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"Latar Belakang. Hipoalbuminemia sudah diketahui merupakan faktor prediktor morbiditas dan mortalitas pada pasien usia lanjut dengan pneumonia dan CRP merupakan petanda klinis yang penting pada pneumonia. Namun hubungan antara kadar CRP dengan penurunan kadar albumin, sebagai protein fase akut negatif, saat infeksi akut belum pernah diteliti sebelumnya.Tujuan. Mendapatkan: (1) perbedaan kadar CRP awal perawatan antara pasien dengan daa tanpa penurunan albumin, (2) perbedaan risiko teradinya penurunan albumin antara pasien dengan kadar CRP awal tinggi dan rendah, dan (3) korelasi antara kadar CRP dan albumin saat awal perawatan pada pasien-pasien usia lanjut dengan pneumonia komunitas yang dirawat di rumah sakit.Metodalogi. Stuart potong-lintang dan kohort-prospektif dilakukan pada pasien-pasien usia lanjut (>60 tahun) dengan diagnosis pneumonia komunitas yang dirawat di RSCM, untuk diamati penurunan kadar albuminnya selama 5 hari perawatan. Pasien-pasien dengan keadaan-keadaan yang dapat mempengaruhi kadar albumin dan CRP, serta infeksi selain pn nimcnia komunitas dieksklusi dari penelitian. Penilaian kadar CRP dilakukan pada hari pertama perawatan (cut-off 20 mg/L), sementara penurunan albumin ditentukan dari perubahan kadar albumin selama 5 hari perawatan (cut-off 10%). Analisis statistik dilakukan dengan uji-t independen, uji chi-square, dan uji korelasi sesuai dengan tujuan penelitian.Hasil Utama. Selama periode April-Juni 2005 terkumpul 26 pasien usia lanjut dengan pneumonia komunitas yang masuk perawatan di RSCM. Hanya 23 pasien yang menyelesaikan penelitian sampai 5 hari dengan 17 pasien memiliki kadar CRP awal tinggi, dan didapatkan penurunan albumin >10% pada 7 pasien setelah 5 hari perawatan. Terdapat perbedaan rerata kadar CRP hari-1 diantara kedua kelompok (175,36 mgfL vs 75,67 mg/L; P = 0,026; 1K95% 13,25-186,13 mgfL). Namun tidak didapatkan perbedaan risiko bermakna antara pasien dengan kadar CRP tinggi dengan pasien dengan kadar CRP rendah scat awal dengan terjadinya penurunan albumin saat awal perawatan (RR = 2,12; P = 0,621; 11(95% 0,256-29,07). Tidak didapatkan pula korelasi antara kadar CRP dan albumin saat awal perawatan (r = 0,205, P = 0,314)Kesimpulan. Tingginya kadar CRP awal perawatan berhubungan dengan terjadinya penurunan kadar albumin selama perawatan, namun tidak ada perbedaan risiko terjadinya penurunan albumin selama perawatan antara pasien dengan CRP awal tinggi dan CRP awal rendah, serta tidak ada korelasi antara kadar CRP dan albumin scat awal perawatan pada pasien-pasien usia lanjut dengan pneumonia komunitas yang dirawat di rumah sakit.

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Backgrounds. Hypoalbuminemia widely known as a predictive factor for increasing morbidity and mortality in elderly patients, including with pneumonia; while CRP has known as a clinical marker for pneumonia. But relationship between CRP level with decrease of serum albumin level, as a negative acute-phase protein, during acute infection has never been studied before.

Objectives. To found: (1) CRP level difference between patient with and without decreased of serum albumin level, (2) risk for developing decreased of serum albumin level in patients with high CRP compared to patients with low CRP level, and (3) correlation between CRP and albumin level on admission in hospitalized elderly patients with community-acquired pneumonia.

Methods. Cross-sectional and prospective-cohort studies was conducted in hospitalized elderly patients with community-acquired pneumonia that admitted to RSCM, to observed the decreased of serum albumin level in five days of hospitalization. Conditions that known could influence CRP and albumin consentration have been excluded, and other infections as well. CRP level was determined on admission (cut-off 20 mgfL), while decreased of serum albumin was observed for 5 days of hospitalization (cu[-off 10%). Statistical analysis was done by using independent t-test, chi-square test, and correlation test appropriately accord-ing to the objectives of the study.

