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"LATAR BELAKANG: Terbang dengan menggunakan pesawat yang memiliki kecepatan tinggi melebihi kecepatan suara (high performance air craft), yang mampu menghasilkan akselerasi +5Gz sampai +9Gz bahkan lebih terutama pada saat melakukan manuver, merupakan suatu tantangan tersendiri yang membutuhkan kepaiawaian dan sikap profesional. Banyak faktor yang mempengaruhi relaxed +Gz force tolerance seperti mean arterial pressure, hasil puncak ekspirasi dan posisi tubuh. METODE: Desain penelitian adalah studi korelasi, yang dilakukan di Lakespra Saryanto Jakarta. Dengan menggunakan populasi semua bakal calon penerbang TNI AU dan subyek dipilih secara random sederhana, semua yang memenuhi kriteria inklusi diambil. Sampel yang diambil sebanyak 31 orang, data yang dikumpulkan berasal dari kuesioner, pencatatan human centrifuge. Hasil penelitian kemudian dilakukan uji statistik berupa analisis regresi inner untnk melihat pengaruh arus puncak ekspirasi terhadap relaxed+Gz force tolerance serta faktor faal yang berpengaruh. HASIL: Rata-rata relaxed +G, -force tolerance 7,51 ± 0,71 G, selanjutnya beberapa faktor yang berpengaruh terhadap relaxed +Gr force tolerance antara lain arus puncak ekspirasi: koefisien regresi sebesar -0,358 dan kemaknaan p = 0,073; mean arterial pressure: koefisien regresi sebesar 0,047 dan kemaknaan p = 0,065, serta forced expiratory in 1 second: koefisien regresi sebesar 1,246 dan kemaknaan p = 0,012) dan yang paling dominan adalah-forced expiratory in l second. KESIMPULAN: Relaxed ±Gz force tolerance dipengaruhi oleh arus puncak ekspirasi. Di samping itu relaxed G tolerance berkaitan pula dengan mean arterial pressure dan FEV1.

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BACKGROUND: The Influence of Peak Expiratory Flow Rate to Relaxed +Gz Force Tolerance at Human Centrifuge Training in Pilot Candidates of Indonesian Air Force 2002BACK GROUND: Flying high performance fighter aircraft is a challenging and demanding profession which regularly imposes significant acceleration force on pilot, particularly during air combat maneuvering, in which +Gz level of +5 to ±9 G or more are frequently experienced. Relaxed +Gz force tolerance is influenced by mean arterial pressure, peak expiratory flow rate and body position.

METHODS: Correlation study design was chosen for this research in Lakespra Saryanto. Simple random sampling is used to choose the subject from all pilot candidates in the population. Thirty one subjects were selected consecutively according to inclusion criteria. Data collected from questionnaire, human centrifuge records. The results were analyzed by linear regression analysis to evaluate the influence of peak expiratory flow rate and relaxed +Gz tolerance, and other physiological factors which might influence the relaxed +Gz tolerance.

RESULTS: The mean value of relaxed +Crz tolerance was 7,51 ± 0,71G. Several factors that influence of relaxed +Gz tolerance was peak expiratory rate (regression coefficient - 0,358, p = 0,073); mean arterial pressure (regression coefficient =0,047, p = 0,065); forced expiratory volume in 1 second (regression coefficient 1,246, p = 0,012). The most dominant was forced expiratory volume in 1 second.

CONCLUSIONS: Relaxed +Gz force tolerance was influenced by peak expiratory flow rate, forced expiratory volume in 1 second and mean arterial pressure."

