Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Obesitas merupakan masalah global yang prevalensinya terus meningkat, terutama pada individu sedenter.  Peningkatan lemak viseral pada obesitas berperan penting dalam terjadinya kelainan metabolik, seperti hiperurisemia. Hiperurisemia dapat mengakibatkan disfungsi endotel yang menyebabkan aterosklerosis. Studi ini bertujuan untuk mengetahui korelasi antara lemak viseral dan asam urat pada pekerja kantor di RSUPN Dr. Cipto Mangunkusumo.Metode: Studi potong lintang ini dilakukan pada 92 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Pengukuran lemak viseral menggunakan bioelectrical impedance analysis (BIA) seca mBCA 525, dengan lemak viseral ≥2,3 L pada laki-laki; ≥1,7 L pada perempuan menunjukkan peningkatan lemak viseral. Faktor komorbiditas juga diobservasi pada studi ini.Hasil: 29% subjek dengan hiperurisemia dan 86% subjek dengan lemak viseral yang tinggi. Median lemak viseral 2,8 L dan rerata asam urat serum 5,7 mg/dL. Komorbid tertinggi, yaitu dislipidemia, disusul dengan hipertensi, merokok, dan DM. Terdapat korelasi positif yang signifikan dengan kekuatan lemah antara lemak viseral dan asam urat serum (r=0,363; p<0,001).Kesimpulan: Ditemukan korelasi positif yang signifikan dengan kekuatan lemah antara lemak viseral dan asam urat serum pada pekerja kantor dengan obesitas

---

Background: Obesity is an increasing, global public health issue, largely in sedentary lifestyle. Increased visceral fat in obesity has an important role in metabolic disorders, including hyperuricemia. Hyperuricemia can result in endothelial dysfunction that causes atherosclerosis. This study examined correlation between visceral fat and uric acid in obese office workers at Dr. Cipto Mangunkusumo Hospital.

Method: This cross sectional study involving 92 office workers with obesity (BMI ≥25 kg/m2) at Dr. Cipto Mangunkusumo Hospital, Jakarta. Visceral fat (VF) was measured using bioelectrical impedance analysis (BIA) seca mBCA 525, and VF ≥2,3 L in men; ≥1,7 L in women was defined as increased VF. The frequencies of comorbidity were also investigated.

Results: 29% of subjects with hyperuricemia and 86% of subjects with increased VF. Median VF was 2.8 L and mean serum uric acid was 5.7 mg/dL. The highest comorbidity is dyslipidemia, followed by hypertension, smoking, and DM. There is a significant positive weak correlation between visceral fat and serum uric acid (r=0.363; p<0.001).

Conclusion: This study shows a significant positive weak correlation between visceral fat and serum uric acid in office workers with obesity."

"Latar belakang. Meningkatnya prevalensi obesitas diikuti pula dengan kejadian sakit kritis pada pasien obesitas. Obesitas merupakan suatu kondisi inflamasi kronis yang memengaruhi disregulasi respon imun dan meningkatkan risiko sepsis. Sepsis merupakan penyebab tersering perawatan di intensive care unit (ICU) dan berkaitan dengan tingginya mortalitas dan morbiditas. Terapi medik gizi yang adekuat diperlukan untuk menopang diregulasi metabolisme pada sakit kritis dan mencegah penurunan status gizi. Pasien obesitas dengan sepsis menunjukkan prognosis yang buruk pada kondisi hiperlaktatemia. Salah satu mikronutrien yang berperan dalam bersihan laktat adalah tiamin. Beberapa studi menunjukkan efek positif suplementasi tiamin pada penurunan kadar laktat dan mortalitas pada pasien sepsis.Kasus. Serial kasus ini memaparkan tiga pasien laki-laki dan satu pasien perempuan, berusia 33-68 tahun dengan status gizi obesitas, mengalami sakit kritis, dan sepsis. Seluruh pasien mendapatkan terapi medik gizi sejak fase akut sakit kritis. Pemberian energi dan protein sesuai dengan kondisi klinis dan toleransi pasien. Seluruh pasien mendapatkan suplementasi tiamin 2x100 mg per enteral yang dimulai pada 24 jam pertama pasca penegakkan diagnosis sepsis selama 7 hari.Hasil. Selama perawatan, asupan energi pasien kasus dapat mencapai 30 kkal/kgBB dan asupan protein mencapai 1,3–1,7 g/kgBB sesuai dengan fungsi ginjal pasien. Tiga pasien mengalami penurunan kadar laktat dan skor SOFA setelah 7 hari suplementasi tiamin. Ketiga pasien tersebut dapat melewati fase kritis di ICU dan pindah ke ruang perawatan biasa, sedangkan satu pasien mengalami peningkatan enzim transaminase dan peningkatan kadar laktat. Pasien tersebut mengalami 3 kali periode sepsis dan meninggal dunia saat perawatan sakit kritis.Kesimpulan. Suplementasi tiamin memberikan efek positif pada penurunan kadar laktat darah dan skor SOFA pada pasien sakit kritis dengan sepsis dan obesitas. Terapi medik gizi yang adekuat dapat menunjang luaran klinis dan kesintasan pada pasien sakit kritis dengan sepsis dan obesitas.

