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"Pasien sirosis hati perlu dievaluasi secara berkala untuk menentukan adanya varises esofagus (VE) dan ukurannya (besar atau kecil), karena VE besar membutuhkan penatalaksanaan yang lebih agresif. Evaluasi ini dilakukan dengan endoskopi yang tidak selalu ada, invasif, dan berbiaya tinggi. Penelitian ini bertujuan untuk mendapatkan pemeriksaan yang non invasif, lebih murah, dan lebih mudah diakses untuk menentukan besarnya VE. Parameter yang diteliti adalah hitung trombosit, prothrombin time (PT), kadar albumin, dan bilirubin. Desain penelitian adalah potong lintang dengan 64 subjek, terdiri atas 24 pasien sirosis hati dengan VE besar dan 40 tanpa VE besar. Pada penelitian ini didapatkan perbedaan bermakna pada hitung trombosit, PT, dan kadar albumin antara kedua kelompok, sedangkan kadar bilirubin tidak memberikan perbedaan yang bermakna. Untuk parameter hitung trombosit didapatkan besar area under the curve untuk memprediksi VE besar sebesar 80,9%, dengan cutoff 89,5 x 103/μL didapatkan sensitivitas 79,2% dan spesifisitas 75,0%; PT 68,4%, dengan cutoff 14,05 detik didapatkan sensitivitas 70,8% dan spesifisitas 67,5%; kadar albumin 76,6%, dengan cutoff 3,275 g/dL didapatkan sensitivitas 70,8% dan spesifisitas 75,0%. Model prediksi sirosis hati dengan VE besar adalah P = 1/(1 + Exp-Logit (y)) dengan Logit (y) = 11,989 – 0,026 x hitung trombosit – 2,243 x kadar albumin – 0,184 x PT.

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Patients with liver cirrhosis require periodic evaluation to determine the presence and size of esophageal varices (EV), because the large ones demand more aggressive management. Evaluation is done using endoscopy, which is not always available, invasive, and costly. This study aims to acquire tests that are noninvasive, cheaper, and more accessible to determine the size of EV. Studied parameters were platelet count, prothrombin time (PT), albumin, and bilirubin level. The study design was cross sectional with 64 subjects, consisted of 24 liver cirrhotic patients with large VE and 40 without.

This study found significant difference in platelet count, PT, and albumin level between both groups, while bilirubin level was not. The size of area under the curve for platelet count to predict large VE was 80.9%, cutoff 89.5 x 103/μL (sensitivity 79.2%, specificity 75.0%), PT 68.4%, cutoff 14.05 seconds (sensitivity 70.8%, specificity 67.5%), and albumin level 76.6%, cutoff 3.275 g/dL (sensitivity 70.8%, specificity 75.0%). Prediction model for liver cirrhosis with large VE was P = 1/(1 + Exp-Logit (y)) with Logit (y) = 11.989 – 0.026 x platelet count – 2.243 x albumin level – 0.184 x PT."

"ABSTRAKPemeriksaan koagulasi rutin PT dan APTT sangat dipengaruhi oleh variabel pra analitik yaitu perbandingan darah dengan antikoagulan sitrat 0,109 M adalah 9:1. Kurangnya volume darah dalam tabung menyebabkan rasio berubah sehingga terjadi pengenceran sampel disebut underfilling. Underfilling pada tabung sitrat 0.109 M menyebabkan nilai PT dan APTT memanjang. Penelitian ini bertujuan untuk membuktikan underfilling menyebabkan pemanjangan PT dan APTT, melihat adakah perbedaan rerata PT dan APTT antar berbagai volume dalam tabung, sekaligus menentukan volume minimal spesimen dalam tabung sitrat yang direkomendasikan untuk pemeriksaan PT dan APTT. Desain penelitian potong lintang dengan 38 subjek sehat dan 38 pasien dengan warfarin. Hasil penelitian ini membuktikan bahwa underfilling menyebabkan pemanjangan PT dan APTT. Terdapat perbedaan rerata PT dan APTT pada berbagai volume spesimen, dan volume minimal spesimen dalam tabung sitrat yang direkomendasikan untuk pemeriksaan PT dan APTT adalah 90 untuk subjek sehat dan 100 untuk pasien dengan warfarin.Kata kunci: pra analitik; pemeriksaan koagulasi; underfilling; pemanjangan PT dan APTT; volume minimal spesimen

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ABSTRACTThe routine coagulation measurement PT and APTT are highly influenced by pre analytical variables, one of which is the ratio of 9 1 between blood and citrate 0.109 M as anticoagulant. Lesser than minimum amount of blood volume in sample tube causes sample dilution known as underfilling. Underfilling of citrate 0.109 M tube results in prolonged PT and APTT. This study aims to prove that underfilling leads to prolonged PT and APTT by comparing mean PT and APTT value between sample tubes with different volume of blood. Furthermore, the recommended minimal volume of specimen in citrated tube would be sought. The study design was cross sectional with 38 healthy subjects and 38 patients on warfarin. This study indeed found that underfilling causes prolonged PT and APTT. There were significant mean difference of each PT and APTT for various specimen volumes. The recommended minimum specimen volume in citrate tube for PT and APTT measurement was 90 for healthy subject and 100 for patients on warfarin.Keywords pra analytic, coagulation measurement, underfilling, prolonged PT APTT, minimum specimen volume."

