Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality globally. It is associated with a low quality of life and socio-economic burden. Airway destruction in COPD pathogenesis is primarily due to the three mechanisms: protease-antiprotease imbalance, chronic airway inflammation, and oxidative stress, which is triggered by exposure to harmful particles, such as cigarette smoking. Neutrophil elastase (NE), a serine protease stored in azurophilic granules of neutrophils, actively participates in airway remodeling and microbiocidal activity. It hydrolyzes elastin, collagen, and other vital extracellular matrix proteins (EMP) in the respiratory tissue. In addition, neutrophil elastase activates other principal proteinases such as matrix metalloprotease (MMP)-2, MMP-9, Cathepsin B, Meprin α protease, and Calpain that amplify EMP degradation. Macrophage, the primary leukocyte, responsible for lung parenchymal inflammation in COPD, is also activated by NE. However, neutrophil elastase level is positively correlated with the degree of airway inflammation and disease severity. Neutrophil elastase activates reactive oxygengenerating systems such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and myeloperoxidase and it also generates mitochondrial-derived-reactive oxygen species formation by inducing the secretion of Interleukin (IL)-1 andTumour necrosis factor (TNF)- α. In addition, neutrophil elastase stimulates respiratory cell apoptosis by direct (e.g., activating the caspase-3 pathway) and indirect mechanisms (e.g., by secretion of Neutrophil Extracellular Traps). Surprisingly, neutrophil elastase may have small anti-inflammatory properties. In conclusion, neutrophil elastase is one of the main culprits responsible for COPD pathogenesis by mediating the activation of Triad COPD pathogenesis.
Introduction: This research aimed to describe the characteristics of primary open-angle glaucoma (POAG) patients in Dr. Soetomo General Hospital Surabaya. Methods: This was a descriptive study to determine the characteristics of POAG in 42 patients recruited from Ophthalmology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, from March to June 2018. This study was conducted because the epidemiological data about characteristics of patients with POAG in Surabaya are not available yet. Results: The ratio of male and female patients with POAG was 1:1, the largest age group of patients was 55-64 years old (38.10%), in which a few patients had history of hypertension (45.24%). Regression of visual acuity was the most common symptoms along with clinical sign of the patients (78.57%), and the most common location of POAG was both eyes (69.05%). Furthermore, the mean of visual acuity of patients with POAG was 0.38 ± 0.36, and the mean of intraocular pressure of patients with POAG was 22.22 ± 9.24 mmHg. Conclusion: POAG is generally bilateral disease that can occur in men and women with no differences with the largest age group of 55-64 years old, the most common symptom and clinical sign was regression of visual acuity.
<p>Hypertension is still one of the leading causes of morbidity and mortality globally. Complications of hypertension cause innumerable social, economic, and health cost burdens, reaching 131 million dollars per year in the United States. However, blood pressure control through lifestyle modifications and pharmacological intervention, achieving blood pressure targets is often unsatisfying. With its simple, cost-efficient, multifunctional, and enormous coverage characteristics, social media is promising to be utilized in health programs. Social media could provide massive information and accommodate the hypertension community to increase hypertension awareness. Incorporating social media in hypertension management improves patients’ lifestyles and pharmacological adherence more than conventional methods. The exact mechanism of how social media-based health programs increase treatmentadherence is complex and has not been well-defined; raised awareness, bidirectional communication, and a qualified coach (physician) seem to be the essential factors. It should also be well aware that screen time duration and emotional alteration due to social media exposure could also potentially increase blood pressure.</p><p>Hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Komplikasi hipertensi menimbulkan beban sosial, ekonomi, dan biaya kesehatan yang mencapai 131 juta dollar setiap tahun di Amerika Serikat. Kontrol tekanan darah melalui modifikasi gaya hidup dan intevensi farmakologis, hasilnya seringkali masih belum memuaskan. Media sosial dengan karakteristiknya yang simpel, murah, multifungsi, dengan cakupan sangat luas tampak menjanjikan untuk digunakan dalam program-program kesehatan. Media sosial dapat menyediakan berbagai informasi dan mengakomodasi komunitas untuk meningkatkan kesadaran terhadap hipertensi. Penggunaan media sosial dalam manajemen hipertensi tampak mampu memperbaiki pola hidup dan ketaatan farmakologi lebih baik daripada metode konvensional. Mekanisme pastinya bersifat kompleks dan masih belum dapat dijelaskan dengan baik; namun peningkatan kesadaraan, komunikasi dua arah, dan pendamping (dokter) terkualifikasi tampak sebagai<br />faktor-faktor penting. Hal yang seharusnya juga diperhatikan adalah durasi screen time dan perubahan emosional karena saat menggunakan media sosial juga dapat berpotensi meningkatkan tekanan darah.</p>
