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Hubungan kadar kisspeptin dan kadar Human Chorionic Gonadotropin (hCG) hipofisis dengan gangguan kognitif minimal pada perempuan pascamenopause = Correlations between kisspeptin level and pituitary Human Chorionic Gonadotropin (hCG) level with minimal cognitive impairment in postmenopausal women

"ABSTRAK Latar Belakang: Gangguan kognitif merupakan salah satu masalah pada aging population berkaitan dengan perubahan neuroendokrin pascamenopause. Gangguan kognitif minimal (minimal cognitive impairment/MCI) merupakan kondisi peralihan fungsi kognitif antara penuaan normal dan demensia.

Tujuan: Untuk mengetahui hubungan kadar kisspeptin dan kadar hCG hipofisis dengan gangguan kognitif minimal pada perempuan pascamenopause.

Metodologi: MCI ditentukan dengan sistem skoring yang terdiri dari status diabetes melitus, toleransi glukosa terganggu, dislipidemia, Geriatric Depression Scale (GDS), uji Rey Osterrieth Complexion Figure (ROCF), uji digit span backward dan uji Trail Making Test B. Studi potong lintang terhadap 181 perempuan pascamenopause usia £ 65 tahun, terbagi 2 kelompok yaitu dengan MCI 90 orang dan tanpa MCI 91 orang.

Hasil: Analisis terhadap usia, lama menopause, indeks massa tubuh, lama pendidikan, kadar kisspeptin dan kadar hCG hipofisis. Kadar kisspeptin menunjukkan perbedaan bermakna anatar kedua kelompok (p<0,001). Kadar kisspeptin dan lama menopause berkorelasi positif dengan skor MCI (r=0,607 dan r=0,542; berurutan). Namun, tidak ada perbedaan kadar hCG hipofisis antara kedua kelompok (p=0,664), dan skor MCI tidak berkorelasi dengan kadar hCG hipofisis (p=0,398; r=0,06).

Kesimpulan: Kadar kisspeptin signifikan lebih tinggi pada perempuan pascamenopause dengan MCI, dan menunjukkan korelasi positif. Sementara kadar hCG hipofisis tidak berbeda di antara kedua kelompok dan tidak menunjukkan korelasi.

ABSTRACT
Backgroud: Cognitive impairment is one of problems among elderly women due to neuroendocrine alteration after menopause. Minimal cognitive impairment (MCI) is a transition state of cognitive function between normal aging and dementia.
Aims: To investigate relationship between kisspeptin and pituitary hCG with MCI in postmenopausal women.
Methods: MCI was determined by scoring; with diabetic status, glucose intolerant, dyslipidemia, Geriatric Depression Scale (GDS), Rey Osterrieth Complexion Figure (ROCF), digit span backward, and Trail Making Test (TMT) B. Using cross-sectional study, 181 postmenopausal women £ 65 years old, were grouped into with and without MCI; 90 and 91 women, respectively.
Results: Data was analysed to their ages, span of menopause, body mass index (BMI), education grade, kisspeptin and hCG level. Kisspeptin level had significantly different among the groups (p<0.001). There was a positive relationship between kisspeptin level and span of menopause to MCI score (R=0.607 and R= 0.542, respectively). Pituitary hCG level, however, showed no difference among the groups. Moreover, MCI score showed no relationship to hCG level (p=0.398; R=0.063).
Conclusions: Kisspeptin level was significantly higher among postmenopausal women with MCI, and showed a positive relationship. While pituitary hCG had no difference among the groups, and showed no relationship."

Depok: Fakultas Kedokteran Universitas Indonesia, 2018

T-Pdf

UI - Tesis Membership Universitas Indonesia Library

Zita Arieselia

Kadar 2,3-dinor-6-keto-prostaglandin-F1, dalam urin wanita pas- camenopause alami dan pramenopause yang minum aspirin 100mg = Urinary 2,3-dinor-6-keto-prostaglandin-fia in healthy postmenopausal women and premenopausal women receiving aspirin 100 mg

"Prevalensi penyakit kardiovmakular meningkat dengan tajam pada wanita pasca menopausa Pada wanita pasca menopause terjadi peningkatan produksi trombosit dan penurunan produksi prosiasiklin. Aspirin dosis rendah (75 - 150 mg) telah lama dikenal sebagai penghambat agregasi trombosit. Aspirin bekerja dengan menghambat produksi tromboksan (suatu zat proagregasi trombosit dan vasokonslriktor poten) serta produksi prostasiklin (suatu zat antiagregasi trombosit dan vasodilator poten).

