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"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. "

"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. "

"Pasien rawat inap di rumah sakit dengan keganasan sering terjadi malnutrisi. Deteksi dini malnutrisi mempercepat terapi awal nutrisi sehingga mengurangi morbiditas dan mortalitas. Penelitian ini merupakan studi uji diagnostik membandingkan MST dan PG-SGA dengan SGA pada pasien kanker ginekologik rawat inap di RSUPN Cipto Mangunkusumo sebanyak 66 orang pada bulan April 2015. Pengumpulan data menggunakan formulir skrining, pemeriksaan fisik, dan pengukuran antropometri. MST memiliki sensitivitas 70%, spesifisitas 88%, PPV 90%, NPV 65%, AUC 0,79. PG-SGA mempunyai sensitivitas 100%, spesifisitas 92%, PPV 95%, NPV 100%, AUC 0,96. Terdapat perbedaan signifikan lama waktu pengerjaan di antara ketiganya, dengan waktu tercepat dimiliki oleh MST. Prevalensi malnutrisi berdasarkan SGA sebesar 60,6%. PG-SGA merupakan alat skrining yang sesuai dalam mendeteksi malnutrisi pasien kanker ginekologik rawat inap.

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Malnutrition is a common problem in hospitalized patients with malignancies. Early recognition of malnutrition leads to appropriate nutritional care plans and reduces rate of both morbidity and mortality. This diagnostic test study which comparing between MST and PG-SGA against SGA, was conducted on 66 hospitalized gynecologic cancer patients in April 2015. Data collection was obtained using screening tool forms, physical examination, and anthropometric measurement. According to SGA, 60.6% of patients were malnourished. MST had a sensitivity of 70% and a specificity of 88%. The PPV of MST was 90%, NPV 65%, and AUC value was 0.79. PG-SGA had a sensitivity of 100% and a specificity of 92%. The PPV of PG-SGA was 95%, NPV 100%, and AUC value was 0.96. There were a significant difference in time spent applying questionnaires between these screening tools, and MST had the quickest among three. PG-SGA is suitable screening tool for detecting risk of malnutrition in hospitalized patients with gynecologic cancer."

"Latar belakang: Kanker saat ini masih menjadi salah satu masalah kesehatan utama di dunia. Insidensi kanker ginekologi di Indonesia masih tinggi. Aspek nutrisi merupakan salah satu aspek yang paling sering mengalami kelainan pada pasien dengan kanker. Patient Generated-Subjective Global Assessment (PG-SGA) merupakan modalitas skrining nutrisi yang mengombinasikan data kualitatif dan semi-kuantitatif. Proses inflamasi sistemik yang terjadi pada pasien kanker dapat mengakibatkan penurunan kadar albumin dan prealbumin. Namun, belum banyak penelitian sebelumnya yang mencari bagaimana korelasi kadar albumin dan prealbumin terhadap skor PG-SGA.Tujuan: Mengetahui parameter yang paling baik dalam mendeteksi malnutrisi untuk pasien dengan onkologi ginekologi di RSUPN Dr. Cipto Mangunkusumo.Metode: Penelitian ini menggunakan metode potong lintang (cross sectional). Subjek dari penelitian ini adalah pasien yang didiagnosis dengan kanker ginekologi yang berobat ke Poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan direncanakan atau telah menjalani terapi pada Oktober 2020 - September 2021. Pasien dengan riwayat keganasan primer selain keganasan ginekologi, menerima terapi kortikosteroid oral atau intravena, riwayat pembedahan saluran cerna yang memengaruhi absorpsi/asupan nutrisi, dan riwayat penyakit liver akut atau kronik dan alkoholisme dieksklusi dari penelitian. Hasil: Didapatkan sebanyak 90 subjek yang diikutsertakan dalam penelitian. Secara keseluruhan, nilai rerata albumin yaitu 4,19 g/dL, rerata prealbumin yaitu 39,1 mg/dL, dan rerata skor PG-SGA yaitu 3 atau kategori A. Terdapat korelasi positif lemah antar kadar albumin dengan prealbumin (r=0,378, p=0,000), Terdapat korelasi negatif lemah antara kadar albumin terhadap skor PG-SGA (r=-0,313, p=0,003), sedangkan tidak terdapat korelasi kadar prealbumin terhadap skor PG-SGA (r=-0,145, p=0,173).Kesimpulan: Didapatkan korelasi antara albumin terhadap skor PG-SGA, namun tidak didapatkan korelasi antara prealbumin terhadap skor PG-SGA.

