<b><i>Background:</i></b> Researchers believe the role of gut microbiota dysbiosis in the raised incidence of early-onset colorectal cancer (EOCRC). The development of EOCRC may be associated with microbiota dysbiosis either dependently or independently (combined with other risk factors). <b><i>Summary:</i></b> Recently, the rising of incidence and mortality of EOCRC have been noted. Some researchers are looking for risk factors influencing this fact. They hypothesize that it may be because of microbiota dysbiosis. Microbiota dysbiosis has been known to promote cancer development through immunity dysregulation and chronic inflammation. Microbiomes profile in late-onset colorectal cancer (LOCRC) among older patients has been documented, but there is still lack of data about microbial profiles among younger colorectal cancer (CRC) patients. This review tries to explain microbial profiles differences between EOCRC and LOCRC as a potential diagnostic biomarker in the future, and whether microbiota can have a role in EOCRC genesis. <b><i>Key Messages:</i></b> Microbiota does vary with age, and EOCRC may be associated with colonization of some specific bacteria. Further studies about gut microbiota profiles in EOCRC and LOCRC may provide a new insight on diagnostic biomarker of CRC.

BackgroundBlood gas analysis and blood lactate measurement have important roles in patient management. Point‐of‐care (POC) testing simplifies and provides rapid blood gas and lactate measurements. This study aimed to compare pH, pCO2, pO2, and lactate measurements between a POC device and a benchtop blood gas analyzer typically used in a hospital central laboratory, and to evaluate the inter‐device variability of the POC device.MethodsA cross‐sectional study was conducted with a sample size of 100. Each sample was measured for pH, pCO2, pO2, and lactate using a Nova pHOx plus L® benchtop blood gas analyzer in the central laboratory and an i‐STAT® handheld POC device. The results of both devices were compared using Pearson or Spearman correlation coefficients and Bland‐Altman tests. Testing of the inter‐device variability was done by using three different i‐STAT® devices, and the results were compared statistically.ResultsStrong correlations were observed for all test results. In Bland‐Altman analysis, ≥95% of the results were within the limits of agreement, with the exception of lactate, which had only 93%. The results that were beyond the limits were primarily lactate levels >8 mmol/L. Biases between the benchtop analyzer and the i‐STAT® were not clinically significant, except pH. No significant inter‐device variability was observed between the i‐STAT® analyzers.ConclusionThis comparison study of pH, pCO2, pO2, and lactate measurements between Nova pHOx plus L® and i‐STAT® analyzers showed good agreement. However, lactate measurement results >8 mmol/L on the i‐STAT® analyzer should be interpreted with caution.

Anemia defisiensi zat besi dan thalassemia β trait merupakan penyebab tersering anemia mikrositik hipokrom di Indonesia. Keduapenyakit tersebut sulit dibedakan hanya dengan pemeriksaan hematologi, oleh karena itu diperlukan pemeriksaan tambahan sepertiferitin dan analisis hemoglobin. Banyak penelitian yang membedakan kedua penyakit tersebut dengan indeks eritrosit. Berbagai indekseritrosit memiliki nilai diagnostik yang berbeda di setiap negara dan belum ada data di Indonesia. Penelitian ini melakukan uji diagnostikIndeks Mentzer, RDW, Green-King, Sirdah dan mencari nilai cut-off baru yang dapat memberikan nilai diagnostik lebih baik. Penelitianterdiri dari 98 subjek definitif anemia defisiensi besi dan 80 subjek thalassemia β trait. Indeks Mentzer didapatkan kepekaan 83,6%,kekhasan 66,2%, NPP 75,2%, NPN 76,8% dan Indeks RDW mempunyai kepekaan 91,8%, kekhasan 75%, NPP 81,8%, NPN 88,2%. Nilaidiagnostik Indeks Green-King didapat kepekaan 96,9%, kekhasan 67,5%, NPP 78,5%, NPN 94,7%, sedangkan Indeks Sirdah adalahkepekaan 92,8%, kekhasan 58,7%, NPP 73,3%, NPN 87,0%. Nilai cut-off baru Indeks Mentzer adalah 13,44, RDWI 233,4, Green-King75,06 dan Sirdah 32,52. Keempat Indeks eritrosit dapat diterapkan untuk orang Indonesia dengan Indeks Green-King sebagai indeksyang terbaik.

Introduction: Invasive candidiasis is a severe form of infection. The incidence of invasive fungal infections has increased, due to the increasing number of patients with impaired immunity who are being treated through prolonged stay in hospital facilities. Neurological patient treatment methods such as antimicrobials, corticosteroid, central venous catheter (CVC), total parenteral nutrition, and mechanical ventilation use are associated with common risk factors for invasive candidiasis. Our study demonstrated invasive candidiasis prevalence among neurological patients. Methodology: A cross-sectional study was done with consecutive sampling of neurological patients who were hospitalized from January 2017 to February 2020 at the Mahar Mardjono National Brain Center Hospital East Jakarta Indonesia. Patients with sepsis, septic shock, or fever (> 38.5 °C), and who had not received antifungals before culture were enrolled in the study. Clinical specimens were obtained from blood, liquor cerebrospinal or other sterile sites, CVC, respiratory tract specimens, and urine or other non-sterile sites. Socio-demographic data, potential risk factors based on previous studies, clinical, and other tests data were obtained from medical records. Classification of invasive candidiasis was according to the Paphitou classification criteria. Results: One hundred and two subjects met the study criteria. The prevalence of invasive candidiasis in neurological patients was 13.7%. All of the isolates were C. parapsilosis. Conclusions: The prevalence of invasive candidiasis was high in the samples studied. The infection was associated with septic shock, tracheostomy, and duration of use of central venous catheter, ventilator, and steroids.

