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"Sepsis adalah keadaan infeksi yang disertai dengan respon infeksi secara sistemik yang merupakan salah satu penyebab morbiditas dan mortalitas pasien dengan penyakit kiritis Penyakit kritis dapat menyebabkan seorang pasien jatuh ke dalam kondisi malnutrisi Prevalensi malnutrisi pada pasien sakit kritis yang dirawat di unit perawatan intensif adalah 50 Tujuan penatalaksanaan nutrisi pasien sepsis adalah untuk menurunkan stres metabolik mencegah kerusakan sel akibat stres oksidatif dan memodulasi fungsi imun Penatalaksanaan nutrisi meliputi kegiatan skrining assessment terapi nutrisi pemantauan dan evaluasi Pasien pada serial kasus ini adalah pasien dewasa dengan diagnosis sepsis yang disebabkan oleh pneumonia 3 pasien dan infeksi intraabdomen 1 pasien Komplikasi sepsis terbanyak dalam serial kasus ini adalah acute kidney injury AKI Kebutuhan energi dihitung berdasarkan rule of thumb yaitu 20 25 kkal kg BB hari pada fase akut dan 25 30 kkal kg BB hari pada fase anabolik Pada pasien yang mendapat continuous renal replacement therapy CRRT diberikan energi 35 kkal kg BB hari Pemberian protein dengan jumlah minimal 1 5 gram kg BB hari diberikan kepada pasien tanpa AKI sementara pada pasien dengan CRRT diberikan protein 1 7 gram kg BB hari Pemantauan terapi nutrisi meliputi tanda klinis toleransi asupan makanan kapasitas fungsional balans cairan parameter laboratorium dan antropometri Selama pemantauan didapatkan semua pasien dapat mencapai kebutuhan energi total dalam waktu kurang dari tujuh hari namun karena terjadi beberapa efek samping seperti peningkatan volume residu lambung dan tekanan karbon dioksida maka dilakukan penurunan asupan pada 2 pasien Pemberian nutrisi pada pasien sakit kritis bersifat individual dan terintegrasi Tatalaksana nutrisi yang baik diharapkan dapat menurunkan laju morbiditas dan mortalitas pasien dengan sepsis

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Sepsis is a state of infection accompanied by systemic inflammatory response syndrome It often associated with increase morbidity and mortality rate in critically ill patient Fifty percent of critically patient admitted in intensive care unit were malnourished Aims of nutritional management of septic patients are to reduce metabolic stress prevent cell damage from oxidative stress and modulate immune function Nutrition intervention in septic patients are including nutrition screening and assessment nutrition therapy monitoring and evaluation Subjects were four adult septic patients caused by pneumonia infection 3 patients and intra abdominal infection 1 patient Most frequent septic complications in this serial case report were acute kidney injury AKI Energy requirementis calculated based on the rule of thumb which is 20 25 kcal kg BW day in the acute phase and 25 30 kcal kg BW day in the anabolic phase Patients whose receiving continuous renal replacement therapy CRRT were given an energy of 35 kcal kg BW day Minimal protein requirement for patient without AKI was 1 5g kg BW day and in patients with CRRT protein intake were 1 7 grams kg BW day Monitoring includes clinical symptoms tolerance of food intake functional capacity fluid balance laboratory and anthropometric findings All patients were able to obtain total energy requirement in less than seven days However reduction of total energy was appied in 2 patients after several days of treatment due to increased gastric residual volume and carbon dioxide pressure Nutrition therapy in critically ill patients is individualized and integrated Proper nutrition therapy may decrease of morbidity and mortality rate in septic patients "

