Hasil Pencarian  ::  Simpan CSV :: Kembali

"Pendahuluan: Osteoartritis adalah penyakit sendi yang utamanya ditandai defek rawan sendi dan merupakan penyebab utama disabilitas muskuloskeletal. Modalitas terapi injeksi intraartikular dengan hormon pertumbuhan terus dikembangkan guna mengurangi morbiditas. Ditemukan adanya pengaruh injeksi hormon pertumbuhan intraartikular terhadap regenerasi tulang rawan sendi, namun belum ada standar dosis dalam pemberian injeksi. Penelitian ini memfokuskan pada efek pengulangan dosis mingguan terhadap perbaikan rawan sendi model hewan coba.Bahan dan Metode: Penelitian eksperimental ini menggunakan desain post test only control group. Kelinci Selandia Baru jantan sebanyak 24 ekor dibagi secara acak menjadi grup kontrol dan 3 grup perlakuan. Semua subjek diinduksi OA dengan menyuntikkan kolagenase intraartikular. Subjek pada grup kontrol diinjeksi dengan cairan fisiologis, grup GH1 diinjeksi dengan hormon pertumbuhan sebanyak 1 kali, grup GH3 sebanyak 3 kali/3 minggu, dan grup GH5 5 kali/5 minggu. Kelinci diobservasi dan dipantau berat badannya, lalu dilakukan evaluasi histopatologi makroskopik dan mikroskopik.Hasil: Analisis skor makroskopik Yoshimi pada grup GH5 dibandingkan dengan grup GH1 dan kontrol menunjukkan perbedaan yang bermakna secara statistik p=0,002 . Analisis skor mikroskopik Mankin didapatkan tulang rawan pada grup GH1, GH3, dan GH5 dibandingkan kontrol mengalami perbaikan pasca perlakuan yang bermakna secara statistik dan kerusakan yang terjadi minimal p < 0,001.Kesimpulan: Injeksi intraartikular hormon pertumbuhan dosis mingguan selama lima minggu memberikan hasil yang lebih baik secara makroskopis dan mikroskopis terhadap degenerasi tulang rawan pada hewan coba model osteoartritis yang diinduksi dengan injeksi intraartikular kolagenase tipe 2 dibandingkan dengan dosis mingguan selama tiga minggu, dosis tunggal, maupun plasebo.

---

Introduction Osteoarthritis, a disease of the joint mainly characterized by a defect on the cartilage and subchondral bone, is one of the main musculoskeletal cause for disability. Intraarticular injection of growth hormone are known as the latest choice in therapy modality. There is some unclear evidence regarding effect of growth hormone injection on cartilage regeneration in osteoarthritis, yet further research is needed. This study focused on cartilage regeneration effect on different weekly dose of intraarticular growth hormone injection.Method This experimental study used a randomized post test only control group design. Twenty four male white New Zealand rabbit were randomly divided into 4 groups control, GH1, GH3, and GH5 . All subjects were injected with intraarticular collagenase. Post induction, control group were injected with normal saline. Intervention groups were all injected with human growth hormone in different cycle, one dose in GH1, 3 times 3 weeks in GH3, and 5 times 5 weeks in GH5. All animal were observed, weight checked regularly, and evaluated for histopathological examination.Result Yoshimi score in GH5 group was significantly lower than control and GH1 group p 0,002 . Those results were confirmed with Mankin score showing statistically significant less damaged and more repaired cartilage tissue on GH1, GH3, and GH5 group compared to control p"

"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.

---

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."

