Background:Omega-3 is a polyunsaturated fatty acid with an ability to regulate cell proliferation and apoptosis through interaction with inflammatory mediators. The potential additional beneficial effects of Omega-3 on chemotherapy patients with breast cancer is not yet completely revealed.Methods:A double-blind randomized control trial (RCT) involving a total of 48 locally advanced breast cancer patients was conducted. Ki-67 and VEGF expressions, as well as overall survival of patients receiving neoadjuvant cyclophosphamide-doxorubicin-5’fluorouracyl (CAF) chemotherapy plus Omega-3 (intervention group) or placebo (control group), were compared. Kaplan-Meier curve and Cox-regression tests were used to assess conditional disease-free survival (DFS) and overall survival (OS) between the two groups.Results:Decreased Ki-67 expression was observed in the intervention group compared to control (42.4±4.8 versus 39.2±5.3; T-test p=0.032). Decreased Ki-67 expression was observed in intervention compared to control group (42.4±4.8 versus 39.2±5.3; T-test p=0.032). Decreased VEGF expression was also seen in the intervention group compared to control (32.7±5.2 versus 29.5±5.4; T-test p=0.041). VEGF expression positively correlated with Ki-67 expression (Spearman’s test p<0.001, R2=0.541). Overall survival in the intervention group was significantly longer in comparison to the control group (mean survival: 30.9 ± 3.71 versus 25.9 ± 3.6 weeks, Mantel-Cox test p=0.048; HR=0.411, 95%CI: 0.201-0.840). Disease-free survival was significantly longer in the intervention group compared to the control group (mean survival: 28.5 ± 3.3 versus 23.7 ± 3.6, respectively; Mantel-Cox test p=0.044, HR= 0.439, 95%CI: 0.222-0.869).Conclusion:Omega-3 fatty acid supplementation improved overall survival and progression-free survival of locally advanced breast cancer treated with CAF neoadjuvant chemotherapy and mastectomy.

The objective of this study was to know the response of supplementation of Phaleria macrocarpa (PM) to adriamycin-cyclophosphamide (AC) in the treatment of C3H mice with breast cancer. Twenty-four C3H mice, who were successfully inoculated with breast cancer cells, were randomly allocated into 4 groups: without treatment, treated with AC, treated with AC + PM 0.07 mg/d, and treated with AC + PM 0.14 mg/d. The tumor size was measured using millimeter calipers before and 12 weeks after treatment. The tumor, liver, and kidneys were removed and prepared for pathologic examination using imunohistochemistry staining, and the apoptotic index was counted using the terminal deoxynucleotidyl transferase dUTP nick end labeling method. AC reduce the tumor growth significantly (P < 0.001), whereas supplementation of PM, which significantly reduced the tumor growth compared with AC only, was at the 0.14 mg/d dose (P = 0.007). AC increase the apoptotic index significantly (P < 0.001), and supplementation with PM showed that the higher dose increased the apoptotic index. The correlation between the apoptotic index and the diameter of tumor was significantly negative (r = -0.884; P = 0.020). The apoptotic index of the liver and kidney increased significantly in the AC group (P < 0.001 and P = 0.002, respectively); supplementation with PM decreased significantly the high apoptotic index caused by AC. We conclude that PM supplementation has a synergic effect to AC treatment in reducing the tumor growth, by increasing apoptosis, and protects the liver and kidney from damage caused by AC.

Background: End Stage Renal Disease (ESRD) has been among the top ten list of non infectious diseases frequently found at RSUP dr. Kariadi and RSUD Kota Semarang. Risk factors for ESRD are metabolic syndrome components, which are having an upward trend. This study had an objective to provided an evidence of metabolic syndrome factors that became risk factors for ESRD.Method: This study applied an analytical observational method with a case control study design. The study used 90 respondents as samples, divided into two different groups: 45 respondents as case samples and 45 respondents as control samples with consecutive sampling. Variables in this study ware the individual characteristics and history of suffering from metabolic syndrome components. Data were collected by interview, medical record, and indepth interview. These data were subject to analyses using univariat, bivariate, and multivariate tests.Results: The study found the risk factors for ESRD as the followings: hypertension term of> 5 years (OR=10,89 and 95% CI=3,08-38,59; p=0,000), diabetes mellitus term of > 5 years (OR=3,84; 95% CI=1,20-12,30; p=0,023), and low HDL-cholesterol history of < 35 mg/dL(men) and < 40 mg/dL(women) with (OR=3.123, 95% CI=1.08-9.04; p=0,04). The indepth interview resulted in adequate knowledge of the respondents about the risk factors for ESRD.Conclusion: Risk factors for ESRD found during the observation were hypertension term of >5 years, diabetes mellitus term of >5 years, and low cholesterol HDL. To prevent theprogression of chronik kidney disease required strict control of metabolic syndrome.

