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"Latar belakang: Ulkus Kaki diabetik atau Diabetic Foot Ulcer merupakan salah satu komplikasi yang berat, karena sering kali ulkus kaki diabetik berakhir dengan amputasi kecacatan dan kematian. USG Doppler merupakan modalitas yang mudah tersedia dan non invasif untuk evaluasi arteri ekstremitas inferior dan dapat mendeteksi tingkat keparahan gangguan aliran darah atau Penyakit Arteri Perifer (PAP) dengan sensitivitas 42,8% dan spesifisitas 97,5%. WHO merekomendasikan klasifikasi Perfusion, Extent/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) sebagai sarana penegakan diagnosis dan membantu menentukan tatalaksana kaki diabetik. Penelitian ini dilakukan untuk melihat korelasi skor PEDIS dalam menilai gangguan aliran arteri tungkai berdasarkan spektral USG Doppler pada penderita ulkus kaki diabetik di RS Cipto Mangunkusumo Jakarta. Subjek dan Metode: Subjek penelitian adalah pasien ulkus kaki diabetes yang dirawat di Divisi Bedah Vaskular dan Endovaskular FKUI-RS Cipto Mangunkusumo Jakarta dan memenuhi kriteria inklusi dan eksklusi. Penelitian ini dilakukan dengan perhitungan menggunakan sensitivitas estimasi sebesar 80%, error absolut (d=5%), prevalensi estimasi 51,8% maka besar sampel minimal adalah 76. Setelah itu diperoleh data berupa skor PEDIS dan hasil spektral USG pada arteri femoralis, arteri poplitea, arteri dorsalis pedis dan arteri tibialis posterior. Penelitian ini mengumpulkan 81 orang subjek dengan 52 orang (64%) jenis kelamin laki-laki, 29 orang (36%) perempuan dan rata-rata usia 59,8+10,5 tahun. Profil gula darah sewaktu subjek median 265 mg/dl dengan kisaran antara 105-571 mg/dl. Pada tabel 3 dalam menentukan Cut Off skor PEDIS menggunakan kurva ROC (Receiver Operating Characteristic), didapatkan Cut Off arteri poplitea >10, sedangkan arteri dorsalis pedis dan arteri tibialis posterior >8.

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Main topics: Diabetic Foot Ulcer or Diabetic Foot Ulcer is one form that is severe, because often diabetic foot ulcers end with disability amputation and death. Doppler ultrasound is an easily available and unlimited modality for lower limb risk and can detect the severity of arterial disease or peripheral arterial sensitivity (PAP) with a sensitivity of 42.8% and specificity of 97.5%. WHO that performs Data Perfusion, Area/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) as a means of enforcing the diagnosis and helps determine the management of diabetic foot. This study was conducted to look at the PEDIS score in assessing the disturbance of limb arterial flow based on Doppler ultrasound in patients with diabetic foot ulcer at Cipto Mangunkusumo Hospital, Jakarta. Subjects were patients with diabetic foot ulcers performed in the Division of Vascular and Endovascular Surgery of the Faculty of Medicine-Cipto Mangunkusumo Hospital Jakarta and fulfilled the inclusion and exclusion criteria. This research was conducted by calculating using an estimation sensitivity of 80%, absolute error (d = 5%), the largest prevalence of 51.8%, then the minimum sample size was 76. After that data was obtained in the form of PEDIS scores and spectral results of ultrasound in the femoral artery, arteries poplitea, dorsalis pedis artery and posterior tibial artery. This study collected 81 subjects with 52 people (64%) male gender, 29 people (36%) women and an average of 59.8 + 10.5 years. The blood sugar profile was median 265 mg/dl with a range of 105-571 mg/dl. In table 3 in determining the PEDIS score Cut-Off using the Receiver Operating Characteristic curve, obtained Cut-ff popliteal artery> 10, while the dorsalis pedis artery and posterior tibial artery> 8."