"ABSTRAK Pendahuluan. Osteoarthritis (OA) adalah sebuah penyakit sendi degeneratif yangmenyebabkan disabilitas dengan prevalensi yang terus meningkat. Hormonpertumbuhan memiliki efek regenerasi tulang rawan secara langsung melaluistimulasi sel kondroblas dan proses morphoangiogenesis juga melalui faktorpertumbuhan secara sistemik. Penelitian ini bertujuan untuk mengetahui manfaatsuntikan sendi dengan hormon pertumbuhan pada kasus Osteoarthritis. Metode Penelitian. Penelitian dilakukan di Rumah Sakit Hewan InstitutPertanian Bogor pada bulan Mei hingga September 2015. Desain penelitian adalahrandomized post test only control group. Sejumlah 21 ekor kelinci Selandia Baruputih, berat 1.9-2.6kg, usia 7-8 bulan. Kelinci dibagi secara acak menjadikelompok kontrol (NaCl 0.9%), suntikan hormon pertumbuhan (4iu), dan suntikanasam hyaluronat (6mg) . Dengan metode acak tersamar dilakukan suntikankolagenase tipe II C. Histolyticum pada hari 1 dan ke 4 pada lutut kiri, kemudiantindakan penyuntikan dilakukan sebanyak tiga kali dengan selang waktu 1minggu. Evaluasi dengan periode kepincangan, skoring makroskopis, histologisdilakukan pada minggu ke-8 pasca penyuntikan pertama. Temuan Penelitian. Berdasarkan hasil penelitian ditemukan periode kepincanganpada grup yang diberikan hormon pertumbuhan lebih singkat, dan bermaknasecara statistik dibandingkan dengan grup kontrol (p<0.001), grup asamhyaluronat (p<0.03), dan grup hormon pertumbuhan (p<0.001). Evaluasi skormakroskopik dengan skor yoshimi menunjukan bahwa kelompok hormonpertumbuhan memiliki kerusakan tulang rawan yang lebih ringan jikadibandingkan dengan grup kontrol (p=0.001) dan grup asam hyaluronat (p=0.04).Skoring histopatologis menggunakan skor modifikasi Mankin menunjukan padakelompok dengan hormon pertumbuhan memiliki angka terendah dibandingkangrup lainnya (p=0.001), grup kontrol (p=0.001), grup asam hyaluronat (p=0.015). Kesimpulan. Suntikan hormon pertumbuhan ke dalam sendi memiliki efektifitasyang lebih baik dibandingkan dengan Asam hyaluronat pada model osteoarthritis.Hormon pertumbuhan memberikan harapan baru sebagai alternatif dalam terapiosteoarthritis.ABSTRACT Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disabilityfor patients all over the globe, with an increasing number of patients. Growthhormone (GH) works trough direct and indirect effect on cartilage regeneration bychondroblast stimulation, stimulation of growth factors and morphoangiogenesisprocess. Further research is needed to know the effects of intra articular jointinjection of growth hormone using validated animal model and reliable outcomemeasurement. Methods. This study was conducted in Animal Hospital of Agricultural InstituteBogor west Java, from May to September 2015. The design of the study wasrandomized posttest only control group. Male white New Zealand rabbit (n=21)weighted 1.9-2.6kg, age 6-7months were used in this study. The sample wasrandomized and divided into three groups. All groups recieved intra articularinjection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline(0.6ml) were done at 2 weeks after collagenase injection once a week forconsecutive 3 weeks. Evaluation of weight and lameness periode is doneperiodically, histopathological and macroscopic score were done at 8 weeks sincethe first injection. Result. The lameness priode for control group is significantly longer than both ofthe experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).Macroscopic score evaluation taken from the lateral condyle of the left femur showed that the GH group received significantly less cartilage damage than theHA group (P=0.04) and placebo (P=0.01). Histopathological score was also foundlowest at the GH group (p=0.001), with significant difference in control(p=0.001), and HA group (p=0.015).).Conclusion. Intraarticular injection of growth hormone is found to be moreeffective compared to hyaluronic acid on rabbit osteoarthritis model. This resultsshowed promising result for intra articular injection of GH as an alternativetreatment for osteoarthritis."