"Luka bakar merupakan salah satu bentuk trauma tersering dan infeksi luka bakar merupakan masalah serius yang menyebabkan hambatan pada maturasi epidermal dan penambahan pembentukan jaringan parut. Pada tahun terkahir berbagai penelitian menemukan patogen yang resisten terhadap terapi antibiotik. Penelitian ini bertujuan mendapatkan gambaran profil bakteri dan antibiogram pada infeksi luka bakar serta mortalitas di Unit Luka Bakar ULB Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo RSUPNCM periode Januari-Desember 2015. Penelitian ini dilaksanakan secara retrospektif dan didapatkan 214 isolat dari spesimen pus, swab, dan jaringan luka bakar yang berasal dari 89 pasien yang dirawat di ULB RSUPNCM. Isolat bakteri terbanyak adalah Pseudomonas aeruginosa, Klebsiella pneumoniae, dan Acinetobacter baumannii. Proporsi mortalitas didapatkan sebesar 32.5

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Burns is one of the most common forms of trauma and burn wound infection is a serious problem that causes a drag on epidermal maturation and addition of scar tissue formation. In recent years various studies finding pathogens that are resistant to antibiotic therapy. This study aims to get an overview of bacteria and antibiogram profile in infections and mortality burns in the Burn Unit dr. Cipto Mangunkusumo General Hospital in the period from January to December 2015. In this study, 214 isolates from pus specimens, swabs, and tissue burns derived from 89 patients treated at Burn Unit dr. Cipto Mangunkusumo General Hospital. Most bacterial isolates is Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii. The proportion of mortality obtained amounted to 32.5."

"ABSTRAKHemolisis merupakan masalah yang umum dijumpai dalam praktik laboratorium dengan prevalensi 3,3 dari total spesimen yang diterima di laboratorium. Hemolisis memiliki pengaruh yang berbeda pada pemeriksaan PT dan APTT pada subyek sehat dan pasien Sysmex CS2100i merupakan alat koagulometer yang menggunakan prinsip deteksi koagulasi dengan transmisi cahaya foto-optikal yang dilengkapi dengan detektor hemolisis ikterik dan lipemik HIL dan multiple wavelength detector. Aspek terpenting dalam praktik laboratorium terkait hemolisis adalah mengetahui batasan indeks hemolisis yang dapat menimbulkan bias bermakna di dalam suatu pemeriksaan dalam hal ini PT dan APTT. Jumlah subyek penelitian sebesar 70 orang yang dibagi dua yaitu, kelompok sehat sebesar 35 orang dan kelompok sakit dengan warfarin sebesar 35 orang. Pembuatan hemolisat dilakukan dengan metode trauma mekanik menggunakan syringe insulin dengan jarum 30G. Pada hasil PT dan APTT subyek sehat didapatkan uji repeated measures ANOVA bermakna, p=0,001 dan subyek sakit dengan warfarin didapatkan uji Friedman bermakna, p=0,001. Uji post-hoc Dunnett subyek sehat untuk hasil PT didapatkan nilai bermakna pada konsentrasi hemolisis 150, 200, 250, 330 dan 500 mg/dL, sedangkan hasil APTT didapatkan hasil bermakna pada konsentrasi hemolisis 250, 330, dan 500 mg/dL. Uji post-hoc Wilcoxon subyek sakit untuk hasil PT didapatkan nilai bermakna pada konsentrasi hemolisis 100, 150, 200, 250, 330 dan 500 mg/dL, sedangkan hasil APTT didapatkan nilai bermakna pada konsentrasi hemolisis 250, 330 dan 500 mg/dL.Bias hemolisis maksimal yang masih dapat diterima dengan kriteria Ricos dkk untuk PT dan APTT subyek sehat masing-masing adalah 100 mg/dL, sedangkan subyek sakit dengan warfarin adalah 50 mg/dL dan 200 mg/dL. Batasan dengan kriteria CLIA untuk PT dan APTT subyek sehat adalah 330 mg/dL dan 250 mg/dL, sedangkan subyek sakit dengan warfarin adalah 330 mg/dL baik untuk PT maupun APTT. Dari grafik scatter didapatkan tren pemanjangan hasil PT dan APTT subyek sehat, sedangkan pada subyek sakit dengan warfarin didapatkan tren pemanjangan hasil PT dan pemendekan hasil APTT. Penerapan batasan bias hemolisis maksimal memungkinkan praktisi laboratorium untuk tetap menerima spesimen dengan interferensi hemolisis pada pemeriksaan PT dan APTT, memastikan hasil yang dikeluarkan tetap akurat, tanpa menunda penatalaksanaan terhadap pasien dan mengurangi biaya dan ketidaknyamanan yang timbul akibat pengambilan kembali spesimen.

