Selasa, 19 Oktober 2010

Fibromyalgia Pain at Night

10 Tips for Better Sleep
By Jeanie Lerche Davis
WebMD Feature
Do you toss and turn at night because of fibromyalgia pain or discomfort?
"People with fibromyalgia tend to have very disturbed sleep," says Doris Cope, MD, director of Pain Management at the University of Pittsburgh School of Medicine. "Even if they sleep 10 hours a night, they still feel fatigued, don't feel rested."
Research shows that with fibromyalgia, there is an automatic arousal in the brain during sleep. Frequent disruptions prevent the important restorative processes from occurring. Growth hormone is mostly produced during sleep. Without restorative sleep and the surge of growth hormone, muscles don't heal and neurotransmitters (like the mood chemical serotonin) are not replenished. The lack of a good night's sleep makes people with fibromyalgia wake up feeling tired and fatigued.
The result: The body can't recuperate from the day's stresses -- all of which overwhelms the system, creating a great sensitivity to pain. Widespread pain, sleep problems, anxiety, depression, fatigue, and memory difficulties are all symptoms of fibromyalgia.
Insomnia takes many forms -- trouble falling asleep, waking up often during the night, having trouble going back to sleep, and waking up too early in the morning. Smoothing out those sleep problems -- and helping people get the deep sleep their bodies need -- helps fibromyalgia pain improve significantly, research shows.
Medications can help enhance sleep and relieve pain. But doctors also advocate lifestyle changes to help sleep come naturally.

Tips to Get Better Sleep With Fibromyalgia

Creating a comfort zone at home is key to better sleep, whether you have fibromyalgia or not. It's all about easing into bedtime feeling relaxed -- and staying relaxed so you sleep through the night.
These 10 tips can help people sleep better:
  • Enjoy a soothing (warm) bath in the evening.
  • Brush your body with a loofah or long-handled brush in the bath.
  • Ease painful tender points with a self-massage device (like a tennis ball).
  • Do yoga and stretching exercises to relax.
  • Listen to calming music.
  • Meditate to tame intrusive thoughts and tension.
  • Sleep in a darkened room. Try an eye mask if necessary.
  • Keep the room as quiet as possible (or use a white-noise machine).
  • Make sure the room temperature is comfortable.
  • Avoid foods that contain caffeine, including teas, colas, and chocolate.

Therapies to Treat Insomnia When You Have Fibromyalgia

If you're still having sleep problems, several therapies can help, including biofeedback, relaxation training, stress reduction, and cognitive therapy. A psychologist who specializes in sleep disorders can discuss these therapies with you.
The therapies help people handle stress better, which helps control fibromyalgia episodes, Cope says. "Fibromyalgia comes and goes," she tells WebMD. "When you're stressed out, that's when it's worse." That's when you're most likely to have insomnia, too.
Medications can also help ease fibromyalgia pain at night, or directly treat insomnia. Medications to ease fibromyalgia at night include antidepressants, anticonvulsants, prescription pain relievers, and sleep aids.
No one therapy will control fibromyalgia pain 100%, Cope adds.
"Medications help some. Exercise helps some. Stress reduction helps some. Cognitive behavior therapy helps some... If you can get restful sleep, you're going to function better when you're awake."
View Article SourcesSources
Reviewed on November 10, 2009
© 2008 WebMD, LLC. All rights reserved.
http://www.medicinenet.com/ 

Early Pregnancy Symptoms

http://www.medicinenet.com/pregnancy_symptoms/article.htm

Introduction

Most women equate a missed menstrual period with the possibility of being pregnant, but other symptoms and signs are experienced by most women in the early stages of pregnancy. It's important to remember that not all women will experience all of these symptoms or have the symptoms to the same degree. Even the same woman can have different types of symptoms in a subsequent pregnancy than she had in previous pregnancies. The following are the most common pregnancy symptoms in the first trimester.

Missed period

A missed menstrual period is most often the first sign of pregnancy. Sometimes a woman who is pregnant may still experience some bleeding or spotting around the time of the expected period, typically 6 to 12 days after conception. When it occurs, this so-called "implantation bleeding" is generally not as heavy or long as a regular menstrual period. This small amount of bleeding that occurs at the time of the expected menstrual period happens when the fertilized egg attaches to the uterine wall and is referred to as implantation bleeding.
Any bleeding during pregnancy is typically lighter than that observed during the regular menstrual period. However, if a woman does not have regular menstrual cycles, she may notice some of the other symptoms of early pregnancy before it is apparent that the menstrual period has been missed. A missed menstrual period also does not confirm that a woman is pregnant even if she has regular cycles, since both emotional and physical conditions may cause absent or delayed periods.

Breast swelling, tenderness, and pain

Feelings of breast swelling, tenderness, or pain are also commonly associated with early pregnancy. These symptoms are sometimes similar to the sensations in the breasts in the days before an expected menstrual period. Women may also describe a feeling of heaviness or fullness in the breasts. These symptoms can begin in some women as early as one to two weeks after conception.

Nausea and vomiting

Nausea and vomiting are also common in early pregnancy. Traditionally referred to as "morning sickness," the nausea and vomiting associated with early pregnancy can occur at any time of the day or night. Its typical onset is anywhere between the 2nd and 8th weeks of pregnancy. Most women who have morning sickness develop nausea and vomiting about one month after conception, but it may develop sooner in some women. Sometimes women report an increased in sensitivity to certain odors or smells that can sometimes cause nausea and/or vomiting.
Elevations in estrogen that occur early in pregnancy are thought to slow the emptying of the stomach and may be related to the development of nausea. Accompanying the characteristic "morning sickness" may be cravings for, or aversions to, specific foods or even smells. It is not unusual for a pregnant woman to change her dietary preferences, often having no desire to eat previous "favorite" foods. In most women, nausea and vomiting begin to subside by the second trimester of pregnancy.

Food cravings

Many women report cravings for certain foods during the early stages of pregnancy. These cravings can persist throughout the entire pregnancy.

Fatigue and tiredness

Fatigue and tiredness are symptoms experienced by many women in the early stages of pregnancy. Some women report feeling fatigued even in the weeks immediately prior to conception. The cause of this fatigue has not been fully determined, but it is believed to be related to rising levels of the hormone progesterone. Of course, fatigue is a very nonspecific symptom that can be related to many causes other than pregnancy.

Abdominal bloating

Some women may experience feelings of abdominal enlargement or bloating, but there is usually only a small amount of weight gain in the first trimester of pregnancy. In this early stage of pregnancy a weight gain of about one pound per month is typical. Sometimes women also experience mild abdominal cramping during the early weeks of pregnancy, which may be similar to the cramping that occurs prior to or during the menstrual period.

