Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 61269 dokumen yang sesuai dengan query
cover
Freesia Novita Kusumawardani
Hubungan Defisiensi Vitamin D Serum Praoperasi dengan Kejadian Infeksi Daerah Operasi Pasca Laparotomi Elektif = Association between Preoperative Serum Vitamin D Deficiency and Surgical Site Infections after Elective Laparotomy
"Latar Belakang: Infeksi daerah operasi (IDO) merupakan salah satu komplikasi pascaoperasi tersering yang meningkatkan morbiditas, mortalitas, dan beban biaya kesehatan. Penerapan strategi pencegahan hanya menurunkan sedikit angka infeksi nosokomial pada pembedahan. Vitamin D diketahui memiliki pengaruh pada regulasi imun dan penyembuhan luka. Namun, hanya sedikit studi yang menilai efek potensialnya dalam mengurangi kejadian IDO dengan hasil yang didapatkan belum konsisten. Penelitian ini bertujuan untuk menilai hubungan status vitamin D serum praoperasi dengan kejadian IDO pascalaparotomi elektif.
Metode: Studi kohort prospektif ini dilakukan pada subjek berusia 18–65 tahun di RS pendidikan tersier, RSUPN Dr. Cipto Mangungkusumo, yang dirawat untuk laparotomi elektif pada bulan Maret hingga Juni 2023. Pengukuran 25-hidroksi vitamin D serum praoperasi menggunakan metode chemiluminescent microparticle immunoassay (CMIA) dengan cutoff defisiensi pada kadar <30 ng/mL. Penegakkan diagnosis IDO berdasarkan kriteria Centers for Disease Control and Prevention dilakukan melalui pemantauan harian selama 30 hari pascaoperasi. Analisis bivariat dan multivariat digunakan untuk menilai hubungan antara variabel bebas dan terikat, serta mengidentifikasi faktor perancu lain yang berhubungan dengan IDO. 
Hasil: Dari total 117 subjek penelitian, sebanyak 90,4% subjek defisiensi vitamin D dan 20,5% subjek mengalami IDO. Defisiensi vitamin D praoperasi signifikan meningkatkan risiko kejadian IDO dibandingkan tidak defisiensi (RR 1,16, 95% CI 1,07–1,26). Analisis lanjutan dengan regresi logistik untuk faktor perancu lain memeroleh bahwa status albumin serum praoperasi menjadi faktor yang paling signifikan meningkatkan risiko kejadian IDO.
Kesimpulan: Terdapat hubungan yang bermakna secara statistik antara defisiensi vitamin D serum praoperasi dengan kejadian IDO pascalaparotomi elektif.
Background: Surgical site infection (SSI) is one of the most common postoperative complications that increases morbidity, mortality, and healthcare costs. The implementation of preventive strategies has only resulted in a slight reduction in nosocomial infection rates in surgical procedures. Vitamin D is known to have an influence on immune regulation and wound healing. However, there have been few studies assessing its potential effect in reducing the incidence of SSI, and the results obtained so far have been inconsistent. This study aims to assess the relationship between preoperative serum vitamin D status and the occurrence of SSI after elective laparotomy.
Methods: This prospective cohort study was conducted on subjects aged 18–65 years at a single tertiary teaching hospital, RSUPN Dr. Cipto Mangunkusumo, who underwent elective laparotomy from March to June 2023. Measurement of preoperative serum 25-hydroxy vitamin D was done using the chemiluminescent microparticle immunoassay (CMIA) method with a deficiency cutoff at levels <30 ng/mL. The diagnosis of SSI was based on the Centers for Disease Control and Prevention criteria through daily monitoring for 30 days postoperatively. Bivariate and multivariate analyses were used to assess the relationship between independent and dependent variables and identify other confounding factors associated with SSI. 
Results: Out of a total of 117 study subjects, 90.4% were vitamin D deficient, and 20.5% developed SSI. Preoperative vitamin D deficiency significantly increased the risk of SSI compared to non-deficiency (RR 1.16, 95% CI 1.07–1.26). Further analysis using logistic regression for other confounding factors revealed that preoperative serum albumin status was the most significant factor in increasing the risk of SSI.
Conclusion: There is a significant statistical association between preoperative serum vitamin D deficiency and the occurrence of SSI after elective laparotomy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Davie Muhamad
Hubungan Kecukupan Protein Praoperasi dengan Kejadian Infeksi Daerah Operasi Pascalaparotomi Elektif = Association Between Preoperative Protein Adequacy and Incidence of Post Elective Laparotomy Surgical Site Infection
"Latar Belakang: Komplikasi pascaoperasi rentan terjadi pada populasi berisiko tinggi salah satunya adalah populasi yang menjalani operasi mayor. Infeksi daerah operasi (IDO) adalah salah satu komplikasi pascaoperasi yang sering ditemukan pada prosedur laparotomi. Pasien yang menjalani operasi akan mengalami respons stres pascaoperasi berupa peningkatan proses inflamasi yang berdampak pada peningkatan proteolisis protein otot. Sangat penting memerhatikan asupan protein praoperasi untuk meningkatkan cadangan protein otot, mendukung penyembuhan luka pascaoperasi dan imunitas. Penelitian terdahulu menjelaskan bahwa peningkatan asupan protein praoperasi sebesar 10% (> 1,2 g/kg BB/hari) dari kebutuhan dapat mengurangi risiko komplikasi (infeksi, non-infeksi dan dekubitus) sebesar 10%.