Main Results. During study period (April to June, 2005) 26 hospitalized elderly patients with community-acquired pneumonia had been included into study, but only 23 of them that finished the study for 5 days. There were 17 patients that have high level of CRP on admission, and 7 patiens that developing decreased of serum albumin level more than 10% in fifth day compared to their serum albumin level on admission. There was significant mean CRP difference among 2 groups (175,36 mgfL vs 75,67 mg/L; P = 0,026; 95%CI 13,25-186,13 mgfL), but there was no risk difference between patients with high and low CRP level on admission for developing decreased albumin level on fifth day of hospitalization (RR = 2,12; P = 0,621; 95%CI 0,256-29,07). And there was no correlation between CRP and albumin level on admission (r = 0,205, P = 0,314)

Conclusions. Patients with high CRP level on admission tend to have decreased of serum albumin level during hospitalization, but there was no risk difference for developing decreased of serum albumin level between patients with high and low CRP level, and there was no correlation between CRP and albumin level on admission in hospitalized elderly patients with community-acquired pneumonia."

"Proses inflamasi pada kanker kepala dan leher menyebabkan peningkatan sitokin proinflamasi dan sintesis protein fase akut c-reactive protein, CRP yang kemudian menyebabkan perubahan metabolisme dan anoreksia pada penderitanya. Seng merupakan zat gizi yang memiliki peran penting dalam menekan inflamasi, namun dilaporkan sekitar 65 pasien kanker kepala dan leher mengalami kekurangan seng. Penelitian potong lintang ini bertujuan mengetahui korelasi antara asupan seng dan kadar seng serum dengan kadar c-reactive protein CRP sebagai upaya menekan inflamasi sehingga dapat mengurangi morbiditas dan mortalitas pasien kanker kepala leher. Dari 49 subyek yang dikumpulkan secara konsekutif di Poliklinik Onkologi RS Kanker Dharmais, 67,3 adalah laki-laki, rentang usia subyek 46 ndash;65 tahun. Frekuensi terbanyak 65,3 adalah kanker nasofaring dan 69,4 berada pada stadium IV. Seratus persen subyek memiliki asupan seng dibawah nilai angka kecukupan gizi. Rerata kadar seng serum subyek adalah 9,83 2,62 mol/L. Sebanyak 51 subyek memiliki kadar CRP yang meningkat. Terdapat korelasi negatif yang lemah antara kadar seng dengan kadar CRP subyek r =-0,292, p =0,042, namun tidak terdapat korelasi antara asupan seng dengan kadar CRP subyek p =0,86.

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The inflammatory process of head and neck cancer leads to increase the proinflammatory cytokines and the synthesis of c reactive protein CRP , which then causes metabolic alteration and anorexia in the patients. Zinc is one of nutrient that has an important role in suppressing inflammation. It is reported that about 65 of head and neck cancer patients have zinc deficiency. The aim of this cross sectional study is to determine the correlation between zinc intake and serum zinc levels with CRP level as an effort to reduce inflammation to reduce the morbidity and mortality of head and neck cancer patients. Subjects were collected by consecutive sampling in the Oncology Polyclinic Dharmais Cancer Hospital, from 49 subjects 67,3 were men, most subjects were in the age range between 46 ndash 65 years. The highest frequency 65,3 is nasopharyngeal cancer and 69,4 are already in stage IV. All subjects in this study have a zinc intake below the recommended dietary allowance RDA in Indonesia. The mean serum zinc level of the subjects was 9.83 2.62 mol L. Most subjects have elevated CRP levels. There was a weak significant negative correlation between zinc concentration and CRP levels of subjects r 0.292, p 0.042, but there was no correlation between zinc intake and CRP levels of subjects p 0.86. "

