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"Pada beberapa tahun ini, peningkatan keparahan penyakit kronis dan gangguan kualitas hidup berhubungan dengan kondisi overweight pada orang dewasa dan termasuk dalam chronic low grade Inflamation. Penelitan terhadap kondisi overweight pada orang dewasa dilihat dari sisi imunitas tergambarkan pada beberapa mediator sel imun khususnya sitokin dalam hal ini TNF-α, IL-6 dan IL-10. Sitokin inflamasi pada individu overweight diproduksi berlebih oleh white adipose tissue sehingga terjadi ketidakseimbangan dalam imunitas. Kuesioner Status imun dapat menilai kerentanan seseorang terhadap penyakit yang berhubungan dengan imunitas. Melalui penelitian ini bertujuan menganalisis hubungan mediator inflamasi: TNF-α/IL-10 dengan skor status Imunitas menggunakan kuesioner yang tervalidasi dan membandingkan sitokin tersebut antara kelompok golongan non- dan Overweight -Obesitas. Penelitian ini menggunakan studi potong lintang dengan data kuesioner pada 100 subjek yang diukur serum darah TNFα, IL-10 menggunakan teknik magnetic luminex multiplex immunoassay. Hasil analisa didapatkan perbedaan bermakna antara nilai TNFα di kelompok non- dengan nilai TNFα pada kelompok obese-overweight dengan p= 0.028 (p<0.05) dan pada rasio sitokin tersebut dengan p= 0.032(p<0.05). Hubungan skor ISQ dengan TNFa korelasi p=0.039 (p<0.05). Dapat disimpulkan adanya hubungan bermakna antara TNFα berikut rasionya dengan skor ISQ serta ditemukan kadar TNFα dan rasionya pada kelompok overweigth-obese lebih tinggi dibandingkan dengan kelompok non Overweight -Obesitas

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In recent years, increased severity of chronic disease and impaired quality of life have been associated with overweight in adults and as part chronic low grade inflammation. Research on overweight conditions in adults in terms of immunity is described in several immune cell mediators, especially cytokines in this case TNF-α, IL-6 and IL-10. Inflammatory cytokines in overweight individuals are produced in excess by white adipose tissue, resulting in an imbalance in immunity. The Immune Status Questionnaire can assess a person's susceptibility to immune-related diseases. This study aims to analyze the relationship between inflammatory mediators: TNF-α/IL-10 with Immunity status scores using a validated questionnaire and compare these cytokines between the non- and Overweight-Obesity groups. This study was cross-sectional study with questionnaire data on 100 subjects and blood serum TNFα, IL-10 were measured using magnetic luminex multiplex immunoassay technique. The results of the analysis showed a significant difference between the TNFα in the non-group and the TNFα in the obese-overweight group with p= 0.028 (p<0.05) and the ratio with p= 0.032 (p<0.05). The relationship between ISQ scores and TNFa correlation p=0.039 (p<0.05). It concluded that there is a significant relationship between TNFα and its ratio with ISQ scores and found TNFα levels and ratios in the overweight-obese group were higher than in the non-Overweight-Obesity group"

"Perawat Spesialis Medikal Bedah berperan penting dalam praktik keperawatan sebagai pemberi asuhan keperawatan kompleks, melakukan analisa ilmiah dan pembuktian ilmiah serta sebagai agen pembaharu. Melalui tulisan ini digambarkan pemberian asuhan keperawatan kepada pasien dengan diagnosis Chronic Limb Threatening Ischemia. Tujuan dari penulisan ini adalah memberikan gambaran praktek keperawatan spesialis medikal bedah menggunakan pendekatan Model Adaptasi Roy. Dari hasil pengumpulan data dan pemeriksaan fisik didapatkan 10 diagnosis keperawatan. Pemberian asuhan keperawatanpun dilakukan kepada 30 pasien sebagai kasus resume, diperoleh perilaku maladaptif pada mode fisiologis dengan diagnose terbanyak yaitu resiko infeksi dan nyeri kronik. Evidence Based Nursing dengan melakukan foot exercises kepada 8 pasien yang mengalami ulkus kaki diabetik dengan hasil yang signifikan terhadap perubahan ukuran luka. Program inovasi menerapkan Hypoglycemia-Nursing Early Warning Score System pada pasien diabetes melitus tipe 2 yang terbukti memudahkan perawat menilai resiko kejadian hipoglikemi berat selama 1 tahun. Pendekatan Model Adaptasi Roy berpengaruh besar terhadap profesi keperawatan. Model ini menjadi salah satu yang banyak digunakan dalam penelitian, pendidikan dan pelayanan keperawatan.

