Hemoglobin is broken down through erythrocyte lysis, releasing its components of globin amino acids, iron, heme, and porphyrin. Heme is further broken down by heme oxygenase into biliverdin and then bilirubin, releasing carbon monoxide and iron in the process. This overview summarizes the biochemical catabolism of hemoglobin and heme.
Dokumen tersebut menjelaskan mekanisme pembentukan dan transportasi bilirubin di hati dan usus, serta mekanisme patofisiologi yang menyebabkan ikterus. Bilirubin dibentuk dari degradasi heme di hati, lalu dikonjugasi dan ditransportasi ke empedu. Di usus, bilirubin dihidrolisis menjadi senyawa lain dan sebagian kecil diserap kembali ke hati (siklus enterohepatik). Ikterus disebabkan oleh pemb
Dokumen ini membahas patogenesis jaundice, termasuk mekanisme pembentukan bilirubin dari pemecahan sel darah merah dan proses eritropoesis yang tidak efektif. Proses konjugasi bilirubin melibatkan sejumlah enzim dan dapat terhambat oleh kegagalan hati serta obstruksi saluran eksresi. Hasil akhirnya adalah peningkatan kadar bilirubin dalam darah yang dapat berdifusi ke jaringan.
Dokumen ini membahas metabolisme bilirubin dan penyebab ikterus neonatorum, termasuk mekanisme pre-hepatik, intra-hepatik, dan pasca-hepatik dari patofisiologi ikterik. Ikterus neonatorum dibagi menjadi kategori fisiologis dan patologis, dengan detail mengenai kriteria diagnosis dan mekanisme penyebab peningkatan bilirubin. Selain itu, terapi sinar dijelaskan sebagai indikasi untuk mengatasi kondisi ikterus berat pada neonatus.
Dokumen ini membahas metabolisme bilirubin, termasuk katabolisme hemoglobin, konjugasi dan sekresi bilirubin di hati, serta siklus urobilinogen. Peningkatan kadar bilirubin dapat mengindikasikan berbagai kondisi medis, termasuk ikterus dan gangguan metabolik. Terdapat juga perbedaan antara bilirubin langsung dan tidak langsung serta pengaruhnya terhadap kesehatan.
Dokumen tersebut membahas proses metabolisme urobilin dan bilirubin dalam tubuh, mulai dari pembentukan urobilinogen di usus, katabolisme heme di hati yang menghasilkan bilirubin, metabolisme bilirubin di hati melalui konjugasi dan sekresi, hingga metabolisme bilirubin di usus menjadi urobilinogen.
Dokumen ini membahas ikterus pada bayi baru lahir, menjelaskan perbedaan antara ikterus fisiologis dan patologis serta penyebab dan faktor risikonya. Tanda, gejala, dan pengelolaan ikterus juga dijelaskan, termasuk pentingnya perawatan, pemberian ASI, dan pengawasan. Penanganan untuk kasus ikterus berat meliputi fototerapi dan transfusi, serta pentingnya rujukan medis bila diperlukan.
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This presentation by Thibault Schrepel, Associate Professor of Law at Vrije Universiteit Amsterdam University, was made during the discussion Artificial Intelligence, Data and Competition held at the 143rd meeting of the OECD Competition Committee on 12 June 2024. More papers and presentations on the topic can be found at oe.cd/aicomp.
This presentation was uploaded with the authors consent.
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The document provides career advice for getting into the tech field, including:
- Doing projects and internships in college to build a portfolio.
- Learning about different roles and technologies through industry research.
- Contributing to open source projects to build experience and network.
- Developing a personal brand through a website and social media presence.
- Networking through events, communities, and finding a mentor.
- Practicing interviews through mock interviews and whiteboarding coding questions.
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1. Core updates from Google periodically change how its algorithms assess and rank websites and pages. This can impact rankings through shifts in user intent, site quality issues being caught up to, world events influencing queries, and overhauls to search like the E-A-T framework.