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Background: Cancer is still one of the major health problems in the world. The incidence of gynecological cancer in Indonesia is still high. Nutritional aspect is one of the most frequent aspects of abnormalities in patients with cancer. Patient Generated-Subjective Global Assessment (PG-SGA) is a nutritional screening modality that combines qualitative and semi-quantitative data. Systemic inflammatory process that occurs in cancer patients can result in a decrease in albumin and prealbumin levels. However, there have not been many previous studies looking at the correlation between albumin and prealbumin levels on the PG-SGA score.

Objective: Knowing the best parameters in detecting malnutrition for gynecological oncology patients at RSUPN Dr. Cipto Mangunkusumo.

Methods: This study used a cross-sectional method. The subjects of this study were diagnosed with gynecological cancer who went to the Gynecological Oncology Polyclinic of RSUPN Dr. Dr. Cipto Mangunkusumo and planned or already undergoing therapy during October 2020 - September 2021. Patients with a history of primary malignancy other than gynecological malignancy, receiving oral or intravenous corticosteroid therapy, history of gastrointestinal surgery affecting nutrient absorption/intake, and history of acute or chronic liver disease and alcoholism was excluded from the study.

Results: There were 90 subjects who were included in this study. Overall, the average level of albumin was 4.19 g/dL, the average level of prealbumin was 39.1 mg/dL, and the average of scored-PG-SGA was 3 or category A. There was a weak positive correlation between albumin and prealbumin levels (r=0.378, p=0.000). This study showed a weak negative correlation between albumin level and scored-PG-SGA (r=-0.313, p=0.003), whereas there was no correlation between prealbumin levels and scored-PG-SGA (r=-0.145, p=0.173).

Conclusion: A weak negative correlation was found between albumin and the scored-PG-SGA, but no correlation was found between prealbumin and the scored-PG-SGA."

"ABSTRAK Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harusdievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukurankekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudahdibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostikKGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapismalnutrisi pasien kanker rawat jalan di RSCM.Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun dipoliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGTdianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai denganmenghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, danmalnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgfdengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuanberturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasienkanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good.;Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good."

"Malnutrisi sering dialami oleh pasien kanker dan dapat menyebabkan penurunan kualitas hidup. Oleh karena itu, identifikasi awal pasien yang berisiko malnutrisi harus dilakukan pada semua pasien kanker, namun hingga saat ini, belum ada baku emas alat skrining yang digunakan di bagian rawat jalan radioterapi. Penelitian ini merupakan studi potong lintang yang dilakukan untuk membandingkan skrining malnutrisi Malnutrition Screening Tool (MST) dan Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) pada 144 pasien kanker yang akan menjalankan radioterapi di RSUPNCM, dengan Patient- Generated Subjective Global Assessment (PG-SGA) sebagai baku emas. Didapati sebanyak 41% pasien berisiko malnutrisi (PG-SGA). Skrining MST dinilai mudah dan cepat dengan rerata waktu pengerjaan 21 detik, dan memiliki nilai sensitivitas 84,75%, spesifisitas 77,65%, nilai prediksi positif (NPP) 0,73, nilai prediksi negatif (NPN) 0,88, dan nilai area under the ROC curve (AUC) 0,812. Skrining abPG-SGA memiliki sensitivitas 98,31%, spesifisitas 92,94%, NPP 0,91, NPN 0,99, AUC 0,956, dan rerata waktu pengerjaan 2 menit 24 detik. Kesimpulan yang dapat diambil adalah abPG-SGA merupakan alat skrining yang lebih baik dan akurat untuk digunakan di bagian rawat jalan radioterapi.

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Malnutrition is common among cancer patients and can lead to decreased quality of life. Therefore, early identification of patients at risk of malnutrition should be performed in all cancer patients, but until now, there is no gold standard of nutrition screening tool that should be used in outpatient radiotherapy setting. This study was a cross-sectional study conducted to compare Malnutrition Screening Tool (MST) and Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) as nutrition screening tools in 144 radiotherapy outpatients against Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Forty-one percent of patients were at risk of malnutrition (PG- SGA). The MST was a simple and quick tool with an average of 21 seconds. It had 84.75% sensitivity, 77.65% specificity, positive predictive value (PPV)=0.73, negative predictive value (NPV)=0.88, and area under the ROC curve (AUC)=0.812. The abPG-SGA yielded 98.31% sensitivity, 92.94% specificity, PPV=0.91, NPV=0.99, AUC=0.956, and it took an average of 2 minutes 24 seconds. In conclusion, the abPG-SGA is a better and more accurate screening tool in outpatient radiotherapy setting."