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Surgical Medical Specialist Nurses play an important role in nursing practice as a provider of advanced nursing care, conduct scientific analysis and scientific evidence and as a reforming agent. Through of this paper we describe the provision of nursing care to patients with a diagnosis of Chronic Limb Threatening Ischemia. The purpose of this paper is to provide an overview of the nursing practice of Surgical Medical Specialists using Roy's Adaptation Model approach. From the results of data collection and physical examination obtained 10 nursing diagnoses. In nursing care was provided to 30 patients as a case of resume, obtained maladaptive behavior in physiological mode with the most diagnoses, the risk of infection and chronic pain. Evidence Based Nursing by performing foot exercises on 8 patients who suffered diabetic foot ulcers with significant results on changes in wound size. The innovative program implementated the Hypoglycemia-Nursing Early Warning Score System in patients with type 2 diabetes mellitus which was proven to make it easier for nurses to assess the risk of severe hypoglycemic events for 1 year. Roy's Adaptation Model approach greatly influencing the nursing profession. This model is one that was widely used in research, education and nursing services"

"Trauma pada nervus ischiadicus merupakan cedera saraf tepi yang mengakibatkan perubahan secara morfologi dan seluler pada neuron dan akson. Pemulihan paska cedera nervus ischiadicus seringkali belum optimal secara fungsional. Saat ini, PRP dikembangkan menjadi salah satu pilihan terapi alternatif selain tindakan pembedahan. Hal ini disebabkan PRP mengandung sitokin dan neurotropin yang berperan dalam regenerasi saraf. Penelitian ini bertujuan untuk melihat peranan PRP pada regenerasi saraf motorik tikus model sciatica dengan crush injury. Penelitian eksperimental ini menggunakan blok biologis tersimpan medulla spinalis dan nervus ischiadicus dari tikus wistar jantan yang diberi perlakuan kontrol, sciatica dan sciatica dengan PRP yang diterminasi hari ke-7 dan 42 di Departemen Anatomi, Fakultas Kedokteran, Universitas Indonesia. PRP sebanyak 0,2 ml diberikan pada area bekas jepitan memakai absorbable gelatin sponge. Penilaian regenerasi saraf dilakukan dengan melihat densitas neuron di medulla spinalis menggunakan pewarnaan khusus toluidine blue dan imunohistokimia protein S100B di sitoplasma sel schwann nervus ischiadicus. Didapatkan hasil signifikan pemeriksaan densitas neuron pada hari ke-7 dan 42 antara kelompok sciatica dan kelompok sciatica + PRP serta hasil signifikan pada pemeriksaan ekspresi protein S100B pada hari ke-7 pada kelompok kontrol maupun kelompok sciatica dengan kelompok sciatica + PRP. Penelitian ini menunjukkan bahwa pemberian PRP dapat meningkatkan proliferasi sel schwann dan berperan dalam neuron survival.

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Trauma to the ischiadicus nerve is a peripheral nerve injury that results in morphological and cellular changes in neurons and axons. Post-injury recovery of the ischiadicus nerve is often not functionally optimal. Currently, PRP has been developed as an alternative therapy option to surgery. This is because PRP contains cytokines and neurotrophins that play a role in nerve regeneration. This study aims to look at the role of PRP in motor nerve regeneration of sciatica model rats with crush injury. This experimental study used stored biological blocks of the spinal cord and nervus ischiadicus from male Wistar rats treated with control, sciatica and sciatica with PRP terminated on days 7 and 42 at the Department of Anatomy, Faculty of Medicine, University of Indonesia. PRP as much as 0.2 ml was given to the crush injury area using absorbable gelatin sponge. Assessment of nerve regeneration was performed by looking at the density of neurons in the spinal cord using toluidine blue special staining and immunohistochemistry of S100B protein in the cytoplasm of schwann cells of the ischiadicus nerve. There were significant results in the examination of neuron density on days 7 and 42 between the sciatica group and the sciatica + PRP group and significant results in the examination of S100B protein expression on day 7 in the control group and the sciatica group with the sciatica + PRP group. This study shows that PRP administration can increase schwann cell proliferation and play a role in neuron survival."

