Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Aortoiliac disease adalah varian dari PAD yang lesi obstruktifnya terdapat di aorta infrarenal, arteri iliaka komunis, arteri iliakan interna, arteri iliaka eksterna, atau kombinasi di antaranya. Diagnosis PAD pada aortoiliac disease dapat dilakukan secara klinis, dengan menilai gejala klinis sesuai klasifikasi Rutherford maupun Fontaine. Jumlah klasifikasinya pada level aorta abdominalis hingga pedis kemudian dibagi 3 segmen sesuai dengan letak anatomi kemudian dapat dihitung menggunakan nilai Lower Leg Arterial Calcium (LLAC) score.Metode: Penelitian ini menggunakan desain cross sectional yang menggunakan data dari rekam medis CT angiography secara restrospektif di RSCM dan beberapa RS Pendidikan jejaringan dari bulan Januari 2019 – Juni 2022. Jumlah sampel sebanyak 20 subjek per kelompok dan dana di analisis menggunakan SPSS versi 25 for Mac.Hasil: Dari 56 subjek penelitian dengan aortoiliac disease, terdapat 20 subjek yang dilakukan operasi bedah bypass terbuka dan 36 subjek yang dilakukan operasi endovaskular. Secara statistik, tidak terdapat perbedaan LLAC score yang bermakna antara pasien aortoiliac disease yang dilakukan operasi bedah terbuka dengan yang dilakukan operasi endovaskular (p>0,05) dan tidak terdapat hubungan antara nilai range LLAC score dengan pilihan tindakan revaskularisasi dengan nilai p=0,601.Kesimpulan: Semua nilai LLAC score pada aortoiliac disease adalah kategori severe. Selain itu, tidak ada perbedaan yang bermakna antara nilai LLAC score dengan tindakan revaskularisasi bedah terbuka dan endovaskular serta tidak ada perbedaan bermakna antara nilai LLAC score kategori severe terhadap tindakan revaskularisasi bedah terbuka dan endovaskular.

---

Background: Aortoiliac disease is a variant of PAD in which obstructive lesions are found in the infrarenal aorta, common iliac artery, internal iliac artery, external iliac artery, or a combination of them. The diagnosis of PAD in aortoiliac disease can be done clinically, by assessing clinical symptoms according to Rutherford's and Fontaine's classifications. The number of classifications at the level of the abdominal aorta to the pedis is then divided into 3 segments according to the anatomical location and can then be calculated using the Lower Leg Arterial Calcium (LLAC) score.Method: This study used a cross-sectional design that used data from CT angiography medical records retrospectively at RSCM and several networked Education Hospitals from January 2019 – June 2022. The number of samples was 20 subjects per group and the funds were analyzed using SPSS version 25 for Mac.Results: A total of 56 study subjects with aortoiliac disease, 20 subjects underwent open bypass surgery and 36 subjects underwent endovascular surgery. Statistically, there was no significant difference in LLAC scores between patients with aortoiliac disease who underwent open surgery and those who underwent endovascular surgery (p>0.05) and there was no relationship between the LLAC score range and the choice of revascularization with a value of p=0.601.Conclusion: All LLAC scores for aortoiliac disease are in the severe category. In addition, there was no significant difference between the LLAC score and open and endovascular revascularization procedures and there was no significant difference between the LLAC score in the severe category for open and endovascular revascularization procedures."

"Turbulensi laju jantung (heart rate turbulence [HRT]) baru-baru ini dianggap sebagai prediktor terbaru paling kuat untuk terjadinya kematian mendadak (sudden cardiac death [SCD]) melebihi prediktor lain yang telah ada sebelumnya. Pasien penyakit jantung koroner yang menjalani reperfusi koroner ternyata memberikan hasil HRT lebih baik dan hal ini mencerminkan pulihnya respon baroreseptor.Penelitian ini akan membandingkan nilai turbulence onset (TO) dan turbulence slope(TS) pada dua jenis reperfusi (PCI dan fibrinolitik) Subjek menjalani monitoring EKG selama 24 jam setelah dilakukan revaskularisasi. TO ditentukan dengan cara mengukur perubahan relatif dua interval RR irama sinus setelah ekstrasistol ventrikel dan dua RR interval terakhir sebelum ekstrasistol ventrikel. TS dihitung dengan dengan mengukur slope maksimum yang dibuat tiap 5 buah RR interval. Terdapat 13 pasien (usia rata-rata 56 + 9 tahun) yang memenuhi syarat untuk ikut dalam penelitian. Sepuluh pasien menjalani fibrinolitik dan tiga pasien menjalani PCI. Terdapat perbedaan bermakna nilai TO antara kelompok PCI dan fibrinolitik (-3,3 + 1,7 % vs -0,2 + 0,9 %; P=0,03). Terdapat kecenderungan kelompok PCI memberikan nilai TS yang lebih baik dibanding kelompok fibrinolitik, walaupun secara statistik tidak signifikan ( 7,7 + 4,4 msec/RR interval vs 3,4 + 2,6 msec/RR interval; P = 0,056). Disimpulkan bahwa subjek dengan STEMI akut yang menjalani PCI mempunyai nilai TO yang lebih baik dibanding subjek yang menjalani terapi fibrinolitik.