"Pendahuluan: Penyakit ginjal kronik (PGK) adalah kondisi hilangnya fungsi ginjal progresif dan ireversibel yang sangat mungkin mengancam jiwa pasien. Penyebab terbanyak PGK adalah diabetes mellitus (DM) dan hipertensi (HT) yang juga memiliki efek terhadap organ lain terutama jantung. Hal ini mengakibatkan disfungsi ginjal berat pada pasien seringkali ditemukan bersama dengan disfungsi jantung. Tata laksana nutrisi optimal diperlukan untuk mendapatkan hasil klinis yang baik. Presentasi kasus: Empat pasien perempuan, usia 49-67 tahun dengan riwayat DM dan HT, datang ke RS dengan keluhan sesak nafas, penurunan kesadaran, dan edema. Pasien didiagnosis dengan congestif heart failure (CHF), PGK (G5, G4, G4, dan G3), HT, DM tipe 2. Berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang didapatkan bahwa pasien berisiko malnutrisi, anemia, hiperuricemia, dan dislipidemia. Selama perawatan, pasien mendapatkan nutrisi secara bertahap sampai mencapai kebutuhan energi total, protein 0,8 g/kg BB, minyak ikan 2 g/hari, multivitamin, dan kalsium, disertai pembatasan asupan garam. Hasil pemantauan menunjukkan bahwa keempat pasien mengalami perbaikan klinis, namun tetap mengalami peningkatan kreatinin. Kesimpulan: Tata laksana nutrisi pasien PGK membutuhkan strategi pemberian nutrisi yang lebih komprehensif, tidak hanya dengan melakukan pembatasan asupan protein.

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Introduction: Chronic kidney disease (CKD) is life threathening condition caused by lost of kidney function progressively and irreversibly. Diabetes Mellitus (DM) and hypertension (HT) are the most common etiology of CKD, which also have impact to other organs such as heart. It make clinical manifestation in CKD patients often found with heart dysfunction, named as cardiorenal syndrome. Optimal nutrition therapy is needed to achieve good clinical outcomes.

Case presentation: Four female patients, ages 49-67 years old with history of DM and HT, came to hospital with chief complain dyspneu, decreased conciousness, and oedema anasarca. Patients had diagnose with CHF, PGK, anemia, DM, and HT. Data from anamnesis, physical, and laboratorium examination showed that all pasien have malnutrition risk, anemia, dyslipidemia, and hiperuricemia. During hospitalization, nutrition had given gradually to reach total energy needs, protein 0,8 g/kg BW, fish oil 2 g/day, multivitamin, calcium and salt restriction to recommended daily intake value. Monitoring result show that all patients have clinically improvement, but not creatinin level which act as marker of kidney damage.

Conclusion: Nutrition management in CKD patients need comprehensif strategy, not only with restriction protein intake."

"Studi kasus serial ini bertujuan untuk memberikan tatalaksana nutrisi pada pasien kanker kepala dan leher yang menjalani terapi kemoradiasi. Status nutrisi seorang pasien kanker merupakan salah satu prediktor dalam menentukan QOL dan survival, tetapi status nutrisi pada kasus serial ini dipengaruhi oleh banyak faktor antara lain metabolisme sel kanker, perubahan metabolisme dalam tubuh, efek samping radiasi, efek samping kemoterapi, serta faktor-faktor lain seperti psikis dan ekonomi. Serial kasus ini merupakan empat pasien kanker kepala dan leher berusia 30-57 tahun yang sedang menjalani kemoradioterapi dan telah mengalami penurunan berat badan bahkan sebelum dilakukan kemoradioterapi. Dalam perjalanan penyakitnya pasien mengalami efek samping terapi yang mempengaruhi status nutrisi pasien. Kebutuhan nutrisi pasien pada kasus serial ini dihitung menggunakan rumus Harris Benedict dengan faktor stres 1,5 dan diberikan protein sebanyak 1,5-2,0 g/kgBB/hari serta lemak 25-30%. Pemberian mikronutrien disesuaikan dengan RDA. Hasil dari kasus serial ini menunjukkan bahwa pasien yang status nutrisinya dapat dipertahankan menghasilkan outcome yang lebih baik daripada pasien yang status nutrisinya menurun. Untuk itu pada kasus keganasan kepala dan leher yang menjalani kemoradiasi sebaiknya diberikan konseling dan terapi nutrisi sejak awal sebelum timbul efek samping kemoradioterapi.

