The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of ...improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
The incidence of CAP due to Drug-Resistant Pathogen (DRP) requires broad-spectrum antibiotic therapy, Drugs Resistance in Pneumonia (DRIP) score can predict these cases. The use of the DRIP score can ...prevent antibiotic failure and long hospitalization, but validation is needed so that the DRIP score can be used according to the local community at Cipto Mangunkusumo National Central Public Hospital.
This research is a retrospective cohort study in CAP patients who were hospitalized during the period January 2019 to June 2020. Data were taken from medical records. Failure of empiric antibiotics occurs when one of these criteria is found: patient mortality, ICU transfer, and escalation of antibiotics as well as length of stay.
480 patients met the criteria. There were 331 patients (69%) with a DRIP score of <4 and 149 patients (31%) with a DRIP score of≥4. A total of 283 patients (59%) of antibiotic failures were detailed in 174 patients with a DRIP score <4 and 109 patients DRIP score ≥4. DRIP calibration using the Hosmer-Lemeshow test obtained p-value= 0.667 (p>0.05). AUC observations on the ROC curve obtained 0.651 (95% CI; 0.601-0.700).
The DRIP score has low accuracy performance and calibration value in predicting empirical antibiotic failure and poor discriminatory value.
Colorectal cancer (CRC) is a significant contributor to cancer-related morbidity and mortality. Biopsy remains the gold standard for CRC diagnosis, but invasive testing may not be preferred as an ...initial diagnostic procedure. Therefore, alternative non-invasive approaches are needed. Circulating tumor cells (CTC) present in the bloodstream have great potential as a non-invasive diagnostic marker for CRC patients. This study aimed to assess the diagnostic potential of CTC in CRC as an adjunctive diagnostic method using a subjective manual identification method and laser capture microdissection at 40x magnification.
A cross-sectional study was conducted on adult patients suspected to have CRC at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, between November 2020 and March 2021. CTC analysis was performed using the negative selection immunomagnetic method with Easysep™ and the CD44 mesenchymal tumor marker. The identification and quantification of CTC were conducted manually and subjectively, with three repetitions of cell counting per field of view at 40x magnification.
Of 80 subjects, 77.5% were diagnosed with CRC, while 7.5% and 15% exhibited adenomatous polyps and inflammatory/hyperplastic polyps, respectively. The diagnostic analysis of CTC for detecting CRC (compared to polyps) using a CTC cutoff point of >1.5 cells/mL suggested sensitivity, specificity, and positive predictive value (PPV) of 50%, 88.89%, and 93.94%. Additionally, the negative predictive value (NPV), as well as the positive and negative likelihood ratio (PLR and NLR) were 34.04%, 4.5, and 0.56, respectively. The subjective manual identification and quantification of CTC were performed at 40x magnification using laser capture microdissection.
This study assessed the diagnostic potential of CTC examination in CRC as an adjunctive diagnostic method using the subjective manual identification method and laser capture microdissection at 40x magnification. Despite the limitations associated with subjective cell counting, the results showed 50% sensitivity and 88.89% specificity in diagnosing CRC. Further studies are needed to optimize the manual identification process and validate the clinical utility of CTC analysis in CRC patients.
Coronavirus disease 2019 (COVID-19) is an emerging pandemic affecting the global population. Community-based quarantine can slow down the pandemic growth while adversely affecting population-wide ...psychological well-being. Affected psychological well-being could potentially influence population compliance in following stipulated community quarantine procedures.
The aim was to quantify psychological distress among Greater Jakarta area residents during the community containment period.
The objective was to measure depression, anxiety, and stress levels using the Indonesian version of the DASS-21. Demographic data on sex, education strata, and working/productive-age group were also collected.
This cross-sectional observational analytic study employed an online questionnaire involving participants acquired through snowball sampling. The questionnaire comprises two parts: demographic data and psychological distress indicators. Linear regression evaluated psychological distress as a response variable.
Among 1,205 women and 824 men, our findings suggested male sex, age in the range of 15-24 years, and having a bachelor's degree or professional qualification have a strong association with psychological distress.
By addressing the population at risk, policymakers can identify better countermeasures for preventing psychological distress.
Community quarantine; COVID-19; DASS-21; Psychological distress
Celiac Disease Alexander, Reinaldo; Abdullah, Murdani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy,
12/2017, Volume:
18, Issue:
3
Journal Article, Book Review
Open access
Celiac disease is a multisystem autoimmune disorder, which is induced by dietary gluten exposure. This disease usually found in European population, but with the increase of Asian population tendency ...to eat western style, which contain gluten, celiac disease frequency is expected to increase in Asian population for the near future. The finding of diagnostic modalities which is highly sensitive and specific, starting with the antigliadin, and then the antiendomysium and anti-transglutaminase antibodies, has increased the awareness of clinicians and patients towards this condition. The understanding of definition, pathogenesis, diagnostic procedure, and current management of celiac disease is needed to avoid morbidity and mortality of this disease.
Background
Squamous cell carcinoma of the oral cavity (OSCC) is the sixth most common malignancy. Surgery is mainstay treatment for oral cancers. Surgery in locally advanced OSCC presents many ...challenges primarily because the head and neck have critical structures that can be damaged by tumor or treatment. It is thought that neoadjuvant chemotherapy (NC) in locally advanced OSCC is able to shrink tumor size. Chemoresistancy is a problem due to hypoxic microenvironment characterized by increased expression of HIF-1α. It is also regulated by miR-210 as well as increased expression of CD44 and CD133. Melatonin has a powerful antioxidant and oncostatic effects that are expected to improve tumor hypoxia and clinical response. Fifty patients with OSCC were included and randomized. miR-210 and CD44 expression were measured before and after intervention using qRT-PCR absolute quantification, and clinical response was evaluated according to RECIST 1.1 criteria. This study aims to determine the effect of melatonin in improving the clinical response of patients with locally advanced oral squamous cell carcinoma (OSCC) after neoadjuvant chemotherapy to miR-210 and CD44 expression.
