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saco-indonesia.com, Usai mengamankan tanda tangan Greg Nwokolo, Persebaya telah kembali mengikat satu pemain asal Kamerun, Danie

saco-indonesia.com, Usai mengamankan tanda tangan Greg Nwokolo, Persebaya telah kembali mengikat satu pemain asal Kamerun, Daniel Monchare. Monchare akan dijadwalkan menandatangani kontrak di Kantor Kadin Jawa Timur (Jatim), Rabu (18/12) siang ini.

"Rencananya memang seperti itu. Dia akan teken hari ini," ujar sekretaris tim Persebaya, Rahmad Sumanjaya, Rabu pagi.

Dibanding tiga pemain asing lainnya, kedatangan Monchare juga terbilang terlambat. Ia seharusnya juga sudah mendarat di Indonesia sejak sepekan lalu. Namun Monchare harus tertahan di Nigeria karena urusan administrasi. "Sebab dia belum pernah main di Indonesia," jelas Rahmad.

Dengan demikian, Monchare juga merupakan pemain asing ketiga yang telah bergabung dengan tim juara Divisi Utama 2013 ini. Sebelumnya, tim asuhan Rahmad Darmawan lebih dulu mengikat gelandang serang Patrice Nzekou dan striker Emmanuel "Pacho" Kenmogne.

Selain sama-sama berasal dari Kamerun, ketiga pemain ini juga berada dalam satu payung agen, yakni Francis Yonga. Kehadiran Monchare juga diharapkan mampu untuk memperkuat tembok pertahanan Persebaya. Sebelumnya, Persebaya juga sudah memiliki Ambrizal, Manahati Lestusen dan Vava Mario Yagalo.


Editor ; Dian Sukmawati

Satu demi satu misteri penyebab diabetes melitus tipe 2 mulai terungkap.

Oleh IRWAN JULIANTO

Saco-Indonesia.com,- Satu demi satu misteri penyebab diabetes melitus tipe 2 mulai terungkap. Para peneliti Harvard School of Public Health (HSPH) baru saja memublikasikan temuan mereka bahwa ada satu jenis protein atau hormon khusus yang ditemukan dalam sel-sel lemak yang terbukti membantu mengatur bagaimana gula darah dikendalikan dan dimetabolisasi untuk energi di dalam hati. Ini dikatakan akan membuka salah satu jalan bagi pengobatan diabetes tipe 2 yang menjangkiti ratusan juta penduduk dunia.

Diabetes tipe ini tidak bergantung pada insulin dan terjadi pada orang-orang dewasa (adult onset), berbeda dengan diabetes tipe 1 yang bergantung pada insulin dan terjadi sejak bayi. Diabetes tipe 2 dapat didefinisikan sebagai suatu kelainan metabolik yang ditandai dengan tingginya kadar glukosa darah akibat terjadinya kekurangan dan resistansi insulin. Kemampuan sel-sel beta pankreas berkurang bahkan rusak sehingga pasien mulai mengalami diabetes, dengan gejala-gejala seperti banyak makan (polifagia), banyak minum (polidipsia), dan banyak kencing (poliuria).

Jumlah kasus diabetes tipe 2 hampir sepuluh kali lipat kasus diabetes tipe 1 yang terjadi karena kerusakan pankreas sejak bayi. Hingga sekarang diyakini bahwa kegemukan menjadi penyebab utama terjadinya diabetes tipe 2 pada orang-orang yang memang secara genetis sudah membawa gen pembawa penyakit ini.

Dua-tiga dekade lalu sudah diketahui adanya hubungan antara kegemukan dan diabetes tipe 2, tetapi belum jelas apakah kegemukan memicu diabetes jenis ini ataukah hanya mempercepat terjadinya. Riset di Amerika Serikat menunjukkan, orang-orang dengan obesitas tiga kali lebih mudah terjangkit diabetes dibandingkan dengan mereka yang tidak kegemukan. Makin tua seseorang, risiko terkena diabetes tipe 2 juga kian besar. Orang-orang berusia 65 tahun, misalnya, lebih mungkin terserang dibandingkan dengan mereka yang berusia di bawah 20 tahun.

