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Abstrak :
Malnutrisi sering ditemukan pada pasien pasca bedah dan berhubungan dengan penurunan fungsi otot, respirasi, imun serta terganggunya penyembuhan luka. Penelitian observasional analitik ini bertujuan mengetahui faktor yang mempengaruhi status nutrisi akut pascabedah. Dilakukan pemeriksaan kadar retinol binding protein (RBP) hari ke-1 dan ke-5 pasca bedah sebagai indikator status nutrisi akut. Asupan nutrisi dan prosentasenya terhadap resting energy expenditure (REE) diukur tiap hari. Dilakukan pemeriksaan kortisol dan C-reactive protein (CRP) sebagai marker respons inflamasi. Dari 35 subyek penelitian sesuai kriteria inklusi disimpulkan kadar RBP hari ke-1, kortisol dan CRP berpengaruh terhadap status nutrisi akut pascabedah. ......Malnutrition is common in postoperative patients and is associated with decreased muscle function, respiratory, immune and disruption of wound healing. This analytic observational study aims to determine the factors that affect the nutritional status of acute post operative patients. We examined the levels of retinol binding protein (RBP) on day 1 and 5 post-operative as an indicator of acute nutritional status. Nutrient intake was calculated for each day and the percentage from resting energy expenditure (REE). We also examined cortisol and C-reactive protein (CRP) as markers of inflammatory response. Of the 35 study subjects who met the inclusion criteria, we can conclude that RBP levels, cortisol and CRP in day 1 are indicators of acute post-operative malnutrition

Abstrak :
Malnutrisi pada anak sakit kritis dalam perawatan intensif menjadi masalah dalam beberapa dekade terakhir dan berhubungan erat dengan morbiditas dan mortalitas. Hingga kini, Rumah Sakit Cipto Mangunkusumo (RSCM) belum memiliki panduan baku mengenai dukungan nutrisi anak sakit kritis. Penelitian bertujuan untuk mengetahui profil pemberian nutrisi enteral (NE) dan waktu pencapaian resting energy expenditure (REE) di Pediatric Intensive Care Unit (PICU) RSCM dan faktor-faktor yang memengaruhi. Penelitian dilakukan secara retrospektif dengan menggunakan data rekam medis anak sakit kritis yang dirawat di PICU RSCM pada tahun 2017-2018. Waktu inisiasi pemberian NE dan pencapaian REE serta faktor-faktor yang memengaruhi pemberian tersebut dicatat dan dilakukan analisis multivariat untuk mencari faktor risiko yang bermakna. Terdapat 203 pasien yang memenuhi kriteria inklusi. Terdapat 120 subyek berjenis kelamin lelaki (59,1%), dengan median usia adalah 35 bulan (rentang usia 1-209 bulan). Kasus bedah terdapat pada 125 subyek (61,6%) dan status gizi normal terdapat pada 87 subyek (42,9%). Prevalensi pemberian NE dini adalah 63,1%, dan pencapaian kalori REE ≤72 jam adalah 67,5%, dengan median 48 jam. Faktor risiko yang menghambat pemberian NE dini adalah pasca-bedah abdomen, penggunaan inotropik, penggunaan ventilator, gejala gastrointestinal sebelum inisiasi, dan status gizi tidak normal dengan odds ratio (OR) 10,89 (IK 95% 4,31-27,50; p=0,009), 4,60 (IK 95% 1,78-11,90; p=0,002), 4,18 (IK 95% 1,56-11,17; p=0,004), 3,40 (IK 95% 1,59-7,29; p=0,002), 2,49 (IK 95% 1,09-5,72; p=0,031). Faktor risiko yang menghambat pencapaian kalori REE ≤72 jam adalah pemberian NE lambat, intoleransi pemberian enteral berupa gejala gastrointestinal dan skor PELOD-2 ≥7 dengan OR 20,62 (IK 95% 6,48-65,65; p=0,000), 14,77 (IK 95% 4,40-49,60; p=0,000), 3,98 (IK 95% 1,01-15,66; p=0,048). Prevalensi pemberian NE dini pada anak sakit kritis di PICU RSCM cukup baik dengan waktu pencapaian REE sesuai dengan target. Faktor terbanyak penghambat pemberian NE dini adalah kondisi pasca-bedah abdomen, sedangkan faktor penghambat pencapaian REE ≤ 72 jam terbanyak adalah pemberian NE lambat. ......Malnutrition of critically ill children remains a major problem that is closely related to high morbidity and mortality in pediatric intensive care unit (PICU) during the last decades. The protocol of nutritional support for critically ill children in Cipto Mangunkusumo Hospital (CMH) has not yet been developed. The study is aimed to evaluate the enteral nutrition (EN) profile, the duration to achieve resting energy expenditure (REE) and number of influencing factors associated with the late EN administration and late REE achievement. The data were collected retrospectively from medical records during the year 2017 to 2018 in PICU CMH. We assessed the timing of EN given and the duration of REE achieved from EN. We performed multivariate analysis to determined significant factors associated with late EN and late REE achievement. Two hundred three subjects were included. One hundred twenty subjects (59%) were boys, with median age of 35 (1-209) months old. One hundred twenty five subjects (61.6%) were post-surgical period and 87 subjects (42.9%) were in good nutritional status. The prevalence of early EN was 63.1%, and REE ≤72 hours was achieved in 67.5% subjects, with the median time was 48 hours. Significant factors inhibit early EN administration were post-abdominal surgery, ventilator use, inotropic use, gastrointestinal symptoms before initiation, and abnormal nutritional status; with OR 10.89 (95% CI 4.31 to 27.50; p=0.009), 4.60 (95% CI 1.78 to 11.90; p=0.002), 4.18 (95% CI 1.56 to 11.17; p=0.004), 3.40 (95% CI 1.59 to 7.29; p=0.002), 2.49, 95% CI 1.09 to 5.72; p=0.031), respectively. While factors inhibit the achievement of REE ≤72 hours were the late EN initiation, enteral intolerance, and PELOD-2 score ≥7 with OR 20.62 (95% CI 6.48 to 65.65; p=0.000), 14.77 (95% CI 4.40 to 49.60; p=0.000), 3.98 (95% CI 1.01 to 15.66; p=0.048), respectively. The prevalence of early EN administration with the duration to achieve REE among critically ill children in the PICU CMH was quite satisfying. The most influencing factor inhibit early EN administration was post-abdominal surgery, while the most significant factor inhibit the achievement of REE ≤72 hours was the late NE administration.

