Habitual Coffee Consumption Does Not Correlate with Blood Pressure, Inflammation and Endothelial Dysfunction But Partially Correlates with Oxidative Stress

BACKGROUND: Coffee is the most widely consumed beverage in the world and has been known to have effects on cardiovascular system. Many researchers have examined the effects of coffee consumption on blood pressure (BP) and risk of cardiovascular disease (CVD), but their results were inconsistent and still remain a subject of controversy. Oxidative stress, inflammation, and endothelial dysfunction have been known as risk factors of hypertension and CVD. Those factors are also known to be affected by coffee consumption. The aim of this study was to examine the relationship between the effects of habitual coffee consumption on BP and to examine the role of oxidative stress (F2 isoprostane), inflammation (high sensitive C-reactive protein (hsCRP)) and endothelial dysfunction (asymmetric dimethylarginine (ADMA)).METHODS: This was a cross-sectional study in which 47 healthy, non-smoking men aged 30-60 years with varying coffee-drinking habits were enrolled. BP and blood/urine analysis of biomarkers were measured in the morning before activity. Coffee consumption was assessed using a questionnaire. The differences among variables were analyzed using ANOVA and the correlations between variables were analyzed using Kendall's Tau correlation analysis.RESULTS: Habitual coffee consumption did not correlate with systolic/diastolic BP (r=-0.02; p=0.856 and r=0.15; p=0.230, respectively). Concentrations of ADMA and hsCRP were also not correlated with coffee consumption (r=0.03; p=0.764 and r=0.04; p=0.701, respectively). Coffee consumption only showed significant correlation with F2 isoprostane (r=0.34; p=0.004).CONCLUSION: BP was not affected by coffee consumption although coffee consumption has a significant correlation with F2 isoprostane. These findings suggest that correlation between coffee consumption and BP might be explained by other factors that were not included in this study

Estimated Blood Loss in Craniotomy

Introduction: Estimated blood loss is an estimation of how much blood is loss during surgery. Surgical procedure requires a preparation of blood stock, but the demand for blood often larger than the actual blood used. This predicament happens because there is no blood requirement protocol being used. This study aims to determine the estimated blood loss during craniotomy procedure and it's conformity to blood units ordered for craniotomy procedure. Methods: This study is a retrospective study using data from Wahidin Sudirohusodo General Hospitals' medi- cal records in the period of January 2010-December 2012. We found 89 craniotomy patients that meet the inclusion criteria comprise of 66 men and 23 women. Results: This study showed that the average estimated blood loss in craniotomy was 3.20 units of whole blood (1120 ml) and the average of the demand of blood ordered was 4.0 units of whole blood (1400 ml). There was no mismatch between the amount of blood ordered for surgery and estimation of blood loss (p=0.73). Conclusion: Estimated blood loss in craniotomy procedure in Wahidin Sudirohusodo hospital, Makassar is 3.20 units of whole blood (1120 ml) was in accordance with amount of blood ordered for surgery

The Analysis of Asymetric Dimethylarginine and Homocysteine in Patients with Chronic Kidney Disease

BACKGROUND: Asymmetric dimethylarginine (ADMA) is a competitive inhibitor of nitric oxide synthase (NOS). ADMA reduces NO synthesis when its concentration elevates. ADMA is a novel risk factor for cardiovascular disease. Plasma ADMA accumulates in patients with endstage renal disease, due to reduced renal clearance. Hyperhomocysteinemia is often found in patients with chronic kidney disease (CKD). Homocysteine may cause ADMA to accumulate; however, the mechanism by which ADMA level elevates in hyperhomocysteinemia is still unclear. Objective of this study was to analyze the concentrations of homocysteine and ADMA and to assess the correlation between homocysteine and ADMA concentrations with the severity of chronic kidney disease.METHODS: This was a cross-sectional study on 75 patients with CKD, comprising men and women aged 40-70 years. Assessments were done on the concentrations of creatinine, homocysteine, ADMA, fasting blood glucose, cholesterol HDL and triglyceride.RESULTS: In later stage of CKD there was significantly higher tHcy concentration as compared with the earlier stage of CKD (p=0.0000). In CKD stage 2 to 4 there was a tendency for ADMA concentration to increase to a significant average (p=0.210), but ADMA concentration was lower at stage 5. There was increased ADMA along with increased tHcy concentration of around 20μ mol/L, and this then decreased. The inverse correlation between tHcy and ADMA concentrations started to appear in CKD stage 4, but this correlation was statistically insignificant (r2 =0.19; p=0.499).CONCLUSIONS: This study showed there was a correlation between homocysteine and ADMA concentrations in patients with CKD stage 2 to 5, although statistically not significant

