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"ABSTRAK Aterosklerosis adalah penyakit sistemik, Peripheral artery disease PAD dan Carotid artery stenosis CS secara luas mencakup penyakit vaskular yang keduanya dikenal sebagai manifestasi spesifik aterosklerosis. Mengingat etiologi umum aterosklerosis perifer yang bisa terjadi di lokasi vaskular yang berbeda, keberadaan penyakit di satu tempat meningkatkan frekuensi penyakit simptomatik dan asimtomatik di tempat lain. Karena keduanya memiliki penyebab yang sama, maka terdapat hipotesis bahwa keduanya berkorelasi satu sama lain. Tujuan penelitian adalah untuk mengetahui faktor-faktor risiko yang berhubungan dengan Carotid artery stenosis CS pada pasien lower extremityPeripheral artery disease PAD berat serta mengetahui prevalensi Carotid artery stenosis CS dan ketebalan Intimal media thicknes IMT pada pasien dengan penyakit lower extremity Peripheral artery disease PAD berat. Penelitian ini dilakukan di RSUPN Cipto Mangunkusumo selama Februari-Mei 2018. Penelitian ini bersifat prospektif, data diambil dari data sekunder berdasarkan anamnesis dan hasil laboratorium sedangkan derajat stenosis dan intimal media thickness dilakukan carotid duplex ultrasound DUS dengan United imaging ultrasound menggunakan probe 8,5 Mhz. Data dikumpulkan, direvisi, dikodekan dan dimasukkan ke paket statistik untuk ilmu sosial SPSS versi 20 dan yang berikut ini dilakukan : Data kualitatif disajikan sebagai jumlah dan persentase sementara data kuantitatif disajikan sebagai rata-rata, standar deviasi, rentang median dan interkuartil. Kurva karakteristik operasi penerima digunakan untuk menilai titik potong terbaik dengan sensitivitas, spesifisitas, nilai prediksi positif dan nilai prediktif negatif. Interval kepercayaan ditetapkan 95 dan margin kesalahan ditetapkan hingga 5 sehingga p-value dianggap signifikan sebagai P> 0,05. Hasil penelitiandidapatkan 50 subjek dengan rentang umur antara 49-80 tahun 63,8 8,8 tahun , dimana yang berjenis kelamin laki-laki sebanyak 31 62 , dan perempuan sebanyak 19 38 . Didapatkan korelasi antara hiperkolesterol dan riwayat merokok dengan derajat Carotid Stenosis dengan nilai ABSTRACT Atherosclerosis is a systemic disease, Peripheral arterial disease PAD and Carotid artery stenosis CS widely include vascular disease bothh known as specific manifestation of atheroscleroris. Given the common etiology of peripheral atherosclerosis that can occur in different vascular sites, the presence of disease in one place increases the frequency of symptomatic and asymptomatic disease elsewhere. Since both have the same cause, there is a hypothesis that the two are correlated with each other. The objective of the study were to investigate the risk factor associated with Carotid artery stenosis CS in patients with severe lower extremity Peripheral arterial disease PAD and to know the prevalence of Carotid artery stenosis CS and degree of Intimal media thickness IMT in patients with severe lower extremity Peripheral arterial disease PAD . This research was conducted at Cipto Mangunkusumo General Hospital during February-May 2018. This is prospective research, the data was taken from secondary data based on hystory taking and laboratory result while the degree of stenosis and intimal media thickness is carotid duplex ultrasound DUS with United imaging ultrasound, using linier probe 8,5 Mhz. Data are collected, revised, encoded and fed into statistical package for social-science SPSS version 20, and the following are performed : Qualitative data are presented as quantities and percentages while quantitative data are presented as mean, standart deviation, median and interquartile range. The reciever operating characteristic curve is use to asses the best ctoff point with sensitivity, specificity, positive predictive value and negative predictive value. The confidence interval is set 95 and the margin error is set to 5 so p-value is considered significant as p"

