Infection in ICU patients can lead to a septic condition with clinical signs similar to Systemic Inflammatory Response Syndrome (SIRS). The high risk of death and high cost of sepsis is the reason to find an early marker in diagnosing sepsis. Blood culture can givea result in 1-3 days, so C reactive protein, procalcitonin and presepsin which are fast and accurate are needed to find a septic condition in SIRS patients. The aim of this study is to determine the diagnostic value of CRP, PCT and presepsin of sepsis with blood culture as the gold standard., The samples were collected from 32 clinically SIRS patients in the Dr. Kariadi Hosiptal, Semarang. The PCT level was measured using ELFA method, CRP level by PET IA method, while presepsin level by CLEA method. The determined area was under curve (AUC) and the cut off level was determined by 2×2 table to find out the sensitivity, spesificity, positive predictive value, negative predictive value and likelihood ratio of CRP, PCT and presepsin as well. The AUC of PCT, CRP and presepsin was 0.78 (cut off 4.314 ng/mL); 0.673 (cut off 10.245 mg/L) and 0.814 (cut off 1134.5 pg/mL). The presepsin level had a higher sensitivity (90%) than PCT (80%) and CRP (70%). PCT specificity was 72.73%, presepsin and CRP specificity each was 68.18%. Based on this study, AUC and sensitivity of presepsin level were found higher than the PCT and CRP level.
Hemoglobin glikasi (HbA1c) telah diakui secara luas sebagai petanda biologis peramal untuk keparahan Diabetes Melitus (DM).Hemoglobin glikosilasi (HbA1c) adalah petanda biologis penting yang mencerminkan kepekatan glukosa plasma puasa dan postprandialselama 120 hari sebelumnya. Telah dianggap sebagai alat penting dalam diagnosis dan manajemen diabetes. Peningkatan kadar HbA1cberarti resistensi insulin jangka panjang dan konsekuensi berat adanya hiperglikemia, dislipidemia, hiperkoagulabilitas dan responsinflamasi. Terdapat hubungan positif antara HbA1c tinggi dan hasil yang buruk pada DM, penyakit kardiovaskular (CVD) dan inflamasi.HbA1c adalah petanda biologis peramal tidak hanya di DM, tetapi juga untuk CVD dan inflamasi.
Patients with end-stage renal disease (ESRD) who undergo hemodialysis have chronic inflammation caused by several factors,including biocompatibility of dialyzer membran. Inflammation will decrease the fetuin A level in serum. The elevation of the markerinflammation (CRP), hyperphosphatemia and decrease of fetuin A level are the risk faktors for vascular calcification. The aim of thisstudy was to know the relationship between serum phosphate, CRP and fetuin A levels in ESRD patients who underwent hemodialysis. Theresearch was carried out by observational cross sectional analytical approach with consecutive sampling on 31 ESRD patients undergoingchronic hemodialysis in the Hemodialysis Unit of the Dr.Kariadi Hospital, by examining levels of CRP by ELISA, serum phosphate byPhosphomolibdate methods and fetuin A by ELISA. The relationships between phosphate serum and CRP, CRP and fetuin A, phosphateserum and fetuin A were analyzed using Spearman correlation test. In this study it was found that 100% of subjects had CRP levels >0.3mg/dL (reference range 0.1-0.3 mg/dL); 61.3% of subjects had serum phosphate >5.1 mg/dL (reference range 2.5-5.1 mg/dL) and allsubjects (100%) had fetuin A levels <0.5 ng/mL (reference range 0.5-1 ng/mL). There was a moderate positive significant correlationbetween serum phosphate and CRP (p=0.024 and r=0.404), there was a strong negative significant correlation between CRP and fetuinA (p=0.000 and r=-0.628). No significant correlation between the phosphate serum and fetuin A (p=0.365 and r=-0.168) was found.Based on this study, it was found that the higher serum phosphate level resulted in a higher CRP and lower fetuin A.
Rusip is a fermented fish product made from anchovies. Several lactic acid bacteria have been identified in rusip fermentation. Lacticacid bacteria are known to be able to reduce serum cholesterol. The aim of the research was to know the lipid profile changes due toadministration of rusip in hypercholesterolemia rats. The research was done by using Pre and Post Randomized Controlled Group Design.The research subjects consisted of twenty-eight Sprague Dawley strain white male rats aged 20 weeks with normal body weight, who weregiven a high-fat high-cholesterol diet, then divided into four (4) groups: control group, without Rusip administration; P1, P2 and P3 whoreceived 2.55; 5.10 and 7.65 mg Rusip/g body weight. After 14 days treatment, blood samples were taken to determine the lipid profileusing enzymatic methods. ANOVA or alternative test, was used to test the difference between the groups at the 95% confidence level. Basedon the research, the administration of Rusip in the treatment group caused significant changes in the lipid profiles of hypercholesterolemiarats (p<0.05). The total cholesterol, triglycerides and LDL cholesterol levels decreased significantly in all three treatment doses (p<0.05).The HDL cholesterol increased significantly in all three treatment doses (p<0.05). The highest change in lipid profile results was obtainedin the treatment of P3 to all variables. In this study, it was found that administration of Rusip could improve the state of blood lipidprofiles of hypercholesterolemia rats. Whereas, the highest changes were obtained in treatment with P3.
Sepsis is the cause of patient’s death in the intensive care unit. Sepsis is an inflammatory response to infections. Infection whencontinued can cause systemic inflammatory response syndrome (SIRS). Clinical signs and pathology of SIRS are similar to sepsis, thusclinical as well as laboratory examination is needed to distinguish these. Culture result usually can be seen at least 24 hours aftersampling. In this case a test is needed to diagnose sepsis quickly so that the patient does not experience more severe conditions. Theindicator used in the diagnostic procedure is to know the diagnostic value of procalcitonin (PCT) levels as well as of interleukin-6 (IL-6)for the diagnosis of sepsis. Thirty-two blood samples of patients treated in the Department of SIRS. Dr. Kariadi Semarang were takenconsecutively from November 2011 up to January 2012. PCT levels are determined by ELFA, levels of IL-6 were determined by ELISAmethod. To determine the sensitivity, specificity, positive predictive value and negative predictive value, 2 × 2 table was used. The ROCcurve (receiver operating characteristic) showed an area under the curve of PCT of 0.83 (95% CI = 0.66 to 0.99), cut-off 5.1 ng/mL wasused as an indicator of sepsis. PCT diagnostic test results showed 88.9% sensitivity, 73.9% specificity, 57.1% positive predictive value andnegative predictive value of 94.4%. The area under the curve for IL-6 was 0.67 (95% CI = 0.47 to 0.86), cut off 47.2 pg/mL as an indicatorof sepsis. Diagnostic tests results showed 77.8% sensitivity, 60.9% specificity, 43.7% positive predictive value and negative predictive valueof 87.5%. It can be concluded that the examination of serum PCT levels can be used as a diagnostic test (screening test) for sepsis.
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