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"Contrast induced nephropathy (CIN) merupakan salah satu komplikasi pemberian media kontras yang paling penting. Akan tetapi, insidens dan faktor-faktor yang mempengaruhi CIN setelah suatu tindakan intervensi koroner belum pernah dilaporkan di Indonesia. CIN didefinisikan sebagai peningkatan kreatinin serum sebesar 0,5 mg/dl atau lebih pada hari ke 3 pasca tindakan. Dari 312 subyek yang ikut dalam penelitian ini didapatkan insidens CIN sebesar 25%. Pada analisis bivariat didapatkan faktor hipertensi, diabetes mellitus, kelas NYHA, volume dan jenis zat kontras, kadar kreatinin serum > 1,5 mg/dl, proteinuria dan fraksi ejeksi ≤ 35% secara bermakna mempengaruhi kejadian CIN. Pada analisis multivariate hanya hipertensi [hazard rasio (HR) = 2,89; 95% interval kepercayaan (CI) = 1,78 s/d 4,71; P = 0,000], diabetes mellitus (HR = 3,09; 95% CI = 1,89 s/d 5,06, P = 0,000), fraksi ejeksi (EF) ≤ 35% (HR = 2,92; 95% CI = 1,72 s/d 4,96; P = 0,000), volume zat kontrast > 300 ml (HR = 7.73; 95% CI 3,09 s/d 19,37; P = 0,000) dan proteinuria (HR = 14,96; 95% CI = 3,45 s/d 64,86; P = 0,000) yang merupakan faktos risiko bebas CIN. Kesimpulannya adalah insidens CIN pada hari ke 3 pada pasien yang dilakukan intervensi koroner sebesar 25%. Hipertensi, diabetes melitus, EF ≤ 35%, volume zat kontras > 300 ml dan proteinuria merupakan faktor risiko bebas CIN.

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AbstractContrast induced nephropathy (CIN) is one of important complication of contrast media administration. Its incidence and risk factors among Indonesian patients undergoing coronary intervention has not been reported yet. CIN was defined as increasing of serum creatinine by 0.5 mg/dl or more in the third day following contrast media exposure. Of 312 patients undergoing coronary intervention, 25% developed CIN. Patient-related risk factors comprised of hypertension, diabetes mellitus, NYHA class, proteinuria, serum creatinine > 1.5 mg/dl and ejection fraction ≤ 35%. Contrast-related risk factors comprised of contrast media volume > 300 ml, contrast media type. However, our final model demonstrated that only hypertension [Hazard ratio (HR) = 2.89, 95% confidence intrval (CI) = 1.78 to 4.71, P = 0.000], diabetes mellitus (HR = 3.09, 95% CI = 1.89 to 5.06, P = 0.000), ejection fraction (EF) ≤ 35% (HR = 2.92; 95% CI = 1.72 to 4.96; P = 0.000), total contrast volume > 300 ml (HR = 7.73; 95% CI = 3.09 to 19.37; P = 0.000) and proteinuria (HR = 14.96; 95% CI = 3.45 to 64.86; P = 0.000) were independent risk factors of CIN. In conclusion, CIN developed in 25% of patients undergoing coronary intervention. The independent risk factors of CIN included hypertension, diabetes mellitus, EF ≤ 35%, contrast volume > 300 ml and proteinuria."

"Skripsi ini bertujuan untuk mengetahui gambaran faktor risiko ergonomi terhadap timbulnya MSDs pada operator crane di area finishing PT. Jakarta Cakratunggal Steel Mills. Penelitian ini menggunakan metode deskriptif kuantitatif dengan menggunakan metode Quick Exposure Check dan pengisian Nordic Body Map untuk mengetahui keluhan subjektif MSDs pada pekerja. Berdasarkan penilaian menggunakan Quick Expossure Checklist (QEC) pada kegiatan kerja memiliki skor 66% sehingga masuk kedalam tingkat risiko sedang dan diperlukan penelitian lebih lanjut serta dilakukan perubahan. Keseluruhan operator (100%) merasakan keluhan MSDs dengan keluhan yang paling banyak di alami adalah pada leher, bahu kiri, bahu kanan, paha kiri, paha kanan. Hal ini disebabkan posisi janggal yang disebabkan oleh aktivitas kerja sebagai operator crane dan faktor peralatan yang dipakai operator. Memperbaiki desain peralatan kerja yang sesuai dengan antropologi pekerja, pemberian informasi terkait ergonomi di tempat kerja dan sosialisasi dapat menjadi cara untuk mencegah tingginya risiko ergonomi pada pekerja operator crane area finishing.