Background: Indonesia is one of the fastest-aging countries. The increased elderly population carries the burden of chronic diseases such as hypertension and diabetes mellitus, along with their complications. The reinforcement of lifestyle changes has been promoted in primary healthcare through the Prolanis program to reduce these diseases’ burden, though its effectivity is unknown.Objective: To evaluate the outcome of the Prolanis program in Jatirejo Primary Healthcare.Methods: In this study, 61 patients were recruited from November 2021 – April 2022. Data were obtained from medical records as pre- and post-follow-up in 6 months period. Data pre- and post-follow-up were analyzed using the Wilcoxon and dependent T-test.Results: There were 64.52% patients with systolic hypertension. The median data of pre- and post- follow up showed that: HbA1C was 5.9% (range 3 – 13) and 6.3% (range 5 – 11) (p 0,959); BUN was 15,3 mg/dL (range 10 – 32) and 14,8 mg/dL (range 13 – 25) (p 0,638); serum creatinine was 0,8 mg/dL (range 0,4 – 3,1) and 1,2 mg/dL (range 0,7 – 2,6) (p 0,026); total cholesterol was 183 (range, 123 – 300) and 219 (range 179 – 231) (p 0,008); triglycerides was 133 (range 82 – 326) and 159 (range 135 – 394) (p 0,416); HDL was 40,65 SD ± 2 and 41 SD ± 2,3 (p 0,206); LDL was 117,5 SD ± 35 and 139,7 SD ± 20 (p 0,886); and urine microalbumin was 53 (range 5 – 200) and 63,5 (range 5 – 200) (p 0,721).Conclusion: Improvement in patients’ outcomes has not been shown after Prolanis program. Further study with larger populations and more variables is needed.
Hypertension is still one of the leading causes of morbidity and mortality globally. Complications of hypertension cause innumerable social, economic, and health cost burdens, reaching 131 million dollars per year in the United States. However, blood pressure control through lifestyle modifications and pharmacological intervention, achieving blood pressure targets is often unsatisfying. With its simple, cost-efficient, multifunctional, and enormous coverage characteristics, social media is promising to be utilized in health programs. Social media could provide massive information and accommodate the hypertension community to increase hypertension awareness. Incorporating social media in hypertension management improves patients’ lifestyles and pharmacological adherence more than conventional methods. The exact mechanism of how social media-based health programs increase treatment adherence is complex and has not been well-defined; raised awareness, bidirectional communication, and a qualified coach (physician) seem to be the essential factors. It should also be well aware that screen time duration and emotional alteration due to social media exposure could also potentially increase blood pressure. Hipertensi masih menjadi salah satu penyebab utama morbiditas dan mortalitas global. Komplikasi hipertensi menimbulkan beban sosial, ekonomi, dan biaya kesehatan yang mencapai 131 juta dollar setiap tahun di Amerika Serikat. Kontrol tekanan darah melalui modifikasi gaya hidup dan intevensi farmakologis, hasilnya seringkali masih belum memuaskan. Media sosial dengan karakteristiknya yang simpel, murah, multifungsi, dengan cakupan sangat luas tampak menjanjikan untuk digunakan dalam program-program kesehatan. Media sosial dapat menyediakan berbagai informasi dan mengakomodasi komunitas untuk meningkatkan kesadaran terhadap hipertensi. Penggunaan media sosial dalam manajemen hipertensi tampak mampu memperbaiki pola hidup dan ketaatan farmakologi lebih baik daripada metode konvensional. Mekanisme pastinya bersifat kompleks dan masih belum dapat dijelaskan dengan baik; namun peningkatan kesadaraan, komunikasi dua arah, dan pendamping (dokter) terkualifikasi tampak sebagai faktor-faktor penting. Hal yang seharusnya juga diperhatikan adalah durasi screen time dan perubahan emosional karena saat menggunakan media sosial juga dapat berpotensi meningkatkan tekanan darah.
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