Studi ini merupakan uji klinik Lidak tersamar dengan 2 kelompok paralel. Kelompok pertama terdiri dari 15 orang wanita pramenopause (3 40 tahun) dan kelompok kedua 15 orang wanita pasca menopause yang telah henti haid selama 3 - 5 tahun. Urin 24 jam dikumpulkan dari setiap subyek sebelum dan sesudah minum aspirin 100 mg salama 7 hari berturut-turut, Kadar prostasiklin dalam win dalam bentuk metabolitnya, 2,3-dinor-6-keto-prostaglandin-F1.1, dianalisis menggunakan metode EIA (Enzyme immunoassay). Tromboksan, dalam bcntuk metabolitnya (ll-dehidro-tromboksan-B2), juga diukur dalam sampel urin ini pada studi terdahulu.

Studi terdahulu menunjukkan bahwa aspirin menurunkan kadar tromboksan secara bermakna pada kedua kelompok dengan persentase penurunan yang lebih besar secara bermakna pada wanita pasca menopause dibandingkan wanita pramenopause. Hasil studi ini menunjukkan bahwa aspirin menurunkan kadar prostasiklin secara bermakna pada wanim pramenopause (selisih = 78,44 nglg kreatinin; p = 0,001) maupun wanita pasca menopause (sclisih = 35,7l ng/g kreatinin; p < 0,001), namun persentase penurunan antara kedua kelompok tidak berbeda bermakna (46,26% vs_ 40,94%; p = 0,574). Penurunan kadar tromboksan dan proslasiklin oleh aspirin perlu dibandingkan (dalam bcntuk penurunan rasio kadar ll- dehidro-tromboksan-B2 / 2,3-dinor-6-keto-prostaglandin-Fu, dalam urin) untuk menilai ekasi aspirin sebagai antitrombodk Perhitungan rasio kadar ll-dehidro-tromboksan-B2/ 2,3-dinor-6-keto-proslaglandin-Fm sebelum pemberian aspirin jauh lebih tinggi pada wanila pascamenopause dibandingkan wanita pramenopause (4,09 vs. 1,l3; p A 0,001)_ Pcnurunan rasio kadar 11-dchidro-tromboksan-Bd 2,3-dinor-6-keto-prostaglandin-Fm olch aspirin jauh lebih besar pada wzmita pasca menopause dibandingkan wanita pramenopause (l,9l vs. 0, 17; p = 0,022).

Dengan demikian disimpulkan bahwa aspirin menurunkan kadar prostasiklin secara bermakna pada masing-masing kelompok dengan persentase penurunan yang tidak berbeda antara kedua kelompok, namun menurunkan rasio kadar 11-dchidro-tromboksan-BJ 2,3-dinor-6-keto-prostaglandin-F1,, yang jauh lebih besar pada wanita pasca menopause dibandingkan pada wanila pramenopausa.

The prevalence of cardiovascular diseases in women increases sharply after menopause. In postmenopausal women, thromboxane production increases while prostacyclin production decreases. Low dose mpirin (75 - 150 mg) has long been known as an antiplatelet aggregator. Aspirin reduces the production of both thromboxane (potent thrombocyte aggregator and vasoconstrictor) and prostacyclin (anti thrombocyte aggregator and potent vasodilator).

The present study was an open-label clinical trial with 2 parallel groups. One group consisted of 15 premenopausal women (age 2 40 years) while the other group 15 postmenopausal women (for 3 - 5 years). Twenty-four hours urine was collected from each subject before and after aspirin 100 mg daily for 7 days. The concentration of prostacyclin was measured as its metabolite (2,3-dinor-6-keto-prostaglandin-Fm) in urine using EIA (Enzyme immunoassay). Thromboxane as its urinary metabolites (11-dehidro-tromboksan-Bg) was also measured in these same urine samples in the previous study.

Previous study showed that aspirin significantly reduced thromboxane in both groups, with significantly larger percentage reduction in postmenopausal women compared to premenopausal women. Results of the present study showed that aspirin reduced prostacyclin signilicantly in both premenopausal women (mean difference = 78.44 ng/g creatinine; p = 0.001) and postmenopausal women (mean difference = 35.71 ng/g creatinine; p < 0.001), but the percentage reduction between the groups was not significantly different (46,26% vs. 4O,94%; p = O,574). The decrease in thromboxane and prostacyclin should be compared (as the decrewe in the ratio of ll-dehidro-tromboksan-B2 / 2,3-dinor-6-keto- prostaglandin-Fia) to assess aspirin efficacy as an antithrombotic. Calculation of the ratio of 11-dehidro-trombol

It was concluded that aspirin reduced prostacyclin significantly in each group with nons ignificant percentage reduction between groups, but reduced the 11-dehidro-tromboksan-BU 2,3-dinor-6-keto-prostaglandin-Fi., ratio much larger in postmenopausal women compared to that in premenopausal women."

