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Ariefa Adha Putra
Efektivitas Revaskularisasi Endovaskuler Pada Pasien Penyakit Arteri Perifer Di Departemen Ilmu Bedah RSCM = The Effectiveness of Endovascular Revascularization in Peripheral Arterial Disease Patients at RSCM Surgery Department
"[LATAR BELAKANG
Penyebab terbanyak Penyakit Arteri Perifer (PAP) pada usia diatas 40 tahun adalah aterosklerosis. Prevalensi penyakit aterosklerosis perifer meningkat pada kasus dengan diabetes melitus, dislipidemia, hipertensi dan perokok. Critical Limb Ischemia (CLI) merupakan manifestasi dari PAP berat, CLI dikaitkan dengan risiko kehilangan tungkai yang sangat tinggi. Pada pasien CLI tanpa adanya revaskularisasi, pasien biasanya akan dilakukan amputasi dalam hitungan minggu atau bulan. Revaskularisasi secara terbuka memiliki morbiditas yang cukup banyak. Seiring kemajuan teknologi, revaskularisasi secara terbuka perlahan-lahan digantikan dengan adanya intervensi endovaskuler dalam dua dekade terakhir. Revaskularisasi endovaskuler di Departemen Ilmu Bedah RSCM baru mulai dilakukan pada tahun 2012 dan di Indonesia saat ini belum ada studi yang menilai hasil dari tindakan revaskularisasi.
METODE
Metode yang diambil adalah analitik komparatif berpasangan dengan disain penelitian longitudinal pre-post study. Selama Agustus 2013 hingga Agustus 2014 didapatkan 16 pasien yang masuk kriteria inklusi. Dilakukan pengambilan data nilai ABI sebelum dan sesudah revaskularisasi endovaskuler. ABI digunakan sebagai penilaian efektivitas revaskularisasi.
HASIL
Hasil didapatkan nilai mean ABI sebelum tindakan 0,7±0,118 dan nilai mean ABI sesudah tindakan 0,844±0,127. Didapatkan peningkatan nilai ABI sesudah tindakan 0,14. Dari hasil uji T berpasangan didapatkan nilai p=0,001. Secara statististik didapatkan peningkatan yang signifikan antara nilai ABI sebelum tindakan dan sesudah tindakan.
KESIMPULAN
Dapat ditarik kesimpulan tindakan revaskularisasi endovaskuler terhadap pasien PAP efektif berdasarkan nilai ABI;BACKGROUND
Peripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.
METHODS
Research method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.
RESULTS
Results are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.
CONCLUSION
Endovascular revascularization in PAD patients effective base on ABI, BACKGROUND
Peripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.
METHODS
Research method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.
RESULTS
Results are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.
CONCLUSION
Endovascular revascularization in PAD patients effective base on ABI]"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
T58879
UI - Tesis Membership  Universitas Indonesia Library
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Indah Fitriani
Pengaruh Klorokuin terhadap risiko penyakit Arteri Perifer pada pasien Lupus Eritematosus Sistemik wanita dewasa usia muda = Effects of Chloroquine on the risk of Peripheral Arterial Disease in young female patients with Systemic Lupus Erythematosus / Indah Fitriani
"ABSTRAK
Latar Belakang. Kejadian aterosklerosis, dilaporkan lebih sering pada pasien lupus eritematosus sitemik (LES) dibandingkan individu tanpa LES, salah satunya adalah penyakit arteri perifer (PAP). Klorokuin diduga memiliki efek protektif terhadap kejadian PAP melalui penekanan kadar sitokin proinflamasi dan efek menurunkan kadar kolesterol, namun beberapa penelitian lain menunjukkan bahwa klorokuin meningkatkan kadar sitokin proinflamasi. Hingga saat ini, penelitian mengenai pengaruh klorokuin belum pernah dilakukan pada populasi pasien LES di Indonesia.
Tujuan Penelitian. Mengetahui pengaruh klorokuin terhadap kejadian PAP pada pasien LES wanita berusia 40 tahun ke bawah.
Metode Penelitian. Studi kasus kontrol dilakukan terhadap pasien LES wanita berusia 40 tahun ke bawah di RS Cipto Mangunkusumo selama Juni-Agustus 2012 yang tidak menderita diabetes melitus ataupun hipertensi sebelum diagnosis LES ditegakkan. Pasien dengan penyakit autoimun selain LES dan gagal ginjal kronik dieksklusi dari penelitian. Pengaruh klorokuin terhadap PAP pada pasien LES dinyatakan dalam odds ratio (OR). Peran variabel perancu dinilai pada analisis regresi logistik berjenjang sehingga didapatkan adjusted OR.
