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"The presence of Chronic Kidney Disease (CKD) increases the risk of death from cardiovascular causes and makes the management of heart failure difficult. The coexistence of CKD and heart failure is increasing in prevalence worldwide and requires a unique and subtle approach to patient management.Managing the kidney in heart failure focuses on the therapeutic management of cardio renal patients. Common heart and kidney failure conditions are presented along with treatment scenarios aimed to reduce cardiovascular mortality and preserve kidney function"

"ABSTRAKGinjal merupakan organ yang dalam keadaan normoksia sekalipun rentan terhadap keadaan hipoksia. Salah satu mekanisme adaptasi terhadap keadaan hipoksia sistemik kronik adalah dengan mengekspresikan Cygb. Cygb berperan untuk mensuplai O2 ke mitokondria. Penyedian O2 dilakukan untuk reaksi hidroksilasi prolin pada sintesis kolagen dan asparagin pada HIF-1. Penelitian ini bertujuan untuk menganalisis ekspresi relatif mRNA dan protein Cygb pada jaringan ginjal tikus yang diinduksi hipoksia sistemik kronik. Penelitian eksperimental ini menggunakan 25 tikus Sprague-Dawley yang dibagi menjadi 5 kelompok, yakni: kontrol (normoksia: 20% oksigen/80% nitrogen), 1, 3, 7 dan 14 hari hipoksia (10% oksigen/90% nitrogen). Organ ginjal diambil setelah tikus dibedah. Parameter yang diukur adalah ekspresi relatif mRNA dan protein Cygb. Pengukuran mRNA dilakukan dengan menggunakan iScript One-Step SYBR Green (BioRad, NY). Protein Cygb diukur dengan menggukan Enzyme-Linked Immunosorbet Assay Kit (USCN). Ekspresi relatif mRNA dan protein Cygb mengalami titik puncak pada hipoksia 3 hari. Keduanya memiliki korelasi sangat kuat (r2 = 0.96, p<0.05). Ekspresi mRNA dan Protein Cygb meningkat pada jaringan tikus yang diinduksi hipoksia sistemik kronik.

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ABSTRACT

Kidney is the organ in a state of normoxia though susceptible to hypoxia. One of the mechanisms of adaptation to chronic systemic hypoxia is to express Cygb. The function of Cygb is to supply O2 to the mitochondria. Supply O2 is needed for the reaction of proline hydroxylation in collagen synthesis and asparagine in HIF-1α. The aim of this study is to analyze the relative expression of Cygb mRNA and protein in chronic ischemia of kidney tissue in the rat. This experimental study used 25 Sprague-Dawley rats divided into 5 group: control (normoxia: 20% oxygen/80% nitrogen), 1, 3, 7 and 14 day hypoxia (10% oxygen/90% nitrogen). Kidney organ were collected after the rats were sacrificed. Parameters measured were: the relative expression of Cygb mRNA and protein. Measurement of Cygb mRNA was done using iScript One-Step SYBR Green (BioRad, NY). Cygb protein was measured using Enzyme-Linked Immunosorbet Assay Kit for (USCN). The peak of relative expression of Cygb mRNA and protein occurred at day 3 of hypoxia. Both parameters were strongly correlated (r2 = 0.96, p <0.05). The relative expression of Cygb mRNA and protein were increased in rat kidney tissue which has been subjected to chronic systemic hypoxia."

"Il recente sviluppo tecnologico degli scanner TC e dei sistemi di visualizzazione delle immagini ha consentito un imponente ingresso della tecnica di angio-TC nella pratica clinico-diagnostica, conferendole un ruolo di primo piano sia nello studio in elezione che in situazioni di urgenza/emergenza, grazie ad immagini di qualità ottimale e di facile interpretazione. Il presente volume intende offrire un’introduzione alle tecniche di imaging vascolare con la massima semplicità e praticità possibili, cercando di riportare in maniera esaustiva le basi della tecnica d’esame, le principali patologie riscontrabili nella pratica clinica e i quadri normali e patologici da riconoscere nello studio post-operatorio. "