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This thesis aims to determine the description of ergonomic risk factors for the emergence of MSDs on crane operators in the finishing area of PT. Jakarta Cakratunggal Steel Mills. This study uses a quantitative descriptive method using the Quick Exposure Check method and the Nordic Body Map to find out the subjective complaints of MSDs on workers. Based on the assessment using the Quick Expossure Checklist (QEC) on work activities it has a score of 66% so that it enters a moderate level of risk and further research is needed and changes are made. Overall operators (100%) felt complaints of MSDs with the most common complaints on the neck, left shoulder, right shoulder, left thigh, right thigh. This is due to the awkward position caused by the demands of duty as a crane operator and the equipment factor used by the operator. Improving the design of work equipment in accordance with the anthropology of workers, providing information related to ergonomics in the workplace and socialization can be a way to prevent the high risk of ergonomics in crane operator area finishing workers."

"Pendahuluan: Hampir 85% kasus karsinoma ovarium terjadi overekspresi endothelin-1 (ET-1) yang memodulasi persinyalan tumorigenesis dan metastasis. Disisi lain, cisplatin sebagai kemoterapi kanker ovarium menimbulkan efek samping dan resistensi terapi. Berbagai penelitian menunjukkan kurkumin berpotensi sebagai antikanker yang meningkatkan efikasi cisplatin dan menekan overekspresi ET-1 pada lini sel nonkanker. Namun, belum banyak penelitian yang mengidentifikasi penekanan ekspresi ET-1 oleh kurkumin dalam regimen terapi bersama cisplatin di kanker ovarium. Oleh karena itu, penelitian ini bertujuan melihat efek ko-kemoterapi kurkumin bersama cisplatin pada kanker ovarium terkait ekspresi relatif mRNA ET-1. Metode: Jaringan ovarium tersimpan dari 24 tikus betina galur Wistar dibagi kedalam 4 kelompok: tikus yang hanya dibedah dan diberi aquadest (sham), tikus yang diimplantasi DMBA tanpa intervensi terapi, tikus yang diimplantasi DMBA dan diberi terapi tunggal cisplatin intraperitoneal 4 mg/kgBB/minggu, tikus yang diimplantasi DMBA dengan diberi terapi cisplatin 4 mg/kgBB/minggu dan kurkumin oral 100 mg/kgBB/hari. Implantasi DMBA dilakukan selama 28 minggu dan intervensi pada hewan coba selama 4 minggu. Setelah itu, jaringan ovarium tersimpan dianalisis ekspresi relatif mRNA ET-1 dengan mesin qRT-PCR menggunakan metode Livak-Schmittgen (2(-Ct)). Hasil: Didapatkan rerata ekspresi relatif mRNA ET-1 [p=0,021] pada kelompok sham (0,349±0,24), kelompok DMBA (3,117±1,532), kelompok DMBA+cisplatin (0,993±0,651), dan kelompok DMBA+kurkumin+cisplatin (0,117±0,081). Ketiga kelompok tidak memiliki perbedaan bermakna dibandingkan sham. Meski demikian, terdapat perbedaan bermakna pada kelompok kombinasi cisplatin serta ko-kemoterapi kurkumin dengan kelompok tanpa intervensi terapi [p=0,019]. Kesimpulan: Terjadi penurunan ekspresi relatif mRNA endothelin-1 di jaringan ovarium model tikus yang diinduksi DMBA setelah pemberian kombinasi cisplatin dan ko-kemoterapi kurkumin.

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Introduction: Endothelin-1 overexpression happens in 85% ovarian carcinoma cases that modulate metastatic and tumorigenesis. Meanwhile, cisplatin as ovarian cancer chemotherapy cause side effects and therapy resistances. Prior studies show potential effect of curcumin as an anticancer could enhance cisplatin efficacy and attenuate ET-1 overexpression in non-cancer cell lines. However, not many studies have identified suppression effect of ET-1 expression by curcumin with cisplatin in ovarian cancer. Therefore, this study is conducted to identify the effect of curcumin with cisplatin in ovarian cancer treatment especially its relation to relative expression of ET-1 mRNA.