Hasil Penelitian. Dari 18 subjek yang menderita PAP (kelompok kasus), sebanyak 8 (44,4 %) menggunakan klorokuin dan dari 72 subjek yang tidak menderita PAP (kelompok kontrol), 20 (27,8 %) di antaranya menggunakan klorokuin. Setelah dilakukan adjustment terhadap variabel perancu (usia, lama menderita sakit, dislipidemia, dan aktivitas penyakit), tidak didapatkan hubungan yang bermakna antara penggunaaan klorokuin dengan kejadian PAP pada pasien LES wanita berusia di bawah 40 tahun (adjusted OR 2,44; IK95 % 0,76 sampai 7,87).
Simpulan. Pengaruh klorokuin terhadap kejadian PAP pada pasien LES wanita berusia 40 tahun ke bawah belum dapat disimpulkan pada penelitian ini.
ABSTRACT
Background. Atherosclerosis is enhanced in systemic lupus erythematosus (SLE) compared to general population, one of which is peripheral arterial disease (PAD). Chloroquine has protective effects in peripheral arterial disease through the suppression of proinflamatory cytokine levels and lipid lowering effect, although other studies have shown the increasing of cytokine levels by chloroquine. To date, no studies have ever been performed to investigate the effect of chloroquine on peripheral arterial disease in Indonesian lupus patients.
Aims. To investigate the effects of chloroquine on peripheral arterial disease in patients with systemic lupus erythematosus aged forty-year-old and below.
Methods. A case control study including female lupus patients aged forty year-old and younger in Cipto Mangunkusumo Hospital between June-August 2012, who do not suffer from diabetes mellitus and/or hypertension before the diagnosis of lupus is confirmed. Patients with other autoimmune disease than lupus and/or with chronic kidney disease were excluded from the study. Effect of chloroquine on peripheral arterial disease in lupus patients is expressed in odds ratio (OR). The role of confounding factors analyzed with multiple logistic regression to estimate the adjusted OR.
Results. Eight (44.4 %) of the total 18 subjects contracting PAD (case group) and 20 (27.8 %) of the total 72 subjects without PAD (control group) were using chloroquine. After adjustments towards confounding factors (age, disease duration, dyslipidemia, and disease activity) were completed, the results showed there was no considerable relation between the use of chloroquine and PAD case in female SLE patients aged below forty-year-old (adjusted OR 2.44; 95 % CI 0.76 to 7.87).
Conclusion. The effect of chloroquine usage on PAD case in female SLE patients aged forty-year-old and below can not be concluded from this study."
Fakultas Kedokteran Universitas Indonesia, 2013
T32258
UI - Tesis Membership  Universitas Indonesia Library
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Khaula Sahida
Analisis praktik keperawatan kesehatan masyarakat perkotaan: intervensi ankle range of motion pada pasien diabetes mellitus tipe 2 dengan komplikasi peripheral arterial disease = The analysis of clinical practice on urban health nursing impact of ankle range of motion on type 2 diabetes melitus patient with peripheral arterial disease
"ABSTRAK
Kondisi pasien diabetes mellitus DM tipe 2 dengan peripheral arterial disease PAD yang tidak ditangani dengan tepat dapat memicu terjadinya neuropati, ulkus pedis diabetik, bahkan amputasi. Intervensi latihan ankle range of motion ROM dipercaya dapat mengurangi gejala dan mencegah progresifitas PAD pada pasien DM tipe 2. Namun pada praktiknya, intervensi ini masih jarang dilakukan. Studi kasus dalam Karya Ilmiah Akhir Ners KIAN ini bertujuan untuk mengidentifikasi pengaruh pemberian intervensi ankle ROM pada pasien DM tipe 2 dengan komplikasi PAD. Hasil analisis menunjukkan bahwa terdapat pengurangan gejala PAD dan peningkatan aliran darah ekstremitas yang ditandai dengan peningkatan saturasi oksigen, kekuatan pulsasi, dan penurunan skala nyeri. Edukasi dan pendampingan latihan ankle ROM pada pasien DM tipe 2 dengan PAD diperlukan agar perfusi jaringan perifer pasien dapat tercapai dengan optimal.
ABSTRACT The conditions of type 2 diabetes mellitus T2DM patient with peripheral arterial disease PAD that is not handled properly can lead to neuropathy, diabetic pedis ulcer, even amputation. Intervention of ankle range of motion ROM exercise is believed to reduce symptoms and prevent the PAD progression. However, in clinical practice, this intervention still rarely done. Therefore, this case report aims to identify the impact of ankle ROM in T2DM patients with PAD complications. The results showed that there was a reduction in PAD symptoms and an increase in limb blood flow characterized by increased oxygen saturation, pulsation, and decreased pain scale. In brief, education and advisory of ankle ROM in T2DM patient with PAD is required to optimize the peripheral perfusion."
