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)

Sex differences in the association of psychological status with measures of physical activity and sedentary behaviour in adults with type 2 diabetes

Aim – To assess the association of psychological variables on leisure time physical activity and sedentary time in men and women with type 2 diabetes mellitus (T2D). Methods – In this cross-sectional study, we evaluated 163 patients with T2D, consecutively recruited at the Diabetes Centre of the Verona General Hospital. Scores on depression and anxiety symptoms, psychosocial factors (including self-efficacy, perceived interference, perceived severity, social support, misguided support behaviour, spouse’s positive behaviour), physical activity and time spent sitting were ascertained using questionnaires responses to the Beck Depression Inventory-II, Beck Anxiety Inventory, Multidimensional Diabetes Questionnaire, International Physical Activity Questionnaire. Results – Physical activity was significantly associated with higher social support in women, and with increased self-efficacy in men. Sedentary time was significantly associated with higher perceived interference, anxiety and depressive symptoms, and with reduced diabetes self-efficacy in women, while it was associated solely with anxiety in men. Depressive symptoms and self-efficacy in women and anxiety symptoms in men were independent predictors of sedentary time when entered in a multivariable regression model also including age, BMI, hemoglobin A1c, diabetes duration, perceived interference and self-efficacy as covariates. Conclusions – Lower self-efficacy and higher symptoms of depression were closely associated with increased sedentary time in women, but not in men, with T2D. It is possible that individualized behavioral interventions designed to reduce depressive symptoms and to improve diabetes self-efficacy would ultimately reduce sedentary behaviours, particularly in women with T2D

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

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](-)

Effects of Aerobic and Resistance Training on Circulating micro-RNA Expression Profile in Subjects with Type 2 Diabetes

Context: Structured exercise programs are of great benefit for the treatment of type 2 diabetes (T2DM). However, whether aerobic (AER) or resistance (RES) exercise training exerts specific epigenetic changes through the expression profile of circulating miRNAs (c-miRNAs) is still largely unknown. Objective: To assess whether the c-miRNAs profile changes after either AER or RES training in subjects with T2DM. Design: Twenty-four patients with T2DM randomized to AER or RES training protocols were randomly selected from the Resistance vs. Aerobic Exercise in Type 2 Diabetes (RAED2) Trial (NAER = 12; NRES = 12). The baseline and post-training levels of 179 c-miRNAs were initially measured by RT-PCR in 6 individuals (NAER = 3; NRES = 3). C-miRNAs exhibiting $40% fold change variation and/or nominal significance from baseline were measured in the whole group. Results: Nineteen c-miRNAs were eventually assessed in the whole group. Compared with baseline, the post-training levels of miR-423-3p, miR-451a, and miR-766-3p were significantly up-regulated, irrespective of exercise type (P&lt;0.0026; 0.05/19), and targeted upstream pathways relevant to fatty acids biosynthesis and metabolic regulation. MiR-451a and miR-423-3p were significantly correlated with fat loss (p = 0.45 and 0.43, respectively) and resulted, alone or in combination, in being predictors of fat loss in generalized linear regression models including exercise type as covariate. Only the association with miR-451a eventually retained significance after further correction for age, sex, body mass index, and HbA1c. Conclusions: Exercise training in T2DM is associated with substantial c-miRNAs profile changes, irrespective of exercise type and other relevant metabolic covariates. The mechanistic significance of the observed relationship between fat loss and the epigenetic modifications induced by exercise warrants further investigation in larger datasets. © 2019 Endocrine Society