---

Heart rate turbulence (HRT) as novel predictor of sudden cardiac death were superior to all other presently available indicators. HRT significantly was improves after successful reperfusion reflecting rapid restoration of baroreceptor response. We investigated turbulence onset (TO) and turbulence slope (TS) values among patients with acute ST-elevation myocardial infarction (STEMI) underwent revascularization by means of primary PCI or fibrinolytic. We hypothesized that the values of TO and TS were different in two kinds of revascularization treatment. The subjects underwent 24 hours ECG recording after revascularization therapy. TO was quantified by the relative change of the first two sinus RR intervals following a ventricular premature beat (VPB) and the last two sinus RR intervals before the VPB. TS was quantified by the maximum positive slope of a regression line assessed over any sequence of five subsequent sinus rhythm RR intervals within the first two sinus rhythm intervals after a VPB. Thirteen patients (mean of age 56 + 9 years old) who underwent revascularization treatment of acute STEMI were eligible as subject of this study.Ten patients underwent fibrinolytic therapy and three patients underwent primary PCI. TO value was significantly different between PCI group and fibrinolytic group (-3.3 + 1.7 % vs -0.2 + 0.9 % ; P=0.03). The Primary PCI group has better outcome on turbulence slope value (TS) than fibrinolytic group but not significance (7.7 + 4.4 msec/RR interval vs 3.4 + 2.6 msec/RR interval; P = 0.056). In conclusion, TO was better in acute STEMI patient undergone PCI compare to that undergone fibrinolytic therapy."

"Latar Belakang: Beban penyakit gagal jantung semakin meningkat dan sekitar 50% kasus adalah HFrEF. Penyakit jantung koroner merupakan penyebab utama HFrEF. Pada kasus ini, pemulihan fungsi ventrikel kiri merupakan tujuan utama terapi karena berhubungan dengan penurunan risiko kejadian kardiovaskular. 1 Populasi dengan pemulihan FEVK dikategorikan sebagai HFrecEF dimana populasi ini memiliki karakteristik yang berbeda. 2 Belum terdapat suatu studi yang melihat prediktor pemulihan FEVK sesuai kriteria HFrecEF JACC pada populasi kardiomiopati iskemik setelah revaskularisasi lengkap.Tujuan: Mengetahui faktor-faktor yang mempengaruhi terjadinya pemulihan FEVK pasca revaskularisasi lengkap operasi bedah pintas arteri koroner pada populasi kardiomiopati iskemik.Metode: Sebuah penelitian kohort retrospektif dengan populasi penelitian kardiomiopati iskemik yang menjalani revaskularisasi lengkap dengan BPAK selama periode Januari 2019 sampai dengan Juli 2022 di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita.Hasil: Terdapat 105 subjek yang memenuhi kriteria inklusi, dengan 72 (68,5%) subjek pada kelompok nonHFrecEF dan 33 (31,5%) subjek pada kelompok HFrecEF. Pada analisis multivariat, LVESD (OR 0,87; p=0,018)) merupakan prediktor independen HFrecEF. Penggunaan RAAS Inhibitor postoperatif menurunkan risiko mortalitas dalam 1 tahun secara signifikan (HR 0,036; p=0,07). Follow up kesintasan 1 tahun menunjukkan tidak ada perbedaan bermakna antara kelompok HFrecEF (95%) dan nonHFrecEF (96%) dengan nilai p=0,999. Terdapat perbedaan kesintasan yang signifikan antara pengguna RAAS Inhibitor dan bukan pengguna RAAS Inhibitor pada populasi penelitian (p<0,0001).Kesimpulan: Nilai LVESD adalah prediktor independen pemulihan FEVK. Angka kesintasan 1 tahun pada seluruh populasi cukup baik yaitu lebih dari 90%. Penggunaan  RAAS Inhibitor pada penelitian ini tidak menunjukkan dampak pemulihan FEVK, namun pengaruhnya pada kesintasan 1 tahun menekankan pentingnya pemberian terapi optimal gagal jantung pada populasi ini.