"ABSTRAKLatar Belakang. Lupus eritematosus sistemik (LES) merupakan penyakit inflamsi autoimun kronik. LES dapat bermanifestasi ke berbagai macam organ, antara lain kulit, sendi, ginjal, paru-paru, sistem saraf, dan organ lainnya. Secara potensial fatal atau mengancam jiwa. Neuropsikiatrik LES (NPLES) merupakan istilah untuk menggambarkan klinis gejala neurologis dan gejala psikiatrik yang terjadi pada 18-60% pasien yang terdiagnosis LES dan merupakan keadaan yang paling berat dari menifestasi Lupus. Kejadian penyakit pembuluh darah otak pada NPLES didapatkan sekitar 5-18% kasus LES.Metode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalah pasien LES yang memenuhi kriteria inklusi penelitian. Subyek diperoleh secara consecutive sampling. Pada subyek dilakukan wawancara, pengisian kuisioner, pemeriksaan fisik dan carotid duplex dan TCD. Dilakukan analisis data menggunakan perangkat SPSS 17.0.Hasil. Diperoleh 100 subyek pasien LES di RSCM. Prevalensi aterosklerosis pada pembuluh darah karotis komunis adalah 31% yang terdiri dari, hard plaque kanan 4%, soft plaque kanan 4%, penebalan intima media 20%, plaque dan penebalan intima media 3%, sedangkan pembuluh darah serebri media 25% yang terdiri dari stenosis pembuluh darah serebri media kanan 13%, serebri media kiri 8%, bilateral 4%.Kesimpulan. Pada semua pasien LES dengan usia < 21-36+ tahun, penggunaan kortikosterosi, dan penyakit penyerta ditemukan adanya aterosklerosis pada pembuluh darah karotis komunis maupun pembuluh darah serebri media. Tidak ditemukan perbedaan yang bermakna.

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ABSTRACTBackground. Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease. Systemic lupus erythematosus (SLE) manifests into a variety organs, such as skin, joint, kidney, lung, nervous system and other organs. Potentially fatal or life-threatening. Neuropsychiatric SLE (NPSLE) is a term that is used to describe the clinical symptoms of neurological and psychiatric symptoms occur in 18-60% of patients diagnosed with SLE and under the most severe manifestation of lupus. The prevalence of cerebrovascular disease in NPSLE obtained approximately 5-18% of SLE cases..Method. The design study is cross-sectional study. The subjects were patients who met the inclusion criteria of the study. Subjects obtained by consecutive sampling. All subjects was interviewed, filled questionnaires, underwent physical examination and Carotid Duplex and TCD examination. Data analysis were performed by using SPSS 17.0 softwareResult. From 100 SLE patients on RSCM, the result showed that the prevalence of atherosclerosis on carotid communis artery was 31%, consists of 4% right hard plaque, 4% right soft plaque, 20% thickening of intima media, 3% plaque and thickening of intima media. Whereas the prevalence of atherosclerosis on cerebri media artery was 25%, consists of 13% stenosis of right cerebri media artery, 8% stenosis of left cerebri media artery, and 4% of bilateral stenosis.Conclusion. In all SLE patient between the age below 21 years old to the age above 36 years old, with corticosteroid therapy and several manifestation of SLE, the result showed that there was no significal difference between the prevalence of atherosclerosis on carotid communis artery and cerebri media artery."

