Pub Date : 2022-05-18DOI: 10.18051/UnivMed.2022.v41.101-103
L. D. Delfino
The topic of sedentary behavior has permeated the scientific community for some time now; however, the COVID-19 pandemic resulted in increased sedentary time irrespective of lockdown conditions or population. (1) Therefore, it is opportune to bring some reflections on the concept of sedentary behavior, taking into account its literal, historical and teleological aspects. The acts of conceptualizing, which consists of defining something, and that of classifying, which is nothing more than separating and organizing by classes using some methodology or system, are human actions carried out to select significant data on a given theme. In addition to having a relevant didactic character, concepts and classifications deserve special attention in their elaboration, as they will compose a whole systematized set. According to Young et al., the daily estimate of time spent by adults in different contexts of energy expenditure is: 8.3 hours in sleeping; 7.7 hours in sedentary behavior; 7.8 hours in light activities and 0.2 hours in moderate or vigorous physical activities. The importance of understanding the meanings of the concepts of sedentary behavior and light physical activity is evident, since 98% of an adult’s daily waking time is spent on these activities. Sedentary behaviors are typically defined by physical activity with low energy expenditure, with a metabolic rate generally less than 1.5 metabolic equivalents of tasks (METs), and in a sitting or reclining posture. The Sedentary Behavior Research Network (SBRN) (4) suggested that journal editors formally define sedentary behavior as any waking behavior characterized by an energy expenditure of less than 1.5 MET’s in a sitting, reclining or lying position. Complementing the classification, there is physical activity of light intensity defined as any activity with energy expenditure between 1.5 and 3.0 METs; moderate intensity physical activity, any activity with a MET value between 3.0 and 5.9; and that of vigorous intensity with values 6 MET’s. These consensus definitions, as presented here, were derived to assist with the standardization, or at least harmonization, of measurement procedures, data processing, and data analytics. This editorial aims to reflect the need to understand sedentary time and behavior, and their relationship(s) with health outcomes, and may be more important than ever with the emergence of the novel Coronavirus 2019 disease (COVID-19). Coronavirus disease (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally been restricted to the factors that encourage regular and frequent physical activity (PA), namely opportunity, capability and motivation. There is a universal need to address the low levels of physical activities postCOVID-19. The consequences of decreased physical activity across all intensities has powerful, potentially recoverable impacts. It is evident that sedentary behavior is present day after day in the contemporary l
{"title":"Reflections on the concept of sedentary behavior during the COVID-19 pandemic","authors":"L. D. Delfino","doi":"10.18051/UnivMed.2022.v41.101-103","DOIUrl":"https://doi.org/10.18051/UnivMed.2022.v41.101-103","url":null,"abstract":"The topic of sedentary behavior has permeated the scientific community for some time now; however, the COVID-19 pandemic resulted in increased sedentary time irrespective of lockdown conditions or population. (1) Therefore, it is opportune to bring some reflections on the concept of sedentary behavior, taking into account its literal, historical and teleological aspects. The acts of conceptualizing, which consists of defining something, and that of classifying, which is nothing more than separating and organizing by classes using some methodology or system, are human actions carried out to select significant data on a given theme. In addition to having a relevant didactic character, concepts and classifications deserve special attention in their elaboration, as they will compose a whole systematized set. According to Young et al., the daily estimate of time spent by adults in different contexts of energy expenditure is: 8.3 hours in sleeping; 7.7 hours in sedentary behavior; 7.8 hours in light activities and 0.2 hours in moderate or vigorous physical activities. The importance of understanding the meanings of the concepts of sedentary behavior and light physical activity is evident, since 98% of an adult’s daily waking time is spent on these activities. Sedentary behaviors are typically defined by physical activity with low energy expenditure, with a metabolic rate generally less than 1.5 metabolic equivalents of tasks (METs), and in a sitting or reclining posture. The Sedentary Behavior Research Network (SBRN) (4) suggested that journal editors formally define sedentary behavior as any waking behavior characterized by an energy expenditure of less than 1.5 MET’s in a sitting, reclining or lying position. Complementing the classification, there is physical activity of light intensity defined as any activity with energy expenditure between 1.5 and 3.0 METs; moderate intensity physical activity, any activity with a MET value between 3.0 and 5.9; and that of vigorous intensity with values 6 MET’s. These consensus definitions, as presented here, were derived to assist with the standardization, or at least harmonization, of measurement procedures, data