Reproducibility of Standing Posture for X-Ray Radiography: A Feasibility Study of the <Emphasis Type="Italic">BalancAid</Emphasis> with Healthy Young Subjects

Unreliable spinal X-ray radiography measurement due to standing postural variability can be minimized by using positional supports. In this study, we introduce a balancing device, named BalancAid, to position the patients in a reproducible position during spinal X-ray radiography. This study aimed to investigate the performance of healthy young subjects’ standing posture on the BalancAid compared to standing on the ground mimicking the standard X-rays posture in producing a reproducible posture for the spinal X-ray radiography. A study on the posture reproducibility measurement was performed by taking photographs of 20 healthy young subjects with good balance control standing on the BalancAid and the ground repeatedly within two consecutive days. We analyzed nine posterior–anterior (PA) and three lateral (LA) angles between lines through body marks placed in the positions of T3, T7, T12, L4 of the spine to confirm any translocations and movements between the first and second day measurements. No body marks repositioning was performed to avoid any error. Lin’s CCC test on all angles comparing both standing postures demonstrated that seven out of nine angles in PA view, and two out of three angles in LA view gave better reproducibility for standing on the BalancAid compared to standing on the ground. The PA angles concordance is on average better than that of the LA angles.     

经碱基切除修复的氧化性DNA损伤与肝癌的发生

在生物体内如果过氧化物的产生和消除存在不平衡均会导致氧化应激的发生．很多病理生理状况跟氧化应激有密切的关系。氧化应激产生的活性氧．可诱发DNA碱基发生化学修饰，在嘌呤残基的C-8位置和DNA整合，形成8-羟基二羟鸟嘌呤并进-步氧化形成8-羟基鸟嘌呤（8-OHdG）。8-OHdG是一种主要的DNA氧化损伤产物，经碱基切除修复通路来完成修复，若不及时修复，则参与癌变的发生。     

Anaphylaxis: lesson learned from five cases

Anaphylaxis is a severe hypersensitivity reaction. Its clinical manifestations vary, affecting several organs at once. Skin symptom is the most frequent manifestation; however, diagnosis of anaphylaxis will only be established when involving one or both vital organs, which are cardiovascular and respiratory system. Other symptom, such as that involving central nervous system or gastrointestinal tract, may accompany. We present five cases of anaphylaxis which vary in onset of symptoms, allergen, degree of severity, therapeutic response and clinical manifestation. Anaphylactic reaction to drugs in these cases is mainly manifested as anaphylactic shock and reaction to food allergen causing obstruction of respiratory tract. Four anaphylactic events occurred at home and only one occurred in a hospital, thus education on anaphylaxis to general community is very important, especially for the patients and their families. Prompt medical assistance in patients with anaphylactic symptoms determines their therapeutic response. Skin test prior to administration of cephalosporin does not give negative predictive value toward anaphylactic event.     

Diabetes and fatty liver: Involvement of incretin and its benefit for fatty liver management

Fatty liver disease is defined as liver condition characterized by hepatic steatosis, closely related to pathological conditions in type 2 diabetes and obesity. The high prevalence of fatty liver disease in obese patients with type 2 diabetes reached 70%, reflecting the importance of these conditions with fatty liver. Although the exact pathological mechanism of fatty liver disease, specifically non-alcoholic fatty liver disease (NAFLD) remains not completely revealed, insulin resistance is suggested as the major mechanism that bridged the development of NAFLD. Indeed, loss of the incretin effect leads to insulin resistance. Since incretin is closely related to insulin resistance and the resistance of insulin associated with the development of fatty liver disease, this pathway suggested a potential me-chanism that explains the association between type 2 diabetes and NAFLD. Furthermore, recent studies indicated that NAFLD is associated with impaired glucagon-like peptide-1, resulting in decreased incretin effect. Nevertheless, improving the incretin effect becomes a reasonable approach to manage fatty liver disease. This review elucidates the involvement of incretin in fatty liver disease and recent studies of incretin as the management for fatty liver disease.     

Relationship between age and metabolic disorders in the population of Bali

Background/Purpose

The purpose of this study is to examine the association between age and metabolic disorders in the population of Bali.

Method

A cross-sectional study was conducted on metabolic syndrome (MS) as defined on the basis of recommended parameters for diagnosis of the syndrome in the population of seven villages of Bali comprising six villages and one suburban area. At least three of the five parameters must be present for the diagnosis. Three hundred ten elderly people aged 60 years or more, with a male:female ratio of 168:142, of 1840 subjects were recruited in the study. The criteria for obesity were based on the 2000 World Health Organization recommendations for Asia Pacific population, for prediabetes [impaired fasting glycemia (IFG) and impaired glucose tolerance] and diabetes mellitus (DM) by American Diabetes Association (2009), and for MS by a joint statement of International Diabetes Federation, National Heart, Lung, and Blood Institute, American Heart Association, World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity (2009).