"Protein-Energy Malnutrition (PEM) is believed to lead to an increased susceptibility to infection, or cause impaired immunity. Infection, occurring with malnutrition, is a major cause of morbidity in all age groups and is responsible for two-thirds of all death under 5 yr of age in developing countries. Many cells of the immune system are known to depend for their function on metabolic pathways that employ various nutrients as critical factors. The most consistent changes in immune competence in PEM are in cell-mediated immunity, the bactericidal function of neutrophils, the complement system, the secretory immunoglobin A, and antibody response."

"Latar Belakang. Sindrom pulih imun (SPI) TB adalah fenomena yang sudah dikenal luas yang dapat menyulitkan terapi antiretroviral. Saat ini belum ada penelitian mengenai insidens dan faktor prediktor terhadap terjadinya SPI TB di Indonesia. Dengan mengetahui insidens dan faktor prediktor yang berperan diharapkan dapat membantu klinisi mengidentifikasi terjadinya SPI TB dan merencanakan tindakan pencegahan dan penatalaksanaan.Tujuan. Mengetahui insidens, kesintasan, dan faktor-faktor prediktor terjadinya SPI TB pada pasien HIV dewasa yang dalam terapi ARV lini pertama.Metode. Penelitian kohort retrospektif terhadap 1344 pasien yang mendapat terapi antiretroviral untuk pertama kali di RSCM pada kurun waktu Januari 2007 - Desember 2011. Faktor prediktor yang diteliti adalah indeks massa tubuh (IMT) saat memulai ARV, jumlah CD4+ baseline, perubahan jumlah CD4+ setelah ARV (pada kedua jenis SPI), interval pemberian OAT dan ARV dan terdapatnya TB ekstraparu atau diseminata (pada yang paradoksikal). Analisis Cox Proportional Hazard Model dilakukan untuk mendapatkan adjusted Hazard Ratio (HR) prediktor yang diteliti.Hasil. Insidens kumulatif SPI TB paradoksikal adalah 11,73 % dengan incidence density 0,59 per 100 pasien-minggu, kesintasan kumulatif 87,1 % (SE 1,8 %), serta rerata kesintasan 22,14 minggu (interval kepercayaan [IK] 95% 21,56-22,70). Insidens kumulatif SPI TB unmasking adalah 3,05 % dengan incidence density 0,29 per 100 pasien-minggu, kesintasan kumulatif 96,6 % (SE 0,6 %), serta rerata kesintasan 11,82 minggu (interval kepercayaan [IK] 95% 11,74-11,90). IMT (adjusted HR 4,141; IK 95% 2,318 – 7,397) dan TB ekstra paru (adjusted HR 4,659; IK 95% 2,556 – 8,489) adalah faktor prediktor yang bermakna terhadap terjadinya SPI TB paradoksikal, sedangkan IMT (adjusted HR 2,755; IK 95% 1,214 – 6,254) menjadi satu-satunya faktor prediktor yang bermakna pada SPI TB unmasking.Kesimpulan : Insidens kumulatif SPI TB paradoksikal adalah 11,73 %, sedangkan insidens kumulatif SPI TB unmasking adalah 3,05 %. IMT dan TB ekstra paru adalah faktor prediktor yang bermakna terhadap terjadinya SPI TB paradoksikal, sedangkan IMT menjadi satu-satunya faktor prediktor yang bermakna pada SPI TB unmasking.

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Background. Immune Reconstitution Inflammatory Syndrome (IRIS) TB is a widely-known phenomenon complicating antiretroviral therapy. There have been no research about incidence of IRIS TB in Indonesia and about predictors of IRIS TB. Determination of incidence and predictors of IRIS TB is expected to help clinicians to identify IRIS TB event earlier in order to manage the patient better and to prevent the event.

