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Abstrak :
Latar Belakang: Sarkopenia merupakan salah satu sindrom geriatri yang dapat menyebabkan luaran yang buruk. Dibutuhkan pemeriksaan yang lebih sederhana dibandingkan Bioelectrical Impedance Analysis (BIA) atau Dual energy X- ray Absorptiometry (DXA) untuk mengukur massa otot sebagai komponen penting sarkopenia. Namun, belum ada studi di Indonesia yang meneliti perannya dalam memprediksi massa otot pada pasien usia 60 tahun atau lebih. Tujuan: Mengetahui performa diagnostik lingkar betis untuk estimasi massa otot sebagai komponen sarkopenia pada pasien usia 60 tahun atau lebih. Metode: Penelitian ini merupakan suatu uji diagnostik menggunakan desain uji potong lintang yang dilakukan di poliklinik geriatri Departemen Ilmu Penyakit Dalam FKUI-RSCM selama bulan April-Juni 2018. Pengukuran massa otot menggunakan DXA dan penentuan titik potong berdasarkan Asian Working Group of Sarcopenia (AWGS). Hasil: Dari 120 subjek didapatkan 46 lelaki (38,3%) dan 74 perempuan (61,7%). Didapatkan titik potong lingkar betis kelompok lelaki dibawah 34 cm (sensitivitas 64.7%, spesifitas 79.3%, NDP 64.7%, NDN 79.3%, AUC 73.1%) dan 29 cm untuk perempuan (sensitivitas 71.4%, spesifitas 95.5%, NDP 62.5%, NDN 97.0%, AUC 96.4%). Simpulan: Akurasi diagnostik lingkar betis cukup baik sebagai prediktor massa otot pada pasien perempuan usia 60 tahun atau lebih.

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Background: Sarcopenia is one of the geriatric syndromes that lead to poor outcomes. A simpler method than Bioelectrical Impedance Analysis (BIA) or Dual energy X- ray Absorptiometry (DXA) is needed to measure muscle mass as essential component of sarcopenia. Previous studies have shown calf circumference (CC) as surrogate marker of muscle mass. However there has been no study on the role of CC in predicting muscle mass in both gender of elderly outpatient. Objectives: To investigate the diagnostic performance of CC to estimate muscle mass in elderly outpatient. Methods: A cross sectional study was conducted at Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital Jakarta during April-June 2018, using DXA as a reference test for measuring muscle mass. Asian Working Group of Sarcopenia (AWGS) criteria was used to classify muscle mass as normal or low. Results: Of the 120 subjects, 46 subjects were male (38.3%) and 74 were female (61.7%).The optimal Cut-off for CC that indicate low muscle mass was 34 cm for (sensitivity 64.7%, specificity 79.3%, PPV 64.7%, NPV 79.3%, AUC 73.1%) and 29 cm for female (sensitivity 71.4%, specificity 95.5%, PPV 62.5%, NPV 97.0%, AUC 96.4%). Conclusion: CC can be used to estimate muscle mass in female elderly outpatient, with good diagnostic performance.

Abstrak :
Latar Belakang: Sarkopenia merupakan sindroma geriatri baru tertinggi dengan luaran klinis yang buruk, sehingga perlu dilakukan penapisan. Instrumen penapisan standar memiliki sensitivitas yang rendah. Mini Sarcopenia Risk Assessment (MSRA) merupakan instrumen baru dengan performa penapisan beragam, sehingga perlu diteliti lagi. Penambahan lingkar betis (LB) pada MSRA diharapkan mendapatkan hasil penapisan yang lebih baik. Tujuan: Mengetahui performa penapisan instrumen MSRA dan MSRA-LB terhadap diagnosis sarkopenia pada pasien lansia. Metode: studi potong lintang dengan subjek lansia di Poliklinik Terpadu Geriatri, Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo telah dilakukan bulan Oktober hingga Desember 2022. Data diambil melalui wawancara dan pemeriksaan antropometri, LB, kekuatan genggaman tangan, indeks massa otot apendikular, dan penilaian performa fisik. Hasil: Diperoleh subjek sebesar 118 pasien dengan proporsi sarkopenia sebesar 19 pasien (16,1%) berdasarkan AWGS 2019. Sensitivitas instrumen MSRA-7, MSRA-5, MSRA-7-LB dan MSRA-5-LB secara berurutan adalah 78,95%, 57,89%, 57,89% dan 42,11%. Sedangkan spesifisitas adalah 30,30%, 46,46%, 87,88% and 93,94%. Model MSRA-LB meningkatkan akurasi diagnosis secara bermakna p=0,003 pada MSRA-7-LB dan p= 0,005 pada MSRA-5-LB p=0,00. Simpulan: Performa penapisan intrumen MSRA memiliki sensitivitas tinggi pada versi 7 butir pertanyaan. Penambahan lingkar betis memperbaiki akurasi diagnosis instrumen MSRA namun tidak meningkatkan sensitivitas instrumen. ......Background: Sarcopenia were the highest prevalence in current geriatric syndrome with unfavorable clinical outcomes and standardized tools to screen was unsensitive. Mini Sarcopenia Risk Assessment (MSRA) has been developed to screen sarcopenia. Even, the performance is inconsistent, that is needed to be evaluated. Adding of calf circumference (CC) was conducted to find better screening performance. Objective: To determine the screening performance of the MSRA and MSRA-CC instruments. Methods: A cross-sectional study was conducted in elderly outpatients Cipto Mangunkusumo Central General Hospital, from October to December 2022. Data were collected through interviews and anthropometric examinations, measurements of body weight, hand grip strength, appendicular muscle mass index, and physical performance. Result: Eligible subjects was 118 patients base on inclusion criteria. Sarcopenia were found 19 (16,1%) subjects based on the 2019 AWGS criteria. The sensitivity values of MSRA-7, MSRA-5, MSRA-7-CC, MSRA-5-CC were 78,95%, 57,89%, 57,89% and 42,11%, respectively. The specificities were 30,30%, 46,46%, 87,88% and 93,94%, respectively. Combination MSRA-CC improved diagnostic accuracy with p value of 7 and 5 version 0,003 and 0,005, respectively. Summary: The high sensitivity screening performance of MSRA has been found in 7 item questions version. Combination MSRA-CC improved diagnostic accuracy of sarcopenia without increasing of sensitivity those instruments.

