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"Infeksi COVID-19 (Corona Virus Disease 2019) dapat meninggalkan gejala sisa multisistemik (long COVID). Gejala long COVID meliputi kelelahan, sesak napas, batuk, sakit kepala, nyeri otot, dan gangguan kesehatan kognitif atau mental seperti kecemasan atau depresi. Salah satu tata laksana long COVID adalah intervensi rehabilitasi dan telerehabilitasi disarankan sebagai salah satu strategi inovatif. Namun, belum dikembangkan model telerehabilitasi untuk pasien long COVID di Indonesia. Oleh karena itu, perlu dilakukan penelitian yang bertujuan untuk mengembangkan model telerehabilitasi dan menilai efektivitasnya terhadap perbaikan kapasitas fungsional, kualitas hidup, tingkat stres oksidatif dan disfungsi endotel pada pasien long COVID di Indonesia. Penelitian dilakukan di Jakarta pada Juni 2022 hingga Juli 2024. Tahap pertama adalah studi kualitatif pengembangan model telerehabilitasi CoFit Rehab untuk pasien long COVID menggunakan metode Delphi yang melibatkan 24 panelis. Tahap kedua adalah uji randomisasi terkontrol pada 41 pasien long COVID (21 subjek perlakuan dan 20 subjek kontrol) untuk menguji efektivitas model telerehabilitasi yang dikembangkan. Selama 12 minggu, subjek perlakuan menjalani intervensi telerehabilitasi dan subjek kontrol menjalani intervensi rehabilitasi standar. Dilakukan pengukuran parameter kapasitas fungsional (uji jalan enam menit, uji sit-to-stand 30 detik dan uji kekuatan genggam tangan), kualitas hidup (kuesioner EQ-5D-5L versi Indonesia), tingkat stres oksidatif (kadar GSH dan rasio GSH/GSSG) dan disfungsi endotel (kadar mikropartikel endotel CD31+CD42b–). Studi kualitatif mendapatkan model telerehabilitasi. Uji randomisasi terkontrol memperlihatkan peningkatan bermakna jarak tempuh uji jalan enam menit baik kelompok kontrol dan kelompok perlakuan. Peningkatan jarak tempuh uji jalan enam menit lebih besar pada kelompok perlakuan. Ditemukan peningkatan bermakna jumlah repetisi uji sit-to-stand 30 detik, kekuatan genggam tangan, skor VAS EQ-5D-5L yang bermakna pada kelompok perlakuan. Ditemukan penurunan bermakna kadar mikropartikel endotel CD31+CD42b– plasma pada kelompok perlakuan. Tidak terdapat perbaikan bermakna pada parameter lain. Model telerehabilitasi CoFit Rehab terbukti lebih unggul dalam memperbaiki kapasitas fungsional dan fungsi endotel pada pasien long COVID dibandingkan rehabilitasi standar.

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COVID-19 (Corona Virus Disease 2019) infection can result in multisystemic sequelae (long COVID). Commonly reported symptoms include fatigue, shortness of breath, cough, headache, muscle pain, and cognitive or mental health disorders such as anxiety or depression. One of the management for long COVID is rehabilitation intervention and telerehabilitation is suggested as one of the innovative strategies. However, a telerehabilitation model (CoFit Rehab) for long COVID patients has not been developed in Indonesia. This study aims to develop a telerehabilitation model for long COVID patients and assess its effectiveness in improving functional capacity, quality of life, oxidative stress levels and endothelial dysfunction in long COVID patients in Indonesia. This study was done in Jakarta from June 2022 until July 2024. The first stage was a qualitative study to obtain a telerehabilitation model for long COVID patients using the Delphi method that involved 24 panelists. The second stage was a randomized controlled trial on 41 long COVID patients (21 treatment subjects and 20 control subjects) to test the effectiveness of the telerehabilitation model that has been developed. For 12 weeks, treatment subjects received telerehabilitation intervention and control subjects received standard rehabilitation intervention. Functional capacity parameters (six-minute walk test, 30-second sit-to-stand test, and handgrip strength test), quality of life (Indonesian version of the EQ-5D-5L questionnaire), oxidative stress levels (GSH levels and GSH/GSSG ratio) and endothelial dysfunction (concentration of CD31+CD42b– endothelial microparticles) were measured. The qualitative study obtained a telerehabilitation model. Randomized controlled trial showed a significant increase in the six-minute walk test distance in both groups. Compare to the control group, the distance increase in the six-minute walk test was greater in the treatment group. There was a significant increase in the total repetitions of the 30-second sit-to-stand test, handgrip strength, and EQ-5D-5L VAS scores in the treatment group. There was a significant decrease of the endothelial microparticle plasma level (CD31+CD42b) in the treatment group. There was no significant improvement in other parameters. The telerehabilitation model (CoFit Rehab) was shown to be superior in improving functional capacity and endothelial function in long COVID patients compared to standard rehabilitation."