Metode: Studi kohort prospektif dilakukan pada 93 pasien dengan kelompok cukup protein sebanyak 48 subjek dan kelompok tidak cukup protein sebanyak 45 subjek yang akan menjalani laparotomi elektif di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Analisis kecukupan protein dilakukan dengan metode wawancara selama 7 hari praoperasi. Pemantauan pasien dilakukan selama 30 hari pascaoperasi untuk menilai adanya komplikasi berupa IDO. Analisis hubungan keduanya dilakuan menggunakan uji Chi-Square dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan kejadian IDO pascalaparotomi elektif.
Hasil: Terdapat hubungan antara kecukupan protein praoperasi dengan kejadian infeksi daerah operasi pascalaparotomi elektif (RR 3,413; IK 95%, 1,363-8,549; p = 0,004). Hasil analisis multivariat menunjukan kecukupan protein praoperasi dan kadar albumin praoperasi berhubungan kuat untuk memprediksi terjadinya infeksi daerah operasi pascalaparotomi elektif.
Kesimpulan: Kecukupan protein dan kadar albumin praoperasi dapat memprediksi kejadian infeksi daerah operasi pascalaparotomi elektif.
Background: Postoperative complications are prone to occur in high-risk populations, one of which is the population undergoing major surgery. Surgical site infection (SSI) is one of the most common postoperative complications in laparotomy procedures. Patients who undergo surgery will experience a postoperative stress response in the form of an increase in the inflammatory process which results in an increase in muscle protein proteolysis. It is very important to focus on preoperative protein intake to increase muscle protein reserves, support postoperative wound healing and immunity. Previous research explained that the increment of preoperative protein by 10% (> 1.2 g/kg BW/day) can reduce the risk of complications (infectious, non-infectious and decubitus) by 10%.
Methods: A prospective cohort study was conducted on 93 patients with sufficient protein group of 48 subjects and protein insufficient group of 45 subjects undergoing elective laparotomy at Dr. Cipto Mangunkusumo Hospital, Jakarta. Analysis of protein adequacy was carried out by interview method for 7 days preoperatively. Patient monitoring was carried out for 30 days postoperatively to assess complications in the form of SSI. Analysis of association between protein adequacy and SSI was carried out by using the Chi-Square test and multivariate analysis was performed to assess the most associated factors with post elective laparotomy SSI.
Results: There is a association between preoperative protein adequacy and the incidence of post elective laparotomy SSI (RR 3,413; 95% CI, 1,363-8,549; p = 0,004). The multivariate analysis showed that preoperative protein adequacy and preoperative albumin levels were strongly related to predict the occurrence of post elective laparotomy SSI.
Conclusion: Preoperative protein adequacy and albumin levels were strongly related to predict post elective laparotomy SSI."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Nadhilah Kaulika
Hubungan Asupan Protein Pra-Operasi dengan Perubahan Kapasitas Fungsional pada Pasien Pasca Laparotomi Elektif = Association between Preoperative Protein Intake and PostElective Laparotomy Functional Capacity Changes
"Latar Belakang: Prosedur pembedahan dapat memicu perubahan aktivitas metabolisme yang ditandai dengan respon inflamasi, serta terjadinya peningkatan proses katabolisme protein yang dapat mengakibatkan penurunan kapasitas fungsional. Asupan protein selama periode pra laparotomi elektif merupakan hal yang dapat membantu mencegah penurunan kapasitas fungsional. Berbagai studi sebelumnya menunjukkan adanya hubungan antara asupan protein terhadap luaran klinis pasca laparotomi elektif, namun hasil penelitian ini menunjukkan hasil yang tidak konsisten. Penilaian kapasitas fungsional melalui pengukuran kekuatan genggam, disebut memiliki hubungan dengan luaran klinis pasca laparotomi elektif. Belum ada penelitian yang menilai hubungan asupan protein pra-operasi dengan perubahan kapasitas fungsional pada pasien pasca laparotomi elektif di RSCM.
Metode: Studi potong lintang dilakukan pada 85 pasien pasca laparotomi elektif di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Dilakukan pengambilan data berupa pengukuran kekuatan genggam pada hari ke-6 pasca laparotomi elektif. Data-data pra-operasi lain didapatkan melalui rekam medis pasien seperti data demografis, etiologi pembedahan, analisis asupan, dan komposisi tubuh. Analisis bivariat untuk menilai korelasi dilakukan dengan uji Pearson pada data berdistribusi normal dan uji Rank Spearman pada data tidak berdistribusi normal.
