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Abstrak :
Ruang lingkup dan cara penelitian: Penderita kanker kolorektal sering mengalami malnutrisi. Untuk memperkecil komplikasi paska bedah, diperlukan tunjangan nutrisi bagi penderita pra bedah kanker kolorektal dengan malnutrisi. Sebagai tunjangan nutrisi, susu lazim digunakan di rumah sakit. Tetapi pemberian susu pada orang dewasa dan keadaan malnutrisi sering menimbulkan intoleransi, sehingga diperlukan bahan makanan lain sebagai penggantl susu. Tempe merupakan sumber gizi tradisional yang memiliki banyak kelebihan karakteristik, diharapkan dapat sebagal pengganti susu. Tujuan penelitian ini adalah membandingkan pengaruh suplementasi formula tempe dan susu terhadap .perubahan kadar transperin serum penderita kanker kolorektal dengan malnutrisi. Penelitian dilakukan di RSUPNCM, Jakarta. Penderita pra bedah kanker kolorektal yang memenuhi kriteria penerimaan di bagi dua kelompok secara acak. Pada kelompok tempe mendapat suplementasi formula tempe 100 g/hari dan kelompok susu diberikan suplementasi susu full cream 75 g/hari, selama 7hari. Pada awal dan akhir penelitian diperiksa kadar transferin serum sebagai parameter status protein. Hasil: Terjadi peningkatan kadar transferin serum yaitu dari (200,36 ± 29,10) mg/dL menjadi (250,36 ± 91,00) mg/dL pada kelompok tempe dan dari {195,33 ± 29,70) mg/dL., menjadi (276,13 ± 134,15) mg/dL pada kelompok susu. Peningkatan ini secara statistik bermakna (p < 0,05). Bila dibandingkan kedua kelompok tersebut, kadar transferin serum sesudah suplementasi secara statistik tidak berbeda bermakna (p > 0,05). Kesimpulan: Suplementasi formula tempe atau susu pada penderita pra bedah kanker kolorektal dengan malnutrisi, dapat meningkatkan kadar transferin serum yang setara. Formula tempe merupakan sumber protein nabati dapat digunakan sebagai pilihan alternatif pengganti susu. ...... Comparison Study Of The Influence Of Tempe Formula And Milk Supplementation Towards The Transferrin Serum Content Of Pre Surgery Colorectal Cancer Patient With Malnutrition.Scope and Method of Study. A colorectal cancer victim often suffers of malnutrition. To reduce complications a colorectal cancer patient with malnutrition requires nutritional support before surgery. Generally in hospitals milk is used as nutritional support. However milk otten causes intolerance to adults and cases of malnutrition, therefore other foodstuff is required to substitute for milk. Tempe represents a traditional source of nutrition with many characteristic advantages and expected useable as a substitute for milk. The aim of this study is to compare the influence of tempe formula and milk supplementation towards the change of transferrin serum content in colorectal cancer patients with malnutrition. The study is conducted at the RSUPNCM in Jakarta. Pre surgery colorectal cancer patients fulfilling the criteria are divided at random into two groups. The tempe group receives a supplementation of 100 grams per day tempe formula, while the milk group is given supplementation of full cream milk powder of 75 grams per day for 7 days. At the beginning and conclusion of the study the transferrin serum content is examined as a paramenter of the protein status. Result: An increase of the transferrin serum content has 1 occured, i.e. from (100,36 ± 29,10) mg/dL to (250,36 ± 91,00) 1 mg/dL in the tempe group and from (195,33 ± 20,70) mg/dL to (276,13 ± 134,15) mg/dL in the milk group. Statistically the increase is significant (p < 0,05). When comparing the two groups the transferrin serum content supplementation does not differ significantly statistic-wise (p > 0,05). Conclusions: The supplementation of either tempe formula or milk to pre surgery colorectal cancer patients with malnutrition equally increases the transferrin serum content. The tempe formula represents a vegetative source of protein and can be used as an alternative option of milk.