"Latar Belakang: Diperkirakan 20-40% pasien kanker mengalami metastasis ke sistem saraf pusat (SSP). Kondisi inflamasi sistemik pada kanker yang dimediasi sitokin berkaitan dengan penurunan massa otot. Pada kondisi inflamasi, sel hepatosit terstimulasi untuk memproduksi protein fase akut c-reative protein (CRP). Kadar CRP di sirkulasi mengalami peningkatan pada lebih dari 50% pasien keganasan. CRP diperkirakan berhubungan dengan penurunan massa otot dan menjadi prediktor dini dalam kehilangan jaringan lean. Penelitian ini dilakukan untuk mengetahui hubungan kadar CRP dengan indeks massa otot skeletal (skeletal muscle mass index, SMI) pada pasien metastasis SSP. Metode: Penelitian ini adalah studi potong lintang pada pasien kanker dengan metastasis SSP di RSCM. Karakteristik subjek berupa usia, jenis kelamin, tipe metastasis, lokasi tumor primer, defisit neurologis, status performa Karnofsky, penyakit komorbid, penyakit infeksi, terapi glukokortikoid, sedang menjalani kemoterapi, radioterapi, dan tindakan bedah, indeks massa tubuh (IMT), status gizi berdasarkan IMT dan kriteria ASPEN, asupan energi, asupan protein, kadar CRP, dan nilai SMI. Dilakukan analisis hubungan kadar CRP dengan SMI.Hasil: Terdapat 57 pasien yang mengalami metastasis SSP. Mayoritas subjek perempuan (56,1%). Median usia 47 tahun. Lokasi metastasis lebih banyak ditemukan di otak (56,1%), tipe metastasis berdasarkan lokasi susunan saraf terbanyak adalah sinkronus (86%), seluruh subjek merupakan oligometastasis, dan lokasi tumor primer mayoritas berasal dari nasofaring (17,5%), payudara (15,8%), dan paru (14%). Defisit neurologis terbanyak yaitu nyeri kanker (68,4%), nyeri kepala (56,1%), dan kelemahan anggota gerak (43,9%). Kelemahan anggota gerak mayoritas hemiparesis (22,8%). Sebagian besar status performa Karnofsky pasien terganggu sedang (45,6%), 63,2% subjek tidak memiliki penyakit komorbid, 68,4% tidak memiliki penyakit infeksi, 52,6% tidak dalam terapi glukokortikoid, 75,4% subjek tidak sedang menjalani kemoterapi, masing-masing 1,8% subjek sedang menjalani radioterapi dan tindakan bedah. Rerata IMT estimasi 21,28 kg/m2 dan mayoritas status gizi berdasarkan IMT estimasi adalah berat badan normal (43,9%). Berdasarkan kriteria ASPEN, mayoritas termasuk malnutrisi sedang (49,1%) dan berat (31,6%). Rerata asupan energi 19 kkal/kgBB dan median asupan protein 0,6 g/kgBB. Median kadar CRP 46,6 mg/L dan 96,5% subjek mengalami peningkatan kadar CRP. Rerata SMI seluruh subjek yaitu 6,17 kg/m2, rerata SMI laki-laki 7,2 kg/m2 sedangkan rerata SMI perempuan 5,4 kg/m2. Terdapat korelasi negatif lemah (r=-0,373) yang bermakna secara statistik (p=0,005) antara kadar CRP dengan SMI pasien metastasis SSP .Kesimpulan: Terdapat korelasi yang bermakna antara kadar CRP dengan SMI pada pasien metastasis SSP.

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Background: It is estimated that 20-40% of cancer patients experience metastases to the central nervous system (CNS). Systemic inflammatory conditions in cancer mediated by cytokines are associated with a decrease in muscle mass. In inflammatory conditions, hepatocyte cells are stimulated to produce the acute-phase protein called c-reactive protein (CRP). Circulating CRP levels increase in over 50% of cancer patients. CRP is believed to be related to a decrease in muscle mass and serves as an early predictor in lean tissue loss. This study was conducted to determine the relationship between CRP levels and the skeletal muscle mass index (SMI) in patients with CNS metastases. Methods: This study is a cross-sectional study on cancer patients with CNS metastases at RSCM. Subject characteristics include age, gender, metastases type, primary tumor location, neurological deficits, Karnofsky performance status, comorbidities, infectious diseases, glucocorticoid therapy, undergoing chemotherapy, radiotherapy, and surgery, body mass index (BMI), nutritional status based on BMI and ASPEN criteria, energy intake, protein intake, CRP levels, and skeletal muscle mass index (SMI). An analysis of the relationship between CRP levels and SMI was conducted.

Results: There were 57 patients with CNS metastases. Most subjects were female (56.1%). The median age was 47 years. Metastases was more commonly found in the brain (56.1%), and the most common type of metastasis based on the nervous system location was synchronous (86%). All subjects had oligometastasis, and most primary tumor locations were in the nasopharynx (17.5%), breast (15.8%), and lungs (14%). The most common neurological deficits were cancer pain (68.4%), headaches (56.1%), and limb weakness (43.9%). Most limb weakness was hemiparesis (22.8%). Most Karnofsky performance status was moderately impaired (45.6%), 63.2% had no comorbidities, 68.4% had no infectious diseases, 52.6% were not on glucocorticoid therapy, 75.4% were not undergoing chemotherapy, and 1.8% each were undergoing radiotherapy and surgery. The estimated mean BMI was 21.28 kg/m2, with the majority having a normal weight (43.9%). According to ASPEN criteria, the majority were moderately malnourished (49.1%) and severely malnourished (31.6%). The mean energy intake was 19 kcal/kgBW, and the median protein intake was 0.6 g/kgBW. The median CRP level was 46.6 mg/L, with 96.5% of subjects experiencing an increased CRP level. The mean SMI for all subjects was 6.17 kg/m2, with male subjects having a mean SMI of 7.2 kg/m2 and female subjects having a mean SMI of 5.4 kg/m2. There was a weak negative correlation (r=- 0.373) that was statistically significant (p=0.005) between CRP levels and SMI in patients with CNS metastases.

Conclusion: CRP levels are correlated with SMI in patients with CNS metastasis. Higher CRP levels are associated with lower SMI in patients with CNS metastases."