2. There are many possible user intents beyond just transactional, navigational and informational. Identifying intent shifts is important during core updates. Sites may need to optimize for new intents through different content types and sections.
3. Responding effectively to core updates requires analyzing "before and after" data to understand changes, identifying new intents or page types, and ensuring content matches appropriate intents across video, images, knowledge graphs and more.
The document provides essential tips on how to handle difficult conversations in a workplace setting, emphasizing the importance of preparation, environment, and timing. It highlights that many employees dread such conversations, often leading to avoidance and worsening situations. Ultimately, the guide aims to promote positive outcomes while maintaining professional relationships.
2024 Trend Updates: What Really Works In SEO & Content MarketingSearch Engine Journal
油
The document outlines key SEO and content marketing trends for 2024, emphasizing the impact of AI, the importance of E-E-A-T (Experience, Expertise, Authoritativeness, Trustworthiness), and a shift towards user-centric content strategies. It advises against focusing on outdated trends like voice search and stresses the need for creating value-driven, authoritative content. Additionally, it highlights the need to leverage AI as a supportive tool rather than relying solely on it for content creation.
Storytelling For The Web: Integrate Storytelling in your Design ProcessChiara Aliotta
油
The document outlines a livestream presentation by Chiara Aliotta on integrating storytelling into web design to enhance user experiences. It covers the storytelling process for designers, emphasizing aspects such as understanding the audience, structuring narratives, and creating emotional connections. The presentation also includes case studies and practical examples to demonstrate effective storytelling in UX/UI design.
This presentation by Thibault Schrepel, Associate Professor of Law at Vrije Universiteit Amsterdam University, was made during the discussion Artificial Intelligence, Data and Competition held at the 143rd meeting of the OECD Competition Committee on 12 June 2024. More papers and presentations on the topic can be found at oe.cd/aicomp.
This presentation was uploaded with the authors consent.
How to Leverage AI to Boost Employee Wellness - Lydia Di Francesco - SocialHR...SocialHRCamp
油
The document discusses leveraging AI to enhance employee wellness through data analytics, automating tasks, and personalized wellness apps, emphasizing the shared responsibility of employee well-being between leaders and organizations. It outlines best practices for using AI in wellness strategies, including ensuring data privacy and security, understanding employee needs, and promoting inclusivity. Lydia Di Francesco, a wellness specialist, shares insights to optimize workplace wellness strategy using AI-driven data analytics and encourages collaboration and transparency.
2024 State of Marketing Report by HubspotMarius Sescu
油
The State of Marketing 2024 report highlights the transformative impact of AI and automation, emphasizing the importance of personalization and engagement to drive growth in a competitive landscape. Marketers are focusing on optimizing budgets, leveraging social media for brand awareness, and utilizing AI tools to enhance efficiency across tasks. Key trends for 2024 include the rise of experiential marketing, content creation that meets user needs, and strengthened connections through personalized customer experiences.
ChatGPT is an AI chatbot developed by OpenAI, built on advanced language models to facilitate human-like conversational interactions. Launched in November 2022, it utilizes a transformer architecture to understand and generate text, with applications ranging from content creation to customer service. Despite its capabilities, there are concerns about potential misuse and biases in its responses, which OpenAI aims to mitigate through moderation and user feedback.
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油
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
油
The November 2023 mental health report indicates that 70% of respondents rate their mental health as 'good' or 'excellent,' with higher diagnoses reported among African Americans and non-Hispanic whites compared to Hispanics and Asians. Younger generations, particularly Gen Z and millennials, are more likely to experience mental health challenges, seek information online, and report that their mental health impacts their work and relationships. Half of the respondents feel comfortable discussing their mental health with professionals, although Gen Z shows the least comfort in this area.