"Latar Belakang: Penyakit kardiovaskular (PK) merupakan penyebab utama kematian dan merupakan beban kesehatan di seluruh dunia. Faktor risiko kardiovaskular salah satunya adalah diabetes melitus (DM) tipe 1. Faktor risiko ini berhubungan dengan durasi sakit dan kontrol gula darah yang diwakili dengan HbA1c. Tanda awal dari gangguan kardiovaskular dapat diperiksa dengan pemeriksaan biomarker seperti ketebalan jaringan adiposa epikardium (epicardial adipose tissue [EAT]), tunika intima media arteri karotis (carotid intima media thickness [CIMT]), dan massa ventrikel kiri (left ventricular [LV] mass).Tujuan: Mengetahui korelasi durasi sakit dan HbA1c terhadap EAT, CIMT dan LV mass pada pasien DM tipe 1.Metode: Penelitian ini adalah studi analitik potong lintang pada pasien DM tipe 1 yang terdapat di registri pasien DM tipe 1 di Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangunkusumo. Pengukuran CIMT, LV mass dan ketebalan EAT menggunakan alat berdasarkan ultrasonografi. Dilakukan analisis regresi linear untuk melihat korelasi durasi sakit dan HbA1c terhadap CIMT, EAT, dan LV mass.Hasil: Median CIMT pada pasien DM tipe 1 adalah 530 (357–700) mikrometer, median EAT 0,4 (0,2-0,7) cm. Terdapat korelasi positif yang moderat durasi sakit terhadap EAT; dengan persamaan EAT (cm) = 0,350 + 0,001 durasi sakit (bulan), r=0,385 p<0,05, R2 14,8%. Terdapat korelasi positif yang moderat durasi sakit terhadap CIMT; dengan persamaan CIMT (mikrometer) = 498,481 + 0,313 durasi sakit (bulan), r=0,372 p<0,05, R2 13,8%. Tidak terdapat korelasi durasi sakit dengan LV mass. Tidak terdapat korelasi HbA1c terhadap CIMT, EAT dan LV mass.Simpulan: Durasi sakit mempunyai korelasi positif terhadap CIMT dan EAT

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Background: Cardiovascular disease is the leading cause of death and is a health burden in the world. One of the cardiovascular risk factors is type 1 diabetes mellitus (DM). This risk factor is related to the disease duration and control of blood sugar represented by HbA1c. Early signs of cardiovascular disorders can be examined by examination of biomarkers such as epicardial adipose tissue (EAT) thickness, carotid intima media thickness (CIMT), and left ventricular (LV) mass.

Objective: To determine the correlation of disease duration and HbA1c to EAT, CIMT and LV mass in patients with type 1 DM.

Methods: This study was a cross-sectional analytic study of type 1 DM patients found in the registry of type 1 DM patients in the Department of Pediatrics at Cipto Mangunkusumo Hospital. CIMT measurements, LV mass measurements and EAT thickness by ultrasound examination. Linear regression analysis was performed to see the correlation of disease duration and HbA1c on CIMT, EAT, and LV mass.

Results: The median CIMT in type 1 DM patients was 530 (357–700) micrometers, the median EAT was 0.4 (0.2-0.7) cm. There was a moderate positive correlation of the disease duration with EAT; by equation EAT (cm) = 0.350 + 0.001 disease duration (month), r=0.385 p<0.05, R2 14.8%. There was a moderate positive correlation of the disease duration with CIMT; by equation CIMT (micrometer) = 498.481 + 0.313 disease duration (month), r=0.372 p<0.05, R2 13.8%. There was no correlation of disease duration with LV mass. There was no correlation of HbA1c to CIMT, EAT and LV mass.

Conclusion: Disease duration has a positive correlation with CIMT and EAT."

"Latar Belakang: Penyakit vaskular aterosklerotik merupakan penyebab penting morbiditas dan mortalitas pasien penyakit ginjal kronik PGK, terutama penyakit ginjal tahap akhir PGTA yang menjalani dialisis. Perbedaan potensial antara tindakan hemodilisis HD dengan Continuous Ambulatory Peritoneal Dialysis CAPD dapat memberi efek berbeda terhadap faktor risiko penyakit kardiovaskular PKV dan dalam mempengaruhi timbulnya PKV. Salah satu faktor yang mendorong timbulnya PKV pada pasien PGTA ialah retensi produk toksin uremik, di antaranya Beta-2 mikroglobulin b2M yang dihubungkan secara independen dan bermakna dengan PKV pada pasien aterosklerosis asimtomatik. Ketebalan tunika intima-media karotis KIMK merupakan petanda aterosklerosis pada pasien PGK. Tujuan: Mengetahui perbedaan kadar b2M serum dan KIMK antara pasien HD dibandingkan pasien CAPD, dan korelasi antara kadar b2M serum dengan KIMK. Metode: Penelitian dilakukan secara potong lintang. Subjek adalah pasien PGTA yang rutin menjalani HD atau CAPD dan memenuhi kriteria penelitian, dilakukan pengumpulan data berupa karakteristik subjek, pemeriksaan fisik, pemeriksaan kadar b2M serum dan pemeriksaan KIMK dengan ultrasonografi. Dilakukan perbandingan rerata kadar b2M serum, rerata KIMK kanan, rerata KIMK kiri antara kelompok pasien HD dan CAPD dengan uji t tidak berpasangan dan uji Mann Whitney, serta uji korelasi Pearson antara kadar b2M serum dengan KIMK. Hasil: Dari 62 subjek penelitian yang terdiri 36 pasien HD dan 26 pasien CAPD, didapatkan kadar b2M serum pasien HD lebih tinggi tetapi tidak bermakna p 0,167; IK95 2,041-11,508, KIMK kanan lebih tebal bermakna pada pasien CAPD p 0,006, KIMK kiri lebih tebal tetapi tidak bermakna p 0,770, dan tidak didapatkan korelasi antara kadar b2M serum dengan KIMK kanan maupun kiri r 0,085 p 0,514 ; r 0,082 p 0,529. Kesimpulan: Kadar b2M serum tidak berbeda bermakna antara pasien HD dengan CAPD, KIMK kanan lebih tebal bermakna pada pasien CAPD, KIMK kiri tidak berbeda antara pasien HD dengan CAPD, tidak didapatkan korelasi antara kadar b2M serum dengan KIMK.