"Latar Belakang: Berdasarkan data dari WHO, penderita penyakit kardiovaskular diduga akan terus meningkat. Salah satu proses patologis yang mendasari penyakit kardiovaskular adalah aterosklerosis. Disfungsi endotel yang mengawali aterosklerosis dimulai sejak anak-anak. Stres oksidatif dapat disebabkan oleh pertambahan usia. Salah satu herba yang memiliki efek antioksidan kuat dan dapat mencegah stres oksidatif adalah Hibiscus sabdariffa Linn.Metode: Penelitian eksperimental dilakukan pada 36 ekor tikus jantan galur Wistar usia 5 minggu selama 4 minggu, 8 minggu, dan 12 minggu. Hewan coba secara acak terbagi atas 12 kelompok, yaitu: kontrol (K4, K8, K12), latihan fisik aerobik (L4, L8, L12), pemberian H. sabdariffa Linn. 400 mg/kgBB/hari (H4, H8, H12) dan kombinasi latihan fisik aerobik dan pemberian H. sabdariffa Linn. 400 mg/kgBB/hari (HL4, HL8, HL12). Pengukuran kadar NO, ET-1, aktivitas spesifik SOD dan MDA menggunakan supernatan dari homogenat aorta abdominal.Hasil: Pola kadar NO kelompok K dan L menurun sesuai peningkatan usia. Terdapat perbedaan bermakna antara kadar NO kelompok K dan L, K dan H, dan K dan HL. Kadar ET-1 pada semua kelompok tidak bermakna secara statistik. Terdapat peningkatan aktivitas spesifik SOD pada kelompok L, H, dan HL dibandingkan K. Terdapat perbedaan bermakna Kadar MDA antara K dan H, L dan HL. Terdapat korelasi sedang antara NO dan aktivitas spesifik SOD.Kesimpulan: latihan fisik aerobik, pemberian H. sabdariffa Linn. 400 mg/kgBB/hari dan kombinasi latihan fisik aerobik dan pemberian H. sabdariffa Linn. 400 mg/kgBB/hari menurunkan kadar MDA dan ET-1, sebalikanya meningkatkan aktivitas spesifik SOD dan NO. Penurunan kadar MDA lebih jelas terlihat pada kelompok HL. Peningkatan aktivitas spesifik SOD meningkatkan produksi NO. Tidak terjadi disfungsi endotel dan stres oksidatif pada seluruh kelompok.

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Background: Based on data from WHO, patients with suspected cardiovascular disease will continue to rise. One of the pathological processes underlying cardiovascular disease is atherosclerosis. Endothelial dysfunction which is the first sign of atherosclerosis begins in childhood. Increasing age is one of the cause of oxidative stress. A herb that has strong antioxidant effects and can prevent oxidative stress is Hibiscus sabdariffa Linn.

Methods: Thirty six male Wistar rats aged 5 weeks were randomly divided into 12 groups consisting of control group (K4, K8, K12), aerobic exercise group (L4, L8, L12), administration of H. sabdariffa L. 400 mg/kgBW/day group (H4, H8, H12) and combination of aerobic exercise and H. sabdariffa L. 400 mg/kgBW/day group (HL4, HL8, HL12). NO, ET-1, MDA level, and SOD activity was measured from abdominal aorta homogenate supernatant.

Results: NO level pattern in the K and L groups tend to decline with age. NO level in L, H and HL groups were higher than K. The difference of ET-1 level in all groups were not statistically significant. Specific activity of SOD in L, H and HL groups were higher than control. The concentration of MDA of group K is significantly lower compare to groups H, L and HL. There is a moderate correlation between specific activity of SOD and NO.

Conclutions: Aerobic exercie, administration of H. sabdariffa L. 400 mg/kgBW/day, and combination of both decreases MDA and ET-1 concentration. While, specific activity of SOD and NO are increased. The decrease at MDA concentration was more prominent in HL group. An increase in spesific activity of SOD, increases the NO level. No endothelial dysfunction nor oxidative stress were observed in all groups."