Depok: Fakultas Kedokteran Universitas Indonesia, 2009

T32325

UI - Tesis Open Universitas Indonesia Library

Nur Hayati Dwi Handayani

Efek kapsul ekstrak etanol kulit buah delima punica granatum l terhadap petanda pembentukan tulang dan kualitas tulang pada wanita pascamenopause = The effects of pomegranate peel ethanol extract punica granatum l on marker of bone formation and bone quality in postmenopausal woman

"Studi tentang efek kulit buah delima (Punica granatum L.) yang diketahui mengandung asam elagat, telah diteliti meningkatkan kadar osteoblas, kalsium, dan fosfor pada tikus ovariektomi, namun belum diketahui apakah memberikan efek pada wanita pascamenopause. Penelitian ini bertujuan mengevaluasi apakah sediaan komersil kapsul ekstrak kulit buah delima memiliki efek terhadap modulasi petanda pembentukan tulang dan kualitas tulang pada wanita pascamenopause. Penelitian ini merupakan uji klinik pendahuluan fase 1 dengan desain paralel, acak, berpembanding plasebo, dan tersamar ganda, dengan 30 subyek. Subyek dirandomisasi untuk mendapatkan sediaan komersil kapsul ekstrak etanol kulit buah delima 2 x 1100 mg/ hari atau plasebo selama 8 minggu. Sebelum dan sesudah perlakuan, diperiksa kadar osteokalsin, kalsium, dan fosfor.

Hasil penelitian ini menunjukkan bahwa pemberian sediaan cenderung menghambat laju perombakan tulang dengan menghambat peningkatan kadar osteokalsin, sebagai salah satu petanda laju perombakan tulang (4,129±5,66 ng/ml pada kelompok plasebo, 1,79±5,04 ng/ml pada kelompok punica, p=0,245), tidak mempengaruhi kadar kalsium (9,13±0,36 mg/dl pada kelompok plasebo, 9,21±0,39 mg/dl pada kelompok punica, p=0,379), dan tidak mempengaruhi kadar fosfor (3,93±0,38 mg/dl pada kelompok plasebo, 4,12±0,41 mg/dl pada kelompok punica, p=0,138). Pemberian sediaan tidak mempengaruhi fungsi hati dan fungsi ginjal, serta dapat ditoleransi dengan baik. Kesimpulan penelitian ini adalah sediaan berpotensi menghambat peningkatan petanda pembentukan tulang dalam darah dan meningkatkan kualitas tulang wanita pascamenopause, serta aman.

Studies of pomegranate peel (Punica granatum L.), which contain ellagic acid, was shown to increase osteoblast, calcium, and phosphorus in ovariectomized rats. The effect of the pomegranate peel extracts on postmenopausal women was not known. This study was aimed to evaluate the effect of commercial capsules of pomegranate peel ethanol extracts in the modulation of bone formation and bone quality markers in postmenopausal women. This study is a pilot study of phase 1 clinical trial using parallel, randomized, double-blind, and placebo controlled design, with 30 subjects. Subjects were randomized to receive commercial capsules of pomegranate peel ethanol extracts 2 x 1100 mg/ day or placebo, for 8 weeks. Levels of osteocalcin, calcium, and phosphorus were examined before and after treatment.
This study showed that administration of the commercial capsules in postmenopausal women tends to reduce blood osteocalcin level (4,129±5,66 ng/ml on placebo group and 1,79±5,04 ng/ml on punica group, p=0,245), does not influence on blood calcium level (9,13±0,36 mg/dl placebo group and 9,21±0,39 mg/dl punica group, p=0,379), does not influence on blood phosphorus level (3,93±0,38 mg/dl placebo group and 4,12±0,41 mg/dl on punica group, p=0,138), does not affect the function of liver and kidney, and was well tolerated. In conclusion, this study demonstrated that the commercial capsules potentially reduce marker of bone formation serum level, increase bone quality on postmenopausal women, and safety."

Depok: Fakultas Farmasi Universitas Indonesia, 2016

T45236

UI - Tesis Membership Universitas Indonesia Library

Indah Pawitaningtyas

Faktor yang berhubungan dengan aktivitas fisik pada wanita pasca menopause dengan obesitas sentral studi kasus pada Kelurahan Limo Kota Depok = Factors related to physical activity in postmenopausal women with central obesity case study at Limo Urban Village Depok City

"ABSTRAK

Tesis ini bertujuan untuk mengetahui faktor yang paling berhubungan dengan aktivitas fisik pada wanita pasca menopause dengan obesitas sentral. Penelitian ini merupakan penelitian kuantitatif dengan desain cross sectional yang dilaksanakan selama bulan Februari sampai Juni 2017. Pengumpulan data dilakukan melalui wawancara dengan menggunakan kuesioner di Kelurahan Limo dengan jumlah responden 130 orang. Dukungan sosial OR = 5,121; 95 CI 2,133 - 12,295 merupakan faktor yang paling dominan berhubungan dengan aktivitas fisik pada wanita pasca menopause dengan obesitas sentral, setelah dikontrol oleh pendidikan dan pekerjaan. Kelompok arisan atau pengajian yang telah ada di wilayah Kelurahan Limo dapat menjadi sarana untuk meningkatkan dukungan sosial masyarakat terhadap aktivitas fisik. Promosi kesehatan terkait pencegahan penyakit tidak menular dan aktivitas fisik dapat disisipkan dalam acara tersebut, melalui ceramah dan tanya jawab oleh kader kesehatan. Selanjutnya mereka dapat mulai menginisiasi pembentukan kelompok senam lokal yang lebih terjangkau bagi masyarakat.