Methods: Frozen ovarian tissue samples from 24 female Wistar rats were divided into 4 groups: a group that only operated on and treated with distilled-water (sham), group with DMBA-implantation, group with DMBA-implantation and intraperitoneal cisplatin 4mg/kgBW/week, group with DMBA-implantation and cisplatin with same dose as before plus oral curcumin 100mg/kgBW/day. After 28 weeks of DMBA-implantation and 4 weeks of intervention, frozen ovarian tissue samples were taken to measure its relative expression of ET-1 mRNA level with qRT-PCR machine.

Results: The mean of relative expression of ET-1 mRNA level [p=0,021] in frozen tissue sample of sham group (0,349±0,24), DMBA-implantation group (3,117±1,532), DMBA+cisplatin-treated group (0,993±0,651), and DMBA+curcumin+cisplatin-treated group (0,117±0,081). This study shows those 3 groups did not have significant difference compared with sham. But among group with cisplatin+curcumin-treated compared to DMBA-implantation shows a significant difference (p=0,019).

Conclusion: The relative expression of ET-1 mRNA in ovarian tissue of DMBA-induced rats model decreases after given by a combination of cisplatin+curcumin co-chemotherapy."

"Latar Belakang: Stunting berdampak pada hipofungsi kelenjar saliva sehingga meningkatkan risiko penyakit gingivitis. Kondisi stunting meningkatkan jumlah Veillonella parvula yang berperan sebagai patogen aksesori gingivitis. Oleh karena itu, pemberian probiotik dilakukan untuk mencegah akumulasi biofilm penyebab gingivitis yang dapat memperparah stunting. Tujuan: Menganalisis korelasi antara penurunan jumlah V. parvula dalam saliva dengan perbaikan status kesehatan periodontal (sBPE) sebelum dan sesudah diberikan intervensi tablet hisap probiotik pada anak usia sekolah dengan status stunting dan non-stunting. Metode: Penelitian non-randomized clinical trial dengan metode open-labeled. Empat puluh sembilan anak usia sekolah dengan status stunting (n=27) dan non-stunting (n=22) dikelompokkan ke dalam enam kelompok yang masing-masing dipisahkan menjadi stunting dan non-stunting, yaitu kontrol positif (Chlorhexidine gluconate 0,2%), tablet hisap probiotik, dan kontrol negatif (sikat gigi dan pasta gigi). Dilakukan pengambilan sampel saliva tidak terstimulasi dan pemeriksaan klinis (sBPE) pada hari ke-0 (baseline) dan hari ke-14 intervensi. Jumlah V. parvula dalam sampel saliva akan diuji menggunakan metode absolute quantification qPCR. Hasil penelitian: Tidak terdapat korelasi signifikan (p>0,05) antara penurunan jumlah V. parvula dalam saliva dengan perbaikan status kesehatan periodontal (sBPE), sebelum dan sesudah diberikan intervensi tablet hisap probiotik pada anak dengan status stunting dan non-stunting. Hasil ini didapatkan karena V. parvula hanya berperan sebagai patogen aksesori gingivitis tanpa menyebabkan infeksi secara langsung. Tablet hisap probiotik signifikan (p<0,05) dalam menurunkan jumlah V. parvula dalam saliva dan memperbaiki status kesehatan periodontal (sBPE) pada anak dengan status stunting. Kesimpulan: Intervensi probiotik dapat menjadi alternatif antiseptik untuk menjaga dan memulihkan keseimbangan bakteri rongga mulut tanpa menimbulkan efek samping jangka panjang dan resistensi antimikroba.

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Background: Stunting affects salivary gland hypofunction, increasing the risk of gingivitis. The condition of stunting elevates the amount of Veillonella parvula, which acts as an accessory pathogen in gingivitis. Therefore, probiotic administration is implemented to prevent the accumulation of biofilm that exacerbates gingivitis and worsens stunting. Objective: To analyze the correlation between the reduction in Veillonella parvula count in saliva and the improvement in periodontal health status (sBPE) before and after probiotic lozenge intervention in stunted and non-stunted school-aged children. Methods: This is a non-randomized clinical trial with an open-labeled design. Forty-nine school aged children, classified into stunted (n=27) and non-stunted (n=22), were divided into six groups for stunting and non-stunting, which are positive control (Chlorhexidine gluconate 0,2%), probiotic lozenges, and negative control (tooth brush and tooth paste). Unstimulated saliva sampling and clinical examinations (sBPE) were conducted on day 0 (baseline) and day 14 of the intervention. The number of V. parvula in the saliva samples was tested using absolute quantification qPCR. Results: There was no significant correlation (p>0,05) between the the reduction in Veillonella parvula count in saliva and the improvement in periodontal health status (sBPE) before and after probiotic lozenge intervention in stunted and non-stunted school-aged children. This result was obtained because V. parvula acts only as an accessory pathogen in gingivitis without directly causing infection. Probiotic lozenges were significantly effective (p<0,05) in reducing the amount of V. parvula in saliva and improving periodontal health status (sBPE) in stunted children. Conclusion: Probiotic intervention can be an alternative to antiseptic in maintaining and restoring the balance of oral bacteria without long-term side effects or antimicrobial resistance."

