Publikasi Staf di Tahun 2019

Background

Global increase of metabolic syndrome (MetS) may have affected Indonesia, however, lack of data in this multiethnic group country warrants a nationwide study for MetS and its components. This study aims to determine the prevalence of metabolic syndrome and its components among Indonesian people based on the province and ethnic groups.

Methods

We obtained 8573 subjects from the Indonesian Family Life Survey Wave 4 (IFLS4), spread over 20 provinces in Indonesia and consisting of 27 ethnic groups. MetS was operationalized according to an adapted Harmonized MetS definition. Prevalence ratios with 95% confidence interval were estimated using log-binomial regression.

Results

The prevalence of MetS in Indonesia is 21.66% with provincial prevalence ranging from 0 to 50%, while the ethnic prevalence ranging from 0 to 45.45%. Significant higher MetS prevalence ratios were found in Jakarta (PR 1.826; 95CI 1.628–2.048), West Nusa Tenggara (PR 1.412; 95CI: 1.222–1.630), West Sumatra (PR 1.404; 95CI: 1.202–1.641), East Java province (PR 1.109; 95CI: 1.001–1.229) and in Sasak (PR 1.532; 95CI:1.304–1.800), Minangkabau (PR 1.469; 95CI:1.251–1.726), Betawi (PR 1.597; 95CI:1.346–1.895), Acehnese ethnic group (PR 2.101; 95CI:1.099–4.020) while significant lower prevalence ratios were observed in Central Java (PR 0.668; 95CI: 0.580–0.770), Yogyakarta (PR 0.695; 95CI: 0.575–0.840), Banten (PR 0.718; 95CI: 0.533–0.968), Bali province (PR 0.724; 95CI: 0.590–0.889) and in Javanese (PR 0.855; 95CI:0.788–0.928), also Balinese ethnic groups (PR 0.669; 95CI:0.535–0.836). The highest prevalence of MetS components among Indonesians was low HDL cholesterol (66.41%), followed by hypertension (64.45%), and central obesity (43.21%).

Conclusions

The prevalence of MetS in Indonesia is moderate with provincial and ethnic prevalence varied. Provincial and ethnic group differences in MetS prevalence ratios were observed. The top two most prevalent MetS components in Indonesian were low HDL cholesterol and hypertension.

Background

The thrombocyte concentrate (TC) preparation process through its storage affects the platelets contained inside. The contaminating leukocytes in TC is an important factor implicated in storage lesion on TC during storage. Leukodepletion is a method to reduce contaminant leukocytes. Myeloperoxidase (MPO) is an enzyme produced by polymorphonuclear cells that have the potential to change structure and function of platelets when there is interaction between them during storage. The aim of this study is assessing the difference in myeloperoxidase level of TC based on its preparation method (leukodepleted and non-leukodepleted) and time storage.

Methods

A cross-sectional observational study was conducted at the Blood Transfusion Services Unit, Dr. Sardjito hospital, Yogyakarta from April to December 2014. Thrombocyte Concentrate products was grouped based on storage time (≤ and >72 hours) and preparation method (leukodepleted and non-leukodepleted), their MPO was then measured.

Results

Mean difference in each group was analyzed using ANOVA test and post hoc test with statistical significance level of p < 0.05. There were 64 eligible subjects, consisted of 29 leukodepleted TCs and 35 non-leukodepleted TCs, based on their storage time, 31 TCs had ≤72 hours storage time and the other 33 TCs > 72 hours. There were significantly lower median MPO level in ≤72 hours TCs than > 72 hours in non-leukodepleted TC group (13.23 ± 6.47 ng/mL vs 15.58 ± 7.82 ng/mL; p = 0.017). In TC group with more than 72 hours storage time, median MPO level in non-leukodepleted was significantly higher than leukodepleted TC (15.58 ± 7.82 ng/mL vs. 11.11 ± 3.97 ng/mL; p = 0,001).

Conclusions

Myeloperoxidase level was lower in non-leukodepleted TC group with ≤ 72 hours than > 72 hours storage time. Furthermore, the MPO level was higher in leukodepleted TC than non-leukodepleted TC in > 72 hours storage time.

Background

Several studies reported that infection of extended-spectrum β lactamase (ESBL)-producing Escherichia coli (E. coli) or Klebsiella pneumoniae (K. pneumoniae) contributed to higher mortality rates but others found it was not associated with mortality.

Methods

A prospective cohort study which involved 72 patients was conducted to assess the risk of mortality of bloodstream infection due to ESBL-producing K. pneumoniae or E. coli as compared to those infected by either K. pneumoniae or E. coli which not produce ESBL.

Results

Mortality in the group of patients infected with ESBL-producing bacteria was 30.6%, whereas in another group which was infected with non ESBL-producing bacteria was 22.2% (p = 0.59). Kaplan–Meier’s analysis showed that the survival rate during 14-days follow-up among these two group was not significantly different (p = 0.45) with hazard ratio 1.41 (95% CI  0.568–3.51). Stratification analysis found that adult and elderly patients, patients with sign of leukocytosis, and patients treated with carbapenem were modifier effect variables.

Conclusions

Overall risk of mortality among exposed group was not statistically different with those un-exposed group. However, in stratification analysis showed that the exposed group had higher mortality risk as compared to un-exposed group especially in adult and elderly patients, patients with sign of leukocytosis, and patients treated with carbapenem.

