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"Tujuan.Mendapatkanserta menentukan performa model prediksi delirium pasca-operasi pasien usia lanjut yang akan menjalani operasi.Metode. Penelitian dengan desain kohort prospektif pada pasien usia lanjut yang akan menjalani operasi dari Gedung A dan PJT RSCM, dari 1 Februarisampai 30 April 2018. Prediktor yang dianalisis yaitu usia, frailty, komorbiditas, status nutrisi, kadar albumin, status kognitif, status depresi, polifarmasi dan jenis operasi. Analisis multivariat dengan cox regression untuk mendapatkan Hazzard Ratio dilakukan pada prediktor yang bermakna. Model prediksi dibuat dari prediktor yang bermakna pada analisis multivariat. Kemampuan kalibrasi model prediksi ditentukan dengan uji Hosmer Lameshow dan kemampuan diskriminasinya ditentukan dengan menghitung AUC dari kurva ROC.Hasil.Terdapat187 pasien dengan median usia 67 tahun rentang 60-69 tahun . Kejadian Delirium pasca-operasi didapatkan sebesar 20,3 . Analisis multivariat mendapatkan usia HR 1,739;IK95 0,914-3,307 , polifarmasi HR 2,125 ;IK95 1,117-4,043 , dan status nutrisi HR 3,044 ; IK95 1,586-5,843 , sebagai prediktor model prediksi. Model Prediksi Delirium berdasarkan jumlah skor dari usia skor 1 , polifarmasi skor 1 , dan status nutrisi skor 2 , distratifikasikan menjadi kelompok risiko rendah skor le; 1 , risiko sedang skor 2-3 , dan risiko tinggi skor 4 . Uji Hosmer-Lemeshow menunjukan kalibrasi yang baik p=0,885 dan AUC menunjukan kemampuan diskriminasiyang cukup baik [ 0,71 IK95 0,614-0,809 ].Kesimpulan. Model prediksi delirium pasca-operasi pasien usia lanjut menggunakan usia, status nutrisi dan polifarmasi, distratifikasi menjadi 3 kelas risiko rendah, sedang, dan tinggi Model ini memiliki kalibrasi yang baik dan diskriminasi yang cukup."

"ABSTRAKLatar Belakang : Aphanizomenon Flos Aquae merupakan suatu spesiesganggang biru-hijau yang dimanfaatkan sebagai suplemen nutrisi di seluruh duniatermasuk di Indonesia dan diketahui memiliki banyak aktivitas biologisbermanfaat seperti efek anti-inflamasi, anti-oksidan dan analgetik. Osteoartritis(OA) lutut merupakan permasalahan yang cukup sering didapatkan pada lanjutusia (lansia) namun sampai saat ini belum tersedia modalitas farmakologik sebagai terapi ajuvan yang sesuai dan aman pada kelompok lansia. Aphanizomenon Flos Aquae dapat menjadi alternatif yang baik sebagai terapiajuvan dalam tatalaksana pasien lansia dengan OA lutut. Tujuan Penelitian : Mengkaji pengaruh AFA terhadap perbaikan klinis OA lututpada lansia berdasarkan indeks WOMAC.Metode : Dilakukan uji klinis acak tersamar ganda mulai November 2014 hinggaMei 2015 terhadap pasien lanjut usia dengan OA lutut di poliklinik Geriatri danReumatologi di RSUP Hasan Sadikin Bandung. Subjek dibagi menjadi 2kelompok yaitu satu kelompok mendapat kapsul berisi AFA 2 kali 2 kapsul (1,28g/hari) dan kelompok lainnya mendapat plasebo selama 60 hari. Skor IndeksWOMAC dinilai pada hari ke-1 dan hari ke-60 untuk menilai luaran klinis pasienOA. Perbedaan skor indeks WOMAC pada akhir penelitian dianalisis dengan ujiMann-Whitney. Hasil : Dari total 254 subjek didapatkan 98 subjek yang memenuhi kriteria awalpenelitian dan kemudian dilakukan randomisasi menjadi kelompok perlakuan danplasebo, masing-masing terdiri dari 49 subjek. Kedua kelompok sebanding padaseluruh faktor prognostik penting. Setelah analisis, skor indeks WOMACkomposit kelompok AFA berbeda secara bermakna (p<0,001) dibanding plasebopada akhir penelitian dengan masing-masing skor 8 (median,RIK 3-18) vs. 18(median,RIK 8-32). Tidak ditemukan adanya efek samping yang serius selamapenelitian. Simpulan : Aphanizomenon Flos Aquae dapat memperbaiki klinis berdasarkanskor indeks WOMAC serta aman diberikan pada pasien lansia dengan OA lutut.