"Latar belakang: Pasien dengan tumor muskuloskeletal (MSK) ganas menunjukkan insidens deep vein thrombosis (DVT) bervariasi. USG Doppler berwarna merupakan modalitas terpilih untuk evaluasi DVT. Tujuan: Menilai hubungan trombus, kecepatan aliran, dan ketebalan dinding vena pada USG Doppler berwarna vena profunda ekstremitas bawah pada pasien dengan tumor primer MSK ganas. Metode: Penelitian ini menggunakan data primer dari pemeriksaan USG Doppler berwarna vena profunda ekstremitas bawah, yaitu trombus, ketebalan dinding vena, dan kecepatan aliran vena, serta data sekunder, yaitu ukuran tumor dari magnetic resonance imaging (MRI) atau computed tomography >(CT) scan dan durasi gejala tumor dari rekam medis. Penelitian dilakukan di Departemen Radiologi dan Poliklinik Orthopaedi dan Traumatologi Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPNCM) bulan Agustus 2020 hingga Maret 2022. Hasil: Terdapat 10% insidens trombus pada sistem vena profunda ekstremitas bawah pada 30 subyek dengan tumor primer MSK ganas. Subyek dengan trombus cenderung memiliki volume tumor lebih besar dibandingkan tanpa trombus, namun secara statistik tidak bermakna. Kesimpulan: Dimensi dan volume tumor pada subyek dengan trombus cenderung lebih besar dibandingkan tanpa trombus. Pada penderita tumor MSK ganas, dapat ditemukan gambaran klinis dan laboratoris yang menyerupai DVT namun belum tentu didapatkan trombus, sehingga USG Doppler berwarna penting untuk membedakan ada tidaknya DVT.

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Background: Patients with malignant musculoskeletal (MSK) tumors show variable incidence of deep vein thrombosis (DVT). Color Doppler ultrasound (CDUS) is the modality of choice for DVT evaluation.

Objective: To assess the relationship of thrombus, flow velocity, and venous wall thickness on CDUS of lower extremities deep veins in patients with primary malignant MSK tumors.

Methods: Primary data from CDUS of lower extremities deep vein, including thrombus, venous wall thickness, and venous flow velocity. Tumor size was taken from magnetic resonance imaging (MRI) or computed tomography (CT) scans. Duration of tumor symptoms was taken from medical records. The study was conducted at the Department of Radiology and the Orthopaedi and Traumatology Polyclinic of the Cipto Mangunkusumo National General Hospital (RSUPNCM) from August 2020 to March 2022.

Results: There was 10% incidence of thrombus in 30 subjects. Subjects with thrombus tended to have larger tumor volume but it was not statistically significant.

Conclusion: Tumor dimensions and volume in subjects with thrombus tend to be larger than those without thrombus. In patients with malignant MSK tumors, clinical and laboratory features that resemble DVT can be found, but not necessarily a thrombus, therefore CDUS is important for distinguishing the presence or absence of DVT."

"[Penyakit Arteri Perifer (PAP) merupakan sumbatan aliran darah arteri selain koroner dan intrakranial. PAP dihasilkan dari proses atherosklerosis, emboli, trombus, dan inflamasi yang mengarah ke stenosis arteri. PAP asimptomatik menempati 3-10% populasi dunia, dan meningkat hingga 15-20% pada 70 tahun ke atas. Divisi kami mencatat 18,1-24,7% pasien kaki diabetik dengan PAP mengalami amputasi pada kurun waktu 3 tahun terakhir. Evaluasi ultrasonografi Doppler pada arteri utama ekstremitas bawah diharapkan mampu mendeteksi secara dini apakah pasien akan diamputasi atau tidak baik mayor maupun minor. Metode yang diambil adalah analitik komparatif kategorik independen dengan disain penelitian kohort retrospektif. Selama Januari 2010 hingga Desember 2011 didapatkan 24 pasien yang masuk kriteria inklusi. Arteri yang diperiksa a.femoralis, a.poplitea, a.tibialis posterior, dan a.dorsalis pedis dengan tampilan spektral mulai dari monofasik, bifasik, atau trifasik terutama dengan pelebaran spektral. Ultrasonografi salah satu modalitas ?operator dependent?, untuk mengurangi bias, peneliti menggunakan operator ultrasonografi adalah peneliti sendiri, trainee atau konsultan divisi kami. Hasil didapatkan spektral bifasik hingga monofasik pada a.femoralis 25,0%, a.poplitea 58,3%, a.tibialis posterior 41,6%, a.dorsalis pedis 45,8%, angka amputasi mayor dan minor masing-masing 4%. Perhitungan statistik didapatkan untuk a.femoralis p=0,054 (95% CI), a.poplitea p=0,006 (95% CI), a.tibialis posterior p=0,010 (95% CI), dan a.dorsalis pedis p=0,021 (95% CI). Secara statistik, prediksi amputasi dapat bermakna pada ultrasonografi Doppler pada a.poplitea, a.tibialis posterior, dan a.dorsalis pedis. Dapat ditarik kesimpulan pemeriksaan ultrasonografi Doppler penting dilakukan pada setiap pasien PAP untuk mengevaluasi secara khusus keadaan empat arteri utama ekstremitas bawah pasien dan untuk prediktor amputasi