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This case studies aims to provide nutritional management of head and neck cancer patients undergoing chemoradiation therapy. Nutritional status of a patient's cancer is one of the predictors in determining QOL and survival. Nnutritional status is influenced by many factors, such as cancer cell metabolism, metabolic changes, the side effects of radiation and chemotherapy, as well as other factors such as psychological and economic. This is a case series of four head and neck cancer patients aged 30-57 years who were undergoing chemoradiotherapy and has lost weight even before chemoradiotherapy. In the course of illness of patients experience side effects of therapy affects the nutritional status of patients. Nutritional needs of patients in the case series were calculated using the Harris Benedict formula and stress factor 1.5. Protein was given 1.5 to 2.0 g protein/kgBW/day and 25-30% of fat. Micronutrient was provide as RDA. Results of this case series suggests that the nutritional status of patients who can be maintained produced better outcomes than patients whose nutritional status declined. For it is in the case of head and neck malignancies who underwent chemoradiation should be given counseling and nutrition therapy early before any side effects of chemoradiotherapy."

"Tatalaksana nutrisi pada pasien cedera kepala sedang dan berat mencakup pemberian makronutrien mikronutrien nutrien spesifik pengelolaan cairan dan elektrolit serta pemantauan dan evaluasi Dukungan nutrisi yang adekuat perlu diberikan pada pasien cedera kepala agar meningkatkan perbaikan kondisi optimal pasien Sebagian besar pasien cedera kepala memiliki status gizi yang baik sebelum terjadinya trauma Pemenuhan nutrisi yang optimal dapat turut menunjang perbaikan inflamasi metabolisme dan menjaga tidak terjadi penurunan status gizi Pasien pada serial kasus ini seluruh pasien laki laki mempunyai rentang usia 19 sampai 49 tahun Adanya penyakit penyerta mempengaruhi luaran akhir pasien cedera kepala Terapi nutrisi diberikan sesuai dengan kebutuhan setiap pasien Kebutuhan energi total dihitung berdasarkan perkiraan kebutuhan energi basal menggunakan persamaan Harris Benedict dikalikan faktor stres 1 4 1 6 dan pemberiannya disesuaikan dengan kondisi klinis pasien Kebutuhan protein 1 5 2 g kg BB hari dan lemak 20 30 Pemantauan mencakup tanda klinis toleransi asupan makanan kapasitas fungsional keseimbangan cairan parameter laboratorium dan antropometri Pemberian nutrisi pada pasien cedera kepala berat dengan sakit kritis bersifat individual dan mencakup semua aspek Tatalaksana nutrisi yang baik dan dilanjutkan dengan edukasi pada pasien dan keluarga diharapkan dapat meningkatkan kualitas hidup pasien cedera kepala dengan meminimalkan komplikasi yang dapat terjadi

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Nutrition therapy in patients with moderate and severe traumatic brain injury includes the provision of macronutrient micronutrient specific nutrition fluid and electrolyte management with monitoring and evaluation Adequate nutrition support should be given in traumatic brain injury to optmalyze outcome patient Three from four this case series have a normoweight before trauma Nutritional support can improve metabolism decrease inflammation and manage nutritional status Patients in this case series all male have an age range from 19 to 49 kg years Their comorbid condition influence outcome of traumatic brain injury patient Nutritional support is given according to each patient rsquo s requirement which is calculated with basal energy requirement using Harris Benedict equation with stress factor 1 4 1 6 and the administration starts with individual condition which gradually increased to reach the total energy expenditure Protein requirement 1 5 2 g kg day and lipid requirement is calculated 20 30 total energy requirement Patient rsquo s monitoring include clinical signs food intake tolerance functional capacity fluid balance laboratory and anthropometric parameter were taken With the management of good nutrition expected quality of life of patients with moderate and severe traumatic brain injury various comorbidities would be better "

