THE ROLE OF SURVIVIN AND RAF-1 KINASE AGAINST ENHANCEMENT OF PANCREATIC BETA-CELL APOPTOSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Objective: This study aimed to reveal differences in levels of survivin and Raf-1 kinase in prediabetes, controlled Type 2 diabetes mellitus (T2DM), uncontrolled T2DM, and their relationship with hemoglobin A1c (HbA1c) levels and serum triglyceride levels.Methods: This study was an observational study with a cross-sectional design. The study involved 60 people with T2DM who visited the endocrine and metabolic clinic and 30 prediabetes patients. The variables were survivin levels and Raf-1 kinase enzymes that examined using enzyme-linked immunosorbent assay techniques. HbA1c values are measured by high-performance liquid chromatography and triglyceride levels measured by enzymatic method.Results: Average levels of Raf-1 kinase were significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (11.6±1.4 pg mL, 9.9±1.1 pg/mL, and 9.1±1.5 pg/mL). Survivin was significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (5.4±0.4 pg mL, 5.0±0.2 pg/mL, and 4.7±0.1 pg/mL). There was no correlation between HbA1c with Raf-1 kinase levels (R=−0.215, p=0.250), but there was a correlation between HbA1c with serum survivin levels (R=−0.6, *p<0.05). There was a correlation between the levels of triglycerides with survivin but not with Raf-1 kinase (R=−0.267, *p=0.039).Conclusion: Survivin and Raf-1 kinase levels are lower in uncontrolled T2DM. This explained the role of survivin and Raf-1 kinase against enhancement of pancreatic beta-cell apoptosis in patients with T2DM

Clinical Picture and Microbiological Pattern in 3rd and 4th Degrees of the Pedis Classification of Diabetic Foot Infection

Diabetic foot infection (DFI) is one complication of diabetes mellitus that has high morbidityand mortality. The success of management of DFI is influenced by many factor. This study aimed to recognize clinical picture and microbiological pattern in 3rd and 4th degrees of the PEDIS classification. The design was a prospective cross-sectional study conducted in RSCM at March until May 2005. The clinical pictures in 52 DFI’pateints were included to the PEDIS classification with the wound’s odour and crepitation. Microbiological examination was done culture for microorganisms and the antibiotiks sensitivity test. The female were greate (55,8%) than male the greatest age group were at 51-60 years old (44,2%). Poorly controlled blood glucose was found in 88%, duration of wound 2 weeks in 56%, wound without critical-limb ischaemia in 81% with wound size 25 cm2 in 58%, with bottom of wound had reached tendons in 75%. Most of the patiens undergroune sepsis (65%), diabetic neouropathy (77%), with odour distance of ≥1 m (65%), and crepitation/gas (63%). We found 96 types of microorganism, of which the greatest number was: E.coli 17,7% with highest sensitivity towards cefepime; S.aureus 15,6% towards co-amoxyclav; Bacteroides spp 4,2% towards co-amoxyclav, sultamicillin and metronidazole

Antibacterial and antioxidative activity tests on extract of siuri (Koordersiodendron pinnatum (Blanco) Merr.) cortex

The aim of the study was to determine the in-vitro antibacterial and antioxidative activities of siuri (Koordersiodendron pinnatum) bark extract. Ethanolic, hexane, chloroform and ethyl acetate extracts were tested for antibacterial activity against 7 bacteria isolates which were 4 Gram Positive bacteria (Staphylococcus aureus, S. epidermidis, Streptococcus agalactiae, Corynebacterium sp.) and 3 Gram Negative bacteria (Salmonella enteritidis, Eschericia coli, Pseudomonas aeruginosa). Extract concentrations used were : 50, 25, 12.5 and 6.75%. The experiments were conducted in triplicate in Mueller Hinton Agar (MHA). Antioxidative test was performed at the concentration of 1, 5 and 10% with aquadest as a negative control and α-tocopherol as positive control. The results showed that the ethyl acetate extract inhibited the growth of 7 bacteria tested, and the growth inhibition area on Gram negative bacteria was wider than that of 10 units of penicillin. Peroxide value of ethanol extract (111.29) was lower than that of  α-tocopherol. Increasing extract concentration reduced the absorbance value.Key words : Koordersiodendron pinnatum, antibacteria, antioxidant

Correlation Between Vitreous Advanced Glycation End Products, and D-dimer with Blood HbA1c Levels in Proliferative Diabetic Retinopathy