"Trauma pada nervus ischiadicus merupakan cedera saraf tepi yang mengakibatkan perubahan secara morfologi dan seluler pada neuron dan akson. Pemulihan paska cedera nervus ischiadicus seringkali belum optimal secara fungsional. Saat ini, PRP dikembangkan menjadi salah satu pilihan terapi alternatif selain tindakan pembedahan. Hal ini disebabkan PRP mengandung sitokin dan neurotropin yang berperan dalam regenerasi saraf. Penelitian ini bertujuan untuk melihat peranan PRP pada regenerasi saraf motorik tikus model sciatica dengan crush injury. Penelitian eksperimental ini menggunakan blok biologis tersimpan medulla spinalis dan nervus ischiadicus dari tikus wistar jantan yang diberi perlakuan kontrol, sciatica dan sciatica dengan PRP yang diterminasi hari ke-7 dan 42 di Departemen Anatomi, Fakultas Kedokteran, Universitas Indonesia. PRP sebanyak 0,2 ml diberikan pada area bekas jepitan memakai absorbable gelatin sponge. Penilaian regenerasi saraf dilakukan dengan melihat densitas neuron di medulla spinalis menggunakan pewarnaan khusus toluidine blue dan imunohistokimia protein S100B di sitoplasma sel schwann nervus ischiadicus. Didapatkan hasil signifikan pemeriksaan densitas neuron pada hari ke-7 dan 42 antara kelompok sciatica dan kelompok sciatica + PRP serta hasil signifikan pada pemeriksaan ekspresi protein S100B pada hari ke-7 pada kelompok kontrol maupun kelompok sciatica dengan kelompok sciatica + PRP. Penelitian ini menunjukkan bahwa pemberian PRP dapat meningkatkan proliferasi sel schwann dan berperan dalam neuron survival.

---

Trauma to the ischiadicus nerve is a peripheral nerve injury that results in morphological and cellular changes in neurons and axons. Post-injury recovery of the ischiadicus nerve is often not functionally optimal. Currently, PRP has been developed as an alternative therapy option to surgery. This is because PRP contains cytokines and neurotrophins that play a role in nerve regeneration. This study aims to look at the role of PRP in motor nerve regeneration of sciatica model rats with crush injury. This experimental study used stored biological blocks of the spinal cord and nervus ischiadicus from male Wistar rats treated with control, sciatica and sciatica with PRP terminated on days 7 and 42 at the Department of Anatomy, Faculty of Medicine, University of Indonesia. PRP as much as 0.2 ml was given to the crush injury area using absorbable gelatin sponge. Assessment of nerve regeneration was performed by looking at the density of neurons in the spinal cord using toluidine blue special staining and immunohistochemistry of S100B protein in the cytoplasm of schwann cells of the ischiadicus nerve. There were significant results in the examination of neuron density on days 7 and 42 between the sciatica group and the sciatica + PRP group and significant results in the examination of S100B protein expression on day 7 in the control group and the sciatica group with the sciatica + PRP group. This study shows that PRP administration can increase schwann cell proliferation and play a role in neuron survival."

"Perawat Spesialis Medikal Bedah berperan penting dalam praktik keperawatan sebagai pemberi asuhan keperawatan kompleks, melakukan analisa ilmiah dan pembuktian ilmiah serta sebagai agen pembaharu. Melalui tulisan ini digambarkan pemberian asuhan keperawatan kepada pasien dengan diagnosis Chronic Limb Threatening Ischemia. Tujuan dari penulisan ini adalah memberikan gambaran praktek keperawatan spesialis medikal bedah menggunakan pendekatan Model Adaptasi Roy. Dari hasil pengumpulan data dan pemeriksaan fisik didapatkan 10 diagnosis keperawatan. Pemberian asuhan keperawatanpun dilakukan kepada 30 pasien sebagai kasus resume, diperoleh perilaku maladaptif pada mode fisiologis dengan diagnose terbanyak yaitu resiko infeksi dan nyeri kronik. Evidence Based Nursing dengan melakukan foot exercises kepada 8 pasien yang mengalami ulkus kaki diabetik dengan hasil yang signifikan terhadap perubahan ukuran luka. Program inovasi menerapkan Hypoglycemia-Nursing Early Warning Score System pada pasien diabetes melitus tipe 2 yang terbukti memudahkan perawat menilai resiko kejadian hipoglikemi berat selama 1 tahun. Pendekatan Model Adaptasi Roy berpengaruh besar terhadap profesi keperawatan. Model ini menjadi salah satu yang banyak digunakan dalam penelitian, pendidikan dan pelayanan keperawatan.

