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Abstrak :
ABSTRAK
Artritis gout umumnya disertai hiperurikemia, walaupun pada keadaan akut kadar asam urat dapat normal. Hiperurikemia dapat menyebabkan kerusakan organ tubuh sehingga mengakibatkan penyulit, cacat dan kematian, juga selain itu dianggap sebagai salah satu faktor risiko penyakit jantung koroner (PJK). Terjadinya PJK pada hiperurikemia dianggap antara lain karena degenerasi endotel pembuluh darah sebagai akibat langsung asam urat. Hiperurikemia sering disertai hiperlipidemia dan peningkatan agregasi trombosit yang dikaitkan dengan PJK maupun kelainan pembuluh darah.

Penelitian ini bertujuan untuk mendapatkan prevalensi dan fenotipe hiperlipidemia serta membuktikan hubungan antara hiperurikemia dengan hiperlipidemia dan peningkatan agregasi trombosit pada penderita artritis gout primer.

Telah diteliti 30 orang laki-laki penderita hiperurikemia artritis gout primer dan sebagai kontrol 30 laki-laki artritis non gout yang berobat jalan ke poliklinik Reumatologi RSCM yang memenuhi kriteria.

Pemeriksaan meliputi kadar asam urat serum, standing serum kolesterol total, trigliserida, kolesterol-HDL, kolesterol-LDL, elektroforesis lipoprotein dan agregasi trombosit.

Pada kelompok penderita didapatkan kadar asam urat serum rata-rata 9,94 mg/dL (7,1 - 14,4 mg/dL), sedangkan pada kelompok kontrol 5,5 mg/dL (4,1 - 6,7 mg/dL). Pada kelompok penderita didapatkan 21 orang (70%) dengan obesitas, sedangkan pada kelompok kontrol didapatkan hanya 2 orang (6,7%) dengan obesitas. Pada kelompok penderita, 24 orang (80%) menunjukkan kadar trigliserida di atas batas normal, dengan hiperlipoproteinemia tipe IV. Sedangkan pada kelompok kontrol didapatkan hanya 8 orang (26,4%) dengan hiperlipoproteinemia tipe IV, 1 orang (3,3%) tipe lib dan sisanya normal. Terdapat perbedaan bermakna (p < 0,05) kadar trigliserida kedua kelompok. Didapatkan korelasi yang baik antara kadar asam urat dengan kadar-trigliserida (r = 0,7641). Pada kelompok penderita, 7 orang (23,3%) dengan kadar kolesterol total di atas nilai normal, sedang pada kelompok kontrol hanya 1 orang (3,3%). Perbedaan ini bermakna (p <0,05), tetapi didapatkan korelasi yang kurang balk antara kadar asam urat dengan kadar kolesterol total (r = 0,2307). Radar kolesterol-HDL pada kelompok penderita didapatkan 16 orang {52,8%) lebih rendah dari nilai normal. Sedangkan pada kelompok kontrol hanya 5 orang {16,6%.). Perbedaan ini bermakna (p{0,05) dan didapatkan korelasi yang terbalik antara kadar asam urat dengan kadar kolesterol-HDL (r = - 0,1782). Pada kelompok penderita, 8 orang (26,4%) dengan kadar kolesterol-LDL yang lebih tinggi dari normal, sedangkan pada kelompok kontrol hanya 1 orang (3,3%), perbedaan ini bermakna (p<0,05). Tidak didapatkan korelasi antara kadar asam urat dengan kadar kolesterol-LDL (r = 0,0356). Pada penelitian ini tidak didapatkan adanya perbedaan agregasi trombosit kelompok penderita dan kontrol. Demikian pula tidak didapatkan korelasi antara kadar asam urat dengan agregasi trombosit, kecuali bila kolesterol total > 250 mg/dL dan LDL > 160 mg/dL (r = 0,74 dan r = 0,63).

Delapan puluh persen penderita hiperurikemia artritis gout primer dengan hiperlipoproteinemia tipe IV. Yang menunjukkan hipertrigliseridemia saja dan hipertrigliseridemia dengan hiperkolesterolemia masing- masing 56,7% dan 23,37. Kadar K-HDL penderita yang lebih rendah dari normal lebih banyak daripada kontrol secara bermakna (p < 0,05). Kadar asam urat berkorelasi baik dengan kadar trigliserida (r = 0,7641), sedangkan dengan kadar kolesterol total korelasinya tidak baik (r = 0,2307) dan tidak didapatkan korelasi dengan agregasi trombosit.