---

Background. The prevalence of obesity is rising worldwide followed by the incidence of critical illness in obese patients. Obesity is a chronic inflammatory condition that affects dysregulation of immune response and increases the risk of sepsis. Sepsis is the most common cause of hospitalization in the intensive care unit (ICU) and is associated with high mortality and morbidity. Adequate medical nutrition therapy is required to support metabolism in the critically ill and prevent deterioration in nutritional status. Obese patients with sepsis and hyperlactatemia exhibit poor prognosis. One of the micronutrients that play a role in lactate clearance is thiamine. Several studies have shown a positive effect of thiamine supplementation on reducing lactate levels and mortality in septic patients.

Case. This case series described three male patients and one female patient, aged 33-68 years with obesity, critical illness, and sepsis. All patients obtained medical nutrition therapy ever since the acute phase of critical illness. Administration of energy and protein was adjusted to clinical conditions and patients` tolerance. All patients received thiamine supplementation 2x100 mg enteral starting in the first 24 hours after diagnosis of sepsis for 7-day period.

Result. During treatment, the energy dan protein intake of case patients attained 30 kcal/kgBW and 1.3–1.7 g/kgBW respectively, according to the patients' tolerance. Three patients had decrement of lactate levels and SOFA scores after 7 days of thiamine supplementation. The three patients were able to surpass the critical phase in the ICU and step down to ward. Meanwhile, one patient experienced an increment in transaminases enzymes and lactate levels. The patient had 3 periods of sepsis and died during critical care.

Conclusion. Thiamine supplementation exhibited positive impact on lactate levels and SOFA scores decrement in critically ill patients with sepsis and obesity. Adequate medical nutritional therapy could promote clinical outcomes and survival in critically ill patients with sepsis and obesity."

"Kelimpahan relatif dan rasio Firmicutes/Bacteroidetes mikrobiota usus dipengaruhi oleh asupan makan dan mempengaruhi kesehatan anak dan dewasa. Namun, penelitian pada ibu hamil di daerah urban masih terbatas dan hasil yang dihubungkan dengan pola makan masih berbeda-beda, terutama di negara berpenghasilan rendah-menengah. Penelitian ini menilai hubungan antara pola makan dengan kelimpahan relatif mikrobiota usus (filum dan genus) dan rasio Firmicutes/Bacteroidetes. Penelitian ini merupakan studi potong lintang yang dilakukan di Puskesmas di empat kota di Jakarta (Pusat, Tengah, Barat dan Utara) merekrut 90 ibu hamil yang datang pada kunjungan Ante Natal Care (ANC). Data asupan makan ibu dengan menggunakan semi quantitative food frequency questioner (SQ-FFQ) diambil oleh enumerator yang sudah ditraining. Data asupan makan dianalisis menggunakan principal component anlysis (PCA) yang akan membentuk pola makan. Sampel feses diambil dan dianalisis dengan Next Generation Sequencing (NGS) 16S rRNA untuk mendapatkan hasil kelimpahan relatif mikrobiota usus . Terbentuk 4 pola makan yaitu pola makan tinggi sumber protein, pola makan tinggi sumber susu dan produk susu, pola makan tinggi sumber karbohidrat dan serat serta pola makan tinggi sumber buah-buahan. Dua filum terbesar yaitu (Firmicutes dan Bacteroidetes) dan 3 genus terbanyak yaitu Prevotella, Faecalibacterium dan Blautia dengan rerata kelimpahan relatif berurutan 69,5%, 12,6%, 5,98%, 8,59% dan 6,59%. Pola makan tinggi karbohidrat dan serat, namun tidak dengan pola makan lain, memiliki nilai p signifikan dengan kelimpahan relatif Faecalibacterium setelah disesuaikan dengan Pendidikan dan suku pada analisis multivariat (β 1,01, CI 95% 0,27-1,73 dan p=0,008). Kesimpulannya, setiap kenaikan pola makan tinggi sumber karbohidrat dan serat dapat menaikkan kelimpahan relatif dari Faecalibacterium sebesar 1,01%. Edukasi tentang pemilihan pola makan yang sehat dan baik untuk serta asupan karbohidrat dan serat yang bervariasi sangat penting dilakukan.

