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Ahmad Hazim
Abstrak :
ABSTRAK
Penatalaksanaan striktur esofagus memerlukan aspek medis yang komprehensif untuk pemenuhan kebutuhan nutrisi yang adekuat dengan terapi non bedah atau terapi bedah. Endoskopi memiliki peranan yang sangat penting pada striktur esofagus yaitu bermanfaat sebagai diagnostik dan terapi. Pilihan penatalaksaan striktur esofagus melalui bantuan endoskopi terdiri dari terapi dilatasi, pemberian kortikosteroid intralesi, pemakaian stents, dan pemandu untuk reseksi tumor. Pemilihan tindakan yang tepat sesuai dengan keadaan klinis pasien kasus per kasus merupakan hal yang penting untuk mencapai target perbaikan striktur pada esofagus, sehingga dapat membantu mengembalikan fungsinya sebagai saluran makanan dan perannya dalam proses menelan.
Jakarta: Bidang Penelitian dan Pengembangan Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia, 2018
610 JPDI 5:2 (2018)
Artikel Jurnal  Universitas Indonesia Library
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Griskalia Christine Theowidjaja
Abstrak :
Latar Belakang. Mortalitas keganasan dengan tromboemboli vena lebih tinggi daripada keganasan tanpa tromboemboli vena. Jenis dan/atau histopatologi keganasan, stadium, terapi keganasan berisiko tinggi trombosis vena dalam, lokasi trombus, usia, imobilisasi, kateter vena sentral, D-dimer, infeksi, dan Indeks Komorbiditas Charlson berpengaruh terhadap mortalitas pasien keganasan dengan trombosis vena dalam. Belum ada data insiden kumulatif mortalitas pasien keganasan dengan trombosis vena dalam di Indonesia dan belum ada model prediksi yang mudah untuk memprediksi mortalitas pasien keganasan dengan trombosis vena dalam. Tujuan. Mengetahui insiden kumulatif mortalitas dan membuat model prediksi berupa sistem skor prediktor mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam. Metode. Penelitian kohort, 223 pasien keganasan dengan trombosis vena dalam di RSCM, Januari 2011-Agustus 2013, diamati 3 bulan. Variabel bebas: usia, jenis dan/atau histopatologi keganasan, stadium keganasan, terapi risiko tinggi terjadi trombosis vena dalam, lokasi trombus, imobilisasi, penggunaan kateter vena sentral, D-dimer awal saat diagnosis trombosis vena dalam, infeksi, dan Indeks Komorbiditas Charlson. Variabel dependen: mortalitas karena semua penyebab. Regresi logistik digunakan untuk mendapatkan sistem skor. Hasil. 61,4% pasien meninggal. Prediktor yang bermakna terhadap mortalitas 3 bulan pertama adalah stadium III-IV, imobilisasi, dan infeksi; dengan masingmasing skor 2-3-2. Total skor risiko rendah (0), risiko sedang (2-4), dan risiko tinggi (5-7) mempunyai mortalitas berturut-turut 10%, 43%, 72%. Simpulan. Insiden kumulatif mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam adalah 61,4%. Telah ditemukan model prediksi mortalitas 3 bulan pertama pasien keganasan dengan trombosis vena dalam. ...... Background. Mortality risk among malignancy with venous thromboembolism (VTE) patients is higher than malignancy patients without VTE. The type and/or histopathology of malignancy, cancer stage, high risk cancer therapy for deep vein thrombosis (DVT), thrombus location, age, immobilization, central venous catheter, D-dimer, infection, and Charlson Comorbidity Index influence the mortality of malignancy patients with DVT. There is no cumulative incidence data and an easy prediction model to predict mortality among malignancy patients with DVT. Objective. To know the cumulative incidence