"Penelitian ini bertujuan untuk mengetahui korelasi antara asupan karbohidrat, protein dan lemak dengan kadar C-Reactive Protein pada pasien kanker paru stadium IIIB-IV. Progresivitas kanker paru dipengaruhi oleh sistem kekebalan tubuh, faktor genetik dan respon inflamasi. CRP sebagai salah satu marker inflamasi dapat diandalkan sebagai salah satu parameter untuk memprediksi perkembangan kanker. Subjek didapatkan melalui consecutive sampling yang melibatkan 49 subjek kanker paru stadium IIIB ndash; IV yang tidak sedang menjalani terapi di RS Kanker 'Dharmais'. Hasil penelitian didapatkan rerata usia 55,82 12,26 tahun, sebanyak 63,3 berjenis kelamin laki-laki. Nilai median CRP yaitu 23,82 0,30 - 207,29 mg/L. Pada penelitian ini tidak ditemukan adanya korelasi yang bermakna antara asupan karbohidrat dengan kadar CRP serum p = 0,919 , asupan protein dengan kadar CRP serum p = 0,257 dan asupan lemak dengan kadar CRP serum p = 0,986 . Kesimpulan: pada penelitian ini tidak didapatkan korelasi antara asupan karbohidrat, protein dan lemak dengan kadar CRP serum sebagai penanda perkembangan kanker.

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The aim of the study was to determine the correlation between carbohydrate, fat and protein intake with the serum C Reactive Protein level in lung cancer patients stage IIIB ndash IV. The progression of lung cancer is influenced by immune system, genetic factors and inflammatory response, therefore CRP can be relied as one of the parameters for predicting cancer cell growth. Subjects were recruited by consecutive sampling, 49 subjects with lung cancer stage IIIB IV who currently not receving any treatment in Dharmais Cancer Hospital participating in this study. The mean age of subject was 55,82 12,26 years old and 63,3 were male. The median value of CRP was 23,82 0,30 207,29 mg L. This study did not showed significant correlation between carbohydate, protein and fat intake with serum CRP value p 0,919 p 0,257 p 0,986, respectively. In conclusion, there is no correlation between carbohydrate, protein and fat intake with serum CRP level in lung cancer stage IIIB ndash IV."

"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."

"Peningkatan berat badan selama hamil dan indeks massa tubuh (IMT) ibu laktasi yang berlebihan berhubungan dengan inflamasi kronis derajat rendah yang dapat menyebabkan dampak negatif bagi kesehatan ibu maupun bayi. Asupan nutrisi diketahui sebagai salah satu faktor utama yang mempengaruhi perubahan berat badan (BB), IMT, serta inflamasi pada ibu laktasi. Inflamasi kronis derajat rendah dapat diukur dengan high sensitivity C-Reactive Protein (hs-CRP), baik di serum maupun ASI. Selain dengan pemeriksaan laboratorium, status inflamasi juga dapat diprediksi oleh skor Dietary Inflammatory Index (DII), suatu alat yang dapat memprediksi potensi inflamasi diet individu. Penelitian ini bertujuan untuk mengetahui korelasi antara skor DII ibu laktasi dengan kadar hs-CRP serum dan ASI ibu 3-6 bulan post partum di Jakarta. Penelitian ini adalah studi potong lintang dengan menggunakan consecutive sampling yang melibatkan 71 subjek ibu laktasi 3-6 bulan post partum yang datang ke Puskesmas Cilincing dan Grogol Petamburan, Jakarta, pada bulan Februari-April 2019. Penilaian asupan nutrisi dilakukan dengan semi-kuantitatif Food Frequency Questionnaires, pemeriksaan antropometri meliputi BB prakehamilan, BB saat pengambilan data, dan tinggi badan, serta pengambilan sampel serum (dengan metode imunoturbidimetri) dan ASI (dengan metode ELISA) untuk pemeriksaan hs-CRP. Median CRP serum adalah 1,74 mg/L dan CRP ASI 6221,17 pg/mL, sementara rerata skor DII adalah 0,624. Ditemukan korelasi positif antara hs-CRP serum dan ASI (r = 0,269, p = 0,023), namun pada penelitian ini tidak didapati korelasi antara skor DII dengan kadar hs-CRP serum maupun ASI (r = -0,124, p = 0,301 dan r = 0,129, p = 0,283).