---

Relative abundance influenced by diet and affect children and adults’ health. However, evidence among urban pregnant women is limited and results on the link of this outcome with dietary pattern is conflicting especially in low-middle income nations. We assessed the relationship between maternal dietary pattern and the relative abundance of gut microbiota and Firmicutes/Bacteroidetes ratio. A cross-sectional study was conducted in primary health care in four districts in Jakarta (Central, East, West and North areas) recruiting 90 pregnant women during their ante natal care visits. Maternal food intake was assessed using a semi-quantitative food frequency questionnaire by trained enumerators and analyzed using principal component analysis to form a dietary pattern. Fecal samples were collected and analyzed with the Next Generation Sequencing (NGS) 16S rRNA to obtain the relative abundance of gut microbiota results. Four eating patterns were formed, namely a high protein sources diet, a high milk and dairy products sources diet, a high carbohydrates and fiber sources diet and a high fruit sources diet. Two largest phyla (Firmicutes and Bacteroidetes) and three largest genera (Prevotella, Faecalibacterium and Blautia) were identified with an average relative abundance value of 69.5%, 12.6%, 5.98%, 8.59% and 6.59%, respectively. High carbohydrate and fiber sources diet, not the other patterns, had a significant value with Faecalibacterium abundance after adjusting for education and ethnicity in multivariate model (β 1.01, CI 95% 0.27- 1.73 and p=0.008). In conlussion, increase high carbohydrate and fiber source diet could increase the relative abundance of Faecalibacterium by 1.01%. Education to choose healthy diet and variety carbohydrate and fiber sources will be needed."

"Latar Belakang: Laparotomi merupakan pembedahan mayor yang dapat menyebabkan penurunan massa otot rangka dan kapasitas fungsional, seperti kekuatan genggam tangan (KGT). Berbagai studi membuktikan penurunan KGT pascaoperasi menimbulkan komplikasi pascaoperasi, serta KGT berkorelasi erat dengan appendicular skeletal muscle index (ASMI). Pengaruh ASMI praoperasi terhadap KGT pascaoperasi belum banyak dilakukan penelitian, sehingga penelitian ini bertujuan menilai korelasi ASMI praoperasi dengan KGT pascaoperasi.Metode: Studi observasional prospektif dilakukan pada subjek berusia 18 – 65 tahun di RS pendidikan tersier, RSUPN Dr. Cipto Mangunkusumo, yang dirawat untuk laparotomi elektif pada Maret sampai Juni 2023. Pengukuran ASMI praoperasi menggunakan bioimpedance analysis (BIA) multifrequency seca® mBCA 525 dengan cutoff laki-laki > 7,0kg/mg2 dan perempuan >5,7 kg/m2. Pengukuran KGT pada tangan kanan dan kiri pascaoperasi pada hari ke-6 pascaoperasi (POD-6) dengan dinamometer tangan spring-type CAMRY® dengan cutoff laki-laki >28 kg/m2 dan perempuan >18 kg/m2. Analisis bivariat dan multivariat digunakan untuk menilai hubungan variabel bebas dan terikat, serta mengidentifikasi faktor perancu yang berhubungan dengan KGT pascaoperasi.Hasil: Pada 85 subjek penelitian, sebanyak 98,82% subjek memiliki ASMI praoperasi rendah, 72,94% subjek memiliki KGT pascaoperasi tangan kanan menurun, dan 80% subjek memiliki KGT pascaoperasi tangan kiri menurun dari cutoff. Didapatkan hasil signifikan pada korelasi ASMI praoperasi dengan KGT pascaoperasi tangan kanan (r=0,444, p<0,001) dan kiri (r=0,423, p<0,001). Analisis lanjutan dengan regresi linier untuk faktor perancu didapatkan indeks massa tubuh (IMT) adalah faktor paling signifikan meningkatkan KGT tangan kanan dan kiri pascaoperasi.Kesimpulan: Terdapat hubungan yang bermakna secara statistik pada korelasi ASMI praoperasi dengan KGT pascaoperasi laparotomi elektif.

