Hasil Pencarian  ::  Simpan CSV :: Kembali

"TUJUAN (1) Menilai efek pemberian dabutamin data perjalanan penyakitmembran hialin (PMFi)" ringan pada xieonatps kurangislan (NKB) (2) ,Mendeteksi gangguan faal, kardiovaskular pada-PMH ringan; (3}; Menilai respons faal kardiovaskular; pada ..PMH ringan; terhadap pemberiandobutamin; (4).Mendeteksi faktor risiko untuk.terjadinya PMH pada NKB. TEMPAT PENELITIAN: Unit perawatan neonatus tingkat II pada rumah sakit rujukan utama, SUBYEK PENELITIAN: NKB dengan ibunya.PENGURURAN DAN INTERVENSI NKB yang.lahir di RSCM diikuti sampai terjadi PMH atau tidak. Faktor risiko dihitung dengan analisis bivariat dan regresi logistik. Faal ven tnkel dari aliran darah otak (ADO diperiksa dengan teknik" Doppler Faal, diastolik' ventikel varian dari kin diestimasi dengan mengukur puncak E, puncak-A, dan rasio Faal sistolik ventrikel kiri diukur dengan periode praejeksi (PPE) dan waktu ejeksi ventrikel kiri (WEVKi) yang"dikoreksi terhadap laju jantung, serta rasio PPE/WEVKi: ADO'dinilai dengan pengukuran kecepatan aliran darah otak (KADO) maksimal dari Ina1, indeks Pour-ot dan akselerasi aliran Perinrih dobutamin diteliti dengan uji intervensi tersamar ganda dengan desain silang. Pengaruh`dobutamin dalam perjalanan PMI-J dinilai dengan analisis kesintasan pasien yang mendapat dobitamin atau placebo, dengan metode Kaplan Meier dan uji Breslow: Efek pada analisis kesehan adalah saat pasien memerlukan ventilasi mekanik atau mengalami perburukan yang mengancam jiwa.

---

PURPOSE To determine: (1) effects of dobutamine administration on the clinical course of preterm infants with mild hyaline membrane disease (HMD); (2) cardiovascular involvement in mild HMD; (3) response of cardiovascular functions in patients with mild HMD to dobutamine administration; (4) risk factors for the development of HMD in preterm infants.

SETTING Level2neonatal unit of a national referral hospital. STUDY SUBJECTS Preterm infants with their respective mothers.

MEASUREMENTS AND INTERVENTION Pre term infants born at Cipto Mangunkuswno Hospital, Jakarta, were followed from birth to detect the development of HMD. The risk or protective factors were calculated by univariate and logistic regression analyses. Right ventricular (RV) and left ventricular (LV) diastolic functions were estimated by measuring points E and A, and E/A ratio_ LV systolic function was estimated by measuring rate-corrected pre-ejection period (PEP) and left ventricular ejection time (LVET), and PEP/ LVET ratio. Cerebral blood flow velocity (CBFV) was determined at the anterior cerebral artery. Maximal and minimal flows were determined and Pourcelot Index calculated; acceleration of the flow was also measured. Comparison of preterms with or without mild HMD was performed in 23 gestational age and birth weight matched pairs infants. Effects of dobutamine were determined by randomized, double-blind, placebo controlled trial in 41 preterm infants with mild HMO. The role of dobutamine in the clinical course of mild HMD was determined by comparing survival curves of placebo-treated and dobutamine-treated patients using Kaplan-Meier method and Breslow hypothesis testing. The need for mechanical ventilation or deterioration of patient's condition was judged as the event of interest.

MAIN RESULTS Eighty-seven out of the 308 preterm infants studied developed HMD. Logistic regression model disclosed that antepartum hemorrhage, mode of delivery, sex, gestational period, and peri natal asphyxia were associated with the development of HMO. RV diastolic function parameters were not significantly different between infants with. or without mild HMD, and dobutamine did not alter the values. In contrast, LV E and A points were significantly different between the 2 groups,, although the E/A ratio was not different. Dobutamine improved the de-pressed LV diastolic function. Infants with mild HMD had significantly longer rate corrected PEP, ' shorter rate corrected LVET, and larger PEP/LVET ratio compared with those without HMD. The dysfunction was improved by dobutamine. CBFV was not significantly different between preterm infants with or without mild HMD, and dobutamine did not alter CBFV but it increased blood flow acceleration. Dabutamine treated infants had a significantly longer mean mechanical-ventilation-free survival than placebo, treated infants, i.e. 78 vs 61 hours.

CONCLUSIONS (1) Administration of dobutamine to standard treatment delays the deterioration of preteen infants with mild HMD, so that use of dobutamine 10 lrg/kg/min early in the course of the disease is recommended. (2) LV diastolic and systolic functions are depressed in mild HMD, and dobutamine can correct the dysfunction; however; RV diastolic function is not disturbed in mild HMD (3) CBFV is not significantly different between preterm infants vvith or without mild HMD; dobutamine hasnigligible effect on CBPV, but it increases.CBE acceleration: (4) As tepartun hemorrhage, mode of delivery, sex, gestational age, and asphyxia are independently associated with the development of HMOwoRDB Dobutamine prevent infants, hyalin"membranes', rardiovascular involvecerebral blood flow"