---

Surgical Medical Specialist Nurses play an important role in nursing practice as a provider of advanced nursing care, conduct scientific analysis and scientific evidence and as a reforming agent. Through of this paper we describe the provision of nursing care to patients with a diagnosis of Chronic Limb Threatening Ischemia. The purpose of this paper is to provide an overview of the nursing practice of Surgical Medical Specialists using Roy's Adaptation Model approach. From the results of data collection and physical examination obtained 10 nursing diagnoses. In nursing care was provided to 30 patients as a case of resume, obtained maladaptive behavior in physiological mode with the most diagnoses, the risk of infection and chronic pain. Evidence Based Nursing by performing foot exercises on 8 patients who suffered diabetic foot ulcers with significant results on changes in wound size. The innovative program implementated the Hypoglycemia-Nursing Early Warning Score System in patients with type 2 diabetes mellitus which was proven to make it easier for nurses to assess the risk of severe hypoglycemic events for 1 year. Roy's Adaptation Model approach greatly influencing the nursing profession. This model is one that was widely used in research, education and nursing services"

"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.

---

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."

"Tujuan : Membandingkan angka keberhasilan pemasangan LMP antara teknik klasik modifikasi dengan teknik introduser.Metode :Uji klinik tersamar ganda. Penelitian dilakukan di Instalasi Bedah Pusat RSCM pada bulan Maret sampai dengan April 2004, pada 118 pasien dewasa yang menjalani operasi berencana dengan anesthesia umum. Pasien dibagi secara acak menjadi 2 kelompok; 59 pasein mendapat perlakuan teknik klasik modifikasi dan 59 pasien lainnya dengan teknik introduser. Apabila berhasil dilanjutkan dengan pemasangan OCT. Selama penelitian dilakukan pengamatan frekuensi upaya pemasangan, perubahan hemodinamik serta komplikasi yang timbul. Analisa statistik dilakukan dengan uji t untuk data numerik, uji x-kuadrat untuk data nominal, dengan tingkat kemaknaan p<0,05.Hasil : Angka keberhasilan pemasangan LMP pada upaya pertama (96% vs 88,1%, p<0,05) lebih tinggi dengan teknik klasik modifikasi, tetapi angka keberhasilan setelah upaya ketiga adalah sama (98,3%) pada kedua kelompok. Angka Keberhasilan pemasangan OGT lebih tinggi pada kelompok teknik klasik modifikasi (86,2% vs 81,1%, p<0,05). Terdapat penurunan hemodinamik yang bermakna pada 1 menit setelah pemasangan LMP. Angka penurunan MAP (6,16% vs 10,25%) dan laju denyut jantung (1,5% vs. 6,83%) lebih kecil pada kelompok teknik klasik modifikasi daripada kelompok teknik introduser. Kamplikasi yang timbul pada penelitian ini adalah ditemukannya darah pada kaf ketika dilakukan ekstubasi (9,32%).Kesimpulan : Teknik klasik modifikasi mempunyai angka keberhasilan pemasangan LMP yang sama dengan teknik introduser.

---

Background: The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff to improve seal and drainage tube to provide a channel for regurgitated fluid and gastric tube placement. In this present double blind, randomized, clinical study, we tested the hypothesis that the rate of successful) PLMA insertion using modified classical technique is higher than introducer technique.

Method : A hundred and eighteen adult patients that underwent elective surgery with general anesthesia were randomly allocated to modified classical technique and introducer technique groups. We compared the rate of successful PLMA insertion technique. Oro gastric tube insertion was attempted if there was no gas leak. We assessed hemodynamic responses and complications of insertion.

