C. Jasirwan, A. Wibowo, A. Sjaaf, Gita Aprilicia, Dyah Purnamasari, E. Yunihastuti, R. Gani
Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.
背景:巨细胞病毒(CMV)是一种常见于人类免疫缺陷病毒(HIV)患者的人类疱疹病毒。在具有免疫能力的患者中，长周期的无症状巨细胞病毒可能会导致肝功能异常，并导致非艾滋病定义的发病率，包括慢性肝病。本研究旨在了解CMV反应性病毒抑制HIV感染患者肝纤维化和脂肪变性的患病率，并总结这些患者的临床表现与肝纤维化和脂肪变性的相关性。方法:于2019年4月至2020年6月在Cipto Mangunkusumo医院HIV综合护理病房进行横断面研究。本研究的受试者年龄在30-40岁之间，IgG巨细胞病毒阳性，并且已经使用稳定的抗逆转录病毒治疗至少一年。瞬时弹性图测量肝脏刚度。肝僵硬度大于7 kPa的患者定义为肝纤维化明显。此外，采用Spearman相关性来评价肝纤维化和脂肪变性与受试者临床表现的相关性。结果:本研究共纳入受试者。男性居多(62.5%)，平均年龄38±4.68岁。CMV DNA的中位数为466(17-21284)拷贝/ml。80例受试者中有17例(21%)出现显著纤维化。在本研究中，与肝纤维化相关的临床参数有胰岛素、空腹血糖、Homa IR、甘油三酯、HDL和血小板。胰岛素与Homa IR呈中等正相关，Homa IR与胰岛素的相关系数为r = 0.475, p 0.001;Homa IR相关系数r = 0.487, p 0.001。结论:肝纤维化发生率为12%。此外，胰岛素和Homa IR与肝纤维化增加呈正相关。
{"title":"Liver Fibrosis and Steatosis in Virally Suppressed HIV-Infected Patients with Cytomegalovirus Seropositivity","authors":"C. Jasirwan, A. Wibowo, A. Sjaaf, Gita Aprilicia, Dyah Purnamasari, E. Yunihastuti, R. Gani","doi":"10.24871/2232021180-187","DOIUrl":"https://doi.org/10.24871/2232021180-187","url":null,"abstract":"Background: Cytomegalovirus (CMV) is a human herpesvirus common in people with human immunodeficiency virus (HIV). In a patient with immunocompetence, long periodic asymptomatic CMV might affect to develop the abnormal liver function and contribute to non-AIDS defining morbidity, including chronic liver disease. This study aims to know the prevalence of liver fibrosis and steatosis in virally suppressed HIV infected patients with CMV reactive and summarize the correlation of clinical presentation with liver fibrosis and steatosis in these subjects.Method: A cross-sectional study in HIV Integrated Care Unit, Cipto Mangunkusumo Hospital, was conducted from April 2019 until June 2020. Subjects enrolled in this study were suppressed HIV patients aged between 30-40 years with positive IgG CMV and already using stable ART for at least one year. Transient elastography measured the liver stiffness. Patients with liver stiffness above 7 kPa were defined as having significant liver fibrosis. In addition, Spearman correlation was conducted to evaluate the correlation of clinical presentation of subjects related to liver fibrosis and steatosis. Results: A total of subjects was included in this study. Dominantly male (62.5%) with average age 38 ± 4.68 years. The median amount of CMV DNA was 466 (17-21284) copy/ml. Significant Fibrosis was found in 17/80 (21%) subjects. In this study, clinical parameters correlated with liver fibrosis were insulin, glucose fasting, Homa IR, triglyceride, HDL, and platelet. A medium positive correlation was found in insulin, and Homa IR, with coefficient correlation for insulin, was r = 0.475, p 0.001; and coefficient correlation for Homa IR was r = 0 .487, p 0.001.Conclusion: The prevalence of liver fibrosis was 12% in these subjects. In addition, insulin and Homa IR had a positive correlation with increasing liver fibrosis.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90003827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Susilawati, Winda Rahayuningtyas, T. Y. Pramana
Background: A persistent infection of hepatitis B virus (HBV) can cause liver cirrhosis and hepatocarcinoma even though the virus itself is non-cytopathic and does not cause cell injury. It has been asserted that liver injury in chronic HBV infection is attributed to the host immune system responding to HBV infection. Cytokines have a critical role in mediating immune responses to viral infection. This study aimed to determine the correlation between the levels of serum IFN-γ, IL-2, IL-17, and TNF- α with the progress of chronic HBV infection that was determined through provisional diagnosis, patient’s age, and the levels of serum transaminases.Method: Blood samples were collected from patients with chronic hepatitis B and the levels of serum IFN-γ, IL-2, IL-17, and TNF-α were measured by using ELISA. The correlation between each cytokine levels and the provisional diagnosis, patient’s age, and serum transaminases were analyzed by using the Spearman correlation test with a p value of 0.05 is considered as statistically significant.Results: A total of 47 samples were collected from patients with chronic hepatitis B (n=38), chronic hepatitis B with liver cirrhosis (n = 6), and chronic hepatitis B with hepatocellular carcinoma (nc = 3). A significant correlation was found between the levels of serum IFN-γ and aspartate aminotransferase (AST) (p = 0.04).Conclusion: The increase of serum IFN-γ and AST levels may highlight the importance of these particular cytokine and liver transaminase in the immune response to chronic HBV infection since IFN-γ is capable to induce apoptotic cell death which promotes AST release and facilitates liver injury.