"ABSTRAKLatar Belakang: Prevalensi penyakit ginjal kronik (PGK) meningkat pada usia lanjut. Berdasarkan Riskesdas 2013, prevalensi PGK lebih tinggi pada usia 55-75 tahun dibandingkan usia kurang dari 55 tahun. Pada usia lanjut terjadi perubahan struktur dan fungsi ginjal, serta adanya riwayat penyakit komorbid seperti diabetesmelitus (DM), hipertensi, penyakit jantung dan pembesaran prostat, menjadi faktor risiko yang meningkatkan terjadinya PGK. Komplikasi yang dapat timbul pada penderita PGK antara lain frailty dan protein energy wasting, yang menyebabkan penurunan kapasitas fungsional dan kualitas hidup, serta peningkatan morbiditas dan mortalitas. Terapi nutrisi yang adekuat berperan penting untuk mencegah protein energy wasting dan komplikasi lain yang dapat timbul pada PGK.Metode: Laporan serial kasus ini memaparkan empat kasus PGK pada pasien usia di atas 60 tahun. Dua pasien memiliki penyakit komorbid DM dan hipertensi, dandua lainnya hanya hipertensi. Keempat pasien dalam serial kasus ini termasuk PGK derajat IV dan V. Pada dua kasus dilakukan hemodialisis, sementara pada dua lainnya belum dilakukan. Masalah yang timbul pada keempat kasus adalahterdapat gejala-gejala sindroma uremia yaitu mual, muntah, anoreksia, lemas, sesak, dan anemia sehingga asupan makanan tidak adekuat dan terjadi penurunankapasitas fungsional. Kebutuhan energi pasien dihitung dengan menggunakan persamaan Harris-Benedict ditambah faktor stres dan pemberian protein disesuaikan dengan sudah atau belum dilakukan hemodialisis. Komposisikarbohidrat dan lemak disesuaikan dengan rekomendasi theurapeutic lifestyle changes (TLC) dan American Diabetes Association (ADA). Suplementasi mikronutrien diberikan sesuai dengan kondisi pasien. Pemantauan pasiendilakukan setiap hari dengan memperhatikan perubahan gejala klinis, tanda vital, imbang cairan, kapasitas fungsional, analisis dan toleransi terhadap makanan,serta hasil pemeriksaan laboratorium.Hasil: Pemantauan yang dilakukan pada empat pasien selama perawatan di rumah sakit menunjukkan terjadi perbaikan gejala klinis serta peningkatan asupan makanan dan kapasitas fungsional.Kesimpulan: Terapi nutrisi dapat mendukung terapi utama pada penderita PGK usia lanjut dalam memperbaiki keadaan klinis dan kapasitas fungsional, serta mencegah komplikasi lebih lanjut

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ABSTRACT

Background: The prevalence of chronic kidney disease (CKD) increases in the elderly. Based on Riskesdas 2013, the prevalence of CKD is higher in the age of 55-75 years old compared to below 55 years of age. In the elderly, there are alterations in kidney structure and function, as well as history of comorbidities include diabetes mellitus, hypertension, heart disease and prostate hypertrophy that increase the factor CKD. Complication that may occur in patients with CKD including frailty and protein energy wasting, which can cause decreased

functional capacity and quality of life, and increased morbidity and mortality. Adequate nutrition therapy plays an important role in preventing protein energy wasting and other complications that may arise in CKD.

Methods: This case series report describes four cases of CKD in patients aged above 60 years old. Two patients have comorbid disease diabetes mellitus and hypertension and the others have only hypertension. The four patients in this case series are in CKD stage IV and V. Two cases with hemodialysis, while in the others has not done yet. Problems arising in all cases are uremic syndrome

symptoms such as nausea, vomiting, anorexia,fatigue, dypsnea, and anemia causing inadequate food intake and decreased functional capacity. Energy requirements of the patients calculated using the Harris-Benedict equation added by stress factor and the amount of protein depends on whether the hemodialysis has or has not been applied. Carbohydrate and fat composition appropriated to the

theurapeutic lifestyle changes (TLC) and the American Diabetes Association (ADA) recommendations. Micronutrients supplementation was given in

accordance to patient's condition. Patient monitoring is carried out every day by observing changes in clinical symptoms, vital signs, fluid balance, functional

capacity, dietary analysis and food tolerance, and laboratory resultsResults: Monitoring conducted in the four patients during treatment at the hospital showed the improvements in clinical symptoms, and increased in food

intake and functional capacity."