processing, and data analytics. This editorial aims to reflect the need to understand sedentary time and behavior, and their relationship(s) with health outcomes, and may be more important than ever with the emergence of the novel Coronavirus 2019 disease (COVID-19). Coronavirus disease (COVID-19) has severely impacted lifestyles worldwide. Responses to COVID-19 have intentionally been restricted to the factors that encourage regular and frequent physical activity (PA), namely opportunity, capability and motivation. There is a universal need to address the low levels of physical activities postCOVID-19. The consequences of decreased physical activity across all intensities has powerful, potentially recoverable impacts. It is evident that sedentary behavior is present day after day in the contemporary l","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":"1 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67589071","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}
Pub Date : 2022-05-18DOI: 10.18051/univmed.2022.v41.184-193
N. Duman, Fatma Yildirim
It is estimated that individuals with lesbian, gay, bisexual, transsexual, intersexual, and other sexual tendencies make up approximately 3-12% of the world population. The proportion of lesbian and bisexual women (LBW) varies between 1-20% of all women. Studies on the subject show that risk factors for gynecological malignancies and breast cancer are more common in lesbian and bisexual women than in heterosexual women. In LBW, it is reported that obesity or high body mass index, inactivity, smoking, alcohol and substance abuse, stress, anxiety disorders, depression, and sexually transmitted diseases are more common than in heterosexual women. In addition, sexually transmitted infections (STIs) such as genital herpes, human papilloma virus (HPV) infections, bacterial vaginosis, trichomoniasis, hepatitis A, syphilis, and HIV disease, that can be transmitted by homosexual relationships, are also common in these women. It is known that genital herpes and HPV are important risk factors especially in the development of cervical cancer. In addition, breastfeeding rates and lactation periods are known to have protective effects against gynecological malignancies and lactation periods are known to have protective effects against breast cancer. This review aims to discuss gynecological malignancy and breast cancer incidence in LBW and the risk factors for these cancers according to current literature. In this context, a total of 340 articles were accessed by entering keywords related to the subject in the PubMed database and analyzed according to their titles and abstracts, while duplicates were removed. However, reviews, qualitative studies, and summaries were not included in the study. A total of 23 research articles were examined, published between 2012-2022, whose full text can be accessed through the PubMed database, investigating gynecological cancer and breast cancer risk factors and screenings in LBW.
{"title":"Gynecological and breast cancer risk factors and screenings in lesbian and bisexual women","authors":"N. Duman, Fatma Yildirim","doi":"10.18051/univmed.2022.v41.184-193","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.184-193","url":null,"abstract":"It is estimated that individuals with lesbian, gay, bisexual, transsexual, intersexual, and other sexual tendencies make up approximately 3-12% of the world population. The proportion of lesbian and bisexual women (LBW) varies between 1-20% of all women. Studies on the subject show that risk factors for gynecological malignancies and breast cancer are more common in lesbian and bisexual women than in heterosexual women. In LBW, it is reported that obesity or high body mass index, inactivity, smoking, alcohol and substance abuse, stress, anxiety disorders, depression, and sexually transmitted diseases are more common than in heterosexual women. In addition, sexually transmitted infections (STIs) such as genital herpes, human papilloma virus (HPV) infections, bacterial vaginosis, trichomoniasis, hepatitis A, syphilis, and HIV disease, that can be transmitted by homosexual relationships, are also common in these women. It is known that genital herpes and HPV are important risk factors especially in the development of cervical cancer. In addition, breastfeeding rates and lactation periods are known to have protective effects against gynecological malignancies and lactation periods are known to have protective effects against breast cancer. This review aims to discuss gynecological malignancy and breast cancer incidence in LBW and the risk factors for these cancers according to current literature. In this context, a total of 340 articles were accessed by entering keywords related to the subject in the PubMed database and analyzed according to their titles and abstracts, while duplicates were removed. However, reviews, qualitative studies, and summaries were not included in the study. A total of 23 research articles were examined, published between 2012-2022, whose full text can be accessed through the PubMed database, investigating gynecological cancer and breast cancer risk factors and screenings in LBW.\u0000 ","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48854913","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}
Pub Date : 2022-05-18DOI: 10.18051/univmed.2022.v41.114-120
A. Afifah, Fajar Wahyu Pribadi, Aulia Salsabiela, Dimo Hari Anggara, Zahra Muthmainnah Komara, Robby Al Fauzy
