The Indonesian Biomedical Journal (Prodia Education and Research Institute)
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Personalized Medicine: The Future of Health Care
Get PDFBACKGROUND: Most medical treatments have been designed for the “average patients”. As a result of this “one-size-fits-all-approach”, treatments can be very successful for some patients but not for others. The issue is shifting by the new innovation approach in diseases treatment and prevention, precision medicine, which takes into account individual differences in people’s genes, environments, and lifestyles. This review was aimed to describe a new approach of healthcare performance strategy based on individual genetic variants.CONTENT: Researchers have discovered hundreds of genes that harbor variations contributing to human illness, identified genetic variability in patients’ responses to different of treatments, and from there begun to target the genes as molecular causes of diseases. In addition, scientists are developing and using diagnostic tests based on genetics or other molecular mechanisms to better predict patients’ responses to targeted therapy.SUMMARY: Personalized medicine seeks to use advances in knowledge about genetic factors and biological mechanisms of disease coupled with unique considerations of an individual’s patient care needs to make health care more safe and effective. As a result of these contributions to improvement in the quality of care, personalized medicine represents a key strategy of healthcare reform.KEYWORDS: precision medicine, genomic, proteomic, metabolomi
Inhibition of Xanthine Oxidase Activity by Ethanolic Extract of Piperomia pellucida L., Acacypha indica L. and Momordica charantia L.
No full textBACKGROUND: Uric acid is a final result of purine catabolism, the enzymatic reactions in the body cells from amino acids or ribonucleotide dinucleotide. Peperomia pellucida L. (P. pellucida), Acalypha indica L. (A. indica) and Momordica charantia L. (M. charantia) are plants which have efficacy to reduce levels of uric acid excess. The aim of this research is to find out the effect of ethanol extract of P. pellucida, A. indica and M. charantia in preventing the formation of uric acid excess by inhibiting the action of the enzyme xanthine oxidase and comparing the inhibition activity of xanthine oxidase on treatments.METHODS: The study design is experimental and conducted using the enzyme xanthine oxidase, xanthine (substrate), pH 7.5 phosphate buffer, samples (P. pellucida, A. indica and M. charantia ethanol extracts) and HCL as reaction breaker. Inhibition of xanthine oxidase was determined enzymatically and unreacted xanthine was measured by UV spectrophotometer at 290 nm. The data were expressed as percent inhibition and the inhibitory concentration (IC)50 were determined using linear regresion of inhibition activity vs. concentration.RESULTS: The IC50 of P. pellucida, A. indica and M. charantia ethanol extracts in inhibiting xanthine oxidase were 19.5 ppm, 77.6 ppm and 17.8 ppm, respectively. IC50 of allopurinol was 1.99 μg/ml, and negative control (combination of enzyme and substrate) has absorbance value of 0.75026.CONCLUSION: Ethanol extract of M. charantia showed the most potent inhibition toward xanthine oxidase compared to the other two extracts.KEYWORDS: xanthine oxidase, Peperomia pellucida L., Acalypha indica L., Momordica charantia L
Modified Glasgow-Blatchford Bleeding Score as an Alternative Predictors of Severity for Non-Variceal Upper Gastrointestinal Bleeding
Get PDFBACKGROUND: Upper gastrointestinal bleeding (UGIB) is a frequent cause of emergency hospital admissions. Despite the dependency of most risk scoring systems for this disorder, the Glasgow-Blatchford bleeding score (GBS) is based on simple variables. This research intended for investigate the accuracy of a modified GBS (mGBS) to predict the severity of non-variceal UGIB.METHODS: Study conducted in Emergency Department of Dr. Saiful Anwar Hospital, Malang, from November 2012 to April 2013. Endoscopy performed between 12-24 hours after the patient stabilized. Sixty patients diagnosed were included. The accuracy of the mGBS in predicting the severity of non-variceal UGIB was compared with the full GBS using receiver operating characteristic (ROC) curve. The severity based on high risk in mGBS score compared by Forrest classification.RESULTS: For prediction of the severity of non-variceal UGIB, the GBS (AUC 0.947, 95% CI 0.87-1.03) had a slightly than the mGBS (AUC 0.943, 95% CI 0.86-1.02, p<0.01). Compared to the GBS, the mGBS was more specific (63% and 97%, respectively) but less sensitive (96% and 84%, respectively).CONCLUSION: The mGBS is an alternative diagnostic tool in predicting the severity of non-variceal UGIB.KEYWORDS: non variceal-UGIB, GBS, modified GB
Intra Arterial Heparin Flushing Increases Cereberal Blood Flow in Chronic Ischemic Stroke Patients