Result : First-attempt insertion successful rate (96% vs. 88,1%, p<0,05) was higher for the modified classical technique, but after the third attempt successful rate were similar (98,3%). Oro gastric tube placement was more successful with modified classical technique (86,2% vs 81,1%, p<0,05). There was a significant decrease in hemodynamic measurement at 1 minute after insertion of the PLMA. There was a smaller decrease in mean arterial pressure (6,16% vs 10,25%) and heart rate (1,5% vs. 6,83%) after insertion with modified classical technique compare with introducer technique. The only complication was the presence of blood on the device following removal (9,32%).

Conclusion : Modified classical technique has a similar ALMA insertion successfulf rate with introducer technique."

"[Latar belakang. Durasi AV delay (DAVD) pada pasien dengan pacu jantung dual chamber menentukan derajat sinkroni atrioventrikular (AV). Pengaturan DAVD yang optimal pada pasien dapat meningkatkan kualitas hidup dan memperbaiki parameter hemodinamik jika dibandingkan dengan pasien yang tidak dilakukan optimalisasi . Namun optimalisasi DAVD merupakan prosedur yang memakan waktu dan biaya. Perlu dicari faktor-faktor yang mempengaruhi nilai DAVD yang optimal.Metode. Penelitian ini merupakan studi potong lintang. Evaluasi dilakukan pada 35 pasien blok AV total dengan pacu jantung permanen dual chamber yang datang ke poliklinik RS Jantung Nasional Harapan Kita periode bulan Oktober sampai dengan pertengahan November 2014. Dilakukan pemeriksaan ekokardiografi terhadap parameter fungsi diastolik pada saat DAVD awal (DAVD pabrikan), lalu dicari DAVD optimal menggunakan VTI-LVOT terbesar.Hasil. Terdapat korelasi lemah antara paramater fungsi diastolik rasio E/A dan nilai DAVD optimal (r - 0,356 dengan p 0,036). Analisa regresi linear antara rasio E/A dengan nilai DAVD optimal (adjusted analysis sesuai usia, fraksi ejeksi, dan DAVD pabrikan) menunjukan nilai koefisien -0.477 dengan nilai p 0,007 (IK 95% - 84.4 s.d. -14.1). Analisa regresi linear antara nilai e' medial dengan DAVD optimal menunjukkan tingkat kemaknaan dengan nilai koefisien -0.390 dan nilai p 0.026 (IK 95% -16.3 s.d. -1.1). Terdapat perbedaan rerata DAVD optimal, 173.46 ±42.23 ms untuk pasien dengan rasio E/A ≥ 1, dan 128.89 ± 42.5 ms untuk rasio E/A <1 (p:0.01).Kesimpulan. Terdapat korelasi negatif yang bermakna antara parameter fungsi diastolik (E/A dan e' medial) dengan DAVD optimal pada pasien dengan pacu jantung permanen dual chamber.;Background. AV Delay Duration (AVD) in patient with dual chamber pacemaker defines atrioventricular synchrony. Optimazation of AVD could improve quality of life and hemodynamic parameters compared to factory setting. Despite that, AVD optimization is a time consuming procedure and not cost effective. factors that influence the optimal AVD should be sought.Methods. This is a cross sectional study on 35 total AV block patients that came to National Cardiovascular Center Harapan Kita from October to November 2014. Echocardiography on left ventricle diastolic indices was performed in factory setting AVD. The AVD that gives to the biggest LVOT VTI was set as the optimal AVD. Statistical analysis was done to correlate between diastolic indices and optial AVD.Results. Weak correlation was noted between diastolic indices (E/A ratio) and optimal AVD (r: - 0,356; p: 0,036). Linear regression analysis showed a negative correlation between E/A ratio {coefficient -0.477; p: 0,007 (CI 95% - 84.4 to -14.1)} and medial e' {coefficient -0.390; p: 0.026 (CI 95% -16.3 to -1.1)} with optimal AVD (adjusted with age, ejection fraction, and factory setting AVD). Different E/A ratio showed a different optimal AVD mean, 173.46 ±42.23 ms for E/A ≥ 1 vs. 128.89 ± 42.5 ms for E/A <1 (p:0.01).Conclusion. This paper shows a negative correlation between echocardiographic diastolic function indices (E/A ratio and medial e') with optimal AVD., Background. AV Delay Duration (AVD) in patient with dual chamber pacemaker defines atrioventricular synchrony. Optimazation of AVD could improve quality of life and hemodynamic parameters compared to factory setting. Despite that, AVD optimization is a time consuming procedure and not cost effective. factors that influence the optimal AVD should be sought.Methods. This is a cross sectional study on 35 total AV block patients that came to National Cardiovascular Center Harapan Kita from October to November 2014. Echocardiography on left ventricle diastolic indices was performed in factory setting AVD. The AVD that gives to the biggest LVOT VTI was set as the optimal AVD. Statistical analysis was done to correlate between diastolic indices and optial AVD.Results. Weak correlation was noted between diastolic indices (E/A ratio) and optimal AVD (r: - 0,356; p: 0,036). Linear regression analysis showed a negative correlation between E/A ratio {coefficient -0.477; p: 0,007 (CI 95% - 84.4 to -14.1)} and medial e' {coefficient -0.390; p: 0.026 (CI 95% -16.3 to -1.1)} with optimal AVD (adjusted with age, ejection fraction, and factory setting AVD). Different E/A ratio showed a different optimal AVD mean, 173.46 ±42.23 ms for E/A ≥ 1 vs. 128.89 ± 42.5 ms for E/A <1 (p:0.01).Conclusion. This paper shows a negative correlation between echocardiographic diastolic function indices (E/A ratio and medial e') with optimal AVD.]"