BackgroundChronic kidney disease (CKD) is a serious health problem in which oxidative stress plays an important role. Oxidative stress is an imbalance of reactive oxygen species (ROS) production and antioxidant defense, where antioxidants have the potential to inhibit CKD progression. Celery contains several substances that have an antioxidant effect. This study aimed to evaluate the administration of celery ethanol extract in the prevention of the progressive damage in CKD caused by oxidative stress in male rats. MethodsTwenty male Sprague-Dawley rats were randomly divided into 5 groups: sham operation (SO, n=4), subtotal nephrectomy (SN, n=4), SN+celery ethanol extract 200 mg/kg BW (SN+S1, n=4), SN+celery ethanol extract 250 mg/kg BW (SN+S2, n=4), SN+celery ethanol extract 300 mg/kg BW (SN+S3, n=4). The celery ethanol extract was given for 14 days before induction of CKD and 21 days after induction of the CKD rat model. Serum creatinine, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were examined in this study. Data were analyzed by One way ANOVA followed by LSD test for creatinine, MDA, SOD, and Kruskal Wallis test for GSH. ResultsThere were significant between-group differences in serum creatinine, SOD, and MDA (p<0.05), but not in GSH (p>0.05). The administration of celery ethanol extract at 250 mg/kg BW was the most effective in preventing an increase in MDA and a decrease in SOD and GSH. ConclusionCelery ethanol extract has the potential to prevent oxidative stress in the CKD rat model.
{"title":"The protective effect of celery ethanol extract on oxidative stress in chronic kidney disease rat model","authors":"A. Afifah, Fajar Wahyu Pribadi, Aulia Salsabiela, Dimo Hari Anggara, Zahra Muthmainnah Komara, Robby Al Fauzy","doi":"10.18051/univmed.2022.v41.114-120","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.114-120","url":null,"abstract":"BackgroundChronic kidney disease (CKD) is a serious health problem in which oxidative stress plays an important role. Oxidative stress is an imbalance of reactive oxygen species (ROS) production and antioxidant defense, where antioxidants have the potential to inhibit CKD progression. Celery contains several substances that have an antioxidant effect. This study aimed to evaluate the administration of celery ethanol extract in the prevention of the progressive damage in CKD caused by oxidative stress in male rats.\u0000MethodsTwenty male Sprague-Dawley rats were randomly divided into 5 groups: sham operation (SO, n=4), subtotal nephrectomy (SN, n=4), SN+celery ethanol extract 200 mg/kg BW (SN+S1, n=4), SN+celery ethanol extract 250 mg/kg BW (SN+S2, n=4), SN+celery ethanol extract 300 mg/kg BW (SN+S3, n=4). The celery ethanol extract was given for 14 days before induction of CKD and 21 days after induction of the CKD rat model. Serum creatinine, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GSH) were examined in this study. Data were analyzed by One way ANOVA followed by LSD test for creatinine, MDA, SOD, and Kruskal Wallis test for GSH.\u0000ResultsThere were significant between-group differences in serum creatinine, SOD, and MDA (p<0.05), but not in GSH (p>0.05). The administration of celery ethanol extract at 250 mg/kg BW was the most effective in preventing an increase in MDA and a decrease in SOD and GSH.\u0000ConclusionCelery ethanol extract has the potential to prevent oxidative stress in the CKD rat model.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46473892","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}
Pub Date : 2022-05-05DOI: 10.18051/univmed.2022.v41.104-113
Ana Satria, Yeni Yeni, Hairil Akbar, Henny Kaseger, Linda Suwarni, Abubakar Yakubu Abbani, Maretalinia Maretalinia
BackgroundThe increasing population of older people can be a positive impact if they could be productive, or it could be negative as a burden if they depend on others. Elderly with physical disabilities can be influenced by various factors, including depression, which can be caused by functional changes in the body due to aging, loss of work, or even the loss of a loved one. This study aimed to determine the relationship between depression and physical disabilities among the elderly in Indonesia who were stratified by gender. MethodsA cross-sectional study using a national survey dataset namely Basic Health Survey and Socio-Economic Survey for 2018 involving 85,427 elderly. Depression and disability were assessed using Mini International Neuropsychiatric Interview and Barthel Index. Chi-Square test and multiple binary logistic regression were used to analyze the data. ResultsThe results revealed that 24.75% of elderly people experienced physical disabilities. The probability of males and females with depression having physical disabilities was respectively 2.95 (95% CI = 2.74-3.17) and 2.49 (95% CI = 2.36-2.64) times higher compared to those without depression. The interaction between depression and gender was statistically significant, in that females with depression had an 11% probability of having physical disability. ConclusionThis study reaffirmed that disability is a risk factor for depression in the elderly and female gender is the effect modifier rather than the risk factor. The male depression group showed more physical disability symptoms than the female depression group. There is collaboration from various sectors to prevent depression and physical disabilities.
