Hubungan Faktor Lingkungan dan Perilaku Terhadap Kejadian Infeksi Saluran Pernafasan Akut (ISPA) di Desa Talok Kecamatan Kresek

Penyakit Infeksi Saluran Pernafasan Akut (ISPA) masih menjadi salah satu masalah kesehatan masyarakat yang penting untuk diperhatikan, karena merupakan penyakit akut dan bahkan dapat menyebabkan kematian pada balita di berbagai negara berkembang termasuk Indonesia. Salah satu faktor yang mempengaruhi terjadinya ISPA adalah lingkungan dan perilaku masyarakat. Tiga Faktor lingkungan juga dapat disebabkan dari pencemaran udara dalam rumah seperti asap rokok, asap dari dapur karena memasak dengan kayu bakar serta kebiasaan menggunakan obat nyamuk bakar didalam rumah. Beberapa perilaku penduduk yang dapat menimbulkan terjadinya ISPA antara lain meludah sembarangan, membakar sampah, kebiasaan merokok, kebiasaan membuka jendela, dan kebiasaan tidur. Metode penelitian yang digunakan adalah deskriptif analitik dan desain penelitiannya berupa cross-sectional. Data yang diambil merupakan data primer dengan teknik wawancara terpimpin menggunakan kuesioner mengenai faktor lingkungan rumah dan perilaku. Dari 28 responden warga binaan diketahui bahwa terdapat kejadian ISPA pada 23 orang (82,1%), terdapat rumah tidak sehat 23 rumah (82,1%), dan perilaku kurang baik 12 orang (42,9).Dari hasil analisis didapatkan nilai P=0,007 terhadap lingkungan, dan p=0,03 terhadap perilaku risiko. terdapat hubungan signifikan faktor lingkungan dan perilaku terhadap Kejadian ISPA

Association of free-living physical activity measures with metabolic phenotypes in type 2 diabetes at the time of diagnosis. The Verona Newly Diagnosed Type 2 Diabetes Study (VNDS)

Objective: Lifestyle is considered a major determinant of risk of type 2 diabetes (T2D). We investigated whether daily physical activity (DPA) is associated with beta-cell function (BF) and/or insulin sensitivity (IS) in patients with T2D at the time of diagnosis. Methods: In 41 subjects enrolled in the Verona Newly-Diagnosed Type 2 Diabetes Study we assessed: (1) IS, by euglycaemic insulin clamp; (2) BF, estimated by prolonged-OGTT minimal modeling and expressed as derivative and proportional control; (3) DPA and energy expenditure (EE), assessed over 48-hours monitoring by a validated wearable armband system. Results: Study participants (median[IQR]; age: 62 [53-67] years, BMI: 30.8 [26.5-34.3] Kg c5m-2, HbA1c: 6.7 [6.3-7.3]%; 49.7 [45.4-56.3] mmol/mol) were moderately active (footsteps/day: 7,773 [5,748-10,927]; DPA 653MET: 70 [38-125] min/day), but none of them exercised above 6 metabolic equivalents (MET). EE, expressed as EETOT (total daily-EE) and EE 653MET (EE due to DPA 653MET) were 2,398 [2,226-2,801] and 364 [238-617] Kcal/day, respectively. IS (M-clamp 630 [371-878] \u3bcmol/min/m2) was positively associated with DPA and EE, independent of age, sex and BMI (p<0.05). Among the DPA and EE parameters assessed, DPA 653MET and EETOT were independent predictors of IS in multivariable regression analyses, adjusted for age, sex, BMI (R2=16%, R2=19%, respectively; p<0.01). None of model-derived components of BF was significantly associated with DPA or accompanying EE. Conclusions Our study highlighted moderate levels of DPA and total EE as potential determinants of IS, but not BF, in T2D at the time of diagnosis. Intervention studies are needed to conclusively elucidate the effect of DPA on these features

Long-Acting GLP-1 Receptor Agonist Exenatide Influence on the Autonomic Cardiac Sympatho-Vagal Balance