Background: Prevalence of type-2 diabetes mellitus have increased significantly. The increasing number of people with diabetes has a major impact on the development of chronic diabetic kidney disease. The research was aimed to clarify several risk factors of chronic diabetic kidney disease on type-2 diabetes mellitus (CDK-DM).Method: The research was based on case control study design. The number of respondents was 140 respondents consisting 70 cases and 70 controls that met the criteria of inclusion and exclusion. The cases were patients with type-2 chronic diabetic kidney disease stadium 2-5. The controls were patients with type-2 chronic diabetic kidney disease with blood sugar levels ≥ 200 mg / dL. The data were then analyzed using logistic regression.Results: The result shows that risk factors of chronic diabetic kidney disease in type-2 diabetes mellitus are diabetes in family (OR = 6,732; 95% CI = 2,623- 17,276), high blood pressure (OR = 6,760; 95% CI = 2,190- 20,867), lack of physical activities (OR = 4,367 95% CI = 1,823-10,462) and lack of family support (OR = 4,203; 95% CI = 1,437-12,295). The probability of chronic diabetic kidney disease occurrence in type-2 diabetes mellitus when four risk factors exist are 96,71%.Conclusion: The host factors have important role of chronic diabetic kidney disease in type 2 diabetes mellitus . The factors proven to be risk factors for occurrence of chronic diabetic kidney disease in type 2 diabetes mellitus were diabetic in the family, Hipertension, poor physical exercise and family Support.

Introduction: Breast cancer is still a major health problem in the world. In the case of breast cancer, surgery is the main treatment option besides chemotherapy, radiation, and immunotherapy such as Artemisia vulgaris (AV). AV is cytotoxic selectively acts as a supplement to breast adenocarcinoma chemotherapy given the Adriamycin-Cyclophosphamide regimen, to improve chemotherapy response.The study was aimed to proving AV extract enhances the chemotherapy response in C3H mice with adenocarcinoma mammae given Adriamycin-Cyclophosphamide Chemotherapy. Method: This study used Post test only control group design on 24 females C3H mice that were randomly selected and divided into four groups: group K (control), P1 (chemotherapy), P2 (extract), and P3 (combination). Adenocarcinoma mammae comes from the inoculation of donor mice. Chemotherapy of Adriamycin 60 mg / m 2 and Cyclophosphamide 600 mg / m 2 were given in two cycles. AV 13 mg (0.2 ml) was given once daily orally. CD34 were evaluated by imunohistochemical staining and tumor mass diameter were counted by calipers. Result: The microvascular density CD34 and tumor mass diameter were obtained in groups of K, P1, P2, P3 respectively 60.76 ± 1.5; 39.70 ± 2.00; 57.10 ± 1.29; 35.26 ± 2.06 and 12.52 ± 1.49; 6.20 + 1.04; 9,94 + 1.21; 3.94 + 0.76. Statistical analysis showed significant differences in CD34 between groups K vs P1, P2, P3 (p = 0.001, p = 0.014, p = 0.001), P1 vs P2 and P3 (p = 0.001, p = 0.033) and P2 (P = 0.001). Tumor mass diameter between groups K vs P1, P2, P3 (p=0.001; p=0.014; p=0,001), P1 with P2 (p= 0.001) P1 with P3 (p = 0.033) and P2 with P3 (p = 0.001). Correlation analysis between CD34 with tumor mass diameter was found to have significant correlation (p = 0.001 and r = 0.932). Conclusion: Artemisia vulgaris is a potential to reduce angiogenesis in terms of decreasing the microvascular density CD34 and tumor mass diameter of adenocarcinoma mammae of C3H mice treated with Adriamycin-Cyclophosphamide chemotherapy and can improve the effectivity.