老年人口的不断增加，如果他们能够有生产力，就会产生积极的影响;如果他们依赖他人，就会成为一种消极的负担。身体残疾的老年人可能受到各种因素的影响，包括抑郁症，抑郁症可能是由于衰老、失去工作甚至失去亲人而导致的身体功能变化。本研究旨在确定印尼按性别分层的老年人抑郁与身体残疾之间的关系。方法利用2018年全国基本健康调查和社会经济调查数据集，对85,427名老年人进行横断面研究。采用Mini国际神经精神病学访谈和Barthel指数对抑郁和残疾进行评估。采用卡方检验和多元二元logistic回归对数据进行分析。结果24.75%的老年人存在身体残疾。男性和女性抑郁症患者发生身体残疾的概率分别是无抑郁症患者的2.95倍(95% CI = 2.74-3.17)和2.49倍(95% CI = 2.36-2.64)。抑郁症和性别之间的相互作用在统计上是显著的，因为患有抑郁症的女性有11%的可能性患有身体残疾。结论残疾是老年人抑郁的危险因素，女性是影响因素而非危险因素。男性抑郁组比女性抑郁组表现出更多的身体残疾症状。各部门合作预防抑郁症和身体残疾。
{"title":"Relationship between depression and physical disability by gender among elderly in Indonesia","authors":"Ana Satria, Yeni Yeni, Hairil Akbar, Henny Kaseger, Linda Suwarni, Abubakar Yakubu Abbani, Maretalinia Maretalinia","doi":"10.18051/univmed.2022.v41.104-113","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.104-113","url":null,"abstract":"BackgroundThe increasing population of older people can be a positive impact if they could be productive, or it could be negative as a burden if they depend on others. Elderly with physical disabilities can be influenced by various factors, including depression, which can be caused by functional changes in the body due to aging, loss of work, or even the loss of a loved one. This study aimed to determine the relationship between depression and physical disabilities among the elderly in Indonesia who were stratified by gender.\u0000MethodsA cross-sectional study using a national survey dataset namely Basic Health Survey and Socio-Economic Survey for 2018 involving 85,427 elderly. Depression and disability were assessed using Mini International Neuropsychiatric Interview and Barthel Index. Chi-Square test and multiple binary logistic regression were used to analyze the data.\u0000ResultsThe results revealed that 24.75% of elderly people experienced physical disabilities. The probability of males and females with depression having physical disabilities was respectively 2.95 (95% CI = 2.74-3.17) and 2.49 (95% CI = 2.36-2.64) times higher compared to those without depression. The interaction between depression and gender was statistically significant, in that females with depression had an 11% probability of having physical disability.\u0000ConclusionThis study reaffirmed that disability is a risk factor for depression in the elderly and female gender is the effect modifier rather than the risk factor. The male depression group showed more physical disability symptoms than the female depression group. There is collaboration from various sectors to prevent depression and physical disabilities.\u0000 ","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42787801","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}
Pub Date : 2022-04-25DOI: 10.18051/univmed.2022.v41.176-183
Cylla Revata, Mulia Rahmansyah
IntroductionTraumatic diaphragmatic hernia (TDH) is uncommon, being encountered in around 0.8%-8% of patients with blunt abdominal trauma. Severe comorbidities such as fractures and thoraco-abdominal or head injuries that accompany TDH, are responsible for poor prognosis and often mask diaphragmatic injury itself. Objective of this case report was to highlight rare blunt TDH case to avoid missed diagnosis leading to complications. Case descriptionSixty seven-year old man presenting with right chest pain without difficulty of breathing after falling from stairs 1 hour before hospital admission. On clinical examination, vitals were stable, but with decreased breath sounds on right lower side of chest. Patient had history of trauma from being crushed by elevator 40 years ago without any proven diaphragmatic injury. Initial erect chest X-ray findings were inhomogeneous opacity shadow on lower right hemithorax suspected to be diaphragmatic hernia and 7th right rib fracture with pleural effusion. Thorax CT scan showed herniated right lobe of liver, gall bladder, and mesenteric fat on right hemithorax causing displacement of mediastinal structures. Patient was diagnosed with delayed TDH and hemothorax caused by newly fractured rib. Patient was referred to a better-equipped facility due to the limited surgical facilities in referring hospital. ConclusionDelayed TDHs are not common, but can lead to serious consequences. Blunt TDH occurs more often on left than on right side, in ratio of approximately 3:1. Traumatic diaphragmatic hernia is sometimes diagnosed many years after traumatic event due to latent phase of disease possibly ranging from days to years.
