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Evans Tofano Bobian
Hubungan Polimorfisme Gly972Arg Gen Insulin Receptor Substrate-1 dengan Nilai Ankle-brachial Index pada Populasi Rural di Indonesia = Association between Gly972Arg Polymorphism of Insulin Receptor Substrate-1 Gene and Ankle-brachial Index Values on Rural Population in Indonesia
"Penyakit Arteri Perifer (PAP) merupakan obstruksi total atau parsial dari arteri perifer yang terutama disebabkan oleh proses aterosklerosis. Disfungsi endotel telah dikenal sebagai penanda dini dari aterosklerosis. Dari penelitian sebelumnya, diketahui polimorfisme Gly972Arg gen IRS-1 berhubungan dengan disfungsi endotel. Hingga saat ini belum ada penelitian yang menghubungkan secara langsung antara polimorfisme IRS-1 dengan penyakit arteri perifer. Penelitian ini bertujuan untuk mengetahui hubungan antara polimorfisme Gly972Arg dengan nilai Ankle-Brachial Index (ABI) sebagai penanda penyakit arteri perifer. Studi observasional (potong lintang) ini dilakukan pada 104 subjek populasi Desa Gunung Sari Kecamatan Pamijahan. Dilakukan pemeriksaan lab untuk polimorfisme Gly972Arg gen IRS-1 dengan metode Taqman Assay. Data pemeriksaan ABI diambil dari data retrospektif di Desa Gunung Sari, Kecamatan Pamijahan, Jawa Barat yang diambil pada tahun 2017. Terdapat 104 subjek yang diikutsertakan dalam penelitian ini, yaitu grup wildtype/CC (6,7%), heterozigot/CT (82,7%), dan homozigot mutan/TT (10,6%). Tidak terdapat hubungan yang bermakna antara polimorfisme Gly972Arg gen IRS-1 dengan nilai ABI (p= 0,7). Setelah dilakukan penyesuaian terhadap merokok, hipertensi, diabetes melitus dan indeks massa tubuh, dapat disimpulkan bahwa hasil hubungan tidak bermakna antara polimorfisme Gly972Arg gen IRS-1 dengan ABI tidak dipengaruhi oleh faktor lain.
Peripheral Artery Disease (PAD) is defined as a total or partial obstruction of peripheral arteries, which mainly caused by an atherosclerotic process. Endothelial dysfunction is widely known as an early predictor of atherosclerosis. From previous studies, Gly972Arg polymorphism of IRS-1 gene is associated with endothelial dysfunction. To date, there is still very limited study about the association between Gly972Arg polymorphism of IRS-1 gene with Ankle-Brachial Index (ABI) as a marker of atherosclerosis in peripheral arteries. Therefore, we attempt to perform a study of association between Gly972Arg polymorphism of IRS-1 gene with ABI values. We performed a cross sectional study on 104 subjects from a rural population in Gunung Sari Village, Pamijahan District, West Java, Indonesia. Laboratory examinations for polymorphism detection uses Taqman Assay Method. Demographic, risk factors, and ABI data were obtained from a retrospective data in 2017. There were 104 subjects in this study. The prevalence of genotypes are as follows: Wildtype (6,7%), heterozygous carrier/CT (82,7%), and homozygous mutant/TT (10,6%). We found no significant association between Gly972Arg of IRS-1 gene with ABI values (p=0,7). After the adjustments for smoking, hypertension, diabetes, and body mass index, we concluded that none of those risk factors affected the results of our study."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T59133
UI - Tesis Membership  Universitas Indonesia Library
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Sophia Utami
Gambaran ultrasonografi dupleks penyakit arteri perifer pada penyandang diabetes mellitus tpe 2 dengan Ankle Branchial Index (ABI) normal
"Latar Belakang: Penyakit arteri perifer (PAP) adalah manifestasi aterosklerosis sistemik, yang seringkali melibatkan penyandang diabetes melitus (DM) tipe 2. Tes ankle brachial index (ABI) telah digunakan sebagai penapis PAP, tetapi ABI normal belum menyingkirkan PAP. USG dupleks (UD) lebih sensitif namun lebih mahal daripada tes ABI, sehingga perlu diketahui karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.
Tujuan: Tujuan penelitian ini adalah untuk membuktikan bahwa UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan ABI normal, mengenali gambaran UD PAP, dan mengenali karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.