Long-acting glucagon-like peptide 1 receptor agonists are increasingly used to treat type 2 diabetes. An increase of heart rate (HR) has been observed with their use. To elucidate the role of the cardiac sympatho-vagal balance as a possible mediator of the reported increase in HR, we performed power spectral analysis of HR variability (HRV) in patients receiving exenatide extended-release (ER). Twenty-eight ambulatory patients with type 2 diabetes underwent evaluation at initiation of exenatide-ER and thereafter at 3 and at 6 months. To obtain spectral analyses of HRV, a computerized acquisition of 10 minutes of RR electrocardiogram intervals (mean values of ~700 RR intervals) were recorded both in lying and in standing positions. All patients showed a substantial increase of HR both in lying and in standing positions. Systolic blood pressure, body weight, and glycated hemoglobin A1c significantly decreased both at 3 and 6 months compared with basal levels. The low-frequency/high-frequency ratio varied from 3.05 \ub1 0.4 to 1.64 \ub1 0.2 (P < 0.001) after 3 months and to 1.57 \ub1 0.3 (P < 0.001) after 6 months in a lying position and from 4.56 \ub1 0.8 to 2.24 \ub1 0.3 (P < 0.001) after 3 months and to 2.38 \ub1 0.4 (P < 0.001) after 6 months in a standing position compared with basal values, respectively. HR variations, induced by exenatide-ER treatment, do not appear to be related to sympathetic autonomic tone. Of note, we observed a relative increase of vagal influence on the heart

STEATOEPATITE NON ALCOLICA E FIBROSI EPATICA IN UNA CASISTICA DI PAZIENTI OBESI SOTTOPOSTI A CHIRURGIA BARIATRICA

Obiettivi dello studio: Valutare la prevalenza di epatopatia steatosica non alcolica (NAFLD) ed in particolare di steatoepatite non alcolica (NASH) e fibrosi epatica in pazienti con obesit\ue0 grave, che sono candidati ad intervento di chirurgia bariatrica. E\u2019 stato inoltre valutato l\u2019andamento delle transaminasi plasmatiche, adiponectina e di alcuni scores non invasivi di fibrosi epatica avanzata dopo 6 e 12 mesi dall\u2019intervento chirurgico.Popolazione e Metodi: Abbiamo studiato un campione di 28 pazienti affetti da obesit\ue0 grave (75% donne, et\ue0 mediana 41 anni, BMI mediano 45 kg/m\ub2), che sono stati sottoposti ad intervento in elezione di sleeve gastrectomy (19 pazienti) o bypass gastrico (9 pazienti). In tutti i pazienti sono stati eseguiti accertamenti metabolici (incluso 2-h clamp euglicemico iperinsulinemico) al baseline ed \ue8 stata eseguita una biopsia epatica durante l\u2019intervento chirurgico. Nessuno di questi pazienti aveva un eccessivo consumo di alcoolici n\ue9 una precedente storia di cirrosi e/o altre epatopatie croniche note.Risultati: Dei 28 pazienti inclusi nello studio, 16 (57%) hanno soddisfatto i criteri istologici per una diagnosi di NASH, mentre i restanti 12 (43%) pazienti non avevano NASH al baseline. Di questi 12 pazienti privi di NASH alla biopsia, 8 pazienti avevano steatosi macrovescicolare di grado lieve o severo (NAFL), mentre solo 4 pazienti (pari al 14.3% del campione totale) erano esenti da NAFLD alla biopsia epatica. Per quanto riguarda il grado di fibrosi epatica, 4 pazienti (14.3%) non avevano fibrosi (stadio F0), 14 (50%) pazienti avevano fibrosi moderata (F2) e 10 (35.7%) avevano \u201cbridging fibrosis\u201d (F3). Nessuno dei pazienti aveva cirrosi epatica precedentemente misconosciuta (F4). Quando i pazienti venivano suddivisi sulla base della presenza/assenza di NASH e/o della severit\ue0 di fibrosi epatica (F3 vs. F0-2), i due gruppi di pazienti erano comparabili per et\ue0, sesso e le principali variabili biochimiche esaminate, incluso transaminasi, APRI index, FIB-4 score e sensibilit\ue0 insulinica (M-clamp). L\u2019intervento chirurgico induceva, sia dopo 6 che 12 mesi, un marcato calo ponderale ed una significativa riduzione dei livelli circolanti di adiponectina in entrambi i gruppi. Al contrario, i valori di transaminasi e gli scores non invasivi di fibrosi epatica avanzata non hanno mostrato alcuna significativa variazione dopo 6 e 12 mesi dall\u2019intervento chirurgico in nessuno dei gruppi di pazienti considerati (NASH vs. no-NASH e F3 vs. F0-2).Conclusioni: Nei nostri pazienti con obesit\ue0 grave, candidati a chururgia bariatrica, la NAFLD \ue8 una patologia assai comune (essendo presente in circa 85% del campione) ed \ue8 gi\ue0 presente anche nelle sue forme istologiche pi\uf9 severe (NASH nel 57% dei casi e fibrosi avanzata nel 35.7% dei casi), pur rimanendo queste forme spesso clinicamente silenti (o pauci-sintomatiche) e senza accompagnarsi a significative alterazioni delle transaminasi circolanti e degli scores non-invasivi di fibrosi avanzata. Questi dati suggeriscono la necessit\ue0 di una diagnosi precoce e tempestiva delle forme pi\uf9 severe della NAFLD (che sono quelle associate ad un maggior rischio di progressione verso la cirrosi e l\u2019epatocarcinoma) in tutti i soggetti obesi che vengono sottoposti a chirurgia bariatrica (da eseguirsi almeno in fase intra-operatoria)