"Skleroderma adalah penyakit autoimun yang melibatkan jaringan ikat. Salah satu gejala klinis skleroderma adalah Fenomena Raynaud dengan perubahan 3 warna pada kulit. Pemeriksaan marker seperti C-reactive protein (CRP) dan laju endap darah (LED) digunakan untuk memeriksa tingkat inflamasi terkait Fenomena Raynaud. Tujuan penelitian adalah menelusuri hubungan kemaknaan antara CRP maupun LED dengan Fenomena Raynaud pada pasien skleroderma. Desain penelitian adalah desain potong lintang dan non-probability sampling. Jumlah sampel adalah 73 (30 memiliki Fenomena Raynaud, 43 tidak memiliki Fenomena Raynaud). Analisis data menggunakan uji chi square (diganti menjadi uji Fisher) untuk mengetahui apakah data yang diperoleh bermakna secara statistik dan klinis. Data bermakna secara statistik jika nilai p < α. Data bermakna secara klinis jika nilai besar efek penelitian > besar efek minimal. Hasil penelitian memperoleh, pasien skleroderma terbanyak adalah 26, 38, dan 47 tahun (masing-masing 6,8%), rentang usia 20-73 tahun, mayoritas wanita (87,7%). Hasil yang diperoleh, tidak terdapat hubungan yang bermakna secara statistik maupun klinis antara CRP dengan Fenomena Raynaud, maupun antara LED wanita dengan Fenomena Raynaud. Hubungan antara LED pria dengan Fenomena Raynaud diperoleh tidak bermakna secara statistik, namun dianggap bermakna secara klinis.

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Scleroderma is an autoimmune disease that involves connective tissue. One of the clinical symptoms is Raynaud's Phenomenon with 3 colors change on the skin. Marker inflammations, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be used for investigating inflammation level in establishing Raynaud's Phenomenon.

The aim was to investigate whether there was a significant relationship between CRP and ESR level with Raynaud's Phenomenon on scleroderma patients. This research use cross sectional design and non-probability sampling. Total sample used was 73 (30 with Raynaud's Phenomenon, 43 did not have). The test used was chi square (then change into Fisher Test) to determine whether the data obtained were statistically and clinically significant. Data is considered statistically significant if the value of p < α. Data is considered clinically significant if value of research effect size > minimal effect size.

The results showed that most of scleroderma patients were 26, 38, and 47 years old (6,8% respectively) with range 20-73 years old, the majority was women (87,7%). The results obtained were no statistically or clinically significant relationship between CRP and Raynaud's Phenomenon, nor between female's ESR and Raynaud's Phenomenon. The relationship between male's ESR and Raynaud's Phenomenon was not statistically significant, but was considered clinically significant. "

"Latar Belakang : Inflamasi kronik berhubungan dengan tumor dan menyebabkan prognosis yang buruk pada pasien kanker. Salah satu penanda inflamasi yang meningkat pada tumor adalah C-Reactive Protein (CRP). Kadar CRP meningkat pada lebih dari 50% pasien keganasan. Peningkatan CRP berhubungan kuat dengan keparahan penyakit pada beberapa kanker. Salah satu zat gizi dalam inflamasi adalah asam lemak omega-3. Asam lemak omega-3 dapat meningkatkan pembentukan specialized pro-resolving mediators (SPM) yang berfungsi meningkatkan mediator antiinflamasi, melindungi blood brain barrier, menurunkan sitokin proinflamasi, menurunkan apoptosis neuron. Penelitian ini bertujuan untuk menilai hubungan asupan asam lemak omega-3 dengan CRP pada pasien tumor sistem saraf pusat.Metode : Studi potong lintang ini dilakukan pada subjek berusia 18-65 tahun di RSUPN Cipto Mangunkusumo pada bulan November hingga Desember 2023. Pengukuran CRP menggunakan metode immunoturbidimetric assay. Pengambilan asupan asam lemak omega-3 menggunakan Food Frequency Questionnaires semikuantitatif. Analisis bivariat digunakan untuk menilai hubungan antara variabel bebas dan terikat.Hasil : Dari total 63 subjek penelitian, sebanyak 35 subjek (55,6%) pada kelompok asupan asam lemak omega-3 < 2 g/hari dan 28 subjek (44,4%) pada kelompok asupan asam lemak omega-3 ≥ 2 g/hari. Nilai median CRP 8,3 (0,6 – 71,5) mg/L. Tidak terdapat hubungan yang bermakna (p = 0,714) antara asupan asam lemak omega-3 dengan CRP pada pasien tumor sistem saraf pusat.Kesimpulan : Tidak terdapat hubungan bermakna antara asupan asam lemak omega-3 dengan CRP pada pasien tumor sistem saraf pusat.