"Practical, didactic format designed to deliver point-of-care information to practitioners of cardiology. Highly illustrated with schematics and useful clinical figures, this will be an essential reference to all outpatient cardiology procedures."

"Percutaneous and coronary interventions, used to treat narrow arteries of the heart caused by/found in those with coronary heart disease. This book is a detailed guide for performing percutaneous procedures and it covers in-depth the procedures that cardiologists and interested specialists must be aware of in order to use the devices proficiently."

"ABSTRAKPenurunan fungsi muskulosketal merupakan masalah kesehatan yang sering dikeluhkan oleh lansia. Karya ilmiah ini menjelaskan mengenai asuhan keperawatan nyeri kronis pada sendi melalui intervensi footbath. Instrumen yang digunakan penulis yaitu Geriatric Pain Meassurement (GPM). Intervensi ini dilakukan terhadap tiga lansia yang berada di Panti Sosial Tresna Werdha. Asuhan keperawatan ini dilakukan selama lima minggu. Evaluasi hasil terhadap tindakan footbath tersebut menunjukkan adanya penurunan tingkat nyeri pada sendi. Evaluasi menggunakan instrument Geriatric Pain Meassurement (GPM) didapatkan dua klien menurun tingkat nyeri dari berat ke sedang. Satu klien tetap berada di tingkat sedang namun skala nyeri berkurang.

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ABSTRACT

Decreased musculosketal function is a health problem that is often complained of by the elderly. This scientific work explains about chronic nursing care in the joints through footbath intervention. The instrument used by the author is Geriatric Pain Meassurement (GPM). This intervention was carried out on three elderly people on the Tresna Werdha Social Home. This nursing care is carried out for five weeks. Evaluation of results for the footbath action The evaluation using the Geriatric Pain Meassurement (GPM) instrument was obtained by two clients decreased from level severity to moderate."

"Pendahuluan: Cidera ginjal akut akibat kontras radiografi yang sering disebut sebagai Contrast-induced nephropathy (CIN) telah menjadi sumber morbiditas dan mortalitas di rumah sakit dengan terus meningkatnya penggunaan media kontras iodinasi dalam pencitraan diagnostik dan prosedur intervensi seperti angiografi pada pasien berisiko tinggi (mencapai 50%) pada 10 sampai 15 tahun terakhir. Terjadi dapat dalam 2 sampai 5 hari setelah tindakan. Metodologi: Sebanyak 101 pasien elektif untuk tindakan kateterisasi jantung diambil dalam studi eksperimental ini dengan metode consecutive sampling, mulai bulan Agustus hingga November 2013. Sampel penelitian dibagi menjadi dua kelompok metode hidrasi yaitu metode hidrasi LVEDP dan metode hidrasi standar. Diagnosis cidera ginjal akut akibat kontras ditegakkan berdasarkan kenaikan kadar serum kreatinin sebesar 0.5 mg/dL atau 25% dalam 3 hari setelah tindakan. Hasil: Dalam studi kami, terdapat 5 orang mengalami cidera ginjal akut akibat kontras, 3 orang (5.7%) dari metode hidrasi LVEDP dan 2 orang (4.2%) dari metode hidrasi standar. Secara statistik angka kejadian cidera ginjal akut pada dua kelompok tidak berbeda bermakna dengan nilai p=0.731. Setelah melalui uji regresi multivariat terhadap variabel-variabel yang dapat mempengaruhi didapatkan nilai odds rasio metode hidrasi LVEDP sebesar 3.6 (95% CI 0.4 - 31.3) terhadap metode hidrasi standar. Kesimpulan: Angka kejadian cidera ginjal akut akibat kontras radiografi antara metode LVEDP dan metode standar tidak berbeda bermakna secara statistik tetapi tampaknya metode LVEDP memiliki kecenderungan meningkatkan risiko untuk terjadi cidera ginjal akut sebesar 3.6 kali dibandingkan dengan metode standar yang digunakan di Rumah Sakit Pusat Jantung Nasional Harapan Kita.