ABSTRACT

This thesis aimed to determine the most related factor to physical activity in postmenopausal women with central obesity. This research was a quantitative research with cross sectional design conducted during February to June 2017. Data collection was done by using questionnaire at Limo Urban Village on 130 respondents. Social support OR 5,121 95 CI 2,133 12,295 is the most dominant factor associated with physical activity in postmenopausal women with central obesity, after controlled by education and employment. The existing social gathering or recitation groups at Limo Urban Village area could be a platform to improve community social support toward physical activity. Health promotion of non communicable disease and physical activity can be inserted through those events, through lecture and discussion by health cadre. Then they can start to initiate the formation of more affordable local sports group for the community."

2017

T48087

UI - Tesis Membership Universitas Indonesia Library

Asnat

Efek gel transfersom fraksi diklormetana kulit buah manggis (garcinia mangostana L.) terhadap elastisitas dan kelembaban kulit pada wanita pascamenopause = The effect of dichloromethane fraction of mangosteen pericarp garcinia mangostana l loaded transfersomes gel on skin elasticity and hydration in postmenopausal women / Asnat

"ABSTRAK

Fraksi diklormetana kulit buah manggis Garcinia mangostana L diketahui kaya akan kandungan xanton dan terbukti memiliki aktivitas antioksidan yang poten. Tujuan penelitian ini adalah untuk mengetahui efek gel transfersom fraksi diklormetana kulit buah manggis terhadap elastisitas dan kelembaban kulit pada wanita pascamenopause. Penelitian ini merupakan penelitian eksperimental acak tersamar tunggal terhadap 46 wanita pascamenopause yang terbagi dalam dua kelompok. Kelompok kontrol diberikan gel transfersom GT dan kelompok perlakuan diberikan gel transfersom fraksi diklormetana kulit buah manggis GTF . Penelitian dilakukan selama 6 minggu dan perubahannya diukur menggunakan Cutometer dan Corneometer. Uji potensi iritasi dilakukan sebelum perlakuan. Efek yang tidak diinginkan dari sediaan diamati selama perlakuan. Perubahan elastisitas dan kelembaban kulit menunjukkan kecenderungan yang meningkat, namun tidak terdapat perbedaan yang bermakna p>0,05 baik pada kelompok kontrol maupun kelompok perlakuan. Hasil kategori respon iritasi menunjukkan iritasi yang tidak berarti Indeks Iritasi Primer=0.083 dan selama penelitian tidak ditemukan efek yang tidak diinginkan. Gel transfersom xanton aman diaplikasikan namun belum memberikan efek dalam perbaikan elastisitas dan kelembaban kulit wanita pascamenopause. Kemungkinan membutuhkan peningkatan dosis zat aktif atau waktu yang lebih lama.

ABSTRACT

Dichlormethane fraction of mangosteen pericarp Garcinia mangostana L. has high contents of xanthones and it has proven to have potential antioxidant activity. The aim of this study was to evaluate the effect of dichlormethane fraction of mangosteen pericarp loaded transfersom gel on skin elasticity and skin hydration in postmenopausal women. This study design was single blind randomized controlled trial on 46 postmenopausal women which were divided into two groups. The control and treatment group were given a transfersom gel GT and a dichlormethane fraction of mangosteen pericarp loaded transfersom gel GTF respectivley. The study was conducted for 6 weeks and the elasticity and hydration status of the skin was measured by Cutometer and Corneometer. The potential irritant test was carried out before the treatment. The adverse effects observed during the the treatment. The irritation response categories showed non significant irritation Primary Irritation Index 0.083 during the study and no adverse effects. The changes in skin elasticity and skin hydration showed an incensement trend, but no significant difference p 0.05 for both the control and treatment group. Transfersome gel xanthones is safe but no effect in improving skin elasticity and skin hydration of postmenopausal women. It may take longer or dose incensement of the active ingredient."