{"title":"The Potential of Serum IFN-γ for Determining the Progression of Chronic Hepatitis B","authors":"T. Susilawati, Winda Rahayuningtyas, T. Y. Pramana","doi":"10.24871/2232021210-216","DOIUrl":"https://doi.org/10.24871/2232021210-216","url":null,"abstract":"Background: A persistent infection of hepatitis B virus (HBV) can cause liver cirrhosis and hepatocarcinoma even though the virus itself is non-cytopathic and does not cause cell injury. It has been asserted that liver injury in chronic HBV infection is attributed to the host immune system responding to HBV infection. Cytokines have a critical role in mediating immune responses to viral infection. This study aimed to determine the correlation between the levels of serum IFN-γ, IL-2, IL-17, and TNF- α with the progress of chronic HBV infection that was determined through provisional diagnosis, patient’s age, and the levels of serum transaminases.Method: Blood samples were collected from patients with chronic hepatitis B and the levels of serum IFN-γ, IL-2, IL-17, and TNF-α were measured by using ELISA. The correlation between each cytokine levels and the provisional diagnosis, patient’s age, and serum transaminases were analyzed by using the Spearman correlation test with a p value of 0.05 is considered as statistically significant.Results: A total of 47 samples were collected from patients with chronic hepatitis B (n=38), chronic hepatitis B with liver cirrhosis (n = 6), and chronic hepatitis B with hepatocellular carcinoma (nc = 3). A significant correlation was found between the levels of serum IFN-γ and aspartate aminotransferase (AST) (p = 0.04).Conclusion: The increase of serum IFN-γ and AST levels may highlight the importance of these particular cytokine and liver transaminase in the immune response to chronic HBV infection since IFN-γ is capable to induce apoptotic cell death which promotes AST release and facilitates liver injury.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82628212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Movement restrictions during the coronavirus disease 2019 (COVID-19) pandemic have inflicted stress and affected drinking behavior. However, limited information is available on the changes in alcohol use among the Japanese population.Method: This retrospective study included 371 subjects aged 20–74 years who underwent medical checkups at Fuyoukai Murakami Hospital before (April 1, 2019 to December 31, 2019) and during the COVID-19 pandemic (April 1, 2020 to May 31, 2020). All data were extracted from medical records. Changes in alcohol consumption and severity were also investigated. A logistic regression model was used to identify the risk factors associated with increased drinking, and seven variables were sequentially introduced into the model—age (≤ 49 years), male sex, prior instructions for alcohol restriction, medication for lifestyle-related diseases (e.g., hypertension, dyslipidemia, type 2 diabetes mellitus, and hyperuricemia), depression or insomnia, essential workers, and smoking.Results: The median age was 46 years, and 81.7% subjects were men. In total, 25.1% subjects increased their alcohol intake, and 24.5% subjects reduced their alcohol intake. The rates of excessive alcohol consumption (≥ 60 g ethanol per day) were 15.9% and 16.7% in the pre-COVID-19 period and during the COVID-19 pandemic, respectively. Multivariate analysis identified only age ≤ 49 years as a risk factor for increased drinking (adjusted odds ratio, 2.20; 95% confidence interval, 1.22–3.99; p = 0.009).Conclusion: Approximately one-fourth of the subjects reported increased drinking, although the overall severity remained stable. The importance of alcohol reduction, particularly among young people, should be emphasized.