Association of Obesity and Breast Cancer Risk: the Role of Estrogen, Tumor Necrosis Factor-alpha, and Adiponectin as Risk Factors (Preliminary Study)

BACKGROUND: Breast cancer is the most frequent cancer diagnosed among women. Many factors influence the carcinogenesis of breast cancer. The aim of this study to analyze the role of obesity (waist circumference and body mass index), serum Estradiol levels, TNF-α, and Adiponectin in the occurrence of breast cancer.METHODS: This was observational study with casecontrol design. Eleven breast cancer patients as cases and twelve Fibroadenoma Mammae (FAM) patients as controls were analyzed. The serum Estrogen, TNF-α and Adiponectin were examined in their association with breast cancer risk.RESULTS: Women with breast tumor and waist circumference > 80 cm have significantly higher breast cancer risk than women with breast tumor and waist circumference 2.30 pg/ml) have higher breast cancer risk (19.25 times) than women with breast tumor and have lower serum TNF-α levels (95% CI=1.77-209.55, p=0.015). Whereas, women with breast tumor and lower Adiponectin/TNF-α ratio (80 cm and low Adiponectin/TNF-α ratio in women with breast tumor are significantly associated with an increased risk for breast cancer

Correlation Between Homeostatic Model Assessment-estimated Insulin Resistance (HOMA-IR) with Asymmetric Dimethylarginine (ADMA) in Prehypertension

BACKGROUND: Not only hypertension, prehypertension has been reported to be linked with increased cardiovascular morbidity and mortality risks as well. Prehypertension has three-fold hypertension and two-fold cardiovascular risks. Pathomechanism that links hypertension with cardiovascular is related with endothelial dysfunction and insulin resistance. Endothelial dysfunction occurs when nitric oxide (NO) biological function was impaired, whereas shown by asymmetric dimethylarginine (ADMA). Subjects with prehypertension had higher insulin resistance events than normotension, whereas shown by homeostatic model assessment-estimated insulin resistance (HOMA-IR). This research was conducted to investigate the correlation of HOMA-IR with ADMA in prehyper- and normo-tension.METHODS: A cross-sectional comparative research was designed. Subjects were recruited and divided into prehyper- and normo-tensive groups. ADMA was measured using ELISA method, while HOMA-IR was calculated by the ratio of fasting insulin and glucose. Spearman 1-tail and Mann Whitney statistical analyses were performed.RESULTS: Comparing to normotensive group, elevated levels of HOMA-IR and ADMA in prehypertensive group were shown, but not significant. In prehypertensive group, we found significant correlation between HOMA-IR and ADMA.CONCLUSION: Insulin resistance and endothelial dysfunction was elevated in prehyper-compared to normotension

Study of Low-grade Chronic Inflammatory Markers in Men with Central Obesity: Cathepsin S Was Correlated with Waist Circumference

BACKGROUND: There is a prevalence increase of overweight and obesity in Indonesia. Central obesity can lead a variety of chronic diseases through the inflammatory process. There are some markers for low-grade chronic inflammatory, such as cathepsin S, high sensitivity C-reactive protein (hs-CRP), interleukin-1- beta (IL-1β). To our current interest that central obesity can lead to various chronic diseases through the inflammatory process, we conducted a study to investigate correlation of Cathepsin S, hs-CRP, IL-1β in men with central obesity.METHODS: A cross-sectional study was conducted. Seventy-eight selected subjects were examined to collect anthropometric data and prepared for sample collection. Collected samples were processed for the following biochemical analyses: fasting glucose, high density lipoprotein (HDL)-cholesterol, triglyceride, serum glutamic oxaloacetic transaminase (SGOT), serum glutamate pyruvate transaminase (SGPT), cathepsin S, hs-CRP, and IL-1β. Data distribution and variable correlation were then statistically analyzed.RESULTS: There were significant correlations between waist circumference (WC) and cathepsin S (p=0.030; r=0.214), hs-CRP and cathepsin S (p=0.007; r=0.276), triglyceride and IL-1β (p=0.019; r=-0.235), WC and systolic blood pressure (SBP) (p=0.003; r=-0.312), WC and fasting glucose (p=0.000; r=0.380), WC and body mass index (BMI) (p=0.000; r=0.708).CONCLUSION: Our study showed that cathepsin S was correlated with central obesity, suggesting that cathepsin S could be a potential inflammatory marker in central obesity in the future

Hubungan antara Kadar Creatine Kinase-MB dengan Mortalitas Pasien Infark Miokard Akut Selama Perawatan di RS. Dr. Wahidin Sudirohusodo, Makasar