Abstrak :
ABSTRAK
Pendahuluan: Thalassemia adalah suatu kelainan genetik akibat kegagalan sintesis rantai globin, mengakibatkan terjadinya anemia berat akibat peningkatan aktivitas eritropoiesis yang inefektif dan hemolisis. Peningkatan aktivitas eritropoiesis akan memacu peningkatan absorpsi besi di usus sehingga terjadi kelebihan besi dalam tubuh. Transfusi darah dilakukan secara berkala untuk mengatasi anemia yang timbul pada pasien thalassemia mayor. Pemberian transfusi berulang akan mempercepat terjadi secondary iron overload, untuk mengatasinya diberikan terapi kelasi rutin.

Tujuan : Mendapatkan perubahan nilai indeks transferin, saturasi transferin, dan feritin sebelum dan sesudah transfusi dan juga sebelum dan sesudah terapi kelasi pada pasien thalassemia mayor. Mendapatkan perbedaan indeks transferin dan saturasi transferin, dan feritin sebagai parameter untuk menilai perubahan status besi pada pasien thalassemia mayor pasca transfusi dan terapi kelasi.

Metode: Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 35 pasien thalassemia mayor usia 7-18 tahun yang mendapat transfusi berulang dan kelator besi rutin. Dilakukan pemeriksaan kadar besi serum, UIBC, TIBC, feritin, transferin, saturasi transferin dan indeks transferin pre transfusi, pasca transfusi dan pasca terapi kelasi.

Hasil: Rerata indeks transferin pasca transfusi 124±22 % lebih rendah secara bermakna dari pre transfusi dengan nilai p=0,016, sedangkan pasca kelasi 123 ± 34.5 % (p=0,045). Saturasi transferin pasca transfusi 96 (51 – 100)% meningkat secara bermakna dibangdingkan pre transfusi 87(69-100)% dengan nilai p=0,026, namum tidak berbeda bermakna pada pasca kelasi 87 (39-100). Kadar feritin serum pasca transfusi 3737 (649 -17.094) mg/dL, meningkat secara bermakna dibandingkan pre transfusi 3315 (544,7-14.964) mg/dL (p=0,018). Perbedaan indeks transferin dan saturasi transferin pre transfusi 45(22-153)% lebih tinggi secara bermakna dibandingkan pasca transfusi 35(6-89)% dengan nilai p=0,000, sedangkan pasca kelasi adalah 41±25 dengan nilai p=0,036.

Kesimpulan: pemeriksaan indeks transferin untuk pemantauan efektifitas terapi kelasi pada pasien thalasemia mayor dapat dipertimbangkan.

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ABSTRACT
Introduction. β thalassemia syndromes are a group of hereditary disorder characterized by genetic deficiency in the synthesis of β-globin chains. It is associated in severe anemia caused by an increase in ineffective erythropoiesis activity and hemolysis. Erythropoiesis activity will spur increased iron absorption in the intestine so there will be an excess of iron in the body. Blood transfusion is used routinely to treat anemia arising in patients with thalassemia major. Repeated transfusion will accelerate occur secondary iron overload, to solve given chelation therapy routine.

Objective :To know the index value changes transferrin, transferrin saturation, and ferritin before and after transfusion and also before and after chelation therapy in patients with thalassemia major. To know difference transferrin index and transferrin saturation, and ferritin as a parameter to assess changes iron status in patients thalassemia major post-transfusion and chelation therapy.

Methods. This was prosphective cohort, There were 35 patients with thalassemia major who receive repeated transfusions and iron kelator routine, with age 7-18 years. Examination of serum iron levels, UIBC, TIBC, ferritin, transferrin, transferrin saturation and transferrin index before transfusion, after transfusion, and after chelation therapy.

Results. Mean transferrin index post-transfusion 124±22% was significantly lower than pre transfusion (p=0.016), as well as post-chelation 123±34.5% with a value of p=0.045. Transferrin saturation post-transfusion 96 (51-100)% increased significantly with pre transfusion 87 (69-100)% with a value of p=0.026, However no significant difference were observed in post chelation therapy 87 (39-100). Post-transfusion serum ferritin level 3737 (649-17094) mg/dL, increased significantly compared to pre transfusion 3315 (544.7-14,964) mg/dL (p=0.018). Differences transferrin index and transferrin saturation pre transfusion was 45 (22-153)% significantly higher than the post-transfusion 35 (6-89)% with a value of p=0.000, while the post chelation thyrapy was 41±25% (p=0.036).

Conclusion. Transferrin index can be considered for monitoring the effectiveness of chelation therapy in patients with thalassemia major.