{"title":"Changes in Alcohol Consumption Among a Population Who Underwent Medical Checkups During the First Wave of the Coronavirus Disease 2019 Pandemic in Japan: A Single-Center Retrospective Study","authors":"Y. Kajihara","doi":"10.24871/2232021169-173","DOIUrl":"https://doi.org/10.24871/2232021169-173","url":null,"abstract":"Background: Movement restrictions during the coronavirus disease 2019 (COVID-19) pandemic have inflicted stress and affected drinking behavior. However, limited information is available on the changes in alcohol use among the Japanese population.Method: This retrospective study included 371 subjects aged 20–74 years who underwent medical checkups at Fuyoukai Murakami Hospital before (April 1, 2019 to December 31, 2019) and during the COVID-19 pandemic (April 1, 2020 to May 31, 2020). All data were extracted from medical records. Changes in alcohol consumption and severity were also investigated. A logistic regression model was used to identify the risk factors associated with increased drinking, and seven variables were sequentially introduced into the model—age (≤ 49 years), male sex, prior instructions for alcohol restriction, medication for lifestyle-related diseases (e.g., hypertension, dyslipidemia, type 2 diabetes mellitus, and hyperuricemia), depression or insomnia, essential workers, and smoking.Results: The median age was 46 years, and 81.7% subjects were men. In total, 25.1% subjects increased their alcohol intake, and 24.5% subjects reduced their alcohol intake. The rates of excessive alcohol consumption (≥ 60 g ethanol per day) were 15.9% and 16.7% in the pre-COVID-19 period and during the COVID-19 pandemic, respectively. Multivariate analysis identified only age ≤ 49 years as a risk factor for increased drinking (adjusted odds ratio, 2.20; 95% confidence interval, 1.22–3.99; p = 0.009).Conclusion: Approximately one-fourth of the subjects reported increased drinking, although the overall severity remained stable. The importance of alcohol reduction, particularly among young people, should be emphasized.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78385269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Liver Fibrosis and Steatosis in Human Immunodeficiency Virus (HIV) Infected Patients","authors":"K. Kalista","doi":"10.24871/2232021167-168","DOIUrl":"https://doi.org/10.24871/2232021167-168","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81505646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Critically ill patients are at risk for stress ulcers in the upper digestive tract. Various risk factors have been associated with this condition. Patients who are critically ill are at risk of bleeding due to stress related mucosal disease (SRMD). Upper gastrointestinal tract problems usually occur as a result of severe physiological stress. Patients may develop gastric erosion and develop stress ulcers with severe gastrointestinal bleeding which can be fatal. Routine pharmacological use of stress ulcer prophylaxis (SUP) does not reduce overall mortality in intensive care patients. This increases the risk of infectious complications, particularly nosocomial pneumonia and Clostridium difficile-associated diarrhea. Early enteral nutrition has been shown to be effective in preventing stress ulceration of the upper gastrointestinal tract in critically ill patients. Routine use of stress ulcer prophylaxis in all critically ill patients may be dangerous and does not appear to be cost-effective. SUP administration must follow an algorithm that clearly balances risks and benefits.