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Background: Atherosclerotic vascular disease is a main cause of morbidity and mortality in chronic kidney disease patients, especially end stage renal disease undergoing dialysis. Potensial difference between hemodialysis HD and continuous ambulatory peritoneal dialysis CAPD treatment could have a different effect on cardiovascular risk factors and may differentially influence the risk of developing CVD. One of the risk factors can induce CVD is uremic toxin retention. Beta 2 microglobulin b2M is a middle molecule uremic toxin independently and significantly related to CVD in patients with asymptomatic carotid atherosclerosis. Carotid intima media thickness CIMT is a surrogate marker of atherosclerosis in chronic kidney disease patients.

Objectives: To know the difference of serum b2M level and CIMT in HD patients group compared to CAPD patients group, and to determine correlations between serum b2M level with CIMT.

Methods: We conducted a cross sectional study. Subjects were ESRD patients undergoing HD or CAPD which fulfilled study criteria were included in study. Data collection included subjects characteristics, physical examination, laboratory examination of serum b2M level, and measurement of CIMT by Doppler ultrasound. We used non pair student t test and Mann Whitney test to compare the mean of serum b2M level and the mean of left and right CIMT between HD group and CAPD group, and Pearson correlation test to serum b2M level and CIMT.

Results: Of 62 subjects, consisted of 36 HD patients and 26 CAPD patients, we found non significant higher serum b2M level in HD patients p 0,167 95 CI 2,041 11,508, significant thicker right CIMT in CAPD patients p 0,006, non significant thicker left CIMT in HD patients p 0,770, and there was no correlation between serum b2M level with right or left CIMT r 0,085 p 0,514 r 0,082 p 0,529.

Conclusions: Serum b2M level was not significant different between HD and CAPD patients, right CIMT was thicker in CAPD patients, left CIMT was not different between HD and CAPD patients, and no correlation between serum b2M level and CIMT."