"ABSTRAKLatar Belakang: Stroke hemoragik merupakan penyakit serebrovaskular yang ditandai dengan pecahnya pembuluh darah sehingga terjadi perdarahan pada otak. Penyebab tersering stroke hemoragik adalah hipertensi. Selain itu penyebab lainnya seperti diabetes melitus dan obesitas dapat menjadi penyulit keadaan klinis pasien. Stroke hemoragik dan beberapa penyulit akan menyebabkan disfungsi neurologis dan disfungsi motorik, yang keduanya akan menyebabkan penurunan asupan nutrisi. Penurunan asupan nutrisi dapat disebabkan penurunan kapasitas fungsional dan gangguan proses menelan atau disfagia. Nutrisi yang tidak adekuat dapat menyebabkan kualitas hidup menurun serta risiko serangan stroke berulang. Terapi medik gizi klinis berperan memberi nutrisi optimal, membatasai natrium, mengontrol glukosa darah dan mengatasi defisiensi mikronutrien. Metode:Serial kasus ini terdiri dari empat kasus stroke hemoragik pada pasien perempuan dan laki-laki dengan rentang usia 50 ndash;65 tahun, dengan penyulit seperti disfagia, penurunan kesadaran, dan perdarahan GIT, disertai penyakit penyerta yaitu Hipertensi dan DM tipe 2. Kasus pertama dan kedua mengalami gejala disfagia dan membutuhkan dukungan nutrisi melalui jalur enteral. Kasus ketiga terdapat penurunan asupan makanan karena penurunan kapasitas fungsional yang terjadi. Kasus keempat mengalami penurunan kesadaran dan perdarahan saluran cerna serta membutuhkan dukungan nutrisi secara enteral dan parenteral. Keempat pasien memiliki indeks massa tubuh obes 1. Masalah nutrisi yang dihadapi keempat pasien ini adalah asupan makro dan mikronutrien yang tidak optimal, jalur pemberian nutrisi, kebutuhan nutrisi yang tidak terpenuhi selama sakit. Terapi medik gizi klinik diberikan sesuai rekomendasi stroke hemoragik ddengan hipertensi dan DM tipe 2. Hasil :Kasus pertama hingga kasus ketiga mengalami perbaikan keadaan klinis, antara lain peningkatan kemampuan menelan, perbaikan tekanan darah, kadar glukosa, dan kapasitas fungsional. Kasus keempat meninggal dunia pada hari perawatan ke-8 akibat edema paru dan gagal jantung. Kesimpulan: Terapi medik gizi klinik yang diberikan dapat membantu keadaan klinis dan kapasitas fungsional pada pasien stroke hemoragik dengan Hipertensi dan DM tipe 2.