---

It is estimated that the disease burden of heart failure has increased and about 50% of cases are HFrEF. Coronary heart disease is the main risk for heart failure. Left ventricular function recovery is the most important goals of heart failure therapy. It is associated with a reduced risk of cardiovascular events. These population is categorized as patients with HFrecEF where they have unique characteristics. There has not been a study looking at predictors of recovery of EF according to the JACC HFrecEF criteria in the ischemic cardiomyopathy population after complete revascularization.

Objectives: To evaluate the factors that predicts the recovery of FEVK after complete revascularization by coronary artery bypass surgery in the ischemic cardiomyopathy population.

Methods: This retrospective cohort study used secondary data. Basic data was obtained through medical record and registry of ischemic cardiomyopathy patients underwent complete revascularization with CABG during the period January 2019 to July 2022 at Harapan Kita Cardiovascular Hospital.

Results: A total of 105 subjects were obtained, there were 72 (68.5%) subjects in the nonHFrecEF group and 33 (31.5%) subjects in the HFrecEF group. In multivariate analysis, LVESD (OR 0.87; p=0.018)) was an independent predictor of HFrecEF. Postoperative use of RAAS Inhibitors reduced the risk of mortality within 1 year significantly (HR 0.036; p=0.07). No significant difference in 1 year survival follow-up between the HFrecEF (95%) and non-HFrecEF (96%) groups with p = 0.999. There was a significant difference in survival between RAAS Inhibitor users and non-RAAS Inhibitor users in the entire study population (p<0.0001).

Conclusion: In ischemic cardiomyopathy patients undergoing CABG, LVESD score is an independent predictor of recovery of LVEF. The 1-year survival rate in the entire population was >90%. Although the use of RAAS inhibitors in this study did not show an impact on recovery of LVEF, its effect on 1-year survival emphasizes the importance of providing optimal therapy for heart failure in this population."

"Level rekomendasi penggunaan rutin intra-arotic balloon pump (IABP) pada pasien dengan renjatan kardiogenik diturunkan menjadi level III. Manfaat penggunaan IABP sebelum revaskularisasi belum diinvestigasi secara uji klinis acak. Tujuan studi ini untuk menilai pengaruh penggunaan IABP sebelum revaskularisasi pada pasien infark miokard akut dengan komplikasi renjatan kardiogenik.Uji klinis acak pembanding terbuka dilakukan di Pusat Jantung Nasional Harapan Kita periode januari 2018 hingga Mei 2020. Randomisasi dilakukan pada 69 subjek infark miokard dengan renjatan kardiogenik. Alokasi kelompok kontrol 34 subjek dan perlakuan (IABP sebelum revaskularisasi) 35 subjek. Luaran primer adalah mortalitas rumah sakit dan pasca revaskularisasi hari ke_30. Luaran sekunder perfusi global (bersihan asam laktat jam ke_12), perfusi regional (kreatinin), performa jantung yang dinilai secara ekokardiografi (Global longitudinal strain) dan penanda biologis untuk regangan miokard (NT-proBNP dan ST2). Variabel hemodinamik ekokardiografi dan komplikasi tindakan juga dilaporkan.Setelah drop out, Analisis perprotokol dilakukan pada 18 subjek kelompok kontrol dan 16 subjek kelompok perlakuan. Mortalitas rumah sakit dan 30 hari pasca revaskularisasi, 12 (66,7%) subjek pada kelompok kontrol dan 9 (56,3%) subjek pada kelompok perlakuan, p 0,533. Pada luaran sekunder tidak ditemukan perbedaan bermakna pada kedua kelompok untuk bersihan laktat efektif jam ke-12; pemeriksaan kreatinin, global longitudinal strain, hemodinamik ekokardiografi dan nilai NT-proBNP dan ST2. Pada hari ke_3, kurva kaplan meier berpisah dan mortalitas RS dini pada kelompok kontrol 9 (50%) subjek dan pada kelompok perlakuan 1 (6,25%) subjek, hasil uji fisher p 0,013. Mortalitas RS lanjut berhubungan dengan IABP dan sepsis. Dua patomekanisme diusulkan untuk menerangkan patomekanisme kematian pada kelompok kontrol dan kelompok perlakuanSimpulan: Penggunaan IABP sebelum revaskularisasi pada subjek infark miokard akut dengan komplikasi renjatan kardiogenik tidak memperbaiki mortalitas rumah sakit dan pasca perawatan hari ke-30. Pada kelompok kontrol diusulkan patomekanime mortalitas serangan fisiologis kali satu. Kelompok perlakuan, patomekanime mortalitas diusulkan serangan fisiologis kali dua.