"Kanker payudara merupakan jenis keganasan tersering pada wanita di Indonesia. Kemoterapi dan inaktivitas fisik selama pengobatan kanker menyebabkan penurunan kapasitas fungsional dan kualitas hidup. Rehabilitasi preventif dengan latihan aerobik terbukti bermanfaat meningkatkan kapasitas fungsional dan kualitas hidup pada populasi ini, namun studi mengenai aktivitas berjalan kaki terukur pedometer masih belum diteliti di Indonesia. Studi ini bertujuan menilai efek aktivitas berjalan kaki harian 4000 langkah selama 8 minggu terhadap kapasitas fungsional dan kualitas hidup pasien kanker payudara stadium II-III yang menjalani kemoterapi. Studi ini adalah one group pre and post test design, dilakukan pada 15 subjek, berusia 25-59 tahun, di poliklinik Rumah Sakit Kanker Dharmais. Kapasitas fungsional ditentukan dari jarak tempuh uji jalan enam menit protokol Nury dan kualitas hidup dengan EORTC-QLQ-C30 versi Bahasa Indonesia, yang dinilai sebelum dan setelah rehabilitasi preventif. Rerata capaian jumlah langkah harian adalah 5005,26+1574 langkah. Tidak ditemukan perbedaan kapasitas fungsional sebelum dan setelah rehabilitasi (436,84±47,87 dan 449,64±51,84, p=0,0143). Terjadi peningkatan kualitas hidup global EORTC QLQ-C30 setelah penerapan aktivitas berjalan kaki terukur (63,89±30,97 dan 82,78±14,24, p=0,011). Aktivitas berjalan kaki terukur pedometer selama 8 minggu mempertahankan kapasitas fungsional dan meningkatkan kualitas hidup pada pasien kanker payudara stadium II-III yang menjalani kemoterapi.

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Breast cancer is the most common cancer amongst Indonesian women. Chemotherapy and physical inactivity during cancer treatment lead to decreased functional capacity and quality of life, which could be prevented by doing aerobic exercise. However, studies on pedometer-based walking activity programs have not been studied in Indonesia. This study aimed to assess the effects of eight weeks of 4000-steps of the pedometer-based walking activity program on functional capacity and quality of life in stage II-III breast cancer patients receiving chemotherapy. This study was a one-group pre-and post-test design with 15 subjects, aged 25-59 years, in the outpatient of Rumah Sakit Kanker Dharmais. The functional capacity was determined from the six-minute walk test distances of the Nury's protocol and quality of life with the EORTC-QLQ-C30 Indonesian version, which were assessed before and after rehabilitation. The average daily step count was 5005.26+1574 steps. There was no difference in functional capacity before and after rehabilitation (436.84±47.87 and 449.64±51.84, p=0.0143). There was an increase in the global quality of life of the EORTC QLQ-C30 after the implementation of measured walking activities (63.89±30.97 and 82.78±14.24, p=0.011). Eight weeks of pedometer-based walking activity program maintains functional capacity and improves the quality of life in stage II-III breast cancer patients receiving chemotherapy."

"Penurunan toleransi latihan dan sesak nafas merupakan manifestasi klinis utama gagal jantung. Kondisi ini menyebabkan pasien tidak dapat melakukan aktivitas sehari-hari yang berakibat pada penurunan kapasitas fungsional dan kualitas hidup. Tujuan dari penelitian ini adalah mengidentifikasi dampak HBET terhadap kapasitas fungsional dan kualitas hidup pasien gagal jantung. Desain penelitian ini adalah quasi experiment, pre-post with control group. Teknik sampling yang digunakan purposive sampling, didapatkan 23 responden yang terbagi menjadi 11 responden kelompok kontrol dan 12 responden kelompok intervensi. Pengumpulan data kapasitas fungsional dilakukan dengan 6MWT dan kualitas hidup menggunakan MLHFQ. Hasil pengukuran didapatkan perbedaan yang signifikan kapasitas fungsional dan kualitas hidup sebelum dan setelah perlakuan pada kedua kelompok. Hasil analisis kapasitas fungsional dan kualitas hidup setelah perlakuan antara kelompok kontrol dan intervensi tidak didapatkan perbedaan yang signifikan, walaupun kelompok intervensi mempunyai mean kapasitas fungsional dan kualitas hidup yang lebih baik. Berdasarkan hasil penelitian tersebut, HBET dapat digunakan sebagai modalitas keperawatan bagi pasien gagal jantung. HBET hendaknya dijadikan bagian integral dari management gagal jantung setelah keluar dari rumah sakit.