of mortality and to make a prediction model (scoring system) to predict the first 3-month mortality among malignancy patients with DVT. Methods. A cohort study of 223 malignancy patients with DVT at Cipto Mangunkusumo National Hospital between January 2011-August 2013, with 3 months of follow-up. Independent variables: age, cancer's type and/or histopathology, cancer stage, high risk cancer therapy for DVT, thrombus location, immobilization, central venous catheter, D-dimer when the patients were diagnosed with DVT, infection, and Charlson Comorbidity Index. Dependent variable: all-caused mortality. Logistic regression was used to make a scoring system. Results. 61.4% patients died. The significant predictors were stage III-IV cancer, immobilization, and infection; with the scores 2-3-2, respectively. Total score for low risk patients (0), intermediate risk patients (2-4), and high risk patients (5-7) with the mortality 10%, 43%, 72%, respectively. Conclusions. The cumulative incidence of the first 3-month mortality in malignancy patients with DVT was 61.4%. There is an applicable prediction model to predict the first 3-month mortality among malignancy patients with DVT.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tesis Membership  Universitas Indonesia Library
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Joko Rilo Pambudi
Abstrak :
Latar Belakang: Aterosklerosis dan penyakit kardiovaskular merupakan penyebab utama meningkatnya morbiditas dan mortalitas penderita artritis reumatoid (AR) Pemeriksaan ketebalan intima media (KIM) arteri karotis dengan ultrasonografi B-mode merupakan surrogate marker aterosklerosis dan penyakit kardiovaskular. Metode: Dilakukan penelitian potong lintang pada 86 subyek penderita AR yang memenuhi kriteria EULAR/ACR 2010 yang berobat di Poliklinik Reumatologi Penyakit Dalam FKUI/RSCM. Aterosklerosis didefinisikan jika ditemukan pada pemeriksaan ultrasonografi KIM ≥ 1,0 mm pada salah satu : a. karotis komunis, a. karotis interna atau bulbus karotis sisi kanan atau kiri. Plak aterosklerosis didefinisikan jika didapatkan abnormalitas pada tebal KIM, bentuk dan atau tekstur dinding arteri. Hasil: Aterosklerosis dan plak aterosklerosis masing-masing didapatkan pada 47 subyek (47,7%) dan 25 subyek (29,0%).Usia ≥ 40 tahun, adanya hipertensi, lama sakit ≥ 24 bulan pada analisis multivariat mempergunakan regresi logistik didapatkan berhubungan bermakna dengan aterosklerosis dengan RO (95%KI) masing-masing 10,70 (2,93-39,10), 4,99 (1,15-21,61) dan 3,66 (1,11-11,99). Adanya hipertensi, adanya anti-CCP dan usia ≥40 tahun berhubungan bermakna dengan plak aterosklerosis dengan RO (95%KI) masing-masing 3,96 (1,15-13,57), 3,20 (1,11-9,24) dan 3,61 (1,03-12,63). Kesimpulan: Proporsi aterosklerosis dan plak aterosklerosis masing-masing didapatkan 47,7 % dan 29 %. Usia ≥ 40 tahun, adanya hipertensi dan lama sakit ≥ 24 bulan berturut-urut merupakan prediktor adanya aterosklerosis sementara adanya hipertensi, antibodi anti-CCP dan usia ≥ 40 tahun merupakan prediktor adanya plak aterosklerosis. ......Background: Atherosclerosis and cardiovascular diseases have been known as the cause of increasing mortality among rheumatoid arthritis (RA) patients. Carotid intima media thickness (CIMT) measurement by B-mode ultrasound have been used as surrogate marker of atherosclerosis and cardiovascular disease. Method: A cross sectional study involving 86 RA patients fulfill EULAR/ACR 2010 critera was conducted at Rheumatology