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.
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