Fakultas Ilmu Keperawatan Universitas Indonesia, 2017
PR-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Budhi Arifin Noor
Analisis Faktor-Faktor yang Memengaruhi Angka Amputasi Mayor dan Mortalitas Pasien Kaki Diabetik dengan Chronic Limb Threatening Ischemia Satu Tahun setelah Tindakan Revaskularisasi di Rumah Sakit Dr. Cipto Mangunkusumo = Analysis of Factors Affecting Major Amputation and Mortality of Diabetic Foot Patients with Critical Limb Threatening Ischemia One Year After Revascularization at Cipto Mangunkusumo Hospital
"Latar belakang: Chronic limb threatening ischemia (CLTI) merupakan bentuk terparah peripheral arterial disease. Pasien kaki diabetik dengan CLTI memiliki risiko amputasi mayor dan mortalitas paska revaskularisasi dan dipengaruhi beberapa faktor seperti usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi. Indonesia belum memiliki data amputasi mayor dan mortalitas kaki diabetik dengan CLTI setelah revaskularisasi dan faktor-faktor yang berpengaruh. Penelitian ini bertujuan mengetahui angka amputasi mayor dan mortalitas satu tahun pasca revaskularisasi beserta faktor-faktor yang memengaruhi di Rumah Sakit Cipto Mangunkusumo (RSCM).
Metode: Kohort retrospektif pasien kaki diabetik dengan CLTI setelah revaskularisasi di RSCM Januari 2010 – Desember 2020. Pengambilan data rekam medis. Luaran utama amputasi mayor dan mortalitas satu tahun setelah revaskularisasi. Dilakukan analisis bivariat dengan uji Kai Kuadrat, jika persyaratan tidak terpenuhi maka menggunakan Fischer-exact, variabel bermakna diuji lebih lanjut dengan regresi logistik.
Hasil: Penelitian melibatkan 150 subjek. Amputasi mayor dan mortalitas satu tahun setelah revaskularisasi sebesar 27,3% dan 24,7%. Tidak didapatkan hubungan yang bermakna antara faktor-faktor yang diteliti dengan amputasi mayor dan mortalitas satu tahun.
Kesimpulan: Didapatkan angka amputasi mayor dan mortalitas 1 tahun pasca revaskularisasi. Usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi bukan merupakan faktor yang memengaruhi angka amputasi dan mortalitas satu tahun.
Background: Chronic limb threatening ischemia (CLTI) is the most severe form of peripheral arterial disease. Diabetic foot patients with CLTI have major amputation and mortality risk after revascularization and affected by factors such as elderly, chronic kidney disease (CKD), cardiac morbidity and hypertension. In Indonesia there are no data regarding diabetic foot major amputation and mortality with CLTI after revacularization and influencing factors. Study aims to determine one year major amputation and mortality and factors that can affect diabetic foot pastients with CLTI after revascularization.
Methods: Retrospective cohort study on diabetic foot patients with CLTI undergoing revascularization at Cipto Mangunkusumo National Hospital from January 2010 to December 2020. The primary outcome was one-year major amputation and mortality after revascularization. Factors included were age, CKD, cardiac comorbidity and hypertension. We conducted bivariate analysis using Chi Square or Fisher-exact test. Variables were further tested using multivariate test.
Result: 150 subjects were enrolled. One-year major amputation and mortality was 27.3% and 24.7%. There are not significant correlations between factors with major amputation and mortality.
Conclusion: Major amputation and mortality rate one year after revascularization at RSCM are gained. Elderly, CKD, cardiac comorbidity and hypertension are not factors affecting one-year major amputation and mortality."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
UI - Tugas Akhir  Universitas Indonesia Library
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Hippocrates Kam
Hubungan kejadian renal artery stenosis terhadap derajat lower peripheral arterial disease berdasarkan ANGIO Score di RSUPN Cipto Mangunkusumo = Relation of incidence of renal artery stenosis in lower peripheral arterial disease based on ANGIO score in Cipto Mangunkusumo Hospital
"ABSTRAK
Penyebab PAD yang paling sering adalah atherosclerosis. PAD berhubungan dengan penyakit atherosklerosis lain seperti renal artery stenosis (RAS). Angka harapan hidup menurun pada pasien yang mengalami RAS, terutama yag stenosisnya diatas 60% namun belum sampai ke tahap gagal ginjal kronik. Dengan penatalaksanaan yang holistik diharapkan angka harapan hidup pasien semakin meningkat.
