Gastroesophageal reflux disease (GERD) is a condition commonly managed in the primary care setting. Patients with GERD may develop reflux esophagitis as the esophagus repeatedly is exposed to acidic gastric contents. Over time, untreated reflux esophagitis may lead to chronic complications such as esophageal stricture or the development of Barrett’s esophagus (BE). BE may progress to oesophageal adenocarcinoma. There is currently a rising incidence of BE. The pathogenesis of BE is not well-understood although genetic and environmental factors play significant roles. BE is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. As patients with BE can be entirely asymptomatic, it is difficult to screen this population group. BE is present in 10%–20% of patients with GERD and has also been detected in patients who deny classic GERD symptoms and are undergoing endoscopy for other indications.
Pendahuluan. Ekstrak teh hijau (senyawa polifenol/katekin) terbukti secara in vitro memiliki kemampuan sebagai antioksidan. Aktivitas fisik submaksimal merupakan salah satu penyebab peningkatan radikal bebas. Peningkatan radikal bebas dapat dideteksi dengan peningkatan MDA yaitu produk akhir dari peroksidasi lemak. Penelitian ini dilakukan untuk mengetahui efek suplementasi antioksidan ekstrak teh hijau terhadap radikal bebas yang ditimbulkan oleh aktivitas fisik submaksimal dengan mengukur kadar MDA plasma. Metode. Uji double blind control trial dilakukan pada 20 orang mahasiswa Fakultas Ilmu Olahraga Universitas Negeri Malang dengan aktivitas fisik submaksimal yaitu lari 1.500 m dalam 12 menit menggunakan mesin treadmill. Subjek terbagi atas dua kelompok: kelompok ekstrak teh hijau (250 mg) dan kontrol (plasebo). Suplemen diberikan satu kapsul per hari selama 14 hari sebelum aktivitas fisik submaksimal. Kadar MDA plasma diambil sebelum aktivitas submaksimal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal. Analisis hasil penelitian menggunakan uji ANOVA dan post hoc dengan Tukey. Penelitian telah dinilai layak secara etik oleh tim Komisi Etik Penelitian Kesehatan Fakultas Kedokteran Universitas Brawijaya. Hasil. Pada kelompok kontrol, rerata kadar MDA plasma kondisi basal, 2 jam dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 52,43 nmol/ml (simpang baku [SB] 12,52 nmol/ml), 55,57 nmol/ml (SB 13,84 nmol/ml), dan 63,86 nmol/ml (SB 12,17 nmol/ml). Namun demikian, peningkatan tersebut tidak bermakna secara statistik (p=0,158). Pada kelompok perlakuan, terdapat penurunan kadar MDA plasma yang bermakna saat 48 jam setelah aktivitas fisik submaksimal dari kondisi basal dengan rerata kadar MDA pada basal dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 36,14 nmol/ml (SB 5,88 nmol/ml) dan 19,86 nmol/ml (SB 8,92 nmol/ml) (p<0,001). Hasil analisis menunjukkan adanya perbedaan bermakna kadar MDA plasma antara kedua kelompok saat basal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal dengan nilai p secara berturut-turut yaitu 0,012; <0,001, dan <0,001. Simpulan. Ekstrak teh hijau dapat menurunkan kadar MDA plasma basal, 2 jam, dan 48 jam setelah aktivitas fisik submaksimal.
Background: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC.
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