Bahan dan Cara Kerja: Penelitian ini menggunakan desain potong lintang dengan mengikutsertakan 40 tungkai. Setiap subyek menjalani roc ABI, pemeriksaan UD dan pen ilaian faktor-faktor risiko. Arteri-arteri ekstremitas bawah d iperiksa, dengan penilaian terhadap ketebalan kompleks intima media (KIM) arteri femoralis, adanya plak, dan evaluasi spektrum Doppler.
Hasil: Dari pemeriksaan UD ditemukan PAP pada 50% (20 dari 40) tungkai. Gambaran UD PAP yang didapatkan berupa penebalan KIM arteri femoralis (20%, 4 dari 20 tungkai) dan adanya plak dengan spektrum Doppler yang masih normal di arteri-arteri ekstremitas bawah (100%, 20 dari 20 tungkai). Terdapat hubungaxi bermakna antara obesitas dan kejadian PAP (Rasio Odds = 22,45).
Kesimpulan: Dari penelitian ini, kami menyimpulkan bahwa: 1) UD dapat mendeteksi PAP pada penyandang DM tipe 2 dengan A131 normal; 2) Gambaran UD PAP pada pasien-pasien tersebut berupa penebalan KIM arteri femoralis dan adanya plak dengan spektnim Doppler normal di arteri-arteri ekstremitas bawah; 3) Obesitas merupakan karakteristik penyandang DM tipe 2 yang paling diprioritaskan untuk menjalani pemeriksaan UD.
Background: Peripheral arterial disease (PAD) is a manifestation of atherosclerosis disease, which commonly involves the non insulin dependent diabetes mellitus (NIDDM) patients. Ankle brachial index (A13I) test has been used as a screening test for PAD, but a normal ABI does not exclude PAD. Duplex ultrasonography (DU) is more sensitive but more expensive than ABI, so it is neccessaty to assess the characteristics q f NIDDM patiens who are mostly indicated to undergo DU examination.
Objectives: The objectives of this study are to prove that DU can detect PAD in NIDDM patients with normal ABI, to assess DU appearances of PAD, and to assess the characteristics of NIDDM patiens who are mostly indicated to undergo DU examination.
Materials and Methods: This study was conducted in a cross sectional design, which involved 40 legs. Every subject underwent ABI and DU examinations. Lower extremity arteries were examined, with assessment for femoral intitnal medial thickness (IMT), the presence of plaque, and evaluation of Doppler spectrum .1-or each artery. The risk factors were evaluated by anamnesis, physical examination and laboratory examination.
Results: From DU examination, as many as 50% (20 _ from 40 legs) are found to have PAD. The DU appearances q f PAD include increase_ femoral artery LMT (20%, 4 from 20 legs) and the presence of plaques with normal Doppler spectrums in the lower extremity arteries (100%, 20 from 20 legs). There was a significant relationship between obesity and the evidence of PAD (Odds ratio = 2 2, 45).
Conclusions: From this study, we conclude that: I) DU can detect PAD in NIDDM patients with normal ABI, 2) 7Tie DUI appearances of PAD in those patients include increase femoral arrey IMT and the presence of plaques with normal Doppler spectntras in the lower extremity arteries: 3) Obesity is the characteristic of NIDDM patients who are mostly indicated to undergo DU examination."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006
T21426
UI - Tesis Membership  Universitas Indonesia Library
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Siti Fazlines
Faktor-Faktor yang Berhubungan dengan Penyakit Arteri Perifer pada Pasien Diabetes Melitus Tipe 2 di Puskesmas DKI Jakarta = Factors Associated with Peripheral Arterial Disease in Type 2 Diabetes Mellitus at Community Health Centers in Jakarta
"Latar belakang : Peningkatan prevalensi penyakit arteri perifer (PAP) sejalan dengan peningkatan prevalensi diabetes melitus tipe 2 (DMT2). Strategi pencegahan komplikasi salah satunya berfokus pada pengendalian faktor risiko dan deteksi dini. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor-faktor yang berhubungan dengan PAP pada pasien DMT2 di tingkat layanan kesehatan primer.
Metode : Penelitian potong lintang ini melibatkan populasi DMT2 berusia 20-65 tahun yang berobat di sepuluh Puskesmas DKI Jakarta pada bulan Agustus 2020 – Juni 2021. Pasien yang dapat dilakukan pemeriksaan ABI dengan menggunakan USG doppler handheld pada salah satu atau kedua tungkai, dengan atau tanpa riwayat PAP sebelumnya, akan dimasukkan sebagai subjek penelitian dan dilakukan pencatatan data dasar usia, jenis kelamin, durasi penyakit diabetes, tekanan darah, kadar kolesterol total, K-HDL, K-LDL dan trigliserida serta riwayat merokok, berat badan, tinggi badan, indeks massa tubuh dan lingkar pinggang. Dianggap PAP bila nilai ABI £0,9 atau >1,3 pada masing-masing tungkai.
