Hasil Pencarian  ::  Simpan CSV :: Kembali

"[LATAR BELAKANG : Tuberkulosis (TB) hingga saat ini masih menjadi masalah kesehatan di dunia. Berdasarkan tuberculosis global report 2013 insidens TB pada tahun 2012 di seluruh dunia tidak jauh berbeda dibandingkan tahun sebelumnya, yaitu sekitar 8,6 juta. Berbagai penelitian menunjukan bahwa TB mempunyai kaitan erat terhadap gangguan hematologi seperti anemia, lekositosis, netrofilia, peningkatan laju endap darah (LED), trombositosis atau trombositopenia. Menurut WHO anemia merupakan indikator yang buruk terhadap status nutrisi dan tingkat kesehatan pasien dengan TB paru. Status nutrisi sendiri mempunyai peran terhadap seluruh fungsi sistem tubuh termasuk sistem imunitas terhadap berbagai penyakit infeksi dan status nutrisi pada pasien TB paru ditemukan secara bermakna lebih rendah dibandingkan orang sehat. Kedua keadaan ini saling berkaitan satu dengan lainnya, malnutrisi dapat menjadi predisposisi terjadinya penyakit TB dan TB itu sendiri dapat menyebabkan malnutrisi.TUJUAN : Penelitian ini untuk mengetahui hubungan antara perubahan nilai pemeriksaan hematologi (DHb, DLekosit, DLED) dan status gizi (DAlbumin, DIMT) pasien TB paru BTA (+) kasus baru sebelum dan sesudah pemberian OAT kategori 1 fase intensif dengan usia, jenis kelamin, konversi sputum dan perubahan gambaran foto toraks.METODE : Penelitian dengan desain uji klinik pre dan post study sejak bulan Januari-Juni 2014. Sebanyak 114 subjek penelitian terpilih sesuai kriteria inklusi dan bersedia mengikuti penelitian hingga akhir fase intensif.HASIL : Dari 114 orang subjek penelitian, 13 orang subjek dikeluarkan karena tidak dapat menyelesaikan penelitian. Terdapat 101 orang subjek penelitian yang bisa menyelesaikan penelitian dengan kelompok usia yang terkecil antara 23-46 tahun. Subjek penelitian terbanyak laki-laki (67,3%) dengan pendidikan terbanyak menengah (40,6%) dan bekerja sebagai pegawai swasta (41,5%). Sebagian besar subjek mengalami konversi sputum (81,2 %) dan perbaikan foto toraks (63,4%). Parameter hematologi mean ΔHb (0,78±1,08), median ΔLeukosit [1.760 (-8.948,93 – 17.738,96)], median ΔLED [-24,00 (-85 – 83)]. Parameter status gizi median ΔAlbumin [0,50 (0 – 2)] dan median ΔIMT [0,93 (-2,34 – 3,51)].KESIMPULAN : Terdapat hubungan yang bermakna antara parameter hematologi (Δleukosit) terhadap konversi sputum (p=0,038) dan parameter status gizi (ΔIMT) terhadap konversi sputum (p=0,004), BACKGROUND: Up to now, tuberculosis is still becoming a world health problem. Based on tuberculosis global report 2013, the incidence of TB in 2012 was not far different from the previous years that was about 8,6 millions. Various studies have showed that TB is closely related to the disturbance of hematology such as anemia, leucocytosis, neutrophylia, increasing of blood sedimentation rate, thrombocytosis or thrombocytopenic. According to WHO, anemia becomes bad indicator to nutritional and health status in patient with TB. While the nutrition status it self has an important role to the whole function of the body system including immune system to avoid various infectious diseases. The nutritional status in patients with TB significantly found lower compared to the healthy persons. These two factors are closely related to each other. Malnutrition cause predisposition of TB whereas TB it self can cause.PURPOSE: This study is aimed to know the relationship between hematology parameter changes (∆Hb, ∆Leucocyte, and ∆erythrocyte sedimentation rate/ESR) and the nutritional status (∆Albumin, ∆BMI) in patients with TB, AFB (+) new case before and after treatment with antituberculosis drugs category I during intensive phase based on age, sex, sputum conversion, and thorax radiology changes.METHOD: This method uses clinically design for Pre and post study from January up to June 2014. Around 114 persons have been selected according to inclusion criteria and agree to join this study until the end of intensive phase.RESULT: From 114 persons used as subjects, 13 are excluded due to the unfinished study. There are 101 subjects who are able to complete this study with the lowest age are 23 to 46. The largest subjects are male (67.3%) with their education are senior high school (40.6%) and working as private employees (41.5%). Most subjects have sputum conversion (81,2%) and radiological improvement (63.4%). In hematology parameter, the mean ∆Hb is (0.78±1.08), the ΔLeucocyte median is [1,760 (-8,948.93 – 17,738.96)], the ΔESR median is [-24.00 (-85 – 83). In nutritional status parameter, the median for ∆Albumin is [0.50 (0–2)] and ∆BMI is [0.93(-2.34 – 3.51)].CONCLUSION: Statistically, there are significant relationship between hematology parameter (∆Leucocyte) to sputum conversion (p=0.038) and nutritional status (∆BMI) to sputum conversion (p=0.004).]"