Frequent urination

A woman in the early stages of pregnancy may feel she has to urinate frequently, especially at nighttime, and she may leak urine with a cough, sneeze, or laugh. The increased desire to urinate may have both physical and hormonal causes. Once the embryo has implanted in the uterus, it begins to produce the hormone known as human chorionic gonadotrophin (hCG), which is believed to stimulate frequent urination. Another cause of frequent urination that develops later is the pressure exerted by the growing uterus on the bladder.

Elevated basal body temperature

A persistently elevated basal body temperature (the oral temperature measured first thing in the morning, before arising from bed) is another characteristic sign of early pregnancy. An elevation in the basal body temperature occurs shortly after ovulation and persists until the next menstrual period occurs. Persistence of the elevated basal body temperature beyond the time of the expected menstrual period is another sign of early pregnancy.

Changes in nipple color

Women may notice a deepening of the color of the area surrounding the nipple, called the areola and/or a dark line going down from the middle of the central abdomen area to the pubic area (known as the linea nigra). Some degree of darkening of the areola persists after pregnancy in many women, but the linea nigra typically disappears in the months following delivery of the baby.

Melasma (darkening of the skin)

Some women may develop a so-called "mask of pregnancy" in the first trimester, referring to a darkening of the skin on the forehead, bridge of the nose, upper lip, or cheeks. The darkened skin is typically present on both sides of the face. Doctors refer to this condition as melasma or chloasma, and it is more common in darker-skinned women than those with lighter skin. Melasma can also occur in some conditions other than pregnancy. Women who have a family history of melasma are at greater risk of developing this sign of pregnancy.

Mood swings and stress

Mood swings and stress are common symptoms reported by many women in the early stages of pregnancy. Many women in the early stages of pregnancy describe feelings of heightened emotions or even crying spells. The rapid changes in hormone levels are believed to cause these changes in mood. Pregnant women may also notice more rapid and drastic changes in their moods.

Headaches

Some women report suffering from headaches early on in their pregnancy, which may be related to corresponding changes in hormone levels.
REFERENCE: eMedicine.com; "Pregnancy Diagnosis."

Last Editorial Review: 11/11/2009

Headache

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Jay W. Marks, MD




What is a headache?

A Headache is defined as a pain in the head or upper neck. It is one of the most common locations of pain in the body and has many causes.

How are headaches classified?

Headaches have numerous causes, and in 2007 the International Headache Society agreed upon an updated classification system for headache. Because so many people suffer from headaches and because treatment sometimes is difficult, it is hoped that the new classification system will allow health care practitioners come to a specific diagnosis as to the type of headache and to provide better and more effective treatment.
There are three major categories of headaches:
  1. primary headaches,
  2. secondary headaches, and
  3. cranial neuralgias, facial pain, and other headaches

What are primary headaches?

Primary headaches include migraine, tension, and cluster headaches, as well as a variety of other less common types of headache.
  • Tension headaches are the most common type of primary headache. Up to 90% of adults have had or will have tension headaches. Tension headaches occur more commonly among women than men.
  • Migraine headaches are the second most common type of primary headache. An estimated 28 million people in the United States (about 12% of the population) will experience a migraine headache. Migraine headaches affect children as well as adults. Before puberty, boys and girls are affected equally by migraine headaches, but after puberty, more women than men are affected. It is estimated that 6% of men and up to 18% of women will experience a migraine headache in their lifetime.
  • Cluster headaches are a rare type of primary headache affecting 0.1% of the population (1 in a 1,000 people). It more commonly affects men in their late 20s though women and children can also suffer these types of headache.
Primary headaches can affect the quality of life. Some people have occasional headaches that resolve quickly while others are debilitated. While these headaches are not life-threatening, they may be associated with symptoms that can mimic strokes or intracerebral bleeding.

What are secondary headaches?

Secondary headaches are those that are due to an underlying structural problem in the head or neck. There are numerous causes of this type of headache ranging from bleeding in the brain, tumor, or meningitis and encephalitis.

What are cranial neuralgias, facial pain, and other headaches?

Neuralgia means nerve pain (neur= nerve + algia=pain). Cranial neuralgia describes a group of headaches that occur because the nerves in the head and upper neck become inflamed and become the source of the pain in the head. Facial pain and a variety of other causes for headache are included in this category.

What causes tension headaches?

While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may spasm and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck inserts, the temple where muscles that move the jaw are located, and the forehead.
There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. These stressors can cause the muscles surrounding the skull to clench the teeth and go into spasm. Physical stressors include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time concentrating. Emotional stress may also cause tension headaches by causing the muscles surrounding the skull to contract.

What are the symptoms of tension headaches?

The pain symptoms of a tension headache are:
  • The pain begins in the back of the head and upper neck and is described as a band-like tightness or pressure.
  • Often is described as pressure encircling the head with the most intense pressure over the eyebrows.
  • The pain usually is mild (not disabling) and bilateral (affecting both sides of the head).
  • The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.
  • The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
  • The pain allows most people to function normally, despite the headache. 

How are tension headaches diagnosed?

The key to making the diagnosis of any headache is the history given by the patient. The health care practitioner will ask questions to understand when the headache began, learn about the quality, quantity, and duration of the pain, and ask about any associated symptoms. The history of tension headache will include pain that is mild to moderate, located on both sides of the head, described as a tightness that is not throbbing, and not made worse with activity. There will be no associated symptoms like nausea, vomiting, or light sensitivity.
The physical examination, particularly the neurologic portion of the examination, is important in tension headaches because it should be normal to make the diagnosis. The only exception is that there may be some tenderness of the scalp or neck muscles. If the health care practitioner finds an abnormality, then the diagnosis of tension headache would not be considered until the potential for other types of headaches have been investigated.

How are tension headaches treated?