---

The guideline recommendation on routine use of Intra Aortic balloon pump (IABP) in cardiogenic shock had been downgraded to level recommendation III. The role of IABP insertion before revascularization has never been investigated in randomized control trial. The aim of this study is to investigate the role of IABP insertion before revascularization in acute myocardial infarction complicated by cardiogenic shock.

Randomized control trial was performed in National Cardiac Center Harapan Kita at the period January 2018–April 2020. We randomly assigned 69 patients cardiogenic shock due to acute myocardial infarction. There are 34 patients assigned to control group (no IABP) and 35 patients assigned to intervention group (IABP before revascularization). Percutaneous Coronary Intervention and medical care were performed according to local protocol. The primary end points were in-hospital mortality and mortality at 30 days post revascularization. The secondary end points were perfusion (lactate clearance, creatinine), cardiac performance (global longitudinal strain), Biomarker for myocardial stretch (NT-proBNP & ST2). Echo hemodynamic and complication variables were also reported.

After drop out, a total of 18 patients in the control group and 16 patients in intervention group (IABP before revascularization were included in per protocol analysis for the primary and secondary end points. The primary end result of in hospital mortality and 30 days post revascularization mortality were identical in 12 patients in the control group (66.7%) and 9 patients in the intervention group (56.3%), p 0,533. There were no significant differences in secondary end points, effective lactate clearance at 12 hour, creatinine, Global Longitudinal Strain, NT-proBNP, ST2 including echo hemodynamic, dose of catecholamine therapy and sepsis. At the third day, Kaplan Meier curve demonstrated early separation with significant difference in mortality 9 patients in the control group (50%) and 1 patients in the intervention group (6,25%), p 0,013. Late in hospital was associated with IABP and sepsis. There was also a trend of greater elevation of NT-proBNP on day 3 in the intervention group. Therefore, pathomechanisms of death for control group and intervention group were proposed.

Conclusion: The use IABP before percutaneous intervention in patient shock cardiogenic due to acute myocardial infarction did not improve clinical outcome in hospital mortality or 30 days post Revascularization. One hit of physiological deterioration model for cardiogenic cardiogenic shock patient and two hit of physiological deterioration model for cardiogenic shock patient treated with IABP before revascularization were proposed. "

"ABSTRAKLatar belakang : Penggunaan konsentrasi kalsium dialisat ([Ca-D]) masih kontroversi. Di Indonesia masih digunakan [Ca-D] yang berbeda-beda antara 1,25 mmol/L ? 1,85 mmol/L. Studi DOPPS mendapatkan kegagalan dalam pencapaian kadar kalsium (Ca), fosfat (PO4), produk CaxP dan hormon paratiroid (HPT) sesuai yang ditargetkan K/DOQI dan semua penyebab risiko mortalitas secara signifikan berhubungan dengan tingginya [Ca]-D