{"title":"Upper Gastrointestinal Bleeding in Critically Ill Patient: Literature Review","authors":"William Faisal, Luciana Rotty","doi":"10.24871/2232021226-233","DOIUrl":"https://doi.org/10.24871/2232021226-233","url":null,"abstract":"Critically ill patients are at risk for stress ulcers in the upper digestive tract. Various risk factors have been associated with this condition. Patients who are critically ill are at risk of bleeding due to stress related mucosal disease (SRMD). Upper gastrointestinal tract problems usually occur as a result of severe physiological stress. Patients may develop gastric erosion and develop stress ulcers with severe gastrointestinal bleeding which can be fatal. Routine pharmacological use of stress ulcer prophylaxis (SUP) does not reduce overall mortality in intensive care patients. This increases the risk of infectious complications, particularly nosocomial pneumonia and Clostridium difficile-associated diarrhea. Early enteral nutrition has been shown to be effective in preventing stress ulceration of the upper gastrointestinal tract in critically ill patients. Routine use of stress ulcer prophylaxis in all critically ill patients may be dangerous and does not appear to be cost-effective. SUP administration must follow an algorithm that clearly balances risks and benefits.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88596833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. N. Esterini, Kirsten Putriani Hartman, J. A. Trixie, Yessi Setianegari, Kurniyanto Kurniyanto
Background: Acute pancreatitis (AP) is an inflammation of the pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit of prophylaxis antibiotics administration to prevent the complication.Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021. Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Risk ratio (RR) was calculated with 95% confidence interval (CI). P 0.05 was considered significant.Results: Twenty trials with a total of 1.287 patients of AP were analysed; 646 patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics were found to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62–0.95; p 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03; p 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality.
{"title":"The Use of Prophylaxis Antibiotics to Prevent Acute Pancreatitis Complications: Meta-Analysis of Clinical Trials","authors":"D. N. Esterini, Kirsten Putriani Hartman, J. A. Trixie, Yessi Setianegari, Kurniyanto Kurniyanto","doi":"10.24871/2232021196-202","DOIUrl":"https://doi.org/10.24871/2232021196-202","url":null,"abstract":"Background: Acute pancreatitis (AP) is an inflammation of the pancreas, a serious emergency with no definitive treatment. It may progress to infected necrosis, non-pancreatitis infection, also death that may occur within the first 1 to 2 weeks. The use of prophylactic antibiotics in AP to prevent complications remains a controversy. The objective of this meta-analysis is to assess the benefit of prophylaxis antibiotics administration to prevent the complication.Method: Trials were identified by searching the medical database. Literature range is within the year 1975 to 2021. Review Manager 5.4.1 was used to analyse data extraction and risk of bias of included studies were elaborated. Risk ratio (RR) was calculated with 95% confidence interval (CI). P 0.05 was considered significant.Results: Twenty trials with a total of 1.287 patients of AP were analysed; 646 patients treated with antibiotic prophylaxis and 641 patients treated with placebo. Prophylaxis antibiotics were found to have significant difference between the two groups. The administration of prophylaxis antibiotics lower the risk of non-pancreatic infections (RR = 0.77; 95% CI: 0.62–0.95; p 0.05) and infected pancreatic necrosis (RR = 0.74; 95% CI: 0.58-0.94; p 0.05). Meanwhile, prophylaxis antibiotics were found to be insignificant to lower the risk of mortality (RR = 0.75; 95% CI: 0.54-1.03; p 0.05). Conclusion: Prophylaxis antibiotics lower the risk of non-pancreatic infections and infected pancreatic necrosis, but did not lower the risk of mortality.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85224731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Role of Argon Plasma Coagulation in Radiation Proctitis: Obtaining Real Clinical Data","authors":"H. Maulahela","doi":"10.24871/222202193-94","DOIUrl":"https://doi.org/10.24871/222202193-94","url":null,"abstract":"<jats:p>-</jats:p>","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74328443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lianda Siregar, I. Loho, A. Waspodo, Rahmanandhika Swadari, Benedicta Audrey Maharani
Background: This study aimed to evaluate the endoscopic features and clinical outcome of patients with chronic radiation proctitis (CRP) at one year after argon plasma coagulation (APC) treatment. Method: Between March 2016 and September 2019, a total of 48 female patients with CRP were treated with APC and their medical records were retrospectively reviewed. APC treatment was done every 3 to 54 weeks, with a median of 8 weeks. Number of APC was decided by the treating physician according to the severity of illness. Endoscopic and clinical features at one year after the final APC were recorded as the effectiveness of APC.Results: Of 48 patients, 26 patients were included in this study. Number of APC sessions varied between 1 to 5 sessions of APC for each patient. Of 26 patients, 22 patients achieved clinical improvement and four patients did not achieve clinical improvement at one year after the last APC session. Of the four patients who failed to achieve clinical improvement, two patients underwent surgery, one patient had occasional mild rectal bleeding, and one patient required regular transfusion. Of 22 patients with clinical improvement at one-year after the last APC, improvement of endoscopic features was found in 20 patients. Of four patients who did not achieve endoscopic improvement, diagnostic colonoscopy showed telangiectasis of more than 50% of rectal surface in 1 patient, presence of blood in 2 patients, and presence of ulceration of 1 cm in 1 patient.Conclusion: APC is an effective treatment option for CRP.