Tension headaches are painful, and patients may be upset that the diagnosis is "only" a tension headache. Even though it is not life-threatening, a tension headache can affect the activities of daily life.
Most people successfully treat themselves with over-the�counter (OTC) pain medications to control tension headaches. The following work well for most people:
If these fail, other supportive treatments are available. Recurrent headaches should be a signal to seek medical help. Massage, biofeedback, and stress management can all be used as adjuncts to help with control of tension headaches.
It is important to remember that OTC medications, while safe, are medications and may have side effects and potential interactions with prescription medications. It always is wise to ask your health care practitioner or pharmacist if you have questions about OTC medications and their use. This is especially important with OTC pain medications, because patients use them so frequently.
It is important to read the listing of ingredients in OTC pain medications. Often an OTC medication is a combination of ingredients, and the second or third ingredient may have the potential for drug interaction or contraindication with medications a patient is currently taking. For example:
  • Some OTC medications include caffeine, which may trigger rapid heartbeats in some patients.
  • In night time preparations, diphenhydramine (Benadryl) may be added. This may cause drowsiness, and driving or using heavy machinery may not be appropriate when taking the medication.
Other examples where caution should be used include the following:
  • Aspirin should not be used in children and teenagers because of the risk of Reye's Syndrome, a disease where coma, brain damage, and death can occur if there is a viral like illness when the and aspirin is  used.
  • Aspirin and ibuprofen are irritating to the stomach and may cause bleeding. They should be used with caution in patients who have peptic ulcer disease or who take blood thinners like warfarin (Coumadin) and clopidogrel bisulfate (Plavix).
  • Acetaminophen, if used in large amounts, can cause liver damage or failure. It should be used with caution in patients who drink significant amounts of alcohol or who have liver disease.
  • One cause of chronic tension headaches is overuse of medications for pain. When pain medications are used for a prolonged period of time, headaches can recur as the effects of the medication wear off. Thus, the headache becomes a symptom of the withdrawal of medication (rebound headache).

What causes cluster headaches?

The cause of cluster headaches is uncertain. It may be that certain parts of the brain begin to malfunction for an unknown reason. The hypothalamus, an area located at the base of the brain is responsible for the body's biologic clock and may be the part of the brain that is the source for the headaches. When brain scans are performed on patients who are in the midst of a cluster headache, there is abnormal activity in the hypothalamus.
Cluster headaches also:
  • tend to run in families and this suggests that there may be a genetic role;
  • may be triggered by changes in sleep patterns;
  • may be triggered by medications (for example, nitroglycerin, used for heart disease).
If an individual is in a susceptible period for cluster headache, cigarette smoking, alcohol, and some foods (for example, chocolate) also can be potential causes for headache.

What are the symptoms of cluster headaches?

Cluster headaches are headaches that come in groups (clusters) lasting weeks or months, separated by pain-free periods of months or years.
  • During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
  • Each episode of pain lasts from 30 to 90 minutes.
  • Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
  • The pain typically is excruciating and located around or behind one eye.
  • Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
  • The nose on the affected side may become congested and runny.
Unlike patients with migraine headaches, patients with cluster headaches tend to be restless. They often pace the floor, bang their heads against a wall, and can be driven to desperate measures. Cluster headaches are much more common in men than women.

How are cluster headaches diagnosed?

The diagnosis of cluster headache is made by taking the patient's history. The description of the pain and it's clock-like recurrence is usually enough to make the diagnosis.
If examined in the midst of an attack, the patient usually is in a painful crisis and may have the eye and nose watering as described previously. If the patient is seen when the pain is not present, the physical examination is normal and the diagnosis again depends upon the history.

How are cluster headaches treated?

Cluster headaches may be very difficult to treat, and it make take trial and error to find the specific treatment regimen that will work for each patient. Since the headache recurs daily, there are two treatment needs. The pain of the first episode needs to be controlled , and additional headaches need to be prevented.
Initial treatment options may include the following:
  • inhalation of high concentrations of oxygen (though this will not work if the headache is well established);
  • injection of tryptan medications, for example, sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt) which are commonly used for migraine treatments as well;
  • injection of lidocaine, a local anesthetic, into the nostril;
  • dihydroergotamine (DHE, Migranal), a medication that causes blood vessels to constrict;
  • caffeine
Prevention of the next cluster headache may include the following:

Can cluster headaches be prevented?

Since cluster headache episodes may be spaced years apart, and since the first headache of a new cluster episode can't be predicted, daily medication may not be warranted.
Lifestyle changes may help minimize the risk of a cluster headache flare. Stopping smoking and minimizing alcohol may prevent future episodes of cluster headache.

What diseases cause secondary headaches?

Headache is a symptom associated with many illnesses. While head pain itself is the issue with primary headaches, secondary headaches are due to an underlying disease or injury that needs to be diagnosed and treated. Controlling the headache symptom will need to occur at the same time that diagnostic tests are being considered to diagnose the underlying disease. Some of the causes of secondary headache may be potentially life-threatening and deadly. Early diagnosis and treatment is essential if damage is to be limited.
The International Headache Society lists eight categories of secondary headache. A few examples in each category are noted. (This is not a complete list).
Head and neck trauma
Blood vessel problems in the head and neck
Non-blood vessel problems of the brain
  • Brain tumors, either primary, originating in the brain, or metastatic from a cancer that began in another organ
  • Seizures
  • Idiopathic intracranial hypertension, once named pseudotumor cerebri, where the pressure is too high in the cerebrospinal fluid within the spinal canal.
Medications and drugs (including withdrawal from those drugs)
Infection
Changes in the body's environment

How are secondary headaches diagnosed?

If there is time, the diagnosis of secondary headache begins with a complete patient history followed by a physical examination and laboratory and radiology tests as appropriate.
However, some patients present in crisis with a decreased level of consciousness or unstable vital signs. In these situations, the health care practitioner may decide to treat a specific cause without waiting for tests to confirm the diagnosis.
For example, a patient with headache, fever, stiff neck, and confusion may have symptoms that suggest meningitis. Since meningitis can be rapidly fatal, antibiotic therapy may be started before blood tests and a lumbar puncture are performed to confirm the diagnosis.

What are the exams and tests for secondary headaches?

