( p = 0.014) and 5.0 vs 2.9 mg/L (p = 0.048). Median levels of interleukin-6 on the 3rd and the 5th day of fever in the group with plasma leakage were 8.56 vs 4.30 pg/mL (p = 0.037) and in the group without plasma leakage were 3.80 vs 2.76 pg/mL (p = 0.005). Median level of C-reactive protein on the 3rd and 5th day of fever in the group with plasma leakage were 10.1 vs 5.0 mg/L (p = 0.0001) and in the group without plasma leakage were 6.8 vs 2.9 mg/L (p = 0.0001). There was no differences in levels of interleukin-6 on the 3rd day of fever between the two groups, while on the 5th day of fever interleukin-6 levels was higher in the group with plasma leakage. The levels of C-reactive protein on the 3rd and the 5th day of fever were higher in the group with plasma leakage. The level of Interleukin-6 and C-reactive protein on the 3rd day of fever were higher than the 5th day of fever in both groups.

Abstrak :
Latar Belakang Pneumonia adalah suatu penyakit akibat infeksi pada paru yang menjadi masalah serius, dengan tingkat mortalitas yang mencapai 42,4% di Indonesia sendiri. Pneumonia dikaitkan dengan mortalitas tinggi, salah satunya pada kondisi kegagalan ekstubasi yang terjadi pada pasien yang memerlukan intubasi. Proses patologis ini dikaitkan dengan peningkatan sitokin proinflamasi seperti IL-6 yang dapat ditemukan pada serum ataupun bilasan bronkoalveolar. Penelitian-penelitin terdahulu belum menentukan kaitan sitokin IL-6 dengan prognosis pasien terkait mortalitas dan kegagalan ekstubasi, serta belum menentukan korelasi kadar IL-6 serum dan bilasan bronkoalveolar pada pasien meninggal dan pasien gagal ekstubasi. Tujuan Mengetahui perbandingan kadar IL-6 pada serum dan bilasan bronkoalveolar pada pasien sesuai dengan status mortalitas dan ekstubasi pada pasien pneumonia berat, serta korelasi kadar IL-6 sersum dan bilasan bronkoalveolar pada pasien meninggal dan gagal ekstubasi. Metode Penelitian dengan desain kohort prospektif dilakukan pada 40 pasien pneumonia berat yang terintubasi dan menjalani tindakan bronkoskopi di IGD dan ruang intensif RSCM sejak November 2020 hingga Januari 2021. Kadar IL-6 pada pemeriksaan serum dan pemeriksaan bilasan bronkoalveolar kemudian dianalisis dengan observasi keberhasilan ekstubasi selama 20 hari dan status mortalitas selama 28 hari. Analisis univariat pada karakteristik pasien dilanjutkan dengan analisis bivariat dengan uji perbedaan dua rerata tidak berpasangan dengan data skala numerik dilakukan pada data sebaran normal dan uji Mann-Whitney dilakukan pada data sebaran tidak normal. Hasil Dalam penelitian, didapatkan rasio gagal ekstubasi dan mortalitas sebesar 80% dan 75% secara berurutan. Tidak ditemukan perbedaan bermakna antara kadar IL-6 serum ataupun bilasan bronkoalveolar pada status mortalitas dan ekstubasi pasien. Namun, ditemukan korelasi positif antara kadar IL-6 serum dan kadar IL-6 bilasan bronkoalveolar pada pasien meninggal (r=0,551) dan gagal ekstubasi (r=0,567). Kesimpulan Tidak terdapat perbedaan bermakna pada kadar IL-6 serum dan bilasan bronkoalveolar antara pasien meninggal dan hidup, serta pasien berhasil atau gagal ekstubasi. Namun, terdapat hubungan positif antara kadar IL-6 serum dan bilasan bronkoalveolar pada pasien meninggal dan gagal ekstubasi. ......Background. Pneumonia is a disease caused by infection in the lungs which has become a serious health issue, with a mortality rate of 42.4% in Indonesia itself. Pneumonia is associated with high mortality, one of which is in conditions of extubation failure that occurs in patients who require intubation. This pathological process is associated with an increase in pro-inflammatory cytokines such as IL-6 that can be found in serum or bronchoalveolar lavage. Previous studies have not determined the association of the IL6 cytokine with the prognosis of patients related to mortality and extubation failure, nor have they determined the correlation of serum IL-6 levels and bronchoalveolar lavage in patients dying and patients failing to extubate. Purpose. To analyze the comparison of IL-6 levels in serum and bronchoalveolar lavage in patients based on their mortality and extubation status in severe pneumonia patients, as well as the correlation of IL-6 levels in serum and bronchoalveolar lavage in patients who died and failed extubation. Method. The study with a prospective cohort design