"[ABSTRAKLatar Belakang: Penelitian mengenai dampak kesehatan dari pajanan asap rokok lingkungan dengan menggunakan kotinin, yaitu suatu hasil metabolisme nikotin yang terdeteksi dalam urin, telah direkomendasikan sebagai pengukuran kuantitatif nikotin dalam tubuh dan biomarker pajanan asap rokok lingkungan. Tujuan: Tujuan penelitian ini untuk melihat hubungan pajanan asap rokok di rumah pada perempuan dewasa bukan perokok, dengan mengukur kadar kotinin urin, CO ekspirasi dan melihat dampak kesehatannya.Metode: Penelitian ini berjenis potong lintang terhadap 60 orang perempuan dewasa bukan perokok terpajan dan 58 orang tidak terpajan asap rokok di rumahnya dalam wilayah Pasar Rebo, Jakarta. Kadar kotinin urin diukur menggunakan metode pemeriksaan ELISA. Sebagai informasi tambahan, kami mengumpulkan data kadar CO ekspirasi, kuesioner kebiasaan merokok anggota keluarga di rumah dan dampak kesehatan respirasi subyek penelitian.Hasil: Nilai median kadar kotinin urin yang didapat adalah 24,65 ng/ml pada kelompok terpajan dan 7,30 ng/ml pada kelompok tidak terpajan (p=0.000). Nilai median kadar CO ekspirasi adalah 5,00 ppm pada kelompok terpajan dan 3,00 ppm pada kelompok tidak terpajan (p=0.000). Durasi terpajan asap rokok (jumlah jam/hari) pada perempuan perokok pasif memiliki hubungan signifikan dengan tinggi rendahnya kadar kotinin urin(p=0.037). Gejala sesak napas yang muncul berhubungan signifikan dengan status pajanan asap rokok subjek (p=0.01). Faktor lama pajanan asap rokok terakhir memiliki hubungan signifikan dengan kadar CO ekspirasi (p=0,004). Nilai titik potong kotinin urin antara kelompok terpajan dan tidak terpajan asap rokok adalah 14,4 ng/ml (sensitifitas 75,0 %, spesifisitas 74,0 %, p=0.000). Nilai titik potong CO ekspirasi adalah 3,5 ppm (sensitifitas 75,0 %, spesifisitas 81,0 %, p=0.000).Terdapat korelasi yang cukup kuat dan signifikan antara kadar CO ekspirasi dan kotinin urin (r=0,641, p=0,000).Kesimpulan: Kadar kotinin urin dan CO ekspirasi pada perempuan dewasa yang terpajan asap rokok lebih tinggi dibandingkan perempuan yang tidak terpajan asap rokok di rumah. Pengukuran kotinin urin adalah metode pengukuran pajanan asap rokok lingkungan dalam tubuh yang sensitif, non-invasif dan efektif.;Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.