"The prevalence of coronary heart disease in the adult population with diabetes mellitus (DM) is far greater (55%) than in the general public (2-4%). There is an acknowledged correlation between type I hidden ischemia and the incidence of myocardiac infarct. There needs to be a way to determine the presence or absence of ischemia. An alternative examination method is the Dobutamine Stress Echocardiography (DSE).This study was conducted at the Metabolic-Endocrine and the Cardiology Out-Patient Clinics of the Department of Internal Medicine ofCipto Mangunkusumo Central Public General Hospital, Jakarta, from February to August 2001.The aim of the study is to detect undetected myocardiac ischemia using the electrocardiography among patients with type 2 diabetes mellitus and podiatric abnormality and testing the correlation between certain factors (sex, age, body mass index, lipid profile, fasting blood glucose, post prandial blood glucose, HbAlc, peripheral vascular disease, smoking, retinopathy, and neuropathy) with myocardiac ischemia.Methodology: The study was designed as a comparative study of the incidence of myocardiac ischemia between type 2 diabetes mellitus patients with and without podiatric abnormalities. The sample consisted of 28 patients. Samples underwent the dobutamine stress echocardiographyResults: dobutamine stress echocardiography examination using Apogee on 14 patients with type 2 diabetes mellitus with podiatric abnormality demonstrated a positive ischemic response in 4 people (28.6%). No positive findings were found in type 2 diabetes mellitus patients without podiatric abnormality.Conclusion: 1. DSE could detect myocardiac ischemia in 28.6% of type 2 diabetes mellitus undetected with electrocardiography. 2. Other factors that influenced a positive dobutamine stress echocardiography were autonomic neuropathy, diabetic retinopathy, the duration of diabetes mellitus, fasting blood glucose, and podiatric abnormality."

"Latar belakang: Penyakit jantung koroner (PJK) masih menjadi masalah di Indonesia bahkan di dunia. Berdasarkan patofisiologinya, PJK dibagi menjadi sindrom koroner akut (SKA) dan kronik (SKK). Salah satu tatalaksana PJK adalah revaskularisasi otot jantung. Namun sangat penting untuk mengetahui viabilitas miokardium untuk kepentingan pengembalian fungsi kontraktilitas miokardium. Saat ini, magnetic resonance imaging (MRI) jantung adalah baku emas yang digunakan untuk mengevaluasi viabilitas miokardium. Namun ketersediaan modalitas ini sangat terbatas. Dobutamine stress echocardiography (DSE) juga dapat mengevaluasi viabilitas miokardium dan memiliki ketersediaan yang lebih luas di Indonesia. Tujuan: Meta analisis ini bertujuan membandingkan sensitivitas dan spesifisitas DSE terhadap MRI kardiak pada pasien dengan SKK. Metode: Meta analisis ini mencari literatur dari empat database yaitu Pubmed, Embase, Cochrane dan Scopus. Meta analisis ini mengacu pada Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 dan Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. Forest plot menampilkan sensitivitas dan spesifisitas DSE dan MRI kardiak. Hasil: Terdapat tiga belas studi yang diinklusi. Dari penyusunan forest plot didapatkan DSE memiliki sensitivitas 75% (CI 0,61 – 0,86) dan spesifisitas 87% (CI 0,82 –0,91), dimana MRI kardiak memiliki sensitivitas 93% (CI 0,88 – 0,96) dan spesifisitas 77% (CI 0,61 – 0,87). Walaupun demikian, perlu diperhatikan beberapa faktor yang dapat menyebabkan overestimation pada sensitivitas dan spesifisitas DSE dan underestimation pada sensitivitas dan spesifisitas MRI kardiak. Kesimpulan: DSE memiliki sensitivitas yang lebih rendah dan spesifistas yang lebih tinggi dibandingkan MRI kardiak. Dengan mempertimbangkan overestimation dan underestimation kedua modalitas tersebut, MRI kardiak memiliki akurasi yang lebih baik dibandingkan DSE. Kata kunci: Sindrom koroner kronik, viabilitas miokardium, dobutamine stress echocardiography, magnetic resonance imaging kardiak.

---

Background: Coronary heart disease (CHD) still becomes a health problem in Indonesia, even in the world. Based on its pathophysiology, CHD is classified to acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). One of the treatment of CHD is myocardial revascularization, however it’s important to know the myocardial viability in prior in order to reverse the contractility function of the myocardium. Nowadays, cardiac magnetic resonance imaging (MRI) is the gold standard for evaluating myocardial viability. Nevertheless, the availibility of MRI is limited. Dobutamine stress echocardiography (DSE) is also able to evaluate myocardial viaiblity and widely available across Indonesia. Purpose: This meta analysis compares the sensitivity and specificity of DSE and cardiac MRI in patients with CCS. Method: This meta analysis searches literatures from four database: Pubmed, Embase, Cochrane and Scopus. We used Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 dan Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy as references. Forest plot is constructed to show the sensitivity and specificity of DSE and cardiac MRI. Result: Thirteen studies were included. The Forest plot shows that DSE has sensitivity of 75% (CI 0,61 – 0,86) and specificity of 87% (CI 0,82 – 0,91), while cardiac MRI has sensitivity of 93% (CI 0,88 –0,96) and specificity of 77% (CI 0,61 – 0,87). Conclusion: DSE has lower sensitivity yet higher specificity than cardiac MRI. Considering the overestimation and underestimation of these modalities, cardiac MRI has higher diagnostic accuracy than DSE."