Tujuan : Mengetahui perbedaan kadar Ca darah, PO4, HPT dan kalsifikasi vaskular pada penggunaan [Ca]-D tinggi dan rendah. Metode : Penelitian adalah studi potong lintang analitik dilakukan di Unit Hemodialisis Divisi Ginjal-Hipertensi RS Cipto Mangunkusumo, Jumlah subyek 46 orang. Dua puluh tiga pasien menggunakan [Ca]-D rendah (1,25 mmol/L) dan 23 pasien menggunakan [Ca]-D tinggi (1,85 mmol/L). Penelitian dilakukan Oktober 2013 ? Mei 2014. Analisis statistik dengan uji Mann Whitney dan uji Chi square. Menggunakan SPSS 20.0.Hasil : Sebanyak 46 pasien, terdiri dari 25 laki-laki dan 21 perempuan, dengan rerata usia 50,87 + 12,74 tahun. Lama HD 45,50 (6-168 bulan). Subyek penelitian yang mencapai target kontrol metabolisme sesuai panduan K/DOQI 2002 pada [Ca]-D rendah : Ca terkoreksi, PO4, produk Ca xPO4, dan HPT yang mencapai target sebanyak 8(34,8%), 10(43,5%), 15(65,2%) dan 2(8,7%) pasien. Pada [Ca]-D tinggi didapatkan 10(43,5%), 8(34,8%), 15(65,2%), 8(34,8%) pasien. Penelitian kami mendapatkan dengan [Ca]-D tinggi hasil lebih baik, hal ini tidak sama dengan hasil penelitian DOPPS. Berbeda dengan PO4 yang hasilnya lebih baik dengan [Ca]-D rendah, namun hasil kami juga lebih baik dari penelitian DOPPS. Hasil pada HPT lebih buruk pada [Ca]-D rendah dibandingkan DOPPS, hal ini mungkin disebabkan kami tidak menggunakan vitamin D untuk mengatasi hiperparatiroid sekundernya. Kalsifikasi vaskular dengan metode KAA pada [Ca]-D tinggi sebanyak 13(48,1%) sedangakan pada [Ca]-D rendah sebanyak 14(51,9%). Dengan metode KAAb pada [Ca]-D tinggi didapatkan kalsifikasi sebanyak 16(47,1%) dan pada [Ca]-D rendah didapatkan 18(52,9%) kalsifikasi. Simpulan : Terdapat perbedaan kadar Ca, PO4, produk Ca x PO4, HPT dan kalsifikasi vaskular, pada penggunaan [Ca]-D tinggi dan rendah, tetapi yang berbeda bermakna hanya Ca dan HPT.

---

ABSTRACTBackground : The use of calcium dialysate is still controversial. In Indonesia, the dose for [Ca-D] still varies between 1,25 mmol/L ? 1,85 mmol/L. DOPPS study shows failure in achieving optimal calcium, phosphate as well as parathyroid hormone level in the blood as targetted by K/DOQI and is related to significantly increased mortality and is closely related with increased [Ca]-D.Aim : Evaluate the difference in Serum Ca, PO4, PTH levels and vascular calcification in concentrations of [Ca]-D high and low.Methods : This is a cross sectional study done in Hemodialysis unit in Nephrology Division of Cipto Mangunkusumo hospital. Total subject recruited was 46 patients, 23 patient using low concentration [Ca]-D (1.25 mmol/L) and 23 patients using high concentration [Ca]-D (1.85mmol/L). Research was conducted in October 2013 until May 2014. Analysis was performed using Mann Whitney test and Chi Square, statistical analysis was done using SPSS 20.0.Result : A total of 46 patients consisting of 25 men and 21 women, with mean age of 50,87 + 12,74 years. Mean length of Dialysis was 45,50 months (6-168 months). Subjects using low concentration [Ca]-D who reached target concentration according to K/DOQI consisted of : corrected Ca in 8 (34,8%) patients while in high concentration [Ca]-D consisted of 10(43,5%) patients, better than DOPPS study. In terms of phosphate levels, low concentration [Ca]-D achieved target PO4 level in 10(43,5%) patients while high concentration [Ca]-D achieved target in 8(34,8%) patients. Corrected Ca x PO4 target levels were obtained equally in both groups which was 15(65,2%) patients. Target PTH level was achieved in low concentrated [Ca]-D up to 2(8,7%) patients, very low may be caused we did not use vitamin D and 8(34,8%) patients in high concentrated [Ca]-D. Vascular calcification using KAA method showed incidence of 13(48,1%) in high concentrated [Ca]-D and 14(51,9%) in low concentrated [Ca]-D group. On the other hand, KAAb methods revealed calcification of 16(47,1%) in high concentrated [Ca]-D and 18(52,9%) calcification in low concentrated [Ca]-D.Conclusion : There is a difference in Ca, PO4, Ca X PO4 product serum level and vascular calcification in high and low [Ca]-D in both group however, statistically significant difference was found only in serum Ca and PTH levels."