was conducted on 40 severe pneumonia patients who were intubated and underwent bronchoscopic procedures in the emergency room and intensive room of RSCM from November 2020 to January 2021. IL6 levels were examined on serum and bronchoalveolar lavage sample, which then analyzed with the observation for extubation status for 20 days and mortality status for 28 days. Univariate analysis on patient characteristics was followed by bivariate analysis with unpaired two-mean difference tests with numerical scale data performed on normal distribution data and Mann-Whitney test performed on abnormal distribution data Result. In the study, the ratio of extubation failure and mortality was 80% and 75% respectively. No significant difference was found between serum IL-6 levels or bronchoalveolar lavage IL-6 levels based on the mortality and extubation status of patients. However, a positive correlation was found between serum IL-6 levels and IL-6 levels of bronchoalveolar lavage in patients who died (r=0.551) and failed extubation (r=0.567). Conclusion. There were no significant differences in serum IL-6 levels and bronchoalveolar lavage between deceased and living patients, as well as patients succeeded or failed to be extubated. However, there was a positive correlation between serum IL-6 levels and bronchoalveolar lavage IL-6 levels in patients who died and failed extubation.

Abstrak :
Latar Belakang: COVID-19 menyebabkan penyakit kritis dan kematian dengan manifestasi utama sindrom pernafasan akut. Prediktor kematian pada kasus COVID-19, seperti IL-6 berperan dalam mengatur respon imun dan inflamasi. Pada kasus berat, peningkatan IL-6 dapat menyebabkan sepsis dan kegagalan multi-organ. CRP juga berkontribusi signifikan terhadap peradangan. Keparahan derajat COVID-19 dipengaruhi oleh komorbiditas seperti penyakit kardiovaskular, diabetes melitus tipe II, dan hipertensi. Tocilizumab, penghambat reseptor IL-6 merupakan terapi baru untuk pasien COVID-19 berat dan kritis. Penelitian ini menilai mortalitas pasien COVID-19 berat yang diberikan dan tidak diberikan terapi tocilizumab setelah dikontrol oleh variabel perancu. Tujuan: Menganalisis pengaruh terapi tocilizumab terhadap kematian pada pasien COVID-19 berat. Metode: Desain penelitian kohort retrospektif, menggunakan data rekam medis pasien COVID-19 di ICU RSCM selama dua tahun. Data dianalisis menggunakan SPSS. Hasil: Total 80 subjek, 52 pasien meninggal dan 28 pasien hidup. Mayoritas pasien memiliki CRP tinggi, IL-6 meningkat, serta tidak memiliki komorbid hipertensi, diabetes mellitus tipe II, dan penyakit kardiovaskular. Analisis statistik menunjukkan tidak ada hubungan yang signifikan antara pemberian terapi tocilizumab dan kematian, serta tidak terdapat perancu dalam penelitian ini. Kesimpulan: Pemberian terapi tocilizumab tidak memperbaiki kejadian mortalitas pada pasien COVID-19 berat. ......Background: COVID-19 causes critical illness and death with the main manifestation of acute respiratory syndrome. Predictors of death in COVID-19 cases, such as IL-6, play a role in regulating the immune response and inflammation. In severe cases, increased IL-6 can cause sepsis and multi-organ failure. CRP also contributes significantly to inflammation. The severity of COVID-19 is influenced by comorbidities such as cardiovascular disease, type II diabetes mellitus, and hypertension. Tocilizumab, an IL-6 receptor inhibitor, is a new therapy for severe and critical COVID-19 patients. This study assessed the mortality of severe COVID-19 patients who were and were not given tocilizumab therapy after controlling for confounding variables. Objective: To analyze the effect of tocilizumab therapy on mortality in severe COVID-19 patients. Methods: Retrospective cohort study design, using medical record data of COVID-19 patients in the ICU RSCM for two years. Data were analyzed using SPSS. Results: A total of 80 subjects, 52 patients died and 28 patients survived. The majority of patients had high CRP, increased IL-6, and did not have comorbid hypertension, type II diabetes mellitus, and cardiovascular disease. Statistical analysis showed no significant association between tocilizumab therapy and mortality, and there were no confounders in this study. Conclusion: Administration of tocilizumab therapy does not reducing mortality rates in severe COVID-19 patients.