"Latar belakang: Infark miokard merupakan sindrom koroner akut yang ditandai dengan nekrosis miokardium. Inflamasi menjadi salah satu proses kunci yang terlibat pada infark miokard. Salah satu molekul yang berperan penting dalam progresi infark miokard adalah Nitrogen Oksida (NO), yang dapat diukur secara tidak langsung sebagai kadar nitrit. Sudah banyak studi tentang peran kardioprotektif ekstrak Centella asiatica, namun masih minim studi terkait perannya dalam memodulasi inflamasi infark miokard, khususnya dalam memodulasi pelepasan NO. Penelitian ini bertujuan untuk menganalisis pengaruh ekstrak daun Centella asiatica terhadap kadar nitrit pada jantung tikus dengan infark miokard akibat induksi isoproterenol. Metode: Penelitian ini menggunakan sampel jaringan jantung tikus jantan galur Wistar yang dibagi dalam tiga kelompok, yaitu kelompok normal, kelompok kontrol negatif yang diberikan isoproterenol 85mg/kgBB, dan kelompok isoproterenol dengan ekstrak etanol-air Centella asiatica 200mg/kgBB telah diberikan oleh peneliti utama sebelumnya. Kadar nitrit diukur pada homogenat jaringan jantung tikus dengan kit uji Griess pada panjang gelombang 540nm. Kadar protein di jaringan jantung diukur dengan uji Bradford pada panjang gelombang 595nm. Hasil: Berdasarkan pengukuran kadar nitrit, rata-rata kadar nitrit tertinggi pada kelompok isoproterenol sebesar 0,082 mM, diikuti dengan kelompok isoproterenol yang diberikan ekstrak Centella asiatica sebesar 0,0707mM, dan terakhir kelompok normal sebesar 0,027mM. Terdapat perbedaan kadar nitrit yang signifikan antara kelompok jaringan jantung isoproterenol dengan kelompok normal (p=0,025). Tidak ada perbedaan kadar nitrit yang signifikan antara kelompok yang diberikan isoproterenol dan ekstrak Centella asiatica dengan kelompok normal (p=0,102). Tidak ada perbedaan kadar nitrit yang signifikan antara kelompok isoproterenol dengan kelompok isoproterenol yang diberikan ekstrak Centella asiatica (p=0,520). Adapun berdasarkan hasil pengukuran kadar protein, tidak ada perbedaan kadar protein yang signifikan antara tiga kelompok percobaan. Kesimpulan: Pemberian isoproterenol meningkatkan kadar nitrit pada jaringan jantung tikus secara signifikan dibandingkan jaringan jantung tikus normal (kontrol). Ekstrak etanol-air Centella asiatica dapat menurunkan kadar nitrit pada jaringan jantung tikus dengan infark miokard akibat induksi isoproterenol.

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Introduction: Myocardial infarction is an acute coronary syndrome with myocardium necrosis. Inflammation becomes one of the principal process in myocardial infarction. One of the molecule with prominent role in myocardial infarction progression is Nitrogen Oxide (NO), which can be measured indirectly as nitrite level. There have been many studies on cardioprotective role of Centella asiatica, but there are still few studies on its role for modulating myocardial infarct inflammation, especially modulating NO release. Therefore, this research aims to analyze the effect of Centella asiatica leave extract toward nitrite level in mouse heart with isoproterenol-induced myocardial infarction. Method: This reseach uses heart tissue samples of male wistar mouse divided into three groups, which are normal group , negative control group with 85mg/kgBB isoproterenol , and isoproterenol group with ethanol-water extract of Centella asiatica 200mg/kgBB given by the main researcher before. Nitrie level measurement of mouse heart tissue homogenate is conducted with Griess kit assay at the wavelength 540nm. Protein level measurement of heart tissue is conducted with Bradford assay at the wavelength 595nm.Result: Based on the nitrite level measurement, isoproterenol group has the highest nitrite level average, which is 0.082 mM, followed by isoproterenol with Centella asiatica group with 0.0707 mM, and control group with lowest nitrite level average of 0.027 mM. There is significant nitrite level difference between isoproterenol group and control group (p=0,025). There is not significant nitrite level difference between isoprotrenol with Centella asiatica group and control group (p=0,102). There is not significant nitrite level difference between isoproterenol group and isoprotrenol with Centella asiatica group (p=0,520). Based on the protein level measurement, there is not significant difference of protein level between all of groups. Conclusion: Isoproterenol increases nitrite level of mouse heart tissues significantly compared to the normal mouse heart tissue (control). Ethanol-water Centella asiatica extract can reduce nitrite level in mouse heart tissue with isoproterenol-induced myocardial infarction."