Diabetes tipe 2 juga diketahui erat hubungannya dengan faktor keturunan. Jika dalam keluarga Anda ada yang mengidap diabetes, kemungkinan Anda terjangkit diabetes cukup besar.

Jika ayah atau ibu Anda dan kakek atau nenek serta bibi atau paman Anda menderita penyakit ini, peluang Anda mengalami diabetes tipe 2 mendekati 85 persen. Jika ayah dan nenek mengidap diabetes, risiko Anda cuma 60 persen. Jika hanya ibu yang menderita, maka 22 persen risikonya bagi Anda akan menderita pula.

Diabetes tipe 2 umumnya terjadi pada orang dewasa akibat perubahan gaya hidup, berkurangnya kegiatan jasmani, dan jenis makanan/minuman yang serba fast food dan soft drink. Namun, saat ini diabetes tipe 2 ditemukan juga pada anak- anak dan remaja di Asia.

Penyakit kronis ini diyakini menyebabkan usia harapan hidup bagi penderitanya sepuluh tahun lebih pendek dibandingkan dengan orang-orang non-diabetik akibat komplikasi penyakit jantung koroner, stroke, dan gagal ginjal. Diabetes tipe 2 juga menyebabkan kecacatan, seperti kebutaan akibat komplikasi retinopati dan meningkatnya risiko sebesar 20 kali amputasi tungkai bawah. Pengidap diabetes ini mudah lupa dan mengalami impotensi.

Multipatologi

Selama berpuluh tahun para peneliti dan dokter dihadapkan pada misteri: tidak semua orang yang kegemukan atau resistan terhadap insulin mengidap diabetes tipe 2. Bahkan, cukup banyak orang yang amat gemuk tak terserang penyakit ini. Para ilmuwan lalu berteori bahwa ada suatu faktor yang tak dikenal yang terlibat dalam metabolisme glukosa dalam hati, dan mungkin kehadiran atau absennya elemen ini, dapat menentukan siapa yang terkena diabetes tipe 2.

Dalam jurnal Cell Metabolism edisi 7 Mei 2013, para peneliti HSPH mengungkapkan, dunia ilmiah sudah lama mengetahui bahwa salah satu peristiwa kunci bagi berkembangnya diabetes tipe 2 adalah produksi glukosa yang tak terkontrol dari hati.

”Namun, mekanisme yang mendasarinya tetap masih sukar dipahami,” kata Gökhan S Hotamisligil, Kepala Departemen Genetika dan Penyakit-penyakit Kompleks, dan JS Simmons, profesor genetika dan metabolisme di HSPH. ”Kami sekarang berhasil mengidentifikasi aP2 sebagai suatu hormon baru yang dikeluarkan dari sel-sel lemak yang mengontrol fungsi kritis ini.”

Lewat percobaan dengan mencit di laboratorium memakai teknologi mutakhir ditemukan bahwa jika jumlah aP2 berlebih, timbullah diabetes. Sebaliknya, jika hormon ini diblok atau di- switch-off, produksi glukosa dari hati dapat dikontrol lebih baik sehingga manifestasinya berupa diabetes tipe 2 dan penyakit-penyakit metabolik lainnya pun dapat dicegah.

Kemampuan sebuah organ—dalam hal ini jaringan lemak—begitu langsung dan menentukan dalam mengendalikan tindakan organ lain, yaitu hati, amat menarik, kata Hotamisligil. ”Kami menduga sistem komunikasi antara jaringan lemak dan hati telah berevolusi untuk membantu sel-sel lemak memberi komando kepada hati untuk menyuplai tubuh dengan glukosa pada saat-saat terjadinya kekurangan nutrien. Betapa pun, ketika sel-sel lemak yang membesar kehilangan kendali terhadap sinyal ini karena kondisi obesitas, tingkat aP2 dalam darah naik, glukosa diguyurkan ke dalam aliran darah dan tidak dapat dibersihkan oleh jaringan-jaringan lain. Hasilnya adalah tingginya kadar glukosa darah dan diabetes 2.”