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Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.;BACKGROUND Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation. METHODS Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division. RESULTS Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI). CONCLUSION Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss., BACKGROUND

Peripheral Arterial Disease (PAD) is an occlusive disease of the blood flow artery beside coronary and intracranial artery. PAD is a result of atherosclerotic process, embolism, thrombus, and inflammation which toward of artery stenosis. Asymptomatic PAD counts 3-10% of worl population, and increasing until 15-20% in patient more than 70 years old. Our division counts 18.1-24.7% of diabetic foot patient with PAD undergoes amputation within this three years. Evaluation of duplex ultrasound in the main artery of lower extremity hopefully can detect whether patient will undergo limb salvage or limb loss, as early as possible, major or minor amputation.

METHODS

Research method is independent category comparative analytic with retrospective cohort design. Within January 2010 to December 2011, we collect 24 patients that rolled on inclusion criteria. We examined femoral, poplitea, posterior tibial, and dorsalis pedis artery, which showed monophasic, biphasic, and triphasic spectrum of duplex imaging of the ultrasound, and all of them has broadening spectrum.Ultrasound is an operator dependent modality, to decrease the bias of this research, operator of the ultrasound is researcher, fellowship doctors and consultants of our division.

RESULTS

Results are 25% in femoral artery, 58.3% in popliteal artery, 41.6% in posterior tibial artery, and 45.8% in dorsalis pedis artery, which counts for biphasic and monophasic spectrum. Amputation rate is 4% for each minor and major amputation. Statistic analysis for correlation of arterial spectrum with amputation are, femoral artery p=0,054 (95% CI), popliteal artery p=0,006 (95% CI), posterior tibial artery p=0,010 (95% CI), and dorsalis pedis artery p=0,021 (95% CI).

CONCLUSION

Based on statistic analysis, amputation can be significant in duplex imaging of popliteal, posterior tibial, and dorsalis pedis artery. Conslusion regards duplex imaging to be performed in four main arteries of lower extremity, to predict limb loss.]"

"ABSTRAKLatar belakang. Diabetes mellitus DM merupakan salah satu penyakit kronis yang komplikasinya masih menjadi masalah besar di Indonesia. Salah satu komplikasi DM yang paling sering dan sering berakhir dengan kecacatan adalah kaki diabetik. Angka amputasi di Indonesia khususnya di RSUPN dr. Cipto Mangunkusumo RSCM masih cukup tinggi dibandingkan dengan negara lain di Asia. Salah satu faktor predisposisi amputasi kaki diabetik adalah perfusi jaringan yang dapat diukur dengan ankle brachial index ABI . Studi sebelumnya menunjukkan hubungan signifikan antara ABI dengan kejadian amputasi. Penelitian ini bertujuan untuk mengetahui hubungan nilai ABI dengan besarnya risiko terjadinya amputasi minor dan mayor pada penderita kaki diabetic dalam populasi kami.Metode. Kami melakukan studi retrospektif pada 84 subjek dengan kaki diabetik yang diamputasi di RSCM selama periode 1 Januari 2013 sampai dengan 31 Desember 2014. Karakteristik subjek dan vaskular termasuk diantaranya ABI dianalisa secara statistik.Hasil. Kami dapatkan sepsis dengan adjusted OR 95 CI : 0,023 0,004 sampai 0,157 dan nilai ABI yang memiliki adjusted OR 95 CI : 2,89 1,33 sampai 6,29 merupakan variabel yang bermakna dengan kejadian amputasi pada pasien kaki diabetik.Kesimpulan. Subjek dengan nilai ABI 1,3 secara independen.