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
油
Creative operations teams expect increased AI use in 2024. Currently, over half of tasks are not AI-enabled, but this is expected to decrease in the coming year. ChatGPT is the most popular AI tool currently. Business leaders are more actively exploring AI benefits than individual contributors. Most respondents do not believe AI will impact workforce size in 2024. However, some inhibitions still exist around AI accuracy and lack of understanding. Creatives primarily want to use AI to save time on mundane tasks and boost productivity.
Organizational culture includes values, norms, systems, symbols, language, assumptions, beliefs, and habits that influence employee behaviors and how people interpret those behaviors. It is important because culture can help or hinder a company's success. Some key aspects of Netflix's culture that help it achieve results include hiring smartly so every position has stars, focusing on attitude over just aptitude, and having a strict policy against peacocks, whiners, and jerks.
PEPSICO Presentation to CAGNY Conference Feb 2024Neil Kimberley
油
PepsiCo provided a safe harbor statement noting that any forward-looking statements are based on currently available information and are subject to risks and uncertainties. It also provided information on non-GAAP measures and directing readers to its website for disclosure and reconciliation. The document then discussed PepsiCo's business overview, including that it is a global beverage and convenient food company with iconic brands, $91 billion in net revenue in 2023, and nearly $14 billion in core operating profit. It operates through a divisional structure with a focus on local consumers.
Content Methodology: A Best Practices Report (Webinar)contently
油
This document provides an overview of content methodology best practices. It defines content methodology as establishing objectives, KPIs, and a culture of continuous learning and iteration. An effective methodology focuses on connecting with audiences, creating optimal content, and optimizing processes. It also discusses why a methodology is needed due to the competitive landscape, proliferation of channels, and opportunities for improvement. Components of an effective methodology include defining objectives and KPIs, audience analysis, identifying opportunities, and evaluating resources. The document concludes with recommendations around creating a content plan, testing and optimizing content over 90 days.
How to Prepare For a Successful Job Search for 2024Albert Qian
油
The document provides guidance on preparing a job search for 2024. It discusses the state of the job market, focusing on growth in AI and healthcare but also continued layoffs. It recommends figuring out what you want to do by researching interests and skills, then conducting informational interviews. The job search should involve building a personal brand on LinkedIn, actively applying to jobs, tailoring resumes and interviews, maintaining job hunting as a habit, and continuing self-improvement. Once hired, the document advises setting new goals and keeping skills and networking active in case of future opportunities.
The 2024 social media marketing trends report highlights significant shifts influenced by generative AI, including the emergence of personalized content, the rise of virtual influencers, and a stronger focus on user-generated content. Insights were gathered from 33 experts across 23 leading independent agencies, providing a perspective that emphasizes creativity and authenticity in marketing strategies. Key trends also include the blending of B2B and B2C approaches, reflecting changes in consumer behavior and the evolving landscape of social media engagement.
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
油
The document discusses trends in paid search for 2024, highlighting changes in user behavior, the implications for financial services, and privacy challenges. It emphasizes the importance of adapting search strategies, utilizing AI-driven tools like performance max and smart bidding, and leveraging first-party data for better marketing efficacy. Key takeaways include holistic SEO and SEM approaches, monitoring shifting user intents, and the need for continuous performance evaluation.
5 Public speaking tips from TED - Visualized summarySpeakerHub
油
The document outlines five public speaking tips from Chris Anderson, TED Talks curator, emphasizing the importance of eye contact, vulnerability, humor, humility, and storytelling. These skills are presented as essential for engaging audiences effectively and are increasingly valuable in today's economy. The article posits that mastering these techniques can enhance speakers' ability to communicate ideas powerfully.
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
油
The document provides an overview of generative AI, particularly focusing on ChatGPT and its implications for business and the job market. It discusses the rapid growth of generative AI, its applications in marketing, and the skills needed for the AI era while addressing potential job displacement and the need for adaptation. The agenda includes a Q&A session and emphasizes rethinking work in collaboration with AI technology.