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ABSTRACTHemolysis is a common problem in laboratory practice with a prevalence of 3.3 of the total specimens received in the laboratory. Haemolysis have a different influence on the examination of the PT and APTT in healthy and patients subjects. Sysmex CS2100i is a coagulometer with the photo optical method, equipped with hemolysis, icteric and lipemic detector HIL and multiple wavelength. The most important aspect in laboratory practice is to know the limits associated with haemolysis that can cause significant bias in PT and APTT assay. The total number of research subjects are 70 people, divided into 35 healthy subjects and 35 patient subject undergoing warfarin therapy. Hemolysate was conducted using a mechanical trauma using insulin syringe with 30G needle.. Repeated measures ANOVA test of PT and APTT on healthy subjects obtained a significant statistical result, p 0.001. The warfarin users also had a significant statistical result with Friedman test, p 0.001. Post hoc Dunnett test on PT values of healthy subjects, obtained a statisticaly significant results in hemolysis concentration of 150, 200, 250, 330 and 500 mg dL, while the APTT results obtained significant statistical results in haemolysis concentration of 250, 330, and 500 mg dL. Wilcoxon post hoc test of PT on patient subjects obtained significant result in the haemolysis concentration of 100, 150, 200, 250, 330 and 500 mg dL, while the APTT values obtained significant results in hemolysis concentration 250, 330 and 500 mg dL. The maximum bias that still could acceptable by Ricos et al criteria for PT and APTT on healthy subjects for both were 100 mg dL, whereas patient subjects undergoing warfarin therapy was 50 mg dL and 330 mg dL. Using CLIA criteria for PT and APTT on healthy subjects resulted maximum bias was 330 mg dL and 250 mg dL, whereas warfarin users was 330 mg dL for PT and APTT. There was a trend of increase in the readings of PT and APTT on healthy subjects, while on patient subjects undergoing warfarin there was a trend of increase in PT and decrease of APTT results. The application of acceptable hemolysis bias limit, enable laboratory practitioners to process hemolysis specimens in PT and APTT assays, ensuring the results is still accurate without delaying clinical decision and to reduce the cost and inconvenience arising from the specimen recollection. "

"Latar belakang: Hemoglobin A1c HbA1c adalah pemeriksaan kontrol glikemik jangka panjang yang banyak digunakan. HbA1c berhubungan dengan risiko komplikasi diabetes. Akurasi pemeriksaan HbA1c dapat dipengaruhi kondisi hemoglobin varian. Hemoglobin varian adalah kelainan struktur hemoglobin. Di Indonesia, Hb. paling sering dijumpai. Sehingga peneliti ingin mengetahui prevalensi penderita hemoglobin varian pada pasien pemeriksaan HbA1c di RSUPNCM dan pengaruh hemoglobin varian terhadap pemeriksaan HbA1c metode afinitas boronat POCT dan ion-exchange HPLC dan gambaran mutasi gen hemoglobin varian heterozigot. Metode: Dilakukan uji ketelitian between day serta uji ketepatan within run menggunakan kontrol normal dan patologis. Subjek uji prevalensi adalah seluruh pasien yang melakukan pemeriksaan HbA1c di RSUPNCM. Terhadap subjek tersebut dilakukan pemeriksaan HbA1c metode ion-exchange HPLC dan pada subjek yang didapatkan variant window dilakukan analisa hemoglobin metode ion-exchange HPLC. Dilakukan uji perbedaan dua rerata antar kelompok pemeriksaan, subjek didapatkan secara konsekutif yang memenuhi krteria inklusi dan eksklusi. Terhadap subjek dilakukan pemeriksaan HbA1c metode ion-exchange HPLC, HbA1c metode afinitas boronat POCT Nycocard, dan HbA1c ion exchange extended HPLC dan dilakukan analisa hemoglobin metode ion-exchange HPLC. Analisa hemoglobin metode ion-exchange HPLC dilakukan terhadap seluruh subjek pada kedua kelompok. Dilakukan analisa DNA dengan metode PCR-RFLP dan metode DNA sequence untuk mengetahui gambaran mutasi hemoglobin varian heterozigot pada penelitian ini. Hasil: Didapatkan proporsi penderita hemoglobin varian sebesar 17 per 994 pasien 1.8 pada pasien yang melakukan pemeriksaan HbA1c di RSUPNCM. Pada uji perbedaan rerata HbA1c, metode afinitas boronat POCT dibandingkan ion-exchange extended HPLC didapatkan nilai HbA1c lebih rendah bermakna secara statistik pada kelompok hemoglobin varian p=0.006. Uji perbedaan rerata HbA1c metode ion-exchange HPLC dibandingkan dengan metode ion-exchange extended HPLC tidak didapatkan perbedaan bermakna pada kelompok subjek hemoglobin normal p= 0.534 dan hemoglobin varian p=0.781. Uji perbedaan median HbA1c metode afinitas boronat dan ion exchange extended HPLC tidak bermakna pada kelompok hemoglobin normal p=0.006. dan terdapat perbedaan bermakna pada kelompok hemoglobin varian p=0.006. Hemoglobin varian heterozigot pada penelitian ini terdiri dari. subjek HbG Makassar dan 19 subjek Hb. heterozigot. Hasil DNA sequence dideteksi HbE homozigot dan Hb. Makassar. Hasil PCR-RFLP didapatkan HbE heterozigot. Kesimpulan: Proporsi hemoglobin varian pada pasien pemeriksaan HbA1c di RSUPNCM adalah 17 per 994 pasien 1.8. Hemoglobin varian menyebabkan nilai HbA1c lebih rendah bermakna secara statistik dan klinis pada pemeriksaan metode afinitas boronat POCT dibandingkan metode ion-exchange extended HPLC. Hasil pemeriksaan HbA1c metode ion-exchange HPLC dibandingkan ion-exchange extended HPLC metode rujukan pada kedua kelompok tidak terdapat perbedaan bermakna. Hasil DNA sequence dideteksi HbE homozigot dan Hb. Makassar. Hasil PCR-RFLP didapatkan HbE heterozigotKata Kunci. Hb. Makassar, Hb E, pemeriksaan HbA1c, ion-exchange extended HPLC.