Abstrak :
ABSTRAK
Serat asbes yang terinhalasi masuk ke dalam alveolus menyebabkan terjadinya peningkatan produksi reactive oxigen spesies (ROS) yang dapat memicu terjadinya reaksi inflamasi. Interleukin 6 merupakan penanda reaksi inflamasi akibat pajanan serat asbes. Vitamin C dan E merupakan antioksidan yang bekerja sebagai scavenger ROS. Vitamin C juga dapat menghambat aktivitas faktor transkripsi NFқB. Vitamin E selain dapat menghambat aktivitas faktor transkripsi JAK/STAT3 dan NFқB, juga dapat menghambat aktivitas COX2 dan LOX5. Penelitian potong lintang di sekretariat serikat buruh pabrik asbes X Kabupaten Karawang bulan Oktober 2014 dilakukan untuk menilai korelasi asupan vitamin C, E dengan kadar interleukin 6 pada pekerja pabrik asbes. Lima puluh dua pekerja pabrik asbes berhasil menyelesaikan protokol penelitian. Hasilnya menunjukkan tidak terdapat korelasi bermakna (p >0,05) antara asupan vitamin C dengan kadar IL-6 dan antara asupan vitamin E dengan kadar IL-6. Terdapat korelasi positif antara kadar vitamin C dengan kadar IL-6 (r = 0,31) dengan p <0,05, namun tidak terdapat korelasi antara kadar vitamin E dengan kadar IL-6.

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ABSTRACT
Asbestos fibers that are inhaled into the alveoli cause increased production of reactive oxygen species (ROS) which may trigger inflammation reaction. Interleukin 6 (IL-6) is a marker of inflammation reaction caused by asbestos fibers exposure. Vitamin C and vitamin E are antioxidants acting as ROS scavengers. Vitamin C can also inhibit the activity of transcription factor NFқB. Vitamin E can inhibit the activities of transcription factors JAK/STAT3 and NFқB as well as the activities of COX2 and LOX5. A cross-sectional sudy at a labor union secretariat in Karawang Regency in October 2014 was conducted to evaluate the correlations between intakes and levels of vitamin C and vitamin E and level of IL-6 in asbestos factory workers. Fifty two asbestos factory workers finished the study. The result showed no significant correlation between vitamin C intake and IL-6 level or between vitamin E intake and IL-6 level. There was a moderate positive correlation between vitamin C level and IL-6 level (r = 0.31, p <0.05), but there was no correlation between vitamin E level and IL-6 level.