Hasil: Didapatkan sebanyak 85 subjek dengan mayoritas perempuan. Etiologi pembedahan mayoritas berupa keganasan. Berdasarkan status gizi, sebagian besar subjek memiliki status gizi normal, diikuti dengan obesitas derajat I, dan berat badan lebih. Prosedur ERAS tidak dilakukan pada mayoritas subjek. Sebanyak 36,5% subjek memiliki nilai FFMI yang rendah. Rerata total asupan energi pra-operasi subjek penelitian sebesar 26 kkal/kg BB, rerata total asupan protein pra-operasi sebesar 50,8 g, dengan total asupan protein per kg BB berkisar 0,5–1,8 g/kgBB. Rerata perubahan kekuatan genggam pra dan pasca laparotomi elektif tangan kanan sebesar 1,1 kg dan tangan kiri sebesar 0,8 kg. Ditemukan korelasi positif lemah antara asupan protein pra operasi dengan perubahan kekuatan genggam kanan (r = 0,18, p = 0,099) dan perubahan kekuatan genggam kiri (r = 0,166, p =0,129). Uji analisis multivariat dengan regresi linear berganda didapatkan bahwa FFMI pra-operasi merupakan faktor yang paling memengaruhi perubahan kekuatan genggam kanan (p = 0,042).
Kesimpulan: Tidak didapatkan korelasi signifikan antara asupan protein pra operasi dengan perubahan kekuatan genggam tangan kanan dan kiri.
Background: Surgical procedures trigger metabolic changes involving inflammatory, hormonal, and immunological responses. Increased protein breakdown can lead to reduced functional capacity. Preoperative protein intake has been suggested as a preventive measure against functional decline. However, research on the relationship between preoperative protein intake and postoperative outcomes has shown conflicting results. Grip strength measurement is a potential surrogate marker for postoperative outcomes, but its association with preoperative protein intake remains unexplored in elective laparotomy patients at RSCM.
Methods: We conducted a cross-sectional study on 85 patients who underwent elective laparotomy at RSUPN Dr. Cipto Mangunkusumo, Jakarta. Grip strength was measured on the 6th day postoperatively, and preoperative data on demographics, surgical etiology, intake analysis, and body composition were collected from medical records. Bivariate analysis was performed to assess correlations using Pearson's test for normally distributed data and Spearman's rank correlation test for non-normally distributed data
Results: The majority of the 85 subjects were female, with malignancy being the primary surgical cause. Most subjects had normal nutritional status and did not follow Enhanced Recovery After Surgery (ERAS) protocols. The mean preoperative energy intake was 1374 kcal (26 kcal/kg body weight), and mean preoperative protein intake was 50.8 g. Weak positive correlations were found between preoperative protein intake and changes in grip strength for the right (r = 0.18, p = 0.099) and left (r = 0.166, p = 0.129) hands. Multivariate analysis showed that preoperative FFMI had the most significant impact on changes in grip strength for the right hand (p = 0.042).
Conclusion: There was no significant correlation between preoperative protein intake and changes in grip strength for the right and left hands in patients following elective laparotomy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Rizka Farah Hilma
Hubungan Antara Kadar Serum Vitamin D (25-Hydroxyvitamin D) dan Kadar Plasma Reseptor Vitamin D Dengan Indeks Bakteri Pada Pasien Kusta = Association between Serum Level of Vitamin D (25-Hydroxyvitamin D) and Plasma Level of Vitamin D Receptor with Bacteriological Index in Leprosy Patients
"Salah satu peran sistem imunitas terhadap infeksi M.leprae adalah respons makrofag melalui interaksinya dengan vitamin D dan reseptor vitamin D (RVD). Interaksi vitamin D dengan RVD pada berbagai sel imun akan menstimulasi ekspresi katelisidin. Penelitian ini bertujuan untuk menganalisis kadar serum 25-hydroxyvitamin D (25(OH)D) dan kadar plasma RVD serta hubungannya dengan IB pada pasien kusta. Penelitian ini berupa observasional-analitik dengan desain potong lintang. Sebanyak 28 subjek penelitian (SP) menjalani pemeriksaan slit-skin smear kemudian diagnosis kusta ditegakkan berdasarkan tanda kardinal kusta. Penelitian ini juga menilai kecukupan pajanan matahari menggunakan kuesioner pajanan matahari mingguan. Kadar serum 25(OH)D diperiksa dengan metode chemiluminescent immunoassay (CLIA) dan kadar plasma RVD dilakukan dengan metode enzyme linked immunosorbent assay (ELISA). Median kadar serum 25(OH)D adalah 12,68 ng/ml (4,88 – 44,74). Median kadar plasma RVD adalah 1,36 ng/ml (0,26 – 8,04). Berdasarkan analisis regresi multivariat, tidak terdapat hubungan antara IB dengan kadar serum 25(OH)D dan kadar plasma RVD (R square = 0,055). Tedapat korelasi positif kuat antara kadar serum 25(OH)D dengan skor pajanan sinar matahari (r = 0,863; p < 0,001).