Clinic FMUI/Cipto Mangunkusumo Hospital. CIMT examinations were perform at right and left side of carotid artery. Atherosclerosis was define if we found CIMT ≥ 1,0 mm at one of CCA, or ICA or carotid sinus. Plaque atherosclerosis presence if 1 of the following 3 criteria were met: abnormal wall thickness, abnormal shape, and abnormal wall texture. Result: Atherosclerosis and plaque was found in 47,7% and 29 % of patients. Age ≥ 40 years old, hypertension and duration of illness ≥ 24 months were associated with atherosclerosis in multivariate logistic regression analysis with OR (95%CI) 10.70 (2.93-39.10), 4.99 (1.15-21.61) and 3.66 (1.11-11.99) respectively. Whereas hypertension, presence of anti-CCP antibody and age ≥ 40 years old, were associated with plaque formation with OR (95%CI) 3.96 (1.15-13.57), 3.20 (1.11-9.24) and 3.61 (1.03-12.63) respectively. Conclusion: Proportion of atherosclerosis and plaque atherosclerosis were 47.7% and 29%. Age ≥ 40 years old, hypertension and duration of illness ≥ 24 months was the predictors of atherosclerosis, while hypertension, presence of anti-CCP antibody and age ≥ 40 years old was the predictors of plaque atherosclerosis.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T58701
UI - Tesis Membership  Universitas Indonesia Library
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Jakarta: Pusat Penerbitan Departemen Ilmu Penyakit Dalam , 2006
616.33 UNI p
Buku Teks  Universitas Indonesia Library
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Mochamad Iqbal Hassarief Putra
Abstrak :
ABSTRAK
Latar Belakang: Infeksi kulit dan jaringan lunak (IKJL) oleh MRSA di ruang rawat inap merupakan masalah nosokomial yang meningkat prevalensinya setiap tahun. Hal tersebut akan meningkatkan angka mortalitas, biaya dan lama rawat bila tidak dikelola dengan baik. Faktor-faktor risiko terjadinya infeksi MRSA pada pasien IKJL di ruang rawat inap penting untuk diketahui agar dapat dilakukan upaya-upaya pencegahan dan pengendalian terhadap faktor-faktor risiko tersebut sehingga pada gilirannya diharapkan kejadian MRSA pada pasien IKJL dapat dicegah atau dikendalikan. Tujuan: Mengetahui proporsi IKJL oleh MRSA dan mempelajari faktor-faktor yang berhubungan dengan risiko terinfeksi MRSA pada penderita IKJL di ruang rawat inap Rumah Sakit Cipto Mangunkusumo (RSCM). Metode: Penelitian ini menggunakan studi kasus kontrol. Data dikumpulkan dari catatan rekam medis pasien rawat inap RSCM yang memiliki IKJL. Kelompok kasus adalah subjek dengan IKJL oleh MRSA, kelompok kontrol adalah subjek dengan IKJL oleh non-MRSA. Analisis bivariat dilakukan pada 9 variabel bebas yaitu pemakaian antibiotik sebelum kultur, infeksi HIV, IVDU, penggunaan kortikosteroid, prosedur medis invasif, DM, keganasan, riwayat hospitalisasi dan ruang rawat. Semua variabel yang mempunyai nilai p<0,25 pada analisis bivariat dimasukkan ke dalam analisis multivariat dengan regresi logistik. Hasil: Selama periode penelitian, proporsi MRSA pada pasien IKJL yang dilakukan kultur di ruang rawat inap adalah 47% (IK 95% 42%- 52%). Terdapat 171 pasien yang memenuhi kriteria, 71 pasien terinfeksi MRSA (kasus) dan 100 pasien terinfeksi non-MRSA (kontrol). Berdasarkan hasil analisis multivariat terdapat tiga variabel yang memiliki kemaknaan secara statistik, yaitu keganasan (OR 6,139; IK 95% antara 1,81-20,86; p=0,004), antibiotik quinolone (OR 4,592; IK 95% antara 2,06-10,23; p<0,001), dan prosedur medis invasif (OR 2,871; IK 95% antara 1,31-6,32; p=0,009).