2017

T46933

UI - Tesis Membership Universitas Indonesia Library

Ervan Surya

Korelasi kadar serum human chorionic gonadotropin (hCG) 12 jam pascapenyuntikan terhadap maturitas oosit pada fertilisasi in vitro (FIV) = Correlation between serum human chorionic gonadotropin (hCG) 12-hours postinjection and oocyte maturation rate in in vitro fertilizatio (IVF)

"Latar belakang: Fertilisasi in vitro (FIV) merupakan salah satu tata laksana utama dalam penanganan infertilitas. Penyuntikan human Chorionic Gonadotropin (hCG)eksogen merupakan salah satu tahapan penting dalam proses FIV untuk proses maturasi oosit. Walaupun sudah terdapat penelitian sebelumnya mengenai korelasi kedua hal tersebut, namun belum didapatkan suatu model prediksi maturitas oosit.

Tujuan: Mengetahui korelasi kadar serum hCG 12 jam pascapenyuntikan terhadap tingkat maturitas oosit pada FIV dan model prediksi maturitas oosit.

Metode: Penelitian ini merupakan sebuah penelitian potong lintang yang dilakukan pada peserta program FIV di Klinik Yasmin, RSUPN dr. Cipto Mangunkusumo, Jakarta, Indonesia sejak Januari 2020 hingga Desember 2020. Pasien dengan riwayat prosedur pembedahan ovarium, kemoterapi, radioterapi, dan peserta poor responder dieksklusi dari penelitian. Dilakukan penyuntikan r-hCG 250 µg secara subkutan pada semua subjek. Kadar serum hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit setiap subjek dikumpulkan dan dianalisis.

Hasil: Didapatkan sebanyak 28 subjek yang diikutsertakan dalam penelitian. Didapatkan korelasi yang tidak bermakna antara kadar hCG 12 jam pascapenyuntikan dan tingkat maturitas oosit (r = 0,052, p = 0,788). Namun, didapatkan kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi pada subjek dengan tingkat maturitas >75% (mean diff 34.78,p = 0.046). Didapatkan titik potong kadar serum hCG 12 jam pascapenyuntikan sebesar 90.15 mIU/mL untuk memprediksi tingkat maturitas yang baik. (sensitivitas 68.2%, spesifisitas 83.3%). Prediksi tingkat maturitas oosit dapat dilakukan dengan mengetahui kadar serum hCG 12 jam pascapenyuntikan dan indeks massa tubuh (IMT) subjek (sensitivitas 83.3%, spesifisitas 68.2%).

Simpulan: Kadar serum hCG 12 jam pascapenyuntikan yang lebih tinggi berhubungan dengan tingkat maturitas oosit yang lebih baik pada peserta program FIV. Tingkat maturitas oosit dapat diprediksi melalui kadar serum hCG 12 jam pascapenyuntikan dan IMT.

Background: In vitro fertilization (IVF) is one of the main treatments of infertility. Exogenous Human chorionic gonadotropin (hCG) injection is an important process of IVF and thought to be vital in determining oocyte maturation.
Purpose: This study aims to determine the relationship between 12 hours post-injection serum hCG and oocyte maturation rate on IVF participants.
Method: This is a cross-sectional study on IVF participants on Yasmin Clinic, dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, during the period of January 2020 to December 2020. Subjects with history of ovarian surgery, chemotherapy, radiotherapy, and poor responder subjects were excluded from the study. Subjects were injected with 250 µg of r-hCG subcutaneously. Twelve hours post-injection serum hCG level and oocyte maturation rate were collected and analyzed accordingly.
Result: A total of 28 subjects were included in the study. It was found that higher 12 hours post-injection serum hCG was related with subjects with >75% oocyte maturation rate (mean diff 23.78, p = 0.046). The cut-off point of 12 hours post-injection serum hCG in order to predict better oocyte maturation rate was found to be 90.15 mIU/mL (sensitivity 68.2%, specificity 83.3%). Oocyte maturation rate predicted may be calculated using body mass index and 12 hours post-injection serum hCG. (sensitivity 83,3%, specificity 68,2%).
Conclusion: Higher 12 hours post-injection serum hCG was associated with higher oocyte maturation rate on IVF subjects. Oocyte maturation rate may be predicted using body mass index and 12 hours post-injection serum hCG."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021

SP-Pdf

UI - Tesis Membership Universitas Indonesia Library

Abdurrahman Hadi

Akurasi kadar Alfa Fetoprotein dan Human Chorionic Gonadotropin serum dalam Penegakkan Diagnosis Tumor Sel Germinal Nonseminoma Mediastinum = Accuracy of Alpha-Fetoprotein and Human Chorionic Gonadotropin Serum in Establishing the Diagnosis of Nonseminomatous Germ Cell Tumors in the Mediastinum

"Latar Belakang: Tumor sel germinal mediastinum merupakan kelompok neoplasma gonad yang

sensitif terhadap kemoterapi, namun agresif dan memiliki prognosis buruk. Penegakkan diagnosis

dini yang tepat adalah hal yang penting dan salah satunya adalah dengan penilaian penanda tumor

alpha fetoprotein (AFP) dan beta human chorionic gonadotropin (ßHCG).