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Background: Chronic inflammation is associated with tumors and causes poor prognosis in tumor patients. One of the inflammatory markers that increase in tumors is C-Reactive Protein (CRP). CRP levels are elevated in more than 50% of patients with malignancies. Elevated CRP is associated with disease severity in some cancers. One of the nutrients in inflammation is omega-3 fatty acids. Omega-3 fatty acids can increase the formation of specialized pro-resolving mediators (SPM) which function to increase anti-inflammatory mediators, protect the blood brain barrier, reduce pro-inflammatory cytokines, reduce neuron apoptosis. This study aims to assess the relationship between omega-3 fatty acid intake and CRP in patients with central nervous system tumors.

Methods: This cross-sectional study was conducted on subjects aged 18-65 years at Cipto Mangunkusumo Hospital from November to December 2023. CRP measurement using immunoturbidimetric assay method. Omega-3 fatty acid intake was collected using semiquantitative Food Frequency Questionnaire. Bivariate analysis was used to assess the relationship between independent and dependent variables.

Results: From the total 63 research subjects, 35 subjects (55,6%) in the omega-3 fatty acid intake group < 2 g/day and 28 subjects (44,4%) in the omega-3 fatty acid intake group ≥ 2 g/day. The median CRP value was 8.3 (0.6 - 71.5) mg/L. There was no significant relationship (p = 0,714) between omega-3 fatty acid intake and CRP in patients with central nervous system tumors.

Conclusion: There is no significant relationship between omega-3 fatty acid intake and CRP in patients with central nervous system tumors."

"Tujuan penelitian ini adalah untuk mengetahui korelasi antara penilaian risiko malnutrisi menggunakan skor PG-SGA dengan kadar CRP serum sehingga dapat digunakan untuk memprediksi tingkat inflamasi pada pasien kanker kepala dan leher stadium I_IV guna mencegah terjadinya kaheksia. Malnutrisi hingga kaheksia pada kanker terjadi karena interaksi faktor tumor, faktor pejamu dan faktor-faktor lainnya. Faktor tumor berupa sitokin pro-inflamasi akan memicu respons pejamu untuk memproduksi protein fase akut seperti CRP. Protein fase akut memerlukan sejumlah substrat yaitu asam amino yang berasal dari otot rangka. Otot rangka akan mengalami degradasi sehingga menyebabkan wasting otot rangka. Oleh karena itu, CRP selain dapat digunakan sebagai marker inflamasi sistemik juga dapat digunakan sebagai salah satu indikator faktor risiko yang berperan dalam terjadinya malnutrisi dan kaheksia. Efek wasting otot rangka yang ditimbulkan secara tidak langsung oleh CRP dapat dinilai dengan terdapatnya penurunan BB maupun berkurangnya massa otot yang juga merupakan komponen dalam penilaian PG-SGA. Penelitian ini merupakan studi potong lintang dengan menggunakan consecutive sampling yang melibatkan 51 subjek kanker kepala dan leher stadium I_IV yang belum mendapatkan terapi. Hasil penelitian didapatkan rerata usia 46,6 13,9 tahun, sebanyak 76,5 berjenis kelamin laki-laki. Kanker nasofaring merupakan kanker terbanyak 80,4 , dan stadium terbanyak yaitu stadium IVA. Rerata indeks massa tubuh IMT yaitu 20,6 4,0 kg/m2, dan sebanyak 37,3 subjek berada pada IMT normal. Berdasarkan skor PG-SGA sebanyak 64,7 subjek berisiko tinggi malnutrisi dengan rerata skor PG-SGA 11,7 6,2. Nilai median CRP yaitu 6,4 0,4_170,4 . Penelitian ini memperoleh korelasi positif yang signifikan antara skor PG-SGA dengan kadar CRP serum dengan kekuatan korelasi lemah r = 0,372; p = 0,007.

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The purpose of this study was to determine the correlation between the malnutrition risk assessment using PG SGA score with serum CRP levels so that it can be used to predict the levels of inflammation in head and neck cancer patients stage I IV to prevent cachexia. Malnutrition and cancer cachexia occurs due to the interaction of tumor factors, host factors and other factors. Tumor factors such as pro inflammatory cytokines will trigger a response of the host to produce acute phase proteins such as CRP. Acute phase protein which require a number of amino acids derived from skeletal muscle. Skeletal muscles will be degraded, causing skeletal muscle wasting. Therefore, CRP can be used as a marker of systemic inflammation and can be used as one indicator of the risk factors also that contribute to malnutrition and cachexia. Effect of skeletal muscle wasting which caused indirectly by the CRP can be assessed by the weight loss and reduced muscle mass which is a component in the assessment of PG SGA also. This study is a cross sectional study using consecutive sampling, 51 subjects head and neck cancer stage I IV who had not received treatment participated in this study. Data showed the mean age of subjects was 46.6 13,9 years, and 76 were male. Most cancer sites were as nasopharyngeal 80,4, and mostly in stage IVA. The mean body mass index BMI is 20,6 40 kg m2, with most of the BMI is normal 37,3. Based on PG SGA score 64,7 of the subjects at high risk of malnutrition, and the PG SGA mean score is 11,7 6,2. The median value of CRP is 6,4 0,4 170,4. The result of this study showed a significant positive correlation between PG SGA score with serum CRP levels with the strength of correlation is weak r 0,372 p 0,007. "