{"title":"Delayed asymptomatic blunt traumatic diaphragmatic hernia: an unusual case report","authors":"Cylla Revata, Mulia Rahmansyah","doi":"10.18051/univmed.2022.v41.176-183","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.176-183","url":null,"abstract":"IntroductionTraumatic diaphragmatic hernia (TDH) is uncommon, being encountered in around 0.8%-8% of patients with blunt abdominal trauma. Severe comorbidities such as fractures and thoraco-abdominal or head injuries that accompany TDH, are responsible for poor prognosis and often mask diaphragmatic injury itself. Objective of this case report was to highlight rare blunt TDH case to avoid missed diagnosis leading to complications.\u0000Case descriptionSixty seven-year old man presenting with right chest pain without difficulty of breathing after falling from stairs 1 hour before hospital admission. On clinical examination, vitals were stable, but with decreased breath sounds on right lower side of chest. Patient had history of trauma from being crushed by elevator 40 years ago without any proven diaphragmatic injury. Initial erect chest X-ray findings were inhomogeneous opacity shadow on lower right hemithorax suspected to be diaphragmatic hernia and 7th right rib fracture with pleural effusion. Thorax CT scan showed herniated right lobe of liver, gall bladder, and mesenteric fat on right hemithorax causing displacement of mediastinal structures. Patient was diagnosed with delayed TDH and hemothorax caused by newly fractured rib. Patient was referred to a better-equipped facility due to the limited surgical facilities in referring hospital.\u0000ConclusionDelayed TDHs are not common, but can lead to serious consequences. Blunt TDH occurs more often on left than on right side, in ratio of approximately 3:1. Traumatic diaphragmatic hernia is sometimes diagnosed many years after traumatic event due to latent phase of disease possibly ranging from days to years.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49495958","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}
Pub Date : 2022-04-09DOI: 10.18051/univmed.2022.v41.71-78
Muhammad Achdiar Raizandha, F. Hidayatullah, Y. Kloping, F. Rizaldi
Background Fournier gangrene (FG) is a life-threatening disease, commonly found in diabetic and immunocompromised patients. Recent studies suggested the use of new parameters apart from the commonly used Fournier gangrene severity index (FGSI), such as the neutrophil-lymphocyte ratio (NLR), the clinical use of which remains questionable. Therefore, we aimed to evaluate the role of the NLR and FGSI as a prognostic factor of mortality in patients with FG. MethodsThis is an analytical study with a retrospective approach involving 109 adult patients diagnosed with FG. Data were collected regarding medical history, symptoms, physical examination findings, and laboratory tests. The FGSI score and NLR were determined. Bivariate analysis was performed using chi-square test and independent t-test. Overall survival between groups was compared using Kaplan–Meier survival estimates and Cox regression test. ResultsOf the 109 patients, 90 survived (82.5%, group 1) and 19 died (17.43%, group 2). The cut-off point of NLR among the patients was 10.9, with a 73.7% sensitivity and 60% specificity. The area under curve value was 0.65 (95% CI; 0.524-0.754; p<0.05). The Kaplan Meier survival analysis showed that NLR was as an independent prognostic factor of mortality in FG patients (HR 5.177; 95% CI; 1.092-8.471; p<0.05), but Cox regression analysis showed that NLR and FGSI were not significant prognostic factors of mortality (p=0.09 and p=0.179; respectively). ConclusionThis study demonstrated that NLR and FGSI are not important as prognostic tools for FG mortality.