"Pada beberapa tahun ini, peningkatan keparahan penyakit kronis dan gangguan kualitas hidup berhubungan dengan kondisi overweight pada orang dewasa dan termasuk dalam chronic low grade Inflamation. Penelitan terhadap kondisi overweight pada orang dewasa dilihat dari sisi imunitas tergambarkan pada beberapa mediator sel imun khususnya sitokin dalam hal ini TNF-α, IL-6 dan IL-10. Sitokin inflamasi pada individu overweight diproduksi berlebih oleh white adipose tissue sehingga terjadi ketidakseimbangan dalam imunitas. Kuesioner Status imun dapat menilai kerentanan seseorang terhadap penyakit yang berhubungan dengan imunitas. Melalui penelitian ini bertujuan menganalisis hubungan mediator inflamasi: TNF-α/IL-10 dengan skor status Imunitas menggunakan kuesioner yang tervalidasi dan membandingkan sitokin tersebut antara kelompok golongan non- dan Overweight -Obesitas. Penelitian ini menggunakan studi potong lintang dengan data kuesioner pada 100 subjek yang diukur serum darah TNFα, IL-10 menggunakan teknik magnetic luminex multiplex immunoassay. Hasil analisa didapatkan perbedaan bermakna antara nilai TNFα di kelompok non- dengan nilai TNFα pada kelompok obese-overweight dengan p= 0.028 (p<0.05) dan pada rasio sitokin tersebut dengan p= 0.032(p<0.05). Hubungan skor ISQ dengan TNFa korelasi p=0.039 (p<0.05). Dapat disimpulkan adanya hubungan bermakna antara TNFα berikut rasionya dengan skor ISQ serta ditemukan kadar TNFα dan rasionya pada kelompok overweigth-obese lebih tinggi dibandingkan dengan kelompok non Overweight -Obesitas