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A reduced exercise tolerance and shortness of breathing are the main clinical manifestations in patient with heart failure. These conditions cause patient's inability to do their daily activities and lead to reduce functional capacity and quality of life. The aim of this study was to identify the impact of the home based exercise training to functional capacity and quality of life of heart failure patient. It used quasy experimental study design pre-post with control group, recruited 23 respondents with purposive sampling technique. They were divided into two groups, 11 respondents as control group and 12 respondents as experimental group. Functional capacity was obtain through observation of six minute walk test, quality of life data were collected by Minessota Living with Heart Failure Questionaire.

The result showed that there was a significant difference of functional capacity and quality of life before and after intervention in both groups. Statistically, the result of functional capacity and quality of life data analysis after intervention showed that there wasn't significant difference in both groups, although the experimental group has a higher mean data of functional capacity and quality of life. Based on this study, HBET could be used as nursing modality for patient with heart failure. HBET should be integrated with heart failure management after discharging from hospital."

"Latar Belakang: Tuberkulosis Paru (TB Paru) merupakan penyakit infeksi yang bersifat kronis dengan tingkat morbiditas dan mortalitas yang tinggi. Perubahan metabolisme akibat infeksi Mycobacterium Tuberkulosa(M.TB) dan aktivasi sistem neurohormal turut berperan terhadap terjadinya malnutrisi, yang dapat memberikan efek negatif terhadap prognosis pasien dengan TB Paru. Penderita TB Paru mengalami penurunan kapasitas fungsional dan kualitas hidup. Terapi Medik Gizi sejak awal diagnosis ditegakkan, akan mendukung proses pemulihan pasien TB.Kasus :Dalam serial kasus ini, dipaparkan empat kasus pasien TB Paru dengan berbagai faktor risiko, diantaranya adalah penyakit TB Paru, TB Miliar, PPOK et causa TB Paru, Meningitis TB. Pada awal pemeriksaan didapatkan adanya defisiensi asupan makronutrien dan mikronutrien, hipoalbuminemia, CRP yang meningkat, hemoglobin (Hb) yang turun, penurunan kapasitas fungsional dan kualitas hidup. Terapi medik gizi diberikan secara individual, sesuai dengan kondisi klinis, hasil pemeriksaan laboratorium, dan analisis asupan makan terakhir. Hasil:Tiga dari empat pasien mengalami peningkatan asupan, perbaikan kondisi klinis, dan kapasitas fungsional serta kualitas hidup pasien. Status nutrisi pasien tidak mengalami perburukan selama perawatan,Kesimpulan:Terapi Medik gizi yang adekuat pada pasien TB dapat mempertahankan status nutrisi pasien dan mendukung perbaikan kondisi klinis, kapasitas fungsional, serta kualitas hidup pasien.

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Background:

Pulmonary tuberculosis (pulmonary TB) is a chronic infectious disease with high morbidity and mortality. Changes in metabolism due to infection with Mycobacterium Tuberculosis and activation of the neurohormal system contribute to the occurrence of malnutrition, which can have a negative effect on the prognosis of patients with pulmonary TB. Patients with pulmonary TB have decreased functional capacity and quality of life.Early medical nutrition therapywill support the recovery process of pulmonary TB patients.

Case :

In this case series, four cases of pulmonary TB patients were presented with various risk factors, including pulmonary TB disease, miliar TB, COPD et causa lung TB, and TB meningitis. Deficiency of macro and micronutrient intake, hypoalbuminemia, increased CRP, decreased hemoglobin (Hb), decreased functional capacity and quality of life were found at the beginning of examination. Nutrition medical therapy is given individually, according to clinical conditions, results of laboratory examinations, and analysis of recent food intake.

Result :

Three out of four patients experience increased intake, improvement of clinical conditions, functional capacity and quality of life. The nutritional status of patients did not experience worsening during treatment.

Conclusion:

Adequate nutritional medical therapy in TB patients can maintain patient nutritional status and support improvement of clinical conditions, functional capacity, and quality of life."