---

Background: Laparotomy is a major surgery that can lead to a decrease in skeletal muscle mass and functional capacity, such as handgrip strength (HGS). Various studies have shown that HGS is decreasing after surgery can result in postoperative complications, and HGS is closely correlated with the appendicular skeletal muscle index (ASMI). Research on the preoperative influence of ASMI on postoperative HGS is limited, so this study aims to assess the correlation between preoperative ASMI and postoperative HGS.

Top of Form

Methods: A prospective observational study was conducted on subjects aged 18-65 years at the tertiary education hospital, RSUPN Dr. Cipto Mangunkusumo, who underwent elective laparotomy from March to June 2023. Preoperative ASMI measurements were taken using multifrequency bioimpedance analysis (BIA) with seca® mBCA 525, with a cutoff for males > 7.0 kg/m2 and females > 5.7 kg/m2. Postoperative HGS measurements for the right and left hands on postoperative day 6 (POD-6) were conducted using a spring-type hand dynamometer CAMRY® with a cutoff for males > 28 kg/m2 and females > 18 kg/m2. Bivariate and multivariate analyses were employed to assess the association between independent and dependent variables, as well as to identify confounding factors associated with postoperative HGS.

Results: In 85 research subjects, 98.82% had low preoperative ASMI, 72.94% experienced a decrease in postoperative right HGS, and 80% had a decrease in postoperative left HGS from the cutoff. Significant results were obtained in the correlation between preoperative ASMI and postoperative right HGS (r=0.444, p<0.001) and left HGS (r=0.423, p<0.001). Further analysis with linear regression for confounding factors revealed that body mass index (BMI) was the most significant factor in increasing postoperative HGS for both right and left hands.

Conclusion: There is a statistically significant in the correlation between preoperative ASMI and postoperative HGS in elective laparotomy."

"Kadar kalium merupakan salah satu biomarker prognostik yang banyak digunakan untuk memprediksi luaran klinis berbagai penyakit. Kadar kalium yang rendah atau hipokalemia berhubungan dengan perlunya pemasangan ventilasi mekanik pada pasien sakit kritis. Berbagai kondisi seperti status nutrisi dan komorbid dapat menyebabkan hipokalemia. Hipokalemia dapat memengaruhi fungsi otot respirasi dan memengaruhi durasi penggunaan ventilasi mekanik. Penelitian ini bertujuan untuk melihat hubungan antara status kalium terhadap kejadian sulit weaning ventilasi mekanik pada pasien sakit kritis di ICU RSCM dan RSUI. Penelitian ini menggunakan desain kohort retrospektif pada subjek berusia ≥18 tahun yang dirawat di ICU RSCM dan RSUI. Diperoleh 52 subjek dengan kelompok yang hipokalemia sebanyak 26 subjek dan kelompok yang normokalemia sebanyak 26 subjek. Rerata usia subjek 49,3±15,1 tahun, jenis kelamin laki-laki 65,4%, status nutrisi berdasarkan indeks massa tubuh (IMT) berat badan normal 34,6%, dan komorbid penyakit keganasan 36,5%. Tidak terdapat hubungan bermakna antara status kalium dengan kejadian sulit weaning ventilasi mekanik selama perawatan di ICU. Sebagian besar subjek yang mengalami hipokalemia tidak mengalami sulit weaning ventilasi mekanik. Penelitian lanjutan diperlukan dengan menggunakan subjek yang lebih banyak dan menganalisis faktor-faktor lain yang dapat memengaruhi kejadian sulit weaning ventilasi mekanik dan status kalium pada pasien sakit kritis yang dirawat di ICU.

---

Potassium levels are one of the prognostic biomarkers that are widely used to predict clinical outcomes of various diseases. Low potassium levels or hypokalemia are associated with the need for mechanical ventilation in critically ill patients. Various conditions such as nutritional status and comorbidities can cause hypokalemia. Hypokalemia can affect respiratory muscle function and influence the duration of mechanical ventilation. This study aims to examine the relationship between potassium status and the incidence of mechanical ventilation weaning difficulty in critically ill patients in the ICU at RSCM and RSUI. This study used a retrospective cohort design on subjects aged ≥18 years who were treated in the ICU at RSCM and RSUI. Total 52 subjects obtained, with 26 subjects in the hypokalemia group and 26 subjects in the normokalemia group. The mean age of the subjects was 49.3±15.1 years old, male gender 65.4%, nutritional status based on body mass index (BMI) of normal weight 34.6%, and comorbid of malignant disease 36.5%. There was no significant relationship between potassium status and the incidence of mechanical ventilation weaning difficulty during treatment in the ICU. Most subjects who experienced hypokalemia did not experience mechanical ventilation weaning difficulty. Further research is needed using more subjects and analyzing other factors that may influence the incidence of mechanical ventilation weaning difficulty and potassium status in critically ill patients treated in the ICU."