One of many immunity system’s roles against M. leprae infection is macrophage response through its interaction with vitamin D and vitamin D receptor (VDR). The interaction between vitamin D and VDR in various immune cells will stimulate the expression of cathelicidin. The objective is to analyze the serum level of 25-hydroxyvitamin D₃ (25(OH)D) and plasma level of VDR as well as their association with IB in leprosy patients. This observational analytic study was performed with cross-sectional design. A total of 28 subjects underwent a slit-skin smear examination and then the diagnosis of leprosy was made based on the cardinal signs. This study also assessed the patient’s sun exposure with weekly sun exposure questionnaire. Serum 25(OH)D level was assessed with chemiluminescent immunoassay (CLIA) method and RVD plasma level was measured by enzyme linked immunosorbent assay (ELISA). Median serum level of 25(OH)D was 12.68 ng/ml (4.88 – 44.74). Median plasma level of VDR was 1.36 ng/ml (0.26 – 8.04). Based on multivariate regression analysis, there was no significant association between BI and serum level of 25(OH)D and plasma level of VDR (R square = 0.055). There was strong positive correlation between serum level of 25(OH)D and sun exposure score (r = 0.863; p < 0.001)."
Depok: Fakultas Kedokteran Universitas Indonesia, 2022
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Gracia Jovita Kartiko
Hubungan Kadar Vitamin D Serum Dengan Sarkopenia Pada Pasien Diabetes Melitus Tipe 2 Usia Dewasa Nongeriatri = Association Between Serum Vitamin D And Sarcopenia In Nongeriatric Adults With Type 2 Diabetes Mellitus
"Latar Belakang: Diabetes melitus (DM) tipe 2 merupakan penyakit metabolik kronik progresif dengan sebagian besar populasi berada pada usia produktif. Di Indonesia, capaian kendali glikemik yang optimal hanya didapatkan pada 20-30% pasien. Hal ini meningkatkan risiko komplikasi muskuloskeletal seperti sarkopenia yang sudah mulai terjadi sejak usia 20 tahun. Vitamin D merupakan salah satu suplementasi nutrisi yang direkomendasikan dalam tata laksana sarkopenia.
Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara vitamin D dengan sarkopenia pada populasi DM tipe 2 usia dewasa nongeriatri.
Metode: Penelitian potong lintang ini melibatkan populasi DM tipe 2 berusia 18-59 tahun yang berobat di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta, Indonesia pada bulan Januari 2021 sampai dengan April 2022. Dilakukan pengukuran massa otot dengan bioimpedance analysis (BIA), kekuatan genggam tangan, kecepatan berjalan, antropometri, serta kadar HbA1c dan vitamin D serum. Titik potong vitamin D ditentukan berdasarkan kurva receiver-operating characteristic (ROC).
Hasil: Dari 99 subjek, 38,4% mengalami sarkopenia, yang terdiri dari 94,7% possible sarcopenia dan 5,3% true sarcopenia. Kadar vitamin D di bawah 32 ng/mL didapatkan pada 78,9% kelompok sarkopenia. Berdasarkan analisis multivariat, prevalensi sarkopenia pada populasi DM tipe 2 dengan defisiensi vitamin D didapatkan 1,94 kali lebih tinggi (p=0,043) dibandingkan dengan populasi DM tipe 2 tanpa defisiensi vitamin D, setelah dilakukan penyesuaian dengan usia, jenis kelamin, HbA1c, dan obesitas.
Kesimpulan: Terdapat hubungan bermakna antara kadar vitamin D dengan sarkopenia pada populasi DM tipe 2 usia dewasa nongeriatri, setelah penyesuaian dengan faktor usia, jenis kelamin, HbA1c, dan obesitas.
Type 2 diabetes mellitus (T2DM) is a chronic progressive metabolic disease with most of the population being at productive age. In Indonesia, optimal glycemic control is only achieved in 20-30% of patients which increases the risk of musculoskeletal complications such as sarcopenia. Sarcopenia has been known to develop since the age of 20. Vitamin D is one of the recommended nutritional supplementations in the management of sarcopenia.
Aim: We aimed to determine the association between serum vitamin D and sarcopenia in nongeriatric adults with T2DM.
Methods: This cross-sectional study involved 18-59 years old T2DM outpatients in Cipto Mangunkusumo Hospital, Jakarta, Indonesia between January 2021 and April 2022. We performed muscle mass measurement using bioimpedance analysis (BIA), handgrip strength, gait speed, anthropometrics, as well as serum vitamin D and HbA1c levels. The cut-off Vitamin D level was determined using receiver-operating characteristic (ROC) curve.
Results: A total of 99 subjects were analyzed of which 38.4% had sarcopenia. The proportion of possible sarcopenia was 94.7% and true sarcopenia 5.3%. Vitamin D level below 32 ng/mL was found in 78.9% of the sarcopenia group. Based on multivariate analysis, the prevalence of sarcopenia in the T2DM population with vitamin D deficiency was found to be 1.94 times higher (p=0.043) compared to the T2DM population without vitamin D deficiency, after adjusting for age, sex, HbA1c, and obesity.