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ABSTRACTBackground: Aphanizomenon Flos Aquae is a species of blue-green algae whichis commonly used as nutritional supplement in the world, including in Indonesiaand is known to have many beneficial biological activities such as antiinflammatory,anti-oxidantand analgesics. Osteoarthritis (OA) knee is a problemthat is quite common in the older people but until now there has not beenpharmacologic modalities as a adjunctive therapy available which are suitable and safe. Aphanizomenon Flos Aquae may become a good alternative as an adjunctive therapy in older patients with knee OA.Objective : To determine the effect of AFA on the improvement of clinicaloutcome of Knee OA in older patients based on WOMAC index scores.Methods : A double-blind randomized clinical trial was conducted fromNovember 2014 until May 2015 to older adult patients with Knee OA at theGeriatric and Rheumatology clinic in Hasan Sadikin General Hospital. Thesubjects were divided into groups, each group received capsules containing AFA2 times 2 capsules (1.28 gr/day) and the other received placebo for 60 days.WOMAC Index scores were assessed at day 1 and day 60. The difference inassessment of WOMAC index scores of each group at the end of the study wereanalyzed by Mann-Whitney. Results : Out of total 254 subjects, there were 98 patients who met the initialcriteria and were randomized into two groups, AFA and placebo group with eachconsisting of 49 subjects. Both groups were comparable in all importantprognostic factors. The composite WOMAC Index scores in AFA group wassignificantly different than the placebo group at the end of the study (p <0.001),with each score of 8 (IQR,median 3-18) vs. 18 (IQR,median 8-32) respectively.There was no serious adverse events found throughout the study. Conclusion : Aphanizomenon Flos Aquae was able to show clinical improvement based on WOMAC scoring index and safe to use in the older adults with Knee OA.;Background: Aphanizomenon Flos Aquae is a species of blue-green algae whichis commonly used as nutritional supplement in the world, including in Indonesiaand is known to have many beneficial biological activities such as antiinflammatory,anti-oxidantand analgesics. Osteoarthritis (OA) knee is a problemthat is quite common in the older people but until now there has not beenpharmacologic modalities as a adjunctive therapy available which are suitable and safe. Aphanizomenon Flos Aquae may become a good alternative as an adjunctive therapy in older patients with knee OA.Objective : To determine the effect of AFA on the improvement of clinicaloutcome of Knee OA in older patients based on WOMAC index scores.Methods : A double-blind randomized clinical trial was conducted fromNovember 2014 until May 2015 to older adult patients with Knee OA at theGeriatric and Rheumatology clinic in Hasan Sadikin General Hospital. Thesubjects were divided into groups, each group received capsules containing AFA2 times 2 capsules (1.28 gr/day) and the other received placebo for 60 days.WOMAC Index scores were assessed at day 1 and day 60. The difference inassessment of WOMAC index scores of each group at the end of the study wereanalyzed by Mann-Whitney. Results : Out of total 254 subjects, there were 98 patients who met the initialcriteria and were randomized into two groups, AFA and placebo group with eachconsisting of 49 subjects. Both groups were comparable in all importantprognostic factors. The composite WOMAC Index scores in AFA group wassignificantly different than the placebo group at the end of the study (p <0.001),with each score of 8 (IQR,median 3-18) vs. 18 (IQR,median 8-32) respectively.There was no serious adverse events found throughout the study. Conclusion : Aphanizomenon Flos Aquae was able to show clinical improvement based on WOMAC scoring index and safe to use in the older adults with Knee OA."