Hasil : Dari 188 pasien DMT2 yang memenuhi kriteria inklusi, sebanyak 27 (14,4%) pasien mengalami komplikasi PAP dan 24 pasien diantaranya adalah perempuan. Proporsi masing-masing untuk PAP ringan, sedang dan berat adalah 56%, 18% dan 26%. Analisis bivariat menunjukkan perempuan 3-4 kali lebih berisiko mendapatkan PAP (IK 95% 1,099-13,253, p=0,024), sementara usia, durasi diabetes, dislipidemia, hipertensi, obesitas, obesitas sentral dan merokok tidak dijumpai adanya perbedaan signifikan. Namun, setelah disesuaikan dengan durasi diabetes dan merokok pada analisis regresi logistik, jenis kelamin perempuan menunjukkan hasil tidak signifikan.
Simpulan : Tidak dijumpai adanya hubungan bermakna antara usia ≥50 tahun, jenis kelamin perempuan, durasi diabetes ≥10 tahun, hipertensi, dislipidemia, kebiasaan merokok, obesitas dan obesitas sentral terhadap PAP pada pasien DMT2.
Background: The increasing prevalence of peripheral arterial disease (PAD) is in line with that of type 2 diabetes mellitus (T2DM). To prevent diabetes complications needs focuses on controlling risk factors and early detection. The aims of the study were to determine the prevalence and predictors of PAD in diabetic patients at the primary care setting.
Method: A cross sectional study of 188 diabetic patients aged 20-65 years old who attended ten community health centers in Jakarta from August 2020 until June 2021. Patients were performed for ABI using handheld doppler ultrasound on one or both limbs, with or without a previous history of PAD, were included. Baseline data such as age, gender, duration of diabetes, blood pressure, total cholesterol levels, c-HDL levels, c-LDL levels, triglyceride levels, smoking history, weight, height, body mass index and waist circumference were recorded. PAD was defined as the ABI value £0.9 or >1.3 in each limb.
Result: Of the 188 T2DM patients who met the inclusion criteria, 27 (14.4%) patients experienced PAD and 24 of them were female. The proportions for mild, moderate and severe PAD were 56%, 18% and 26%, respectively. Bivariate analysis showed that female were 3-4 times at risk of PAP (95% CI 1.099-13.253, p=0.024), while there were no significant differences in age, duration of diabetes, dyslipidemia, hypertension, obesity, central obesity and smoking. However, after adjusting for duration of diabetes and smoking in logistic regression analysis, female had no statistically significant.
Conclusion: No significant relationship was found among age, gender, duration of diabetes, dyslipidemia, hypertension, obesity, central obesity, smoking and PAP in T2DM."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Alexander Jayadi Utama
The relationship between renal arterry stenosis and degree of angio score on the lower extremity peripheral arterial disease in Cipto Mangunkusumo
"Introduction: The most common cause of the peripheral arterial disease (PAD) is atherosclerosis. PAD is associated with other atherosclerotic diseases such as renal artery stenosis (RAS). Life expectancy decreases in patients with RAS, especially those whose stenosis is above 60% but has not reached the stage of chronic kidney failure. This study aims to determine the prevalence of RAS in PAD patients, the relationship between angiographic scoring system (ANGIO Score), history of hypertension, and diabetes mellitus with the degree of RAS. Method: This research was a cross-sectional study conducted at Cipto Mangunkusumo Hospital from February to May 2019. Patients with a diagnosis of lower extremity PAD and had been assessed with CT angiography examination, were included in this study. The degree of RAS and ANGIO Score were calculated. Sampling was done by the total sampling method. Results Most patients were women 33 (50.8%), while men were 32 (49.2%). 90.8% of the patients had diabetes, while 61.5% of the sample had hypertension. Grade 1 RAS was the most found. There was no correlation between ANGIO Score on age, sex, and diabetes mellitus, but there was a significant relationship with hypertension. There was a relationship between RAS with age and hypertension, but there was no relationship with diabetes mellitus and gender. ANGIO Score and RAS had a significant relationship (p <0.001). Conclusion: There was a relationship between the ANGIO Score and the severity of RAS. The cut-off score of 9 for the ANGIO Score had a sensitivity of 85.7% and a specificity of 61.4% for predicting RAS."