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ABSTRACT<>br>Background Hemorrhagic stroke is a cerebrovascular disease characterized by rupture of blood vessels resulting in bleeding in the brain. The most common cause of hemorrhagic stroke is hypertension. In addition, other causes such as diabetes mellitus and obesity could worsening the patient's clinical situation. Hemorrhagic strokes and some complications will cause neurologic dysfunction and motoric dysfunction, both of which will lead to a decrease in nutrient intake. Decreased nutritional intake could caused due to decreased functional capacity and impaired ingestion or dysphagia. Inadequate nutrition can lead to decreased quality of life as well as the risk of recurrent stroke. Medical clinical nutrition therapy plays an optimal role in nutrition, restricting sodium, controlling blood glucose and overcoming micronutrient deficiencies. Methods This case series consists of four cases of hemorrhagic stroke in female and male patients with age range 50-65 years, with complications such as dysphagia, consciousness derivation, and gastrointestinal bleeding, accompanied by comorbidities susch as Hypertension and type 2 DM. The first and second cases have symptoms of dysphagia and require nutritional support through the enteral route. The third case there is a decrease in food intake due to decreased functional capacity that occurs. The fourth case has consciousness derivation and gastrointestinal bleeding that requires support of enteral and parenteral nutritions. All of patients had obesity 1 body mass index. Nutritional problems faced by these four patients were unoptimal macro and micronutrient intake, nutritional pathways, unfulfilled nutritional needs during illness. Medical clinical nutrition therapy is given as recommended by hemorrhagic stroke with hypertension and type 2 diabetes mellitus Result The first case to the third case has improved clinical conditions, including increased ability to swallow, improvement of blood pressure, glucose levels, and functional capacity. The fourth case died on the 8th day of treatment due to pulmonary edema and heart failure. Conclusion Clinical nutrition therapy provided could improved clinical and functional capacity in hemorrhagic stroke patients with hypertension and type 2 DM."

"[ABSTRAKLatar belakang. Individu dewasa di masyarakat menunjukkan perubahan pola makan dan kurang aktivitas sehingga berisiko untuk menderita hiperkolesterolemia dan obesitas. Hiperkolesterolemia dapat diatasi dengan terapi nutrisi. Minyak bekatul mengandung zat aktif yang bekerja secara sinergis dan telah terbukti dari penelitian sebelumnya berperan dalam pengendalian lipid yaitu gamma-oryzanol, fitosterol, dan derivat vitamin E (tokotrienol dan tokoferol). Penelitian ini bertujuan untuk menilai perbaikan profil lipid pada pemberian minyak bekatul dengan jumlah yang berbeda tanpa merubah pola makan subyek. Metode. Uji klinis, desain paralel, alokasi acak selama 4 minggu pada laki-laki usia 19-55 tahun, kolesterol total 200-300 mg/dl, dan IMT 20-30 kg/m2. Subyek diambil secara konsekutif dan dibagi menjadi kelompok 45 ml/hari dan kelompok 15 ml/hari minyak bekatul. Sebelum perlakuan dilakukan wawancara data demografi, aktifitas fisik dan pemeriksaan antropometri. Asupan makan dinilai sebelum dan setelah perlakuan. Pemeriksaan laboratorium profil lipid dilakukan sebelum dan setelah perlakuan 4 minggu.Hasil. Dari total 20 subyek (10 subyek kelompok 45 ml/hari dan 10 subyek kelompok 15 ml/hari) didapatkan karakteristik yang setara antara kedua kelompok menurut usia, tingkat pendidikan, status gizi, aktivitas fisik, kebiasaan merokok, riwayat hiperkolesterolemia keluarga, antropometri dan profil lipid. Asupan makanan meliputi asupan energi, karbohidrat, protein, lemak dan serat sebelum perlakuan tidak berbeda bermakna antara kelompok. Asupan lemak setelah perlakuan berbeda bermakna antara kedua kelompok dikarenakan perbedaan pemberian jumlah minyak.Setelah perlakuan selama 4 minggu, didapatkan penurunan kolesterol total secara statistik berbeda bermakna antara kedua kelompok (p=0,049). Pada kelompok 45 ml/hari kadar kolesterol total turun sebanyak 14% dan pada kelompok 15 ml/hari terjadi penurunan kadar kolesterol total 7,8%. Penurunan LDL dan trigliserida serta peningkatan HDL secara statistik tidak berbeda bermakna antara dua kelompok (p >0,05). Pada penelitian ini tidak terjadi perubahan berat badan yang bermakna pada kedua kelompok.Kesimpulan. Konsumsi minyak bekatul 45 ml/hari menyebabkan perbaikan profil lipid yang lebih baik dibandingkan konsumsi minyak bekatul 15 ml.hari.