"Bone mineral content at old age is dependent upon the peak bone mass achieved in youth and subsequent adult bone loss (Matkovic, 1992). Adequate calcium consumption during childhood is beneficial for the acquisition of peak bone mass and density. It is therefore, calcium has been considered to play important role in the pathogenesis of osteoporosis (NIH, 1994), and osteoporosis has been described as a pediatric disease that manifests itself in old age (Lysen and Walker, 1997). If children fail to take in enough calcium, they are more likely to develop osteoporosis later in life (Insel et al., 2002). Nevertheless, calcium is one of the nutrients that most likely to be low or deficient in children's diets (Krause's, 2000). Recently, calcium has been suspected to have a positive effect in preventing some disorders, including diarrhea. Bovee et al., (2003) indicated that low calcium intake has been shown to impair host resistance to food-borne intestinal infections. Because of childhood morbidity and mortality due to infectious diarrhea is very high in developing countries, adequate dietary calcium intakes of the children will likely improve their bone as well as intestinal health (Bovee et al., 2003). Dairy products are always regarded as primary source of calcium. It is difficult to meet the RDA for calcium without milk or milk products (Krause, 1992). Unfortunately, the general Indonesian population does not commonly consume milk.

The results of 1997 national survey on households' food consumption pattern across provinces in Indonesia reveal that milk consumption was zero, or milk product was never consumed in the last three months at the time of survey (Sumarno at al., 1997). In line with the 1997 national survey, Ariani et al., (1997) reported that the level of milk consumption was lower than that of other animal products across the provinces in Indonesia, and in general, milk consumption of Indonesian population was below the standard of adequacy of milk consumption according to Widyakarya National Pangan dan Gizi 1998 (4.6 kg/cap/year). The above facts indicate that many Indonesians may consume calcium-deficient diet."

"Gemuk bio overbased kalsium sulfonat kompleks dibuat dari minyak kelapa sawit terepoksidasi yang digunakan sebagai base oil dan overbased kalsium sulfonat kompleks sebagai thickening agent. Thickening agent yang digunakan dalam penelitian ini adalah kalsium sulfonat, kalsium karbonat, dan kalsium hidroksida sebagai sabun utama (overbased kalsium sulfonat) serta kalsium oleat terepoksidasi dan kalsium asetat (kalsium oleat-asetat) sebagai pengompleksnya. Perbandingan campuran kalsium sulfonat-karbonat-hidroksida sebagai overbased kalsium sulfonat dengan kalsium oleat terepoksidasi-asetat sebagai pengompleks yaitu 5% : 95% dan 50% : 50%. Gemuk ini dihasilkan dari proses saponifikasi yang menggunakan reactor batch tertutup, dilanjutkan dengan proses pendinginan, dan terakhir proses homogenisasi. Pengaruh variasi komposisi pengompleks sebagai thickener dapat dilihat dari pengujian karakteristik gemuk bio yang terdiri dari uji sifat fisik dan kimia seperti uji tampilan gemuk, uji mulur, uji penetrasi, dan uji dropping point, serta uji four ball untuk mengetahui performa dari gemuk. Hasil terbaik yang didapat pada perbandingan overbased kalsium sulfonat : kalsium oleat-asetat sebesar 5% : 95% yaitu gemuk dengan komposisi thickening agent 35% dengan rentang penarikan mulur 9.5 cm, tingkat konsistensi NLGI #2, nilai dropping point 250˚C, dan nilai keausan sebesar 0.2 mg. Untuk gemuk dengan perbandingan overbased kalsium sulfonat : kalsium oleat-asetat sebesar 50% : 50% yaitu gemuk dengan komposisi thickening agent 50% dengan rentang penarikan mulur 7 cm, tingkat konsistensi NLGI #2, nilai dropping point 269˚C, dan nilai keausan sebesar 0.3 mg.

---

Overbased calcium sulfonate grease bio complex is made from palm oil epoxidized as a base oil and overbased calcium sulfonate complex as a thickening agent. Thickening agent used in this study is calcium sulfonate, calcium carbonate, and calcium hydroxide as a major soap (overbased calcium sulfonate) and epoxidized oleic calcium and acetate calcium (oleic-acetate calcium) as complexing. Comparison of a mixture of calcium sulfonate-carbonate-hydroxide as overbased calcium sulfonate with epoxidized oleic calcium-acetate calcium as complexing is 5% : 95% and 50% : 50%.