"ABSTRACTSkleroderma (sklerosis sistemik) merupakan penyakit autoimun dengan ciri fibrosis kulit dan organ viseral. Skleroderma menurunkan kualitas hidup penderitanya dan menyebabkan kematian, yang dapat diakibatkan oleh penyakit paru interstisial (ILD) sebagai manifestasi fibrotik pada skleroderma. Pemantauan ILD pada skleroderma memerlukan penilaian penanda inflamasi, termasuk di antaranya adalah laju endap darah (LED) dan kadar protein c-reaktif (CRP) darah, serta penilaian fungsi paru dengan menilai kapasitas vital paksa (KVP). Penelitian ini dilakukan untuk mengetahui korelasi antara LED dan CRP dengan KVP pada pasien skleroderma di Rumah Sakit Cipto Mangunkusumo Jakarta. Penelitian potong lintang dilakukan dengan mengumpulkan data dari rekam medis pasien tahun 2013-2015. Hasil penelitian menunjukkan tidak adanya korelasi yang signifikan antara LED dengan KVP (r=0,209; p=0,287) dan CRP dengan KVP (r=0,261; p=0,241).

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ABSTRACTScleroderma (systemic sclerosis) is an autoimmune disease characterized by the fibrosis of skin and visceral organs. Scleroderma affects the quality of life and cause mortality, which may be caused by interstitial lung disease (ILD) as the fibrotic manifestation of scleroderma. Monitoring of ILD in scleroderma requires the evaluation of markers of inflammation, including erythrocyte sedimentation rate (ESR) and CRP level, and also evaluation of lung function by measuring forced vital capacity (FVC). The objective of this study is to determine the correlation of ESR and CRP to FVC in scleroderma patients of Cipto Mangunkusumo Hospital Jakarta. A cross-sectional study was done by gathering data from medical records of patients from year 2013-2015. The study showed that there is no significant correlation between ESR and FVC (r=0,209; p=0,287 and between CRP and FVC (r=0,261; p=0,241)."

"Pendahuluan. Skor CURB-65 merupakan suatu sistem skor untuk menilai derajat penyakit pneumonia, namun beberapa penelitian menilai performanya kurang baik, sehingga diperlukan faktor prognostik lain sebagai penambah variabel. C-Reactive Protein dinilai mempunyai peran sebagai faktor independen dalam memprediksi mortalitas pasien pneumonia. Penelitian ini dilakukan untuk menilai peran C-Reactive Protein pada skor CURB-65 dalam memprediksi mortalitas 30 hari pasien pneumonia komunitas rawat inap. Metode. Penelitian ini merupakan studi prospektif berbasis riset prognostik dengan subjek penelitian yaitu pasien pneumonia komunitas yang dirawat di IGD dan gedung A Rumah Sakit dr. Cipto Mangunkusumo RSCM, Jakarta bulan Oktober-November 2017. Keluaran yang dinilai pada penelitian ini yaitu mortalitas pasien dalam 30 hari. Pada subjek dilakukan penilaian performa skor CURB-65 sebelum dan setelah ditambah dengan nilai C-Reactive Protein. Performa diskriminasi dinilai dengan area under the curve AUC. Hasil. Sebanyak 200 pasien ikut serta dalam penelitian ini dengan angka mortalitas 37. Performa diskriminasi skor CURB-65 menunjukkan nilai AUC 70,1 IK 95 0,62-0,77. Setelah ditambahkan dengan nilai C-Reactive Protein berdasarkan cut off ge;48,5 mg/L, didapatkan peningkatan nilai AUC skor CURB-65 menjadi 88,0 IK 95 0,83-0,92. Simpulan. C-Reactive Protein memiliki peran pada skor CURB 65 sebagai prediktor mortalitas 30 hari pasien pneumonia komunitas rawat inap.

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Introduction. CURB 65 is a scoring system to evaluate the degree of pneumonia, but some research identified that its performance to predict mortality was below expectations. Therefore, we need other prognostic factor as an added value. C Reactive Protein has a role as an independent factor to predict mortality in community acquired pneumonia. This study aims to evaluate role of C Reactive Protein in CURB 65 score to predict 30 days mortality in hospitalized community acquired pneumonia patient.