Results
Melatonin administration reduced miR-210 levels but not significant (
p
= 0.767). CD44 expression also decreased in the melatonin group compared with placebo yet was not significant (
p
= 0.103). There was a decrease in the expression of miR-210 and CD44 followed by a decrease in the percentage of residual tumor but not significant (
p
= 0.114).
Conclusion
In OSCC, the addition of 20-mg melatonin to neoadjuvant chemotherapy (NC) reduced the expression of miR-210 and CD44 and decreased the percentage of tumor residue; however, no statistically significant result was observed.
Trial registration
This study is registered to
ClinicalTrials.gov
under trial registration number: NCT04137627 with date of registration on October 22, 2019—retrospectively registered, accessible from:
https://clinicaltrials.gov/ct2/show/NCT04137627
The concept of consuming microorganisms in the treatment of a medical condition and in health maintenance has gained much attraction, giving rise to an abundance of medical claims and of health ...supplements. This study identified relevant clinical questions on the therapeutic use of probiotics and reviewed the literature in irritable bowel syndrome, inflammatory bowel disease, impaired intestinal immunity, liver disease, intestinal infections, and common childhood digestive disorders. Statements were developed to address these clinical questions. A panel of experienced clinicians was tasked to critically evaluate and debate the available data. Both consensus and contentious statements are presented to provide to clinicians a perspective on the potential of probiotics and importantly their limitations.
nasopharyngeal cancer (NPC) is the most common type of head and neck cancer in Indonesia (28.4%). Reports showed that 18.9% of cases came with advanced stage. Chemotherapy play important role in ...advanced stage. However, patients with the same stage of the disease may have different treatment response, likely due to the different tumor biological characteristics. Cyclin D1 is a protein involved in the cell cycle, which will stimulate proliferation. This study aimed to examine the proportion of cyclin D1 in NPC and its association with treatment response.
a retrospective cohort study was conducted on advanced NPC patients that underwent chemotherapy at Cipto Mangunkusumo Hospital from 2015 until 2018. Cyclin D1 immunohistochemistry staining was done by antigen retrieval methods using the cyclin D1 NovocastraTM monoclonal antibody. The cyclin D1 expression was evaluated with h-score. Treatment response was reviewed based on the RECIST 1.1 criteria.
fifteen subjects (48.4%) had a positive expression of cyclin D1. Higher proportion of cyclin D1 positive was found in responsive group compare with non-responsive group (66.7% vs. 33.3%, p = 0.032). Statistically significant difference in mean h-score was observed between the subjects who responded and those who did not respond (116.24 SD57.80 vs. 77.97 SD45.27, p = 0.048).
this study suggests that a higher expression of cyclin D1 is associated with a good treatment response in NPC patients.
تقيم هذه الدراسة مستويات المصل لعامل النمو الشبيه بالأنسولين -١ وسكلروستين كعلامات لانخفاض تكوين العظام لدى النساء قبل انقطاع الطمث المصابات بداء السكري من النوع ٢.
تم إجراء دراسة مقطعية حيث تم قياس ...مستويات مصل عامل النمو الشبيه بالأنسولين -١ وسكلروستين في مصل ٤٠ امرأة قبل انقطاع الطمث مع أو بدون داء السكري باستخدام مقايسة الممتز المناعي المرتبط بالإنزيم. وتمت مقارنة مستويات عامل النمو الشبيه بالأنسولين -١ وسكلروستين بين المجموعات.
كان متوسط مستويات عامل النمو الشبيه بالأنسولين -١ في الدم ٤٠.٦٠نانوغرام / مل و٤٢.٧ نانوغرام / مل في المجموعات المصابة بالسكري وغير المصابة بالسكري، على التوالي مع عدم وجود فرق معنوي. كانت مستويات سكليروستين في المصل أعلى بكثير في مجموعة مرضى السكري مقارنة بالمجموعة غير المصابة بالسكري، ١٣٢.١ بيكوغرام / مل و٩٦.٠بيكوغرام / مل، على التوالي.
كانت مستويات سكليروستين أعلى بشكل ملحوظ في النساء في فترة ما قبل انقطاع الطمث المصابات بداء السكري مقارنة مع غير المصابات بداء السكري. نظرا لأن سكلروستين يؤثر على تمايز ونضج بانيات العظم، فقد يكون من المحتمل أن يكون سكلروستين المصل مفيدا كعلامة على انخفاض تكوين العظام لدى النساء المصابات بالسكري قبل انقطاع الطمث.
This study assesses the serum levels of insulin-like growth factor-1 (IGF-1) and sclerostin as markers of decreased bone formation in premenopausal women with type 2 diabetes mellitus.
A cross-sectional study was conducted to measure serum levels of IGF-1 and sclerostin in 40 premenopausal women with and without diabetes mellitus using an enzyme-linked immunosorbent assay. The levels of IGF-1 and sclerostin were compared between the groups using the Mann Whitney test and unpaired t-test, respectively.
The median IGF-1 serum levels were 40.60 ng/mL and 42.7 ng/mL in the diabetic and non-diabetic groups, respectively, with no significant difference. The serum levels of sclerostin were significantly higher in the diabetic group than in the non-diabetic group (132.1 pg/mL and 96.0 pg/mL, respectively; p < 0.001).
The levels of sclerostin were significantly higher in premenopausal women with diabetes mellitus than in the non-diabetic group. Since sclerostin influences the differentiation and maturation of osteoblasts, serum sclerostin might potentially be useful as a marker of decreased bone formation in premenopausal women with diabetes.
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