The patient history and physical examination provide the initial direction for determining the cause of secondary headaches. Therefore, it is extremely important that patients with severe headaches seek medical care and give their health care practitioner an opportunity to assess their condition. Tests that may be useful in making the diagnosis of the underlying disease causing headaches include:
  • blood tests,
  • computerized tomography (CT Scan),
  • magnetic resonance imaging (MRI) scans of the head, and
  • lumbar puncture.
Specific tests will depend upon what potential issues the health care practitioner and patient want to address.
Blood tests
Blood tests provide helpful information in association with the history and physical examination in pursuing a diagnosis. For example, an infection or inflammation in the body may cause a rise in the white blood cell count, the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). These two tests are very non-specific, that is, they may be abnormal with any infection or inflammation, and abnormalities do not point to a specific diagnosis of the cause of the infection or inflammation.
Blood tests can also assess electrolyte disturbances, and a variety of organ functions like liver, kidney, and thyroid.
Computerized tomography of the head
Computerized tomography (CT scan) is able to detect bleeding, swelling, and tumors. It can also show evidence of previous stroke. With intravenous contrast injection, it can also be used to look at the arteries of the brain.
Magnetic resonance imaging (MRI) of the head
MRI is able to better look at the anatomy of the brain, meninges (the layers that cover the brain and the spinal cord). While it is more precise, the time to perform the scan is significantly longer than for computerized tomography. This type of scan is not available at all hospitals. Moreover, it takes much longer to perform, requires the patient to cooperate by holding still, and requires that the patient have no metal in their body (for example, a heart pacemaker or metal foreign objects in the eye).
Lumbar puncture
Cerebro-spinal fluid, the fluid that surrounds the brain and spinal cord, can be obtained with a needle that is inserted into the spine in the lower back. Examination of the fluid can reveal infection (such as meningitis due to bacteria, a virus, or tuberculosis) or blood from hemorrhage. In almost all cases, computerized tomography is done prior to lumbar puncture to make certain there is no bleeding, swelling, or tumor in the brain. Pressure within the space can be measured when the lumbar puncture needle is inserted. Elevated pressures may make the diagnosis of idiopathic intracranial hypertension in combination with the appropriate circumstances.

When should I seek medical care for a headache?

A patient should seek medical care if their headache is:
  • The "worst headache of your life." This is the wording often used in textbooks as a cue for medical practitioners to consider the diagnosis of a subarachnoid hemorrhage due to a ruptured cerebral aneurysm. The amount of pain will often be taken in context with the appearance of the patient and other associated signs and symptoms.
  • Different than your usual headaches
  • Starts suddenly or is aggravated by exertion, coughing, bending over, or sexual activity
  • Associated with persistent nausea and vomiting
  • Associated with fever or stiff neck
  • Associated with seizures
  • Associated with recent head trauma or a fall
  • Associated with changes in vision, speech, or behavior
  • Associated with weakness or change in sensation
  • Not responding to treatment and is getting worse
  • Requires more than the recommended dose of over-the-counter medications for pain
  • Disabling and interfering with work and quality of life

Headache At A Glance
  • The head is one of the most common sites of pain in the body.
  • The most common types of headache can be classified as 1) primary, 2) secondary, and 3) cranial neuralgias, facial pain, and other headaches.
  • The most common types of primary headaches are 1) tension, 2) migraine, and 3) cluster.
  • Tension headaches are the most common type of primary headache and usually are treated with over-the-counter medications for pain
  • Secondary headaches are a symptom of an injury or an underlying illness.
  • Patients should seek medical care for new onset headaches, fever, stiff neck, change in behavior, vomiting, weakness or change in sensation.
References: International Headache Society. The Classification.
<http://ihs-classification.org/en/02_klassifikation/>

Previous contributing author and editor: Dennis Lee, MD and Harley I. Kornblum, MD, PhD

Pregnant or Not? How To Know

Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.
To learn whether you are pregnant or not, a pregnancy test may provide you with the answer. This test can be done in the privacy of your home using one of several available test kits. Or the test can be performed in your doctor's office or clinic. Home pregnancy tests are always done on urine while those in a doctor's office or clinic may be done on urine or blood.
All pregnancy tests are based upon measurement of the same hormone -- human chorionic gonadotrophin or hCG -- which is only present in a woman when she is pregnant. This hormone is made after the egg is fertilized and its levels rise rapidly in early pregnancy. It acts to support progesterone, a hormone necessary to maintain the pregnancy.
Most home pregnancy tests are done because of a missed period. If a woman has regular menstrual cycles, a home test can be very informative. It can tell whether or not there is a pregnancy as early as the first day of the missed period (which is about two weeks after conception).
Manufacturers of home test kits claim that their kits are 97%-99% accurate, but the sensitivities of different test kits depend on the levels of hCG in the urine required for a positive result. If your test result is positive, see your healthcare provider promptly.
Sometimes a home test is negative if the test is done too early because there may not yet be enough hCG to test positive. If you believe you may be pregnant but your home test kit result is negative, you should always test again, either on the following day or within the following week. Some home test kits come with supplies for two separate tests. Repeat testing is recommended in all such cases.
Urine hCG tests are qualitative because they only detect hCG levels above a certain level. These tests are used when it is enough to know simply whether you are pregnant or not.
By contrast, blood hCG tests are quantitative because they measure the exact amount of hCG. These tests are more sensitive and can tell if you are pregnant even before you miss a period (as early as one week after conception).
Your doctor may also want to know the exact amount of hCG in order to evaluate the progression of your pregnancy. This can help determine the age of a fetus and identify problems with a pregnancy. In very rare cases, tumors or other conditions can result in the production of hCG and lead to false positive pregnancy test results. Your doctor can explain more about the significance of hCG levels as they apply to your specific situation.
Taking a drug containing hCG can, not surprisingly, can cause a false positive test result. While alcohol and illegal drugs do not affect pregnancy test results, remember that you should NOT drink alcohol or use illegal drugs if there is any possibility you could become pregnant.
http://www.medicinenet.com/