Method. A prospective cohort study was conducted to hospitalized community acquired pneumonia patients in Cipto Mangunkusumo Hospital, Jakarta from October to November 2017. Outcome of the study was mortality in 30 days. Performance of CURB 65 score was evaluated before and after addition of C Reactive Protein. Discrimination was evaluated with area under curved AUC.

Results. Total of 200 patients were included in this study with number of mortality was 37. Performance discrimination CURB 65 score was shown by ROC curve, the AUC is 70,1 CI 95 0,62 ndash 0,77. After addition of C Reactive Protein based of cut off ge 48,5 mg L, the AUC score improved to 88,0 CI 95 0,83 ndash 0,92.

Conclusion. C Reactive Protein has a role to CURB 65 score to predict 30 days mortality in hospitalized community acquired pneumonia patient."

"Latar belakang dan tujuan: Dari berbagai literatur, salah satu penyebab kegagalan respons klinis pasien pneumonia komunitas adalah akibat pemberian terapi antibiotik yang tidak tepat. Pemberian terapi antibiotik yang tidak tepat dapat meningkatkan risiko kematian dan resistensi antibiotik di kemudian hari. Tujuan penelitian ini adalah untuk mengevaluasi ketepatan penggunaan antibiotik dengan menggunakan metode Gyssens yang merupakan alat penilaian kualitatif yang dipakai oleh PPRA di Indonesia serta membandingkannya dengan luaran pasien pneumonia komunitas.Metode: Penelitian ini merupakan penelitian kohort retrospektif di Rumah Sakit Umum Pusat Persahabatan. Data diambil dari rekam medis pasien berusia di atas 18 tahun yang didiagnosis pneumonia komunitas dan dirawat inap selama periode Januari- Desember 2019. Penelitian ini menganalisis pemberian antibiotik empiris pada saat pasien pertama kali didiagnosis pneumonia komunitas.Hasil: Jumlah sampel pada penelitian ini adalah 108 subjek. Proporsi pasien yang diberikan antibiotik empiris tidak tepat berdasarkan metode Gyssens adalah 58,3% dan yang diberikan antibiotik empiris telah tepat adalah 41,7%. Pasien yang mendapatkan terapi antibiotik empiris tidak sesuai dengan pedoman PDPI memiliki risiko meninggal sebesar 2,875 kali lipat (IK 95% 1,440 – 5,739, p=0,004). Pasien yang diberikan antibiotik empiris dalam waktu setelah 8 jam didiagnosis pnemunia komunitas memiliki risiko meninggal sebesar 3,018 kali lipat (IK 95% 1,612 – 5,650, p=0,002). Dari analisis multivariat, faktor prediktor independen yang berhubungan dengan kejadian mortalitas pasien pneumonia komunitas dalam 30 hari adalah kejadian pneumonia berat dengan risiko sebesar 7,3 kali lipat (IK 95% 2,24-23,88, p=0,001), penyakit CVD dengan risiko sebesar 5,8 kali lipat (IK 95% 1,28-26,46, p=0,023), dan ketidaktepatan pemberian antibiotik empiris dengan risiko sebesar 4,2 kali lipat (IK 95% 1,02-17,74, p=0,048).Kesimpulan: Pada penelitian ini terdapat hubungan yang bermakna antara penggunaan antibiotik empiris tidak tepat berdasarkan metode Gyssens dengan luaran pasien yaitu kejadian mortalitas 30 hari (p=0,001).

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Background and Purpose: From many literatures, one of the causes of clinical response failure in community-acquired pneumonia patients is due to the inappropriate empirical antibiotics use. Improper administration of empirical antibiotics can increase the risk of death and antibiotic resistance later in life. The purpose of this study is to evaluate the appropriateness of the empirical antibiotics use using the Gyssens method which is a qualitative assessment tool used by the antibiotic stewardship program in Indonesia and to compare it with the outcome of community-acquired pneumonia patients.

Method: This study is a retrospective cohort study at the Persahabatan General Hospital. Data is taken from the medical records of patients over the age of 18 who are diagnosed with community-acquired pneumonia and hospitalized during the January- December 2019 period. This study analyzes the administration of empirical antibiotics when the patient is first diagnosed with community-acquired pneumonia.

Results: The number of samples in this study were 108 subjects. The proportion of patients who were given empirical antibiotics incorrectly based on the Gyssens method was 58.3% and those given empirical antibiotics were appropriate was 41.7%. Patients who received empirical antibiotic therapy not in accordance with PDPI guidelines had a 2.875-fold risk of death (95% CI 1.440 - 5.739, p = 0.004). Patients who were given empirical antibiotics after 8 hours of being diagnosed by the community-acquired pneumonia had a risk of death of 3,018-fold (95% CI 1.612 – 5.650, p = 0,002). From a multivariate analysis, independent predictors related to the mortality of community- acquired pneumonia patients within 30 days were the incidence of severe pneumonia with a risk of 7.3-fold (95% CI 2.24-23.88, p = 0.001), CVD with a risk of 5.8-fold (95% CI 1.28-26.46, p = 0.023), and inappropriate empirical antibiotics use with a risk of 4.2 fold (95% CI 1.02-17.74, p = 0.048).