HOMA-Estimated Insulin Resistance Is an Independent Predictor of Cardiovascular Disease in Type 2 Diabetic Subjects

OBJECTIVE—To evaluate whether homeostasis model assessment-estimated insulin resistance (HOMA-IR) is an independent predictor of cardiovascular disease (CVD) in type 2 diabetes. RESEARCH DESIGN AND METHODS—Conventional CVD risk factors (sex, age, smoking, plasma lipids, blood pressure, and metabolic control) and insulin resistance (estimated by HOMA) were evaluated at baseline in 1,326 patients with type 2 diabetes examined within the Verona Diabetes Complications Study. At baseline and after a mean follow-up of 4.5 years, CVD was assessed by medical history, physical examination, electrocardiography, and echo-Doppler of carotid and lower limb arteries. Death certificates and medical records of subjects who died during the follow-up were carefully scrutinized to identify cardiovascular deaths. In statistical analyses, CVD was an aggregate end point including both fatal and nonfatal coronary, cerebrovascular, and peripheral vascular disease as well as ischemic electrocardiographic abnormalities and vascular lesions identified by echo-Doppler. RESULTS—At baseline, 441 subjects were coded positive for CVD (prevalent cases). Incident cases numbered 126. Multiple logistic regression analyses showed that, along with sex, age, smoking, HDL/total cholesterol ratio, and hypertension, HOMA-IR was an independent predictor of both prevalent and incident CVD. A 1-unit increase in (log)HOMA-IR value was associated with an odds ratio for prevalent CVD at baseline of 1.31 (95% CI 1.10–1.56, P = 0.002) and for incident CVD during follow-up of 1.56 (95% CI 1.14–2.12, P < 0.001). CONCLUSIONS—HOMA-IR is an independent predictor of CVD in type 2 diabetes. The improvement of insulin resistance might have beneficial effects not only on glucose control but also on CVD in patients with type 2 diabetes

Vitamin D Deficiency Is Associated with Increased Osteocalcin Levels in Acute Aortic Dissection: A Pilot Study on Elderly Patients

An imbalance between degradation and reconstruction of the aortic wall is one of the leading causes of acute aortic dissection (AAD). Vitamin D seems an intriguing molecule to explore in the field of AAD since it improves endothelial function and protects smooth muscle cells from inflammation-induced remodeling, calcification, and loss of function, all events which are strongly related to the aging process. We quantified 25-hydroxy vitamin D, calcium, parathormone, bone alkaline phosphatase, and osteocalcin levels in 24 elderly AAD patients to identify a potential pathological implication of these molecules in AAD. Median 25-hydroxy vitamin D (10.75 ng/mL, 25th–75th percentiles: 6.86–19.23 ng/mL) and calcium levels (8.70 mg/dL, 25th–75th percentiles: 7.30–8.80 mg/dL) suggested hypovitaminosis D and a moderate hypocalcemia. Thirty-eight percent of AAD patients had severe (<10 ng/mL), 38% moderate (10–20 ng/mL), and 24% mild 25-hydroxy vitamin D deficiency (20–30 ng/mL). A significant inverse correlation was observed between 25OHD and osteocalcin levels. All the other molecules were unchanged. A condition of hypovitaminosis D associated to an increase in osteocalcin levels is present in AAD patients. The identification of these molecules as new factors involved in AAD may be helpful to identify individuals at high risk as well to study preventing strategies