{"title":"Neutrophil-lymphocyte ratio and fournier gangrene severity index are not prognostic factors of mortality in fournier gangrene patients","authors":"Muhammad Achdiar Raizandha, F. Hidayatullah, Y. Kloping, F. Rizaldi","doi":"10.18051/univmed.2022.v41.71-78","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.71-78","url":null,"abstract":"Background Fournier gangrene (FG) is a life-threatening disease, commonly found in diabetic and immunocompromised patients. Recent studies suggested the use of new parameters apart from the commonly used Fournier gangrene severity index (FGSI), such as the neutrophil-lymphocyte ratio (NLR), the clinical use of which remains questionable. Therefore, we aimed to evaluate the role of the NLR and FGSI as a prognostic factor of mortality in patients with FG.\u0000MethodsThis is an analytical study with a retrospective approach involving 109 adult patients diagnosed with FG. Data were collected regarding medical history, symptoms, physical examination findings, and laboratory tests. The FGSI score and NLR were determined. Bivariate analysis was performed using chi-square test and independent t-test. Overall survival between groups was compared using Kaplan–Meier survival estimates and Cox regression test.\u0000ResultsOf the 109 patients, 90 survived (82.5%, group 1) and 19 died (17.43%, group 2). The cut-off point of NLR among the patients was 10.9, with a 73.7% sensitivity and 60% specificity. The area under curve value was 0.65 (95% CI; 0.524-0.754; p<0.05). The Kaplan Meier survival analysis showed that NLR was as an independent prognostic factor of mortality in FG patients (HR 5.177; 95% CI; 1.092-8.471; p<0.05), but Cox regression analysis showed that NLR and FGSI were not significant prognostic factors of mortality (p=0.09 and p=0.179; respectively).\u0000ConclusionThis study demonstrated that NLR and FGSI are not important as prognostic tools for FG mortality.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44870632","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}
Pub Date : 2022-04-07DOI: 10.18051/univmed.2022.v41.90-99
Bagus Hermansyah, D. Agustina, S. Zulaikha, A. Habibi
Nearly 35 million cases and one million deaths over the nine months of the COVID-19 pandemic have been reported worldwide. Africa and some countries with endemic parasitic infections had a low incidence of COVID-19. By contrast, the United States and several European countries, having a non-endemicity of parasitic infections, recorded a high incidence of COVID-19. Some parasites have an immunomodulatory mechanism that can induce an immune tolerance state in the infected persons by balancing pro-inflammatory and anti-inflammatory responses. Emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Hence, the aim of this literature review is to show and identify that an increase in the number of regulatory immune cells due to the immunomodulatory role of a pre-existing parasitic infection could reduce the risk of COVID-19. This study explored the existing literature to determine the role of parasitic infections in modulating the immune response and possibly reduce the risk of COVID-19 infection in endemic countries. The mechanism of immunomodulation by parasites is the increased numbers of Treg cells, M2 macrophages, eosinophils, the Th2 cytokines IL-4 and IL-5, and the pro-inflammatory downregulation of IFN λ, TNF α, and IL-6, which play an essential role in inducing cytokine storms in COVID-19 infection. This condition will probably occur in an individual with parasitic infection in a community with limited facilities and infrastructure to treat parasitic infections, particularly in developing countries. To conclude, in endemic areas, the immunomodulatory effect of parasitic infection to reduce the risk of COVID-19 cases/deaths is a possibility if the host is immunocompetent. Herein, the current knowledge on the immunomodulatory role of COVID-19 and helminth co-infections will be discussed.