ABSTRACT
Background: Patients with skin and soft tissue infections (SSTI) caused by MRSA in the inpatient ward are nosocomial problem which its prevalence has increased every year. It will increase the mortality rates, costs and lenghts of stay for patients if it’s not well-managed. It’s important to know exactly the risk factors for MRSA infection among patients with SSTI in inpatient ward in order to prevent and control the risk factors, that in turn, it is expected that the incidence of MRSA among patients with SSTI can be prevented or controlled. Aim: : To find out the proportion of MRSA-caused SSTI and studying the factors associated with the risk of MRSA infection on patients with SSTI in Rumah Sakit Cipto Mangunkusumo (RSCM) inpatient ward. Method: This research used case-control design. The data were collected from inpatient ward medical records who have SSTI. The case group are Subjects who have MRSA caused SSTI, the control group are Subjects who have non MRSA caused SSTI. Bivariate analysis was performed in 9 independent variables which were pre-cultured antibiotic use, HIV infection, IVDU, corticosteroid use, invasive medical procedure, diabetes melitus, malignancy, hospitalization history and wards. All of variables, in the bivariate analysis, produced the p value <0.25 were entered in the multivariate analysis with logistic regression. Result: During the study periode, the proportion of MRSA-caused SSTI which culture was performed in inpatient ward was 47% (95% CI 42%- 52%). There were 171 patients fulfilled the criteria which consist of 71 patients infected by MRSA (case group) and 100 patients infected by non-MRSA (control group). Based on the multivariate analysis, there were three variables statistically significance, which firstly was malignancy (OR 6.139; 95% CI 1,81-20,86; p=0.004), quinolone class of antibiotic (OR 4.592; 95% CI 2,06-10,23; p<0.001), and invasive medical procedure (OR 2.871; 95% CI 1,31-6,32; p=0.009).
Fakultas Kedokteran Universitas Indonesia, 2013
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UI - Tesis Membership  Universitas Indonesia Library
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Rabbinu Rangga Pribadi
Abstrak :
ABSTRAK
Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harus dievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA), namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukuran kekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudah dibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostik KGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapis malnutrisi pasien kanker rawat jalan di RSCM. Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun di poliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGT dianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai dengan menghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN. Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, dan malnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf dengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasien kanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT
Background: Malnutrition has a huge impact on cancer patients and therefore it has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming nature and the need of trained health personnels. Measurement of HGS is faster and easier, but there is no sufficient information regarding its cutoff point and diagnostic accuracy for cancer patients in Indonesia. Aim: defining cut-off point and diagnostic accuracy of HGS as a malnutrition screening modality for outpatient cancer population at RSCM. Method: A cross-sectional study was conducted at RSCM oncology outpatient clinic from May 4 th -October 1 st , 2015. Subjects were 18-59 years old. Cut-off point and diagnostic accuracy of HGS were analyzed to generate sensitivity, specificity, PPV, NPV, LR+, and LR- . Result: The proportion of well nourished, moderately malnourished, and severely malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV 92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a malnutrition screening modality in male and female cancer patients were good and moderately good. ;Background: Malnutrition has a huge impact on cancer patients and therefore it has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming nature and the need of trained health personnels. Measurement of HGS is faster and easier, but there is no sufficient information regarding its cutoff point and diagnostic accuracy for cancer patients in Indonesia. Aim: defining cut-off point and diagnostic accuracy of HGS as a malnutrition screening modality for outpatient cancer population at RSCM. Method: A cross-sectional study was conducted at RSCM oncology outpatient clinic from May 4 th -October 1 st , 2015. Subjects were 18-59 years old. Cut-off point and diagnostic accuracy of HGS were analyzed to generate sensitivity, specificity, PPV, NPV, LR+, and LR- . Result: The proportion of well nourished, moderately malnourished, and severely malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV 92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a malnutrition screening modality in male and female cancer patients were good and moderately good.