"ABSTRAKLatar Belakang: Diabetes Melitus Tipe 1 DM tipe 1 merupakan salah satu jenis diabetes yang menyerang usia anak. Diabetes tipe ini dicirikan dengan riwayat ketoasidosis diabetikum KAD dan penggunaan insulin seumur hidup. Penderita DM tipe 1 rentan terhadap komplikasi mikrovaskular dan makrovaskular. Atherosklerosis merupakan komplikasi makrovaskular yang dapat dideteksi secara dini dengan melihat penebalan tunika intima dan media dari pembuluh darah. Sampai saat ini, belum ada data mengenai prevalensi penebalan pembuluh darah pada pasien diabetes melitus tipe 1 dan apakah penebalan tersebut berhubungan dengan riwayat kejadian KAD di Indonesia. Metode: Terdapat 30 pasien kontrol diabetes melitus tipe 1 yang mengikuti penelitian dengan desain potong lintang ini. Pemeriksaan penebalan Arteri Karotis Komunis AKK yang dilakukan menggunakan alat ultrasonografi resolusi tinggi dengan 2 operator. Dilakukan pula pemeriksaan tekanan darah dan pengukuran antropometri. Riwayat KAD, kadar HbA1c terakhir, dan durasi sakit ditentukan melalui rekam medis. Hasil penelitian dilakukan analisis statistik menggunakan uji Pearson, uji Spearman, dan Uji Chi-Square untuk mendapat nilai kemaknaan. Hasil: Prevalensi Penebalan AKK pada pasien anak dengan DM Tipe 1 sebesar 43,3 IK95 0,343-0,523. Tidak terdapat hubungan antara penebalan AKK dengan riwayat KAD p=0,64 dan frekuensi KAD p= 0,499, r=0,128. Dilakukan pengujian 4 variabel independen yakni durasi sakit p=0,249, nilai IMT p=0,944, nilai Sistolik p=0,077, dan kadar HbA1c terakhir p=0,249 dengan hasil tidak ada hubungan bermakna secara statistik. Kesimpulan: Prevalens penebalan AKK pada pasien anak dengan DM Tipe 1 sebesar 43,3. Durasi sakit,Riwayat KAD, Frekuensi KAD, kadar HbA1c terakhir, nilai sistolik, dan nilai IMT belum dapat disimpulkan karena keterbatasan sampel. K

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ABSTRACTIntroduction Type 1 Diabetes Mellitus T1DM is one of the kind of diabetes whom common in childhood. The characteristics of this disease are the event of Diabetics Ketoacidosis DKA and permanently dependent on insulin therapy. There are several microvascluar and macrovascular complications associated with diabetes mellitus. Atherosclerosis is the macrovascular complications that the progression of plaque from Atherosclerosis can be detected early by knowing the thickness of intima and media layer of vascular. Until now, there is no data about the prevalence of Carotid Intima media thickness CIMT and its relationship with DKA history in Indonesia. Methods thirty consecutive patients with T1DM were registered into this cross sectional study. High resolution ultrasonography scanner performed by 2 operator was used to examine CIMT. There were examination on blood pressure and measurement on BMI. The history of DKA, the last HbA1c, and duration of DM were determined by medical record. Pearson, Spearman, and Chi Square test were used for the statistical analysis. Results the prevalence of the CIMT in patients with T1DM was 4.,3 IK95 0.343 0.523. There was no correlation between CIMT and the history of DKA p 0.64 as well as the frequency of DKA p=0.499, r 0.128. After analyzed the duration of diabetes p 0.249, BMI p 0.944, HbA1c p 0.249, Systolic value p 0.077, the results was not significantly correlated. Conclusion The Prevalence of CIMT in patients with T1DM is 43.3. The history of DKA, duration of diabetes, BMI, Systolic value, HbA1c are not yet concluded due to samples limitiation."

"Ultrasound and carotid bifurcation atherosclerosis provides a comprehensive overview of the most recent advancements in instrumentation, imaging techniques including the use of contrast enhancement agents, plaque image analysis and its automation, elastography and plaque motion analysis; also, the use of ultrasonic and other biomarkers in the detection of the high risk cardiovascular individual. Finally, it deals with the application of IVUS, TCD and carotid plaque characterization in clinical practice and in stroke risk stratification. "

"ABSTRAKPenyebab 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.

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ABSTRACTBackground: 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."

"Introduction: The most common cause of the peripheral arterial disease (PAD) is atherosclerosis. PAD is associated with other atherosclerotic diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients with RAS, especially those whose stenosis is above 60% but has not reached the stage of chronic kidney failure. This study aims to determine the prevalence of RAS in PAD patients, the relationship between angiographic scoring system (ANGIO Score), history of hypertension, and diabetes mellitus with the degree of RAS. Method: This research was a cross-sectional study conducted at Cipto Mangunkusumo Hospital from February to May 2019. Patients with a diagnosis of lower extremity PAD and had been assessed with CT angiography examination, were included in this study. The degree of RAS and ANGIO Score were calculated. Sampling was done by the total sampling method. Results Most patients were women 33 (50.8%), while men were 32 (49.2%). 90.8% of the patients had diabetes, while 61.5% of the sample had hypertension. Grade 1 RAS was the most found. There was no correlation between ANGIO Score on age, sex, and diabetes mellitus, but there was a significant relationship with hypertension. There was a relationship between RAS with age and hypertension, but there was no relationship with diabetes mellitus and gender. ANGIO Score and RAS had a significant relationship (p <0.001). Conclusion: There was a relationship between the ANGIO Score and the severity of RAS. The cut-off score of 9 for the ANGIO Score had a sensitivity of 85.7% and a specificity of 61.4% for predicting RAS."