Abstrak :
Tujuan : Mengetahui keadaan metabolisme penderita obesitas setelah menjalani diet rendah kalori seimbang selama 14 hari, dengan mengukur resting energy expenditure (REE) dan kadar T3 serum Tempat : Rumah Sakit Sumber Waras, Jakarta Barat Metodologi: Dilakukan penelitian pada 37 orang perempuan obes yang memenuhi kriteria penerimaan dan penolakan serta bersedia mengikuti penelitian ini. Penelitian ini merupakan studi quasi eksperimental pra dan pasca perlakuan. Setiap subjek menjalani diet rendah kalori seimbang 1000 kkal selama 14 hari. Pemeriksaan antropometri, REE dan kadar T3 serum dilakukan pada awal, hari ke 7 dan akhir perlakuan. REE diukur dengan kalorimetri tak langsung (REE ukur) dan dihitung dengan menggunakan persamaan Harris-Benedict (REE hitung). Hasil: Pada akhir perlakuan terjadi penurunan yang bermakna (p <0,05) pada berat badan, massa lemak, massa bebas lemak, REE ukur dan REE hitung masing-masing dari 71,22±8,63 kg menjadi 69,15±8,37 kg (penurunan 2,9%), dari 35,32J2,58% menjadi 33,94,58% (penurunan 1,38%), dari 45,96±4,89 kg menjadi 45,544,82 kg (penurunan 0,92%), dari 1815,0822,37 kkal menjadi 1718,97±269,50 kkal (penurunan 5,29%) dan dari 1428,07+84,02 kkal menjadi 1408,25 1,52 kkal (penurunan 1,39%). Penurunan kadar T3 serum yang bermakna terjadi pada hari ke 7 (p = 0,001), dari 0,9005±0,1530 ng/mL menjadi 0,836210,1611 mg/mL (penurunan 7,1%). Pada akhir penelitian, dibandingkan dengan hari ke 7, terjadi pertingkatan T3 yang tidak beramakna. Pada hari ke 7 terdapat korelasi positif bermakna (r = 0,349; p = 0,034) antara perubahan REE ukur dengan perubahan T3. Pada hari ke 15 terdapat korelasi positif bermakna (r = 0,401; p = 0,014) antara perubahan REE ukur dengan perubahan massa bebas lemak. Perubahan T3 pada hari ke 7 mempunyai korelasi positif bermakna (r = 0,385; p = 0,019) dengan perubahan berat badan pada minggu pertama dan dengan perubahan massa bebas lemak pada minggu pertama (r = 0,345; p = 0,036). Pads penurunan berat badan sebesar 2,9% terdapat penurunan REE ukur dan REE hitung masing-masing 5,29% dan 1,39%. Rata-rata REE ukur lebih besar 27% daripada REE hitung. Kesimpulan : Setelah terjadi penurunan berat badan dengan diet rendah kalori seimbang, penderita obesitas berada dalam kondisi hipometabolisme yang ditandai dengan penurunan RFE ukur, REE hitung dan kadar T3 serum.