The document provides career advice for getting into the tech field, including:
- Doing projects and internships in college to build a portfolio.
- Learning about different roles and technologies through industry research.
- Contributing to open source projects to build experience and network.
- Developing a personal brand through a website and social media presence.
- Networking through events, communities, and finding a mentor.
- Practicing interviews through mock interviews and whiteboarding coding questions.
Google's Just Not That Into You: Understanding Core Updates & Search IntentLily Ray
油
1. Core updates from Google periodically change how its algorithms assess and rank websites and pages. This can impact rankings through shifts in user intent, site quality issues being caught up to, world events influencing queries, and overhauls to search like the E-A-T framework.
2. There are many possible user intents beyond just transactional, navigational and informational. Identifying intent shifts is important during core updates. Sites may need to optimize for new intents through different content types and sections.
3. Responding effectively to core updates requires analyzing "before and after" data to understand changes, identifying new intents or page types, and ensuring content matches appropriate intents across video, images, knowledge graphs and more.
The document provides essential tips on how to handle difficult conversations in a workplace setting, emphasizing the importance of preparation, environment, and timing. It highlights that many employees dread such conversations, often leading to avoidance and worsening situations. Ultimately, the guide aims to promote positive outcomes while maintaining professional relationships.
3. GLIKOLISIS
REAKSI ENZIMATIK MENGOKSIDASI GLUKOSA
SUASANA AEROB : GLUKOSA PIRUVAT
SUASANA AN AEROB :
GLUKOSA PIRUVAT ASAM LAKTAT
TUJUAN :
1. MENGHASILKAN ENERGI
2. MENYEDIAKAN PIRUVAT MENDORONG SIKLUS ASAM
SITRAT ( SAS ) ENERSI >>
3. BERLANGSUNG DI SITOPLASMA ( EKSTRA MITOKONDRIA
)
AS.PIRUVAT ASETIL KoA SA
1 MOL GLUKOSA S
( AEROB ) AS.PIRUVAT ASETIL KoA SA
S
AN AEROB ASAM LAKTAT
4. JALUR REAKSI GLIKOGEN
ATP ADP
DIET Glc Glc-6P Fruk-6P
Heksokinase Isomerase ATP
Glukokinase
Fosfofruktokinase
ENZIM KUNCI
ADP
Fruk-1,6P2
ATP Aldolase
ADP
3P-Glis Glis-3P dehidr
1,3P2-Glis Glis-3P (OH)2-ASETON-P
P-Glis kinase Isomerase
P-Glis. mutase NAD+
NADH O2
2P-Glis H +
AEROB OKS -RESP-
H+ e H+ e
H + , e- H2O
Enolase
ANAEROB
P.E.P
H + , e- 3ADP
ADP 3ATP
Piruvat kinase +
H ,e -
ATP
H+, e-