"Latar Belakang: Disfungsi saluran cerna berhubungan dengan luaran klinis yang lebih buruk pada pasien sakit kritis. Kadar albumin serum yang rendah merupakan salah satu faktor yang dapat meningkatkan risiko disfungsi saluran cerna. Hubungan kadar albumin dengan disfungsi saluran cerna masih inkonklusif karena pendekatan diagnostik disfungsi saluran cerna yang belum terstandarisasi dengan baik. Gastrointestinal dysfunction score (GIDS) instrumen dengan subjektivitas minimal dan reproduktifitas maksimal, diharapkan dapat menegakkan diagnosis disfungsi saluran cerna dengan objektivitas yang lebih baik. Penelitian ini dilakukan untuk mengetahui hubungan antara kadar albumin saat admisi dengan terjadinya disfungsi saluran cerna yang dinilai menggunakan GIDS. Metode: Penelitian ini merupakan penelitian kohort prospektif pada subjek berusia ≥18 tahun yang dirawat di ruang rawat intensif Rumah Sakit Umum Pusat Nasional (RSUPN) dr. Cipto Mangunkusumo dan Rumah Sakit Universitas Indonesia (RSUI). Karakteristik subjek penelitian berupa usia, jenis kelamin, status gizi, penyakit komorbid, diagnosis admisi intensive care unit (ICU), waktu inisiasi pemberian nutrisi oral atau enteral, kebiasaan mengonsumsi alkohol, dan skor sequential organ failure assessment (SOFA). Dilakukan analisis bivariat untuk menilai hubungan kadar albumin saat admisi dengan disfungsi saluran cerna. Hasil: Diperoleh 64 subjek, kelompok kadar albumin rendah 32 subjek dan kelompok kadar albumin normal 32 subjek. Rerata usia subjek 50,2±15,7, laki-laki 64,1%, 26,6% subjek dengan status gizi berat badan normal berdasarkan indeks massa tubuh (IMT), 50% subjek dengan malnutrisi secara klinis,  21,9% subjek dengan diagnosis komorbid diabetes melitus dan 3,1% subjek dengan parkinson, 34,4 % subjek dengan diagnosis admisi bedah, 95,3% subjek mendapatkan nutrisi oral atau enteral ≤ 48 jam, median skor SOFA 3 (0-12). Rerata kadar albumin  subjek dengan disfungsi saluran cerna 2,7±0,6 g/dL, rerata kadar albumin  subjek tidak disfungsi saluran cerna 3,7±0,7 g/dL. 31,3% subjek mengalami disfungsi saluran cerna. Terdapat hubungan signifikan secara statistik antara kadar albumin saat admisi dengan disfungsi saluran cerna RR 9 (95%CI 2,3-35,6; p <0,001) dan skor GIDS, p<0,001. Kesimpulan: Terdapat hubungan bermakna antara kadar albumin saat admisi dengan disfungsi saluran cerna. Pemeriksaan kadar albumin saat admisi ICU idealnya dilakukan secara rutin dan diikuti dengan koreksi kadar albumin apabila ditemukan kondisi hipoalbuminemia.