Tujuan: Untuk mengetahui prevalensi RAS pada pasien PAD serta melihat hubungan antara Angio Score, riwayat hipertensi dan diabetes melitus terhadap derajat RAS yang terjadi.
Metode: Desain yang digunakan adalah desain potong lintang. Penelitian ini dilakukan di RSUPN Dr. Cipto Mangunkusumo selama periode Februari hingga Mei 2019. Penelitian dilakukan di RSUPN Dr. Cipto Mangunkusumo dengan diagnosis lower extremity PAD dan dari pemeriksaan CT Angiografi didapatkan stenosis pada pembuluh darah tungkai, serta tampak arteri renalis pada pemeriksaan CTA yang dilakukan pada pasien tersebut. Pengambilan sampel dilakukan dengan metode total sampling.
Hasil: sampel terbanyak berjenis kelamin wanita (50,8%) sedangkan pria sebanyak 32 orang (49,2%). Sebanyak 90,8% pasien yang diteliti menderita diabetes sedangkan 61,5% dari sampel menderita hipertensi. RAS derajat 1 merupakan yang terbanyak ditemukan. Tidak ada hubungan ANGIO Score terhadap usia, jenis kelamin dan diabetes mellitus, namun ada terhadap hipertensi. Terdapat hubungan antara RAS dengan usia dan hipertensi, namun tidak terdapat hubungan terhadap diabetes mellitus dan jenis kelamin. ANGIO Score dan RAS terdapat hubungan yang bermakna (p<0,001).
Simpulan: Perbandingan ANGIO Score berdasarkan derajat stenosis mendapatkan hasil uji Kruskall Wallis mendapatkan nilai p<0,001 dan dilanjutkan dengan uji Mann Whitney mendapatkan bahwa perbedaan sudah terjadi saat perbandingan derajat stenosis 0 dengan derajat 1 dan seterusnya (p<0,001). Semakin tinggi nilai ANGIO Score (cut off pada score 9), angka spesifitas semakin tinggi.
ABSTRACT
Background: The most common cause of PAD is atherosclerosis. PAD is associated with other atherosclerosis diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients who experience RAS, especially those with stenosis above 60% but have not yet reached the stage of chronic renal failure. With holistic management, it is expected that the patient's life expectancy will increase.
Objective: To determine the prevalence of RAS in PAD patients and to see the relationship between Angio Score, history of hypertension and diabetes mellitus to the degree of RAS that occurred.
Method: The design used is a cross-sectional design. This research was conducted at RSUPN Dr. Cipto Mangunkusumo during the period February to May 2019. The study was conducted at RSUPN Dr. Cipto Mangunkusumo with a diagnosis of lower extremity PAD, which obtained an ABI score of <0.9, severe ischemia until both unilateral and bilateral limb necrosis and CT angiography examination found stenosis in the leg veins, and the appearance of the renal artery on CTA examination performed on patients that is. Sampling is done by the total sampling method.
Results: the most samples were female (50.8%) while men were 32 (49.2%). As many as 90.8% of patients studied had diabetes while 61.5% of the samples suffered from hypertension. 1st degree RAS is the most found. There is no relationship between ANGIO Score with age, gender and diabetes mellitus, but there is a hypertension. There is a relationship between RAS and age and hypertension, but there is no relationship to diabetes mellitus and gender. ANGIO Score and RAS have a significant relationship (p <0.001).