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Objective: to determine the metabolic state of obese females after treatment with balanced low-calorie diet for 14 days by measuring resting energy expenditure (REE) and serum T3 level as indicators. Location : Sumber Waras hospital , West Jakarta Methods : The study was carried out on 37 obese females who have been recruited based on inclusion and exclusion criteria. This study is a quasi experimental study with a pre and posttest treatment design. Every subject received a balanced low-calorie diet (LCD) of 1000 kcal/day for 14 days. Antropometric measwrements, REE and serum T3 levels were examined at the beginning, at day 7 and at the end of study. REE were measured and calculated by indirect calorimetry (measured-REE) and using Harris-Benedict equation (calculated-REE) respectively. Result : Balanced LCD given for 14 days significantly (p <0.05) decreased body weight (BW) , fat mass, fat free mass, measured-REE and calculated-REE from 71.22±8.63 kg to 69.15±8.37 kg (decreased 2,9%), from 35.32.58% to 33.94±2.58% (1,38%), from 45.96±4.89 kg to 45.54±4.82 kg (0,92%), from 1815.0822.37 kcal to 1718.97±269.50 kcal (5,29%), and from 1428,.7±84.02 kcal to 1408.25±81.52 kcal (1,39%) respectively. There was a significant decrease (p = 0.001) in serum T3 leveI at day 7 from 0.9005±0.1530 ng/mL to 0.836210.1611 nglmL (decrease 7,1%). At the end of the study, serum T3 levels increased not significantly compared to day 7. At day 7, there was a significant positive correlation (r = 0.349; p = 0.034) between the change in measured-REE and the change in serum T3 levels. At day 15, a significant positive correlation (r = 0.401; p = 0.014) was found between the change in measured-REE and the change in fat free mass. The changed of serum T3 levels at day 7 had significant positive correlation (r = 0,385; p = 0,019) with the changed of BW in the first week. The changed of serum T3 levels at day 7 had significant positive correlation (r = 0,345; p = 0,036) with the changed of fat free mass in the first week. After reduction of BW by 2.9%, there was a decrease of measured-REE and calculated-REE, 5.29% and 1.39%, respectively. The measured-REE was 27% higher than calculated-REE. Conclusion : Weight-reduced obese subjects with balanced LCD were in hypometabolic state indicated by a reduction in measured and calculated-REE, and serum T3 levels.

Abstrak :
Tujuan : Mengetahui pengaruh diet rendah kalori seimbang terhadap resting energy expenditure (REE), respiratory quotient (RQ) dan profil lipid serum untuk menurunkan morbiditas dan mortalitas penderita obesitas. Tempat : Rumah Sakit Sumber Waras Jakarta Bahan dan cara : Penelitian merupakan suatu eksperimental pra dan pasca pemberian diet rendah kalori seimbang 1000 Kkal dengan komposisi 55 % karbohidrat, 20 % protein dan 25 % lemak selama 14 hari terhadap 38 subjek perempuan obes (19-55 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data karakteristik sosial demografi, data asupan energi dan makronutrien, antropometri, REE, RQ, kadar kolesterol total, trigliserida, kolesterol LDL dan kolesterol HDL serum. Hasil : Setelah pemberian diet 1000 kkal selama 14 hari pada perempuan obes terjadi penurunan bermakna dari berat badan sebesar 2,64% (p= 0,001), penurunan IMT 2,77% (p= 0,001), penurunan persentase massa lemak tubuh 1,44% (p= 0,001), peningkatan persentase massa bebas lemak 1,36% (p= 0,001), penurunan rasio Lpi-Lpa 2,5% (p= 0,001), penurunan tidak bermakna dari REE 4,41% (p= 0,071), penurunan bermakna dari RQ 4,78% (p= 0,036), penurunan kolesterol total 6,67% (p= 0,001), penurunan trigliserida 22,92% (p= 0,001), penurunan kolesterol LDL 4,22% (p 0,027) dan penurunan kolesterol HDL serum 5,54% (p= 0,004). Simpulan : Pemberian diet rendah kalori seimbang sebesar 1000 Kkal/hari selama 14 hari terbukti dapat menurunkan secara bermakna berat badan, IMT, persentase massa lemak, meningkatkan persentase massa bebas lemak, menurunkan rasio Lpi-Lpa, RQ, kolesterol total, trigliserida, kolesterol LDL dan kolesterol HDL serum, tetapi tidak menurunkan secara bermakna REE pada perempuan obes.

