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Hasil Pencarian

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Ariani Dewi Widodo
"[ABSTRAK
Latar Belakang Lemak merupakan sumber energi penting, komponen utama struktur membran sel dan media penyerapan vitamin larut lemak A, D, E, dan K. Lemak adalah nutrisi utama perkembangan otak anak, penting untuk memeriksa malabsorpsi lemak secara akurat dan tepat. RSCM merupakan rujukan pemeriksaan analisis feses, dengan sekitar 840 pemeriksaan mikroskopik lemak per tahun. Pemeriksaan mikroskopik lemak merupakan satu-satunya yang tersedia di laboratorium RSCM untuk pemeriksaan lemak feses.
Tujuan Mengetahui kehandalan pemeriksaan mikroskopik lemak pada analisis feses dalam menggambarkan malabsorpsi lemak pada anak.
Metode Uji diagnostik kehandalan pemeriksaan mikroskopik lemak menggunakan Sudan III dibandingkan dengan steatokrit dalam mendiagnosis malabsorpsi lemak pada anak usia 6-60 bulan.
Hasil Didapatkan 68 sampel yang terdiri dari 41 laki-laki dan 27 perempuan, median usia 14,3 bulan. Konsistensi feses terbanyak adalah lembek (50,0%). Dengan metode mikroskopik didapatkan lemak terbanyak adalah positif satu pada 29 sampel (42,6%). Sensitivitas pemeriksaan mikroskopik lemak didapatkan sebesar 49,15%, spesifisitas sebesar 66,67%, dengan nilai prediksi positif 90,63% dan nilai prediksi negatif 16,67%.
Kesimpulan Pemeriksaan mikroskopik lemak memiliki sensitivitas yang tidak terlalu tinggi dalam mendiagnosis malabsorpsi lemak dan perlu dilengkapi dengan metode lain seperti steatokrit.

ABSTRACT
Background Lipid is a very important source of energy, major component of cell membrane structure and media for absorption of lipid-soluble vitamins A, D, E, and K. Lipid is the major nutrition for brain development, and thus it is important to test lipid malabsorption accurately. RSCM is the referral hospital for fecal analysis, with 840 lipid microscopic examination done each year. This microscopic test is the only method currently available for fecal lipid malabsorption at RSCM laboratory.
Objective To know whether the lipid microscopid test as a part of fecal analysis that have been done so far is effective in representing lipid malabsorption in children.
Methods Diagnostic test for effectivity of lipid microscopic test using Sudan III compared to steatocrit test in diagnosing lipid malabsorption in children 6-60 months old suspected to have lipid malabsorption.
Results Sixty-eight children consisting of 41 boys and 27 girls were included in the study, with median age 14,3 months. The most common stool consistency was mushy (50,0%). Using microscopic method the most frequent group was positive one in 29 subjects (42,6%). Sensitivity of lipid microscopic test was found to be 49,15% with specificity 66,67%, PPV 90,63% and NPV 16,67%.
Conclusion The lipid microscopic test has a moderate sensitivity in diagnosing fat malabsorption, and needs to be complemented with other method such as steatocrit., Background Lipid is a very important source of energy, major component of cell membrane
structure and media for absorption of lipid-soluble vitamins A, D, E, and K. Lipid is the
major nutrition for brain development, and thus it is important to test lipid malabsorption
accurately. Cipto Mangunkusumo Hospital (CMH) is a referral hospital for fecal analysis,
with 840 lipid microscopic examination done each year. This microscopic test is the only
method currently available for fecal lipid malabsorption at CMH laboratory.
Objective To know whether the lipid microscopic test as a part of fecal analysis that is
performed routinely so far is effective in representing lipid malabsorption in children.
Methods Diagnostic test for effectivity of lipid microscopic test using Sudan III compared to
steatocrit test in diagnosing lipid malabsorption in children 6-60 months old suspected to
have lipid malabsorption.
Results Sixty-nine children consisting of 41 boys and 27 girls were included in the study,
with median age 14,3 months. The most common stool consistency was mushy (50,0%).
Using microscopic method the most frequent group was positive one in 29 subjects (42,6%).
Sensitivity of lipid microscopic test was found to be 49,15% with specificity 66,67%, PPV
90,63% and NPV 16,67%.
Conclusion Lipid microscopic test has a moderate sensitivity in diagnosing fat malabsorption, and needs to be complemented with other method such as steatocrit.]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Ariani Dewi Widodo
"ABSTRAK
Diare persisten merupakan masalah kesehatan serius dan sering menyebabkan malnutrisi. Kerusakan mukosa pada diare diduga menyebabkan penurunan hormon sekretin dan kolesistokinin sehingga mengurangi stimulasi ke pankreas dan memperberat diare persisten dan malnutrisi.Penelitian ini bertujuan untuk mengetahui fungsi eksokrin pankreas pada anak diare persisten, anak malnutrisi, mendapatkan nilai referensi pemeriksaan fecal elastase-1 FE-1 anak Indonesia, dan mengetahui kehandalan analisis feses dan steatokrit dalam mendeteksi insufisiensi eksokrin pankreas.Penelitian potong lintang pada tahap pertama dilakukan untuk mendapatkan sebaran nilai FE-1 pada anak normal, membandingkan nilai FE-1 subjek diare persisten dan malnutrisi dengan anak normal, dan mengetahui sensitivitas, spesifisitas, dan kemampuan diskriminasi analisis feses dan steatokrit dalam mendeteksi insufisiensi eksokrin pankreas. Tahap kedua uji klinis dua kelompok paralel tersamar ganda dilakukan untuk menguji efek suplementasi enzim pankreas 8371 USP unit tiga kali sehari selama sebulan pada anak diare persisten. Penelitian dilakukan di 5 Rumah Sakit di Jakarta Januari 2015 minus;Juli 2016 pada anak berusia 6 ndash;60 bulan.Sebanyak 182 anak usia 6 ndash;60 bulan direkrut sebagai subjek yang terdiri dari 31 anak dengan diare persisten, 31 anak dengan malnutrisi, dan 120 anak normal. Nilai cut-off FE-1 yang didapatkan pada penelitian ini adalah 307 mcg/g feses. Terdapat perbedaan bermakna nilai FE-1 antara subjek diare persisten dan anak normal. Tidak ditemukan perbedaan bermakna nilai FE-1 antara subjek malnutrisi dan anak normal. Terdapat perbedaan bermakna lama diare sekitar 7 hari antara kedua kelompok. Kadar FE-1 dan prealbumin antara baseline dan endpoint pada kelompok plasebo dan perlakuan tidak berbeda bermakna. Uji kehandalan masing-masing komponen analisis feses dan steatokrit menunjukkan hasil sensitivitas dalam rentang 5 ndash;32 , spesifisitas 73 ndash;98 , nilai prediksi positif 1 ndash;43 , dan nilai prediksi negatif 87 ndash;89 . Nilai AUC analisis feses dan steatokrit masing-masing adalah 0,664 IK 95 0,539 ndash;0,788 dan 0,501 IK 95 0,372 ndash;0,629 sedangkan AUC gabungan sebesar 0,671.Kesimpulannya, pada penelitian ini didapatkan adanya insufisiensi eksokrin pankreas pada anak dengan diare persisten. Suplementasi enzim pankreas terbukti dapat memperpendek lama diare secara bermakna. Analisis feses dan/atau steatokrit memiliki sensitivitas yang rendah, spesifisitas yang tinggi, dan kemampuan diskriminasi kurang.Kata kunci: anak, diare persisten, fungsi eksokrin pankreas, malnutrisi, suplementasi enzim pankreas