"Latar Belakang: Hipertensi arterial paru (HAP) memiliki mortalitas yang tinggi. HAP dapat disebabkan oleh defek septum atrium sekundum (DSAS). DSAS dengan HAP perlu diperiksa dengan kateterisasi jantung kanan (KJK) untuk menilai resistensi vaskular paru (RVP). Pengukuran pulmonary artery compliance (Cp) dengan cara invasif merupakan prediktor miliki nilai prognostik untuk meramalkan penyakit vaskular paru (PVP) dan mortalitas dibanding RVP. Fasilitas KJK belum tersedia merata di Indonesia. Gambaran notch pada kurva PW Doppler alur keluar ventrikel kanan (AKVKa) ditemukan pada pasien dengan Cp rendah. Karena itu, kami mencoba mencari korelasi antara time-tonotch dengan Cp yang didapat secara invasif. Tujuan: Penelitian ini bertujuan untuk mengetahui apakah terdapat korelasi antara time-to-notch dengan Cp pada pasien DSAS. Metode: Penelitian ini merupakan studi potong lintang dengan consecutive sampling pada pasien DSA sekundum dewasa (≥ 18 tahun) yang menjalani kateterisasi jantung kanan (KJK) di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita sejak Maret 2019 sampai Juni 2022. Parameter time-tonotch dari ekokardiografi akan diuji korelasinya dengan Cp yang didapat dari KJK. Hasil: Terdapat 84 pasien DSAS yang dilakukan analisis. Dari korelasi bivariat didapatkan bahwa time-to-notch memiliki korelasi positif sedang dengan Cp (r = 0,575, p < 0.0001). Variabel lain yang bermakna dalam uji bivariat adalah TRVmax, AKVKa VTI, PVAccT, TAPSE dan hemoglobin. Melalui regresi linier didapatkan bahwa variabel time-to-notch, TRVmax dan TAPSE dapat memprediksi Cp (R2 =0,49). Kesimpulan: Terdapat korelasi positif dengan kekuatan sedang antara time-to-notch dan Cp pada pasien DSAS. Kombinasi time-to-notch, TRVmax dan TAPSE dapat memprediksi Cp.

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.Background: Pulmonary arterial hypertension (PAH) is a devastating condition with a high mortality rate. Secundum atrial septal defect (ASD) may cause PAH. It needs right heart catheterization (RHC) to assess pulmonary vascular resistance (PVR) in such patients. Pulmonary artery compliance (Cp) is another parameter gained from RHC that has better diagnostic and prognostic value to assess PAH compared to RVP. RHC facility is still not widely available in Indonesia. Low Cp is one of the factors influencing the notching in the right ventricular outflow tract (RVOT) PW Doppler curve. Therefor we try to find the correlation between time-to-notch and Cp. Objective: The study aims to evaluate correlation between time-to-notch and Cp in patients with secundum ASD. Methods: This is a cross sectional study with consecutive sampling in grown-up secundum ASD patients (≥ 18 years old) undergoing right heart catheterization (RHC) in National Cardiac Centre Harapan Kita from March 2019 to June 2022. The correlation between time-to-notch gained from echocardiography and Cp gained from RHC are then assessed. Results: There are 84 patients with secundum ASD included for analysis. From bivariat correlation time-to-notch and Cp have positive moderate correlation (r = 0.575, p < 0.0001). Other variables that also have significant correlation with Cp include TRVmax, RVOT VTI, PVAccT, TAPSE, and haemoglobin. However, multivariate analysis shows that only time-to-notch, TRVmax and TAPSE can predict Cp (R2= 0.49). Conclusions: There is moderate positive correlation between time-to-notch and Cp in secundum ASD. Combination time-to-notch, TRVmax and TAPSE can predict Cp."