Conclusion: In this study there was a significant relationship between the use of inappropriate empirical antibiotics use based on the Gyssens method and the outcome of community-acquired patients, which was the 30-days mortality (p = 0.001)."

"Latar belakang: Laparotomi merupakan teknik operasi untuk membuka akses kavitas peritoneum dengan membentuk sayatan terbuka di area abdomen. Cedera mukosa akibat trauma pembedahan mengganggu homeostasis epitel, merusak ekosistem mikrobiom, meningkatkan produksi sitokin proinflamasi dan berkaitan dengan kejadian komplikasi pascaoperatif. Probiotik Lactobacillus acidophillus memperkuat sawar usus, mempertahankan ekosistem mikrobiom dan berpotensi memodulasi respon imun. Namun, belum terdapat penelitian mengenai dampak pemberian Lactobacillus acidophilus terhadap kadar c-reactive protein (CRP) pascalaparotomi gastrointestinal sebagai penanda inflamasiTujuan: Penelitian ini bertujuan untuk mengetahui dampak pemberian Lactobacillus acidophilus terhadap kadar CRP pascalaparotomi gastrointestinalMetode: Penelitian ini merupakan uji klinis acak tersamar ganda. Sebanyak 56 subjek yang akan menjalani operasi laparotomi gastrointestinal dimasukkan ke dalam penelitian. Subjek penelitian diberikan kapsul probiotik Lactobacillus acidophilus 109 (kelompok probiotik) atau diberikan kapsul laktosa (kelompok plasebo) selama 3 hari sebelum operasi. Kadar CRP diukur 3 hari sebelum prosedur dan 3 hari sesudah prosedur.Hasil: Lima puluh enam subjek dengan 28 subjek pada tiap kelompok, mengikuti penelitian hingga selesai. Pada hari ketiga pascaoperatif, probiotik secara efektif menurunkan peningkatan respon inflamasi dengan nilai akhir CRP pada kelompok probiotik lebih rendah dibandingkan kelompok plasebo (median probiotik 89,65 mg/L vs. plasebo 204 mg/L, p < 0,001). Perubahan peningkatan nilai CRP lebih rendah pada kelompok probiotik dibandingkan kelompok plasebo (median probiotik 84,8 mg/L vs. plasebo 187,6 mg/L, p < 0,001). Terdapat efek samping yang signifikan (mual, diare, muntah dan rasa kembung di perut) pada kelompok probiotik selama penelitian (p = 0,04).Simpulan: Pemberian probiotik preoperatif menurunkan secara signifikan peningkatan CRP pada pasien pascalaparotomi gastrointestinal

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Background: Laparotomy is a surgical technique to open access to the peritoneal cavity by forming an open incision in the abdominal area. Mucosal injury due to surgical trauma can disrupt epithelial homeostasis, impair the microbiome ecosystem, increase the production of proinflammatory cytokines and relating to the incidence of postoperative complications. Lactobacillus acidophillus probiotic administration improve the intestinal barrier function, maintains the microbiome ecosystem and potentially modulate immune responses. However, there has been no research on the impact of Lactobacillus acidophilus administration on C-Reactive Protein (CRP) levels after gastrointestinal laparotomy as a marker of inflammation.

Objective: This study aimed to determine the impact of Lactobacillus acidophilus on CRP levels after gastrointestinal laparotomy

Methods: This study is a randomized controlled trial. Fifty six subjects scheduled gastrointestinal laparotomy surgery were enrolled. Subjects received Lactobacillus acidophilus 109 probiotic capsules (probiotic group) or lactose capsules (placebo group) for 3 days before surgery. CRP levels were measured 3 days before the procedure and 3 days after the procedure.

Results: Fifty-six subjects with 28 subjects in each group completed the study. On the third postoperative day, probiotics effectively suppressed the elevating inflammatory response with the final CRP value in the probiotic group lower than the placebo group (median probiotic 89.65 mg/L vs. placebo 204 mg/L, p < 0.001). Elevated CRP values ​​were lower in the probiotic group than in the placebo group (median probiotic 84.8 mg/L vs. placebo 187.6 mg/L, p < 0.001). There was a significant side effects (nausea, diarrhea, vomiting, and bloating) in the probiotic group during study (p = 0.04).

Conclusions: Preoperative probiotic administration significantly reduced elevated CRP in patients After Undergoing Gastrointestinal Laporotomy."