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AbstractBackgroundhr>ABSTRACT. Diabetes mellitus is one of the chronic diseases in which the complication is still a major problem in Indonesia. One of the most frequent complications of diabetes mellitus and often ends up with a disability is diabetic foot. The number of amputation in Indonesia, especially in dr. Cipto Mangunkusumo Hospital RSCM is quite high compared to other countries in Asia. One of predisposing factors of diabetic foot amputation is the tissue perfusion that can be measured by the ankle brachial index ABI . All the studies carried out abroad and in RSCM show a significant relationship between ABI and the incidence of amputation. This study aims to determine the relationship of ABI score with the magnitude of minor and major amputation risks in patients with diabetic foot.Method. The retrospective study was conducted in 84 patients with diabetic foot that were amputated at the RSCM during the period of January 1, 2013 to December 31, 2014. Samples were taken consecutively. Statistical analysis is done to find out a relationship between predisposing factors with the incidence of minor and major amputations in patients with diabetic foot. Chi Square test or Fisher, as well as multivariate analysis using logistic regression is used. The significance if p was "

"ABSTRAKUlkus kaki diabetikum merupakan salah satu komplikasi kronis Diabetes Melitus yang biasanya muncul 10 tahun setelah onset Diabetes Melitus. Ulkus kaki diabetikum dapat menimbulkan sensasi nyeri dan ketidaknyamanan yang dapat mempengaruhi kualitas tidur pasien. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara tingkat keparahan ulkus dengan kualitas tidur pada pasien ulkus kaki diabetikum di Rumah Perawatan Luka RUMAT Wilayah Bekasi dan Jakarta. Desain penelitian ini menggunakan analisis kuantitatif dengan pendekatan potong lintang Cross-Sectional . Sebanyak 73 pasien ulkus kaki diabetikum dilibatkan dan diwawancarai melalui teknik purposed random sampling. Kuesioner yang digunakan adalah PSQI Pittsburgh Sleep Quality Index untuk menilai kualitas tidur pasien dan format pengkajian luka Wagner untuk menilai derajat keparahan ulkus pasien. Hasil penelitian dianalisis menggunakan uji chi square dan menunjukkan adanya hubungan yang bermakna antara tingkat keparahan ulkus dengan kualitas tidur pada pasien ulkus kaki diabetikum p=0,004; ? ? =0,05. Pasien dengan luka yang lebih parah berisiko 5,2 kali lebih tinggi memiliki kualitas tidur buruk dibandingkan dengan pasien dengan derajat luka yang lebih ringan 95 CI: 1,783;15,475. Melalui hasil penelitian ini direkomendasikan peningkatan perawatan luka untuk proses penyembuhan yang lebih berkualitas. Hal tersebut untuk mewujudkan kualitas tidur yang lebih baik.

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ABSTRACTDiabetic foot ulcer is one of Diabetes Mellitus chronic complications that occur around 10 years after Diabetes Mellituss onset. Ulcers made sense of pain and discomfort that affecting patient 39s sleep quality. This study identified the relation between ulcers severity with sleep quality among diabetic foot ulcer patients in Clinic of Wound Care RUMAT Bekasi and Jakarta. Design of this study is analytical with cross sectional approach. That are 73 patients with diabetic foot ulcer who participated and interviewed by a purposed random sampling technique. Two kinds or questionnaire are used, namely Pittsburgh Sleep Quality Index PSQI to assess patient 39 s sleep quality and Wagner 39s Wound Assessment Format to assess patients ulcer severity. The result are analyzed using Chi square test and showed a significant relationship between ulcer severity and sleep quality among diabetic foot ulcer patient rsquo s p 0,004 0,05. Patients with more ulcer severity had 5,2 time more risk to have poor sleep quality than patients with low severity ulcer 95 CI 1.783 15.475. From the results, it is recommended to improve wound care quality. It should be considered for better sleep quality among diabetic patients. "