{"title":"Parasite immunomodulatory role in reducing the prevalence of COVID-19 in endemic regions","authors":"Bagus Hermansyah, D. Agustina, S. Zulaikha, A. Habibi","doi":"10.18051/univmed.2022.v41.90-99","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.90-99","url":null,"abstract":"Nearly 35 million cases and one million deaths over the nine months of the COVID-19 pandemic have been reported worldwide. Africa and some countries with endemic parasitic infections had a low incidence of COVID-19. By contrast, the United States and several European countries, having a non-endemicity of parasitic infections, recorded a high incidence of COVID-19. Some parasites have an immunomodulatory mechanism that can induce an immune tolerance state in the infected persons by balancing pro-inflammatory and anti-inflammatory responses. Emerging reports also stated that COVID-19 and helminth co-infections may have more hidden outcomes than predictable ones. Hence, the aim of this literature review is to show and identify that an increase in the number of regulatory immune cells due to the immunomodulatory role of a pre-existing parasitic infection could reduce the risk of COVID-19. This study explored the existing literature to determine the role of parasitic infections in modulating the immune response and possibly reduce the risk of COVID-19 infection in endemic countries. The mechanism of immunomodulation by parasites is the increased numbers of Treg cells, M2 macrophages, eosinophils, the Th2 cytokines IL-4 and IL-5, and the pro-inflammatory downregulation of IFN λ, TNF α, and IL-6, which play an essential role in inducing cytokine storms in COVID-19 infection. This condition will probably occur in an individual with parasitic infection in a community with limited facilities and infrastructure to treat parasitic infections, particularly in developing countries. To conclude, in endemic areas, the immunomodulatory effect of parasitic infection to reduce the risk of COVID-19 cases/deaths is a possibility if the host is immunocompetent. Herein, the current knowledge on the immunomodulatory role of COVID-19 and helminth co-infections will be discussed.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44482495","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}
Pub Date : 2022-03-30DOI: 10.18051/univmed.2022.v41.64-70
Yeva Rosana, Ida Effendi, Wresti Indriatmi, A. Yasmon
BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions. METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification. RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions. CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.
{"title":"Microscopic examination using negative staining for rapid diagnosis of syphilis","authors":"Yeva Rosana, Ida Effendi, Wresti Indriatmi, A. Yasmon","doi":"10.18051/univmed.2022.v41.64-70","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.64-70","url":null,"abstract":"BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions.\u0000METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification.\u0000RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions.\u0000CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41531780","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}
Pub Date : 2022-03-28DOI: 10.18051/univmed.2022.v41.56-63
Hamidreza Shahraki Mojahed, Somayeh Nakhaei
BackgroundDeath and the anxiety of it becomes more apparent when confronted with a chronic disease. The aim of this study was to determine the level of death anxiety among patients with depression and schizophrenia, and the relationship between severity of the symptoms and death anxiety in these patients. MethodsA cross-sectional study was conducted on 29 patients with a depressive disorder, 18 with schizophrenia spectrum disorder and 31 healthy subjects, through face-to-face interviews. The general severity of the psychiatric disorder was measured using the Clinical Global Impression Scale (CGI). The severity of depressive symptoms was measured using the Beck Depression Inventory (BDI). Psychosocial performance was measured using the personal and social performance scale (PSP). To evaluate death anxiety, the Bochum Questionnaire on attitude to death and death anxiety 2.0 (BOFRETTA 2.0) was used. One-way ANOVA and Pearson correlation tests were used to analyze the data. ResultsRegarding the BOFRETTA attitude scale, the schizophrenic patients (23.1±9.12) showed significantly higher scores than healthy subjects (18.4 ±4.56) and depressive patients (19.8 ± 5.20) (p<0.050). The healthy controls achieved the least scores of BOFRETTA anxiety scale followed by depressive (30.67±10.33) and schizophrenic patients (31.30±12.18). However, there were no significant between-group differences regarding this scale. We found significant correlations of all BOFRETTA dimensions (attitude, anxiety, sum score) with CGI, PSP and BDI. ConclusionThere was a significant relationship between the severity of symptoms and death anxiety in both depressed and schizophrenic patients. However, the latter showed a more negative attitude towards death.