Disarankan agar dilakukan pemantauan kelainan kadar lipid pada penderita hiperurikemia artritis gout primer. Diperlukan penelitian lebih lanjut dengan jumlah sampel yang lebih banyak terutama dengan kolesterol total > 250 mg/dl dan kolesterol LDL > 160 mg/dL juga hubungan radikal bebas dengan hipertrigliseridemia.

Abstrak :
[ABSTRAK
Latar Belakang:Artritis Reumatoid (AR) merupakan penyakit inflamasi sendi autoimun yang multi-sistemik persisten, eksaserbatif dan progresif. Anti-mutated citrullinated vimentin antibodies (Anti MCV) adalah autoantibodi golongan anti citrullinated protein antibody (ACPA) yang memiliki sensitifitas sama namun lebih spesifik dibandingkan dengan anti cyclic citrullinated protein (Anti CCP). Anti MCV berkaitan erat dengan gen HLA DRB1*04 yang berperan penting dalam patogenesis AR. Studi korelasi anti MCV dengan destruksi sendi dan aktifitas penyakit masih kontroversial dan karakteristik pasien AR di Indonesia yang berbeda, menjadi alasan penting dilakukannya penelitian ini.

Tujuan: Mengetahui hubungan antara kadar anti MCV dengan destruksi sendi dan aktifitas penyakit pada pasien artritis reumatoid

Metode: Penelitian ini merupakan studi potong lintang pada 37 pasien AR berdasarkan kriteria EULAR/ACR 2010 yang berobat di poliklinik Reumatologi RSCM periode September-Nopember 2014 dengan metode consecutive sampling. Anti MCV diukur dengan metode ELISA. Penilaian destruksi sendi menggunakan skor Sharp yang dimodifikasi Van der Heijde (SSvH) sedangkan aktifitas penyakit dinilai dengan disease activity score (DAS) 28 meliputi DAS 28-CRP dan DAS 28-LED. Korelasi anti MCV dengan destruksi sendi dan aktifitas penyakit dinilai dengan uji korelasi Spearman serta p untuk kemaknaan. Data penyerta lain adalah data demografis, jenis dan dosis terapi, status gizi, faktor reumatoid (FR), CRP, LED, dan darah tepi.

Hasil: Sebanyak 37 subjek diikutsertakan pada penelitian ini, dengan 34 (91,9%) adalah perempuan. Anti MCV positif ditemukan 26 subjek (70,3%), sedangkan FR positif ditemukan 21 (56.%). Median anti MCV didapatkan 26 IU/ml (minimal 10 IU/ml, maksimal 151 IU/ml) termasuk titer rendah. Median SSvH yaitu 31 (2-107), dengan nilai median erosi 5(0-49) dan joint space narrowing (JSN) 26 (0-64). Rerata nilai DAS 28-CRP 2,69 (SB 1,34) dan median DAS 28-LED 4,08 (2,10-5,97) yang masing-masing termasuk dalam kelompok aktivitas penyakit rendah dan sedang.Pada analisis bivariat didapatkan korelasi positif yang lemah antara anti MCV dengan SSvH sebesar r = 0,393 (p=0,016) dan korelasi positif yang lemah antara anti MCV dengan skor DAS 28-CRP (r=0,365, p=0,013) namun tidak ada korelasi antara anti MCV dengan skor DAS 28-LED.

Simpulan: Terdapat korelasi positif lemah yang bermakna antara titer anti MCV dengan destruksi sendi dan skor aktivitas penyakit DAS 28-CRP, korelasi antara titer anti MCV dengan skor DAS 28-LED tidak ada.;

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ABSTRACT
Background:Rheumatoid Arthritis is a multi-systemic, persistent, exasperated and progressive auto immune joint inflamation disease. Anti-mutated citrullinated vimentin antibodies (Anti MCV) is an auto antibody in the category of anti citrullinated protein antibody (ACPA) that has same sensitivity but more specific compared with anti cyclic citrullinated protein (anti CCP). Anti MCV is closely related to gen HLA DRB1*04 which has important role in pathogenesis of rheumatoid arthritis. Study on correlation between anti MCV and joint destruction and disease activity is still controversial and the different characteristics of AR patients in Indonesia become a strong reason for this study.

Objective:The aim of this study was to described the correlation between anti-mutated citrullinated vimentin (anti MCV) with joint destruction and disease activity of in rheumatoid arthritis patients.

