No abstract

Pneumocystis Pneumonia (PCP) is a potentially life-threatening infection that can occur in individuals who are immunocompromised. In PCP steroid use is still recommended especially in patients with moderate and severe severity. Corticosteroids are given along with anti-pneumocystis therapy and are known to reduce the incidence of mortality and respiratory failure associated with PCP. Innate immunity and adaptive immunity are symbiotic relationships to provide optimal defense for the lungs and other organs and tissues from infection PCP. The corticosteroid mechanism in PCP is based on an anti-inflammatory mechanism especially its role in inhibiting neutrophils. Many clinicians believe the administration of anti-pneumocystis causes the acceleration of inflammation. Because the inflammatory process increases when anti-pneumocystis therapy is started, corticosteroid therapy is useful before inflammation occurs which causes extensive damage to the lungs.

Background: In Indonesia, the National guideline for tuberculosis only recommended taking the DST to check INH resistance only for re-treatment cases of rifampicin-susceptible TB (RS-TB) detected by Xpert MTB/RIF. This study was conducted mainly to evaluate the proportion of isoniazid resistance in new cases of RS-TB according to the Xpert MTB/RIF. Methods: This was an observational descriptive study in RS-TB new patients diagnosed by Xpert MTB/RIF. Sputum samples were examined using first-line LPA and evaluated by culture-based DST. Results of first-line LPA and culture-based DST were compared and presented. Results: Fifty-four new cases of RS-TB (according Xpert MTB/RIF) were enrolled in this study. INH resistance was detected in 4 (7.4%) using FL-LPA and in 5 (9.3%) using culture-based DST. RIF resistance was also found in 1 (1.9%) using FL-LPA and in 2 (3.7%) using culture-based DST. Ethambutol resistance was also detected in 4 (7.4%) using culture-based DST. Conclusion: First-line LPA successfully revealed 4 (7.4%) of Hr-TB in new RS-TB cases detected by the Xpert MTB/RIF. In new cases with RS-TB detected by the Xpert MTB/RIF, FL- LPA can be used as rapid molecular DST to detect RIF and INH resistance followed by culture-based DST to examine other drug resistance.

Tumor angiogenesis, a process in which blood vessels penetrate and grow in a tumor environment, is needed for oxygen and nutrient supply and plays an important role in the survival of solid neoplasms. Angiogenesis does not only have a role in tumor development and metastasis, but also acts as marker of cancer itself (hallmark of cancer). Several mechanisms of angiogenesis include vasculogenesis, sprouting angiogenesis, intussusception microgrowth, and vasculogenic mimicry. Knowing these different mechanisms will be helpful in choosing the best agents or drugs for cancer therapy. The first anti-angiogenic drug used was bevacizumab, a monoclonal antibody, directed against VEGF. Bevacizumab has significant clinical benefits in patients with advanced NSCLC.