A New Way To Kill Cancer Cells

Unlike normal cells, cancer cells can grow and age without dying — one of the reasons they’re so dangerous. But researchers at Washington State University have developed a way to help cancer cells age and die, which could lead to treatment that slows or stops tumor growth.
The research, by Weihang Chai of the Washington State University School of Molecular Biosciences and colleagues, was reported in the current issue of The EMBO Journal. It was funded in part by the National Institutes of Health and the American Cancer Society. I spoke with Chai this week.
How do cancer cells differ from normal cells in terms of their mortality?
The big difference between cancer cells and normal cells is that cancer cells can divide forever and live forever. We call this immortality. The normal cells will divide for a number of divisions and then stop growing. They get old and either they die or they sit there and do nothing. They are mortal.
Cancer cells have a way to maintain their telomeres. Their telomeres don’t get shortened. Each time the normal cells divide they lose some telomere DNA sequences. Eventually when the telomere DNA becomes too short, they stop growing. There are also other factors contributing to the mortality of normal cells.
Is the immortality of cancer cells what makes them so dangerous?
The cancer cells divide uncontrollably. Then you have more and more cancer cells in one location of your body that can invade the surrounding tissues and disrupt the function of the normal tissues. They form the tumor. The cancer cells also can circulate around your body and get into other places and form tumors in the new locations. This is in part due to the immortality of cancer cells. They don’t die. Normal cells grow at one location and at some point they will stop.
Talk about your work on making cancer cells “more mortal.”
The majority of the cancer cells, about 90 percent, they activate a molecule called telomerase. Telomerase is usually not activated in normal cells, except for in stem cells. In cancer cells, the telomerase is active. The function of telomerase is to add telomere DNA at the short telomeres. That’s why cancer cells don’t lose their telomeres. In the normal cells telomerase is off, so there is no way to maintain their telomere length. [This would suggest that] if you kill the telomerase in cancer cells, the telomere [would gradually shorten] and the cancer cells will die.
However, recently we have found that the telomerase extends just one strand of DNA. The other strand should be synthesized by other molecules, other proteins. We found the molecule that’s responsible for synthesizing the other strand. If you block the function of this molecule, then the telomere cannot be maintained properly, so the cell also just stops growing.
We’re just at this stage now. We don’t know how this whole thing works. We’re working on that and hopefully in the future we can design a way to target this process, not directly target telomerase but target the synthesis of the other strand. That’s another way of stopping the cancer cell’s growth.
What’s the next step to move this research forward?
The next step will be to find out how this whole thing is regulated. We’d like to know whether in normal cells the synthesis of the other strand also occurs because you want to specifically target the cancer cells. If this does exist, [we want to know] whether the same process is regulated by different pathways in normal cells compared to cancer cells. Our ultimate goal is to see if there are any specific targets we can inhibit in the cancer cells.
Could this eventually become a treatment for people with cancer?
We hope so. It’s going to be a long way. That probably will involve some other research groups, not just our group.

Food Allergies vs. Food Intolerance

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Medical Author: Melissa Stoppler, M.D.
Medical Editor: Barbara K. Hecht, Ph.D.
Sometimes people become sick from eating a particular food, because they cannot properly process or digest the food, or because they have a true allergic (immune) reaction to the food. Food allergies and food intolerance are sometimes confused with each other, but they are quite different in terms of their origin, symptoms and treatment.
Food Allergies
True allergic reactions to food involve the body's immune system. When the body identifies a food as harmful, it produces antibodies directed against that food. The next time the food is consumed, the body mounts an immune response with the release of histamine and other chemicals that trigger allergic symptoms. A common example of a food allergy is to peanuts.
With a food allergy, symptoms may occur almost immediately or up to hours after consuming the particular food. These symptoms may affect the respiratory system, gastrointestinal tract, cardiovascular system, or the skin.
Food allergy symptoms can include:
Severe allergic reactions may result in a drop in blood pressure, loss of consciousness, or even death.
There are no medications that can cure food allergies. Diligent avoidance of the offending food is the only sure way to prevent a reaction. People with food allergies must thoroughly examine food labels and ask questions about the ingredients of dishes. For example, the label on a breakfast cereal may read: "May contain soy, peanuts and/or other tree nuts."
Severe life-threatening allergic reactions can be treated with the prescription drug epinephrine. This drug is available as a pen-style injector.
Food Intolerance
Food intolerance is different from food allergy in that it does not involve an immunologic reaction. A common type of food intolerance is lactose intolerance. Persons with lactose intolerance lack an enzyme (called lactase) needed to digest the milk sugar (called lactose). They can develop gas, bloating, and abdominal pain when they consume milk products.
Some types of food intolerance can be treated. For example, lactase tablets are available without a prescription to aid those with severe symptoms of lactose intolerance and lactose-free dairy products are available at most supermarkets.
If an individual thinks they may have either food allergy or food intolerance, keep a diary of the foods eaten and any symptoms experienced. A food diary can help the doctor establish the correct diagnosis. A doctor can also order simple skin tests or blood tests to determine if an individual is allergic to specific foods. The strategy of dealing with a food allergy is different than dealing with food intolerance.
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Lactose Intolerance

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What is lactose intolerance?

Lactose intolerance is the inability to digest and absorb lactose (the sugar in milk) that results in gastrointestinal symptoms when milk or food products containing milk are consumed.

What causes lactose intolerance?

Lactose is a large sugar molecule that is made up of two smaller sugars, glucose and galactose. In order for lactose to be absorbed from the intestine and into the body, it must first be split into glucose and galactose. The glucose and galactose are then absorbed by the cells lining the small intestine. The enzyme that splits lactose into glucose and galactose is called lactase, and it is located on the surface of the cells lining the small intestine.
Lactose intolerance is caused by reduced or absent activity of lactase that prevents the splitting of lactose (lactase deficiency). Lactase deficiency may occur for one of three reasons, congenital, secondary or developmental.
Congenital causes of lactose intolerance
Lactase deficiency may occur because of a congenital absence (absent from birth) of lactase due to a mutation in the gene that is responsible for producing lactase. This is a very rare cause of lactase deficiency, and the symptoms of this type of lactase deficiency begin shortly after birth.
Secondary causes of lactose intolerance
Another cause of lactase deficiency is secondary lactase deficiency. This type of deficiency is due to diseases that destroy the lining of the small intestine along with the lactase. An example of such a disease is celiac sprue.
Developmental causes of lactose intolerance
The most common cause of lactase deficiency is a decrease in the amount of lactase that occurs after childhood and persists into adulthood, referred to as adult-type hypolactasia. This decrease in lactase is genetically programmed, and the prevalence of this type of lactase deficiency in different ethnic groups is highly variable. Thus, in Asian populations it is almost 100%, among American Indians it is 80%, and in blacks it is 70%; however, in American Caucasians the prevalence of lactase deficiency is only 20%. In addition to variability in the prevalence of lactase deficiency, there also is variability in the age at which symptoms of lactose intolerance appear. Thus, in Asian populations, the symptoms of lactase deficiency (intolerance) occur around the age of 5, among Blacks and Mexican-Americans by the age of 10, and in the Finnish by age 20.
It is important to emphasize that lactase deficiency is not the same as lactose intolerance. Persons with milder deficiencies of lactase often have no symptoms after the ingestion of milk. For unclear reasons, even persons with moderate deficiencies of lactase may not have symptoms. A diagnosis of lactase deficiency is made when the amount of lactase in the intestine is reduced, but a diagnosis of lactose intolerance is made only when the reduced amount of lactase causes symptoms.

What are the symptoms of lactose intolerance?