Methods:This is a cross-sectional study on 37 RA patients based on criteria of EULAR/ACR 2010 who came to Rheumatology outpatient clinic Cipto Mangunkusumo Hospital, period of September ? November 2014 with the method of consecutive sampling. Anti MCV is measured with ELISA method, while joint destruction is scored with Sharp score modified with Van der Heijde ( SSvH ). disease activity score (DAS) 28 is used in disease activity covering DAS 28-CRP and DAS 28-LED. Correlation between anti MCV and joint destruction as well as disease activity is measured with Spearman correlation test with p for significance. Other supporting data include demography, type and dose of therapy, nutrition status, rheumathoid factor, CRP, LED, and peripheral blood.

Results:37 subjects were taken into this study, with 34 (91,9%) are women. Positive anti MCV was found in 26 subjects (70,3%) while positive FR was found in 21 subjects (56%). Median of anti MCV was obtained 26 IU/ml (minimal 10 IU/ml, maximal 151 IU/ml )which is including in low titer. Median of SSvH was 31 (2 ?107) with erosion median score of 5 (0-49) and joint space narrowing (JSN) of 26 (0-64). Average score of DAS 28-CRP was 2,69 (SD1,34) and median score of DAS 28-LED was 4,08 (2,10-5,97), each of which is included in low and medium disease activity. In bivariate analysis it?s found that there is a weak significant positive correlation between anti MCV and SSvH of r = 0,393 (p=0,016) and between anti MCV and score of DAS 28-CRP (r= 0,365 , p=0,013) but there is no correlation between anti MCV and score of DAS 28-LED.

Conclusion:There is a weak significant positive correlation between anti MCV and joint destruction and level of disease activity score DAS 28-CRP. Apart from that, there is no correlation between anti MCV and DAS 28-LED., Background:Rheumatoid Arthritis is a multi-systemic, persistent, exasperated and progressive auto immune joint inflamation disease. Anti-mutated citrullinated vimentin antibodies (Anti MCV) is an auto antibody in the category of anti citrullinated protein antibody (ACPA) that has same sensitivity but more specific compared with anti cyclic citrullinated protein (anti CCP). Anti MCV is closely related to gen HLA DRB1*04 which has important role in pathogenesis of rheumatoid arthritis. Study on correlation between anti MCV and joint destruction and disease activity is still controversial and the different characteristics of AR patients in Indonesia become a strong reason for this study. Objective:The aim of this study was to described the correlation between anti-mutated citrullinated vimentin (anti MCV) with joint destruction and disease activity of in rheumatoid arthritis patients. Methods:This is a cross-sectional study on 37 RA patients based on criteria of EULAR/ACR 2010 who came to Rheumatology outpatient clinic Cipto Mangunkusumo Hospital, period of September – November 2014 with the method of consecutive sampling. Anti MCV is measured with ELISA method, while joint destruction is scored with Sharp score modified with Van der Heijde ( SSvH ). disease activity score (DAS) 28 is used in disease activity covering DAS 28-CRP and DAS 28-LED. Correlation between anti MCV and joint destruction as well as disease activity is measured with Spearman correlation test with p for significance. Other supporting data include demography, type and dose of therapy, nutrition status, rheumathoid factor, CRP, LED, and peripheral blood. Results:37 subjects were taken into this study, with 34 (91,9%) are women. Positive anti MCV was found in 26 subjects (70,3%) while positive FR was found in 21 subjects (56%). Median of anti MCV was obtained 26 IU/ml (minimal 10 IU/ml, maximal 151 IU/ml )which is including in low titer. Median of SSvH was 31 (2 –107) with erosion median score of 5 (0-49) and joint space narrowing (JSN) of 26 (0-64). Average score of DAS 28-CRP was 2,69 (SD1,34) and median score of DAS 28-LED was 4,08 (2,10-5,97), each of which is included in low and medium disease activity. In bivariate analysis it’s found that there is a weak significant positive correlation between anti MCV and SSvH of r = 0,393 (p=0,016) and between anti MCV and score of DAS 28-CRP (r= 0,365 , p=0,013) but there is no correlation between anti MCV and score of DAS 28-LED. Conclusion:There is a weak significant positive correlation between anti MCV and joint destruction and level of disease activity score DAS 28-CRP. Apart from that, there is no correlation between anti MCV and DAS 28-LED.]