Evaluation of the in vitro interaction of doripenem and amikacin against Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae was done by classifying them into four groups: doripenem and amikacin sensitive (DOR-S/AMK-S), doripenem sensitive and amikacin resistant (DOR-S/AMK-R), doripenem resistant and amikacin sensitive (DOR-R/AMK-S), and both doripenem and amikacin resistant (DOR-R/AMK-R). The MIC of each antibiotic and their combination was obtained using the Etest method. The fractional inhibitory concentration index was calculated to classify the results as synergistic, additive, indifferent, or antagonistic interaction. In the DOR-S/AMK-S class, 1 isolate of A. baumannii showed synergy and the other 5 showed additive results, 5 isolates of P. aeruginosa showed additive and 1 isolate showed indifferent result, and 2 isolates of K. pneumoniae showed additive and the other 4 showed indifferent results. In the DOR-S/AMK-R class, 3 isolates of A. baumannii showed additive and the other 3 showed indifferent results, 2 isolates of P. aeruginosa showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. In the DOR-R/AMK-S class, 1 isolate of A. baumannii showed additive and the other 5 showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 4 isolates of K. pneumoniae showed additive and the other 2 showed indifferent results. In the DOR-R/AMK-R class, 6 isolates of A. baumannii showed indifferent results, 1 isolate of P. aeruginosa showed additive and the other 5 showed indifferent results, and 1 isolate of K. pneumoniae showed additive and the other 5 showed indifferent results. Synergy occurred in only 1 (1.5%) isolate. Additive interaction occurred in 24 (35.3%) isolates, and indifferent interaction occurred in 43 (63.2%) isolates. Doripenem sensitive combined with amikacin sensitive reduced MIC significantly in all bacterial isolates when compared to single MIC of each antibiotic.

BACKGROUND: Amino acids are important for proliferation and maintenance of tumor cells. Breast cancer patients were found to have significant changes in the number of amino acids, which are assumed to be correlated with the molecular subtypes of breast cancer. Therefore, current study was conducted to analyze plasma amino acids in breast cancer patients with luminal A and B subtypes.METHODS: Breast cancer and control subjects were recruited, and venous blood was collected for the measurement of plasma amino acids. Total 19 plasma amino acids were measured using reverse-phase high-performance liquid chromatography with C18 column. Mean comparison for normally distributed and homogeneous data was further analzyed using independent sample T-test, with p<0.05 was considered as significant.RESULTS: From total 19 amino acids, only 7 amino acids; cysteine, glutamic acid, histidine, ornithine, threonine, tyrosine, valine, were statistically different between the healthy control and breast cancer subjects. Eventhough no amino acids was found to be statistically different between breast cancer subjects with luminal A and B subtypes, but some amino acids were found to be significantly different when correlated to various breast cancer risk factors.CONCLUSION: Amino acid profile of patients with Luminal A and B subtypes of breast cancer differs compared to healthy controls and is also correlated with breast cancer risk factors. Increase in cysteine level in Luminal A subtype patients and decrease of alanine and leucine in Luminal B subtype patients can be used as a biomarker.KEYWORDS: amino acid, plasma, breast cancer, risk factor, biomarker

Thyroid-stimulating hormone (TSH) is an important parameter in diagnosing thyroid disease, using serum according to World Health Organization’s (WHO) recommendations. The use of plasma can help improving turnaround time (TAT) but the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples was done to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), and plasma tubes with heparin-gel separator (Tube III); and to show an overview of TSH levels according to gender and age. The median TSH levels in tubes I, II, and III were 1.380 (0.032-7.420) µIU/mL, 1.380 (0.030-7.480) µIU/mL, and 1.360 (0.030-7.460) µIU/mL respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSH levels differences of tubes II and III compared to tube I were -0.9% (-7.2 - 2.2) and -1.7% (-8.0 - 1.6) respectively. Biases of the measurement results obtained were in accordance with the spesicified desirable bias according to Ricos. The median TSH levels of the male and female groups was 1.500 (0.032-4.250) µIU/mL and 1.345 (0.058-7.420) µIU/mL respectively. Median TSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) µIU/mL and 1.730 (0.088-5.760) µIU/mL respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levels showed higher median in the male and older group.

Iron overload disorder is a condition due to an excessive rate of iron acquisition compared to the rate of body iron loss that happens constantly. The clinical manifestations vary depending on the location of the damaged organs. Consequently, the symptoms of iron overload may mimic many diseases such as cirrhosis, diabetes mellitus, arthropathy, and skin pigmentation. The laboratory results which may point to iron overload are as follows: transferrin saturation >45%, serum ferritin level >300 ng/ml in men and >200 ng/ml in women. It is thus imperative that the molecular mechanism of iron metabolism and pathogenesis of iron overload are well understood in order to correct the interpretation of the laboratory results for iron overload. The standard management is blood removal by phlebotomy to maintain the level of the serum ferritin at 50 ng/mL in order to prevent irreversible hepatic cirrhosis