Get PDFBACKGROUND: Recently, stroke therapy is focused on reperfusion therapies for restoring cerebral blood flow (CBF) and minimizing the undesired effects of neuron ischemia. However, the thrombolytic therapy to restore CBF was restricted with narrow time window. On other hands, not many patients can reach the treatment immediately after the onset of stroke. A wider time window therapy that might increase CBF would probably helpful. This study aims to investigate the CBF improvement after intra arterial heparin flushing (IAHF) therapy in chronic stroke patients.METHODS: A clinical trial was conducted with time sampling. We collected chronic ischemic stroke subjects (with stroke onset ≥30 days) within periods February-September 2015. We investigated CBF before and after IAHF treatment in 75 chronic stroke patients. The difference before and after IAHF treatment in subgroup which is classified with infarct size and lesion area was tested. CBF was measured using MRI Quality Arterial Spin Labeling (qASL) with region of interest around infarct lesion.RESULTS: We found a significant CBF improvement (p<0.001) around infarct area after IAHF treatment with average 10.39mL/100g/min raised. CBF improvement was found in lacunar infarct (p<0.001) and non lacunar (p<0.001), also in infarct in cortical (p<0.05), subcortical (p<0.001) and both area (p<0.05).CONCLUSION: IAHF is associated with increased CBF around infarct area and IAHF probably offers some benefit for chronic stroke.KEYWORDS: IAHF, CBF, chronic stroke, ischemic, lacunar, non lacunar, cortical lesion, subcortical lesio
Isolation of Mesenchymal Stem Cells from Adipose Tissue
Get PDFBACKGROUND: In searching for the best source of stem cells, researcher found adipose stem cells as one of the ideal source due to its easiness in harvesting and its potential for differentiating into other cell lineage.METHODS: We isolated stem cells from adipose tissue, cultured and confirmed its immunophenotype using polymerase chain reaction.RESULTS: Cluster of differentiation (CD)44, CD73, CD90, CD105 were expressed, which represent immunophenotype of mesenchymal stem cells. CONCLUSION: Mesenchymal stem cells can be isolated from adipose tissue. KEYWORDS: adipose, mesenchymal stem cells, isolation, immunophenotyp
Differences in Maternal Leptin Serum Levels between Normal Pregnancy and Preeclampsia
Get PDFBACKGROUND: Maternal circulating leptin, placental leptin gene expression and protein levels are increased in preeclampsia as compared with those in normal pregnancy. Increased serum leptin levels in preeclampsia which correspond with increased gestational age can be used independently or with other parameters as a marker for the severity of preeclampsia. The advantages of this examination in identifying preeclampsia severity are its simplicity, fast result, low cost and applicability.METHODS: A cross-sectional study was conducted in delivery room, polyclinic of Dr. M. Djamil Hospital, and Biomedical Laboratories of Medical Faculty of Andalas University from December 2013 to April 2014. The samples were collected from 68 women with singleton pregnancy in their third trimester (>28 weeks) presenting to the polyclinic and the delivery room of Dr. M. Djamil hospital. Differences in maternal serum leptin between preeclampsia and normal pregnancy were determined using t-test and Wilcoxon test for data with and without normal distribution, respectively, where p<0.05 indicating a significant results.RESULTS: The mean maternal serum leptin levels in normal pregnancy and preeclampsia were 1588.7964 ± 8.01074 ng/mL and 1608.1725 ± 6.69579 ng/mL, respectively. Thus, there is a statistically significant difference in mean maternal serum leptin levels between the normal pregnancy and preeclampsia (p<0.05).CONCLUSION: There are significant differences in maternal serum leptin levels between women with normal pregnancy and preeclampsia.KEYWORDS: leptin, preeclampsia, pregnanc
Combination of Fibrinogen and High-sensitivity C-reactive Protein Measurements is Potential in Identification of Acute Coronary Syndrome
Get PDFBACKGROUND: Acute myocardial infarction (AMI) is one of cardiovascular diseases with high morbidity and mortality rates. Novel biomarkers that can detect accurately acute coronary syndrome (ACS) at early stage, are necessary to improve current strategies and/or to identify subjects who are at risk. Fibrinogen and high-sensitivity C-reactive protein (hs-CRP) roles in inflammation process could be potential for ACS early detection. This study was conducted to evaluate measurements of fibrinogen and hs-CRP on ACS.METHODS: An analytic observational study with cross sectional approach was conducted on patients with Troponin I positive. After signing informed consent, anamnesis and complete blood count were conducted. Besides that, liver function, renal function, and blood glucose tests were conducted as well. Samples of selected subjects were quantified with enzyme-linked immunosorbent assay (ELISA) for Troponin I, fibrinogen and hs-CRP. Then statistical analyses were performed.RESULTS: There were 76 subjects in each ACS and non-ACS groups. ACS group showed significant higher levels of both fibrinogen and hs-CRP compared to Non-ACS group (p=0.000). Among evaluated risk factors, diabetes mellitus (DM) (p=0.003) and hypertension (p=0.000) were significantly higher in ACS group than in non-ACS group. Among evaluated clinical factors, blood glucose (p=0.001) and age (p=0.000) were significantly higher in ACS group than in non-ACS group. Combination of fibrinogen and hs-CRP measurements showed the highest sensitivity (75.00%), specificity (80.26%), accuracy (77.63%), positive predictive value (79.19%) and negative predictive value (76.25%).CONCLUSION: Since fibrinogen and hs-CRP were increased in ACS group and combination of fibrinogen and hs-CRP measurements showed the highest sensitivity, specificity, accuracy, positive predictive value and negative predictive value, we suggest that combination of fibrinogen and hs-CRP measurements could give added value to identify ACS.KEYWORDS: fibrinogen, hs-CRP, biomarker, ACS, acute coronary syndrome, atherosclerosis, inflammatio