This grease is produced from the saponification process which uses a closed batch reactor, followed by a cooling process, and the final homogenization process. Effect of complexing composition variations as a thickener can be seen from the test characteristics of bio grease, consisting of physical and chemical properties test such as a test to see grease, creep testing, penetration testing, dropping point testing, and four ball test to determine the performance of the grease.

The best results were obtained in comparison overbased calcium sulfonate : oleic calcium-acetate at 5% : 95% are grease with thickening agent composition of 35% with a range of 9.5 cm, the level of consistency of NLGI # 2, the value of dropping point 250˚C, and value of wear 0.2 mg. For the grease by comparison overbased calcium sulfonate : oleic calcium-acetate at 50% : 50% are grease with thickening agent composition of 50% with a range of 7 cm, the level of consistency of NLGI # 2, the value of dropping point 269˚C, and anti-wear value is 0.3 mg."

"ABSTRAKPada pembuatan gemuk bio ini digunakan Kalsium karbonat atau CaCO3 berukuran submikro-mikro sebagai aditif padat untuk meningkatkan sifat antiwear dari gemuk bio yang dihasilkan dengan NLGI #2. Penelitian ini diawali dengan pengepoksidasian minyak sawit pada suhu 65 ˚C; sintesis gemuk bio yang meliputi proses pengadukan, pemanasan, dan saponifikasi pada suhu maksimum 165 ˚C; homogenisasi pada suhu 70 ˚C; serta pengujian karakteristik dan performa gemuk bio yang meliputi uji konsistensi, uji dropping point, serta four ball test untuk menguji sifat antiwear gemuk bio dengan kecepatan putaran sebesar 1150 rpm. Adapun variabel yang terdapat pada penelitian ini yaitu waktu dan suhu selama proses sebagai variabel control; komposisi aditif CaCO3 sebagai variabel bebas; ukuran partikel CaCO3, komposisi base oil, thickener agent, dan BHT serta hasil uji karakteristik sebagai variabel terikat. Hasil yang didapat yaitu gemuk bio NLGI #2 dengan dropping point pada suhu 301 ˚- 317 ˚C. Untuk hasil pengujian antiwear terbaik didapat pada gemuk bio dengan penambahan 3,5% CaCO3 submikro-mikro dengan pengurangan massa ball bearing sebesar 0,7 mg, sementara pada gemuk bio dengan 0% CaCO3 pengurangan tersebut sebesar 250 mg.

---

ABSTRACTIn the making of this bio grease, calcium carbonate or CaCO3 in submicro-micro size is used as a solid additive to increase its antiwear properties. To start the research, the epoxidation of palm oil in 65 ˚C is done first; and then synthesizing of bio grease which consists of mixing, heating, and saponification with maximum temperature at 165 ˚C; homogenization in 70 ˚C; and characterization tests that includes the concistency test, dropping point test, and four ball test. The variable contained in this research are time and temperature as control variable; composition of CaCO3 as independent variable; CaCO3 particle size, composition of base oil, thickener agent, BHT, and the result of characterization test as dependent variable. To start the research, the epoxidation of palm oil is done first, and then synthesizing of bio grease, and characterization testing that includes the elasticity test, concistency test, dropping point test, and four ball test in 1150 rpm. The results of this research are, the bio grease has NLGI #2 with 301 ˚- 317 ˚C in dropping point test. For the antiwear test, the best result is possessed by bio grease with 3.5% of CaCO3 addition with reduction of mass ball bearing as much as 0.7 mg, meanwhile in bio grease with 0% of CaCO3 gave 250 mg reduction of mass ball bearing."

"Infark ventrikel kanan yang terutama terjadi sebagai komplikasi infark enitas penaykit tersendiri dimana dapat terjadi gangguan hemodinamik mayor."