Metode: penelitian ini dilakukan dengan desain uji diagnostik dengan pendekatan potong lintang

terhadap pasien tumor sel germinal nonseminoma mediastinum di RSUP Persahabatan sejak

Januari 2015 hingga Desember 2022 dengan mengukur kadar Alfa Fetoprotein dan Human

Chorionic Gonadotropin serum dan dilakukan pemeriksaan histopatologi. Analisis data dilakukan

untuk menguji sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, akurasi diagnostik,

dan analisis kurva receiver operating characteristic (ROC).

Hasil: Dari total 362 subjek yang memenuhi kriteria inklusi, dari kedua penanda tumor AFP dan

ßHCG didapatkansensitivitas 90,77% (IK 95% 80,98% - 96,54%), spesifisitas 97,98% (IK 95%

95,65% - 99,26%), nilai duga positif 90,77% (IK 95% 81,61% - 95,61%), nilai duga negatif

97,98% (IK 95% 95,77% - 99,05%), rasio kekerapan positif 45,4 (IK 95% 20,27 – 99,58), rasio

kekerapan negatif 0,09 (IK 95% 0,04 – 0,2), serta nilai akurasi diagnostik sebesar 96,69% (IK

95% 94,28% - 98,28%).

Kesimpulan: Pemeriksaan kadar Alfa fetoprotein dan ßhuman chorionic gonadotropin memiliki

akurasi 96,69%, sensitivitas 90,77% spesifisitas 97,98%, nilai duga positif 90,77%, nilai duga

negatif = 97,98% dalam penegakkan diagnosis tumor sel germinal nonseminoma mediastinum

Background: Mediastinal germ cell tumors are a group of gonadal neoplasms that are sensitive
to chemotherapy, but very aggressive and have poor prognosis. Early and correct diagnosis is
important, one of them is by measuring tumor markers in serum: alpha-fetoprotein (AFP) and
beta human chorionic gonadotropin (βHCG).
Method: This study was conducted with a diagnostic test with a cross sectional approach design
on patients with mediastinal germ cell tumors at RSUP Persahabatan from January 2015 to
December 2022, and also assessment of tumor markers alpha-fetoprotein (AFP) and beta human
chorionic gonadotropin (βHCG) serum and histopathology examination. Data analysis was
carried out to find the sensitivity, specificity, positive predictive value, negative predictive value,
diagnostic accuracy, and receiver operating characteristic (ROC)
Results: Of a total of 362 eligible subjects, the sensitivity was 90.77% (95% CI 80.98% -
96.54%), the specificity was 97.98% (95% CI 95.65% - 99.26%), the positive predictive value
was 90.77% (95% CI 81.61% - 95.61%), the negative predictive value was 97.98% (95% CI
95.77% - 99.05%), the positive likelihood ratio was 45.4 (95% CI 20.27 - 99.58), the negative
likelihood ratio was 0.09 (95% CI 0.04 - 0.2), and the diagnostic accuracy was 96.69% (95% CI
94.28% - 98.28%).
Conclusion: the sensitivity was 90.77%, the specificity was 97.98%, the positive predictive value
was 90.77%, the negative predictive value was 97.98%, and the diagnostic accuracy was 96.69%."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023

T-pdf

UI - Tesis Membership Universitas Indonesia Library

Andon Hestiantoro

Peran gonadotropin, estradiol, soluble leptin receptor sob-r , leptin, dan keluhan menopause sebagai penapis hendaya kognitif nir-demensia (HKND) pada perempuan pascamenopause = The Role of gonadotropin estradiol soluble leptin receptor sob r leptin and menopausal symtoms as screening method for cognitive impairment no dementia cind in postmenopausal women

"ABSTRAK

Pada perempuan pascamenopause diperlukan marka biokimiawi dan klinis pada masa jendela terapeutik yang diharapkan dapat digunakan untuk menapis HKND yang berperan sangat penting dalam menghindari dampak demensia tipe alzheimer setelah terapi hormon. Penapisan HKND dapat dimanfaatkan juga untuk upaya terapeutik HKND pada perempuan pascamenopause dan mencegah perburukan ke dalam kondisi demensia tipe alzheimer. Dilakukan studi potong lintang pada 282 perempuan pascamenopause di Jakarta yang dibagi menjadi 2 kelompok, yaitu kelompok positif dengan HKND dan kelompok tanpa HKND. Pemeriksaan dilakukan pada sejumlah variabel seperti usia, lama menopause, keluhan vasomotor, IMT, kadar FSH, kadar LH, kadar leptin, kadar estradiol, dan status kognitif, kemudian dianalisis secara statistik. Diperoleh nilai FSH yang berhubungan bermakna dengan kejadian HKND p = 0,018 , serta variabel lain seperti nisbah FSH/estradiol p = 0,029 dan nisbah FSH/sOB-R p = 0,011 , sementara variabel lain tidak bermakna. Analisis multivariat menunjukkan nisbah FSH/estradiol adalah variabel yang paling berperan terhadap kejadian HKND, dengan nilai OR 1,15. Berdasarkan kurva ROC didapat nilai titik potong nisbah FSH/estradiol dalam memprediksi HKND adalah 1,94 dengan sensitivitas 66,5 dan spesifisitas 46,8 . Nisbah FSH/estradiol pada perempuan pascamenopause yang menderita HKND yang lebih tinggi secara bermakna dibandingkan dengan kelompok tanpa HKND dikaitkan dengan peran neuron KNDy terhadap peningkatan sekresi GnRH dan rendahnya neurosteroid estradiol di otak perempuan pascamenopause yang berisiko menderita HKND. Nilai nisbah FSH/estradiol > 1,94 dapat digunakan untuk penapis diagnostik HKND pada perempuan pascamenopause.