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Excessive gestational weight gain (GWG) and body mass index (BMI) in lactating mothers are associated with chronic low-grade inflammation which can cause negative effects to mother and baby. Nutrient intake has been known as important factor to affect inflammation, which can be measured by high sensitivity Creactive protein (hs-CRP). Beside laboratory assesment, level of inlammation can be determined by Dietary Inflammatory Index (DII) score, a tool developed to predict inflammation potential in diet consumed.

This study aimed to examine the correlation between DII score with serum and breast milk hs-CRP in lactating mothers. A cross-sectional study was conducted by consecutively enrolling 71 lactating mothers, 3-6 months post-partum, age 20-35 years old, visiting Grogol Petamburan and Cilincing community health center on February-April 2019. Dietary assessment was conducted using semi-quantitative food frequency questionnaire. Anthropometric measurements included were pre-pregnancy weight, post-partum weight, and body height. Serum hs-CRP was measured by immunoturbidimetry method, and breast milk hs-CRP by ELISA method. Median of serum and breast milk CRP were 1,74 mg/L and 6221,17 pg/mL, respectively. Mean of DII score was 0,624. Positive correlation was found between serum and breast milk hs-CRP (r = 0,269, p = 0,023), but we can not find correlation between DII score with serum and breast milk hs-CRP (r = -0,124, p = 0,301 and r = 0,129, p = 0,283). There is no correlation between DII score with serum and breast milk hs-CRP."

"Latar belakang. Bedah kanker kolorektal (KKR) adalah kasus terbany1k di Divisi Bedah Digestif RSUPNCM, di mana 46% di antaranya adalah karena kanker rektum I (K.R). Trauma pembedahan menimbulkan inflamasi, respon fase akut (RFA), dan stres metabolik. C- reactive protein (CRP) adalah protein fuse akut (PFA) dengan peningkatan tertinggi di antara PFA lainnya dan telah digunakan secara luas sebagai penanda inflamasi. Stres metabolik menyebabkan perubahan metabolisme zat gizi yang ditandai dengan peningkatan kadar glukosa darah sewaktu (GDS) plasma. Secara tidak langsung, pemberian terapi gizi adekuat dapat menekan laju inflamasi dan mempercepat proses penyembuhan pasca bedah. Tujuan. Untuk mengetahui peran terapi gizi adekuat selama tujuh hari terhadap perubahan kadar CRP serum dan GDS plasma pasien pasca bedah KR pada hari ke satu dan ke tujuh pengamatan. Metode. Penelitian ini adalah studi eksperimental dengan desain paralel, acak, dan tidak tersamar. Penelitian dilaksanakan di ruang rawat bedah kelas Ill RSUPNCM, pengumpulan data dilaksanakan pada bulan April- Agustus 2009. .9erdasarkan kriteria penelitian didapatkan 24 subyek yang dibagi menjadi dua, kelompok perlakuan (P) dan kontrol (K). Pengumpulan data dilakukan dengan metode wawancara, pengukuran antropometri, dan pemeriksaan laboratorium. Hasil. Karakteristik awal kedua kelompok adalah sebanding pada HI. Rerata asupan energi kelompok P adalah 1 211 ,23 ± 161 ,95 kkallh ari (82,86 ± 9,91 % kebutuhan energi total atau KET), adekuat, dan lebih tinggi bermakna (p< 0,001) dibandingkan kelompok K yaitu 831,93 ± 129,58 kkal/hari (55,75 ± 9,48% KET). Rerata asupan protein subyek tidak adekuat meskipun asupan protein kelompok P lebih tinggi bennakna (p< 0,001). Kelompok P mengalami peningkatan berat badan (BB) 0,71 ± 0,79 kg sedangkan kelompok K mengalami penurunan BB 0,85 ± 1,06 kg. Penurunan kadar CRP serum kelompok P (7,13 ± 1,43 mg/L) berbeda bermakna (p=0,005) dengan kelompok K (5,20 ± 1,58 mg/L). Peningkatan kadar GDS plasma kelompok P (26,00 ± 29,67 mg/dL) cenderung lebih tinggi dari kelompok K (10,00 ± 24,40 mg/dL), sejalan dengan peningkatan asupan energi yang lebih tinggi. Kadar CRP serum memiliki korelasi positif derajat rendah (r-0,266) dan tidak bennakna (p=0,358) dengan kadar ODS plasma. Kesimpulan. Pemberian terapi gizi adekuat selama tujuh hari berperan untuk mempercepat penurunan kadar CRP serum pasien pasca bedah KR. "