Abstrak :
Latar Belakang: Inflamasi pada kehamilan normal disebabkan oleh oksidatif stress yang disebabkan oleh produksi radikal bebas dan peningkatan biomarker inflamasi, seperti IL-6. 830 wanita meninggal setiap harinya karena hamil dan melahirkan, diantaranya 15% disebabkan oleh komplikasi pada kehamilan seperti preeklampsia. Preeklampsia merupakan sebuah sindrom yang muncul pada kehamilan, terutama pada trimester ketiga, dan terasosiasi dengan inflamasi yang berlebihan. Sebagai antioksidan, vitamin C diduga berperan menurunkan stress oksidatif pada kehamilan dan persalinan, sehingga menurunkan tingkat kematian ibu, sehingga dilakukan penelitian untuk mencari hubungan antara asupan vitamin C dan kadar IL-6 sebagai biomarker dari inflamasi. Metode: Penelitian berdesain potong- lintang dilakukan di Rumah Sakit Cipto Magunkusumo pada 40 orang ibu hamil trimester ketiga dikelompokkan menjadi preeklampsia dan non-preeklampsia. Subjek diwawancara menggunakan semi-kuantitatif food frequency questionnaire yang diolah dengan NutriSurvey untuk asupan vitamin C, dan ELISA untuk kadar IL-6. Data diuji distribusinya dengan uji normalitas Shapiro-Wilk, kemudian dilakukan analisis univariat dengan uji T tidak berpasangan, Mann-Whitney, dan Chi-square; serta bivariat dengan uji korelasi Spearman. Analisis dilakukan dengan SPSS for Windows ver. 20. Hasil: Hasil yang tidak signifikan ditunjukkan pada usia subjek dan usia gestasi terhadap preeklampsia dan non- preeklampsia dengan p=0,545 dan p=0,34. Asupan vitamin C yang ditunjukkan oleh subjek preeklampsia sedikit lebih tinggi dibandingkan dengan kelompok non-preeklampsia dengan median sebesar 76,37(28,05–396,88) mg dan 68,87(8,57–198,53) mg dengan p=0,358. Sedangkan, kelompok preeklampsia menunjukkan kadar IL-6 yang lebih tinggi dibandingkan kelompok non-preeklampsia [15,8(2,2–67,4) pg/ml vs 6,8(1,8–43,5) pg/ml] dengan perbedaan yang tidak signifikan. Uji korelasi non-parametrik menunjukkan tidak adanya asosiasi yang signifikan antara vitamin C dan kadar IL-6 (p=0,361; r= -0,147). Selain itu juga, tidak ditemukan adanya perbedaan yang bermakna antara asupan vitamin C dan kadar IL-6 untuk setiap kelompok dengan r= -0,143 dan -0,198 secara berturut-turut. Pembahasan: Tidak didapatkan hubungan yang signifikan antara asupan vitamin C dan kadar IL-6 pada ibu hamil trimester ketiga pada penelitian ini. Hasil ini dapat disebabkan oleh asupan vitamin C pada subjek yang kurang (<85 mg) pada kedua kelompok dan juga inflamasi pada trimester ketiga yang meningkat. Selain itu, penelitian ini hanya meneliti hubungan asupan vitamin C dengan kadar IL-6, sedangkan peran melawan stress oksidatif dan inflamasi melibatkan seluruh antioksidan, baik eksogen maupun endogen. Oleh karena itu, penelitian lebih lanjut mengenai hubungan antioksidan lainnya dengan IL-6 sangat disarankan. ......Background: Inflammation in pregnancy is primarily caused by systemic oxidative stress due to production of free radicals and increased levels of inflammatory biomarkers such as IL-6. Every day, 830 women associated with pregnancy and childbirth die globally, approximately 15% of which is caused by prenatal complications such as preeclampsia. Preeclampsia is a syndrome developed during pregnancy which occurs mostly on the third trimester and is strongly associated with inflammation. As an antioxidant, vitamin C could potentially play a role in reducing oxidative stress in either pregnancy or delivery, thus decreasing mortality rate. Therefore, a research to investigate the relationship between vitamin C intake and levels of IL-6 as a biomarker of oxidative stress was conducted. Methods: A cross-sectional study done in Cipto Mangunkusumo National General Hospital. 40 women in third trimester pregnancy are then grouped into preeclampsia and non- preeclampsia, and surveyed via Food Frequency Questionnaire and NutriSurvey for vitamin C, as well as ELISA assay for IL-6 expression. All data was firstly analyzed using Shapiro- Wilk normality test, then analyzed univariately using unpaired T-test, Mann-Whitney, and Chi-square; bivariate analysis was conducted with Spearman correlation test. All analysis was done using SPSS software ver. 20. Results: There is no significant difference shown between mean age and gestational age of the preeclampsia and non-preeclampsia group with p=0.545 and p=0.34 respectively. Subjects in the preeclampsia group were shown to consume vitamin C slightly higher than the non-preeclampsia with median values of 76.37(28.05–396.88) mg and 68.87(8.57–198.53) mg respectively with p=0.358. On the other hand, the preeclampsia group expressed higher level of IL-6 than the non-preeclampsia [15.8(2.2–67.4) pg/ml vs 6.8(1.8–43.5) pg/ml] with no significant difference. A nonparametric correlation test showed no significant association between vitamin C (p=0.361; r = -0.147) and total IL-6 level. There was also no significant difference between vitamin C consumption and IL-6 level for each group with r= -0.143 and -0.198 respectively. Discussion: There was no significant association between vitamin C intake and IL-6 level on third trimester pregnancy women (p= 0.361). This result could be caused by inadequate intake of vitamin C in both groups and the increase of inflammation on the third trimester. In addition, this study only examined association between vitamin C and IL-6 level, while role of neutralizing oxidative stress and inflammation involved both endogenous and exogenous antioxidants. Therefore, further research should be considered to study vitamin C alongside the other antioxidants level and IL-6 level.