Abstrak :
ABSTRACT
Background: sarcopenia is one of many geriatric problems that may lead to major clinical outcomes. Calf and thigh circumference have good correlation with muscle mass, whereas SARC-F questionnaire is very predictive of muscle function. There has not been a study that evaluates the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire in detecting sarcopenia. The aim of this study was to investigate the diagnostic performance of calf and thigh circumference in combination with SARC-F questionnaire compared to standard diagnostic methods of sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) to predict sarcopenia in patient aged 60 years or older. METHODS: this cross-sectional study was conducted in Geriatric Clinic Cipto Mangunkusumo Hospital, Jakarta, Indonesia during April-June 2018. Analysis was performed using receiver operating characteristic (ROC) curve to determine the cut-off point as well as sensitivity (Sn), specificity (Sp), positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR+ and LR-) of calf and thigh circumference as an indicator of low muscle mass, and SARC-F questionnaire score to detect decreased muscle function. RESULTS: from 120 participants, there were 46 men (38.3%) and 74 women (61.7%). The combination of calf circumference with cut-off point below 34 cm in men and below 29 cm in women, thigh circumference below 49 cm in men and below 44 cm in women with SARC-F questionnaire score of ≥4 have Sn, Sp, PPV, NPV, LR+, and LR- of 15.79%; 99.01%; 75.00%; 86.21%; 15.95; and 0.85 respectively. CONCLUSION: combination of calf and thigh circumference with SARC-F questionnaire showed good diagnostic accuracy in predicting sarcopenia in elderly outpatients.

Abstrak :
Latar belakang : Bayi berat lahir rendah adalah bayi dengan berat badan <2500. Bayi BBLR berkontribusi terhadap 60 ? 80% kematian neonatal. Berat lahir harus diukur dengan baik, namun menurut WHO dan UNICEF 2004 separuh bayi yang lahir di negara berkembang tidak ditimbang, karena alat timbang tidak ada, rusak, atau bahkan tidak pernah dikalibarasi, sehingga perlu ukuran pengganti yang dapat mengidentifikasi BBLR. Tujuan dari penelitian ini adalah didapatkannya ukuran antropometri (lingkar kepala, lingkar lengan atas, lingkar dada, lingkar paha dan lingkar betis) alternatif pengganti yang paling akurat untuk mengidentifikasi BBLR pada bayi yang lahir dari perempuan Etnis Jawa di Kecamatan Bumiayu Kabupaten Brebes tahun 2014. Metode : Penelitian analitik dengan desain studi cross sectional. Variabel yang diukur adalah berat badan, lingkar kepala, lingkar lengan atas, lingkar dada, lingkar paha dan lingkar betis bayi baru lahir. Ukuran dilakukan dalam rentang waktu 0 hingga 24 jam setelah kelahiran bayi. Semua ukuran dilakukan pencatatan dengan ukuran 0,1 cm terdekat dan 0.1 gram untuk berat badan. Metode statistik standar diadopsi untuk kekuatan hubungan (r), penentuan nilai AUC, titik potong (cut of point) sensitivitas, spesifisitas, NDP dan NDN. Hasil penelitian menunjukan bahwa lingkar betis memiliki tingkat sensitivitas tertinggi (88.9%) dibandingkan dengan ukuran lainnya. Dengan nilai duga positif (NDP) dan nilai duga negatif (NDP) yang juga paling tinggi. Dengan cut of point 9.75 cm, yaitu jika lingkar betis bayi <9.75 cm maka, bayi dikatakan BBLR.

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Background: Low birth weight infants are those with birth weight less than 2500 grams. LBW infant cases contribute to 60-80% of neonatal deaths. In fact, every birth weight should be measured accurately. Still, according to WHO and UNICEF in 2004, half of those infants born in the developing countries were not weighed because of some reasons: the scales did not exist, damaged, or even never been calibrated. Thus, it is necessary to identify surrogate measurement of LBW. The purpose of this research is to collect anthropometric measurements (head, upper-arm, chest, thigh, and calf circumference) as an accurate alternative to identify LBW infants born of women at Sub-district of Bumiayu, Brebes Regency in 2014. Methods: This study was conducted through cross-sectional design. The variables measured were head, upper-arm, chest, thigh circumference, and calf circumference, and also weight of newborns. Measurements were made in a span of 0 to 24 hours after birth. All measurements were recorded to the nearest size of 0.1 cm and 0.1 gr for weight loss. The method of standard statistic was adopted for the strength of the relationship (r), the determination of the value of AUC, cut point (cut of point) sensitivity, specificity, NDP and NDN. The results : Showed that the calf circumference had the highest level of sensitivity (88.9%) compared with other measurements. Having cut of point 9.75 cm, calf circumference showed the highest positive predictive value (NDP) and negative predictive value (NDP). In other words, infants with calf circumference less than 9.75 cm are those born with LBW.