Guru Besar FK UI yang mendalami diabetes, Sidartawan Soegondo, menyatakan, temuan para ilmuwan Harvard ini merupakan sumbangan berarti bagi perkembangan ilmu kedokteran. ”Akhir-akhir ini saya mengajarkan bahwa diabetes tipe 2 adalah penyakit dengan multipatologi,” ujarnya ketika dihubungi pada Selasa (21/5). Kini, selain organ pankreas, diabetes tipe 2 diketahui pula dipicu juga oleh metabolisme sembilan organ lain, antara lain hati dan ginjal.

 

Sumber :Kompas Cetak/http://health.kompas.com/read/2013/05/22/06524140/Harapan.Baru.untuk.Terapi.Diabetes.Tipe.2
Editor :Liwon Maulana

WASHINGTON — The last three men to win the Republican nomination have been the prosperous son of a president (George W. Bush), a senator who could not recall how many homes his family owned (John McCain of Arizona; it was seven) and a private equity executive worth an estimated $200 million (Mitt Romney).

The candidates hoping to be the party’s nominee in 2016 are trying to create a very different set of associations. On Sunday, Ben Carson, a retired neurosurgeon, joined the presidential field.

Senator Marco Rubio of Florida praises his parents, a bartender and a Kmart stock clerk, as he urges audiences not to forget “the workers in our hotel kitchens, the landscaping crews in our neighborhoods, the late-night janitorial staff that clean our offices.”

Gov. Scott Walker of Wisconsin, a preacher’s son, posts on Twitter about his ham-and-cheese sandwiches and boasts of his coupon-clipping frugality. His $1 Kohl’s sweater has become a campaign celebrity in its own right.

Senator Rand Paul of Kentucky laments the existence of “two Americas,” borrowing the Rev. Dr. Martin Luther King Jr.’s phrase to describe economically and racially troubled communities like Ferguson, Mo., and Detroit.

Photo
 
Senator Marco Rubio of Florida praises his parents, a bartender and a Kmart stock clerk. Credit Joe Raedle/Getty Images

“Some say, ‘But Democrats care more about the poor,’ ” Mr. Paul likes to say. “If that’s true, why is black unemployment still twice white unemployment? Why has household income declined by $3,500 over the past six years?”

We are in the midst of the Empathy Primary — the rhetorical battleground shaping the Republican presidential field of 2016.

Harmed by the perception that they favor the wealthy at the expense of middle-of-the-road Americans, the party’s contenders are each trying their hardest to get across what the elder George Bush once inelegantly told recession-battered voters in 1992: “Message: I care.”

Their ability to do so — less bluntly, more sincerely — could prove decisive in an election year when power, privilege and family connections will loom large for both parties.

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Questions of understanding and compassion cost Republicans in the last election. Mr. Romney, who memorably dismissed the “47 percent” of Americans as freeloaders, lost to President Obama by 63 percentage points among voters who cast their ballots for the candidate who “cares about people like me,” according to exit polls.

And a Pew poll from February showed that people still believe Republicans are indifferent to working Americans: 54 percent said the Republican Party does not care about the middle class.

That taint of callousness explains why Senator Ted Cruz of Texas declared last week that Republicans “are and should be the party of the 47 percent” — and why another son of a president, Jeb Bush, has made economic opportunity the centerpiece of his message.

With his pedigree and considerable wealth — since he left the Florida governor’s office almost a decade ago he has earned millions of dollars sitting on corporate boards and advising banks — Mr. Bush probably has the most complicated task making the argument to voters that he understands their concerns.

On a visit last week to Puerto Rico, Mr. Bush sounded every bit the populist, railing against “elites” who have stifled economic growth and innovation. In the kind of economy he envisions leading, he said: “We wouldn’t have the middle being squeezed. People in poverty would have a chance to rise up. And the social strains that exist — because the haves and have-nots is the big debate in our country today — would subside.”

