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"ABSTRAKLatar Belakang. Kejadian aterosklerosis, dilaporkan lebih sering pada pasien lupus eritematosus sitemik (LES) dibandingkan individu tanpa LES, salah satunya adalah penyakit arteri perifer (PAP). Klorokuin diduga memiliki efek protektif terhadap kejadian PAP melalui penekanan kadar sitokin proinflamasi dan efek menurunkan kadar kolesterol, namun beberapa penelitian lain menunjukkan bahwa klorokuin meningkatkan kadar sitokin proinflamasi. Hingga saat ini, penelitian mengenai pengaruh klorokuin belum pernah dilakukan pada populasi pasien LES di Indonesia.Tujuan Penelitian. Mengetahui pengaruh klorokuin terhadap kejadian PAP pada pasien LES wanita berusia 40 tahun ke bawah.Metode Penelitian. Studi kasus kontrol dilakukan terhadap pasien LES wanita berusia 40 tahun ke bawah di RS Cipto Mangunkusumo selama Juni-Agustus 2012 yang tidak menderita diabetes melitus ataupun hipertensi sebelum diagnosis LES ditegakkan. Pasien dengan penyakit autoimun selain LES dan gagal ginjal kronik dieksklusi dari penelitian. Pengaruh klorokuin terhadap PAP pada pasien LES dinyatakan dalam odds ratio (OR). Peran variabel perancu dinilai pada analisis regresi logistik berjenjang sehingga didapatkan adjusted OR.Hasil Penelitian. Dari 18 subjek yang menderita PAP (kelompok kasus), sebanyak 8 (44,4 %) menggunakan klorokuin dan dari 72 subjek yang tidak menderita PAP (kelompok kontrol), 20 (27,8 %) di antaranya menggunakan klorokuin. Setelah dilakukan adjustment terhadap variabel perancu (usia, lama menderita sakit, dislipidemia, dan aktivitas penyakit), tidak didapatkan hubungan yang bermakna antara penggunaaan klorokuin dengan kejadian PAP pada pasien LES wanita berusia di bawah 40 tahun (adjusted OR 2,44; IK95 % 0,76 sampai 7,87).Simpulan. Pengaruh klorokuin terhadap kejadian PAP pada pasien LES wanita berusia 40 tahun ke bawah belum dapat disimpulkan pada penelitian ini.

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ABSTRACTBackground. Atherosclerosis is enhanced in systemic lupus erythematosus (SLE) compared to general population, one of which is peripheral arterial disease (PAD). Chloroquine has protective effects in peripheral arterial disease through the suppression of proinflamatory cytokine levels and lipid lowering effect, although other studies have shown the increasing of cytokine levels by chloroquine. To date, no studies have ever been performed to investigate the effect of chloroquine on peripheral arterial disease in Indonesian lupus patients.Aims. To investigate the effects of chloroquine on peripheral arterial disease in patients with systemic lupus erythematosus aged forty-year-old and below.Methods. A case control study including female lupus patients aged forty year-old and younger in Cipto Mangunkusumo Hospital between June-August 2012, who do not suffer from diabetes mellitus and/or hypertension before the diagnosis of lupus is confirmed. Patients with other autoimmune disease than lupus and/or with chronic kidney disease were excluded from the study. Effect of chloroquine on peripheral arterial disease in lupus patients is expressed in odds ratio (OR). The role of confounding factors analyzed with multiple logistic regression to estimate the adjusted OR.Results. Eight (44.4 %) of the total 18 subjects contracting PAD (case group) and 20 (27.8 %) of the total 72 subjects without PAD (control group) were using chloroquine. After adjustments towards confounding factors (age, disease duration, dyslipidemia, and disease activity) were completed, the results showed there was no considerable relation between the use of chloroquine and PAD case in female SLE patients aged below forty-year-old (adjusted OR 2.44; 95 % CI 0.76 to 7.87).Conclusion. The effect of chloroquine usage on PAD case in female SLE patients aged forty-year-old and below can not be concluded from this study."