ENOL-PIRUVAT KETO-PIRUVAT LAKTAT
L.D.H
5. ENERGI GLIKOGEN
ATP ADP
DIET Glc Glc-6P Fruk-6P
Heksokinase Isomerase ATP
Glukokinase
AEROB Fosfofruktokinase
ADP
OKS. RESP. 2 X 3 = 6
TK SUBSTRAT 2 X 2 = 4
= 10 - 2 = 8ATP //Mol Glc
1 =9 ATP Mol Glc
Fruk-1,6P 2
ATP Aldolase
ADP
3P-Glis Glis-3P dehidr
1,3P2-Glis Glis-3P (OH)2-ASETON-P
P-Glis kinase Isomerase
P-Glis. mutase NAD+
NADH O2
1
2P-Glis H +
AEROB OKS RESP
H2O
Enolase
ANAEROB
P.E.P
ADP
ADP ATP
Piruvat kinase 3
ATP
ENOL-PIRUVAT KETO-PIRUVAT LAKTAT
L.D.H
6. ENERGI GLIKOGEN
ATP ADP
DIET Glc Glc-6P Fruk-6P
Heksokinase Isomerase ATP
ANAEROB Fosfofruktokinase
OKS. RESP. 2 X 3 = 6 ADP
= 10 -
2 = 8 / Mol Glc
-
TK SUBSTRAT 2 X 2 = 4 1 = 3 ATP //Mol Glc
2 = 2 ATP Mol Glc Fruk-1,6P2
ATP Aldolase
ADP
3P-Glis Glis-3P dehidr
1,3P2-Glis Glis-3P (OH)2-ASETON-P
P-Glis kinase Isomerase
P-Glis. mutase NAD+
1 NADH
XO2
H
X
+
2P-Glis AEROB OKS RESP
H2O
Enolase
ANAEROB
P.E.P
ADP
ADP 3 ATP
Piruvat kinase
ATP
ENOL-PIRUVAT KETO-PIRUVAT LAKTAT
L.D.H
7. GLIKOLISIS DI SEL DARAH MERAH
SAAT BUTUH BPG
ATP
ATP ADP
DARAH Glc Glc-6P Fruk-6P
Heksokinase Isomerase ATP
Fosfofruktokinase
2,3-BIFOSFOGLISERAT ADP
( BPG )
2,3 BPG-Fossfatase Fruk-1,6P2
ATP BPG-mutase Aldolase
ADP
3P-Glis Glis-3P dehidr
1,3P2-Glis Glis-3P (OH)2-ASETON-P
P-Glis kinase Isomerase
P-Glis. mutase NAD+
NADH
H+, e-H
+
2P-Glis
Enolase H + , e-
P.E.P
H + , e-
ADP
Piruvat kinase H+, e-
ATP
H+, e- LAKTAT
ENOL-PIRUVAT KETO-PIRUVAT
L.D.H
8. Defisiensi piruvat kinase tidak sering ditemukan,
tetapi merupakan defisiensi enzim enzim tersering
kedua yang menyebabkan anemia hemolitik
Mekanismenya diperkirakan disebabkan oleh
gangguan glikolisis sehingga terjadi penurunan
produksi ATP ( Defisienssi enzim piruvat kinase)
akan mempengaruhi berbagai aspek integritas
membran .
9. METABOLISME BILIRUBIN
PORFIRIN :
Porfirin adalah Senyawa siklik gabungan dari 4 cincin pirol
dan jembatan metenil ( -CH =)
SENYAWA INI DAPAT BERIKATAN DENGAN
LOGAM Fe ATAU Mg
Fe heme
heme + protein hemoprotein
contoh : Hb
Mg : Khloropil
Ikatan Porfirin + logam Metalopofirin
10. HEMOGLOBIN. A
Heme Heme
H C N CH C
H
N CH
N Fe N N Fe N
H C N CH H C N CH
硫
留 留 Globin
硫
C
H N CH C
H
N CH
N Fe N N Fe N
C
H N CH C
H N CH
Heme
Heme
11. KATABOLISME HEME
SETIAP 120 HARI ERITROSIT / Hb DIPECAH.
ERITROSIT HEMOGLOBIN HEME (Fe+++ + BIL ) + GLOBIN
PEMECAHAN TERJADI DI SEL-SEL RES ( HEPAR, LIEN & SUMSUM
TULANG ), OLEH SEL-SEL MAKROFAG.
PADA ORANG DEWASA, 70 Kg, SETIAP HARI 賊 6 GRAM Hb DIPECAH.
1 GRAM Hb MENGHASILKAN 35 MG BILIRUBIN TIAP HARI DIHA-
SILKAN 250 350 MG BILIRUBIN.