Objective. The objective of this research was to determine the incidence, survival, and predictors of IRIS TB event in adult HIV patient on first line antiretroviral therapy.

Method. Retrospective cohort was performed to 1344 patients (392 patients have been diagnosed with TB and 952 patients have not) who received antiretroviral therapy for the first time in RSCM Hospital between January 2007 – December 2011.

The predictors analyzed in this research were body mass index (BMI), baseline CD4+, changes of CD4+ after ARV therapy (in both type of IRIS TB), time interval between anti tuberculosis and antiretroviral therapy initiation, and the presence of extrapulmonary or disseminated TB (in paradoxical IRIS TB). Cox Proportional Hazard Model analysis was performed to get adjusted Hazard ratio (HR) of the observed predictors.

Result. Cumulative incidence of paradoxical IRIS TB was 11,73 % with incidence density 0,59 per 100 patient-week, cumulative survival 87,1 % (SE 1,8 %), and mean survival 22,14 weeks (CI 95% 21,56-22,70). Meanwhile, cumulative incidence of unmasking IRIS TB was 3,05 % with incidence density 0,29 per 100 patient-week, cumulative survival 96,6 % (SE 0,6 %), and mean survival 11,82 weeks (CI 95% 11,74-11,90).

BMI (adjusted HR 4,141; CI 95% 2,318 – 7,397) and extrapulmonary TB (adjusted HR 4,659; CI 95% 2,556 – 8,489) were predictors for paradoxical IRIS TB, while BMI (adjusted HR 2,755; CI 95% 1,214 – 6,254) was the only predictor for unmasking IRIS TB.

Conclusion: Cumulative incidence of paradoxical IRIS TB was 11,73 % with cumulative survival 87,1 % and mean survival 22,14 weeks. Meanwhile, Cumulative incidence of unmasking IRIS TB was 3,05 % with cumulative survival 96,6 % and mean survival 11,82 weeks. BMI and extrapulmonary TB were predictors for paradoxical IRIS TB, while BMI was the only predictor for unmasking IRIS TB."

"Secara geografis Indonesia sangat berpotensi sekaligus rawan bencana alam. Beberapa dampak bencana alam yang ditimbulkan terhadap masyarakat adalah timbulnya cedera, depresi, dan penyakit. Ketiga hal tersebut berkaitan erat dengan sistem imun manusia. Untuk menanggulangidampak bencana, pemerintah(BPPT) hendak mengeluarkan suatu produk pangan baru yang berasal dari ektrak buah delima yang secara in vitro terbukti meningkatkan respon imun tubuh manusia. Diperlukan penelitian toksisitas oral akut dan subkronik produk pangan darurat BPPT tersebut.Penelitian ini menggunakan true experimental design dengan pemilihan sampel secara random alokasi. Pada uji toksisitas oral akut digunakan 5 ekor tikus jantan dengan pemberian dosis 9g/kg BB. Setelah 14 haritidak terdapat efek toksik yang bermakna dan tikus yang mati sehingga nilai LD50> 9 g/kg BB.Pada uji toksisitas oral subkronik digunakan 4 grup perlakuan (1 g/kg BB, 2 g/kg BB, 4 g/kg BB, kontrol) untuk tiap jenis kelamin dengan jumlah @10 ekor tikus. Pada setiap grup diberikan perlakuan, observasi, dan pengukuran berat badan secara berkala selama 90 hari.Pada akhir periode perlakuan dibandingkan hasil observasi makroskopik dan mikroskopik antar kelompok. Secara umum grup tikus dengan dosis 1 g/kg BB tidak menunjukan tanda toksisitas yang bermakna, grup tikus dengan dosis 2 g/kg BB mulai menunjukan gangguan pada fungsi organ, dan grup tikus dengan dosis 4g/kg BB telah mengalami kerusakan jaringan berdasarkan pemeriksaan histopatologi. Berdasarkan hasil tersebut maka NOEL (No Observed Effect Level) pada tikus jantan dan betina adalah 1 g/kg BB.