"Diabetes melitus merupakan penyakit kronik dengan tingkat morbiditas dan mortalitas yang tinggi. Salah satu komplikasi yang ditakuti adalah kaki diabetik. Berdasarkan data di RSCM pada tahun 2011 sebanyak 1,3% dari pasien kaki diabetik harus menjalani amputasi. Borkosky dkk (2013) menunjukkan tingginya insidens re-amputasi pada pasien kaki diabetik sebesar 19,8%. Amputasi berulang membutuhkan biaya pengobatan yang tidak murah, selain itu dapat meningkatkan morbiditas dan mortalitas pasien. Oleh karena itu diperlukan suatu penelitian untuk mengetahui faktor-faktor risiko terjadinya re-amputasi pada pasien kaki diabetik. Penelitian ini adalah deskriptif analitik, didapatkan adanya kecenderungan penurunan jumlah kasus amputasi kaki diabetik di RSCM dari tahun 2009-2015. Level amputasi terbanyak yang dilakukan pada pasien kaki diabetik adalah amputasi minor pada level Ray. Trauma, neuropati perifer, nilai ABI ≤0,9, dan kadar HbA1c ≥7% merupakan faktor risiko terjadinya re-amputasi pada pasien kaki diabetik. trauma merupakan faktor risiko terbesar terjadinya reamputasi pada pasien kaki diabetik (p=0,000; OR 73,842; 95%CI 19,236-283,457). Jika semua faktor risiko tersebut dimiliki oleh pasien maka risiko kumulatif untuk dilakukan re-amputasi sebesar 100%.

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Diabetic mellitus is one of chronic diseases with high morbidity and mortality. One of complications of diabetic mellitus is foot diabetic. Based on data in Cipto Mangunkusumo General hospital, in 2011, prevalence of amputation for foot diabetic patients was 1,3%. Borkosky et al (2013) showed high incidence of reamputation among foot diabetic patients 19,8%. Re-amputation is highly cost and can increase morbidity and mortality in diabetic patients. Thus research needs to be done to find out risk factors of re-amputation among foot diabetic patients.

This research showed that foot diabetic amputation cases in RSCM had been decreased from 2009-2015. The most common amputation level was Ray amputation. Foot trauma, peripheral neuropathy, ABI score ≤0,9 and HbA1c level ≥7% are risk factors for re-amputation in foot diabetic patients. Foot trauma was the biggest risk factor for re-amputation in foot diabetic patients (p=0,000; OR 73,842; 95% CI 19,236-283,457). The cummulative risk factor for re-amputation for those who have all the risk factors is 100%."

"Tujuan :Mengetahui gambaran atheroskierosis arteri karotis komunis dan arteri ekstremitas bawah (femoralis komunis) pada pasien stroke iskemik dengan USG Color Doppler dan pengaruh faktor-faktor resiko terhadap terjadinya atheroskierosis (plak).BAHAN DAN METODEPenelitian "cross sectional", dimulai dari bulan November 2004 sampai dengan April 2005. Penelitian pada 32 pasien stroke iskemik (berdasarkan klinis&CT Scan), menggunakan CDU, transduser 10 MHz. Dilakukan pemeriksaan CDU arteri karotis dan ekstremitas bawah (kanan-kiri) untuk melihat adanya penebalan intima-media, plak, dan pola aliran darah. Faktor-faktor resiko stroke (usia, jenis kelamin, DM, merokok, hiperkoleslerol, riwayat jantung dan stroke) pada pasien dicatat. Hasil dianalisa olch peneliti dan spesialis radiologi.HASILRata-rata diameter lumen arteri karotis komunis kanan dan kid adalah 0,89 dan 0,85 cm. Rata-rata diameter lumen arteri femoralis komunis adalah 0,90 dan 0,90 cm. Faktor resiko terbesar penyebab stroke adalah hipertensi (84,4%), disusul riwayat stroke (53,1%), diabetes militus (50,1%), merokok (46,9%), hiperkolesterol (31,3%), jantung (18,8%). Jumlah temuan penebalan intima-media pada arteri karotis dan femoralis komunis hampir sama. Tetapi temuan plak arteri femoralis komunis lebih sering dibandingkan pada arteri karotis komunis, dan pada uji Mc Nemar terdapat hubungan bermakna bahwa plak di arteri femoralis komunis lebih awal dibandingkan pada arteri karotis komunis. Lokasi plak tersering berada di biffurcatio. Pada penelitian ini tidak didapatkan stenosis bermakna, sehingga nilai PI dan RI masih dalam batas normal. Faktor resiko penyebab timbulnya plak tersering adalah hiperkolesterol, disusul DM, jantung, stroke, merokok. Semakin banyak Faktor resiko, maka sernakin besar kemungkinan terdapat plak di arteri karotis komunis dan terutama di arteri femoralis komunis.KESIMPULANTemuan plak di arteri femoralis komunis lebih awal dan lebih sering terjadi dibandingkan di arteri karotis komunis, yang diduga sering mcnyebabkan pelepasan thrombus penyebab stroke iskemik