12. DI R E S :
ERI TUA / RUSAK DIMAKAN OLEH MAKROFAG
ERI Hb HEME + GLOBIN
GLOBIN ASAM AMINO
HAPTOGLOBIN
HEM DI OKSIDASI OLEH SISTEM HEMOKSIGENASE, MENGHASILKAN :
> Fe++ Fe++ + ( HEMIN )
> BILIVERDIN ( TETRA PIROL LINEAR / TERBUKA )
DARAH
Fe +++
lepas TRANSFERIN HEPAR
BILIVERDIN DI OKSIDASI BILIRUBIN DARAH
( pigmen hijau ) ( pigmen kuning merah )
DARAH : BILIRUBIN + ALBUMIN BILIRUBIN ALBUMIN HEPAR
13. DI HEPAR :
ALBUMIN DILEPASKAN, DIGANTI DENGAN LIGANDIN.
BILIRUBIN-LIGANDIN MASUK KE SEL HAPATOSIT, KEMUDIAN DI KONJU-
GASI-KAN DENGAN ASAM GLUKORONAT OLEH ENZIM URIDIN DIFOSFO-
GLUKORONIL TRANSFERASE ( UDP-GLUKORONIL TRANSFERASE ).
HASILNYA : BILIRUBIN DIGLUKORONIDA
UDP-GLUKOSA DEHIDROGENASE
UDP-GLUKOSA UDP-GLUKORONAT
2 NAD 2 NADH + 2 H+
UDP-GLUKORONAT UDP-GLUK.TRANSFERASE BILIRUBIN MONO GLUKORONIDA
+ + UDP
BILIRUBIN
UDP-GLUK.TRANSFERASE
UDP-GLUKORONAT + BILI.MONOGLUKORONIDA
BILI. DIGLUKORONIDA + UDP
2 mol. BILI. MONOGLUKORONIDA BILI. DIGLUKORONIDA + BILIRUBIN
14. BILIRUBIN DIGLUKORONIDA DISEKRESI KE DALAM EMPEDU, SECARA
AKTIF DITERUSKAN KE USUS.
DI USUS :
DI ILEUM & COLON, KONJUGASI DILEPASKAN.
BILIRUBIN DI REDUKSI OLEH BAKTERI USUS menjadi
UROBILINOGEN / STERKOBILINOGEN.
UROBILINOGEN / SEKRESI MELALUI FESES
STERBILINOGEN
di REABSORPSI MASUK KE HEPAR:
sebagian di OKSIDASI MENJADI
BILIRUBIN LAGI KONJUGASI
lagi DAN SETERUSNYA.
SIKLUS ENTEROHEPATIK
Sebagian lagi PEREDARAN DARAH SISTEMIK
KE GINJAL KE URINE.
15. KATABO Fibroblas
LISME & OTAK R E S
SDM
EKSKRE Hb
SI HEME GLOBULIN
HEME
Heme-Oksigenase
Fe+++
REOKSIDASI BILIRUBIN BILIVERDIN
HEPAR
LIGANDIN
ALBUMIN BILIRUBIN
UDP-Glukuronil
BILIRUBIN
BILI-GLUK
BILI-GLUK
Transferase2 2
ALUR PIGMEN GINJAL
2-GLUKURONAT
SIRKULASI
ENTERO-HEPATIK
Saluran
Empedu V. PORTA UROBILIN
STERKOBLNG
STERKOBILIN
STERKOBLNG
ENZ. FLORA USUS
USUS STERKOBILINMUSCLE
16. KATABOLISME Hb DAN EKSKRESI BILIRUBIN
HEPA
R R E Hb
. ASAM GLUKORONAT
LI LU
K S
BI I G
HEME +GLOBIN
BILIRUBIN
BILIRUBIN
M IN
D UDP Glukoronil
BU UB
IN
Transferase
AL LIR
A.A
BI
BILIVERDIN HAPTOGLO
E BIN
G
UROBILINOGEN O
N
LI
BI GINJAL
O
R GINJAL
U
N
UROBILINOGEN
UROBILIN
USU GEN (URINE )
RED STERKOBILINO
S BILI.DIGLU
BILI. UROBILI /
K
COLON STERKOBILIN ( FESES )