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Background: Hemoglobin A1c HbA1c is. widely used long term glycemic control check. HbA1c is associated with the risk of diabetes complications. Accuracy of HbA1c examination can be influenced by hemoglobin variant condition. Hemoglobin variant is hemoglobin structure disorder. In Indonesia, Hb. is most commonly found. Researcher wanted to know the prevalence of hemoglobin variant patient in HbA1c examination patient at RSUPNCM and the influence of hemoglobin variant on HbA1c examination of POCT boronate affinity method and HPLC ion exchange and gene mutation heterogeneous hemoglobin variant.

Method: Performed between day precision test and accuracy test within run using normal and pathological control. The subjects of prevalence test were all patients performing HbA1c examination at RSUPNCM. Against this subject, HbA1c examination of the HPLC ion exchange method and in the subjects obtained by the variant window was analyzed by the HPLC ion exchange method hemoglobin. The difference test was performed between the two groups, the subjects were obtained in. consecutive manner which fulfilled the inclusion and exclusion krteria. Subjects were subjected to HbA1c examination of the HPLC ion exchange method, HbA1c POCT Nycocard boronate affinity method, and HbA1c ion exchange extended HPLC and HPLC ion exchange hemoglobin analysis performed. The HPLC ion exchange method hemoglobin analysis was performed on all subjects in both groups. DNA analysis was performed using PCR RFLP method and DNA sequence method to find out the heterozygot hemoglobin mutations in this study.

Result: The proportion of variant hemoglobin patients was 17 per 994 patients 1.8 in patients who performed HbA1c examination at RSUPNCM. In the HbA1c mean difference test, the POCT boronate affinity method versus the HPLC extended exchange ion obtained significantly lower HbA1c values in the variant hemoglobin group. 0.006. HbA1c difference test of the HPLC ion exchange method compared with the HPLC extended ion exchange method found no significant difference in the normal hemoglobin group. 0.534 and the variant hemoglobin group. 0.781. The median HbA1c difference test of the boronate affinity method and the extended exchange ion HPLC was not significant in the normal hemoglobin group. 0.006. and there was. significant difference in the variant hemoglobin group. 0.006. Variant hemoglobin heterozygous in this study consisted of. subjects of HbG Makassar and 19 Hb. heterozygous subjects. The DNA sequence result was detected by HbE homozygot and Hb. Makassar. Results of PCR RFLP obtained HbE heterozygotes.

Conclusion: The proportion of variant hemoglobin in HbA1c examination patients at RSUPNCM was 17 per 994 patients 1.8. Variant hemoglobin causes significantly lower HbA1c values statistically and clinically on examination of the POCT boronate affinity method than the HPLC extended exchange ion method. HbA1c examination of ion exchange HPLC method compared to HPLC extended exchange ion reference method in both groups was not significantly different. The DNA sequence result was detected by HbE homozygot and Hb. Makassar. Results of PCR RFLP obtained HbE heterozygotesKey Words Hb. Makassar, Hb E, HbA1c examination, ion exchange extended HPLC."