Jakarta: PESBEVI, 2020
616 JINASVS 1:1 (2020)
Artikel Jurnal  Universitas Indonesia Library
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Nyityasmono Tri Nugroho
Level of patency for a one year period of infra-inguinal arterial bypass in patients with peripheral artery disease
"Introduction: Peripheral arterial disease (PAD) is the most common macroangiopathic complication in type II diabetes mellitus, arising from inadequate blood sugar control. In the presence of PAD, the risk of limb loss will also increase, and arterial bypass is one method to reduce the risk of amputation. In Indonesia, the level of patency for the arterial bypass has not yet been published. On bypass with venous grafts, the patency rates at the location of infrapopliteal reach at 70-80%, while the prosthetic graft is 30-50%. Method: From 2009 to 2012, patients with arterial bypasses were analyzed. The level of patency was described by ultrasound examination and pulsation on clinical examination in the distal anastomosis, reduced pain, and other examinations that support adequate revascularization. Identification of risk factors that affect patency, particularly protective risk factors, were also taken into account. Results: From 2009 to 2012, 29 patients with infra-inguinal arterial bypass were collected. The ratio of men to women was 5:1, with a one-year patency rate of 88% in men, and 75% in women, for an overall of 86.2%. The irreversible risk factor affecting patency was male (p = 0.117). Modifiable risk factors that decreasing patency level were smoking (p = 0.042) and more advanced stage of PAD (p = 0.067). Smoking cessation (p = 0.041) and the use of drugs after bypass procedure (p = 0.072) were known to increase the level of patency. Conclusion: The one-year patency rate for infra-inguinal artery bypass was 37-89%. Smoking cessation was known to increase the level of patency."
Jakarta: PESBEVI, 2020
616 JINASVS 1:1 (2020)
Artikel Jurnal  Universitas Indonesia Library
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Arief Nur rachmanto
Hubungan Kadar Short-Chain Fatty Acid Feses dan Berbagai Parameter Ultrasonografi pada Pasien Diabetes Melitus Tipe 2 Tanpa Penyakit Arteri Perifer Ekstremitas Bawah di Rumah Sakit Cipto Mangunkusumo serta Faktor-faktor yang Memengaruhi = Fecal Short-Chain Fatty Acid Correlation with Various Ultrasonography Parameter of Type 2 Diabetes Mellitus Non-Peripheral Artery Disease of Lower Limb Patients in Cipto Mangunkusumo Hospital and Its Affecting Factors
"Diabetes melitus (DM) merupakan kondisi yang mendorong perkembangan dan progresi penyakit arteri perifer (PAP). Short Chain Fatty Acid (SCFA) memiliki peran dalam modulasi sistem imun yang merupakan komponen penting dalam patogenesis dari aterosklerosis. Peran SCFA dalam regulasi kadar glukosa dan aterosklerosis memiliki kemungkinan penggunaan SCFA sebagai upaya mencegah PAP pada pasien DM Tipe 2. Oleh karena itu, penelitian ini bertujuan untuk mencari tahu hubungan antara SCFA dengan parameter ultrasonografi pada pasien diabetes melitus tipe 2 tanpa penyakit arteri perifer ekstremitas bawah Metode: Sebuah penelitian potong lintang pada pasien diabetes melitus tanpa PAP pada selama Februari 2023 s/d Mei 2023 di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo. Seluruh pasien dilakukan ultrasonografi pada ekstremitas bawah untuk menilai diameter, volume flow, peak systolic value, gelombang spektral, dan plak. Kemudian dialukan pemeriksaan SCFA dari feses Hasil: Terdapat 39 pasien yang diikutsertakan pada penelitian ini. Pada penelitian ini ditemukan korelasi positif sedang antara diameter SFA dengan propionat persen (r= 0,408; p= 0,025), terdapat korelasi negatif antara PSV CFA dengan total SCFA (p= 0,007), korelasi positif antara valerat persen dengan PSV PTA (r= 0,375; p= 0,041) dan PSV DPA (r= 0,379; p= 0,039), terdapat korelasi antara VF DPA dengan total SCFA (p =0.025), dan korelasi antara VF PTA dengan total SCFA (p=0,006) dan asetat absolut (p=0,038). Hasil ini dapat dipengaruhi oleh antropometri, jenis kelamin, kadar kolesterol, tekanan darah dan kadar gula darah pasien Kesimpulan: Terdapat potensi hubungan antara kadar SCFA dengan parameter ultrasonografi ekstremitas bawah. Perlu penelitian lebih lanjut dengan desain kohort dengan jumlah sampel yang lebih banyak untuk mengevaluasi efek sebab-akibat terkait hubungan SCFA dengan parameter-parameter klinis dan ultrasonografi pasien DM tanpa PAP.