"ABSTRAKDisfungsi seksual merupakan masalah umum penyerta pada penyakit gagal jantung. Pasien gagal jantung laki-laki mengalami disfungsi seksual lebih tinggi jika dibandingkan dengan perempuan. Penelitian ini bertujuan untuk mengetahui hubungan kapasitas fungsional dan depresi dengan disfungsi seksual pada pasien gagal jantung laki-laki. Desain penelitian ini adalah analitik cross sectional dengan jumlah sampel 81 pasien gagal jantung laki-laki. Hasil penelitian menunjukkan tidak ada hubungan antara kapasitas fungsional dengan disfungsi seksual dan adanya hubungan antara depresi dengan disfungsi seksualitas, dengan kekuatan hubungan sedang dan arah hubungan positif p=0,002; ?=0,05; r=0,4 . Rekomendasi dari penelitian ini ialah perlu dilakukan intervensi keperawatan untuk mencegah atau menangani masalah depresi dalam asuhan keperawatan disfungsi seksual pasien gagal jantung laki-laki.

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ABSTRACTSexual dysfunction is a common problem in heart failure patients. Male heart failure patients are more likely than females to suffer from sexual dysfunction. This study aimed to identify correlation of functional capacity and depression with sexual dysfunction in male patient with heart failure. A total of 81 heart failure patients were included in this cross sectional study. The result showed that there was no correlation between functional capacity and sexual dysfunction. However, there was a significant correlation between depression and sexual dysfunction which was proven by a positive and moderate power of correlation p 0,002 0,05 r 0,4 . This finding shows that depression intervention is recommended to reduce the risk of sexual dysfunction in male patient with heart failure."

"ABSTRAKPenelitian ini bertujuan untuk mengetahui efek pemberian hidroksiklorokuin 400 mg selama 12 minggu terhadap kadar sVCAM-1 dan sE-Selectin sebagai petanda disfungsi endotel pada pasien artritis reumatoid. Penelitian ini juga melihat peran HOMA-IR, FFA dan ox-LDL terhadap perbaikan disfungsi endotel.Penelitian ini menggunakan dua disain yaitu uji klinis acak tersamar ganda dan kohort prospektif dilakukan pada pasien artritis reumatoid dengan terapi metotreksat di poliklinik Reumatologi RS Cipto Mangunkusumo, Jakarta, pada periode Februari 2016-Mei 2017. Pasien dengan terapi insulin, anti-hipertensi dan terapi lain yang mempengaruhi kadar sVCAM-1 dan sE-Selectin dieksklusi dari penelitian. Subjek yang eligibel dirandomisasi menjadi dua kelompok, kelompok yang mendapat hidroksiklorokuin HCQ 400 mg dan kelompok placebo, dan diikuti selama 12 minggu. Pemeriksaan sVCAM-1, sE-Selectin, HOMA-IR, FFA dan ox-LDL dilakukan pada awal penelitian dan pada minggu ke-12. Perbedaan persentase perubahan kadar sVCAM-1 dan sE-Selectin sebelum dan setelah perlakuan antara kedua kelompok dianalisis dengan uji-t dan uji Mann-Whitney. Persentase perubahan kadar sVCAM-1 dan sE-Selectin dikorelasikan dengan persentase perubahan HOMA-IR, FFA dan ox-LDL, dengan uji Spearman.Sebanyak 37 subjek diikutkan dalam penelitian, dan terdapat 3 subjek yang drop-out pada masing-masing kelompok, sehingga didapatkan 15 subjek pada kelompok HCQ dan 16 subjek pada kelompok placebo. Kadar sVCAM-1 serum minggu ke-12 pada kelompok HCQ menurun sebesar 17,1 median , sementara pada kelompok plasebo meningkat sebesar 9,7 , dan perbedaan tersebut bermakna secara statistik. Kadar E-Selectin pada kelompok terapi HCQ mengalami penurunan dalam persen yang lebih besar dibandingkan pada kelompok plasebo, tapi perbedaan tersebut tidak bermakna. Perubahan kadar sVCAM-1 dan sE-Selectin, juga dibuktikan tidak berkorelasi dengan perubahan HOMA-IR, FFA dan ox-LDL.Terapi hidroksiklorokuin pada pasien artritis reumatoid terbukti memperbaiki disfungsi endotel dengan menurunkan kadar sVCAM-1, namun tidak terbukti menurunkan sE-Selectin. Variable sVCAM-1 dan sE-Selectin tidak berkorelasi dengan HOMA-IR, FFA dan ox-LDL Kata kunci: artritis reumatoid, disfungsi endotel, hidroksiklorokuin, sE-Selectin, sVCAM-1.