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ABSTRACTBackground. Adult individuals in Indonesian society showed changes in diet pattern and lack of physical activity that increasing risk for hypercholesterolemia and obesity. Hypercholesterolemia would be treated with nutritional therapy. Rice bran oil contains active substances (gamma-oryzanol, phytosterols, and derivatives of vitamin E (tocotrienols and tocopherols) that work in synergy and have been proven on previous research controlling lipid profil. This study aimed to assess the lipid profile improvement in intake of rice bran oil with different amounts without changing the eating patterns of the subjects.Methods. It was parallel and randomized clinical trial for 4 weeks in male with 19-55 years of age, total cholesterol level 200-300 mg/dl, and BMI of 20−30 kg/m2. All subjects were recruited consecutively and classified into two groups that received 45 ml/day or 15 ml/day rice bran oil for 4 weeks. The demographic data interviews, physical activity and anthropometric examination were taken before intervention. Food intake were assessed before and after intervention. Laboratory test of lipid profile performed before and after 4 weeks of treatment. Results. A total of 20 subjects consisting of 10 subjects with 45 ml/day rice bran oil and 10 subjects with 15 ml/day had obtained similar characteristics in age, education level, nutritional status, physical activity, smoking, family history of hypercholesterolemia, BMI and lipid profiles. Food intake includes intake of energy, carbohydrate, protein, fat and fiber before treatment did not significantly difference between two groups. Fat intake after treatment was significantly different between the two groups due to differences in the amount of oil.After 4 weeks treatment, there was a decrease in total cholesterol significantly different between the two groups (p = 0,049). In the group that received 45 ml/ day of rice bran oil total cholesterol level decreased 14% and in the group of 15 ml/day total cholesterol level decreased 7,8%. The reduction of LDL and triglycerides and the increasing of HDL was not significantly different between the two groups (p >0,05). In this study, no changes in body weight were significant in both groups.Conclusion. Rice bran oil consumption 45 ml/day led to improvements in lipid profiles better than consumption 15 ml/day;Background. Adult individuals in Indonesian society showed changes in diet pattern and lack of physical activity that increasing risk for hypercholesterolemia and obesity. Hypercholesterolemia would be treated with nutritional therapy. Rice bran oil contains active substances (gamma-oryzanol, phytosterols, and derivatives of vitamin E (tocotrienols and tocopherols) that work in synergy and have been proven on previous research controlling lipid profil. This study aimed to assess the lipid profile improvement in intake of rice bran oil with different amounts without changing the eating patterns of the subjects.Methods. It was parallel and randomized clinical trial for 4 weeks in male with 19-55 years of age, total cholesterol level 200-300 mg/dl, and BMI of 20−30 kg/m2. All subjects were recruited consecutively and classified into two groups that received 45 ml/day or 15 ml/day rice bran oil for 4 weeks. The demographic data interviews, physical activity and anthropometric examination were taken before intervention. Food intake were assessed before and after intervention. Laboratory test of lipid profile performed before and after 4 weeks of treatment. Results. A total of 20 subjects consisting of 10 subjects with 45 ml/day rice bran oil and 10 subjects with 15 ml/day had obtained similar characteristics in age, education level, nutritional status, physical activity, smoking, family history of hypercholesterolemia, BMI and lipid profiles. Food intake includes intake of energy, carbohydrate, protein, fat and fiber before treatment did not significantly difference between two groups. Fat intake after treatment was significantly different between the two groups due to differences in the amount of oil.After 4 weeks treatment, there was a decrease in total cholesterol significantly different between the two groups (p = 0,049). In the group that received 45 ml/ day of rice bran oil total cholesterol level decreased 14% and in the group of 15 ml/day total cholesterol level decreased 7,8%. The reduction of LDL and triglycerides and the increasing of HDL was not significantly different between the two groups (p >0,05). In this study, no changes in body weight were significant in both groups.Conclusion. Rice bran oil consumption 45 ml/day led to improvements in lipid profiles better than consumption 15 ml/day, Background. Adult individuals in Indonesian society showed changes in diet pattern and lack of physical activity that increasing risk for hypercholesterolemia and obesity. Hypercholesterolemia would be treated with nutritional therapy. Rice bran oil contains active substances (gamma-oryzanol, phytosterols, and derivatives of vitamin E (tocotrienols and tocopherols) that work in synergy and have been proven on previous research controlling lipid profil. This study aimed to assess the lipid profile improvement in intake of rice bran oil with different amounts without changing the eating patterns of the subjects.Methods. It was parallel and randomized clinical trial for 4 weeks in male with 19-55 years of age, total cholesterol level 200-300 mg/dl, and BMI of 20−30 kg/m2. All subjects were recruited consecutively and classified into two groups that received 45 ml/day or 15 ml/day rice bran oil for 4 weeks. The demographic data interviews, physical activity and anthropometric examination were taken before intervention. Food intake were assessed before and after intervention. Laboratory test of lipid profile performed before and after 4 weeks of treatment. Results. A total of 20 subjects consisting of 10 subjects with 45 ml/day rice bran oil and 10 subjects with 15 ml/day had obtained similar characteristics in age, education level, nutritional status, physical activity, smoking, family history of hypercholesterolemia, BMI and lipid profiles. Food intake includes intake of energy, carbohydrate, protein, fat and fiber before treatment did not significantly difference between two groups. Fat intake after treatment was significantly different between the two groups due to differences in the amount of oil.After 4 weeks treatment, there was a decrease in total cholesterol significantly different between the two groups (p = 0,049). In the group that received 45 ml/ day of rice bran oil total cholesterol level decreased 14% and in the group of 15 ml/day total cholesterol level decreased 7,8%. The reduction of LDL and triglycerides and the increasing of HDL was not significantly different between the two groups (p >0,05). In this study, no changes in body weight were significant in both groups.Conclusion. Rice bran oil consumption 45 ml/day led to improvements in lipid profiles better than consumption 15 ml/day]"