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Intan Suri Baginda
Abstrak :
ABSTRAK
Gastroesophageal reflux disease (GERD) merupakan suatu kondisi patologis yang disebabkan oleh refluks kandungan lambung ke dalam esofagus. GERD memiliki dampak yang besar terhadap penderitanya baik secara fisik, psikologik, sosial maupun ekonomi. Penurunan kualitas hidup dan produktifitas kerja sering ditemukan pada penderita GERD. Berbagai terapi farmakologis telah dikembangkan, namun belum memberikan hasil yang optimal. Hal tersebut mendorong pengembangan modalitas terapi lain, salah satunya akupunktur tanam benang. Penelitian ini bertujuan untuk mengetahui efektifitas terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap gejala dan kualitas hidup penderita GERD. Uji klinis acak tersamar ganda dengan pembanding dilakukan terhadap 52 penderita GERD yang dialokasikan secara acak ke dalam kelompok kombinasi akupunktur tanam benang dan medikamentosa (kelompok perlakuan) atau kelompok akupunktur sham dan medikamentosa (kelompok kontrol). Akupunktur tanam benang dilakukan pada titik CV12 Zhongwan, ST36 Zusanli dan BL21 Weishu sebanyak 2 kali dengan interval 15 hari. Skor GERDQ, RQS dan SF-36 digunakan untuk mengukur keluaran terapi. Hasil penelitian menunjukkan bahwa penurunan skor GERDQ pada kelompok perlakan lebih besar dari kelompok kontrol (p<0,001) dan peningkatan skor RQS serta peningkatan skor seluruh komponen SF-36 pada kelompok perlakuan lebih besar dibanding kelompok kontrol (p<0,001). Kesimpulan penelitian adalah terapi kombinasi akupunktur tanam benang dan medikamentosa lebih efektif dalam mengurangi gejala dan meningkatkan kualitas hidup penderita GERD dibandingkan dengan terapi medikamentosa saja ABSTRACT
Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.
Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tugas Akhir  Universitas Indonesia Library
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Dinas Yudha Kusuma
Abstrak :
ABSTRAK
Tujuan: mendapatkan kuesioner Minnesota Living with Heart Failure MLHFQ versi bahasa Indonesia yang sahih dan handal untuk digunakan di Indonesia. Metode: studi ini merupakan studi potong lintang dengan 85 subyek rerata usia 58 11, pria 55 pasien gagal jantung kronik di poli kardiologi Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta. Kesahihan diuji dengan menilai kesahihan konstuksi multitrait multimethod analysis dan kesahian eksternal dengan membandingkan dengan kuesioner SF-36. Keandalan dinilai dengan menggunakan cronbach ?, dan intraclass coefficient correlation ICC . Hasil: MLHFQ bahasa Indonesia memiliki korelasi sedang-kuat antara domain dan item pertanyaan r 0,571-0,748, ABSTRACT
Aim to obtain a valid and reliable Indonesian version of MLHFQ for Indonesian application. Methods This cross sectional study enroled 85 patients mean age 58 11, male 55 with chronic heart failure of of cardiology clinic Ciptomangunkusumo Central Hospital Jakarta. Validity of MLHFQ was evaluated by measuring construct validity using multitrait multimethod analysis and by compairing MLHFQ with SF 36. Reliability of MLHFQ was evaluated by calculating Intraclass Correlation Coefficient ICC and by calculating cronbach to determine internal consistency Results Indonesian version of MLHFQ has moderated strong correlation item to domain correlation r 0,571 0,748, p
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Farah Diba Harhara
Abstrak :
Latar Belakang. Peningktan prevalensi kanker kolon proksimal menjadi perhatian di beberapa dekade terakhir. Fenomena yang sering disebut “ Right Shifting ” ini mulai muncul dibanyak negara maju. Telah diketahui pula terdapat perbedaan di tingkat molekular antara kanker kolon proksimal dan kanker kolorektal distal yang membuat para ahli menganggap dua penyakit ini merupakan dua entitas penyakit yang berbeda. perbedaan ini memunculkan perbedaan karakteristik antara keduanya. Maka timbul pertanyaan apakah terdapat perbedaan faktor-faktor yang berhubungan dengan kanker kolorektal pada umumnya mulai dari faktor genetik maupun lingkungan. Tujuan. Mengetahui hubungan usia, jenis kelamin indeks massa tubuh, riwayat keluarga kebiasan merokok, konsumsi alkohol, gejala klinis dan jenis diferensiasi