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ABSTRACTThis study aims to evaluate the effect of hydroxychloroquine on sVCAM 1 and sE Selectin levels decreasing as endothelial dysfunction marker in rheumatoid arthritis patients. This study also assessed the correlation between changes in sVCAM 1 and sE Selectin levels with other variables of changes in HOMA IR, FFA and ox LDL.Two kinds of methods i.e. double blind randomized controlled trial and prospective cohort, were conducted, on patients with rheumatoid arthritis with methotrexate treatment at Rheumatology Outpatient Clinic of Cipto Mangunkusumo Hospital Faculty of Medicine Universitas Indonesia, Jakarta, during February 2016 July 2017. Patients with insulin, anti hypertension and other treatment which could affect sVCAM 1 and sE Selectin level, were excluded. Eligible subjects were randomly assigned into two groups. Eighteen subjects were administered hydroxychloroquine 400 mg daily and 19 patients were given placebo for 12 weeks. sVCAM 1, sE Selectin, HOMA IR, FFA dan ox LDL were examined in the beginning and in the end week 12. Differences of serum sVCAM 1 and sE Selectin level in percentage, before and after experiment, were evaluated, by T test or alternatively by Mann Whitney test. Differences of serum sVCAM 1 and sE Selectin level in percentage, were correlated with difference of serum HOMA IR, FFA and ox LDL level, by Spearman test.There were 37 subjects enrolled in the study, and there were 3 drop out subjects in each group, finally there were 15 subjects in the HCQ group and 16 in the placebo group. Serum sVCAM 1 level decreased 17.1 median in HCQ treatment group, while in placebo group, it increased 9,7 median compared with pre treatment value. The difference in percentage rate change of sVCAM between two group was significant. On the other hand, the change of E Selectin serum level in HCQ group was found a higher percentage of decrease compared with placebo group, but the difference was not significant. Changes in sVCAM 1 and sE Selectin levels were also proven no correlation with HOMA IR, FFA and ox LDL changes.Treatment of HCQ in patients with rheumatoid arthritis appears beneficial to improve endothelial dysfunction by lowering serum sVCAM 1, but not proven to decrease sE Selectin. The sVCAM 1 and sE Selectin variables were not correlated with HOMA IR, FFA and ox LDL Keywords endothelial dysfunction, hydroxychloroquine, rheumatoid arthritis, sE Selectin, sVCAM 1."

"Rehabilitasi pasien penyakit paru obstruktif kronik (PPOK) yang stabil bertujuan untuk mengurangi sesak, meningkatkan toleransi latihan, dan meningkatkan status kesehatan. Pada dekade terakhir banyak dikembangkan teknik terapi mandiri salah satunya adalah menggunakan perangkat positive expiratory pressure (PEP). Penelitan ini bertujuan untuk menilai efektivitas latihan pernapasan menggunakan perangkat PEP pada volume ekspirasi paksa detik pertama (VEP1), kapasitas fungsional, dan kualitas hidup pada pasien PPOK. Desain penelitian yang digunakan yaitu studi intervensional prospektif yang membandingkan efek sebelum dan sesudah latihan pernapasan menggunakan PEP selama 8 minggu. Subjek yang menyelesaikan penelitian sebanyak 20 orang. Latihan pernapasan dilakukan dua kali sehari dengan durasi 15 menit pada masing-masing sesi latihan. Tekanan yang digunakan disesuaikan dengan kemampuan pasien yaitu inspirasi berbanding ekspirasi 1:3. Tekanan ditentukan sebelum memulai latihan dan dievaluasi setiap dua minggu. Hasil keluaran yang dinilai adalah nilai VEP1, kapasitas fungsional yang diukur dengan kecepatan berjalan dalam uji jalan 4 meter dan kualitas hidup yang diukur dengan kuesioner St. George s Respiratory Questionnaire (SGRQ). Nilai VEP1 sebelum intervensi adalah 1369,5±569,63 ml dan sesudah sebesar 1390±615,01 ml (p=0.585). Kecepatan berjalan sebelum intervensi 1,43±0.31 m/s dan sesudah 1,56±0,40 m/s (p=0.248). Skor kuesioner SGRQ domain gejala terdapat penurunan dari rerata 44,00±17,88% menjadi 25,31±14,06% (p=0.000), domain aktivitas dari rerata 54,22±28,18% menjadi 40,38±24,25% (p=0.006), domain dampak dari 32,83% (0,00-67,46) menjadi 16,32% (0,00-61,33) (p=0.002), dan skor total dari 39,46% (6,30-75,42) menjadi 25,96% (5,24-61,34) (p=0.001). Peningkatan kecepatan berjalan dan perbaikan skor SGRQ memenuhi nilai minimum clinically important difference (MCID). Latihan pernapasan menggunakan perangkat PEP selama 8 minggu dapat meningkatkan nilai VEP1, kapasitas fungsional dan kualitas hidup pasien PPOK.