The common primary symptoms of lactose intolerance are gastrointestinal include:
Less common symptoms of lactose intolerance include:
  • abdominal bloating,
  • abdominal distention, and
  • nausea.
Unfortunately, these symptoms can be caused by several gastrointestinal conditions or diseases, so the presence of these symptoms is not very good at predicting whether a person has lactase deficiency or lactose intolerance.
Symptoms occur because the unabsorbed lactose passes through the small intestine and into the colon. In the colon, one type of normal bacterium contains lactase and is able to split the lactose and use the resulting glucose and galactose for its own purposes. Unfortunately, when they use the glucose and galactose, these bacteria also release hydrogen gas. Some of the gas is absorbed from the colon and into the body and is then expelled by the lungs in the breath. Most of the hydrogen, however, is used up in the colon by other bacteria. A small proportion of the hydrogen gas is expelled and is responsible for the increased flatulence (passing gas). Some people have an additional type of bacterium in their colons that changes the hydrogen gas into methane gas, and these people will excrete only methane or both hydrogen and methane gas in their breath and flatus.
Not all of the lactose that reaches the colon is split and used by colonic bacteria. The unsplit lactose in the colon draws water into the colon (by osmosis). This leads to loose, diarrheal stools.
The severity of the symptoms of lactose intolerance varies greatly from person to person. One reason for this variability is that people have different amounts of lactose in their diet; the more lactose in the diet, the more likely and severe the symptoms. Another reason for the variability is that people have differing severities of lactase deficiency, that is, they may have mild, moderate, or severe reduction in the amounts of lactase in their intestines. Thus, small amounts of lactose will cause major symptoms in severely lactase deficient people but only mild or no symptoms in mildly lactase deficient people. Finally, people may have different responses to the same amount of lactose reaching the colon. Whereas some may have mild or no symptoms, others may have moderate symptoms. The reason for this is not clear but may relate to differences in their intestinal bacteria.

How are lactase deficiency and lactose intolerance diagnosed?

Although there are several good ways to diagnose lactose intolerance, most people who consider themselves lactose intolerant have never been formally tested for intolerance. This is unfortunate because at least 20% of people who think they are lactose intolerant are not, and 20% of people who think they are not intolerant, in fact, are intolerant.
Why should so many people believe that they are lactose intolerant when they are not? This erroneous belief may be common for several reasons. People with unexplained (undiagnosed) gastrointestinal symptoms are looking for an explanation for their symptoms. Since lactose intolerance is a well-known condition, it provides these people with a ready (and welcome) explanation for their symptoms. Confirmation that lactose intolerance is present often is made subjectively and without careful correlation between ingestion of milk or milk products and symptoms. Extrapolating from data on the effect of placebo, it can be hypothesized that between 20 and 40 percent of people who think they feel better on stopping milk, in fact, are no better. Feeling better for them is analogous to a beneficial (positive) response to placebo.
Formal testing for lactose intolerance is valuable. Not only can testing confirm lactose intolerance and prompt the institution of a reduced or lactose-free diet, but it also can exclude lactose intolerance and direct attention to diagnosing other conditions and diseases that are responsible for the symptoms.

Elimination diet

Probably the most common way that people self-diagnose lactose intolerance is by an elimination diet, a diet that eliminates milk and milk products. There are several problems with this type of "testing."
  1. Milk products are so common in prepared foods from the supermarket or restaurant that it is likely that an elimination diet that is not rigorous (i.e., does not eliminate all milk-containing products) will still include substantial amounts of milk. Thus, persons with severe lactase deficiency attempting an elimination diet may be ingesting enough lactose to have symptoms and erroneously conclude that lactose intolerance is not responsible for the symptoms.
  2. People often make the assumption that they are lactose intolerant based on a short trial of elimination. A short trial may be adequate if symptoms are severe and occurring daily, but not if the symptoms are subtle and/or variable. In the latter case, an elimination diet may need to be continued for several weeks.
  3. Because symptoms of lactose intolerance are subjective and variable, there always is the possibility of a "placebo effect" in which people think they feel better eliminating milk when, in fact, they are no better. As discussed previously, with subjective symptoms such as those of lactose intolerance, a placebo effect might be expected to occur 20%-40% of the time.
If an elimination diet is to be used for diagnosing lactose intolerance, it should be a rigorous diet. A rigorous diet requires counseling by a dietician or reading a guide to a lactose-elimination diet. The diet also needs to be continued long enough to clearly evaluate whether or not symptoms are better. If there is doubt about improvement on the diet, particularly if symptoms normally fluctuate in intensity over weeks or months, repeated periods of lactose elimination should be tried until a firm conclusion can be drawn. Elimination of all milk products should eliminate symptoms completely if lactose intolerance alone is the cause of the symptoms.

Milk challenge

A milk challenge is a simpler way of diagnosing lactose intolerance than an elimination diet. A person fasts overnight and then drinks a glass of milk in the morning. Nothing further is eaten or drunk for 3-5 hours. If a person is lactose intolerant, the milk should produce symptoms within several hours of ingestion. If there are no symptoms or symptoms are substantially milder than the usual symptoms, it is unlikely that lactose intolerance is the cause of the symptoms. It is important that the milk that is used is fat-free in order to eliminate the possibility that fat in the milk is the cause of symptoms. It is not possible to eliminate the possibility that symptoms are due to milk allergy, a very different condition than lactose intolerance; however, this usually is not confusing since allergy to milk is rare and primarily occurs in infants and young children. (If milk allergy is a consideration, pure lactose can be used instead of milk.)
An important issue is the amount of milk required for the milk challenge.
  • If a person drinks several glasses of milk or ingests large amounts of milk-containing products in their normal diet, then a larger amount of milk should be used in the challenge, 8-16 ounces in an adult, equivalent to one or two large glasses of milk.
  • If the person being tested usually does not drink several glasses of milk or ingest larger quantities of milk-containing products, there may be a problem with using 8-16 ounces of milk for testing. These larger quantities of milk used for testing may cause symptoms, but the smaller amounts of milk or milk products that these persons ingest in their normal diet may not be enough to cause symptoms. Technically, they may be lactose intolerant when they are tested with larger amounts of milk, but lactose in their normal diet cannot be responsible for their usual symptoms.
Recognition of this issue is important in interpreting the results of a milk challenge.