Conclusion: The comparison of ANGIO Score based on the degree of stenosis obtained the results of the Kruskall Wallis test obtained a p value of <0.001 and continued with the Mann Whitney test found that the difference had occurred when the ratio of stenosis degrees was 0 with degrees 1 and so on (p <0.001). The higher the ANGIO score (cut off at score 9), the higher the specificity."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
T55567
UI - Tesis Membership  Universitas Indonesia Library
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Robby Effendy Thio
Perbandingan Keamanan dan Efektivitas Terapi Kombinasi Rivaroksaban-Aspirin dengan Monoterapi Aspirin pada Penyakit Arteri Perifer Ekstremitas Bawah Pascarevaskularisasi: Sebuah Tinjauan Sistematis dan Analisis Meta = Effectivity and Safety Comparison between Rivaroxaban-Aspirin Combination and Aspirin Monotherapy on Lower Peripheral Artery Disease after Revascularization: Systematic Review and Meta-analyses
"Pendahuluan: Saat ini, pengobatan antiplatelet tunggal menggunakan aspirin atau clopidogrel direkomendasikan untuk pasien penyakit arteri perifer (PAD) pasca-revaskularisasi. Namun, penelitian terbaru menyarankan bahwa kombinasi rivaroxaban dan aspirin lebih menguntungkan. Kami melakukan tinjauan sistematis untuk menentukan efikasi dan keamanan kombinasi rivaroxaban dan aspirin dibandingkan dengan aspirin saja. Metode: Kami melakukan tinjauan sistematis berdasarkan Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Pencarian dilakukan di Cochrane, PubMed, Scopus, EBSCOHost, dan Google Scholar menggunakan kata kunci. Kriteria inklusi dan eksklusi diterapkan. Studi yang dipilih dinilai menggunakan Cochrane risk of bias tool versi 2 untuk inklusi. Studi yang terpilih diekstraksi untuk karakteristik dan hasil. Hasil dianalisis secara kualitatif dan kuantitatif. Kami menggunakan model efek tetap atau acak untuk menentukan rasio tergabung yang sesuai. Interval kepercayaan 95% dan nilai p kurang dari 0,05 digunakan sebagai indikator signifikansi statistik. Hasil: Dua studi terkontrol acak multicenter dimasukkan setelah pencarian dan penilaian dengan risiko bias rendah. Kedua studi menunjukkan hasil efektivitas primer yang lebih baik dalam kelompok kombinasi dan perbaikan risiko perdarahan mayor. Analisis kuantitatif menemukan tingkat komplikasi PAD yang lebih rendah (OR=0,79; 95% CI=0,66–0,95) termasuk infark miokard, stroke, kematian kardiovaskular, dan iskemia tungkai akut. Kelompok kombinasi memberikan hasil keamanan primer (OR=1,32; 95% CI=1,06–1,67) dan sekunder (OR=1,47; 95% CI=1,19–1,84) yang lebih rendah. Kesimpulan: Kombinasi rivaroxaban dan aspirin memberikan hasil klinis yang lebih baik pada pasien PAD pasca-revaskularisasi. Namun, kombinasi ini harus digunakan dengan hati-hati karena dapat meningkatkan risiko perdarahan pada populasi tersebut.
Introduction: Currently, single antiplatelet treatments using aspirin or clopidogrel were recommended for post-revascularization peripheral artery disease (PAD) patients. However, recent study suggested that combination of rivaroxaban and aspirin was more favorable. We conducted a systematic review to determine efficacy and safety of rivaroxaban and aspirin combination compared to aspirin alone. Method: We conducted a systematic review based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Searching was conducted on Cochrane, PubMed, Scopus, EBSCOHost, and Google Scholar using keywords. Inclusion and exclusion criteria were applied. Selected studies were appraised using Cochrane risk of bias tool v.2 for inclusion. Included studies were extracted for characteristics and outcomes. Outcomes were analyzed qualitatively and quantitatively. We used fixed- or random-effect model to determine pooled ratio per appropriate. A 95% confidence interval and p-value of 0.05 and below were used as indicators of statistical significance. Results: Two multicentered, randomized controlled studies were included after searching and appraisal with low risk of bias. Both studies showed greater primary effectivity outcome in combination group and improvements of major bleeding risk. Quantitative analysis found lower PAD complications rate (OR=0.79; 95% CI=0.66–0.95) which including myocardial infarct, stroke, cardiovascular death, and acute limb ischemia. Combination group provided lesser primary (OR=1.32; 95% CI=1.06–1.67) and secondary (OR=1.47; 95% CI=1.19–1.84) safety outcome. Conclusion: Combination of rivaroxaban and aspirin provided better clinical outcome in postrevascularization PAD patients. However, this combination should be used carefully as this yield larger risk of bleeding in the population."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Tjiang, Margaret Merlyn
Pengaruh lama sakit terhadap kejadian penyakit Arteri Perifer pada pasien Lupus Eritematosa Sistemik wanita dewasa muda = The effect of disease duration on Peripheral Arterial Disease on young female patient with Systemic Lupus Erythematosus / Tjiang, Margaret Merlyn
"ABSTRAK