{"title":"Argon plasma coagulation for the treatment of chronic radiation proctitis – real-world data from Indonesian National Cancer Center","authors":"Lianda Siregar, I. Loho, A. Waspodo, Rahmanandhika Swadari, Benedicta Audrey Maharani","doi":"10.24871/2222021106-109","DOIUrl":"https://doi.org/10.24871/2222021106-109","url":null,"abstract":"Background: This study aimed to evaluate the endoscopic features and clinical outcome of patients with chronic radiation proctitis (CRP) at one year after argon plasma coagulation (APC) treatment. Method: Between March 2016 and September 2019, a total of 48 female patients with CRP were treated with APC and their medical records were retrospectively reviewed. APC treatment was done every 3 to 54 weeks, with a median of 8 weeks. Number of APC was decided by the treating physician according to the severity of illness. Endoscopic and clinical features at one year after the final APC were recorded as the effectiveness of APC.Results: Of 48 patients, 26 patients were included in this study. Number of APC sessions varied between 1 to 5 sessions of APC for each patient. Of 26 patients, 22 patients achieved clinical improvement and four patients did not achieve clinical improvement at one year after the last APC session. Of the four patients who failed to achieve clinical improvement, two patients underwent surgery, one patient had occasional mild rectal bleeding, and one patient required regular transfusion. Of 22 patients with clinical improvement at one-year after the last APC, improvement of endoscopic features was found in 20 patients. Of four patients who did not achieve endoscopic improvement, diagnostic colonoscopy showed telangiectasis of more than 50% of rectal surface in 1 patient, presence of blood in 2 patients, and presence of ulceration of 1 cm in 1 patient.Conclusion: APC is an effective treatment option for CRP.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90120118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.
{"title":"The Differences of T-Regulator Cells, Alanine Aminotransferase Serum and Aspartate Aminotranspherase Between Hepatitis B Chronic Patients with and without Liver Fibrosis","authors":"Yostila Derosa, Nasrul Zubir, Raveinal Arnelis","doi":"10.24871/2222021116-123","DOIUrl":"https://doi.org/10.24871/2222021116-123","url":null,"abstract":"Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90564585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Simadibrata, F. Witjaksono, Y. Wulandari, Raja Mangatur Haloho, R. R. Pribadi, M. Abdullah, Aditya Rachman, A. Wijaya, Batara Bisuk, D. M. Simadibrata, Rizka Mutiara, Kaka Renaldi
Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.
{"title":"High-Protein Dietary Supplementation and Nutritional Status Improvement of Malnourished Patients in Hospital Care","authors":"M. Simadibrata, F. Witjaksono, Y. Wulandari, Raja Mangatur Haloho, R. R. Pribadi, M. Abdullah, Aditya Rachman, A. Wijaya, Batara Bisuk, D. M. Simadibrata, Rizka Mutiara, Kaka Renaldi","doi":"10.24871/2222021147-153","DOIUrl":"https://doi.org/10.24871/2222021147-153","url":null,"abstract":"Hospital malnutrition is common in Indonesia and other developing countries. In Asia, the prevalence of hospital malnutrition ranges between 27-39%. The causes of malnutrition in hospital care include insufficient food intake and increased catabolic processes due to underlying causes such as metabolic disease, infection, and malignancy. Several studies have demonstrated that malnutrition increases the morbidity and mortality of hospitalized patients, prolongs hospital stay, and delays recovery. Therefore, healthcare providers must recognize malnutrition early by conducting nutritional screening and assessment to prevent worsening of malnutrition and administer the optimal nutritional therapy to patients. Apart from giving a standard diet, high-protein food supplementation in liquid form remains a suitable alternative for patients, especially since it is easily digestible. A high protein diet is associated with a better mortality rate, better weight gain, and improved SGA score in patients.","PeriodicalId":22564,"journal":{"name":"The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87234612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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