---

Background: Gastrointestinal dysfunction is associated with worse clinical outcomes in critically ill patients. Low serum albumin levels are one factor that can increase the risk of gastrointestinal dysfunction. The relationship between albumin levels and gastrointestinal dysfunction is still inconclusive because the diagnostic approach to gastrointestinal dysfunction is not yet well standardized. Gastrointestinal dysfunction score (GIDS) is an instrument with minimal subjectivity and maximum reproducibility, which is expected to provide a diagnosis of gastrointestinal dysfunction with better objectivity. This research was conducted to determine the relationship between albumin levels at admission and the occurrence of gastrointestinal dysfunction as assessed using GIDS. Methods: This study is a prospective cohort study of subjects aged ≥18 years who were treated in the intensive care unit at RSUPN dr. Cipto Mangunkusumo and RSUI. Characteristics of research subjects included age, gender, nutritional status, comorbid diseases, ICU admission diagnosis, time of initiation of oral or enteral nutrition, alcohol consumption habits, and SOFA score. Bivariate analysis was carried out to assess the relationship between albumin levels at admission and gastrointestinal dysfunction. Results: There were 64 subjects, 32 subjects in the low albumin level group and 32 subjects in the normal albumin level group. Mean age of subjects 50.2 ± 15.7, 64.1% male, 26.6% subjects with normal weight nutritional status based on BMI, 50% subjects with clinical malnutrition, 21.9% subjects with comorbid diagnosis of diabetes mellitus and 3.1%  subjects with Parkinson's, 34.4%  subjects with surgical admission diagnosis, 95.3% subjects received oral or enteral nutrition ≤ 48 hours, median SOFA score 3 ( 0-12). The mean albumin level of subjects with gastrointestinal dysfunction was 2.7 ± 0.6 g/dL, the mean albumin level of subjects without gastrointestinal dysfunction was 3.7 ± 0.7 g/dL. 31.3% of subjects experienced gastrointestinal dysfunction. There was a statistically significant relationship between albumin levels at admission and gastrointestinal dysfunction RR 9 (95%CI 2.3-35.6; p <0.001) and GIDS score, p<0.001. Conclusion: There is a significant relationship between albumin levels at admission and gastrointestinal dysfunction. Albumin levels examination during ICU admission should ideally be carried out routinely and followed by correction of albumin levels if hypoalbuminemia is found."

"Latar Belakang: Pembedahan saluran cerna dapat menurunkan kapasitas fungsional, terlihat dari penurunan kekuatan genggam tangan, yang berhubungan dengan malnutrisi dan inflamasi. Albumin adalah parameter nutrisi penting yang dapat memengaruhi kekuatan otot, tetapi hubungan antara perubahan kadar albumin dengan perubahan kekuatan genggam tangan pada pasien pasca bedah saluran cerna belum banyak diteliti.Metode: Penelitian ini adalah studi kohort prospektif pada 52 pasien dewasa (19–65 tahun) yang menjalani pembedahan saluran cerna di RSUPN Dr. Cipto Mangunkusumo. Kadar albumin serum diukur sebelum dan setelah operasi, sementara kekuatan genggam tangan dinilai menggunakan dinamometer digital. Analisis korelasi Spearman digunakan untuk menilai hubungan antara perubahan kadar albumin dan kekuatan genggam tangan.Hasil: Mayoritas subjek memiliki kekuatan genggam tangan praoperasi rendah, dengan rata-rata penurunan kekuatan genggam pascaoperasi sebesar 3,5 kg. Mayoritas pasien juga mengalami hipoalbuminemia pascaoperasi, dengan rerata penurunan kadar albumin 0,4 g/dL. Uji korelasi menunjukkan hubungan bermakna antara perubahan kadar albumin dan kekuatan genggam tangan pascaoperasi (r = 0,328; p = 0,018). Kesimpulan: Terdapat korelasi sedang yang signifikan antara perubahan kadar albumin dan perubahan kekuatan genggam tangan pada pasien pasca bedah saluran cerna.

---

Background: Gastrointestinal surgery can reduce functional capacity, evidenced by a decline in handgrip strength, which is associated with malnutrition and inflammation. Albumin is an essential nutritional parameter that can influence muscle strength, but the relationship between changes in serum albumin levels and handgrip strength in postoperative gastrointestinal surgery patients has not been extensively studied. Methods: This study is a prospective cohort involving 52 adult patients (aged 19–65 years) who underwent gastrointestinal surgery at Dr. Cipto Mangunkusumo National General Hospital. Serum albumin levels were measured preoperatively and postoperatively, while handgrip strength was assessed using a digital dynamometer. Spearman correlation analysis was used to evaluate the relationship between changes in serum albumin levels and handgrip strength.

Results: The majority of subjects had low preoperative handgrip strength, with an average decrease in postoperative handgrip strength of 3.5 kg. Most patients also experienced postoperative hypoalbuminemia, with an average albumin level reduction of 0.4 g/dL. Correlation analysis revealed a significant moderate association between changes in serum albumin levels and handgrip strength (r = 0,328; p = 0,018). Conclusion: There is a significant moderate correlation between changes in serum albumin levels and changes in handgrip strength in postoperative gastrointestinal surgery patients."