"Latar Belakang: Acute Kidney Injury pada COVID-19 merupakan komplikasi penting dan dikaitkan dengan peningkatan risiko kematian diduga diperantarai kondisi inflamasi dan disregulasi imun, baik di awal maupun selama perawatan. Tujuan: Untuk mengetahui hubungan antara IL-6, IL-10, TNF-" dengan AKI dan memprediksi perburukan hematuria, dan kejadian AKI Metode: Studi potong lintang dan prospektif kohort melibatkan 43 pasien COVID-19 derajad sedang dan berat yang dirawat di Rumah Sakit Pertamina Pusat di Jakarta, Indonesia dari bulan November 2020 hingga Januari 2021. Selama observasi dilakukan pemeriksaan darah lengkap, serum kreatinin, urinalisis, kadar IL-6, IL-10, TNF-" pada hari pertama dan hari ketujuh pengobatan atau sebelum hari ketujuh jika pasien meninggal atau dipulangkan, dan perubahannya di analisis. Insiden AKI ditentukan ketika perubahan serum kreatinin dan urin output memenuhi kriteria pedoman Kidney Disease Improving Global Outcomes. Uji korelasi dilakukan terhadap peningkatan sitokin dengan perubahan hematuria dan kreatinin. Uji Wilcoxon dilakukan untuk mengetahui perbedaan kadar sitokin diantara status albuminuria. Selanjutnya dilakukan uji Receiver Operator Characteristic untuk melihat kemampuan prediksi IL-6, IL-10, TNF-" terhadap perburukan hematuria dan kejadian AKI, menggunakan AUC minimal 0,7 dengan batas bawah IK 95% lebih dari 0,5 dan nilai p <0,05 Hasil: Terdapat korelasi antara peningkatan kadar serum IL-10 dengan perubahan serum kreatinin (r= -0,343; p 0,024) tetapi tidak pada perubahan IL-6 dan TNF-a. Perubahan hematuria tidak berkorelasi dengan peningkatan ketiga kadar sitokin. Juga tidak ada perbedaan dalam kadar sitokin di antara kelompok albuminuria. Kadar serum TNF-" dihari pertama perawatan dapat memprediksi AKI pada hari ke tujuh, AUC 85%; p=0,045 (IK 0,737-0,963), tetapi tidak dapat memprediksi perburukan hematuria Kesimpulan: Terdapat korelasi antara peningkatan IL-10 dengan perubahan serum kreatinin. TNF-! pada hari pertama perawatan dapat memprediksi kejadian AKI di hari ketujuh perawatan pasien COVID-19 derajat sedang dan berat.

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Background: Acute Kidney Injury is an important complication and is associated with increased risk of death in COVID-19 due to inflammatory conditions and immune dysregulation, both at the beginning and during treatment. Aim: To determine the relationship between IL-6, IL-10, TNF-α with AKI and their ability to predict the worsening of hematuria, and the incidence of AKI. Methods: 43 moderate and severe COVID-19 patients treated from November 2020 to January 2021 at Pertamina Central Hospital in Jakarta, Indonesia were included in this cross-sectional and prospective cohort study. During observation, tests including complete blood count, serum creatinine, urinalysis, levels of IL-6, IL-10 and TNF-α were performed on the first and seventh day of treatment, or before day 7 if the patient died or was discharged, and the changes were analyzed. The incidence of AKI is determined when changes in serum creatinine and urine output meet the criteria in the Kidney Disease Improving Global Outcomes guidelines. Correlation test was performed on increased cytokines with changes in hematuria and creatinine. Wilcoxon test was performed to obtain differences in cytokine levels among albuminuria status. Receiver Operator Characteristic test was then carried out to see the predictive ability of IL-6, IL-10, TNF- α on the worsening of hematuria and the incidence of AKI. Results: There was a correlation between increased serum IL-10 levels with changes in serum creatinine (r= -0.343; p 0.024), but not in IL-6 and TNF-a levels. On the other hand, changes in hematuria did not correlate with an increase in the levels of the three cytokines. There was also no significant difference in the levels of cytokines among albuminuria groups. Serum TNF-! levels on the first day of treatment were able to predict AKI on the seventh day (AUC 85%; p=0.045; 95%CI 0.737-0.963), but did not predict the worsening of hematuria. Conclusion: There was a correlation between increased serum IL-10 with changes in serum creatinine. TNF-! on the first day of treatment can predict the incidence of AKI on the seventh day of treatment for moderate and severe COVID-19 patients."