Breath test

The hydrogen breath test is the most convenient and reliable test for lactase deficiency and lactose intolerance. For the breath test, pure lactose, usually 25 grams (the equivalent of 16 oz of milk), is ingested with water after an overnight fast. In persons who are lactose intolerant, the lactose that is not digested and absorbed in the small intestine reaches the colon where the bacteria split the lactose into glucose and galactose and produce hydrogen (and/or methane) gas. Small amounts of the hydrogen and methane are absorbed from the colon into the blood and then travel to the lungs where they are excreted in the breath. Samples of breath are collected every 10 or 15 minutes for 3-5 hours after ingestion of the lactose, and the samples are analyzed for hydrogen and/or methane. If hydrogen and/or methane are found in the breath, it means that the small intestine of the person was unable to digest and absorb all of the lactose. He or she is lactase deficient. The amount of hydrogen or methane excreted in the breath is roughly proportional to the degree of lactase deficiency, that is, the larger the amount of hydrogen and/or methane produced, the greater the deficiency. The amount of hydrogen and/or methane in the breath, however, is not proportional to the severity of the symptoms. In other words, a person who produces little hydrogen and/or methane may have more severe symptoms than a person who produces a large amount hydrogen and/or methane.
The breath test is the best test for determining lactase deficiency and lactose intolerance, but it has several weaknesses. The first is that it is a long, boring test. The second is that it suffers from the same issue as the milk challenge test with respect to the quantity of lactose that should be used. (See previous discussion.) Lastly, the breath test can be falsely abnormal when there is spread of bacteria from the colon into the small intestine, a condition called bacterial overgrowth of the small bowel. When overgrowth occurs, the bacteria that have moved up into the small intestine get to the lactose in the intestine before there has been enough time for the lactose to be digested and absorbed normally, and these bacteria produce hydrogen and/or methane. This may lead erroneously to a diagnosis of lactose intolerance. Other conditions also interfere with the breath test. Thus, diseases that markedly speed up transit of lactose through the small intestine prevent lactose from being fully digested and absorbed, leading to a misdiagnosis of lactose intolerance. Recent treatment with antibiotics can suppress colonic bacteria and their production of hydrogen or methane and lead to a misdiagnosis of lactose tolerance. Fortunately, these latter conditions are uncommon and usually can be anticipated on the basis of a person's history or symptoms.

Blood glucose test

The blood glucose test is an older test for lactase deficiency and lactose intolerance. For the blood glucose test, lactose is ingested (usually 0.75 to 1.5 gm of lactose per kg of body weight) after an overnight fast, and serial blood samples are drawn and analyzed for glucose. If the level of blood glucose rises more than 25 mg/100ml, it means that the lactose has been split in the intestine and the resulting glucose has been absorbed into the blood. This implies that lactase levels are normal. Unfortunately, the blood glucose test, though simple in principle, requires the collection of multiple samples of blood. Moreover, the test has many real and potential problems, the most common of which is false positive tests, that is, an abnormal test in people who have normal lactase levels and no lactose intolerance. For these reasons, the blood glucose test is not often used.

Stool acidity test

The stool acidity test is a test for lactase deficiency in infants and young children. For the stool acidity test, the infant or child is given a small amount of lactose orally. Several consecutive stool samples then are tested for acidity. With a deficiency of lactase, unabsorbed lactose enters the colon and is split into glucose and galactose. Some of the glucose and galactose is broken down by the bacteria into acids, for example, lactic acid. Lactic acid turns the stool acidic. Therefore, a lactase deficient infant or child will develop an acidic stool following the test dose of lactose.
Despite the availability of the stool acidity test, the superiority of breath testing has led to modifications in the equipment for collecting breath samples that makes it easier to do breath testing in young children and even infants. As a result, the stool acidity test is not done frequently.
Intestinal biopsy
The most direct test for lactase deficiency is biopsy of the intestinal lining with measurement of lactase levels in the lining. The biopsy can be obtained by endoscopy or by special capsules that are passed through the mouth or nose and into the small intestine. The analysis of lactase levels in the biopsy requires specialized procedures that are not often available, and, as a result, lactase levels are not often measured except for research purposes.

What are the sources of lactose in the diet?

Although milk and foods made from milk are the only natural sources of lactose, lactose often is "hidden" in prepared foods to which it has been added. People with very low tolerance for lactose should know about the many food products that may contain lactose, even in small amounts. Food products that may contain lactose include:
  • bread and other baked goods;

  • processed breakfast cereals;

  • instant potatoes, soups, and breakfast drinks;

  • margarine;

  • lunch meats (except those that are kosher);

  • salad dressings;

  • candies and other snacks; and

  • mixes for pancakes, biscuits, and cookies.
Some products labeled nondairy, such as powdered coffee creamer and whipped toppings, also may include ingredients that are derived from milk and, therefore, contain lactose.
Smart shoppers learn to read food labels with care, looking not only for milk and lactose in the contents but also for such words as whey, curds, milk by-products, dry milk solids, and nonfat dry milk powder. If any of these are listed on a label, the item contains lactose.
In addition to food sources, lactose can be "hidden" in medicines. Lactose is used as the base for more than 20% of prescription drugs and about 6% of over-the-counter drugs. Many types of birth control pills, for example, contain lactose, as do some tablets used for stomach acid and gas. However, these products typically affect only people with severe lactose intolerance because they contain such small amounts of lactose.

How is lactose intolerance treated?

Dietary changes
The most obvious means of treating lactose intolerance is by reducing the amount of lactose in the diet. Fortunately, most people who are lactose intolerant can tolerate small or even moderate amounts of lactose. It often takes only elimination of the major milk-containing products to obtain sufficient relief from their symptoms. Thus, it may be necessary to eliminate only milk, yogurt, cottage cheese, and ice cream. Though yogurt contains large amounts of lactose, it often is well-tolerated by lactose intolerant people. This may be so because the bacteria used to make yogurt contain lactase, and the lactase is able to split some of the lactose during storage of the yogurt as well as after the yogurt is eaten (in the stomach and intestine). Yogurt also has been shown to empty more slowly from the stomach than an equivalent amount of milk. This allows more time for intestinal lactase to split the lactose in yogurt, and, at least theoretically, would result in less lactose reaching the colon.
Most supermarkets carry milk that has had the lactose already split by the addition of lactase. Substitutes for milk also are available, including soy and rice milk. Acidophilus-containing milk is not beneficial since it contains as much lactose as regular milk, and acidophilus bacteria do not split lactose.
For individuals who are intolerant to even small amounts of lactose, the dietary restrictions become more severe. Any purchased product containing milk must be avoided. It is especially important to eliminate prepared foods containing milk purchased from the supermarket and dishes from restaurants that have sauces.
Another means to reduce symptoms of lactose intolerance is to ingest any milk-containing foods during meals. Meals (particularly meals containing fat) reduce the rate at which the stomach empties into the small intestine. This reduces the rate at which lactose enters the small intestine and allows more time for the limited amount of lactase to split the lactose without being overwhelmed by the full load of lactose at once. Studies have shown that the absorption of lactose from whole milk, which contains fat, is greater than from non-fat milk, perhaps for this very reason. Nevertheless, the substitution of whole milk or yogurt for non-fat milk or yogurt does not seem to reduce the symptoms of lactose intolerance.
Lactase enzyme
Caplets or tablets of lactase are available to take with milk-containing foods.
Adaptation
Some people find that by slowly increasing the amount of milk or milk-containing products in their diets they are able to tolerate larger amounts of lactose without developing symptoms. This adaptation to increasing amounts of milk is not due to increases in lactase in the intestine. Adaptation probably results from alterations in the bacteria in the colon. Increasing amounts of lactose entering the colon change the colonic environment, for example, by increasing the acidity of the colon. These changes may alter the way in which the colonic bacteria handle lactose. For example, the bacteria may produce less gas. There also may be a reduction in the secretion of water and, therefore, less diarrhea.
Calcium and vitamin D supplements
Milk and milk-containing products are the best sources of dietary calcium, so it is no wonder that calcium deficiency is common among lactose intolerant persons. This increases the risk and severity of osteoporosis and the resulting bone fractures. It is important, therefore, for lactose intolerant persons to supplement their diets with calcium. A deficiency of vitamin D also causes disease of the bones and fractures. Milk is fortified with vitamin D and is a major source of vitamin D for many people. Although other sources of vitamin D can substitute for milk, it is a good idea for lactose-intolerant persons to take supplemental vitamin D to prevent vitamin D deficiency.