Diabetes mellitus (DM) is a condition that promotes the development and progression of peripheral arterial disease (PAD). Short Chain Fatty Acid (SCFA) has a role in modulating the immune system in the pathogenesis of atherosclerosis. The role of SCFA in the regulation of glucose levels and atherosclerosis has the possibility of using SCFA as an effort to prevent PAD in Type 2 DM patients. Therefore, this study aims to find out the relationship between SCFA and ultrasound parameters in type 2 DM patients without lower extremity peripheral artery disease. Methods: A cross-sectional study of DM patients without PAD from February 2023 to May 2023 at Cipto Mangunkusumo National Central General Hospital. All patients underwent ultrasonography of the lower extremities to assess diameter, volume flow, peak systolic value, spectral waves, and plaques. Then a SCFA examination of the stool is carried out Results: There were 39 patients included in this study. This study found a positive correlation between SFA diameter and propionate percent (r= 0,408; p= 0,025), there was a negative correlation between PSV CFA and total SCFA (p= 0,007), a positive correlation between valerate percent and PSV PTA (r= 0,375 ; p = 0,041) and PSV DPA (r = 0,379; p = 0,039), there is a correlation between VF DPA and total SCFA (p = 0,025), and a correlation between VF PTA and total SCFA (p = 0,006) and absolute acetate (p =0.038). These results can be influenced by anthropometry, gender, cholesterol levels, blood pressure and blood sugar levels of the patient. Conclusion: There is a potential relationship between SCFA levels and lower extremity ultrasound parameters. Further research is needed with a cohort design with a larger number of samples to evaluate the causal effect related to the relationship between SCFA and clinical and ultrasound parameters of DM patients without PAP."
Depok: Fakultas Kedokteran Universitas Indonesia, 2023
SP-pdf
UI - Tesis Membership  Universitas Indonesia Library
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Faisal Ali Ahmad Kler
Evaluasi spektrum gelombang USG Doppler dan kaitannya dengan Ankle Brachial Index (ABI) dan faktor-faktor risiko pada pasien Peripheral Arterial Disease (PAD) = The evaluation of Doppler Ultrasonography spectral waveform and its relationship with Ankle Brachial Index (ABI) value and risk factors in Peripheral Artery Disease (PAD) paitents
"[ABSTRAK
Salah satu komplikasi dari Peripheral Arterial Disease (PAD) adalah kerusakan tungkai bawah hingga tidak
dapat digunakan untuk beraktifitas. PAD disebabkan oleh gangguan vaskular yang menyebabkan atherosklerotik
pada vaskular di bagian distal. Suatu penelitian kohort di Swedia menyatakan bahwa penyembuhan primer, laju
amputasi dan mortalitas pada pasien PAD berhubungan dengan derajat insufisiensi vaskular. Dengan demikian perlu dilakukan penelitian untuk mengetahui karakteristik vaskular pada kasus PAD secara kuantitatif maupun kualitatif serta hubungannya dengan nilai Ankle Brachial Index (ABI) dan gambaran gelombang Doppler Ultrasonography(DUS). Metode penelitian menggunakan studi potong lintang. Hasil penelitian didapatkan
pasien PAD dengan nilai ABI rata-rata 0,7 dengan gambaran gelombang DUS yang berubah dari trifasik
menjadi non-tirfasik dominan pada arteri infrapopliteal. ABI di bawah 0.9 menunjukkan perubahan pada gelombang DUS dari arteri femoralis hingga a.dorsalis pedis dengan nilai p <0.05. Faktor-faktor risiko yang paling tampak adalah usia di atas 45 tahun yang menunjukkan peningkatan risiko PAD. Selain itu hubungan
ABI dan faktor ?faktor risiko menunjukkan bahwa hiperlipidemia dan diabetes melitus menunjukkan hubungan signifikan dengan p<0,05. Sedang pada hubungan DUS dan faktor-faktor risiko hanya usia >45 tahun yang
tampak secara statistik signifikan meski secara klinis faktor-faktor risiko yang lain menunjukkan jumlah
persentase yang diatas 50%. Disimpulkan bahwa dengan mengetahui nilai ABI dapat ditentukan derajat