Conclusion: There is a significant relationship between vitamin D levels and sarcopenia in nongeriatric adults with T2DM, after adjusting for age, sex, HbA1c, and obesity."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Fajar Englando Alan Adesta
Hubungan kadar vitamin D serum awal perawatan dengan kecepatan pertumbuhan jaringan granulasi luka kaki diabetik pada perawatan hari ke-21 = Association between initial serum vitamin D level with granulation growth rate of diabetic foot ulcer after 21 days of treatment
"Latar Belakang. Penyembuhan luka kaki diabetik (LKD) memerlukan waktu yang lama sehingga risiko infeksi, amputasi, dan kematian menjadi lebih tinggi. Salah satu parameter untuk menilai penyembuhan luka adalah pertumbuhan jaringan granulasi. Kadar Vitamin D diketahui terkait dengan risiko terjadinya LKD, infeksi, dan penyembuhan luka. Namun sampai saat ini masih belum diketahui pengaruhnya terhadap pertumbuhan jaringan granulasi LKD.
Tujuan. Untuk mengetahui hubungan antara kadar vitamin D serum awal perawatan dengan kecnepatan pertumbuhan jaringan granulasi luka kaki diabetik pada perawatan hari ke-21.
Metode. Penelitian ini menggunakan bahan tersimpan berupa serum dan dokumentasi foto LKD dari penelitian sebelumnya. Analisis kadar 25(OH)D pada sampel serum darah awal perawatan menggunakan metode Elisa. Sedangkan analisis kecepatan pertumbuhan jaringan granulasi dinilai berdasarkan hasil foto LKD pasien pada visit ke-4 dengan menggunakan program ImageJ.
Hasil. Dari 52 sampel yang dianalisis, kadar 25(OH)D pada awal perawatan menunjukan nilai median = 8.8 ng/mL. Hasil analisis menunjukan bahwa tidak didapatkan hubungan antara kadar vitamin D dengan kecepatan pertumbuhan jaringan granulasi (p=0.815).
Kesimpulan. Tidak ada hubungan yang signifikan antara kadar vitamin D serum awal perawatan dengan kecepatan pertumbuhan jaringan granulasi luka kaki diabetik pada perawatan hari ke-21.
Background. Wound in diabetic foot ulcer need a long time to heal which increase risk of infection, amputataion and mortality. One of the criteria in wound healing is growth of granulation tissue. Vitamin D level is known to be related to increase incidence of diabetic foot ulcer, infection, and wound healing. But until now, the effect of vitamin D to the growth of granulation tissue is not clear.
Objective. To know the Association between initial serum vitamin D level with granulation growth rate of diabetic foot ulcer after 21 days of treatment.
Methods. This research uses stored sample in form of serum and footage documentation. It is the initial blood sample from 52 patients with DFU before starting treatment. Vitamin D is calculated with 25 (OH) D level by using ELISA. Analysis of growth in granulation tissue is counted by comparing the footage documentation at initial treatment to the 21st day of treatment with the help of ImageJ software.
Result. From 52 analysed sample, vitamin D level at initial presentation showed a median value of 8.8 ng/mL. The result of the analysis showed that there was no statistically significant association between vitamin D level with the granulation growth rate of diabetic foot ulcer (p=0,815).
Conclusion. There is no significant association between initial serum vitamin D level with granulation growth rate of diabetic foot ulcer after 21 days of treatment."
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Adelina
Hubungan antara Kejadian Ileus Pascaoperasi Laparotomi dengan Status Hidrasi Praoperasi Berdasarkan Bioelectrical Impedance Vector Analysis di RSUPN dr. Cipto Mangunkusumo = Association between Postoperative Ileus After Laparotomy and Preoperative Hydration Status Measured by Bioelectrical Impedance Vector Analysis at dr. Cipto Mangunkusumo Hospital
"Latar Belakang: Ileus pascaoperasi (IPO) terjadi pada 3 – 32% pascaoperasi abdomen mayor. Prevalensi IPO di RSUPN dr. Cipto Mangunkusumo (RSCM) sendiri belum diketahui. Imbang cairan perioperatif berkontribusi terhadap kejadian IPO. Berbagai studi menunjukkan imbang cairan intra- dan pascaoperasi yang positif berhubungan dengan peningkatan risiko IPO, namun peran status hidrasi praoperasi belum diketahui. Pemeriksaan bioelectrical impedance vector analysis (BIVA) mulai digunakan untuk evaluasi status hidrasi, namun metode ini belum umum digunakan untuk evaluasi cairan perioperasi. Penelitian ini dilakukan untuk mengetahui insidensi IPO di RSCM, serta mengetahui hubungan antara IPO dengan status hidrasi praoperasi berdasarkan BIVA. Metode: Penelitian ini adalah studi potong lintang pada pasien yang menjalani laparotomi elektif di RSCM, Jakarta. Diambil karakteristik praoperasi berupa data demografis, antropometri, dan status hidrasi yang meliputi BIVA, osmolalitas serum, imbang cairan, dan rasio blood urea nitrogen/creatinine (rasio BUN/Cr); karakteristik intraoperasi yaitu imbang cairan intraoperasi, lama operasi, dan jumlah perdarahan; serta status hidrasi pascaoperasi yang dinilai pada hari kedua pascaoperasi. Dilakukan analisis hubungan IPO dengan status hidrasi praoperasi berdasarkan BIVA, yang dilanjutkan dengan analisis multivariat untuk menyingkirkan faktor perancu.