Resveratrol: A Sirtuin Activator and The Fountain of Youth
Get PDFBACKGROUND: An organism’s lifespan is inevitably accompanied by the aging process, which involves functional decline, a steady increase of a plethora of chronic diseases, and ultimately death. Thus, it has been an ongoing dream of mankind to improve healthspan and extend life.CONTENT: There are only a few proposed aging interventions: caloric restriction, exercise, and the use of low-molecular-weight compounds, including spermidine, metformin, resveratrol, and rapamycin. Resveratrol, a constituent of red wine, has long been suspected to have cardioprotective effects. Interest in this compound has been renewed in recent years, first from its identification as a chemopreventive agent for skin cancer, and subsequently from reports that it activates sirtuin deacetylases and extends the lifespans of lower organisms. Resveratrol have been shown to prevent and reduce the severity of age-related diseases such as atherosclerosis, stroke, myocardial infarct, diabetes, neurodegenerative diseases, osteoarthritis, tumors and metabolic syndrome, along with their ability to extend lifespan.SUMMARY: The purpose of aging research is the identification of interventions that may avoid or ameliorate the ravages of time. In other words, the quest is for healthy aging, where improved longevity is coupled to a corresponding healthspan extension. It is only by extending the healthy human lifespan that we will truly meet the premise of the Roman poet Cicero: “No one is so old as to think that he may not live a year.”KEYWORDS: aging, caloric restriction, mimetic, healthspan, sirtuin activato
Chronodisruption and Obesity
Get PDFBACKGROUND: Attempts to understand the causes of obesity and develop new therapeutic strategies have mostly focused on caloric intake and energy expenditure. Recent studies have shown that the circadian clock controls energy homeostasis by regulating circadian expression and/or activity of enzymes, hormones, and transport systems involved in metabolism. Moreover, disruption of circadian rhythms leads to obesity and metabolic disorders.CONTENT:Regularly alternating periods of light and darkness, such as normally occur with the rising and the setting of the sun, are essential for the maintenance of undisturbed circadian rhythms in all organisms including humans. The light-dark environment, as detected by specialized photoreceptors in the retinas, impacts the endogenous circadian clock in the anterior hypothalamus, the suprachiasmatic nuclei. These nuclei, via both neural and humoral signals, communicate with cells throughout the organism to establish regular circadian rhythms. The introduction of artificial sources of light roughly 150 years ago has significantly undermined the naturally occurring light-dark environment and, likewise, has disturbed circadian rhythms since light is now available at unusual times, i.e., at night. Light at night is known to cause circadian disruption and melatonin suppression. Many potentially pathophysiological consequences of these artificial light-mediated changes, include cancer, cardiovascular diseases, insomnia, metabolic syndrome, diabetes, and cognitive disorders may be aggravated by the increased exposure to light at night, which is inevitable in well-developed societies that have undergone extensive electrification.SUMMARY: Therefore, it is plausible that resetting of the circadian clock can be used as a new approach to attenuate obesity. Feeding regimens, such as restricted feeding, calorie restriction and intermittent fasting, provide a time cue and reset the circadian clock and lead to better health. In contrast, high-fat diet leads to disrupted circadian expression of metabolic factors and obesity.KEYWORDS: obesity, circadian clock, metabolism, chronodisruptio
Cardiovascular Disease Risk and Barriers to Physical Activity
Get PDFBACKGROUND: The prevalence of obesity is increasing and tends to be higher in adult population groups who are also more educated and employed as a civil/military/police/oficers. This study aims to analyze cardiovascular disease (CVD) risk, perceptions about physical activity and barriers experienced to perform physical activity, also stage of change to physical activity.METHODS: The study design was an observational study, use qualitative methods with in-depth interviews and quantitative analysis CVD risk also stage of change to physical activity questionnaire.RESULTS: Framingham 10-years CVD risk of obese men in University of Surabaya was 11.97% (1.70 to 29.90) based on lipid profile and 13.90% (2.30 to 30.00) based on body mass index. Perception of obese men in University of Surabaya regarding physical activity had findings several barriers that can be grouped into time constraint, facility constraint, low motivation, and knowledge about physical activities.CONCLUSION: In this study we found that 10-years CVD risk of obese men in University of Surabaya can be categorized as medium risk. There are several barriers regarding life style modification for physical activity and exercise, whereas the subjects included in this study are quite ready to start the program, but improvement for the readiness before starting the program will still be needed.KEYWORDS: CVD risk, obese men, physical activit