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Located in ?The Pacific Ring of Fire?, it is irrefutable that Indonesia is vulnerable to natural disasters. Indeed, countless severe catastrophes result inthe emergence of closely-related human immune system problems, such as: injury, depression and illness. To deal with the issues, the Government (BPPT) has been planning meticulously to launch a new food product derived from pomegranate fruit extracts that can improve the human immune response system. It is then necessary to have further research onacute oral toxicity and sub-chronicoral toxicity of BPPT's emergency food product.

The study employed true experimental designmethodology as its principal and using randomize allocation sampling. A dose of 9 g/kg BB was given to five male ratsin an acute oral toxicity test. After 14 days, there were no significant toxic effects and no rat died. As such, the value of the LD50is > 9 g/kg BB. Another analysis was done in a sub-chronicoral toxicity test by using four treatment groups (1 g/kg BB, 2 g/kg BB, 4 g/kg BB, control) @ 10 rats for each sex.Foreachgroup, there were stringent monitoringas well asregular periodical body weight measurement within 90 days.

At the end of the treatment period, the results gathered from macroscopic and microscopic measurements were compared among groups. In general, group1 g/kg BB dose rats did not show significant signs of toxicity. Group 2g/kg BB dose rats started to show interference with the organ functions. As for the group4 g/kg BB dose rats, theyhad damaged tissue in histopathological examination. Based from these outcomes, it is clear that NOEL (No Observed Effect Level) in male and female rats is 1 g/kg BB."

"Tuberkulosis (TB) disebabkan oleh infeksi kuman Mycobacterium tuberculosis merupakan satu dari sepuluh penyebab kematian tertinggi di dunia yang dapat dicegah melalui vaksinasi. Vaksin BCG sebagai satu-satunya vaksin TB, memiliki beberapa kekurangan, diantaranya tingkat proteksi yang tidak merata di populasi orang dewasa dan kekhawatiran aplikasinya pada populasi imunokompromais, hal ini mendorong dikembangkannya vaksin TB alternatif. PE11 merupakan protein yang bertanggung jawab dalam rekonstruksi komponen lipid dinding sel M. tuberculosis dan berdasarkan analisis in-siliko diketahui memiliki domain pengenalan terhadap antibodi dan MHC-II. Dalam studi ini, gen pe11 dari M. tuberculosis strain Beijing diinsersikan ke dalam plasmid pcDNA3.1, pcDNA3.1-pe11, yang kemudian diuji kemampuannya dalam menginduksi respon imun humoral dan mediator seluler pada mencit Balb/c sebagai bentuk DNA vaksin. Berdasarkan uji western blot, respon imun humoral berupa IgG spesifik terhadap protein rekombinan PE11-His berhasil dikonfirmasi. Selain itu, mediator imun seluler dari splenosit mencit pasca vaksinasi dan pajanan antigen secara in-vitro menunjukkan adanya peningkatan produksi IL-12, IFN-γ dan IL-4 dibandingkan dengan kelompok kontrol, namun tidak terhadap sitokin IL-10.

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Tuberculosis (TB) caused by infection bacteria Mycobacterium tuberculosis, one of ten causes of death in the world that can be prevented through vaccination. The BCG vaccine, as the only TB vaccine, has several drawbacks, including an uneven level of protection in adult population and risk application in immunocompromised population, this has led to the development of an alternative TB vaccine. PE11 is a protein that is responsible for the reconstruction of the lipid component of the cell wall of M. tuberculosis and based on in-silico analysis is known to have the recognition domain for antibodies and MHC-II. In this study, the pe11 gene from the Beijing strain of M. tuberculosis was inserted into the plasmid pcDNA3.1, pcDNA3.1-pe11, then tested for its ability to induce humoral immune responses and cellular mediators in Balb/c mice as a form of vaccine DNA. Based on the western blot test, the specific IgG humoral immune response to the recombinant protein PE11-His was confirmed. In addition, cellular immune mediators from post-vaccination mice splenocytes and in-vitro antigen exposure showed increased production of IL-12, IFN-γ and IL-4 compared to the control group, but not to the IL-10 cytokine."