Hasil: Sebanyak 90 subjek menjalani laparotomi elektif untuk kasus digestif (37,8%), ginekologi (57,8%), urologi (2,2%), serta join digestif-vaskular dan digestif- ginekologi (2,2%). Status hiperhidrasi praoperasi berdasarkan BIVA didapatkan sebanyak 38,9% dan meningkat menjadi 74,4% pascaoperasi. Osmolalitas serum pra- dan pascaoperasi berada dalam rentang normal dan tidak menunjukkan perubahan yang bermakna, sedangkan imbang cairan dan rasio BUN/Cr meningkat bermakna pascaoperasi. Status hiperhidrasi praoperasi berhubungan bermakna dengan IPO (OR 3.386, 95%CI 1.319 – 8.601; p=0.009). Namun berdasarkan analisis multivariat, hanya jumlah perdarahan intraoperasi (> 500 mL) yang berhubungan dengan IPO (OR 7.95, 95% CI 1.41 – 44.78; p=0.019). Stratifikasi lebih lanjut menunjukkan status hiperhidrasi praoperasi meningkatkan risiko IPO pada subjek dengan jumlah perdarahan intraoperasi kurang dari 500 mL (OR 6.8, 95% CI 1.436 – 32.197; p =0.016). Kesimpulan: Status hidrasi praoperasi menentukan keluaran klinis pascaoperasi. Status hiperhidrasi praoperasi berdasarkan BIVA ditemukan berhubungan dengan peningkatan risiko IPO laparotomi, namun status hiperhidrasi praoperasi dapat dimodifikasi oleh jumlah perdarahan intraoperasi. Dibutuhkan studi lebih lanjut hubungan antara IPO dengan status hiperhidrasi praoperasi, terutama pada kelompok subjek dengan jumlah perdarahan intraoperasi kurang dari 500 mL.
Background: Postoperative ileus (POI) is a complication commonly found after major abdominal surgery, with a prevalence of 3 – 32%. Prevalence of POI at dr. Cipto Mangunkusumo Hospital (RSCM) is yet to be reported. Perioperative hydration status contributes to the risk of developing POI. Studies have shown that positive intra- and postoperative fluid balance are associated with increased risk of POI, but the role of preoperative hydration status is not yet known. Bioelectrical impedance vector analysis (BIVA) has started to be used widely to evaluate hydration status, nonetheless it is still not commonly used in evaluation of perioperative hydration status. This study aims to determine POI incidence in RSCM, and to explore the association between IPO and preoperative hydration status evaluated with BIVA. Methods: This study was a cross-sectional study done at RSCM, Jakarta. We recruited patients who were scheduled to undergo elective laparotomy. Preoperative characteristics were collected such as demographical data, anthropometry, and hydration status including BIVA, serum osmolality, fluid balance, and blood urea nitrogen/creatinine (BUN/Cr) ratio; intraoperative characteristics such as fluid balance, length of surgery, and total bleeding volume; and postoperative hydration status which was analyzed in postoperative day two. Analysis to determine the associatiob between POI and preoperative hydration status by BIVA was done, and continued with logistic regression analysis to control confounding factors.
Results: Ninety subjects recruited in this study underwent elective laparotomy for digestive (37,8%), gynecology (57,8%), urology (2,2%), also joined digestive-vascular and digestive-gynecology (2,2%) surgery. Preoperative hyperhydration by BIVA was found in 38,9% subjects, and increased to 74,4% postoperatively. Pre- and postoperative serum osmolality were within normal range and did not show any significant increment, while fluid balance and BUN/Cr ratio increased postoperatively. Preoperative hyperhydration was associated with POI (OR 3.386, 95%CI 1.319 – 8.601; p=0.009). Only total bleeding volume (> 500 mL) was found to increase the risk of POI after logistic regression analysis (OR 7.95, 95% CI 1.41 – 44.78; p=0.019). Further stratification analysis showed that preoperative hyperhydration increased the risk of POI in subjects with total bleeding less than 500 mL (OR 6.8, 95% CI 1.436 – 32.197; p =0.016). Conclusion: Preoperative hydration status has an impact on postoperative clinical outcome. Preoperative hyperhydration was found to increase the risk of POI, but preoperative hyperhydration status could be modified by the degree of intraoperative bleeding. Further study needs to be done to determine the link between POI and preoperative hyperhydration, especially in subjects with total bleeding less than 500 mL."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Sri Lestari
Hubungan kadar vitamin D dengan tingkat keparahan rinitis alergi pada anak usia 6-18 tahun = Association between vitamin D serum level and severity level of allergic rhinitis in children age 6-18 years
"ABSTRAK