"Latar Belakang: Infeksi merupakan penyebab kematian yang penting pada thalassemia. Peningkatan risiko infeksi disebabkan oleh banyak faktor antara lain karena kelebihan besi dan splenektomi. Penelitian ini bertujuan mengetahui perbedaan fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi serta mengetahui hubungan fungsi fagositosis monosit dengan kadar feritin serum. Metode: Penelitian dilakukan di Departemen Patologi Klinik RSCM, Jakarta pada September 2013 ? Februari 2014. Desain penelitian potong lintang, dengan subjek penelitian pasien thalassemia mayor, terdiri dari 58 subjek pasca splenektomi dan 58 subjek non splenektomi yang telah dilakukan macthing umur dan jenis kelamin. Dilakukan pemeriksaan fagositosis monosit menggunakan E.coli yang telah diopsonisasi dan dilabel FITC sebagai target, (PhagotestTM) dan diperiksa dengan flow cytometry BD FACSCalibur. Kadar feritin serum diperiksa dengan Cobas e 601. Hasil: Median fagositosis monosit pada 58 subjek pasca splenektomi 5,03 (0,17 ? 22,79) %, dan pada 58 subjek non splenektomi 7,09 (0,11 ? 27,24) %, dan nilai p > 0.05. Kadar feritin serum pada subjek pasca splenektomi 6.724 (644,60 ? 21.835) ng/mL dan subjek non splenektomi 4.702,50 (1.381 ? 14.554) ng/mL, dan nilai p < 0.05. Hasil uji korelasi fungsi fagositosis monosit dengan kadar feritin didapatkan r = 0.13 (nilai p = 1.00). Kesimpulan: Tidak terdapat perbedaan bermakna antara fungsi fagositosis monosit pada pasien thalassemia mayor pasca splenektomi dan non splenektomi. Kadar feritin serum pada pasien thalassemia mayor pasca splenektomi lebih tinggi secara bermakna dibandingkan non splenektomi. Tidak didapatkan hubungan antara fagositosis monosit dengan kadar feritin serum.

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Background: Infection is an important cause of death in thalassemia. Increase of risk of infection could be due to iron overload and post-splenectomy. The study aimed to determine the difference of phagocytosis function of monocyte between post-splenectomized and non- splenectomized patients with thalassemia major, and the correlation of phagocytosis function of monocyte and serum ferritin level.

Methods: The study was conducted in Department of Clinical Pathology Cipto Mangunkusumo hospital, Jakarta, in September 2013 ? Februari 2014. It was a cross sectional study. The study subjects consisted of 58 post-splenectomized patients and 58 non-splenectomized patients with age and sex matching. Phagocytosis function of monocyte was determined using E.coli opsonized and labelled with FITC as target, (Phagotest TM) and was measured by flow cytometry BD FACSCalibur. Serum ferritin level was measured using Cobas e 601.

Result: Median phagocytosis of monocyte was 5,03 (0,17 ? 22,79) %, in 58 post- splenectomized subjects and 7,09 (0,11 ? 27,24) % in non-splenectomized subjects; p value > 0.05. Serum ferritin level was 6.274 (644,60 ? 21.835) ng/mL in post-splenectomized subjects and 4.702,50 (1.381 - 14.554) ng/mL in non-splenectomy subjects; p value < 0.05. The correlation between phagocytosis function of monocyte and serum ferritin level was r = 0.13 ( p value = 1.00).

Conclusion: There was no statistical difference of phagocytosis function of monocyte between post-splenectomized subjects and non-splenectomized subjects. Serum ferritin level in post- splenectomized was higher than non-splenectomized subjects. There was no correlation between phagocytosis function of monocyte and serum ferritin level."

"[ABSTRAKGastro Entero Pancreatic Neuro Endocrine Tumor (GEP-NET) merupakan keganasan yang jarang dijumpai di dunia dibandingkan dengan keganasan gastrointestinal lainnya. Menurut dataGEP-NET kadang sulit dibedakan dengan Irritabel Bowel Syndrome (IBS) dalam mendiagnosisnya. Keluhan GEP-NET antara lain nyeri perut, diare, flushing, sampai penurunan berat badan. Keluhan IBS antara lain nyeri perut, mual, diare atau dengan tanpa konstipasi. Saat ini telah dikembangkan pemeriksaan Chromogranin A (CgA) untuk membantu dalam pemeriksaan penapisan pasien yang menderita IBS maupun pasien yang dicurigai GEP-NET.Penelitian ini merupakan penelitian deskriptif untuk mengetahui kadar CgA pada kelompok normal, mengetahui kadar CgA pada pasien yang didiagnosis IBS, mengetahui kadar CgA pada pasien yang memiliki risiko GEP-NET dan mengetahui perbedaan kadar CgA pada pasien yang didiagnosis IBS dan pasien yang dicurigai menderita GEP-NET yang keduanya memiliki risiko GEP-NET.Pada penelitian ini didapatkan kadar CgA serum pada kelompok kontrol normal dengan nilai mean 50,70 μg/L, median 48,89 μg/L dengan rentang minimum-maksimum antara 42,66-80,62 μg/L. Pada penelitian ini didapatkan kadar CgA serum pada kelompok IBS dengan nilai mean 76,67 μg/L, median 64,82 μg/L dengan rentang minimum-maksimum antara 45,52-243,18 μg/L. Pada penelitian ini didapatkan kadar CgA serum pada kelompok yang dicurigai GEP- NET denga nilai mean median 66,23 μg/L dengan rentang minimum-maksimum antara 49,89-656,41 μg/L.Pada penelitian ini tidak terdapat perbedaan kadar CgA pada populasi pasien yang didiagnosa IBS maupun pada pasien yang dicurigai menderita GEP-NET yang keduanya memiliki risiko menderita GEP-NET dikemudian hari.