ABSTRACT
Persistent diarrhea is a serious health problem and is closely related to malnutrition. Prolonged mucosal injury in diarrhea is thought to cause reduced secretin and cholecystokinin CCK secretion, which decreases stimulation to the pancreas and further aggravate persistent diarrhea and malnutrition.This research aims to study pancreatic exocrine function in children with persistent diarrhea and children with malnutrition, to obtain reference values of fecal elastase 1 FE 1 in Indonesian children, and to assess the ability of stool analysis and steatocrit in detecting exocrine pancreatic insufficiency.Cross sectional study was done to obtain FE 1 distribution in healthy children, to study FE 1 levels in children with persistent diarrhea and children with malnutrition, and to study the sensitivity, specificity, and discriminative capacity of stool analysis and steatocrit in detecting exocrine pancreatic insufficiency. A randomized, two double blind parallel group, placebo controlled clinical trial was conducted to evaluate the effects of 8371 USP units of pancreatic enzyme replacement therapy PERT 3 times daily for 1 month in children with persistent diarrhea. This study involved children age 6 ndash 60 months in 5 hospitals in Jakarta from January 2015 to July 2016.As much as 182 children 6 ndash 60 months of age consisting of 31 children with persistent diarrhea, 31 children with malnutrition, and 120 healthy children were recruited as subjects. Cut off point of FE 1 in this study was 307 mcg g faeces. Significant difference of FE 1 was found between children with persistent diarrhea and healthy children. The FE 1 difference between subjects with malnutrition and healthy children was not significant. Duration of diarrhea was 7 days significantly shorter in the PERT group. Changes of FE 1 and prealbumin values between baseline and endpoint in placebo and treatment group were found to be statistically insignificant. The diagnostic value of each stool analysis component and steatocrit test showed that the sensitivity was within range of 5 ndash 32 , specificity 73 ndash 98 , positive predictive value 1 ndash 43 and negative predictive value 87 ndash 89 . The AUC values of stool analysis and steatocrit were 0.664 95 CI 0.539 ndash 0.788 and 0.501 95 CI 0.372 ndash 0.629 , respectively, and the combined AUC 0,671.In conclusion, exocrine pancreatic insufficiency was observed in children with persistent diarrhea, and PERT has been proven to significantly shorten the duration of diarrhea by 1 week. Stool analysis and or steatocrit has low sensitivity, high specificity, and low discrimination capacity.Keywords children, exocrine pancreatic function, malnutrition, pancreatic enzyme supplementation, persistent diarrhea"
2017
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UI - Disertasi Membership  Universitas Indonesia Library