Latar belakang. Penyakit arteri perifer (PAP) merupakan komplikasi lanjut yang mempengaruhi mortalitas dan morbiditas pasien lupus eritematosus sistemik (LES) namun diluar negeri belum banyak penelitian yang mempelajari hubungan lama sakit dengan kejadian PAP pada pasien LES dan belum pernah dilakukan di Indonesia. Tujuan. Mengetahui peningkatan kejadian penyakit arteri perifer pada pasien LES wanita dewasa muda dengan lama sakit 5 tahun atau lebih dibandingkan kurang dari 5 tahun. Metode. Studi kasus kontrol yang dilakukan selama periode Juni-Agustus 2012 di RSUPN Cipto-Mangunkusumo, Jakarta. Subjek penelitian adalah pasien LES wanita berusia 40 tahun atau kurang yang mengunjungi poliklinik rematologi dan alergi-imunologi. Subjek dibagi dalam dua kelompok, kasus dan kontrol kemudian dilakukan penelusuran secara retrospektif melalui wawancara dan data rekam medis. Hubungan lama sakit dan kejadian PAP pada pasien LES dinyatakan dalam odds ratio (OR) dan peran variabel perancu di analisis dengan regresi logistik berjenjang sehingga didapatkan fully adjusted OR. Hasil. Sebanyak 90 subjek direkrut, 18 subjek termasuk dalam kelompok kasus dan 72 subjek dalam kelompok kontrol. Karakteristik faktor risiko tradisional tidak jauh berbeda diantara dua kelompok. Pada analisis multivariat didapatkan fully adjusted OR hubungan lama sakit 5 tahun atau lebih dengan kejadian PAP 1,9 (IK 95% 0,575-6,543). Peningkatan usia dan lama mendapatkan terapi steroid merupakan faktor perancu. Simpulan. Terdapat peningkatan kejadian penyakit arteri perifer pada pasien LES wanita yang berusia 40 tahun atau kurang dengan lama sakit lima tahun atau lebih dibandingkan lama sakit kurang dari lima tahun, namun peningkatan risiko ini tidak bermakna secara statistik.
ABSTRACT
Background. Peripheral arterial disease is a chronic complication that affect morbidity and mortality in SLE patient, however researches studying the relationship of disease duration and peripheral arterial disease event is only a few in overseas and never been studied in Indonesia. Objectives. To obtain information about the increased event of peripheral arterial disease on young woman with SLE with disease duration five years or longer compared with less than five years. Methods. This was a case control study conducted between June-August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subject were SLE women aged 40 years or younger who visited Rheumatolgy and Allergy-Immunlogy outpatients clinics. Subjects were assigned to case and control group and were trace retrospectively by interview and medical record. The relationship between disease duration and peripheral arterial disease was stated using OR and the role of confouding factors was analyse using logistic regression one by one, result in fully adjusted OR. Results. A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group. Traditional risk factor were similiar in both group. In multivariat analysis, there is a relation between disease duration 5 years or longer with peripheral arterial disease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy is the confounding factors. Conclusion. There is an increase event of peripheral arterial disease in SLE woman aged 40 or younger with disease duration five years or longer compared with less than five years, but this increasing was not statistically significant. "
Fakultas Kedokteran Universitas Indonesia, 2012
T32156
UI - Tesis Membership  Universitas Indonesia Library
cover
Owens, Christopher D.
Handbook of endovascular peripheral interventions
"The Handbook of endovascular peripheral interventions has been written to serve as a comprehensive guide for both the beginner and advanced interventionalist. Covering all aspects of percutaneous peripheral vascular interventions, each chapter of this highly illustrated book provides a brief background, etiology, clinical presentation, imaging, and percutaneous treatment of different vascular conditions. Importantly, tips of the trade and how i do it sections within each chapter make the handbook practical for daily use. These invaluable pearls are provided by contributing chapter authors who are experts in the field.
The handbook of endovascular peripheral interventions is a collaborative effort between cardiologists, vascular surgeons, and radiologists. Since each subspecialty brings unique expertise and experience to the field, this handbook will be a valuable resource for all physicians currently working in peripheral vascular interventions."
New York: Springer, 2012
e20426161
eBooks  Universitas Indonesia Library
cover
Hendri
Tingkat Kesembuhan Ulkus Kaki Diabetik dengan Penyakit Arteri Perifer yang Dilakukan Revaskularisasi dan yang Tidak Dilakukan Revaskularisasi di RSUPN Cipto Mangunkusumo, Jakarta = Healing Rate Comparison of Revascularized and Non-revascularized Diabetic Foot Ulcers with Peripheral Arterial Disease
"Latar Belakang: Tindakan revaskularisasi menjadi hal yang penting dalam penyembuhan ulkus kaki diabetikum dengan penyakit arteri perifer, karena berperan dalam merestorasi fungsi perfusi jaringan tungkai. Selain itu, beberapa studi juga melaporkan bahwa tindakan ini juga dapat mengurangi risiko komplikasi kardiovaskular. Namun, belum ada penelitian di Indonesia yang secara ekslusif membahas efektivitas revaskularisasi pada pasien ulkus kaki diabetik dengan penyakit arteri perifer. Tujuan penelitian ini adalah membandingkan tingkat kesembuhan ulkus kaki diabetik dengan penyakit arteri perifer terhadap pasien yang dilakukan revaskularisasi maupun yang tidak dilakukan revaskularisasi.