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ABSTRACTGastro Entero Pancreatic Neuro Endocrine Tumors (GEP-NET) is a malignancy that is rarely found in the world compared to other gastrointestinal malignancies. According to data registration data The Surveillance, Epidemiology and End Results (SEER) an increase in the incidence of sharp from 1973 (from 0.92 to 1.28 in 100,000 population per year), to 2004 (from 5.09 to 5.42 in 100,000 population per year).GEP-NET is difficult to distinguish from Irritabel Bowel Syndrome (IBS) in diagnose sometimes. GEP-NET complaints include abdominal pain, diarrhea, flushing, until the weight loss. Complaints of IBS include abdominal pain, nausea, diarrhea or with no constipation. We have been developed examination Chromogranin A (CgA) to assist in the screening examination of patients who suffer from IBS and patients who are suspected of suffering from GEP-NET.This study is a descriptive study to determine levels of CgA in the normal group, knowing CgA levels in patients diagnosed IBS, knowing CgA levels in patients who have a risk of GEP-NET and know the difference CgA levels in patients diagnosed with IBS and patients suspected of suffering from GEP- NET who both have risk GEP-NET.In this study, serum levels of CgA in the normal control group with a mean of 50,70 μg/L, median 48,89 μg / L with a minimum-maximum range between 42,66 to 80,62 μg/L. In this study, serum levels of CgA in the IBS group with a mean of 76,67μg /L, median 64,82 μg/L with a minimum-maximum range between 45,52 to 243,18 μg/L. In this study, serum levels of CgA in the group suspected of GEP-NET premises mean median value 66,23 μg/L with a minimum-maximum range between 49.89 to 656.41 g / L. In this study there was no difference in the levels of CgA IBS patients diagnosed population and in patients suspected of suffering from GEP-NET are both at risk of suffering from GEP-NET in the future., Gastro Entero Pancreatic Neuro Endocrine Tumors (GEP-NET) is a malignancy that is rarely found in the world compared to other gastrointestinal malignancies. According to data registration data The Surveillance, Epidemiology and End Results (SEER) an increase in the incidence of sharp from 1973 (from 0.92 to 1.28 in 100,000 population per year), to 2004 (from 5.09 to 5.42 in 100,000 population per year).GEP-NET is difficult to distinguish from Irritabel Bowel Syndrome (IBS) in diagnose sometimes. GEP-NET complaints include abdominal pain, diarrhea, flushing, until the weight loss. Complaints of IBS include abdominal pain, nausea, diarrhea or with no constipation. We have been developed examination Chromogranin A (CgA) to assist in the screening examination of patients who suffer from IBS and patients who are suspected of suffering from GEP-NET.This study is a descriptive study to determine levels of CgA in the normal group, knowing CgA levels in patients diagnosed IBS, knowing CgA levels in patients who have a risk of GEP-NET and know the difference CgA levels in patients diagnosed with IBS and patients suspected of suffering from GEP- NET who both have risk GEP-NET.In this study, serum levels of CgA in the normal control group with a mean of 50,70 μg/L, median 48,89 μg / L with a minimum-maximum range between 42,66 to 80,62 μg/L. In this study, serum levels of CgA in the IBS group with a mean of 76,67μg /L, median 64,82 μg/L with a minimum-maximum range between 45,52 to 243,18 μg/L. In this study, serum levels of CgA in the group suspected of GEP-NET premises mean median value 66,23 μg/L with a minimum-maximum range between 49.89 to 656.41 g / L. In this study there was no difference in the levels of CgA IBS patients diagnosed population and in patients suspected of suffering from GEP-NET are both at risk of suffering from GEP-NET in the future.]"