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PurposeTo asses atherosclerosis of common carotid artery and common femoral artery in patient with ischemic stroke, and risk factor that influence formation of atherosclerosis (plaque).MATERIALS AND METHODSStudy cross sectional; begin from November 2004 to April 2005. Examinations of 32 patients ischemic stroke (based on clinical and CT Scan) use CDU, transducer 10 MHz. CDU carotid and femoral artery right-left was done to evaluated Intima-Media Thickness (IMT) and plaque. Risk factors of stroke (age, sex, diabetes, smoking, hipercholesterol, history of CAD and CVD); in patients being recorded. Reviewed by observer, radiologist.RESULTThe mean lumen of diameter right and left command carotid artery is 0,89 and 0.85 cm. The mean of lumen diameter right and left command femoral artery is 0,90 and 0,90 cm. The most frequence risk factor causing ischemic stroke is hipert'nsi (84,4%), then follow history of CVD (53,1%), diabetes (50,1%), smooking (46,9%), hipercholesterol (31,3%), and CAD (18,8%). Amount of Intima-Media Thickness in carotid artery, as common as femoral artery. But plaque in common femoral artery more frequency than in common carotid artery, and with Mc Nemar test there is association that plaque finding in common femoral artery earlier than common carotid artery. Plaque location more frequent in biffurcatio. The most frequency risk factors causing plaque is hipercholesterol, then follow diabetes, CAD, stroke, smoking. Too much risk factor in ischemic stroke, too much plaque finding in common carotid artery and common femoral artery.CONCLUSIONPlaque finding in common femoral artery more frequency and earlier than in common carotid artery that suspected release thrombus cause of ischemic stroke."

"Neuropati diabetik merupakan salah satu komplikasi yang sering muncul pada pasien DM, terutama mereka yang selalu dalam tingkat gula darah yang tinggi dan lama menderita DM lebih dari 10 tahun. Neuropati diabetes ini juga diperberat dengan buruknya perawatan kaki dan aktifitas fisik yang rendah.. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan dengan kepatuhan pasien neuropati diabetes melakukan perawatan kaki dalam pencegahan ulkus diabetikum. Rancangan penelitian ini adalah analitik kuantitatif dengan pendekatan cross sectional . Pemilihan sampel dengan cara purposive sampling dan diteliti pada 100 responden. Uji statistik dengan menggunakan uji T-test dan Chi square. Hasilnya terdapat hubungan yang signifikan nilai dukungan keluarga terhadap kepatuhan perawatan kaki diabetes dengan p-value 0,0005, tidak terdapat hubungan yang signifikan nilai kejelasan informasi terhadap kepatuhan perawatan kaki diabetes dengan p-value 0,160, tidak terdapat hubungan yang signifikan antara lama menderita DM dengan nilai kepatuhan dengan p-value 0,292. Rekomendasi dari penelitian ini adalah melakukan penelitian yang berhubungan dengan kepatuhan perawatan kaki diabetes dengan jumlah sampel yang lebih besar dan meneliti aspek predictor yang lebih bervariasi.

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Diabetic neuropathy is a frequent complication in patients with diabetes, especially in patients whose blood sugar level are always high, and have had diabetes for more than 10 years. Diabetic neuropathy can also be exacerbated by poor foot care and low physical activity. The purpose of this study was to determine the factors associated with patient compliance with diabetic neuropathy. The design of this study is a quantitative analytical cross-sectional approach. The selections of samples were done in purposive sampling method and were studied in 100 respondents. Statistical tests using T-test and Chi square test. The results are: a significant correlation value of family support for compliance with p-value 0.0005, no significant correlation values clarity of information on diabetic foot care compliance with pvalue 0.160, no significant correlation value of long-suffering DM with diabetic foot care compliance with p-value of 0.292. Recommendation of this study is to conduct research on diabetic foot care compliance with a larger sample size and examine the predictors with more varied aspects related to the compliance of diabetic foot care."