"ABSTRAKLatar belakang. Penyakit arteri perifer (PAP) merupakan komplikasi lanjut yang mempengaruhi mortalitas dan morbiditas pasien lupus eritematosus sistemik (LES) namun diluar negeri belum banyak penelitian yang mempelajari hubungan lama sakit dengan kejadian PAP pada pasien LES dan belum pernah dilakukan di Indonesia. Tujuan. Mengetahui peningkatan kejadian penyakit arteri perifer pada pasien LES wanita dewasa muda dengan lama sakit 5 tahun atau lebih dibandingkan kurang dari 5 tahun. Metode. Studi kasus kontrol yang dilakukan selama periode Juni-Agustus 2012 di RSUPN Cipto-Mangunkusumo, Jakarta. Subjek penelitian adalah pasien LES wanita berusia 40 tahun atau kurang yang mengunjungi poliklinik rematologi dan alergi-imunologi. Subjek dibagi dalam dua kelompok, kasus dan kontrol kemudian dilakukan penelusuran secara retrospektif melalui wawancara dan data rekam medis. Hubungan lama sakit dan kejadian PAP pada pasien LES dinyatakan dalam odds ratio (OR) dan peran variabel perancu di analisis dengan regresi logistik berjenjang sehingga didapatkan fully adjusted OR. Hasil. Sebanyak 90 subjek direkrut, 18 subjek termasuk dalam kelompok kasus dan 72 subjek dalam kelompok kontrol. Karakteristik faktor risiko tradisional tidak jauh berbeda diantara dua kelompok. Pada analisis multivariat didapatkan fully adjusted OR hubungan lama sakit 5 tahun atau lebih dengan kejadian PAP 1,9 (IK 95% 0,575-6,543). Peningkatan usia dan lama mendapatkan terapi steroid merupakan faktor perancu. Simpulan. Terdapat peningkatan kejadian penyakit arteri perifer pada pasien LES wanita yang berusia 40 tahun atau kurang dengan lama sakit lima tahun atau lebih dibandingkan lama sakit kurang dari lima tahun, namun peningkatan risiko ini tidak bermakna secara statistik.

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ABSTRACTBackground. Peripheral arterial disease is a chronic complication that affect morbidity and mortality in SLE patient, however researches studying the relationship of disease duration and peripheral arterial disease event is only a few in overseas and never been studied in Indonesia. Objectives. To obtain information about the increased event of peripheral arterial disease on young woman with SLE with disease duration five years or longer compared with less than five years. Methods. This was a case control study conducted between June-August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subject were SLE women aged 40 years or younger who visited Rheumatolgy and Allergy-Immunlogy outpatients clinics. Subjects were assigned to case and control group and were trace retrospectively by interview and medical record. The relationship between disease duration and peripheral arterial disease was stated using OR and the role of confouding factors was analyse using logistic regression one by one, result in fully adjusted OR. Results. A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group. Traditional risk factor were similiar in both group. In multivariat analysis, there is a relation between disease duration 5 years or longer with peripheral arterial disease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy is the confounding factors. Conclusion. There is an increase event of peripheral arterial disease in SLE woman aged 40 or younger with disease duration five years or longer compared with less than five years, but this increasing was not statistically significant. "