Increase of CK-MB level is associated with myocardial infarction size and severity. The aim of this study is to evaluate the correlation between the admission CK-MB level of acute myocardial patients and the in-hospital mortality. Secondary data of 60 acute myocardial infarction patientshospitalized in Intensive Cardiac Care Unit of Dr.Wahidin Sudirohusodo Hospital Makassar from June 2010 to July 2011 were taken. Admission CK-MB levels between the period of 3 hours to 1 week after onset were then analyzed. The mean of admission CK-MB level in the in-hospital survived and non survived acute myocardial infarction patients were 89.52+121.59 U/l and 202.88+192.75 U/l respectively (Mann Whitney Test, p=0.005). There were significant mortality rate difference amongall CK-MB quartiles with mortality rate 13.3%, 6.7%, 40% and 46.7 % in 1st, 2nd, 3rd, and 4th quartile respectively (Chi Square Test, p=0.031) but the odds ratio of mortality between quartiles were not different.. There was significant difference of admission CK-MB levels in the in-hospitalsurvived and non survived acute myocardial infarction.Keywords : CK-MB, myocardial infarction, mortalityAbstrakPeningkatan kadar CK-MB pada infark miokard akut menunjukkan luas dan parahnya penyakit. Penelitian ini bertujuan untuk menilai hubungan antara kadar CK-MB pada pasien infark miokard akut saat masuk rumah sakit dan mortalitas pasien selama perawatan di rumah sakit.. Data sekunder diambil dari rekam medis 60 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo, Makassar periode Juli 2010 hingga Juni 2011. Kadar CK-MB diperoleh saat masuk rumah sakit antara 3 jam hingga 1 minggu setelah onset. Rerata kadar CK-MB pada penderita infark miokard akut yang survive dan meninggal selama perawatan adalah 89,52+121,59 U/l dan 202,88+192,75U/l (Uji Mann Whitney, p=0,005). Ditemukan perbedaantingkat mortalitas yang bermakna antar kuartil CK-MB masing-masing 13,3%, 6,7%, 40% dan 46,7% pada kuartil 1, 2, 3 dan 4 berturut-turut ( Uji Chi Square, p=0,031) tetapi risiko mortalitas antar kuartil tidak berbeda bermakna. Ditemukan perbedaan bermakna kadar CK-MB pada pasien yang survive maupun yang meninggal selama perawatan.Kata kunci : CK-MB, infark miokard, mortalita

Capacity and Utilization of Blood Culture in Two Referral Hospitals in Indonesia and Thailand.

It is generally recommended that sepsis patients should have at least two blood cultures obtained before antimicrobial therapy. From 1995 to 2015, the number of blood cultures taken each year in a 1,100-bed public referral hospital in Ubon Ratchathani northeast Thailand rose from 5,235 to 56,719, whereas the number received in an 840-bed referral public hospital in South Sulawesi, Indonesia, in 2015 was 2,779. The proportion of patients sampled for blood cultures out of all inpatients in South Sulawesi in 2015 (9%; 2,779/30,593) was lower than that in Ubon Ratchathani in 2003 (13%; 8,707/66,515), at a time when health expenditure per capita in the two countries was comparable. Under-use of bacterial cultures may lead to an underestimate and underreporting of the incidence of antimicrobial-resistant infections. Raising capacity and utilization of clinical microbiology laboratories in developing countries, at least at sentinel hospitals, to monitor the antimicrobial resistance situation should be prioritized

An Antioxidant Marker, Aminolevulinic Acid Dehydratase, Was Correlated with Bone Turnover Activity

BACKGROUND: Recent studies have indicated that lead may affect activities on bone cells, but the mechanism is not yet clear. Therefore, we conducted a study to investigate correlation of chronic low-concentration lead exposure with bone turnover activity (ratio of C-telopeptide (CTx) and Procollagen Type 1 Amino-terminal Propeptide (P1NP) (CTx/P1NP)) and antioxidant (aminolevulinic acid (ALA) dehydratase (ALAD)) in a workers community. METHODS: An observational study with cross-sectional design was carried out. Fifty two subjects from a workers community in Jakarta, Indonesia, had provided informed consents and undergone medical history, physical and laboratory examinations. Hair lead concentration was measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) method. Meanwhile, P1NP was measured by Enzyme-linked immunosorbent assay (ELISA) and CTx was measured by Electro-chemiluminescence Immunoassay (ELICA) method. RESULTS: The mean hair lead concentration was 4.85 ppm. Based on Mayo Clinic reference, 28.85% of investigated subjects had hair lead concentration of ≥5 ppm. Hair lead concentration was not correlated with ALAD, CTx, P1NP concentrations or CTx/P1NP. ALAD concentration was significantly correlated with CTx/P1NP (p<0.05; r=0.35).SUMMARY: ALAD concentration was correlated with CTx/P1NP ratio, indicating that the role of antioxidant was possibly caused by accumulated chronic low-concentration lead exposure, which was correlated with bone turnover activity