"Latar Belakang: Chronic limb threatening ischemia (CLTI) merupakan tahap akhir dari penyakit arteri perifer (PAP) yang menyebabkan morbiditas dan mortalitas yang tinggi. Penyakit arteri perifer dapat menjadi penanda aterotrombosis pada sistem vaskular lainnya. Peran mikrobiota usus dalam penyakit vaskular telah menjadi perhatian dalam penelitian terbaru. Perubahan komposisi mikrobiota usus dapat terjadi pada berbagai penyakit termasuk DM dan penyakit kardiovaskular. Short chain fatty acid (SCFA) adalah produk fermentasi mikrobiota usus dan dapat mempengaruhi kesehatan usus dan peradangan. SCFA dapat menghambat pembentukan foam cells dan mengurangi produksi sitokin pro-inflamasi oleh endotel. Deposit kalsium pada arteri adalah karakteristik dari proses aterosklerosis dan dapat dinilai menggunakan CT angiography. Tujuan dari penelitian ini adalah untuk mengevaluasi hubungan antara kadar SCFA dalam feses dengan tingkat kalsifikasi arteri pada pasien CLTI dengan DM.Metode: Penelitian desain potong lintang pada 30 subjek CLTI dengan DM tipe 2 yang dirawat di RSUPN Cipto Mangunkusumo. Pengukuran kadar SCFA dengan sampel feses. Analisis statistik menggunakan SPSS versi 25, nilai p<0.05 menunjukkan kemaknaan secara statistik.Hasil: Sebanyak 30 subjek penelitian CLTI dengan DM, didapatkan 17 subjek dengan diagnosis CLTI ekstremitas inferior sinistra dan 13 subjek dengan diagnosis CLTI ekstremitas inferior dekstra memiliki nilai kalsifikasi terberat pada regio right femoropopliteal dengan skor 449,46 ± 289,92 diikuti regio left femoropopliteal dengan skor 425 (0-6759). Didapatkan korelasi positif sedang antara persentase propionat dan skor LLAC regio left below knee (r=0,521; p= 0,032). Didapatkan korelasi positif lemah antara kadar HDL dengan aortoiliac score (r=0,371; p=0,043). Terdapat korelasi positif sedang pada kadar LDL dengan LLAC regio left below knee (r=0,535; p=0,027) serta korelasi positif kuat antara nilai kolestrol total dengan LLAC regio left below knee (r=0,671; p=0,003).Kesimpulan: Ekskresi SCFA pada feses yang tinggi dapat mencerminkan nilai LLAC yang tinggi terutama regio femoropopliteal pada subjek CLTI dengan diabetes melitus.

---

Background: Chronic limb threatening ischemia (CLTI) is the end stage of peripheral artery disease (PAD) and is associated with high morbidity and mortality. Peripheral artery disease can serve as a marker of atherothrombosis in other vascular systems. The role of gut microbiota in vascular diseases has gained attention in recent research. Changes in gut microbiota composition have been observed in various diseases, including type 2 diabetes mellitus (DM) and cardiovascular diseases. Short chain fatty acids (SCFA), which are products of gut microbiota fermentation, can influence gut health and inflammation. SCFA can inhibit foam cell formation and reduce the production of pro-inflammatory cytokines by endothelial cells. Arterial calcification, assessed using CT angiography, is a characteristic feature of atherosclerosis. The aim of this study was to evaluate the relationship between fecal SCFA levels and arterial calcification in CLTI patients with DM.

Methods: A cross-sectional study was conducted on 30 CLTI subjects with type 2 DM who were treated at RSUPN Cipto Mangunkusumo. SCFA levels were measured using fecal samples. Statistical analysis was performed using SPSS version 25, with a significance level of p<0.05.

Results: the 30 CLTI subjects with DM, 17 had CLTI in the left lower extremity and 13 had CLTI in the right lower extremity. The highest calcification score was found in the right femoropopliteal region with a score of 449.46 ± 289.92, followed by the left femoropopliteal region with a score of 425 (0-6759). A moderate positive correlation was found between the percentage of propionate and the LLAC score in the left below knee region (r=0.521; p=0.032). A weak positive correlation was observed between HDL levels and the aortoiliac score (r=0.371; p=0.043). There was a moderate positive correlation between LDL levels and the LLAC score in the left below knee region (r=0.535; p=0.027), as well as a strong positive correlation between total cholesterol levels and the LLAC score in the left below knee region (r=0.671; p=0.003).

Conclusion: High fecal SCFA excretion may reflect high LLAC scores, particularly in the femoropopliteal region, in CLTI subjects with diabetes mellitus.

"