Latar belakang: Rinitis alergi RA merupakan masalah kesehatan global dengan prevalensi tinggi pada anak. Akhir-akhir ini, kekurangan vitamin D pada anak dipercaya berhubungan dengan disregulasi sistem imun, yang berujung pada makin beratnya RA. Analisis hubungan antara kadar vitamin D dan keparahan RA diperlukan untuk mencegah komplikasi lebih lanjut. Tujuan: 1 Mengetahui rerata kadar vitamin D pada anak dengan rinitis alergi; 2 Membandingkan rerata kadar vitamin D pada anak dengan rinitis alergi dan anak pada populasi normal; 3 Mengetahui rerata kadar 25 OH D serum sesuai dengan tingkat keparahan rinitis alergiMetode: Penelitian potong lintang pada 60 anak usia 6-18 tahun yang memenuhi kriteria inklusi dan berkunjung ke RSCM dan RSI Pondok Kopi. Seluruh subyek dibagi menjadi kelompok rinitis alergi n=30 dan kontrol n=30 . Kemudian, dilakukan pemeriksaan kadar 25 OH D serum dengan cara CLIA chemiluminescence immunoassay . Kadar 25 OH D serum normal, insufisiensi, dan defisiensi lalu dihubungkan dengan RA berdasarkan lama gejala yaitu intermiten dan persisten. Hasil: Rerata kadar vitamin D pada anak dengan rinitis alergi didapatkan 17,75 SB 5,60 ng/mL. Tidak terdapat perbedaan bermakna antara rerata kadar vitamin D di kelompok RA 17,75 5,60 ng/mL dengan kelompok kontrol 19,22 6,11 ng/mL , p=0,336. Didapatkan hubungan bermakna antara rerata kadar vitamin D pada rinitis intermiten 22,82 4,59 ng/mL dengan rinitis persisten 15,22 4,19 ng/mL , p
ABSTRACT
Background. Allergic rhinitis AR was a global health problem with high prevalence in children. Recently, vitamin D deficiency in children was found to have a correlation with immune system dysregulation, which leads to more severe symptoms of AR. Association between vitamin D serum level and AR incidence is needed to prevent further complications.Aim. 1 to recognize mean vitamin D serum level in children with AR 2 to compare mean vitamin D serum level in children with AR and normal children population 3 to find out mean vitamin D serum level according to severity level of AR.Methods. A cross sectional study was performed in 60 children aged 6 18 years old, who meet the inclusion criteria and visit CM hospital and Islamic Pondok Kopi hospital. All subjects were divided into 2 groups AR group n 30 and control group n 30 . Blood were taken for 25 OH D serum level examination with CLIA method. Association between 25 OH D serum level normal, insufficiency, deficiency and severity level of AR intermittent and persistent was then being analyzed.Results. Mean vitamin D serum level in children with AR was 17,75 SD 5,60 ng mL. There was no significant difference between mean vitamin D serum level in AR group 17,75 5,60 ng mL and control group 19,22 6,11 ng mL , p 0,336. Association was found between mean vitamin D serum level in intermittent rhinitis 22,82 4,59 ng mL and persistent rhinitis 15,22 4,19 ng mL , p"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Inayah Syafitri
Pengaruh terapi Vitamin D3 terhadap kadar 25(OH)D dan 1,25(OH)2D serum pada wanita hamil dengan defisiensi dan insufisiensi Vitamin D = The effect of Vitamin D therapy on 25(OH)D and 1,25(OH)2D serum maternal concentration in pregnant women with insufficiency or deficiency of Vitamin D
"Tujuan: Mengetahui dosis terapi vitamin D yang optimal untuk ibu hamil dengan defisiensi dan insufisiensi vitamin D
Metode: Uji klinis acak terkontrol dilakukan Juni 2019–Desember 2022 di RSUPN Cipto Mangunkusumo dan RSUD Koja, Jakarta. Subjek adalah wanita hamil usia kehamilan ≤14 minggu dengan defisiensi atau insufisiensi vitamin D (25(OH)D<30 ng/ml). Subjek dibagi menjadi 2 kelompok, kelompok pertama mendapatkan terapi vitamin D3 50.000 IU/minggu dan kelompok kedua mendapatkan terapi vitamin D3 5.000 IU/hari. Intervensi diberikan selama 4 minggu. Pengukuran kadar 25(OH)D dan 1,25(OH)2D dilakukan pada awal dan akhir intervensi.
Hasil: Subjek awal berjumlah 60 orang, dan 8 subjek mengalami drop out. Karakteristik dasar subjek pada kedua kelompok setara. Kadar awal 25(OH)D tidak menunjukkan perbedaan bermakna di antara kedua kelompok (p=0,552). Pemberian terapi vitamin D3 50.000 IU/minggu selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 14,5±4,3 menjadi 27,9±9,3 ng/mL, p<0,001) dan meningkatkan kadar 1,25(OH)2D namun secara statistik tidak signifikan (p=0,257). Pemberian terapi vitamin D3 5.000 IU/hari selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 15,3±4,7 ng/mL menjadi 26,9±6,1 ng/mL, p<0,001) dan juga meningkatkan kadar 1,25(OH)2D secara signifikan (p=0,042). Namun tidak didapatkan perbedaan yang bermakna baik pada delta 25(OH)D (p=0,694), maupun delta 1,25(OH)2D di antara kedua kelompok dosis (p=0,641).