"ABSTRAK Latar belakang: Luka bakar merupakan suatu trauma yang dapat memicu respons inflamasi lokal dan sistemik sehingga menimbulkan komplikasi berbagai organ, diantaranya disfungsi pernapasan. Hipermetabolisme, hiperkatabolisme, dan adanya disfungsi pernapasan yang terjadi, memerlukan tatalaksana nutrisi adekuat untuk menurunkan respons inflamasi, mencegah peningkatan produksi CO2, mencegah wasting otot dan meningkatkan imunitas Metode: Empat pasien dalam serial kasus ini mengalami luka bakar berat karena api, dirawat di ruang perawatan intensive care unit ICU unit luka bakar rumah sakit Cipto mangunkusumo RSCM dan menggunakan alat bantu ventilasi mekanik. Target energi menggunakan metode Xie dan Harris-Benedict dengan berat badan sebelum sakit. Pemberian nutrisi diberikan sesuai dengan rekomendasi untuk sakit kritis fase akut 20 ndash;25 kkal/kg BB dengan komposisi karbohidrat 55-65 , Protein 1,5-2 g/kgBB, lemak

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ABSTRACT Background Burn injury is a trauma that can trigger local and systemic inflammatory response, resulting complications of various organs, including respiratory dysfunction. Hipermetabolism, hypercatabolism, and the presence of respiratory dysfunction that occurs, require adequate nutritional management to decrease inflammatory responses, prevent increased CO2 production, prevent muscle wasting and enhance immunity. Method Four patients in this series of cases suffered severe burns from fire, were treated in the intensive care unit ICU hospital burning unit Cipto mangunkusumo hospital RSCM and used mechanical ventilation aids. Energy targets use Xie and Harris Benedict methods with weight loss before illness. Nutrition was given in accordance with recommendations for acute phase critical pain 20 25 kcal kg BW with carbohydrate composition 55 65 , 1.5 2 g kgBB protein, fat "