{"title":"Death anxiety and its association with severity of mental illness in patients with depression and schizophrenia","authors":"Hamidreza Shahraki Mojahed, Somayeh Nakhaei","doi":"10.18051/univmed.2022.v41.56-63","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.56-63","url":null,"abstract":"BackgroundDeath and the anxiety of it becomes more apparent when confronted with a chronic disease. The aim of this study was to determine the level of death anxiety among patients with depression and schizophrenia, and the relationship between severity of the symptoms and death anxiety in these patients.\u0000MethodsA cross-sectional study was conducted on 29 patients with a depressive disorder, 18 with schizophrenia spectrum disorder and 31 healthy subjects, through face-to-face interviews. The general severity of the psychiatric disorder was measured using the Clinical Global Impression Scale (CGI). The severity of depressive symptoms was measured using the Beck Depression Inventory (BDI). Psychosocial performance was measured using the personal and social performance scale (PSP). To evaluate death anxiety, the Bochum Questionnaire on attitude to death and death anxiety 2.0 (BOFRETTA 2.0) was used. One-way ANOVA and Pearson correlation tests were used to analyze the data.\u0000ResultsRegarding the BOFRETTA attitude scale, the schizophrenic patients (23.1±9.12) showed significantly higher scores than healthy subjects (18.4 ±4.56) and depressive patients (19.8 ± 5.20) (p<0.050). The healthy controls achieved the least scores of BOFRETTA anxiety scale followed by depressive (30.67±10.33) and schizophrenic patients (31.30±12.18). However, there were no significant between-group differences regarding this scale. We found significant correlations of all BOFRETTA dimensions (attitude, anxiety, sum score) with CGI, PSP and BDI.\u0000ConclusionThere was a significant relationship between the severity of symptoms and death anxiety in both depressed and schizophrenic patients. However, the latter showed a more negative attitude towards death.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43099320","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}
Pub Date : 2022-03-22DOI: 10.18051/univmed.2022.v41.47-55
Y. Arliny, D. Yanifitri, Diennisa Mursalin
Background Diabetes mellitus (DM) is known to increase the risk of infection including tuberculosis (TB). Some studies also showed that 2-15% of latent TB infection (LTBI) will progress to active TB. This study aimed to obtain the prevalence of LTBI and to determine the risk factors of LTBI in patients with type 2 diabetes mellitus (T2DM). Methods This was a cross-sectional study on 242 adult T2DM patients. For LTBI screening we performed the interferon gamma release assay (IGRA) (Quantiferon TB Gold Plus test) and for confirmation of active TB (pulmonary TB) we performed GeneXpert MTB/Rif sputum examination and chest X-ray. Glycosylated hemoglobin (HbA1c) levels, smoking history and BCG scar were collected. Multivariate logistic regression was used to analyze the data. Results Positive IGRA results were found in 99 of 242 uncomplicated T2DM patients while LTBI was found in 82 patients (33.8%). There were significant differences between T2DM patients with latent TB and T2DM patients without infection in HbA1c and specific IFN-ã levels (TB1 minus nil and TB2 minus nil), i.e. 8.5% and 7.6%, 2.5 IU/mL and 0.06 IU/mL, and 2.6 IU/mL and 0.08 IU/mL, respectively. Multivariate analysis showed that the risk factors for LTBI in T2DM patients were smoking history, HbA1c >7%, and no BCG scar. Conclusions Because LTBI is prevalent in T2DM, it is important to screen for it in T2DM patients due to the risk of developing severe active TB. Absence of a BCG scar and high HbA1c levels are strong predictors of LTBI in T2DM patients.
{"title":"High glycosylated hemoglobin level as a risk factor of latent tuberculosis infection in patients with uncomplicated type 2 diabetes mellitus","authors":"Y. Arliny, D. Yanifitri, Diennisa Mursalin","doi":"10.18051/univmed.2022.v41.47-55","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.47-55","url":null,"abstract":"Background Diabetes mellitus (DM) is known to increase the risk of infection including tuberculosis (TB). Some studies also showed that 2-15% of latent TB infection (LTBI) will progress to active TB. This study aimed to obtain the prevalence of LTBI and to determine the risk factors of LTBI in patients with type 2 diabetes mellitus (T2DM).\u0000Methods This was a cross-sectional study on 242 adult T2DM patients. For LTBI screening we performed the interferon gamma release assay (IGRA) (Quantiferon TB Gold Plus test) and for confirmation of active TB (pulmonary TB) we performed GeneXpert MTB/Rif sputum examination and chest X-ray. Glycosylated hemoglobin (HbA1c) levels, smoking history and BCG scar were collected. Multivariate logistic regression was used to analyze the data.\u0000Results Positive IGRA results were found in 99 of 242 uncomplicated T2DM patients while LTBI was found in 82 patients (33.8%). There were significant differences between T2DM patients with latent TB and T2DM patients without infection in HbA1c and specific IFN-ã levels (TB1 minus nil and TB2 minus nil), i.e. 8.5% and 7.6%, 2.5 IU/mL and 0.06 IU/mL, and 2.6 IU/mL and 0.08 IU/mL, respectively. Multivariate analysis showed that the risk factors for LTBI in T2DM patients were smoking history, HbA1c >7%, and no BCG scar.\u0000Conclusions Because LTBI is prevalent in T2DM, it is important to screen for it in T2DM patients due to the risk of developing severe active TB. Absence of a BCG scar and high HbA1c levels are strong predictors of LTBI in T2DM patients.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44175445","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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