---

ABSTRACTObjective: The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.Method: We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.Results: Significant median urinary cotinine concentrations were found; 24,65 ng/ml in ETS-exposed group and 7,30 ng/ml in non-exposed to ETS group(p=0,000). Significant median CO expirationalso were found; 5,00 ppm in ETS exposed group and 3,00 ppm in non-exposed to ETS group (p=0.000). Total ammount of time (hours/day) women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations result (p=0,037). The respiratory symptoms (dyspnea) occured to subjects showed significant relation with ETS exposure status (p=0,01). Time duration of last exposed to ETS had significant relation with CO expiration (p=0.004).The urinary cotinine concentrations cut-off point to differentiate ETS exposed and non-ETS exposed group in adult women was 14,4 ng/ml (sensitivity 75%,specificity 74%,p=0.000). The CO expiration cut-off point was 3,5 ppm (sensitivity 75%, specificity 81%, p=0.000). Strong and significant correlation was found between CO expiration and urinary cotinine value (r=0,641, p=0,000).Conclusion: The urinary cotinine concentration and CO expiration are significantly higher in women exposed to tobacco smoke at home group than the non-exposed group. Urinary cotinine measurement is a sensitive, noninvasive and effective method to correlate with ETS exposure.;Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.Objective:The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.Method :We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.Results :. Significant median urinary cotinine concentrations were found; 24,65 ng/ml in ETS-exposed group and 7,30 ng/ml in non-exposed to ETS group(p=0,000). Significant median CO expirationalso were found; 5,00 ppm in ETS exposed group and 3,00 ppm in non-exposed to ETS group (p=0.000). Total ammount of time (hours/day) women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations result (p=0,037). The respiratory symptoms (dyspnea) occured to subjects showed significant relation with ETS exposure status (p=0,01). Time duration of last exposed to ETS had significant relation with CO expiration (p=0.004).The urinary cotinine concentrations cut-off point to differentiate ETS exposed and non-ETS exposed group in adult women was 14,4 ng/ml (sensitivity 75%,specificity 74%,p=0.000). The CO expiration cut-off point was 3,5 ppm (sensitivity 75%, specificity 81%, p=0.000). Strong and significant correlation was found between CO expiration and urinary cotinine value (r=0,641, p=0,000)Conclusion :The urinary cotinine concentration and CO expiration are significantly higher in women exposed to tobacco smoke at home group than the non-exposed group. Urinary cotinine measurement is a sensitive, noninvasive and effective method to correlate with ETS exposure., Introduction :Studies of environmental tobacco smoke (ETS) health effects using cotinine, a nicotine metabolite detected in urine, has been recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans.Objective:The aim of this study is to correlate dailyindoor ETS exposure in non-smokers (adult women) by measuring urinary cotinine levels, CO expiration and it`s health effects.Method :We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method. In addition, CO expiration data and other information were collected through questionnaire regarding smoking habits of the subjects family members at home and respiratory health effects occured to subjects.Results :. Significant median urinary cotinine concentrations were found; 24,65 ng/ml in ETS-exposed group and 7,30 ng/ml in non-exposed to ETS group(p=0,000). Significant median CO expirationalso were found; 5,00 ppm in ETS exposed group and 3,00 ppm in non-exposed to ETS group (p=0.000). Total ammount of time (hours/day) women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations result (p=0,037). The respiratory symptoms (dyspnea) occured to subjects showed significant relation with ETS exposure status (p=0,01). Time duration of last exposed to ETS had significant relation with CO expiration (p=0.004).The urinary cotinine concentrations cut-off point to differentiate ETS exposed and non-ETS exposed group in adult women was 14,4 ng/ml (sensitivity 75%,specificity 74%,p=0.000). The CO expiration cut-off point was 3,5 ppm (sensitivity 75%, specificity 81%, p=0.000). Strong and significant correlation was found between CO expiration and urinary cotinine value (r=0,641, p=0,000)Conclusion :The urinary cotinine concentration and CO expiration are significantly higher in women exposed to tobacco smoke at home group than the non-exposed group. Urinary cotinine measurement is a sensitive, noninvasive and effective method to correlate with ETS exposure.]"