lesi terhadap kejadian kanker kolon proksimal. Metode. Desain potong lintang. Menggunakan data sekunder dari registri Pusat Endoskopi Saluran Cerna dan unit rekam medis Rumah Sakit Cipto Mangunkusumo yang melibatkan 261 subjek kanker kolorektal yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pencatatan data usia, jenis kelamin, indeks massa tubuh, riwayat keluarga, konsumsi rokok, alkohol, jenis diferensiasi lesi dan manifestasi klinis. Analisis bivariat dan multivariat dilakukan pada faktor – faktor tersebut. Hasil. Didapatkan proporsi kanker kolon proksimal dan kanker kolorektal distal berturut – turut adalah 39% dan 61%. Sebagian besar subjek adalah laki-laki dengan proporsi 55,9% dengan rerata usia 51,9 (SB 13,2). Tidak didapatkan hubungan antara usia tua, jenis kelamin wanita, riwayat keluarga, indeks massa tubuh yang tinggi, konsumsi rokok, alkohol dan lesi diferensiasi buruk dengan kanker kolon proksimal. Terdapat hubungan bermakna antara anemia (OR 1,903; 95% IK 1,15 – 3,15; P = 0,012), penurunan berat badan (OR 2,04; 95% IK 1,23 – 3,38; P = 0,001), nyeri perut (OR 8,55; 95% IK 4,08 – 17,89; P = <0,001), massa abdomen (OR 8,85; 95% IK 4,54 – 12,21 ; P = <0,001), dan gejala kluster proksimal (OR 2,37; 95% IK 1,43 – 3,95; P = <0,001) dengan kanker kolon proksimal. Analisis multivariat didapatkan hubungan antara gejala kelompok kluster proksimal (AUC 0,829; 95% IK; 0,781 – 0,876) dan gejala individual seperti nyeri perut, massa abdomen, hematoskezia, diare, tenesmus (AUC 0,907; 95% IK 0,867 – 0,946) dengan kanker kolon proksimal. Kesimpulan. Beberapa gejala klinis (gejala indivisual maupun gejala kelompok) berhubungan dengan kanker kolon proksimal. Gejala kluster proksimal dan gejala individu seperti nyeri perut dan massa abdominal berhubungan dengan kanker kolon proksimal. ......Background. Increasing the prevalence of proximal colon cancer has been a concern in the past few decades. This phenomenon which is often called "Right Shifting" is starting to emerge in many developed countries. It is also known that there are differences in the molecular level between proximal colon cancer and distal colorectal cancer which makes experts consider these two diseases to be two different disease entities. this difference raises characteristic differences between the two. So the question arises whether there are differences in factors associated with colorectal cancer in general, starting from genetic and environmental factors. Objective. Knowing the association between age, sex, body mass index, family history, smoking habits, alcohol consumption, clinical symptoms, and types of lesion differentiation in proximal colon cancer. Methods. Cross-sectional design. Using secondary data from the Central Gastrointestinal Endoscopy Center and the Cipto Mangunkusumo Hospital medical record unit involving 261 colorectal cancer subjects who met the inclusion and exclusion criteria. Data on age, sex, body mass index, family history, cigarette consumption, alcohol consumption, type of lesion differentiation and clinical manifestations were recorded. Bivariate and multivariate analyzes were carried out on these factors. Results. The proportion of proximal colon cancer and distal colorectal cancer was 39% and 61%, respectively. Most subjects were men with a proportion of 55.9% with an average age of 51.9 (SB 13.2). There was no association between old age, female gender, family history, high body mass index, cigarette consumption, alcohol, and poorly differentiated lesions with proximal colon cancer. There was a significant association between anemia (OR 1.903; 95% CI 1,15 – 3,15; P = 0,012), weight loss (OR 2.04; 95% CI 1.23 – 3.38; P = 0,001), abdominal pain (OR 8.55; 95% CI 4.08 – 17.89; P = <0,001), abdominal mass (OR 8.85; 95% CI 4.54 – 12.21 ; P = <0,001 ), and proximal cluster symptoms (OR 2.37; 95% CI 1.43 – 3.95; P = <0,001) with proximal colon cancer. Multivariate analysis found an association between symptoms of the proximal cluster group (AUC 0.829; 95% IK; 0.781 - 0.876) and individual symptoms such as abdominal pain, abdominal mass, hematochezia, diarrhea, tenesmus (AUC 0.907; 95% IK 0.867 - 0.946) and colon cancer proximal. Conclusions. Some clinical symptoms (individual symptoms and group symptoms) are associated with proximal colon cancer. Proximal cluster symptoms and individual symptoms such as abdominal pain and abdominal mass are associated with proximal colon cancer.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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Dian Azzahra