ABSTRACT

Biochemical and clinically important markers are needed in the window therapeutic period for postmenopausal women which are expected to be used as a screening methods for CIND as it is very important in avoiding the effect of dementia associated Alzheimer disease after hormone therapy. CIND screening was also useful for CIND treatment strategies in postmenopausal women and preventing postmenopausal women from impaired cognitive function due to dementia. A cross sectional study included 282 postmenopausal women in Jakarta was done, and subjects were further classified into two groups, with CIND and without CIND. Several related variables such as age, duration of menopause, vasomotor symptoms, BMI, FSH level, LH level, leptin level, estradiol level, and cognitive status, were assessed and analyzed statistically. The prevalence of CIND was significantly correlated with FSH level p 0.018 , along with ratio of FSH levels estradiol p 0.029 and ratio of FSH sOB R p 0.011 , while other variables were not. By multivariate analysis, FSH estradiol ratio of 1.15 was found as the most significant factor with probability of having CIND in postmenopausal women. Using the ROC curve, the ratio threshold of FSH estradiol to predict CIND was 1.94, with sensitivity 66.5 and specificity 46.8 . Level of FSH estradiol ratio in postmenopausal women with CIND was significantly higher than women without CIND, and is related to the role of KNDy neurons that induce the secretion of GnRH, and low level of neurosteroid estradiol in postmenopausal women rsquo s brain with risk of CIND. Ratio of FSH estradiol levels 1.94 could be used for screening methods of CIND in postmenopausal women."

2017

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Wita Septiyanti

Korelasi nilai MRI T2* dan T2* relaksometri serta SIR T2* hipofisis dengan kadar FSH dan LH pada pasien thalassemia mayor = Correlation between T2&T2* relaxometry and SIR T2 value of pituitary with degree of FISH and LH level and Fe status in thalassemia major patients

"Latar belakang dan tujuan: Thalassemia adalah penyakit anemia hemolitik yang diturunkan, merupakan penyakit genetik yang paling sering di dunia. Transfusi secara berkala pada pasien thalassemia dapat menyebabkan deposit besi pada berbagai organ seperti hipofisis. Deposit besi pada hipofisis dapat menyebabkan hipogonadotropik hipogonadisme. Biopsi merupakan pemeriksaan baku emas untuk menilai deposit besi pada organ, namun hal ini tidak dapat dilakukan pada hipofisis. Pemeriksaan MRI mulai digunakan unutuk mengukur kadar besi pada berbagai organ salah satunya hipofisis.

Metode: Uji korelasi dengan pendekatan potong lintang untuk mengetahui nilai korelasi nilai MRI T2 dan T2 relaksometri serta SIR T2 hipofisis dengan kadar FSH dan LH pada pasien thalassemia mayor. Pemeriksaan dilakukan 28 subjek penelitian dalam kurun waktu Desember 2016 hingga Maret 2016.

Hasil: Terdapat korelasi antara nilai relaksometri T2 hipofisis potongan koronal dengan kadar FSH dan LH, serta terdapat pula korelasi antara nilai SIR T2 hipofisis dengan kadar LH. Tidak terdapat korelasi antara nilai relaksometri T2 potongan koronal-sagital dengan kadar FSH dan LH, serta tidak terdapat pula korelasi antara SIR T2 hipofisis dengan kadar FSH.

Kesimpulan: Nilai relaksometri T2 hipofisis potongan koronal dan SIR T2 hipofisis dapat digunakan sebagai acuan deposit besi pada hipofisis serta dapat memonitor terapi kelasi pada pasien thalassemia - mayor.