Metode: Penelitian ini berlangsung dari Januari hingga Mei 2023, di RSUPN Cipto Mangunkusumo, dengan desain kohort retrospektif.
Hasil: Jumlah sampel pada masing-masing tindakan adalah 23 pasien. Tingkat kesembuhan pasien ulkus kaki diabetik dengan penyakit arteri perifer yang mendapatkan tindakan revaskularisasi adalah 78,3% (18 pasien), sementara yang tidak mendapatkan tindakan revaskularisasi 26,1% (6 pasien). Pasien yang menjalani tindakan revaskularisasi memiliki peluang 14,944 (1,102–202,692) kali lebih tinggi untuk mengalami kesembuhan luka dibandingkan pasien ulkus kaki diabetik dengan penyakit arteri perifer yang tidak mendapatkan tindakan revaskularisasi (p < 0,01). Setelah mengontrol faktor perancu, tindakan revaskularisasi tetap ditemukan berpengaruh terhadap kesembuhan pasien dengan WIfI stadium 2-3 memiliki peluang 11,926 (1,438–98,883) untuk mengalami penyembuhan luka dibandingkan pasien dengan WIfI stadium 4.
Kesimpulan: Tingkat kesembuhan pasien revaskularisasi lebih tinggi dibandingkan non-revaskularisasi. Selain itu, keparahan luka berdasarkan WIfI juga berpengaruh pada kesembuhan luka pasien.
Background: Revascularization is important in the healing of diabetic foot ulcers with peripheral arterial disease, because it plays a role in restoring the perfusion function of the leg tissues. In addition, several studies also report that this action can also reduce the risk of cardiovascular complications. However, there is no study in Indonesia that exclusively discusses the effectiveness of revascularization in diabetic foot ulcer patients with peripheral arterial disease. This study aims to compare the healing rates of diabetic foot ulcers with peripheral arterial disease in patients who underwent revascularization and those who did not undergo revascularization.
Methods: This study was conducted from January to May 2023, at Cipto Mangunkusumo General Hospital, with a retrospective cohort design.
Results: The number of samples in each group was 23 patients. The healing rate for diabetic foot ulcer patients with peripheral arterial disease who received revascularization was 78.3% (18 patients), while those who did not receive revascularization was 26.1% (6 patients). Patients who underwent revascularization had a 14.944 (1.102–202.692) times higher chance of getting their wound healed than patients with diabetic foot ulcers with peripheral arterial disease who did not receive revascularization (p <0.01). After controlling for confounding factors, revascularization was still found to have an effect on healing. Patients with WIfI stage 2-3 had a 11,926 (1,438–98,883) chance of experiencing wound healing compared to patients with stage 4 WIfI.
Conclusion: The wound healing rate for revascularized patients is higher than non-revascularized patients. In addition, the severity of the wound based on WIfI score also affects the patient's wound healing.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tesis Membership  Universitas Indonesia Library
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Lisa Safitri
Profil penyakit arteri perifer berdasarkan nilai indeks ankle brachial dan indeks toe brachial pada penyakit ginjal kronik predialisis dan faktor yang diduga berhubungan = Peripheral artery disease based on ankle brachial index and toe brachial index profile in predialysis chronic kidney disease and assumed related factors
"Latar Belakang: Prevalensi penyakit arteri perifer PAP pada pasien dengan penyakit ginjal kronik PGK terlihat meningkat sejak stadium 3. Alat diagnostik nilai indeks ankle brachial ABI cukup akurat dalam mendeteksi PAP pada populasi normal. Pada PGK yang sering terjadi kalsifikasi pembuluh darah dimana nilai ABI dapat menjadi normal atau tinggi meski sudah ada stenosis pembuluh darah. Kalsifikasi pada ibu jari jarang terjadi membuat pemeriksaan nilai indeks toe brachial TBI mempunyai kelebihan dalam menilai PAP pada PGK.
Tujuan: Untuk mendapatkan proporsi PAP berdasarkan nilai ABI dan TBI serta informasi mengenai profil PAP pada PGK predialisis dan faktor yang diduga berhubungan.