"Lataar Belakang : Pasca nefrektomi ginjal, terjadi proses kompensasi dari ginjal sisa dalam bentuk hiperfiltrasi untuk mempertahankan laju filtrasi glomerulus, yang dapat berujung pada penyakit ginjal kronik. Sejumlah penelitian menemukan adanya perubahan hemodinamika vaskular ginjal pada ginjal sisa donor yang diperiksa menggunakan ultrasonografi (USG) Doppler. Akan tetapi penelitian tersebut umumnya berfokus pada jangka panjang, dan menggunakan parameter indeks resistensi (RI), belum banyak penelitian yang memfokuskan pada parameter indeks pulsatilitas (PI) dalam jangka pendek, yang dapat bermanfaat untuk memperkirakan prognosis donor. Tujuan : Penelitian ini bertujuan untuk mengetahui gambaran USG Doppler dan adanya perbedaan nilai PI pada ginjal sisa donor transplantasi ginjal antara sebelum dan sesudah nefrektomi dalam jangka pendek. Metode : Desain penelitian merupakan studi prospektif historikal tanpa pembanding menggunakan data sekunder. Sampel adalah donor hidup transplantasi ginjal yang telah menjalani nefrektomi di RSUPN Cipto Mangunkusumo (RSCM) periode Maret 2019 hingga Januari 2020. Data USG Doppler berupa parameter PI a. renalis, segmental, interlobar, dan arkuata di superior, mid, dan inferior ginjal yang tidak dioperasi/ginjal sisa beserta rerata seluruhnya mulai dari preoperasi, H+1, H+7, dan H+30 pasca operasi. Hasil : Didapatkan 40 sampel USG Doppler ginjal sisa donor (rentang usia 24 hingga 66 tahun). Gambaran USG Doppler pada nilai rerata PI preoperatif, H+1, H+7, dan H+30 pasca operasi secara berturut-turut adalah: a. renalis: 1,33, 1,42, 1,31, dan 1,08; a. segmentalis: 1,24, 1,27, 1,18, dan 1,17. a. interlobaris: 1,11, 1,20, 1,19, dan 1,08; a. arkuata: 1,09, 1,14, 1,06, dan 1,02. Pada analisis kemaknaan dengan ANOVA tidak ada perbedaan bermakna pada perubahan rerata nilai PI a. renalis, segmentalis, interlobar, dan arkuata baik keseluruhan maupun per segmen ginjal, kecuali a. interlobar mid ginjal (p = 0,049). Akan tetapi pada analisis post hoc membandingkan dua titik waktu berbeda, tidak didapatkan perbedaan yang bermakna Kesimpulan : Tidak terdapat perbedaan bermakna dari nilai PI ginjal sisa donor sebelum dan sesudah nefrektomi dalam jangka pendek.

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Background : After kidney nephrectomy, there is a compensation process in remnant kidney in the form of hyperfiltration to preserve glomerular filtration rate, which may lead to chronic kidney disease. Several studies found changes in renal vascular hemodynamics in donor’s remnant kidney, examined by Doppler ultrasound (US). However those studies mostly focused on long term and used resistive index (RI), while not many studies focused on pulsatility index (PI) in short term, which may be beneficial to predict donor’s prognosis. Objective : This study aimed to know the Doppler US of and differences in PI values in renal transplantation donor’s remnant kidney before and after nephrectomy within short term. Method : The study design is historical prospective without comparison using secondary data. Samples are renal transplantation donor underwent nephrectomy in Cipto Mangunkusumo National Central General Hospital (RSUPN-CM) from March 2019 until January 2020. Doppler ultrasound data presented in the form of PI parameter of renal, segmental, interlobar, and arcuate arteries, in superior, middle, and inferior kidney of unoperated/remnant kidney and their mean, from pre-surgery, D+1, D+7, and D+30 after surgery. Result : This study obtained 40 samples of donor’s remnant kidney Doppler US (age range 24-66 years old). Doppler US of mean PI from pre-surgery, D+1, D+7, and D+30 after surgery consecutively were: renal artery: 1.33, 1.42, 1.31, and 1.08;segmental artery: 1.24, 1.27, 1.18, and 1.17; interlobar artery: 1.11, 1.20, 1.19, and 1.08; arcuate artery: 1.09, 1.14, 1.06, and 1.02. Significance analysis using ANOVA showed no significant difference of PI value changes of renal, segmental, interlobar, and arcuate artery, both in the mean of whole and segments of kidney, except interlobar artery in the middle segment of kidney (p = 0.049). However, post hoc analysis comparing two different time points showed no significant difference. Conclusion : There was no significant difference of donor’s remnant kidney PI value before and after nephrectomy within short term."