Abstrak :
ABSTRAK
Nyeri sendi merupakan salah satu gangguan pada sistem muskuloskeletal yang mengalami perubahan akibat proses penuaan. 66 % lansia yang tinggal di komunitas mengalami nyeri sendi. Nyeri kronis memiliki implikasi besar bagi kesehatan, fungsi, dan kualitas hidup lansia. Penelitian ini bertujuan mengetahui pengaruh latihan yoga ringan terhadap nyeri sendi dan status kesehatan lansia di Kota Depok. Desain penelitian ini menggunakan quasi experimental dengan pendekatan pre and post with control group. Intervensi yang diberikan berupa latihan yoga ringan. Pengambilan sampel dengan cara multistage random sampling dengan jumlah sampel 74 lansia. Instrumen penelitian yang digunakan adalah indeks WOMAC nyeri dan survey kesehatan Short Form-12 (SF-12). Analisis bivariat menunjukkan latihan yoga ringan berpengaruh terhadap tingkat nyeri (p=0,000) dan status kesehatan (p=0,0000). Latihan yoga ringan layak dijadikan sebagai salah satu intervensi keperawatan untuk menurunkan nyeri sendi dan meningkatkan status kesehatan lansia

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ABSTRACT
Joint pain is one of the problems in musculoskeletal system associated with aging process. Approximately 66% older person in the community experiencing joint pain. Chronic pain has a big impact on older person health, function, and quality of live. The aim of this study was to identify the effect of gentle yoga exercise on joint pain and health status of elderlies at Depok's City. The design of this study was quasi experimental with pre and post with control group. Gentle yoga exercise was used as the intervention of this study. A total number of 74 older person was taken using multistage random sampling. The instruments used were WOMAC pain and health survey Short Form-12 (SF-12). Bivariate analysis showed pointing out gentle yoga exercises affected the level of pain (p = 0.000) and health status (p = 0.0000). Gentle yoga exercises could be one of the nursing intervention to decrease joint pain and improve health status in older person

Abstrak :
Latar belakang: Perdarahan sendi berulang merupakan morbiditas utama pada pasien hemofilia karena dapat menimbulkan artropati hemofilik yang menyebabkan keterbatasan gerak dan disabilitas sehingga menurunkan kualitas hidup. Penelitian bertujuan mengetahui korelasi pemeriksaan klinis sendi, penilaian aktivitas fungsional dan kualitas hidup pada anak hemofilia. Metode: Penelitian dengan desain potong lintang di RSCM pada Agustus−November 2022 pada anak 4−16 tahun, hemofilia A atau B derajat sedang atau berat yang mengalami perdarahan sendi berulang. Penelitian dilakukan dengan menilai HJHS, PedHALshort serta Haemo-QoL dan mencari korelasi skor HJHS dengan skor PedHALshort dan Haemo-QoL. Hasil: Sebanyak 95 subyek hemofilia, dengan hemofilia A (77,3%) dan 70,1% hemofilia berat. Skor HJHS median 4 (1−9), skor PedHALshort median 74,5 (62,73-89,09), skor Haemo-QoL mean (SD) 74,51 (15,58). Skor HJHS berkorelasi negatif sedang dengan PedHALshort (r= -0,462, p< 0,0001), skor HJHS berkorelasi sedang dengan Haemo-QoL (r= 0,469, p< 0,001). Simpulan: Semakin tinggi skor HJHS menunjukkan adanya kerusakan pada sendi maka semakin rendah skor PedHALshort dan semakin tinggi skor Haemo-QoL yang menunjukkan semakin terganggu aktivitas fungsional serta kualitas hidupnya. ......Background: Recurrent joint bleeding is the major morbidity in patient with hemophilia that can cause hemophilic arthropathy causes limitation of daily activities, disability, and reducing quality of life. Research objective are to determine the relationship between the clinical evaluation of joints, the assessment of functional activity determined and assessment of the quality of life with HJHS, so we can diagnose arthropathy, prevent disability and better management. Methods: Study with cross-sectional design at RSCM on August-November 2022, children aged 4-16, with moderate or severe hemophilia A and B with recurrent joint bleeding. The study was conducted by assessing HJHS, PedHALshort and Haemo-QoL, determine the relationship between HJHS with PedHALshort and Haemo-QoL score. Result: A total of 95 hemophilia subjects, with hemophilia A (77.3%) and 70.1% severe hemophilia. HJHS median score 4 (1-9), PedHALshort median score 74.5 (62.73-89.09), Haemo-QoL mean (SD) 74.51 (15.58). The HJHS score had a moderate negative correlation with PedHALshort (r= -0.462, p<0.0001), the HJHS score had a moderate correlation with Haemo-QoL (r= 0.469, p<0.001). Conclusion: The higher of HJHS score indicates a joint disorder, the lower of PedHALshort and the higher of Haemo-QoL indicates the more impaired functional activity and poorer quality of life.