Metode: Penelitian potong lintang pada pasien PGK di poliklinik Ilmu Penyakit Dalam, poliklinik Ginjal Hipertensi, poliklinik Kardiologi dan poliklinik Kardiologi Pusat Jantung Terpadu RSCM periode Oktober 2015-Maret 2016. Data didapatkan dari hasil wawancara, pemeriksaan fisik, nilai ABI dan TBI, serta pemeriksaan laboratorium. Studi deskriptif dilakukan dengan melihat proporsi PAP berdasarkan nilai ABI dan TBI, proporsi variabel dan penentuan nilai rerata dan median.
Hasil: Terdapat 75 pasien yang memenuhi kriteria penelitian. Proporsi PAP berdasarkan nilai ABI dan TBI 60 IK 95 49 -; 71. Nilai ABI. 0,9 dan TBI. 0,7 digunakan sebagai cut off dalam diagnosis PAP. Proporsi PAP pada tiap stadium ginjal mulai terlihat besar. Pasien dengan PAP lebih banyak laki-laki 51,1 dan rerata IMT 23,57 3,5 kg/m2. Median usia pasien 64 tahun 33-74 tahun. Nilai median ABI 1,04 0,7-1,26 dan TBI 0,61 0,31-0,74. Sebagian besar tidak merokok 53,3, mempunyai komorbiditas hipertensi 84, diabetes melitus 64, penyakit jantung koroner 57 dan dislipidemia 40. Nilai median laju filtrasi glomerulus 31,6 6,3-57,6, nilai median albuminuria 153 mg/g kreatinin 7,9-10767,3, nilai median kalsium. mg/dL 7,2-9,8 mg/dL, nilai median fosfat 3,9 mg/dL 1,9-5,7 mg/dL, rerata nilai produk CaxPO4 33,7 6,5 mg2/dL2 dan nilai median hsCRP 1,3 mg/L 0,1-19,19 mg/L. Proporsi pasien dengan hipertensi lebih besar pada pasien dengan PAP. Sementara proporsi DM tidak terkontrol lebih besar dibandingkan yang terkontrol 44. 20.
Simpulan: Proporsi PAP pada pasien PGK predialisis berdasarkan nilai ABI dan TBI sebesar 60. PAP pada PGK predialisis lebih banyak pada subjek dengan komorbiditas, diabetes melitus yang tidak terkontrol, stadium. klasifikasi Fontaine dan kecenderungan albuminuria yang meningkat.
Background The prevalence of peripheral artery disease PAD in chronic kidney disease patients is increasing in CKD stage. or higher. Ankle brachial index is an accurate diagnostic tool in population without CKD. Higher prevalence of arterial calcification in CKD can lead to. normal or high ABI in stenotic vessel. Toe vessels are less susceptible to calcification, therefore toe brachial index TBI measurement can be more useful for PAD assessment in CKD population.
Objectives: The aim of the study is to determine the profile of PAD based on ankle brachial index and toe brachial index in predialysis CKD patients.
Methods: cross sectional study was conducted in outpatient clinics of Dr. Cipto Mangunkusumo hospital from October 2015 to March 2016. The data were obtained by interview, ABI and TBI measurement, and analyzing the laboratories values.
Results: In 75 patients ABI and TBI measurement were conducted simultaneously. ABI 0.9 and or TBI 0.7 had been used as cut off values for diagnosing PAD. PAD proportion based on ABI and TBI in CKD predialysis is 60 IK 95 49 - 71. PAD proportion in every CKD stage are high. Most of the subject are male 51.1 and the mean body mass index value is 23.57 3.5 kg m2. The age median is 64 year old 33 74 year old. The median value of ABI is 1.04 0.7 1.26 and TBI 0.61 0.31 0.74. Most of the patients are non smoker 53.3, had hypertension 84, diabetic 64, coronary artery disease 57 and dyslipidemia 40. Median value of glomerulus filtration rate is 31.6 ml menit 1.73 m2 6.3 57.6 ml menit 1.73 m2, median value of albuminuria 153 mg. kreatinin 7.9 10767.3 median value of calcium. mg dL 7.2 9.8 mg dL, median value of phosphate 3.9 mg dL 1.9 5.7 mg dL, mean value of CaxPO4 product is 33.7 6.5 mg2 dL2 and median value of hsCRP 1.3 mg. 0.1 19.19 mg.. Most patient with PAD had. greater proportion of hypertension. The proportion of uncontrolled diabetes are higher in patient with PAD 44 vs 20.
Conclusion PAD proportion based on ABI and TBI is 60 IK 95 49 - 71. Most of the patients with PAD in CKD predialyis are with uncontrolled diabetes, stage II of Fontaine classification, increased albuminuria. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
T55632
UI - Tesis Membership  Universitas Indonesia Library
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