"Pasien sakit kritis mengalami peningkatan laju atrofi otot yang memengaruhi keberhasilan ekstubasi. Pemeriksaan massa otot dengan alat tervalidasi terbatas karena instabilitas klinis, kesulitan transfer pasien, dll. Lingkar betis (LB) berkorelasi dengan hasil pemeriksaan massa otot tervalidasi, sederhana, dan efisien. Studi bertujuan mengetahui hubungan LB awal admisi dengan keberhasilan ekstubasi. Studi kohort prospektif melibatkan 65 subjek berusia 18−70 tahun, pengguna ventilasi mekanis di RSUPN dr. Cipto Mangunkusumo dan RS Universitas Indonesia. Pemantauan sejak admisi ICU hingga pasien ekstubasi atau maksimal 14 hari pasca intubasi. Subjek didominasi laki-laki (67,7%), rerata usia 48,2 ± 13,8 tahun, dan indeks massa tubuh 23,77 ± 6,30 kg/m2. Sebagian besar pasien bedah (81,5%) dan memiliki komorbiditas (81,5%). Durasi intubasi 43 jam (12-401). Rerata LB awal 32,8 ± 3,4 cm dan LB akhir 32,1 ± 3,6 cm, terdapat beda rerata -0,68 cm (p <0,001). Tidak ditemukan hubungan LB awal dengan keberhasilan ekstubasi (RR 1,23; IK 95%: 0,89−1,69, p = 0,199). Lingkar betis awal sebagai pemeriksaan untuk massa otot bukan prediktor keberhasilan ekstubasi. Analisis tambahan menemukan perbedaan rerata bermakna LB awal dan LB akhir yang diukur. Perubahan LB didapatkan perbedaan nilai bermakna antara kelompok berhasil ekstubasi dibandingkan sulit ekstubasi.

---

Critically ill patients experience an increased rate of muscle atrophy that affects the success of extubation. Examination of muscle mass with validated tools is limited due to clinical instability, difficulty in patient transfer, etc. Calf circumference (LB) correlates with the results of a validated, simple and efficient muscle mass examination. The study aims to determine the relationship between initial LB admission and successful extubation. A prospective cohort study involving 65 subjects aged 18−70 years, users of mechanical ventilation at RSUPN dr. Cipto Mangunkusumo and University of Indonesia Hospital. Monitoring from ICU admission until the patient is extubated or a maximum of 14 days after intubation. Subjects were predominantly male (67.7%), mean age 48,2 ± 13,8 years, and body mass index 23,77 ± 6,30 kg/m2. Most of the patients were surgical (81,5%) and had comorbidities (81,5%). Duration of intubation 43 hours (12-401). The mean initial LB was 32,8 ± 3,4 cm and final LB 32,1 ± 3,6 cm, there was a mean difference of -0,68 cm (p <0.001). There was no association between early LB and extubation success (RR 1,23; 95% CI: 0,89−1,69, p = 0,199). Initial calf circumference as a test for muscle mass is not a predictor of successful extubation. Additional analysis found significant mean differences in initial LB and final LB measured. There was a significant difference in LB changes between the successful extubation group compared to the difficult extubation group."

"Malnutrisi memiliki dampak pada pasien rawat inap di rumah sakit (RS), dan diperlukan skrining gizi yang dilakukan dalam 48 jam sejak admisi RS. Penilaian kekuatan genggam tangan (KGT) memiliki potensi sebagai alat skrining gizi pada pasien rawat inap dewasa, namun belum terdapat data titik potong dan nilai diagnostik KGT pada pasien rawat inap dewasa. Penelitian ini bertujuan untuk mendapatkan titik potong dan nilai diagnostik KGT sebagai skrining gizi pasien rawat inap dewasa di RSCM. Penelitian menggunakan desain potong lintang pada subjek berusia 18-59 tahun yang dirawat inap di RSCM. Diperoleh 161 subjek penelitian dengan median usia 46 tahun (18-59), perempuan 56,5%. Proporsi subjek dengan status malnutrisi berdasarkan GLIM adalah 42,2%. Rerata KGT adalah 24,9±10,7 kgf. Titik potong KGT seluruh subjek adalah 23,4 kgf, dengan sensitivitas 58,82%, spesifisitas 60,22%, nilai duga positif 51,95%, nilai duga negatif 66,67%, rasio kemungkinan positif 1,48 dan rasio kemungkinan negatif 0,68. Nilai diagnostik KGT sebagai skrining gizi pasien rawat inap dewasa di RSCM dianggap kurang. Penelitian lanjutan diperlukan untuk menentukan titik potong dan nilai diagnostik KGT sebagai skrining gizi pada masing masing jenis kelamin.