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Rehabilitation of stable chronic obstructive pulmonary disease (COPD) aims to reduce dyspnoe, increase exercise tolerance, and improve health status. In the last decade, many independent therapy techniques have been developed, one of them is positive expiratory pressure (PEP). The aim of this study was to assess the effectiveness of breathing exercises using a PEP device on Forced Expiratory Volume in 1 second (FEV1), functional capacity, and quality of life in COPD patients. The study design was a prospective interventional studies that compared the effects before and after breathing exercises using PEP for 8 weeks. Twenty subjects completed the study. Breathing exercises were carried out twice a day, 15 minutes duration at each session. The pressure used is adjusted to the patient's ability, reaching inspiration to expiration ratio of 1:3. Pressure was determined before starting the exercise and evaluated every two weeks. The outcome were FEV1, functional capacity measured by walking speed in the 4 meter gait speed assesment and quality of life as measured by the St. George s Respiratory Questionnaire (SGRQ). FEV1 ​​before intervention were 1369,5±569,63 ml and after 1390±615,01 ml (p=0.585). Walking speed before intervention was 1,43±0,31 m/s and after 1,56±0,40 m/s (p=0,248). The symptom domain SGRQ questionnaire score has a decrease from 44,00±17,88% to 25,31±14,06% (p=0,000), the activity domain from 54,22±28,18% to 40,38±24,25% (p=0.006), the impact domain of 32,83% (0,00-67,46) to 16,32% (0,00-61,33) (p=0,002), and the total score of 39,46% (6,30-75,42) to 25,96% (5,24-61,34) (p=0.001). Increase in walking speed and SGRQ score exceed the minimum clinically important difference (MCID). Breathing exercises using a PEP device for 8 weeks can increase FEV1, functional capacity and quality of life of COPD patients."

"ABSTRAKEndometriosis merupakan penyakit ginekologi ditandai dengan implantasi jaringan endometrium di luar rongga uterus, berhubungan erat dengan proses inflamasi kronis. Stres oksidatif menjadi aktivator terjadinya proses inflamasi kronis di endometriosis. Oktil galat terbukti lebih efektif menekan proses inflamasi dibandingkan asam galat dan heptil galat pada sel kultur primer endometriosis. Penelitian ini bertujuan menganalisis pengaruh oktil galat pada proses inflamasi dan stres oksidatif pada tikus Wistar model endometriosis. Tiga puluh ekor tikus Wistar dibagi menjadi tiga kelompok, yaitu kelompok uji, kontrol endometriosis dan kelompok normal. Kelompok uji dilakukan autotransplantasi lalu diberikan suspensi oktil galat dan CMC selama satu bulan. Kelompok endometriosis dilakukan autotransplantasi lalu diberikan larutan CMC selama satu bulan, sedangkan kelompok normal hanya dilakukan laparotomi. Seluruh tikus kemudian dieuthanasia, dari kelompok uji dan kontrol endometriosis diambil jaringan endometriosisnya sedangkan dari kelompok sehat diambil jaringan endometriumnya untuk dianalisis. Analisis MDA (Malondialdhyde) dan SOD (Superoxide Dismutase) dilakukan secara spektofotometri, kadar NF-ĸB dengan ELISA dan IL-1β (Interleukin-1 Beta) dengan LUMINEX. Pemberian oktil galat pada kelompok uji tidak menurunkan kadar MDA namun berpotensi menekan kondisi stres oksidatif dengan meningkatkan kadar SOD. Oktil galat terbukti menekan aktivasi NF-ĸB secara signifikan, namun tidak menekan kadar IL-1β. Oktil galat berperan sebagai antiinflamasi pada tikus Wistar model endometriosis dengan cara induksi peningkatan SOD dan hambatan langsung pada translokasi nuklear NF-ĸB.