Background and abjective Thalassemia is a hereditary hemolytic anemia disorder, it is one of the most common genetic disease in the world. Periodic transfusion for thalassemia patients may lead to iron deposit in various organs such as pituitary gland. Iron deposit in pituitary gland may induce hypogonadotropic hypogonadism. Biopsy and histopathology assessment is the gold standard examination to assess organ iron deposit, however this method is inapplicable for pituitary gland. MRI examination has been started to be used for measurement of iron level in various organ, such as pituitary gland.
Method: This study uses cross sectional method. MRI T2 and T2 relaxometry value as well as SIR T2 of pituitary gland was correlated with FSH and LH level in patients with major thalassemia. This study involves 28 subjects and conducted from December 2016 to March 2017.
Result: There is a correlation between relaxometry values of T2 pituitary gland on coronal slice with the level of FSH dan LH. There is also a correlation between pituitary SIR T2 value with the level of LH. There are no correlation between relaxometry values of T2 on coronal sagittal slices with the level of FSH and LH, furthermore there are no correlation between pituitary SIR T2 with FSH level.
Conclusion: Relaxometry value of pituitary T2 on coronal slice and pituitary SIR T2 value may be use as reference for iron deposit on pituitary gland as well as to monitor chelating therapy in major thalassemia patients."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017

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Sandi Puspita

Hubungan kadar leptin plasma dengan fungsi kognitif pada lanjut usia di Jakarta = The association between plasma leptin level and cognitive function in elderly in Jakarta

"Peningkatan jumlah lanjut usia di Indonesia sering diiringi dengan peningkatan gangguan kognitif. Leptin diketahui memiliki fungsi protektif terhadap fungsi kognitif pada lanjut usia, namun hingga saat ini hasil temuan peran leptin pada fungsi kognitif masih beragam, dan belum banyak dibahas di Indonesia. Selain itu peneliti melakukan analisis tambahan menggunakan Food Record dan penilaian antropometri pada subjek. Penelitian ini bertujuan untuk mengetahui hubungan antara kadar plasma leptin dengan fungsi kognitif pada lanjut usia di Jakarta. Penelitian ini merupkan penelitian analitik deskriptif potong lintang yang menggunakan purposive sampling sebagai metode pengambilan sampel. Subjek merupakan lanjut usia yang bertempat tinggal di Panti Sosial yang kemudian dilakukan pemeriksaan fungsi kognitif menggunakan instrumen MoCA-INA, kuesioner IADL, GPAQ, Food Record, plasma leptin, komposisi tubuh serta antropometri, yang dianalisis secara univariat, bivariat dan multivariat.

Hasil dari penelitian, karakteristik subjek berusia 60-74 tahun, dengan mayoritas jenis kelamin wanita (69,1%), dengan status gizi normal (45,5%), massa lemak berkisar antara 18,10-57,10 %, massa otot berkisar antara 20,20-57,50 kg. Mayoritas tidak merokok, tingkat pendidikan rendah (≤ 12 tahun wajib belajar), aktifitas fisik sedang dengan keseluruhan kapasitas fungsional subjek mandiri. Sebesar (96,4%) lanjut usia mengalami gangguan fungsi kognitif, kadar leptin plasma memiliki nilai terendah 1,4 ng/mL, tertinggi 119,48 ng/m dengan median 6,2 ng/mL. Pada analisis bivariat ditemukan kadar leptin, IMT (Indeks Massa Tubuh), massa lemak, pendidikan, dan IADL memiliki hubungan bermakna dengan fungsi kognitif pada lanjut usia di Jakarta. Korelasi kadar leptin plasma dengan fungsi kognitif pada lanjut usia di Jakarta memiliki korelasi positif sedang dengan nilai r 0,52 dan signifikansi 0,000.

The increasing of elderly population often accompanied by a rise in cognitive disorders. Leptin is known to have a protective function against cognitive decline in elderly. However, current finding regarding the role of leptin in cognitive function is vary, and has not been extensively discussed in Indonesia. Food record and anthropometric assessment is conducted as an additional analyses on subject. Aim of this study is to determine the relationship between plasma leptin levels and cognitive function in the elderly in Jakarta. This is a cross sectional descriptive analytical research using purposive sampling as the sampling method. Subject are elderly residing in social welfare home, and being assessed using MOCA-INA instrument, IADL and GPAQ questionnaire, plasma leptin, body composition, anthropometric and Food Record are measured. The data is analysed through univariate, bivariate and multivariate analysis.
Result of this study are subject characteristic of age ranging from 60-74 years, with female as the majority (67.5%), normal nutritional status (46.2%), body fat ranging from 18.10 to 57.10 %, muscle mass 20.20 to 57.50 kg. Majority of subject do not smoke, have a low education level (≤ 12 year of education), engage in moderate physical activity, and having independent functional capacity. A total of 96.2% of the subject experience cognitive impairment. Plasma leptin levels ranging from 1.4 to 8.5 ng/mL, with median of 5.9 ng/mL. There is a significant relationship between leptin levels, body mass index, body weight, total body fat, education and IADL with cognitive function in the elderly in Jakarta. The correlation between plasma leptin levels and cognitive function in the elderly in Jakarta, shows a moderately positive correlation with r value of 0.47 and a significance of 0.000."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2024

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