"[LATAR BELAKANGPenyebab terbanyak Penyakit Arteri Perifer (PAP) pada usia diatas 40 tahun adalah aterosklerosis. Prevalensi penyakit aterosklerosis perifer meningkat pada kasus dengan diabetes melitus, dislipidemia, hipertensi dan perokok. Critical Limb Ischemia (CLI) merupakan manifestasi dari PAP berat, CLI dikaitkan dengan risiko kehilangan tungkai yang sangat tinggi. Pada pasien CLI tanpa adanya revaskularisasi, pasien biasanya akan dilakukan amputasi dalam hitungan minggu atau bulan. Revaskularisasi secara terbuka memiliki morbiditas yang cukup banyak. Seiring kemajuan teknologi, revaskularisasi secara terbuka perlahan-lahan digantikan dengan adanya intervensi endovaskuler dalam dua dekade terakhir. Revaskularisasi endovaskuler di Departemen Ilmu Bedah RSCM baru mulai dilakukan pada tahun 2012 dan di Indonesia saat ini belum ada studi yang menilai hasil dari tindakan revaskularisasi.METODEMetode yang diambil adalah analitik komparatif berpasangan dengan disain penelitian longitudinal pre-post study. Selama Agustus 2013 hingga Agustus 2014 didapatkan 16 pasien yang masuk kriteria inklusi. Dilakukan pengambilan data nilai ABI sebelum dan sesudah revaskularisasi endovaskuler. ABI digunakan sebagai penilaian efektivitas revaskularisasi.HASILHasil didapatkan nilai mean ABI sebelum tindakan 0,7±0,118 dan nilai mean ABI sesudah tindakan 0,844±0,127. Didapatkan peningkatan nilai ABI sesudah tindakan 0,14. Dari hasil uji T berpasangan didapatkan nilai p=0,001. Secara statististik didapatkan peningkatan yang signifikan antara nilai ABI sebelum tindakan dan sesudah tindakan.KESIMPULANDapat ditarik kesimpulan tindakan revaskularisasi endovaskuler terhadap pasien PAP efektif berdasarkan nilai ABI;BACKGROUNDPeripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.METHODSResearch method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.RESULTSResults are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.CONCLUSIONEndovascular revascularization in PAD patients effective base on ABI, BACKGROUNDPeripheral Arterial Disease (PAD) above 40 years old mostly cause by atherosclerotic. Peripheral Atherosclerotic prevalence increase with DM, dyslipidemia, hypertension and smoking. CLI had higher amputation risk. Without revascularization CLI patients will do amputation within week or month. Surgical revascularizaton had many morbidity, endovascular revascularization established within 2 decade. Endovascular revascularization in RSCM surgery department established at 2012 and in Indonesia no research to evaluate revascularization effectiveness.METHODSResearch method is dependent category comparative analytic with longitudinal pre-post study. Within August 2013 to August 2014, we collect 16 patients that rolled on inclusion criteria. We collect ABI results before endovascular revascularization and ABI results after endovascular revascularization. ABI were used to evaluated revascularization effectiveness.RESULTSResults are ABI mean before endovascular revascularization 0,7±0,118 and ABI mean after endovascular revascularization 0,844±0,127. There were ABI increased after endovascular revascularization mean 0.14. Statistic analysis with pairing T-test result p=0.001. Based on statistic analysis there were significant increase between ABI before endovascular revascularization and ABI after endovascular revascularization.CONCLUSIONEndovascular revascularization in PAD patients effective base on ABI]"

"ABSTRAK Kondisi pasien diabetes mellitus DM tipe 2 dengan peripheral arterial disease PAD yang tidak ditangani dengan tepat dapat memicu terjadinya neuropati, ulkus pedis diabetik, bahkan amputasi. Intervensi latihan ankle range of motion ROM dipercaya dapat mengurangi gejala dan mencegah progresifitas PAD pada pasien DM tipe 2. Namun pada praktiknya, intervensi ini masih jarang dilakukan. Studi kasus dalam Karya Ilmiah Akhir Ners KIAN ini bertujuan untuk mengidentifikasi pengaruh pemberian intervensi ankle ROM pada pasien DM tipe 2 dengan komplikasi PAD. Hasil analisis menunjukkan bahwa terdapat pengurangan gejala PAD dan peningkatan aliran darah ekstremitas yang ditandai dengan peningkatan saturasi oksigen, kekuatan pulsasi, dan penurunan skala nyeri. Edukasi dan pendampingan latihan ankle ROM pada pasien DM tipe 2 dengan PAD diperlukan agar perfusi jaringan perifer pasien dapat tercapai dengan optimal.

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ABSTRACT The conditions of type 2 diabetes mellitus T2DM patient with peripheral arterial disease PAD that is not handled properly can lead to neuropathy, diabetic pedis ulcer, even amputation. Intervention of ankle range of motion ROM exercise is believed to reduce symptoms and prevent the PAD progression. However, in clinical practice, this intervention still rarely done. Therefore, this case report aims to identify the impact of ankle ROM in T2DM patients with PAD complications. The results showed that there was a reduction in PAD symptoms and an increase in limb blood flow characterized by increased oxygen saturation, pulsation, and decreased pain scale. In brief, education and advisory of ankle ROM in T2DM patient with PAD is required to optimize the peripheral perfusion."