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Objective : To identify the effect of balanced low calorie diet on REE, RQ and serum lipid profile of obese women in reducing morbidity and modality of obese people. Place : Sumber Waras Hospital, Jakarta. Materials and Methods : The study was an experimental, pre and post balanced low calorie diet (1000 Kcals/day, 55% carbohydrate, 20% protein and 25% fat) for 14 days. Thirty eight obese women, 19.-55 years old had been selected as subjects according to inclusion and exclusion criteria The data that had been collected were social and demographic characteristics, the energy and macronutrient intake, anthropometric, REE, RQ, level of total serum cholesterol, triglyceride, LDL cholesterol and HDL cholesterol. Results : After 14 days balanced low calorie diet , there were significant reduction of body weight 2,64% (p= 0,001), body mass index 2,77% (p= 0,001), percentage of fat mass 1,44% (p= 0,001), increarnent percentage of fat free mass 1,36% (p= 0,001), reduction of waist to hip ratio 2,5% (p= 0,001), insignificant reduction of REE 4,41% (p= 0,071), significant reduction of RQ 4,78% (p= 0,036), level of total serum cholesterol 6,67% (p= 0,001), triglyceride 22,92% (p= 0,001), LDL cholesterol 4,22% (p= 0,027) and HDL cholesterol 5,54% (p= 0,004). Conclusion : Balanced low calorie diet was had been shown to reduce body weight, body mass index, percentage of fat mass, to increase percentage of fat free mass, to reduce waist to hip ratio, RQ, level of total serum cholesterol, triglyceride, LDL cholesterol and HDL cholesterol of obese women significantly, but didn't reduce REE significantly.

Abstrak :
Tantalum dan Niobium masuk kedalam logam critical in mid term yang diperkirakan akan habis pada tahun 2020. Berdasarkan ketersediaan sumber, terak timah dapat menjadi sumber alternatif untuk mendapatkan logam tantalum dan niobium dalam bentuk Tantalum Pentaoksida Ta2O5 dan Niobium Nb2O5 . Di terak timah juga mengandung Logam Tanah Jarang LTJ oksida yang dapat ditingkatkan kadarnya. Penelitian ini bertujuan untuk mengetahui peningkatan kadar Tantalum, Niobium dan LTJ dengan menggunakan proses pelindian dengan variabel bebas temperatur pelindian Terak timah dilakukan pemanggangan di temperatur 900 C selama 2 jam lalu didinginkan dengan cepat menggunakan larutan NaOH 0.5 M, kemudian dilakukan pengayakan dengan ukuran 100, minus;100 120, minus;120 180. Setelah itu dilakukan pelinidan dengan menggunakan larutan HCl 6 M, S/L 1:30, dan lama pelindian ialah 50 menit. Pelindian dilakukan dengan variabel bebas yaitu temperatur pelindian. Temperatur pelindian yang digunakan ialah 25 , 45 , 65 C. Hasil penelitian ini menunjukan setelah pemanggangan dan pendinginan cepat distribusi ukuran terbanyak di ukuran 100 dan terjadi penurunan kadar Tantalum, Niobium, dan LTJ. Hasil pelindian menunjukan semakin tinggi temperatur maka kadar Tantalum, Niobium, dan LTJ di terak timah meningkat, didapatkan temperatur optimun pelindian di 45 C dengan peningkatan sebesar 240 untuk Niobium dan 164.3 untuk Tantalum.

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Tantalum and Niobium were known include as critical in mid term, expected to be exhausted in 2020. Based on availability sources, Tin Slag can be an alternative source for Tantalum Pentaoxide Ta2O5 , Niobium Pentaoxide Nb2O5 and Rare Earth Elements REE. This research aimed to find out effect of effect Natrium Hydroxide as quenching media and leaching process with variable of temperatur leaching for increasing Tantalum, Nobium, and REE oxides grade with leaching process. Tin slang roasted at 900 C for two hours and quenched in NaOH 0.5 M, the sieved to the size of 100, minus 100 120, minus 120 180. Leaching process with Chloride Acid 6 M, S L 1 30, and leached for 50 minutes. The leaching variable temperature used were 25 , 45 , 65 C. The roasting and quencheds result showed the highest mass distribution at 100 and the grade were decreased. The result of leaching, higher temperature leaching then Tantalum, Niobium, and REE oxides grade increased. The optimum temperature was 45 C, increased 240 for Niobium and 164.3 for Tantalum.