"ABSTRAKSepsis merupakan penyakit umum di perawatan intensif dan hampir 1/3 pasien yang dirawat di ICU adalah pasien sepsis. Banyak penelitian dilakukan untuk mencari penanda sepsis yang handal dan jumlah apoptosis limfosit mulai banyak diteliti sebagai penanda sepsis. Apoptosis limfosit terjadi mulai 24 jam pertama setelah onset sepsis. Saat ini belum terdapat data yang menunjukkan dapat digunakannya jumlah apoptosis limfosit sebagai penanda prognostik sepsis. Tujuan penelitian ini adalah mengetahui dapat tidaknya jumlah apoptosis limfosit digunakan sebagai penanda prognostik pada pasien sepsis beratDesain penelitian adalah uji prognosis secara prospektif, terdiri dari 30 pasien sepsis berat dibagi berdasarkan mortalitas 14 hari, yaitu 15 pasien hidup dan 15 pasien meninggal. Diagnosis sepsis berdasarkan modifikasi definisi sepsis oleh International Sepsis Definitions Conference 2001. Jumlah apoptosis limfosit dihitung menggunakan metode flowcytometry dengan reagen antibodi monoklonal CD45 berlabel PerCP, Annexin V berlabel FITC, dan Propidium Iodide. Pada kedua kelompok tersebut dicatat data karakteristik subyek dan dilakukan penghitungan jumlah apoptosis limfositRerata jumlah apoptosis limfosit pada kelompok pasien hidup adalah 0,992% dengan simpang baku 0,44% dan rerata jumlah apoptosis limfosit pada kelompok pasien meninggal adalah 1,5853% dengan simpang baku 0,57%. Jumlah apoptosis limfosit pada kedua kelompok berbeda bermakna dengan nilai p 0,004. Ditentukan nilai cut-off jumlah apoptosis limfosit 0,97%untuk menentukan prognosis pasien sepsis, dengan AUC 0,791 (IK 95% 0,631 ? 0,951), sensitivitas 86,7%, dan spesifisitas 60%. Kurva Kapplan Meier berdasarkan nilai cut-off 0,97% menunjukkan gambar yang memenuhi asumsi proporsional hazard dengan rasio hazard 0,182 (IK 95% 0,041 - 0,814), p = 0,026.Kami menyimpulkan jumlah apoptosis limfosit pasien sepsis berat dapat digunakan untuk memprediksi pasien yang meninggal dilihat dari mortalitas 14 hari, dengan nilai AUC sedang. Cut-off jumlah apoptosis limfosit 0,97% dapat digunakan sebagai cut-off dalam tatalaksana pasien sepsis berat

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ABSTRACTSepsis is a common illness in intensive care, almost 1/3 of patients admitted to the ICU were sepsis patients. There are plenty of researches to find a reliable marker of sepsis and the number of apoptotic lymphocytes began widely studied as a marker of sepsis. Apoptosis of lymphocytes occurred from the first 24 hours after the onset sepsis. There are currently no data on whether the number of apoptotic lymphocytes can be used as a prognostic marker of sepsis. The purpose of this study was to determine whether the number of apoptotic lymphocytes can be used as a prognostic marker in patients with severe sepsisThis was a prospective prognosis study, consisting of 30 severe sepsis patients grouped based on 14-day mortality, 15 patients are survivors and 15 patients are nonsurvivors. The diagnosis of sepsis is based on a modified definition of sepsis by the International Sepsis Definitions Conference 2001. The number of apoptotic lymphocytes was calculated using flowcytometry with PerCP-labeled anti-CD45 monoclonal antibody, FITC-labeled Annexin V, and Propidium Iodide. In both groups, characteristics of subjects were recorded and the number of apoptotic lymphocytes was calculated.The mean of apoptotic lymphocytes in the survivor group is 0.992% with a standard deviation of 0.44%, and the mean of apoptotic lymphocytes in the nonsurvivor group is 1.5853% with a standard deviation of 0.57%. The difference between the two groups is significant with p = 0.004. This study yields an apoptotic lymphocytes cut-off value of 0.97% to determine prognosis of severe sepsis patients, with AUC of 0.791 (CI 95% from 0.631 to 0.951), 86.7% sensitivity and 60% specificity. Kapplan Meier curve based on the 0.97% cut-off demonstrates that hazard proportion is fulfilled with hazard ratio of 0.182 (95% CI 0.041 to 0.814) and p= 0.026. It is concluded that the number of apoptotic lymphocytes in severe sepsis patients can be used to predict nonsurvivors based on 14-day mortality, with moderate AUC. The apoptotic lymphocytes cut-off value of 0.97% can be used as a cut-off for severe sepsis patient management"

"ABSTRAKPendahuluan: Hiperglikemia dalam kehamilan ditemui pada 25% kehamilan di Asia Tenggara, dan jika tidak terkontrol dapat menimbulkan komplikasi serius. Hemoglobin glikat (HbA1c) merupakan penanda standar status glikemik, namun dapat meningkat palsu pada kehamilan lanjut. Albumin glikat sebagai indikator status glikemik baru yang tidak dipengaruhi oleh anemia dapat menjadi alternatif dalam kehamilan.Tujuan: Mengetahui penggunaan HbA1c dan albumin glikat pada kehamilan dengan status glikemik normal.Metode: Sampel darah diambil dari 60 ibu hamil dengan usia kehamilan 21-36 minggu. Dilakukan pemeriksaan HbA1c, Hb, MCV, MCH, RDW, albumin glikat, albumin, besi serum, glukosa darah, saturasi transferin, dan TIBC. Parameter-parameter tersebut dibandingkan antara empat kelompok usia kehamilan (I: 21-24 minggu, n=17; II: 25-28 minggu, n=16; III: 29-32 minggu, n=16; dan IV: 33-36 minggu, n=11) menggunakan uji ANOVA atau Kruskal-Wallis dengan uji post-hoc.Hasil: Kadar albumin glikat tidak berbeda bermakna antara keempat kelompok (p=0.061). Kadar HbA1c lebih tinggi pada kelompok IV (4.59 ±0.28 %) daripada kelompok I (4.24 ± 0.27%, p=0.009). Kadar Hb kelompok II {10.9 (7.9 ? 11.6) g/dL} lebih rendah dibandingkan III (11.68 ± 0.84 g/dL, p=0.004) dan IV (11.74 ± 0.66 g/dL, p=0.001). Kadar albumin pada kelompok IV (3.59 ± 0.22 g/dL) lebih rendah dibandingkan kelompok I (3.82 ± 0.19 g/dL, p=0.006). Tidak ada perbedaan bermakna MCV, MCH, RDW-CV, besi serum, TIBC, dan saturasi transferin antar kelompok usia kehamilan (semua p>0.05)Kesimpulan: Kadar HbA1c berbeda menurut usia kehamilan, sedangkan pemeriksaan albumin glikat tidak terpengaruh dengan usia kehamilan. Albumin glikat dapat menjadi penanda status glikemik pada usia kehamilan 21-36 minggu.