Background: proliferative diabetic retinopathy (DR) is an advanced form of DR that eventually could lead to blindness. Levels of vitreous advanced glycation end products (AGEs) and D-dimer may reflect the pathological changes in the retina, but only few studies have assessed their correlation with blood hemoglobin A1C (HbA1c) levels. This study aimed to find the association between blood HbA1c levels with vitreous AGEs and D-dimer levels in patients with proliferative DR. Methods: an analytical cross-sectional study was performed in subjects with proliferative DR who underwent vitrectomy. Subjects were divided into 2 subgroups, i.e. uncontrolled (HbA1c >7%) and controlled (HbA1c <7%) groups. Vitreous AGEs and D-dimer levels were assessed; the levels were compared between uncontrolled and controlled hyperglycemic patients. Statistic correlation tests were also performed for evaluating blood HbA1c, vitreous AGEs, and D-dimer levels. Results: a total of 47 patients were enrolled in this study and 32 (68.1%) of them were women. Median vitreous AGEs level was 11.0 (3.0 – 48.0) µg/mL; whereas median vitreous D-dimers level was 5,446.0 (44.0 – 37,394.0 ) ng/mL. The median vitreous AGEs levels was significantly higher in patients with uncontrolled vs. controlled hyperglycemia (14.0 vs. 4.0 mg/mL; p<0.001). There was a significant positive correlation with moderate strength between blood HbA1c level and vitreous AGEs level (r=0.524; r2=0.130; p=0.0001). Blood HbA1c level could be used to predict vitreous AGEs level by using the following calculation: vitreous AGEs = -1.442+ (1.740xblood HbA1c). Vitreous D-dimer levels were not significantly different between uncontrolled and controlled hyperglycemia (median 4607.5 vs. 5701.6 ng/mL; p = 0.458). There was a positive significant correlation between blood HbA1c and vitreous D-dimer levels (r = 0.342; p = 0.019); however the correlation was weak. Vitreous AGEs level had a positive significant correlation with vitreous D-dimer levels (r = 0.292; p = 0.046) and the correlation strength was also weak. Conclusion: median vitreous AGEs levels were significantly higher in proliferative DR patients with uncontrolled than those with controlled hyperglycemia. Blood HbA1c level can be used to assess vitreous AGEs level in patients with proliferative DR by using the following calculation: vitreous AGEs = -1.442+(1.740 x HbA1c). However, the blood HbA1c level can not be used to predict vitreous D-dimer level in patients with proliferative DR

The Changes of Amino Terminal Pro B-type Natriuretic Peptide (NT-proBNP) Concentration and Left Ventricular Ejection Fraction on Doxorubicin Chemotherapy Patients

Introduction. Cancer patients who received chemotherapy regimen containing doxorubicin has been known to have serious side effect in heart, called as cardiotoxicity. The measurement of NT-proBNP proposed to be used as a new parameter to identify and evaluate cardiotoxicity in cancer patients earlier before it has been manifested, superior than measurement of left ventricle ejection fraction (LVEF). The aims of this study to examine the changes of NT-proBNP concentration and LVEF on patients with cancer who receive chemotherapy regimen containing doxorubicin. Methods. The study used pre and post test design to observe the changes of NT-proBNP concentration and LVEF on the patients who receive naïve doxorubicin chemotherapy and after chemotherapy-cycle I to cyce IV at the Ciptomangunkusumo hospital, Jakarta. Echocardiography and NT-proBNP were examined on naïve chemotherapy and after chemotherapy each cycle. Statistical analysis was performed by using two way Anova and Friedman nonparametric test. Results. During the period of October 2007 to June 2008, a total of 29 consecutive patiets receiving doxorubicin chemotherapy regimen CHOP (Cyclophosphamide, doxorubicin, Vincristine, Prednisone and FAC-5 Fluorouracil, doxorubicin, Cyclophosphamide) were collected. The increase of median NT-proBNP concentration between naïve chemotherapy and: post chemotherapy cycle I was 32 pg/mL (12,5-124,6 pg/mL), post chemotherapy cycle II was 135 pg/mL (44-275,2 pg/mL), post chemotherapy cycle III was 275,1 pg/mL (97,8-907,2 pg/mL), post chemotherapy cycle IV was 514,6 pg/mL (80,6-6458,2 pg/mL). With Friedman test, p< 0,000. With Anova two way test, it was found the difference between naïve LVEF and LVEF: post chemotherapy cycle I was 5,1% (p 0,000), post chemotherapy cycle II 8,9% (p 0,000), post chemotherapy cycle III 11,2% (p 0,000), post chemotherapy cycle IV 12,5% (p 0,000). Conclusions. Elevated NT-proBNP concentration and LVEF reduction had been observed in doxorubicin chemotherapy patients

TOKSISITAS AKUT EKSTRAK METANOL RUMPUT LAUT COKELAT Sargassum echinocarpum

The aim of this study was to evaluate acute toxicity of methanol extract of Sargassum echinocarpum on male and female of mice (Mus musculus) strain BALB/c two month age. S. echinocarpum was obtained from Talango Island in April 2008. The powder of S. echinocarpum was macerated by methanol (1:3) at 4 °C for 3 x 24 hours, then concentrated, dried, and extracted. The extract was screened to observe the phytochemical compounds. For acute toxicity extracts was given orally and once on one hour before feeding. The dose treatments were 0; 625; 1250; 2500; and 5000 mg/kg body weight (BW). Parameters measured were phytochemical contain, body weight during the study, 50 percent of lethal doses, and histology score of liver and kidney. The phytochemical study showed that methanol extract of S. echinocarpum contained tannins, polyphenols, saponins, glycosides, and steroids. On 1250 mg/kg BW or more, methanol extract of S. echinocarpum inhibited the increasing of body weight on mice, but, until 5000 mg/kg BW, it did not cause mortality on mice. On 1250 mg/kg BW or more, methanol extracts caused necrosis on hepatocyt and tubulus.Key words: acute toxicity, methanol extract, Sargassum echinocarpu

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. Funding: UK Medical Research Council, US National Institutes of Health. © 2014 Elsevier Ltd

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X. 256 hal.. 24 c

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ix.161hal.;15x24c