"Ganggunan fungsi Paru Obstruktif, Restriktif dan Campuran Obstruktif dan Restriktif adalah penurunan kapasitas paru yang salah satu penyebab adalah pajanan debu dan dan bahan kimia di tempat kerja. Tujuan penelitian ini adalah untuk mengetahui hubungan konsentrasi debu (TSP) di dalam ruangan kerja dengan gangguan fungsi paru pada pekerja di PT. KS tahun 2010. Penelitian ini menggunakan metode survei (survey research method) yang dilakukan tanpa intervensi atau noneksperimental, analitik dan bertujuan untuk menjelaskan suatu keadaan atau situasi dengan rancangan survei potong silang (cross sectional). Variabel yang diamati adalah Konsentrasi Debu (TSP) ruangan, umur, lama bekerja, kebiasaan merokok, riwayat penyakit paru, kebiasaan olah raga dan kebiasaan pemakaian APD. Jenis data yang digunakan adalah data primer dan sekunder, dan pengumpulan data menggunakan kuesioner dan wawancara. Analisis data yang digunakan adalah analisis univariat, bivariat dan multivariat.Hasil penelitian menunjukan bahwa ada hubungan yang signifikan antara Kebiasaan merokok dan pemakaian APD, gangguan fungsi paru dengan nilai p masing masing p=0.000 dan p=0.003. Sedangkan konsentrasi debu, umur, lama bekerja, riwayat penyakit dan kebiasaan olah raga tidak menunjukan hubungan yang signifikan. Hasil analisis regresi logistik dari 2(dua) variabel kebiasaan merokok dan tidak memakai APD yaitu kebiasaan merokok beresiko 5 kali mendapatkan gangguan fungsi paru dan tidak menggunakan APD beresiko 3.71 kali mendapatkan gangguan fungsi paru dibandingkan dengan yang menggunakan APD. Saran, dimasa datang sebaiknya dibuat sistem yang terintegrasi dapat menyatukan antara data pemeriksaan kesehatan pekerja, data kualitas udara di dalam lingkungan kerja setiap unit kerja sehingga analisis serta evaluasi terhadap kondisi kesehatan pekerja dapat menghasilkan kesimpulan yang lebih akurat dan pemilihan serta pemakaian APD yang tepat.

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Obstructive, Restrictive and Mixed Obstructive-Restrictive Pulmonary function disturbances is a lung decreased capacity due to the accumulation of dust which causing the decline and airway blockage and the narrowing of pulmonary tract that interfere with the respiratory tract and lung tissue damage. This disease can occur to the workers in an environment polluted by chemical fumes or dust which may increase the risk of Obstructive, Restrictive and Mixed Obstructive-Restrictive pulmonary disease. The purpose of this study is to determine the relationship of dust concentration (TSP) in the working room with the Pulmonary function disturbances of the workers of PT. KS in year 2010. This study is using survey research methods which is a research carried out without an intervention to the research subjects or non experimental. This study is an analytic study that aims to explain a condition or a situation with a cross sectional survey design. The observed variables are the Dust Concentration (TSP)of the rooms, Age, length of work, smoking habits, history of pulmonary disease, exercise habits and customs of the use of PPE (Personal Protection Equipment). The type of data used are primary and secondary data, and the data collection is using questionnaires and interviews. The analysis of the data used is by univariate, bivariate and multivariate analysis.The results showed that there was a significant relationship between smoking habits and the use of PPE with lung function disturbances with a value of p respectively p = 0.000 and p = 0.003. While the dust concentration, age, length of work, medical history and exercise habits showed no significant relationship. The results of logistic regression analysis of 2 (two) variables i.e smoking and not using PPE, that is smoking habits have 5 times the risk of having lung function disturbances and do not use PPE have 3.71 times the risk of getting lung function impairment compared with ones who use PPE. Suggestion, in the future there should be an integrated system that can unify the workers' health examination data, air quality data in the working environment of each unit of work, ambient air quality data and data quality of air emissions so that the analysis and evaluation of health conditions of workers can produce more accurate conclusions for the selection and the use of proper PPE."