Background

Methods

We further modified the intact DV by altering two amino acids at specific proteolytic cleavage sites to generate three stable DV mutants: DV(PP), (PE), and (AA). Results of both SDS-PAGE and MALDI-TOF-MS showed that all three DV mutants were more stable than the intact DV, and DV(PE) was predominantly resistant to proteolysis. Competitive ELISA assessed affinities of intact β2GPI and those mutants to cardiolipin.

Results

In culture system, all DV and DI mutants potently inhibited HUVEC’s proliferation by 18-30% as compared to control. Only DI and nicked β2GPI showed significant inhibition in HUVEC’s tube formation. Moreover, DV(PE)-coated affinity columns demonstrated its binding property towards anionic lipids and could substantially isolate anionic DOPS from zwitterionic DOPC as a purification model.

Conclusions

In summary, the proteolytic resistant and unhindered phospholipid (PL) binding properties of DV(PE) have made it an appealing element for subsequent prospective studies. Future in-depth characterization and optimized applications of cleavage-resistant DV(PE) would complement its full capacity as a novel clinical modality in the field of vascular imaging and/or lipidomics studies.

Background

Methods

This cross-sectional study is an observational analytic study evaluating the association between hs-CRP, HbA1c, and body mass index. The research subjects were all healthy on a community gathering in community service programs, and if there were any signs or symptoms of infection or inflammation, they would be excluded. Measurements of hs-CRP and HbA1c were carried out using the HPLC and ELISA methods, respectively. The measurement results were analyzed to evaluate the characteristics of the subject and assess the relationship between the parameters studied with different mean and correlation tests.

Results

In 25 subjects involved, it was found that 96% had an HbA1c value of <6.5% with a normal body mass index of 15 subjects (60%), and the rest were in the category of overweight. The median hs-CRP level was 2.99 mg / L (0.81-13.74 mg / L), with a low heart risk category of only 4% of all study subjects. There was no correlation between hs-CRP with HbA1c (r = 0.35; p = 0.868) and body mass index (r = 0.37; p = 0.069). Only one subject was included in the diabetes diagnostic criteria, but 96% of the study population had hs-CRP, which was included in the medium-risk and high-risk category for heart disease.

Conclusions

Background

Methods

Surveillance of microbial pattern and their antibiotics susceptibility in Indonesia 2017 were developed by Indonesian Association of Clinical Pathology and Laboratory Medicine. Data aggregation was sourced from 31 hospitals antibiogram report which were joined the system of national data collection in forlabinfeksi.or.id. with standardized inclusion criteria. Data was analyzed descriptively, based on hospital type-A-B-C.

Results

There were 15.302 isolates included, 4.761 (31,1%) were positive Gram and 10.541 (68,9%) were negative Gram, 61,6% reported by type-A hospital, 16,4% by type-B and 22% by type-C. Positive and negative Gram patterns respectively were E. faecalis and E.coli  (blood and urine), Streptococcus spp and K. pneumoniae (sputum), S. aureus and E.coli (pus), E. faecalis and E.coli  (wound), coagulase negative Staphylococcus and Enterobacteriaceae (CSF). Antibiotic susceptibility pattern was slightly different among various types of hospital and among various clinical specimens. Positive Gram bacteria had good vancomycin susceptibility in all hospital types, except in sputum from Type-A and B hospital, also in blood and urine from Type-C hospital, similarly with linezolide susceptibility. Susceptibility pattern among Gram negative- bacteria for carbapenem and amikacin was good, in all hospital types, except on A. baumannii.  For A. baumannii, antibiotic carbapenem, amikacin and ceftazidime susceptibility were 20-66%, 35-80%, and up to 83%, respectively. For P. aeruginosa, antibiotic susceptibility pattern was equal among all hospital types. Their susceptibility against cephalosporin (ceftazidime), fluoroquinolone (ciprofloxacin) and aminoglycoside (amikacin) were better in higher type-hospital.

Conclusions

Background

Methods

This is an observational prospective cohort study involving 39 patients who were admitted to the Intensive care unit (ICU) of Dr. Sardjito General Hospital Yogyakarta during June-August 2018. The inclusion criteria were ICU patients with age>19 years old, and exclusion criteria were chronic renal failure and kidney transplantation. The AKI established based on an increase in serum creatinine levels ≥0,3 mg/dl in 48 hours or urine volume <0.5 ml /kg/hour in 6 hours. Mann Whitney test, Spearman correlation, and Chi-Square were used for statistical analysis. Data were analyzed using SPSS version 17 for windows.

Results

The results showed that there were no significant differences between the urine NGAL levels of AKI and non-AKI patients (130 (85-177) ng/dL; 56.65 (2.8-1500) ng/dL, p=0.407). In this study, only 3 cases of AKI were obtained from 39 subjects. Further analysis was carried out by looking at the correlation between urine NGAL levels and urine leukocyte count. The results showed a moderate correlation between them (r=0.6, p=0.001). The proportion of patients with elevated urine NGAL levels was greater in the group of patients with elevated urine leukocyte counts compared to the group with normal urine leukocyte counts (86,7%; 13,3%, p=0,008).

Conclusions