Abstrak :
Latar Belakang. Prevalensi gangguan kognitif pada pasien artritis reumatoid (AR) berpotensi menurunkan kapasitas fungsional, kualitas hidup, dan kepatuhan berobat. Tujuan dari penelitian ini adalah untuk mengetahui prevalensi gangguan kognitif pada pasien AR di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (RSCM) dan faktor-faktor yang memengaruhinya. Metode. Penelitian dengan desain potong-lintang ini mengikutsertakan pasien AR berusia ≥18 tahun yang berobat di Poliklinik Reumatologi RSCM pada periode Oktober-Desember 2021. Data demografik, klinis, terapi, dan laboratorium dikumpulkan. Status fungsi kognitif dinilai dengan kuesioner MoCA-INA. Analisis bivariat dan multivariat regresi logistik dilakukan untuk mengidentifikasi faktor prediktif terjadinya gangguan kognitif pada pasien AR: usia, jenis kelamin, tingkat pendidikan, durasi penyakit, aktivitas penyakit, skor faktor risiko penyakit kardiovaskular, depresi, terapi kortikosteroid, dan methotrexate. Hasil. Dari total 141 subjek yang dianalisis, 91,5% adalah perempuan, dengan rerata usia 49,89±11,73 tahun, sebagian besar tingkat pendidikan menengah (47,5%), median durasi penyakit 3 tahun (0,17-34 tahun), memiliki aktivitas penyakit ringan (median DAS-28 LED 3,16 (0,80-6,32)), dan skor faktor risiko penyakit kardiovaskular rendah (median 4,5% (0,2-30 %)). Sebanyak 50,4% subjek diklasifikasikan mengalami gangguan kognitif, dengan domain kognitif yang terganggu adalah visuospasial/eksekutif, atensi, memori, abstraksi, dan bahasa. Analisis regresi logistik menunjukkan usia tua (OR 1,032 [IK95% 1,001–1,064]; p=0,046) dan tingkat pendidikan rendah (pendidikan dasar) (OR 2,660 [IK95% 1,008–7,016]; p=0,048) berhubungan dengan gangguan kognitif pada pasien AR. Kesimpulan. Prevalensi gangguan kognitif pada pasien AR di RSCM sebesar 50,4%, dengan faktor prediktif terjadinya gangguan kognitif tersebut adalah usia tua dan tingkat pendidikan yang rendah. ......Background. Cognitive impairment in rheumatoid arthritis (RA) patients could decrease functional capacity, quality of life, and medication adherence. The objective of this study was to explore the prevalence and possible predictors of cognitive impairment in RA patients in Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. Method. This cross-sectional study included Indonesian RA patients aged ≥18 years old, who visited rheumatology clinic at Dr. Cipto Mangunkusumo Hospital, on October to December 2021. Demographic, clinical, therapeutic, and laboratory data were collected. Cognitive function was assessed using MoCA-INA questionnaire. Bivariate and multivariate logistic regression analysis were performed to identify predictive factors of cognitive impairment in RA patients: age, gender, education level, disease duration, disease activity, cardiovascular disease (CVD) risk factor scores, depression, corticosteroid, and methotrexate therapy. Results. Of the total 141 subjects analysed, 91.5% were women, mean age 49.89±11.73 years old, mostly had intermediate education level (47.5%), median disease duration 3 (0.17-34) years. They had mild disease activity (median DAS-28 ESR 3.16 (0.80-6.32)), and low CVD risk factor score (median 4.5 (0.2-30) %). In this study, 50.4% of the subjects were classified as having cognitive impairment. The cognitive domains impaired were visuospatial/executive, attention, memory, abstraction, and language. In logistic regression analysis, old age (OR 1.032 [95%CI 1.001–1.064]; p=0.046) and low education level (OR 2.660 [95%CI 1.008–7.016]; p=0.048) were associated with cognitive impairment. Conclusion. The prevalence of cognitive impairment in RA patients in Dr. Cipto Mangunkusumo Hospital was 50.4%, with the its predictive factors were older age and lower education level.
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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