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ABSTRACTEndometriosis is a gynecological disease characterized by the implantation of endometrial tissue outside the uterine cavity, related to the chronic inflammatory process. Oxidative stress activates the occurrence of chronic inflammatory in endometriosis. Octyl gallate is more effective in suppressing the inflammatory process than gallic acid and heptil gallate in primary endometriosis culture cells. This study aimed to analyze the effect of octyl gallate on the inflammatory process and oxidative stress in endometriosis Wistar rat models. 30 Wistar rats were divided into three groups, the test group, endometriosis control and normal groups. The test group was autotransplantated and then given a suspension of octyl galate and CMC for one month. The endometriosis group was autotransplanted and then given a CMC solution for one month, while the normal group only underwent laparotomy. All rats were then euthanized, from the test and endometriosis group the endometriosis tissue was taken while from the normal group endometrial tissue was taken for analysis. MDA and SOD were measured using spectrophotometry, NF-ĸB with ELISA and IL-1β with LUMINEX. Induction of octyl gallate in the test group did not reduce MDA levels but could potentially suppress oxidative stress conditions by increasing SOD levels. Octyl gallate significantly inhibit the NF-ĸB activation, but not suppressing IL-1β levels significantly. Octyl gallate act as anti-inflammatory agent in endometriosis Wistar rat model through the enhancement of SOD and direct inhibition to nuclear translocation of NF-ĸB."

"ABSTRAKAngka kejadian kanker payudara di Indonesia tertinggi diantara jenis kanker padawanita dengan prevalensi nyeri diperkirakan 40-89%. Tujuan penelitian ini adalahmengembangkan model pengelolaan nyeri berbasis kenyamanan dengan strategicoaching dan mengidentifikasi pengaruhnya terhadap derajat nyeri, kenyamanan, dankualitas hidup pasien kanker payudara. Penelitian ini dilakukan melalui dua tahap,yaitu tahap 1 berupa penelitian deskriptif kualitatif dan pengembangan model, sertatahap 2 berupa penelitian kuasi eksperimen pre-post test control group design.Metode sampling tahap 1 digunakan purposive sampling dengan 11 partisipan. Tahap2 sampel dipilih secara consecutive sampling dengan jumlah 64 responden (32 pasienkelompok intervensi dan 32 pasien kelompok kontrol). Hasil penelitian tahap satuteridentifikasi 12 tema dan dihasilkan model pengelolaan nyeri berbasis kenyamananbeserta perangkatnya. Hasil penelitian tahap dua membuktikan bahwa ada pengaruhyang signifikan dari model pengelolaan nyeri berbasis kenyamanan dengan strategicoaching terhadap penurunan derajat nyeri, peningkatan kenyamanan, peningkatanstatus fungsional dan perbaikan status gejala pasien kanker payudara. Namun, tidakada pengaruh pada status kesehatan/kualitas hidup global. Rekomendasi penelitianhendaknya perawat menerapkan model pengelolaan nyeri berbasis kenyamanansebagai bentuk nyata pengelolaan nyeri kanker secara holistik dalam pelayanankeperawatan.

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ABSTRACTIncidence of breast cancer in Indonesia is still the highest among the other type ofcancer deseases on women with the prevalence of pain estimated from 40 ? 89per cent. The purpose of this research was to develop model of pain managementbased on comfort with coaching strategy and identify its effect on pain severity,comfort, and quality of life patient breast cancer. This study was conducted in twostages. The first stage was descriptive qualitative research and the development ofmodel. The second stage was quasi-experimental research with pre - post test controlgroup design. The sampling method that used to stage 1 was purposive samplingwith 11 partisipants. Sampling method on stage 2 this study was consecutivesampling with 64 breast cancer patients (32 respondents as intervention group and 32respondents as control group). The first stage of the study resulted 12 themes and hasresulted the model of pain management based on comfort and its devices. The secondstage of research proved that there were significance effects from the model of painmnagement based on comfort with coaching strategy toward decreasing painseverity, increasing comfort and functional status, and repairing symptom status forbreast cancer patients. However, there was no effect on global health status/quality oflife. This study recommends that nurse should apply the model of pain managementbased on comfort as a concrete holistic cancer pain management in setting practice ofnursing care."