What are the long-term consequences of lactose intolerance?

The important long-term health consequence of lactose intolerance is calcium deficiency that leads to osteoporosis. Less commonly, vitamin D deficiency may occur and compound the bone disease. Both of these health issues can be prevented easily by calcium and vitamin D supplements. The real problem is that many lactose intolerant people who consciously or unconsciously avoid milk do not realize that they need supplements.

What is new in lactose intolerance?

It is now possible to test the DNA of individuals to make a diagnosis of lactase deficiency. This is likely to be an important research tool for studying lactase deficiency. It is still too early to know how helpful this sophisticated test will be in the clinical evaluation and treatment of patients. It is an expensive test. Moreover, the test is not very good at distinguishing between lactase deficiency and lactose intolerance since the symptoms of lactose intolerance vary in severity among individuals. The important question to answer is, does lactose cause symptoms, and not, whether an individual is lactase deficient.
In 1998, scientists were able to make lactose intolerant rats tolerant to lactose by transferring the gene for lactase to their intestinal lining cells. It is unlikely that this type of gene therapy will find much of an application in people. Nevertheless, it is a fascinating example of what science can accomplish.

Lactose Intolerance At A Glance
  • Lactose intolerance is an inability to digest lactose, the main sugar in milk, that gives rise to gastrointestinal symptoms.
  • Lactose intolerance is caused by a deficiency of the intestinal enzyme lactase that splits lactose into two smaller sugars, glucose and galactose, and allows lactose to be absorbed from the intestine.
  • The primary symptoms of lactose intolerance are diarrhea, flatulence (passing gas), and abdominal pain. Abdominal bloating, abdominal distention, and nausea also may occur.
  • Lactose intolerance can be diagnosed by eliminating lactose from the diet, milk challenge, breath test, blood glucose test, stool acidity test, and intestinal biopsy.
  • Lactose intolerance is treated with dietary changes, supplements of lactase enzyme, and adaptation to increasing amounts of milk.
  • Avoidance of milk and milk-containing products can lead to a dietary deficiency of calcium and vitamin D that, in turn, can lead to bone disease (osteoporosis).
REFERENCE: eMedicine.com. Lactose Intolerance.
<http://emedicine.medscape.com/article/187249-overview>

Membersihkan Laut dengan Mikrobakteri



Memakai alam untuk membersihkan alam adalah metode yang paling tepat. Demikian pula hasil penelitian Lembaga Ilmu Pengetahuan Indonesia (LIPI) dengan National Institute of Technology and Evaluation (NITE) Jepang yang didiseminasikan di Jakarta, Selasa (10/2).

Ketika wilayah laut di Indonesia akhirnya disadari sering dicemari oleh tanker-tanker minyak yang membawa minyak mentah dari kawasan Timur Tengah ke negara-negara Asia Timur, mikrobakteri yang hidup bebas di laut bisa digunakan untuk mengurai minyak di laut lebih cepat.

"Nama prosesnya bioremediasi, artinya mengeliminasi polutan dengan proses biologi. Ini sudah ada dari dulu. Cuma proses biodegradasi, Indonesia belum punya," ujar peneliti teknik lingkungan LIPI, Dwi Susilaningsih, di Jakarta.

Proses biodegradasi adalah penguraian minyak di laut dengan material biologi, salah satunya dengan bakteri. Dalam kurun waktu tiga tahun penelitian ini dilakukan, ditemukan 182 spesies dan 53 genus baru di tiga wilayah perairan Indonesia yang menjadi rute utama kapal tanker, yaitu Selat Malaka, Selat Sunda, dan Selat Lombok.

Dwi menjelaskan, daripada memikirkan bahan-bahan dengan kandungan zat kimia untuk membersihkan laut dan akhirnya malah kembali mencemarkan, lebih baik Indonesia memanfaatkan kekayaan bakterinya di laut. "Coba bayangkan, polusi minyak, contohnya di Pulau Pramuka, sudah kayak aspal kerasnya menempel di akar-akar bakau. Itu bisa diuraikan dengan bakteri," ujar Dwi.

Fumiyoshi Okazaki, salah satu peneliti dari NITE Jepang, memaparkan penelitiannya yang bertajuk "Diversity and Functional Analysis of Petroleum Hydrocarbon-degrading Bacterial Communities in Coastal Zones of Indonesia".

Penelitian yang berpusat di Selat Malaka dan Selat Lombok ini menyebutkan peran Acinetobacter dan Alcanivorax yang sangat dominan dalam biodegradasi. "Mikroba alam itu yang bertanggung jawab terhadap remediasi minyak," ujar Okazaki.
"Populasi bakteri secara konstan bekerja dan kadar n-Alkanes secara konstan pula menurun setelah tujuh hari masa inkubasi," tuturnya.

Sementara itu, Dwi berharap agar hasil penelitian ini menjadi rekomendasi bagi pemerintah untuk menelurkan regulasi terkait sistem bioremediasi untuk menangani polusi minyak di wilayah laut Indonesia.

Oleh : Lin
Sumber : Kompas (10 Februari 2009)