Ekstrak Virgin Coconut Oil Sebagai Sumber Pangan Fungsional

Virgin Coconut Oil (VCO) merupakan salah satu jenis minyak nabati yang dapat bermanfaat dari aspek medis dan nutrisi karena dapat mencegah dan membantu mengobati penyakit tertentu serta dapat mempermudah proses pencernaan makanan dan penyerapan gizi. VCO dapat bertindak sebagai antioksidan dan antifotooksidan yang disebabkan oleh kandungan komponen minor (mikronutrien). Tujuan penelitian ini adalah mengekstrak komponen minor VCO menjadi produk untuk pangan fungsional yang mampu berperan sebagai antioksidan dan mengetahui peran VCO sebagai antiradikal bebas secara in vitro. Penelitian ini menggunakan metode eksperimental dengan 3 tahap yaitu: 1. Ekstraksi VCO menggunakan pelarut etanol dan metanol, 2. Pengujian penangkapan radikal bebas ekstrak VCO secara in vitro dengan metode 1,1-difenil-2-pikrilhidrazil (DPPH), 3. Identifikasi dan pengujian komponen kimia pada ekstrak VCO, identifikasi dan pengujian komponen minor pada ekstrak VCO dengan menggunakan High Performance Liquid Chromatography (HPLC). Hasil penelitian ini menunjukkan bahwa rendemen ekstrak VCO semakin tinggi dengan semakin tingginya persentase pelarut, ekstraksi dengan menggunakan etanol menghasilkan rendemen ekstrak yang lebih tinggi dibanding dengan menggunakan metanol. Aktivitas antioksidan dan kandungan total tokoferol dari ekstrak VCO semakin tinggi dengan semakin tingginya persentase pelarut yang digunakan. Salah satu senyawa tokoferol yang terdapat dalam VCO adalah -tokoferol. Berdasarkan analisa statistik menunjukkan bahwa etanol dan metanol menghasilkan sifat kimia ekstrak yang relatif sama, sehingga dapat direkomendasikan bahwa untuk mengekstraksi komponen minor dari VCO dapat menggunakan etanol karena di samping aman dari aspek kesehatan juga dapat menghasilkan rendemen ekstrak yang lebih tinggi

Improved testing for vitamin B-12 deficiency:correcting MMA for eGFR reduces the number of patients classified as vitamin B-12 deficient

Background Methylmalonic acid (MMA) can detect functional vitamin B-12 deficiencies as it accumulates early when intracellular deficits arise. However, impaired clearance of MMA from blood due to decreased glomerular filtration rate (eGFR) also results in elevated plasma MMA concentrations. Alternative to clinical trials, a data mining approach was chosen to quantify and compensate for the effect of decreased eGFR on MMA concentration. Methods Comprehensive data on patient's vitamin B-12, eGFR and MMA concentrations were collected (n=2906). The relationship between vitamin B-12, renal function (eGFR) and MMA was modelled using weighted multiple linear regression. The obtained model was used to estimate the influence of decreased eGFR on MMA. Clinical impact was examined by comparing the number of patients labelled vitamin B-12 deficient with and without adjustment in MMA. Results Adjusting measured MMA concentrations for eGFR in the group of patients with low-normal vitamin B-12 concentrations (90-300pmol/L) showed that the use of unadjusted MMA concentrations overestimates vitamin B-12 deficiency by 40%. Conclusions Through a data mining approach, the influence of eGFR on the relation between MMA and vitamin B-12 can be quantified and used to correct the measured MMA concentration for decreased eGFR. Especially in the elderly, eGFR-based correction of MMA may prevent over-diagnosis of vitamin B-12 deficiency and corresponding treatment

Cancer risk perception in relation to associated symptoms in Barrett's patients: A cross sectional study on quality of life

Background: Barrett’s oesophagus affects patients’ quality of life and may be a psychological burden due to the threat of developing an oesophageal adenocarcinoma. Objective: Assessing the oesophageal adenocarcinoma risk perceived by non-dysplastic Barrett’s oesophagus patients and its association with quality of life, illness perception and reflux symptoms. Methods: This cross-sectional questionnaire study included 158 Barrett’s oesophagus non-dysplastic patients aged 18–75 years. Based on their annual and lifetime oesophageal adenocarcinoma risk estimations measured with the Magnifier Scale, patients were classified as overestimating or underestimating. Associations between the groups where assed on demographics, reflux symptoms and results of the Outcomes Study Short-Form-36 (SF-36) and the Brief Illness Perception Questionnaire (B-IPQ). Results: The annual oesophageal adenocarcinoma risk was overestimated by 41%. Overestimating patients had lower means on the SF-36 domains: bodily pain (annual p = 0.007 and lifetime p = 0.014), general health (annual p = 0.011 and lifetime p = 0.014), vitality (annual p = 0.030), physical functioning (lifetime p = 0.028), worse illness perception (total score p = 0.001) and significantly more reflux symptoms. Conclusions: Overestimation of the oesophageal adenocarcinoma risk by Barrett’s oesophagus patients was associated with decreased quality of life and worse illness perceptions, which is most likely caused by symptoms of dyspepsia and reflux. These symptoms should be adequately treated, and patients may be in need of extra support and specific information about their oesophageal adenocarcinoma risk

Assessment of Comorbidity in Bariatric Patients through a Biomarker-Based Model-A Multicenter Validation of the Metabolic Health Index

