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Abstrak :
ABSTRAK
Latar belakang Berbagai studi terdahulu melaporkan bahwa alfacalcidol mampu meningkatkan kekuatan otot, keseimbangan dan signifikan dalam menurunkan kejadian jatuh pada ras Kaukasia. Namun belum ada penelitian yang membuktikan peran alfacalcidol terhadap mobilitas fungsional pada ras Asia.

Tujuan Mengetahui pengaruh pemberian alfacacidol 0,5 µg selama 90 hari terhadap mobilitas fungsional dasar perempuan usia lanjut di Indonesia.

Metode Dilakukan uji klinis acak tersamar ganda pada bulan April-September 2012 terhadap 95 pasien perempuan usia lanjut di Poliklinik Geriatri RS Cipto Mangunkusumo Jakarta, Indonesia. Subyek dibagi menjadi kelompok yang mendapat alfacalcidol dan kalsium 500 mg sehari sekali selama 90 hari dan kelompok yang mendapat plasebo dan kalsium 500 mg. Dilakukan uji timed-up and Go Test (TUG) pada awal dan akhir penelitian. Dilakukan analisis per protokol dan uji Mann-Whitney untuk melihat perbedaaan mobilitas fungsional pada kedua kelompok setelah intervensi.

Hasil 95 subyek dirandomisasi dan dibagi menjadi dua kelompok, terdiri dari 48 subyek yang mendapat plasebo dan 47 subyek mendapat alfacalcidol. Setelah tiga bulan pengamatan didapatkan perbaikan waktu uji TUG yang signifikan pada kedua kelompok (2,49 vs 1,83 detik; p<.0001). Terdapat perbaikan waktu uji TUG yang signifikan dari kelompok alfacalcidol dibandingkan dengan kelompok plasebo (9,01 vs.10,07 detik; p = 0.028).

Kesimpulan Alfacalcidol dengan dosis 0,5 µg satu kali per hari selama 90 hari terbukti mampu meningkatkan mobilitas fungsional dasar pada perempuan usia lanjut Indonesia.

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ABSTRACT
Background Previous studies reported the D-analog alfacalcidol, increases muscle power and balance and lead to a highly significant decreases in the number of fallers and falls in Caucasian elderly community-dwelling population.

Objective To determine the effect of alfacalcidol on functional mobility in Indonesian elderly women community-dwelling population.

Methods A randomized, double-blind controlled trial was conducted in elderly women subjects geriatric clinic of Cipto Mangunkusumo National Hospital Jakarta Indonesia on April-September 2012. Intervention group was given 0,5 mcg alfacalcidol and 500 mg calcium daily for 90 days and another group was given placebo and 500 mg calcium. Balance test, Timed-up and Go Test (TUG) was measured at the beginning and after 3 months. Per protocol analysis to functional mobility after intervention between the two groups was performed.

Results 95 subjects were fulfiling study criteria and randomized into 2 groups, containing 47 subjects in alfacalcidol group and 48 subjects in placebo group. Both groups were comparable in all important prognostic factors including age, BMI, nutritional status, muscle strength. After three months the mean time in alfacalcidol group used for the TUG was decrease significantly by 2,49 s (p<.0001). There were significant improvement of the median time for TUG in the group that received alfacalcidol compared to placebo (9,01 vs.10,07 p = 0.028).

Conclusion Treatment with 0.5 mg alfacalcidol with calcium effectively improved functional mobility in Indonesian elderly women.

Abstrak :
Latar Belakang: Risiko perdarahan tidak berkorelasi linear dengan jumlah trombosit pada kondisi trombositopenia. Terdapat perbedaan fungsi trombosit pada trombositopenia gangguan produksi dengan destruksi perifer. Pada trombositopenia, hasil fungsi agregasi trombosit dengan light transmission aggregometry tidak valid. Diperlukan pemeriksaan fungsi trombosit yang dapat dikerjakan pada kondisi trombositopenia. Tujuan: Mengkaji fungsi agregasi trombosit pada pasien trombositopenia Metode: Studi potong lintang terhadap 60 pasien trombositopenia gangguan produksi dan destruksi perifer di Rumah Sakit Cipto Mangunkusumo selama Desember 2023 sampai April 2024. Dilakukan pemeriksaan jumlah trombosit, IPF, dan fungsi agregasi trombosit. Hasil: Terdapat perbedaan fungsi agregasi antara trombositopenia gangguan produksi dengan destruksi perifer (40% vs 77,7%). Didapatkan perbedaan nilai IPF antara trombositopenia gangguan produksi dengan destruksi perifer (5,65% vs 21%). Tidak didapatkan korelasi antara jumlah trombosit dengan fungsi agregasi trombosit pada trombositopenia gangguan produksi maupun destruksi perifer (r=0,214, p=0,231; r=0,364 p=0,062). Tidak didapatkan korelasi antara jumlah trombosit dengan fungsi agregasi trombosit pada trombositopenia gangguan produksi maupun destruksi perifer. Didapatkan titik potong IPF 10,25% untuk membedakan trombositopenia gangguan produksi dan destruksi perifer dengan sensitivitas 80,8% dan spesifisitas 68%. Kesimpulan: Fungsi agregasi trombosit pada trombositopenia destruksi perifer lebih baik daripada trombositopenia gangguan produksi. Fungsi agregasi trombosit tidak berkorelasi dengan jumlah trombosit maupun dengan IPF. ......Background: The risk of bleeding does not linearly correlate with platelet count in thrombocytopenia.There is difference between platelet function in central and peripheral thrombocytopenia. Platelet aggregation function assay performed by light transmission aggregometry is not valid in thrombocytopenia. Platelet aggregation assay that can be performed in thrombocytopenia is needed. Objective: To assess platelet function in thrombocytopenia patients. Methods: A cross-sectional study was conducted on 60 thrombocytopenic patients at Cipto Mangunkusumo Hospital from December 2023 to April 2024. Platelet count and immature platelet fraction (IPF) were done by automatic blood cell counter while platelet aggregation by Plateletworks ADP Kit Results: There was a difference in platelet aggregation function between central thrombocytopenia and peripheral thrombocytopenia (40% vs 77.7%). A difference in IPF values was found between central thrombocytopenia and peripheral thrombocytopenia (5.65% vs. 21%). No correlation between platelet count and platelet aggregation function in thrombocytopenia (r=0.214, p=0.231 vs. r=0.364, p=0.062). No correlation was found between IPF and platelet aggregation function (r=-0.139, p=0.498 vs. r=-0.282, p=0.171). The cut-off value of IPF was 10.25% to distinguish central and peripheral thrombocytopenia. Conclusion: Platelet aggregation function in peripheral thrombocytopenia was better than central thrombocytopenia. Platelet aggregation function did not correlate neither platelet count nor IPF.