"ABSTRAK Latar Belakang: Penilaian status gizi pada lanjut usia saat ini menggunakan Mini Nutritional Assessment MNA , namun memakan waktu yang cukup lama, dilakukan oleh tenaga kesehatan, dan tidak praktis bila digunakan di komunitas. Pemeriksaan kekuatan genggam tangan dapat dijadikan instrumen penapisan status gizi pada lanjut usia. Keuntungan dari pemeriksaan kekuatan genggam tangan antara lain sederhana, alatnya mudah dibawa, tidak membutuhkan waktu yang lama, praktis dan mudah digunakan oleh bukan tenaga kesehatan, tetapi belum ada data titik potong dan akurasi diagnosis kekuatan genggam tangan pada lanjut usia di komunitas.Tujuan: Mendapatkan titik potong dan akurasi diagnosis kekuatan genggam tangan sebagai penapis status gizi pada lanjut usia di komunitas.Metode: Penelitian potong lintang pada subjek berusia ge; 60 tahun di Posbindu di kecamatan Pulogadung, Jakarta Timur selama Januari-Februari 2017. Titik potong kekuatan genggam tangan dianalisis menggunakan kurva Receiver Operating Characteristics ROC . Akurasi diagnosis kekuatan genggam tangan dibandingkan dengan Mini Nutritional Assessment, dinilai dengan menghitung sensitivitas, spesifisitas, nilai duga positif NDP , nilai duga negatif NDN , rasio kemungkinan positif RKP , dan rasio kemungkinan negatif RKN .Hasil: Nilai Area Under the Curve AUC pada lanjut usia laki-laki dan perempuan adalah 90,5 IK95 82,0 ndash;99,0 dan 79,6 IK95 71,7 ndash;87,6 . Titik potong kekuatan genggam tangan lanjut usia laki-laki dan perempuan untuk mendeteksi kondisi malnutrisi berturut-turut adalah le; 25 kg dan le; 18 kg dengan sensitivitas 87,5 dan 77,8 , spesifisitas 80,0 dan 65,0 , NDP 66,7 dan 55,6 , NDN 93,3 dan 83,9 , RKP 4,4 dan 2,2, RKN 0,1 dan 0,3.Simpulan: Titik potong kekuatan genggam tangan lanjut usia laki-laki dan perempuan untuk mendeteksi malnutrisi berturut-turut adalah le; 25 kg dan le; 18 kg. Akurasi diagnosis kekuatan genggam tangan lanjut usia laki-laki dan perempuan dalam mendeteksi malnutrisi berturut-turut dinilai baik dan sedang.Kata Kunci: malnutrisi, lanjut usia, kekuatan genggam tangan, MNA ABSTRACT

Backgound Assessment of elderly nutritional status using Mini Nutritional Assessment MNA may take longer time, should be performed by healthcare professional and not simple when using in community. Handgrip strength assessment could be a nutritional screening method for elderly. The benefits of using handgrip strength are simple, reliable, and easy performance method, but there is no sufficient information regarding its cutoffpoint and diagnostic accuracy for community living elderly.Objective To verify the cutoff point and accuracy of handgrip strength for nutritional assessment of community living elderly.Method A crossectional study was conducted at Posbindu in Pulogadung, Jakarta Timur in January February 2017. Subjects were men and women ge 60 years old. Cutoff point of malnutrition was analyzed by the ROC curve. Diagnostic accuracy of handgrip strength was calculated.Results The area under the curve AUC value of hand grip strength in elderly men and women were 90.5 CI 95 82.0 99.0 and 79.6 CI95 71.7 87.6 . Cutoff point of handgrip strength for diagnosis of malnutrition according to the reference standard were le 25 kg for men and le 18 kg for women, with the sensitivity, specificity, PPV, NPV, LR , and LR were 87.5 and 77.8 , 80.0 and 65.0 , 66.7 and 55.6 , 93.3 and 83.9 , 4,4 and 2,2, 0,1 and 0,3 for men and women, respectively.Conclusions Cutoff point of handgrip strength for diagnosis of malnutrition were le 25 kg for men and le 18 kg for women. Diagnostic accuracy of handgrip strength for diagnosis malnutrition in elderly men and women were good and moderate."