Background: Colon cancer, a colorectal cancer, is the third most common epithelial malignancy in the world. Family history, bloody stool, palpable mass, anemia, and abdominal MSCT are symptoms and signs of colon carcinoma.Objective: To determine the relationship between the 5 variables and the incidence of colon carcinoma at Dr. Kariadi Hospital, Semarang in 2016.Methods: a Cross-sectional observational analytical study using medical record (RM) and complementary primary data. The inclusion criteria werethe complete medical record, and clinical diagnosis of suspected colon carcinoma. Data obtained from the department of Anatomy Pathology/PA (11,794PA results) were traced to the medical record section (46 patients with suspected colon carcinoma). The incomplete data were confirmed by: contacting the patient/family, obtaining the archive in the laboratory and radiology resulting in 27 patients meeting the inclusion criteria. Analysis was done using chi-square test, Spearman-Kendall bivariate correlation, and logistic regression.Results: Abdominal MSCT was moderately associated with colon carcinoma (p = 0.003; r = 0.488), while family history, bloody stool, palpable mass, and anemia were not associated with colon cancer. Analysis between predictors of outcome: Bloody stool was moderately associated with anemia (p = 0.006; r = 0.411), and anemia was weakly associated MSCT (p = 0.035; r = 0.351). Abdominal MSCT was the predictive factor for colon carcinoma (p = 0.021).Conclusion: Abdominal MSCT was found to be associated with the incidence of colon carcinoma. Bloody stool was associated with anemia, and anemia was associated with abdominal MSCT. MSCT was the predictive factor for colon cancer.

<p><br />Insiden kanker payudara di seluruh dunia masih tinggi. Pembedahan tetap merupakan pilihan utama dengan modalitas lain berupa kemoterapi, radiasi, dan imunoterapi antara lain Artemisia vulgaris (AV). Penelitian dilakukan untuk membuktikan efek pemberian ekstrak AV terhadap kadar IL-12 dan indeks apoptosis sel kanker pada adenokarsinoma mammae. Penelitian ini menggunakan desain post test only control group design menggunakan 24 ekor mencit C3H betina yang dibagi secara acak menjadi empat kelompok, yaitu: K (kontrol), P1 (kemoterapi), P2 (ekstrak AV), dan P3 (kombinasi kemoterapi dan ekstrak AV). Adriamycin 0,18mg dan Cyclophosphamide 1,8mg diberikan sebanyak 2 siklus. Ekstrak AV diberikan 13mg (0,2ml) perhari. Kadar IL-12 dinilai dengan pengecatan imunohistokimia sedangkan indeks apoptosis dengan hematoxilin eosin. Rerata kadar IL-12 dan indeks apoptosis didapatkan K, P1, P2, P3 berturut-turut 60,28+1,54, 50,40+1,56, 75,40+1,46, 53,48+1,35 dan 2,18+0,80, 18,00+1,58, 3,34+0,51, 20,32+1,39. Analisis statistik menunjukkan terdapat perbedaan bermakna pada kadar IL-12 antara kelompok K vs P1, P2, P3 (p=0,001), P1 vs P2 (p=0,001), P1 vs P3 (p=0,028), P2 vs P3 (p=0,001) dan indeks apoptosis antara kelompok K vs P1, P3 (p=0,001), P1 vs P2 (p=0,001), P1 vs P3 (p=0,035), P2 vs P3 (p=0,001). Terdapat hubungan positif kuat yang signifikan antara kadar IL-12 dengan indeks apoptosis (p=0,041 dan r=0,893). Pemberian ekstrak Artemisia vulgaris dapat meningkatkan kadar IL-12 dan indeks apoptosis sel kanker pada mencit C3H dengan adenokarsinoma mammae yang diberi regimen kemoterapi Adriamycin-Cyclophosphamide.</p>

Latar belakang : Stress neurologis, melalui sitokin-sitokin internal di dalam sawar otak akan menyebabkan sekresi kortisol oleh kelenjar adrenal melalui HPA axis. Tujuan penelitian ini adalah membuktikan bahwa terdapat korelasi antara pengaruh depresi terhadap kadar kortisol pada penderita tumor payudara stadium III B. Metode : Penelitian ini merupakan penelitian klinis CrossSectional, yang dilakukan pada 40 pasien wanita penderita kanker payudara duktal invasif stadium lanjut lokal (stadium IIIA, IIIB, dan IIIC). Tingkat depresi diukur dengan quesioner standar Beck Depression Inventory (BDI). Kadar kortisol dihitung dengan metode ELISA, dan diambil dari serum sampel pada jam 09.0010.00. Hasil : Kadar kortisol rerata 254,98; SD 48,65 ng/ml, hasil BDI minimum 4, maksimal 9, dengan median 7. Berdasarkan hasil Spearman corellation terdapat hubungan  bermakna antara nilai BDI dengan kadar kortisol (p<0,001, r=0,868). Simpulan : Sesuai dengan teori yang ada, kadar kortisol berhubungan erat dengan ekspresi kortisol. Proses sitokin-sitokin internal di otak pada pasien dengan IDC masih berlangsung sesuai teori, tetapi hal ini masih perlu diteliti lebih lanjut lagi. Pada penelitian ini juga terbukti quesioner BDI mempunyai korelasi yang kuat untuk pengukuran tingkat depresi yang dilihat dari parameter kortisol.