BACKGROUND: The metabolic health index (MHI) is a biomarker-based model that objectively assesses the cumulative impact of comorbidities type 2 diabetes mellitus, hypertension and dyslipidemia on the health state of bariatric patients. The MHI was developed on a single-center cohort using a fully laboratory data-driven approach, resulting in a MHI score on a range from 1 to 6. To show universal applicability in clinical care, the MHI was validated externally and potential laboratory-related shortcomings were evaluated. METHODS: Retrospective laboratory and national bariatric quality registry data were collected from five Dutch renowned bariatric centers (n = 11 501). MHI imprecision was derived from the cumulative effect of biological and analytical variance of the individual input variables of the MHI model. The performance of the MHI (model) was assessed in terms of discrimination and calibration. RESULTS: The cumulative imprecision in MHI was 0.25 MHI points. Calibration of the MHI model diverged over the different centers but was accounted for by misregistration of comorbidity after cross-checking the data. Discriminative performance of the MHI model was consistent across the different centers. CONCLUSIONS: The MHI model can be applied in clinical practice of bariatric centers, regardless of patient mix and analytical platform. Because the MHI is based on objective parameters, it is insensitive to diverging clinical definitions of comorbidities. Therefore, the MHI can be used to objectify severity of metabolic comorbidities in bariatric patients. The MHI can support the patient-selection process for surgery and objectively assessing the effect of surgery on the metabolic health state

Prognostic Value of Combined Biomarkers in Patients With Heart Failure: The Heartmarker Score

Background: Heart failure (HF) biomarkers have prognostic value. The aim of this study was to combine HF biomarkers into an objective classification system for risk stratification of patients with HF. Methods: HF biomarkers were analyzed in a population of HF outpatients and expressed relative to their cut-off values (N-terminal pro-B-type natriuretic peptide [NT-proBNP] >1,000 pg/mL, soluble suppression of tumorigenesis-2 [ST2] >35 ng/mL, growth differentiation factor-15 [GDF-15] >2,000 pg/mL, and fibroblast growth factor-23 [FGF-23] >95.4 pg/mL). Biomarkers that remained significant in multivariable analysis were combined to devise the Heartmarker score. The performance of the Heartmarker score was compared to the widely used New York Heart Association (NYHA) classification based on symptoms during ordinary activity. Results: HF biomarkers of 245 patients were analyzed, 45 (18%) of whom experienced the composite endpoint of HF hospitalization, appropriate implantable cardioverter-defibrillator shock, or death. HF biomarkers were elevated more often in patients that reached the composite endpoint than in patients that did not reach the endpoint. NT-proBNP, ST2, and GDF-15 were independent predictors of the composite endpoint and were thus combined as the Heartmarker score. The event-free survival and distance covered in 6 minutes of walking decreased with an increasing Heartmarker score. Compared with the NYHA classification, the Heartmarker score was better at discriminating between different risk classes and had a comparable relationship to functional capacity. Conclusions: The Heartmarker score is a reproducible and intuitive model for risk stratification of outpatients with HF, using routine biomarker measurements

Inactivation of the E3 Ubiquitin Ligase IDOL Attenuates Diet-Induced Obesity and Metabolic Dysfunction in Mice

Objective- The E3 ubiquitin ligase IDOL (inducible degrader of the LDLR [LDL (low-density lipoprotein) receptor]) is a post-transcriptional regulator of LDLR abundance. Model systems and human genetics support a role for IDOL in regulating circulating LDL levels. Whether IDOL plays a broader metabolic role and affects development of metabolic syndrome-associated comorbidities is unknown. Approach and Results- We studied WT (wild type) and Idol(-/-) (Idol-KO) mice in 2 models: physiological aging and diet-induced obesity. In both models, deletion of Idol protected mice from metabolic dysfunction. On a Western-type diet, Idol loss resulted in decreased circulating levels of cholesterol, triglycerides, glucose, and insulin. This was accompanied by protection from weight gain in short- and long-term dietary challenges, which could be attributed to reduced hepatosteatosis and fat mass in Idol-KO mice. Although feeding and intestinal fat uptake were unchanged in Idol-KO mice, their brown adipose tissue was protected from lipid accumulation and had elevated expression of UCP1 (uncoupling protein 1) and TH (tyrosine hydroxylase). Indirect calorimetry indicated a marked increase in locomotion and suggested a trend toward increased cumulative energy expenditure and fat oxidation. An increase in in vivo clearance of reconstituted lipoprotein particles in Idol-KO mice may sustain this energetic demand. In the BXD mouse genetic reference population, hepatic Idol expression correlates with multiple metabolic parameters, thus providing support for findings in the Idol-KO mice. Conclusions- Our study uncovers an unrecognized role for Idol in regulation of whole body metabolism in physiological aging and on a Western-type diet. These findings support Idol inhibition as a therapeutic strategy to target multiple metabolic syndrome-associated comorbidities

Genetic architecture of plant stress resistance: multi-trait genome-wide association mapping

Plants are exposed to combinations of various biotic and abiotic stresses, but stress responses are usually investigated for single stresses only. Here, we investigated the genetic architecture underlying plant responses to 11 single stresses and several of their combinations by phenotyping 350 Arabidopsis thaliana accessions. A set of 214 000 single nucleotide polymorphisms (SNPs) was screened for marker-trait associations in genome-wide association (GWA) analyses using tailored multi-trait mixed models. Stress responses that share phytohormonal signaling pathways also share genetic architecture underlying these responses. After removing the effects of general robustness, for the 30 most significant SNPs, average quantitative trait locus (QTL) effect sizes were larger for dual stresses than for single stresses. Plants appear to deploy broad-spectrum defensive mechanisms influencing multiple traits in response to combined stresses. Association analyses identified QTLs with contrasting and with similar responses to biotic vs abiotic stresses, and below-ground vs above-ground stresses. Our approach allowed for an unprecedented comprehensive genetic analysis of how plants deal with a wide spectrum of stress conditions

Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department: a multicentre randomised clinical trial

Background: Chest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Methods: Pragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings. Results: 2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1-8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1-8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%). Conclusions: Short-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Trial registration number: NTR6163