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Who Is Running for President (and Who’s Not)?

Republicans’ emphasis on poorer and working-class Americans now represents a shift from the party’s longstanding focus on business owners and “job creators” as the drivers of economic opportunity.

This is intentional, Republican operatives said.

In the last presidential election, Republicans rushed to defend business owners against what they saw as hostility by Democrats to successful, wealthy entrepreneurs.

“Part of what you had was a reaction to the Democrats’ dehumanization of business owners: ‘Oh, you think you started your plumbing company? No you didn’t,’ ” said Grover Norquist, the conservative activist and president of Americans for Tax Reform.

But now, Mr. Norquist said, Republicans should move past that. “Focus on the people in the room who know someone who couldn’t get a job, or a promotion, or a raise because taxes are too high or regulations eat up companies’ time,” he said. “The rich guy can take care of himself.”

Democrats argue that the public will ultimately see through such an approach because Republican positions like opposing a minimum-wage increase and giving private banks a larger role in student loans would hurt working Americans.

“If Republican candidates are just repeating the same tired policies, I’m not sure that smiling while saying it is going to be enough,” said Guy Cecil, a Democratic strategist who is joining a “super PAC” working on behalf of Hillary Rodham Clinton.

Republicans have already attacked Mrs. Clinton over the wealth and power she and her husband have accumulated, caricaturing her as an out-of-touch multimillionaire who earns hundreds of thousands of dollars per speech and has not driven a car since 1996.

Mr. Walker hit this theme recently on Fox News, pointing to Mrs. Clinton’s lucrative book deals and her multiple residences. “This is not someone who is connected with everyday Americans,” he said. His own net worth, according to The Milwaukee Journal Sentinel, is less than a half-million dollars; Mr. Walker also owes tens of thousands of dollars on his credit cards.

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But showing off a cheap sweater or boasting of a bootstraps family background not only helps draw a contrast with Mrs. Clinton’s latter-day affluence, it is also an implicit argument against Mr. Bush.

Mr. Walker, who featured a 1998 Saturn with more than 100,000 miles on the odometer in a 2010 campaign ad during his first run for governor, likes to talk about flipping burgers at McDonald’s as a young person. His mother, he has said, grew up on a farm with no indoor plumbing until she was in high school.

Mr. Rubio, among the least wealthy members of the Senate, with an estimated net worth of around a half-million dollars, uses his working-class upbringing as evidence of the “exceptionalism” of America, “where even the son of a bartender and a maid can have the same dreams and the same future as those who come from power and privilege.”

Mr. Cruz alludes to his family’s dysfunction — his parents, he says, were heavy drinkers — and recounts his father’s tale of fleeing Cuba with $100 sewn into his underwear.

Gov. Chris Christie of New Jersey notes that his father paid his way through college working nights at an ice cream plant.

But sometimes the attempts at projecting authenticity can seem forced. Mr. Christie recently found himself on the defensive after telling a New Hampshire audience, “I don’t consider myself a wealthy man.” Tax returns showed that he and his wife, a longtime Wall Street executive, earned nearly $700,000 in 2013.

The story of success against the odds is a political classic, even if it is one the Republican Party has not been able to tell for a long time. Ronald Reagan liked to say that while he had not been born on the wrong side of the tracks, he could always hear the whistle. Richard Nixon was fond of reminding voters how he was born in a house his father had built.

“Probably the idea that is most attractive to an average voter, and an idea that both Republicans and Democrats try to craft into their messages, is this idea that you can rise from nothing,” said Charles C. W. Cooke, a writer for National Review.

There is a certain delight Republicans take in turning that message to their advantage now.

“That’s what Obama did with Hillary,” Mr. Cooke said. “He acknowledged it openly: ‘This is ridiculous. Look at me, this one-term senator with dark skin and all of America’s unsolved racial problems, running against the wife of the last Democratic president.”

A former member of the Boston Symphony Orchestra, Mr. Smedvig helped found the wide-ranging Empire Brass quintet.

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