"[ABSTRAKPenyakit paru obstruktif kronik (PPOK) merupakan penyebab utama morbiditas dan mortalitas di dunia.Beberapa faktor risiko PPOK juga merupakan faktor risiko terjadinya tuberkulosis (TB).Beberapa penelitian di luar ditemukan prevalens TB paru pada pasien PPOK sekitar 2,6% - 10%.Indonesia khususnya di RSUP Persahabatan belum ada data proporsi TB paru pada pasien PPOK.Objektif: tujuan penelitian ini adalah mendapatkan angka proporsi TB paru pada pasien PPOK di RSUP Persahabatan Jakarta.Metode: desain penelitian ini adalah potong lintang. Pasien PPOK (belum diobati dengan obat anti tuberkulosis) yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi.Subjek diperiksa dahak BTA dan pemeriksaan Xpert MTB/RIF. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, skor CAT, penilaian status gizi, spirometri dan foto toraks. Semua data dilakukan analisis dengan uji chisquare.Hasil: subjek terbanyak adalah laki-laki (97,3%) dengan kelompok usia 60-79 tahun (74,3%), dengan komorbid terbanyak penyakit jantung (41,9%), gejala klinis terbanyak batuk berdahak (81,1%). Berdasarkan derajat PPOK terbanyak adalah GOLD 3 (44,6%) dan frekuensi eksaserbasi tersering 0-1 (78,4%) dengan menggunakan steroid sebanyak 59,5%. Pada penelitian ini didapatkan pemeriksaan dahak BTA positif 1,4% dan Xpert MTB/RIF positif 2,7%, artinya pemeriksaan Xpert MTB/RIF mempunyai angka kepositifan lebih tinggi dibanding dahak BTA. Dalam penelitian ini didapatkan proporsi TB paru pada pasien PPOK sebanyak 2,7%.Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara derajat PPOK, status gizi, penggunaan kortikosteroid, status merokok dengan prevalens TB paru pada pasien PPOK (p > 0,05).Pada penelitian ini didapatkan hubungan bermakna pada frekuensi eksaserbasi PPOK, hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru (p < 0,05).Kesimpulan: proporsi TB pada pasien PPOK di RSUP Persahabatan Jakarta adalah 2,7%. Terdapat hubungan yang bermakna secara statistik antara frekuensi eksaserbasi PPOK dengan proporsi TB paru pada pasien PPOK (p = 0,0006). Terdapat hubungan yang bermakna secara statistik antara hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru pada pasien PPOK dengan nilai p < 0,05 (p = 0,000).

---

ABSTRACTChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Some of the risk factors for COPD are also risk factors for tuberculosis (TB). Some studies abroad have found the prevalence of pulmonary tuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence of pulmonary tuberculosis patients with COPD in Indonesia, particularly in The Department of Pulmonology PersahabatanHospital, Jakarta. Objective: the purpose of this study is to obtain proportion of pulmonary TB in COPD patients in The Department of Pulmonology Persahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients (anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic PersahabatanHospital which meet the inclusion and exclusion criteria. Subjects went through acid-fast bacilli sputum smear and Xpert MTB/RIF examination. On patients visit, symptoms, exacerbations history, history of smoking, use of corticosteroids (oral or inhaled), comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-ray data had been obtained. All data were analyzed with chi-square test. Results: most subjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly found comorbid was heart disease (41.9%), and mostly found clinical symptoms was productive cough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the most exacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In this study, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive 2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFB sputum smear. The proportion of pulmonary tuberculosis in patients with COPD was 2.7%. We also found no statistically significant relationship between classification of COPD, nutritional status, use of corticosteroids, smoking status with the proportion of pulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant difference in the exacerbations frequency of COPD, the results of sputum smear examination and the results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05).Conclusion: the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is astatistically significant difference between the frequency of exacerbations of COPD with proportion of pulmonary TB in patients with COPD (p = 0.0006). An association is statistically significant different between the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000)., Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity andmortality in the world. Some of the risk factors for COPD are also risk factors fortuberculosis (TB). Some studies abroad have found the prevalence of pulmonarytuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence ofpulmonary tuberculosis patients with COPD in Indonesia, particularly in The Departmentof Pulmonology Persahabatan Hospital, Jakarta. Objective: the purpose of this study is toobtain proportion of pulmonary TB in COPD patients in The Department of PulmonologyPersahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients(anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic Persahabatan Hospitalwhich meet the inclusion and exclusion criteria. Subjects went through acid-fast bacillisputum smear and Xpert MTB/RIF examination. On patients visit, symptoms,exacerbations history, history of smoking, use of corticosteroids (oral or inhaled),comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-raydata had been obtained. All data were analyzed with chi-square test. Results: mostsubjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly foundcomorbid was heart disease (41.9%), and mostly found clinical symptoms was productivecough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the mostexacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In thisstudy, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFBsputum smear. The proportion of pulmonary tuberculosis in patients with COPD was2.7%. We also found no statistically significant relationship between classification ofCOPD, nutritional status, use of corticosteroids, smoking status with the proportion ofpulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant differencein the exacerbations frequency of COPD, the results of sputum smear examination andthe results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05). Conclusion:the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is a statistically significant differencebetween the frequency of exacerbations of COPD with proportion of pulmonary TB inpatients with COPD (p = 0.0006). An association is statistically significant differentbetween the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000).]"