"Latar Belakang : Model prediksi risiko mortalitas dan morbiditas pascapembedahan jantung digunakan untuk penjelasan kepada pasien mengenai risikoperioperasi, pemilihan tatalaksana, perbandingan hasil pascaoperasi dan alokasidana oleh penjamin kesehatan nasional. Husink dkk mengembangkan suatu sistemskor prediksi mortalitas dan morbiditas pasca pembedahan katup jantung yaitu skorHarapan Kita pada tahun 2015. Sistem skor model prediksi mortalitas memilikidaya kalibrasi dan diskriminasi yang baik sedangkan model prediksi morbiditasmemiliki daya kalibrasi baik dan daya diskriminasi sedang. Sampai saat ini belumada validasi eksternal pada sistem skor Harapan Kita tersebut, sehingga perludilakukan untuk dapat selanjutnya diimplementasikan secara klinis. Tujuan : Memvalidasi secara eksternal sistem skor Harapan Kita sebagai prediktormortalitas dan morbiditas di rumah sakit pasien yang menjalani pembedahan katupjantung. Metode : Penelitian merupakan studi potong lintang dengan metode validasieksternal temporal yang dilakukan di Departemen Kardiologi dan KedokteranVaskular Universitas Indonesia/Rumah Sakit Jantung dan Pembuluh DarahHarapan Kita, menggunakan data sekunder Januari 2015 hingga September 2016,yang diambil secara total sampling. Analisis data ditujukan untuk mendapatkannilai kalibrasi dan diskriminasi. Hasil : Sampel akhir berjumlah 789, kejadian mortalitas di rumah sakit 8.6 68dari 789 sampel dan prediksi mortalitas dengan skor Harapan Kita 11.9 .Kejadian morbiditas di rumah sakit 34.7 dan prediksi morbiditas dengan skorHarapan Kita 19.1 . Setelah dilakukan penghitungan skor Harapan Kita padasemua sampel studi, didapatkan nilai kalibrasi prediksi mortalitas p = 0.169 dandiskriminasi/AUC sebesar 0,761 95 IK; 0.702-0.821 sedangkan prediktormorbiditas kalibrasi p = 0.689 dan AUC 0.753 95 IK; 0.716-0.789. Kesimpulan : Sistem skor Harapan Kita secara eksternal valid untuk memprediksimortalitas dan morbiditas pasien yang menjalani pembedahan katup jantung.

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Background: Mortality and morbidity risk prediction model after cardiac surgeryis used to explain perioperative risk, choice of treatment, comparation of surgeryresults, and for financial allocation consideration by national health insurance.Harapan Kita score was developed in 2015. This scoring system had a goodcalibration and discrimination for predicting mortality also a good calibration butmoderate discrimination for predicting morbidity. However this score never beenexternally validated.

Objective: To validate externally the Harapan Kita scoring system as an inhospitalmortality and morbidity predictor in patients who is undergoing valvular heartsurgery.

Methods: This is a cross sectional study with temporal external validation methodthat performed at the Department of Cardiology and Vascular Medicine,Universitas Indonesia National Cardiovascular Center Harapan Kita, usingsecondary data from January 2015 until September 2016, which taken by totalsampling method. Data analysis is intended to develop the calibration anddiscrimination level.

Results: The final samples were 789, with 8.6 68 from 789 samples mortalityevent and a mortality predictor of Harapan Kita Score 11.9. The Odds Ratio OR of all variables were similar with the OR of Harapan Kita score previous study. Callibration value for mortality predictor were p 0.169 with a discrimination AUC 0.761 95 CI 0.702 0.821 meanwhile calibration value formorbidity predictor were p 0.689 and AUC 0.753 95 CI 0.716 0.789.

Conclusion: Harapan Kita scoring system valid externally to predict in hospitalmortality and morbidity in patients undergoing valvular heart surgery"