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ABSTRACTIntroduction: Hyperglycemia during pregnancy is found in 25% of pregnancy in Southeast Asia, and when uncontrolled may cause serious complications. Glycated hemoglobin (HbA1c) is a standard indicator for glycemic status, but can show false increase during late pregnancy. Glycated albumin, a new glycemic status indicator which is unaffected by anemia, may be an alternative for pregnancy.Purpose: To examine the usefulness of HbA1c and glycated albumin during pregnancy with normal glycemic status.Method: Blood samples were taken from 60 pregnant women between 21-36 weeks of pregnancy. Tests were done for HbA1c, Hb, MCV, MCH, RDW, glycated albumin, albumin, serum iron, blood glucose, transferrin saturation, and TIBC. These parameters were compared among four groups of age of pregnancy (I: 21-24 weeks, n=17; II: 25-28 weeks, n=16; III: 29-32 weeks, n=16; and IV: 33-36 weeks, n=11) using ANOVA or Kruskal-Wallis test with post-hoc tests.Results: Glycated albumin was not statistically different among the groups (p=0.061). HbA1c level was higher in group IV (4.59 ± 0.28%) compared to group I (4.24 ± 0.27%, p=0.009). Hb level of group II {10.9 (7.9 ? 11.6) g/dL} was lower than group III (11.68 ± 0.84 g/dL, p=0.004) and IV (11.74 ± 0.66 g/dL, p=0.001). Albumin level of group IV (3.59 ± 0.22 g/dL) was lower than group I (3.82 ± 0.19 g/dL, p=0.006). No statistically significant difference was found for MCV, MCH, RDW-CV, serum iron, TIBC, and transferin saturation among pregnancy age groups (all p>0.05)Conclusion: HbA1c was different with different pregnancy age, but glycated albumin was not affected by pregnancy age. Therefore glycated albumin may be used as glycemic status indicator during pregnancy age of 21-36 weeks."

"Panduan dari American Diabetes Association (ADA) tahun 2015 menyarankan penggunaan aspirin (75-162 mg/hari) pada pasien DM untuk pencegahan primer maupun sekunder terhadap penyakit kardiovaskular. Namun, sebagian pasien yang minum aspirin tidak mencapai respons inhibisi yang diharapkan (resistensi aspirin). Terdapat teori yang menyatakan bahwa kontrol metabolik pada diabetes berkontribusi menurunkan sensitivitas trombosit terhadap aspirin. Penelitian ini bertujuan mengetahui proporsi resistensi aspirin pada pasien DM tipe 2, serta hubungannya dengan kontrol glikemik yang dinyatakan dengan HbA1c. Penelitian ini menggunakan desain potong lintang terhadap 82 pasien DM yang minum aspirin. Pada pasien dilakukan pemeriksaan agregasi trombosit dengan agregometer Chrono-log. Definisi resistensi aspirin adalah agregasi trombosit ≥ 20% dengan agonis asam arakidonat 0,5 mg/mL. HbA1c diperiksa menggunakan metode afinitas boronat dari Nycocard. Didapatkan proporsi resistensi aspirin sebanyak 14,6%. Tidak ditemukan hubungan yang bermakna antara kendali HbA1c yang buruk dengan resistensi aspirin.

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Guidelines from the American Diabetes Association (ADA) in 2015 suggested the use of aspirin (75-162 mg / day) in patients with diabetes mellitus for primary or secondary prevention of cardiovascular disease. However, some patients who took aspirin did not achieve the expected inhibition response (aspirin resistance). There is a theory which states that the metabolic control in diabetes contributes to decrease sensitivity of platelets to aspirin. This study aims to determine proportion of aspirin resistance in patients with type 2 diabetes, as well as its relation with glycemic control that is represented by HbA1c. This study used cross-sectional design on 82 diabetic patients who took aspirin. Platelet aggregation was assessed using Chrono-log aggregometry. Resistance to aspirin was defined as ≥ 20% platelet aggregation with arachidonic acid 0,5 mg / mL. HbA1c was assessed with boronic affinity method of Nycocard. Twelve subjects (14,6%) of type 2 diabetic patients were found to be resistant to aspirin therapy. There was no significant association between poor HbA1c control and aspirin resistance."