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Background: Contrast Induced Nephropathy (CIN) remains a major problem because of the use of iodinated contrast media in heart catheterization is increasing. Incidence of CIN among high-risk patients is up to 50%. Intravenous hydration with normal saline before and after cardiac catheterization is the most effective methods to prevent this problem, but the hydration rate, duration and total hydration amount is still a question. By using Left Ventricular End Diastolic Pressure (LVEDP) data, we could adjust the hydration according to the needs of each patient.

Methods: A total of 101 high-risk patients (estimated Glomerular Filtration Rate by Cockroft-Gault <60mL/min/1.73m2) who undergoes elective heart catheterization were included in this study from August to November 2013 at the Cardiovascular Hospital Harapan Kita Jakarta. Samples were divided into two groups of hydration methods (standard and LVEDP based) by consecutive sampling methods. CIN is diagnosed by absolute rise of > 0.5% mg/dL or 25% increase of serum creatinine from baseline within 3 days after procedures.

Results: There were total of 5 patients who experienced CIN, 3 (5.7%) patients from LVEDP hydration method and 2 (4.2%) patients from standard hydration method. Statistically, the incidence of CIN between two groups was not significant with p=0.731. After a multivariate regression analysis, the odd ratio of LVEDP hydration method is 3.6 (95% confident interval of 0.4 - 31.3).

Conclusion: There is no statistically significant difference incidence of CIN between LVEDP hydration method and standard hydration methods, but LVEDP hydration method seems tend to increase the risk of CIN."

"Penyakit kardiovaskuler yang dikenal sebagai penyakit jantung merupakan penyebab utama kematian di seluruh dunia. Sebanyak sepertiga hingga setengah dari penyakit jantung merupakan Penyakit Jantung Koroner (PJK). Katerisasi jantung dengan tujuan diagnosis yang dikenal sebagai angiografi koroner adalah salah satu prosedur yang paling umum dilakukan pada porang dewasa. Pemeriksaan ini merupakan baku emas untuk diagnosis PJK dengan meminimalkan sayatan bedah (minimum invasive) sehingga dapat menurunkan risiko komplikasi dan tingkat mortalitas daripada prosedur invasive lain. Pengelolaan sediaan farmasi, alat kesehatan, dan BMHP merupakan standar pelayanan kefarmasian di rumah sakit. Staf di unit farmasi seperti apoteker maupun tenaga teknis kefarmasian diharapkan tidak hanya memiliki pengetahuan tentang obat-obat saja naum juga jenis-jenis BMHP agar dapat memaksimalkan pelayanan secara efektif dan efisien, khususnya dalam tindakan CAG. BMHP yang digunakan dalam tindakan CAG terdiri dari sheath, guiding wire, dan kateter. Berdasarkan akese ke pembuluh darah, jenis sheath dibagi menjadi sheath transradial dan transfemoral. Jenis-jenis guiding wire dibagi berdasarkan bentuk tipnya menjadi straight tip (ujung lurus), J tip, dan angled tip. Berdasarkan bentuknya yang menyesuaikan anatomi dan fungsi, kateter diagnostik dibagi menjadi Judkins, Amplatz, Multipurpose, Tiger, dan Pigtail.

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Cardiovascular disease, known as heart disease, is a leading cause of death worldwide. Approximately one-third to half of heart diseases are coronary heart disease (CHD). Coronary angiography, a diagnostic procedure commonly performed in adult patients, is a gold standard for CHD diagnosis, minimizing surgical incisions (minimally invasive) and reducing the risk of complications and mortality compared to other invasive procedures. The management of pharmaceutical preparations, medical devices, and Single-Use Medical Materials (BMHP) is a standard pharmaceutical service in hospitals. Pharmacy unit staff, including pharmacists and pharmaceutical technicians, are expected to possess knowledge not only about medications but also about various single-use medical material to maximize service effectiveness and efficiency, especially in coronary angiography (CAG) procedures. BMHP used in CAG procedures consist of sheaths, guiding wires, and catheters. Based on vascular access, sheaths are categorized as transradial and transfemoral sheaths. Guiding wires are classified based on the shape of their tips, which include straight tip, J-tip, and angled tip. Diagnostic catheters are divided into various types, such as Judkins, Amplatz, Multipurpose, Tiger, and Pigtail, designed to conform to anatomy and function."