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Latar Belakang: Hibiscus sabdariffa Linn dikenal sebagai herbal yang memiliki efek antioksidan dan antiinflamasi. Inflamasi merupakan salah satu mekanisme terjadinya diabetes mellitus, sebuah penyakit metabolik yang terjadi akibat gangguan pada insulin dan fungsi sel beta pancreas. Penelitian ini bertujuan untuk mengetahui potensi Hibiscus sabdariffa Linn. terhadap kadar HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) dan Interleukin-6 pada kondisi diabetes mellitus. Metode: Dua puluh empat tikus Sprague-Dawley ditempatkan secara acak menjadi enam kelompok; kontrol normal, normal dengan 200mg/kgBB Hibiscus, normal dengan 500mg/kgBB Hibiscus, kontrol diabetes, diabetes dengan 200mg/kgBB Hibiscus, dan diabetes dengan 500mg/kgBB Hibiscus. Hibiscus sabdariffa Linn diberikan selama 5 minggu kepada kelompok Hibiscus, dan sampel darah dari tiap kelompok diambil untuk menilai kadar gula darah, insulin, dan IL-6. Kadar IL-6 diukur menggunakan ELISA. HOMA-IR dicek menggunakan tes non-parametrik Kruskal-Wallis dan IL-6 dicek menggunakan one-way ANOVA untuk menilai signifikansi statistik. Hasil: Tikus di kelompok diabetes yang diberikan 200mg/kgBB dan 500mg/kgBB Hibiscus memiliki nilai HOMA-IR dan kadar IL-6 yang lebih rendah walau tidak ada signifikansi statistik antar kelompok HOMA-IR (p= 0.127) dan IL-6 (p = 0.760). Kesimpulan: Penelitian ini tidak menghasilkan signifikansi statistik terhadap penurunan HOMA-IR dan IL-6. ......Introduction: Hibiscus sabdariffa Linn. is known as one of the herbs that possess antioxidant and anti-inflammatory benefits. Inflammation has been long suggested to be one of the pathophysiology of diabetes mellitus, a metabolic disorder that is rooted from insulin impairment and beta cell dysfunction. This study objective is to explore the antiinflammatory effect of Hibiscus sabdariffa Linn towards HOMA-IR (Homeostasis Model Assessment-Insulin Resistance) and Interleukin-6 in diabetes mellitus condition. Methods: Twenty four Sprague-Dawley rats were randomly allocated into six different group; normal control group, normal with 200mg/kgBW of Hibiscus, normal with 500mg/kgBW of Hibiscus, diabetic control, diabetic with 200mg/kgBW of Hibiscus, and diabetic with 500mg/kgBW of Hibiscus. Hibiscus sabdariffa Linn. was administered for 5 weeks for the Hibiscus group, and the blood samples of each group are drawn to obtain blood glucose, insulin, and IL-6. IL-6 level was measured using ELISA kit. HOMA-IR statistical significance was checked using non-parametric Kruskal-Wallis test and IL-6 statistical significance was calculated using one-way ANOVA. Results: Rats in diabetic group that are treated with 200mg/kgBW and 500mg/kgBW had lower value of HOMA- IR and IL-6 although there were no statistical significance between both HOMA-IR (p = 0.127) and IL-6 (p = 0.760) group. Conclusion: This study does not yield statistically significant decrease of both HOMA-IR and IL-6.

