1,721,082 research outputs found
The Role of Fecal Occult Blood Test in Screening of Colorectal Cancer and Inflammatory Bowel Disease
No full textColorectal cancer (CRC) and inflammatory bowel disease (IBD) are a quite common colon disease in the world. The World Gastroenterology Organization (WGO) recommends screening test to detect colorectal cancer, i.e. fecal occult blood test (FOBT) and colonoscopy. Diagnosis of CRC is established based on a good history taking, clinical manifestation, physical examination and laboratory examination. Other supporting laboratory tests include routine laboratory test of hemoglobin for detecting anemia, examination of bleeding stool either macroscopically or microscopically. Radiographic examination, either colon in loop or colonoscopy (if such modalities are available), shall be performed to confirm the occurrence of cancer mass in the colon. Moreover, biopsy examination is carried out to obtain the histopathological feature of tumor mass or the type of cancers. WGO has made a guideline for CRC screening, which consists of 6 cascades, which depend on the risk of colorectal cancer and local facilities available. There are several kinds of FOBT, but the most frequently used include three methods, i.e.: the FOBT guaiac base/traditional, the fecal immunochemical test (FIT) and the FOB + transferrin rapid test (OT 102c & OT 103c). FIT and FOB + transferrin rapid test have a quite high sensitivity and specificity in detecting the lower gastrointestinal tract bleeding caused by colorectal cancer and IBD. Keywords: FOBT, colorectal cancer, IB
The role of probiotics to improve gut health in the elderly
Full text linkRecent studies have reported that there is a group of microbiota, which have been shown to bring beneficial effects on human's health. They are called probiotics. Probiotics have been defined as live, non pathogenic microorganisms that, when administered in adequate amounts, confer a health benefi t on the host. The administration of probiotics can change the composition of the gut microbiota. Several probiotics preparations seem to have a role in the prevention of certain diseases as well as treatment of various conditions. Probiotics have been shown to be helpful in relieving constipation, promoting recovery from diarrhea, reducing the risks of colorectal cancer, normalizing nutritional status, and improving the symptoms of irritable bowel syndrome, inflammatory bowel disease, and lactose intolerance. However, the benefits associated with probiotics are strain specific. Therefore, the use of probiotics to confer health benefits should indicate the dosage regimens of each probiotics strain, based on adequate clinical trials. Although probiotics are generally regarded as safe, careful monitoring should be performed on the use of probiotics in the elderly patients. (Med J Indones 2011; 20:226-31
Pancreatic Cancer: Review of Etiology, Clinical Features, Diagnostic Procedures, Treatment and Mesothelin Role
No full textPancreatic cancer is one with high mortality cancer in the world. Ninety percent of pancreatic cancer is pancreatic adenocarcinoma. Various factors is associated with an increased risk of pancreatic cancer including age, sex, race, genetic, history of chronic pancreatitis, diabetes mellitus, gallstone, obesity, Helicobacter pylori infection, smoking, diet, and polution exposure. A lot of cases were diagnosed in late stadium due to non-specific early clinical symptoms, and also, until now, there is no examination tool that may screen pancreatic cancer in the earliest stage. Total surgery resection is the therapy of choice in the early stadium of pancreatic cancer, and other therapy modalities are chemotherapy, radiotherapy. Combination of these modalities is frequently used in order to increase the effectiveness of therapy. Mesothelin, a surface glycoprotein on normal mesothelial cells, is overexpressed in pancreatic cancer; therefore, although it is not a cancer specific antigen, it can be used in diagnostic and treatment of pancreatic cancer. Several studies about mesothelin application in pancreatic cancer have been performed; however, more studies are needed to improve the application of mesothelin on pancreatic cancer. Keywords: pancreatic cancer, risk factor, therapy, mesotheli
Child Pugh C and Male Gender were Related to Nutritional Status of Liver Cirrhosis Patients in Koja Hospital Jakarta
No full textBackground: Malnutrition is found in 65-90% patients with liver cirrhosis. Malnourished patients with cirrhosis have a higher rate of complications. Aim of this study was to evaluate the prevalence and risk of malnutrition in liver cirrhosis patients at Koja hospital, Jakarta. Method: All liver cirrhosis patients visited Koja hospital during January - March 2009 was evaluated. An inclusion criterion was liver cirrhosis. An exclusion criterion was unable to speak Indonesia. The distributions of age, gender, body mass index (BMI), triceps skin-fold thickness (TSF), mid-upper arm circumference (MUAC), mid-arm muscle circumference (MAMC), Child Pugh classification were assessed. The criteria of malnutrition was done according to MAMC and BMI. Result: There were 38 liver cirrhosis patients fit the criteria. Twenty five (65.8%) cases were classified as malnutrition according to MAMC, 21 (55.3%) were classified as malnutrition according to BMI. Four patients (10.5%) were Child Pugh scores A, 15 Child Pugh B (39.5%) and the rest 19 patients (50.0%) were Child Pugh C. There was a trend correlation between malnutrition according to MAMC and Child Pugh criteria but not statistically significant. Conclusion: In our study we found 65.8% of liver cirrhosis patients were malnourished according to MAMC. Malnutrition was higher in male, as well as in Child Pugh score C. MAMC is more accurate than BMI in assessing nutritional status in liver cirrhosis. Keywords: liver cirrhosis, nutritional status, MAMC, BMI, Child Pugh scor
Potential interaction between proton pump inhibitor and clopidogrel
Full text linkClopidogrel is an anti-platelet agent commonly used in patients with atherosclerotic cardiovascular (CV) disease. Although formerly considered safe, several studies reported that the use of clopidogrel may cause a significant increase in the rate of gastrointestinal (GI) bleeding. This adverse effect could be minimized by coadministration of proton pump inhibitor (PPI). However, since PPI and clopidogrel share the same metabolic pathway, it has been hypothesized that the administration of PPI following clopidogrel therapy may cause a reduction in its anti-platelet effect, thereby increasing the risk of CV events. Recent studies found no significant inhibition in the activation of clopidogrel by CYP2C19 with administration of PPI in vitro. Pharmacokinetic and pharmacodynamic studies, as well as clinical studies, reported conflicting results regarding the potential interaction between PPI and clopidogrel. Until now, the available study investigated the PPI-clopidogrel interaction are primarily observational. The COGENT study is the only prospective, placebo-controlled trial examined the PPI-clopidogrel interaction. This study revealed no significant increase in CV events in patients receiving PPI following clopidogrel therapy, compared to the control group. Though remains controversial, current expert consensus recommended the administration of PPI in patients receiving clopidogrel, particularly in high-risk patients. (Med J Indones. 2013;22:57-62)
Keywords: Cardiovascular, clopidogrel, gastrointestinal, proton pump inhibito
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