---

In recent years, increased severity of chronic disease and impaired quality of life have been associated with overweight in adults and as part chronic low grade inflammation. Research on overweight conditions in adults in terms of immunity is described in several immune cell mediators, especially cytokines in this case TNF-α, IL-6 and IL-10. Inflammatory cytokines in overweight individuals are produced in excess by white adipose tissue, resulting in an imbalance in immunity. The Immune Status Questionnaire can assess a person's susceptibility to immune-related diseases. This study aims to analyze the relationship between inflammatory mediators: TNF-α/IL-10 with Immunity status scores using a validated questionnaire and compare these cytokines between the non- and Overweight-Obesity groups. This study was cross-sectional study with questionnaire data on 100 subjects and blood serum TNFα, IL-10 were measured using magnetic luminex multiplex immunoassay technique. The results of the analysis showed a significant difference between the TNFα in the non-group and the TNFα in the obese-overweight group with p= 0.028 (p<0.05) and the ratio with p= 0.032 (p<0.05). The relationship between ISQ scores and TNFa correlation p=0.039 (p<0.05). It concluded that there is a significant relationship between TNFα and its ratio with ISQ scores and found TNFα levels and ratios in the overweight-obese group were higher than in the non-Overweight-Obesity group"

"ABSTRAKPenyakit ginjal kronik PGK merupakan penyakit kronik progresif yang mengakibatkan penurunan fungsi ginjal dan bersifat irreversible. Pasien PGK stadium akhir membutuhkan terapi pengganti ginjal untuk memertahankan tubuh dari toksisitas uremia. Prosedur dialisis bersifat katabolik, sehingga pasien yang menjalani hemodialisis HD mengalami peningkatan kebutuhan energi dan protein yang penting untuk mencegah terjadinya protein-energy wasting PEW . Empat orang pasien dalam serial kasus ini mengalami PGK stadium akhir dan telah menjalani hemodialisis dengan rentang waktu yang berbeda, 2 orang dalam rawat inap dan dua orang lainnya rawat jalan. Pasien didiagnosis dengan PGK stadium 5 dengan HD, hipertensi, diabetes melitus, dan ensefalopati uremikum. Walaupun saat pemeriksaan status gizi pasien normoweight dan satu orang mengalami malnutrisi ringan, seluruh pasien memiliki riwayat asupan protein 10 dalam 6 bulan, sehingga dibutuhkan terapi medik gizi yang mencakup penentuan kebutuhan makro dan mikronutrien, nutrien spesifik, sesuai dengan toleransi dan kondisi klinis pasien. Hasil pemantauan menunjukkan pasien mengalami perbaikan klinis, toleransi asupan dan kapasitas fungsional serta kualitas hidup pasien dapat dipertahankan. Terapi medik gizi berperan penting pada semua pasien PGK yang menjalani HD dengan mencegah PEW, memperbaiki kondisi klinis, serta meningkatkan kapasitas fungsional pasien.Kata kunci: terapi medik gizi, penyakit ginjal kronik, hemodialisis, hipertensi.

---

ABSTRACT

Chronic kidney disease is a irreversible progressive chronic process that causes worsening renal function. Patients with end stage renal disease needs renal replacement therapy to protect themselves from uremia toxicity. Patients who have to undergo dialysis are in high catabolism state and has an increased energy and protein expenditure. Adequate energy and protein for these patients are needed to prevent protein energy wasting PEW . Four cases from this serial case has ESRD and has been on hemodialysis with different time frames. Two outpatient and two inward patients who have CKD stage V with hypertension, diabetes mellitus, and uremic encephalopathy. Although only one patient I categorized as mildly malnourished, 3 of four patients experienced weigth loss 10 in 6 months. Thus, medical nutritional therapy is needed to determine energy and protein requirements in these patients. Evaluation and monitoring form these cases shows that all patients have better clinical outcome, better nutrition intake, and functional capacity were preserved. Medical nutrition therapy has an important role in all CKD patients with dialysis to prevent PEW, to improve their clinical outcome and to increasetheir functional capacity. Key words medical nutrition therapy, chronic kidney disease, hemodialysis, hipertension."