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ABSTRACT
Pendahuluan: Penuaan adalah penurunan integritas struktur dan fungsi organisme yang bersifat progresif dan tidak dapat kembali. Pada manusia, hal ini berdampak pada penurunan kognisi dan kekuatan otot, serta peningkatan kerentanan terhadap penyakit degeneratif. Kecepatan penuaan individu berkaitan dengan derajat stres oksidatif yang ditentukan oleh keseimbangan antara radikal bebas dan antioksidan. Ekstrak etanol Centella asiatica (CA) diketahui berefek antioksidan dan antiinflamasi sehingga berpotensi sebagai agen antipenuaan untuk individu tua. Metode: Tikus Sprague-Dawley (SD) tua dibagi ke dalam tiga kelompok, yaitu kontrol negatif (n = 6), kontrol positif (vitamin E 6 IU, n = 7), dan perlakuan (ekstrak etanol CA 300 mg/kg berat badan, n = 8). Sebagai pembanding, terdapat satu kelompok tambahan yang terdiri atas tikus SD muda (n = 6). Kognisi tikus SD sebelum perlakuan ditentukan menggunakan labirin Y. Perlakuan kemudian diberikan selama 28 hari dan kognisi tikus dinilai setiap minggunya. Pada hari ke-29, kekuatan otot tikus diukur dengan uji genggaman dan tikus diterminasi untuk diukur kadar interleukin-6 (IL-6) darah dengan enzyme-linked immunosorbent assay (ELISA). Hasil: Peningkatan kekuatan otot (p = 0,014) dan penurunan kadar IL-6 darah (p = 0,001) yang signifikan ditemukan pada kelompok perlakuan dengan CA dibandingkan kontrol negatif, namun tidak ditemukan perbedaan signifikan secara statistik pada kognisi baik antarkelompok setiap minggu maupun antarminggu setiap kelompok (p > 0,05). Kesimpulan: Pemberian ekstrak etanol CA menurunkan kadar IL-6 darah dan meningkatkan kekuatan otot pada tikus SD tua, namun tidak berefek terhadap kognisi. Penelitian lebih lanjut diperlukan untuk mempelajari efek CA sebagai agen antipenuaan.

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ABSTRACT
Introduction: Aging is progressive and irreversible declines in structural integrity and function of organisms. In human, it leads to cognition and muscle strength impairment, also increased vulnerability to degenerative disorders. Individual aging rate is influenced by degree of oxidative stress, determined by equilibrium between free radicals and antioxidants. Centella asiatica (CA) ethanolic extract has antioxidant and anti-inflammatory effects so it potentially acts as antiaging agent for aged individuals. Methods: Aged Sprague-Dawley (SD) rats were divided into three groups: negative control (n = 6), positive control (vitamin E 6 IU, n = 7), and treatment (CA ethanolic extract 300 mg/kg body weight, n = 8). There is an additional group of young SD rats for comparison (n = 6). Their cognition was measured with Y-maze prior treatment. The treatment was given for 28 days and the cognition level was measured each week. At day 29, their muscle strength was measured with grip test and the rats were terminated to determine their blood interleukin-6 (IL-6) level with enzyme-linked immunosorbent assay (ELISA). Results: Significant muscle strength improvement (p = 0,014) and blood IL-6 level reduction (p = 0,001) were found in group receiving CA treatment compared with negative control, but differences in cognition were not significant, both among groups each week and among weeks each group (p > 0,05). Conclusions: CA ethanolic extract treatment reduces blood IL-6 level and improves muscle strength in aged SD rats, but exerts no effect to cognition. Further studies are required to investigate CA effect as antiaging agent.