---

Malnutrition has a significant impact on hospitalized patients, and nutritional screening should be performed within 48 hours since patient admission. Handgrip strength (HGS) has a potential value as nutritional screening method in adult hospitalized patient, yet cut off and diagnostic value are not established. This study aimed to define average, cut off point and diagnostic value of HGS as nutrition screening method for adult hospitalized patient at RSCM. The study used a cross-sectional design on hospitalized patients, age 18-59 years old. One hundred and sixty one subjects were recruited, with median age 46 years old (18-59), 56,5% were female. Proportion of malnourished subjects based on GLIM criteria was 42,2%. Average HGS was 24,9±10,7 kgf. Cut off point of HGS was 23,4 kgf, with sensitivity 58,82%, specificity 60,22%, positive predictive value 51,95%, negative predictive value 66,67%, positive likelihood ratio 1,48 and negative likelihood ratio 0,68. Diagnostic value of HGS as nutritional screening method was considered poor. Further study is needed to determine sex based cut off point and diagnostic value of HGS."

"Latar Belakang: Pasien kanker kepala-leher (KKL) berisiko mengalami malnutrisi dan penurunan massa otot dan kekuatan otot sehingga kapasitas fungsional dan kualitas hidup menurun. Folat berperan dalam sintesis, perbaikan, dan metilasi DNA, serta meregulasi kadar homosistein yang berperan juga dalam sintesis dan regenerasi sel otot. Namun, keterkaitan antara asupan folat dengan kapasitas fungsional pada populasi tersebut belum banyak diteliti.Metode: Penelitian ini menggunakan desain potong lintang terhadap 53 pasien KKL dewasa dengan malnutrisi yang belum menjalani radiasi di RSUPN Dr.Cipto Mangunkusumo. Data asupan folat diperoleh melalui SQ-FFQ, sedangkan kapasitas fungsional diukur menggunakan kekutan genggam tangan (KGT) dengan dinamometer Jamar. Analisis korelasi digunakan untuk mengevaluasi hubungan antar variabel.Hasil: Dari 53 subjek dengan rerata usia 43,3 ± 11,2 tahun, terdapat 62,3% subjek laki-laki dan 77,4% subjek mengalami malnutrisi sedang. Asupan folat subjek 190,2 (59,2-644,0) mcg/hari, 90,6% pasien memiliki asupan folat di bawah angka kecukupan gizi yang dianjurkan. Hasil KGT sebesar 28,0 (12,0-45,0) kg, 56,6% subjek menunjukkan hasil normal. Tidak ditemukan hubungan yang bermakna secara statistik antara asupan folat dengan KGT (r = 0,205, p > 0,05).Kesimpulan: Penelitian ini tidak menemukan hubungan yang bermakna antara asupan folat dengan kapasitas fungsional pada pasien KKL dengan malnutrisi.

---

Background: Head and neck cancer (HNC) patients are at risk of malnutrition and decreased muscle mass and muscle strength, resulting in decreased functional capacity and quality of life. Folate is involved in DNA synthesis, repair, and methylation processes, and it helps regulate homocysteine levels, which are important for the formation and regeneration of muscle cells. However, the relationship between folate intake and functional capacity in this population has not been widely studied.

Methods: This study used a cross-sectional design on 53 adult HNC patients with malnutrition who had not undergone radiation at Dr. Cipto Mangunkusumo National Hospital. Folate intake data were obtained through SQ-FFQ, while functional capacity was measured using handgrip strength (HGS) with a Jamar dynamometer. Correlation analysis was used to evaluate the relationship between variables.

Results: This study included 53 participants with a mean age of 43.3 ± 11.2 years; 62.3% were male, and 77.4% were classified as having moderate malnutrition. Subjects had a folate intake of 190.2 (59.2–644.0) mcg/day, with 90.6% of them consuming less than the recommended dietary allowance. HGS results were 28.0 (12.0-45.0) kg, 56.6% of subjects showed normal results. No statistically significant correlation was found between folate intake and handgrip strength (r = 0.205, p > 0.05).

Conclusion: This study found no significant correlation between folate intake and functional capacity in head and neck cancer patients with malnutrition."