Kesimpulan: Terapi vitamin D3 50.000 IU/minggu selama 4 minggu sama efektifnya dengan vitamin D3 5.000 IU/hari dalam meningkatkan kadar 25(OH)D serum pada wanita hamil dengan defisiensi dan insufisiensi vitamin D. Kedua dosis tersebut juga aman dan dapat ditoleransi oleh ibu hamil.
Objective: To determine the optimal therapeutic dose of vitamin D for pregnant women with insufficiency or deficiency of Vitamin D
Methods: A randomized controlled trial was conducted from June 2019 to December 2022 at Cipto Mangunkusumo National Center General Hospital and Koja District Hospital in Jakarta, Indonesia. Subjects were ≤14 weeks gestation pregnant women with insufficiency or deficiency of Vitamin D (25(OH)D<30 ng/ml]. Two intervention groups were randomly assigned: 5,000 IU vitamin D3 daily or 50,000 IU weekly. Maternal blood samples were collected before and after four weeks of interventions to assess changes in serum concentrations of 25(OH)D and 1,25(OH)2D).
Result: Sixty subjects were randomized into two groups, and eight subjects were dropped out. The basic demographics of subjects in both groups were equivalent. There were no differences in baseline levels of 25(OH)D between two groups (p=0.552). In the 50,000 group, 25(OH)D levels increased from 15.3 ± 4.7 ng/mL to 26.9 ± 6.1 ng/mL (p<0.001). The 1,25(OH)2D levels increased however, the increase is not statistically significant. While in the 5,000 group, the 25(OH)D levels increased from 14.5 ± 4.3 ng/mL to 27.9 ± 9.3 ng/mL (p<0.001) and the 1,25(OH)2D levels increased significantly (p=0.042). However, the increment 25(OH)D and 1,25(OH)2D were not statistically significant between two groups.
Conclusion: Vitamin D3 50,000 IU weekly is equally effective and safe as 5,000 IU daily in increasing 25(OH)D serum levels in pregnant women with insufficiency or deficiency of Vitamin D."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Izzah Aulia
Hubungan Kadar Kalsidiol Serum Pasien Keratosis Seboroik di Daerah Pesisir dengan Sun Index dan Asupan Vitamin D = Association of Serum Calcidiol of Seborrheic Keratoses Patient in The Coastal Area with Sun Index and Vitamin D Intake
"Keratosis Seboroik (KS) merupakan salah satu tumor jinak epidermis dengan faktor risiko utama pajanan matahari yang berlebihan. Selain pajanan matahari, defisiensi vitamin D diduga berperan pada patogenesis KS. Defisiensi vitamin D dapat disebabkan pajanan matahari yang kurang maupun kurangnya asupan vitamin D. Daerah pesisir memiliki karakteristik pajanan matahari yang tinggi. Oleh karena itu, diperlukan penelitian yang menilai hubungan kadar vitamin D (kalsidiol serum) pasien KS di daerah pesisir dengan pajanan matahari (sun index) dan asupan vitamin D. Penelitian ini bersifat deskriptif-analitik dengan desain potong lintang. Dilakukan wawancara dengan menggunakan kuesioner sun index, food frequency questionnaire semikuantitatif vitamin D, pemeriksaan fisis dan dermoskopi untuk menilai ukuran terbesar lesi KS, serta pengukuran kadar kalsidiol serum pada 39 individu usia 19-59 tahun di Kecamatan Cilincing, Jakarta Utara. Median ukuran lesi KS adalah 2 mm; median nilai sun index adalah 3,95; median kadar kalsidiol serum sebesar 14,3 ng/ml, dan median asupan vitamin D adalah 4,3 mcg/hari. Tidak ditemukan korelasi yang bermakna antara sun index dan kadar kalsidiol dengan ukuran lesi KS, serta sun index dan asupan vitamin D dengan kadar kalsidiol pada masyarakat pesisir tersebut.
Seborrheic keratosis (SK) is a benign epidermal tumor with high sun exposure as a major risk factor. In addition, vitamin D deficiency is thought to play a role in the pathogenesis of SK. Vitamin D deficiency can be caused by insufficient sun exposure or a lack of vitamin D intake. Coastal areas are characterized by high sun exposure. Therefore, research assessing the relationship of vitamin D levels of SK patients living in a coastal area with sun exposure and vitamin D intake needs to be done. This is an analytic-descriptive cross-sectional study. We performed interview using sun index questionnaire; semi quantitative food frequency questionnaire for vitamin D; physical examination and dermoscopy to determine the largest diameter of SK lesions; and measurement of serum calcidiol levels in 39 individuals with 19-59 years age living in Cilincing District, North Jakarta. The Spearman correlation test was used to assess the relationship between variables. Median of the largest SK lesions size, sun index, serum calcidiol, and vitamin D intake were 2 mm, 3.95, 14.3 ng/ml, and 4.3 mcg/day, respectively. There were no significant correlations between sun index and calcidiol level with SK lesion size, as well as sun index and vitamin D intake with calcidiol level in this coastal population."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
<<   1 2 3 4 5 6 7 8 9 10   >>