Abstracts of 51st EASD Annual Meeting

Background and aims: Presence and frequency of beta cell (BC) dysfunction(BCD) and insulin resistance (IR) in patients with newly diagnosedtype 2 diabetes mellitus (NDT2D) are imperfectly known, becauseprevious studies used small cohorts and/or only surrogate indexes of BCfunction and IR.We sought to assess BC function and IR with state-of-artmethods in the VNDS.Materials and methods: In 712 GADA-negative, drug naïve, consecutiveItalian NDT2D patients we assessed: 1. standard parameters; 2. insulinsensitivity (IS) by the euglycaemic insulin clamp); 3. BC functionby state-of-art modeling of prolonged (5 hours) OGTT-derived glucose/C-peptide curves. Thresholds for BCD and IR were the 25th percentilesof BC function and IS assessed with the same methods of the VNDS inItalian subjects with normal glucose regulation of the GENFIEV (n=340)and GISIR (n=386) studies, respectively.Results: In the VNDS, 89.8% [95% C.I.: 87.6 - 92.0%] and87.8% [85.4 - 90.2] patients had BCD and IR, respectively. Patientswith only one defect were 19.7% [16.8 - 22.6]. IsolatedBCD and isolated IR were present in 10.9% [8.6 - 13.2] and8.9% [6.8 - 11.0] patients, respectively. Coexistence of BCDand IR was observed in 78.9% [75.9 - 81.9] of the patients.1.4% [0.5 - 2.3] of the patients had no detectable alterations inBC function and IS. Patients (19.7%) with only one metabolicdefect had lower BMI, fasting glucose, HbA1c, triglycerides andBC function, and higher HDL-cholesterol and IS than patientswith both BCD and IR (p<0.01 or less after Bonferroni’scorrection).Conclusion: In conclusion, in NDT2DM patients: 1. at least 75.9% haveboth BCD and IR; 2. At least 87.6% and 85.4% have BCD and IR,respectively; 3. At least 16.8% have only one defect and a significantlydifferent (milder) metabolic phenotype compared to patients with bothdefects. These findings may be relevant to therapeutic strategies centeredon the metabolic phenotype of the patient.Clinical Trial Registration Number: NCT00879801; NCT01526720Supported by: University of Veron

The PLATO mission

PLATO (PLAnetary Transits and Oscillations of stars) is ESA’s M3 mission designed to detect and characterise extrasolar planets and perform asteroseismic monitoring of a large number of stars. PLATO will detect small planets (down to <2REarth) around bright stars (<11 mag), including terrestrial planets in the habitable zone of solar-like stars. With the complement of radial velocity observations from the ground, planets will be characterised for their radius, mass, and age with high accuracy (5%, 10%, 10% for an Earth-Sun combination respectively). PLATO will provide us with a large-scale catalogue of well-characterised small planets up to intermediate orbital periods, relevant for a meaningful comparison to planet formation theories and to better understand planet evolution. It will make possible comparative exoplanetology to place our Solar System planets in a broader context. In parallel, PLATO will study (host) stars using asteroseismology, allowing us to determine the stellar properties with high accuracy, substantially enhancing our knowledge of stellar structure and evolution. The payload instrument consists of 26 cameras with 12cm aperture each. For at least four years, the mission will perform high-precision photometric measurements. Here we review the science objectives, present PLATO‘s target samples and fields, provide an overview of expected core science performance as well as a description of the instrument and the mission profile towards the end of the serial production of the flight cameras. PLATO is scheduled for a launch date end 2026. This overview therefore provides a summary of the mission to the community in preparation of the upcoming operational phases

Bond activation by electron transfer in indenyl ruthenium(II) cpmplexes. The electrochemical reduction of [Ru(eta5-C9H7)ClL2] and [Ru(eta5-C9H7)L2]+

The reduction of half-sandwich indenyl complexes of general formula [Ru(eta(5)-C9H7)Cl(L)(2)] (L = PPh3, 1; L-2 = 1,5-cyclooctadiene, 2) and [Ru(eta(5)-C9H7)(L)(2)](+) has been carried out in order to investigate the effects of electron transfer on the structural and chemical properties of the complexes. The reduction of these complexes proceeds by irreversible bielectronic processes. In the case of the metal halide complexes, the first electron transfer generates a 19-electron radical anion, which undergoes Ru-Cl bond cleavage to form a 17-electron Ru-eta(5)-C9H7)(L)(2) radical, which is in turn reduced at a less negative potential. Therefore the overall process proceeds according to a ECE mechanism, characterized by two electron transfers separated by a chemical reaction. The cationic [Ru(eta(5)-C9H7)(L)(2)](+) complexes were generated in situ by chloride abstraction, upon reacting complex 1 or 2 with AgBF4 or AgPF6; both [Ru(eta(5)-C9H7)(PPh3)(2)](+) (1a(+)) and [Ru(eta(5)-C9H7)COD](+) (2a(+)) undergo a monoelectronic reductive process forming the radical intermediates, which rapidly dimerize. The [Ru(eta(5)C(9)H(7))COD]. radical is sufficiently stable to be detected by cyclic voltammetry and partially generates the 18-electron anion [Ru(eta(5)-C9H7)COD](-)