Results

The prevalence of IFG and DM were twofold in the elderly as compared with those in the younger-aged groups (21.4 vs. 11.7; 11.7 vs. 4.8, respectively). Blood pressure and fasting blood sugar levels were higher in the elderly than in the younger-aged group (133/81 mmHg vs. 117/76 mmHg; 102.7 mg/dL vs. 93.0 mg/dL, respectively; p < 0.001). There was no statistically significant difference in triglyceride and high-density lipoprotein cholesterol levels between both groups. Waist circumferences were lower among the elderly than among younger-aged groups (75.8 cm vs. 80.9 cm; p < 0.001). The elderly, with lower waist circumference, revealed significantly higher prevalence of MS as compared with the younger-aged group {22.9% vs. 17.3%; p = 0.026; prevalence risk 1.423 [confidence interval (CI) = 1.043G–1.944]}. The subjects who had 1, 2, 3, 4, and 5 components of MS were 34.6%, 23.8%, 13.0%, 4.3%, and 0.9%, respectively. The prevalence risk of each component of MS for the occurrence of MS were: elevated triglyceride [30.2 (CI = 14.5G–63.1)], elevated fasting blood sugar [8.5 (CI = 4.5G–15.8)], increased waist circumference [8.1 (CI = 4.3G–15.0)], reduced high-density lipoprotein cholesterol [4.4 (CI = 2.4G–7.9)], and elevated blood pressure [3.7 (CI = 1.9G–7.2)].

Conclusions

It could be inferred that in comparison with the younger-age group, the elderly had higher (twice) prevalence of IFG and DM, lower prevalence of central obesity, but higher prevalence of MS. Old age (60 years and more) had 1.4-fold risk for MS as compared with that in the younger-aged group, and elevated triglyceride levels appeared to be the most important risk factor for MS.     

Overview of Helicobacter pylori Infection in Indonesia: What Distinguishes It from Countries with High Gastric Cancer Incidence?

Helicobacterpylori infects more than half the human population. However, the prevalence in Indonesia is low, as is the prevalence of gastric cancer. Hence, it could be instructive to compare these prevalence rates and their determining factors with those of countries that have high gastric cancer incidence. Ethnicity and genetic characteristics of H. pylori are important determinants of the H. pylori infection rate in Indonesia. The infection rate is higher in Bataknese, Papuans and Buginese than in Javanese, the predominant ethnic group. Ethnicity is also an important determinant of the genetic characteristics of H. pylori. Analysis of CagA in the EPIYA segment showed that the predominant genotypes in Papuans, Bataknese and Buginese are ABB-, ABD- and ABC-type CagA, respectively. Meanwhile, in the countries with high gastric cancer incidence, almost all strains had East Asian type CagA. An antibiotic susceptibility evaluation showed that the standard triple therapy can still be used with caution in several cities. There is a very high rate of resistance to second-line regimens such as levofloxacin and metronidazole. Recent studies have shown that furazolidone, rifabutin and sitafloxacin are potential alternative treatments for antibiotic-resistant H. pylori infection in Indonesia. Rather than focusing on early detection and eradication as in countries with high gastric cancer prevalence, countries with low gastric cancer prevalence should focus on screening the several groups that have a high risk of gastric cancer. (Gut Liver 2021;15:-665)     

Preventive effect of Peperomia pellucida (L.) Kunth herbs on ovariectomy-induced osteoporotic rats

Osteoporosis is a metabolic skeletal disorder leading to bone fracture which adversely impacts the quality of life. In the present, we aimed to investigate the effect of Peperomia pellucida (L.) Kunth herb juice and ethanolic extract on ovariectomy (OVX)-induced osteoporotic rat model. Osteoporosis was induced by OVX with a double dorsolateral approach on female Wistar rats. Female Wistar rats undergoing sham surgeries (sham-control group) served as controls. The ovariectomized rats were divided into six groups based on administered treatments, (i) CMC Na 0.3% (OVX-control group), (ii) standard drug (ethynil estradiol 4.5 µg/kg), (iii) P. pellucida juice at dose of 50 mg/kg, and (iv) 100 mg/kg, (v) P. pellucida ethanolic extract at dose of 50 mg/kg, and (vi) 100 mg/kg. Treatments were started 1 week after the surgeries and lasted for 6 weeks. Rats treated with 100 mg/kgP. pellucida ethanol extract had significantly decreased serum ALP level and reduced excretion of urine calcium compared with the OVX-control group (P<0.05). These levels were not significantly altered when compared with the sham-control group (P<0.05). Furthermore, 100 mg/kg ethanolic extract-treated group showed improvement on three-dimensional image of the trabecular bone compared with the OVX-control group. Trabecular cavity formation in 100 mg/kg ethanolic extract-treated group was minimal. Ethanolic extract of Peperomia pellucida (L.) Kunthherbs at a dose of 100 mg/kg had preventive effect on OVX-induced osteoporotic rats.