keparahan PAD dan juga dengan mengetahui gelombang DUS saja maka dapat diketahui oklusi di tingkat segmen arteri yang mana.Selain itu, usia di atas 45 tahun, hiperlipidemia dan juga diabetes melitus merupakan faktor risiko yang penting untuk terjadinya atherosklerosis dan penyumbatan pada distal arteri. Penggunaan DUS untuk menentukan tingkat penyumbatan sangat informatif dalam hal penggambran gelombang, aman dan murah sehingga dapat menetukan tindakan selanjutnya.ABSTRACT One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. ;One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it?s safe, low cost and can indicate towards future intervention. , One of the complications of Peripheral Arterial Disease (PAD) is the damage that can be made to the lower
extremities causing difficulties to perform any activities with it. PAD is caused by vascular insufficiency known as atherosclerotic of the distal vascular. A cohort research in Sweden described that the primary recovery, amount of amputation and mortaltiy of PAD patients is related to the degree of vascular insufficiency. As for which, a research should be made to endorsed the knowhow of the vascular characteristics on PAD patients
quantitatively and qualitatively in accordance to ABI value and DUS spectral waveform. Methods used is cross
sectional. The result was, PAD patients had mean ABI value of 0.7 with changes of DUS spectral waveform
from triphasic to non-triphasic dominantly seen in infrapopliteal arteries. ABI less than 0.9 has a significant value towards changes in the spectral waveform from the femoral artery to the dorsal pedis artery. The risk factors such as age above 45 years old shows a significant relationship with the increase in PAD risk (p <0.05). Besides that, p <0.05 was also seen in hyperlipidemia and diabetes mellitus patients with PAD. As for the
relation between DUS and the risk factors, age above 45 years old was seen significant statistically eventhough
clinically all risk factors showed a percentage above 50%. It is concluded that by knowing the ABI value, the
degree of severity of PAD can be acknowledge and by knowing the waveform of DUS only one can know the
level of occlusion in an arterial segment. Besides that, age above 45 years, hyperlipidemia and diabetes mellitus are the important risk factors that causes atherosclerosis and occlusion in distal arteries. The usage of DUS to evaluate the level of occlusion is very informative showing images, it’s safe, low cost and can indicate towards future intervention. ]"
Fakultas Kedokteran Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Sigit Mohammad Nuzul
Efektivitas latihan buerger-allen terhadap sirkulasi perifer ekstremitas bawah pada pasien diabetes mellitus tipe 2 di Rumah Sakit Umum Daerah Undata dan Anutapura Kota Palu Provinsi Sulawesi Tengah = Effectiveness of buerger-allan exercise to improve lower extremity perfusion among patients with type 2 diabetes mellitus in Undata Hospital and Anutapura Hospital Palu City on Sulawesi Tengah District
"Tingginya prevalensi diabetes mellitus tipe 2 dan makanan khas daerah yang mengandung cukup banyak lemak menyebabkan peningkatan resiko peripheral arterial disease di Kota Palu. Latihan Buerger Allen merupakan salah satu cara mencegah dan mengatasi penyakit ini. Akan tetapi, latihan tersebut kurang digunakan karena belum adanya penelitian terkait latihan ini yang dipublikasikan di Indonesia. Penelitian ini bertujuan untuk mengetahui pengaruh latihan ini terhadap sirkulasi perifer pada ekstremitas bawah pasien diabetes mellitus tipe 2. Penelitian ini merupakan quasi-experimental, model pretest?posttest nonequivalent control group dengan 24 responden. Latihan ini diberikan kepada kelompok perlakuan selama 4 hari, 3 kali sehari, 2 siklus latihan selama 22 menit. Hasil uji statistik menunjukkan ada perbedaan bermakna nilai ankle brachial index antara pretest dan posttest pada kelompok perlakuan (p = .047; α .05), sebaliknya tidak ada perbedaan yang bermakna pada kelompok kontrol (p = .083; α .05). Secara statistik disimpulkan bahwa ada perbedaan bermakna antara nilai ankle brachial index posttest kelompok perlakuan dengan kontrol (p = .045; α .05), sehingga disimpulkan latihan ini efektif meningkatkan sirkulasi arteri perifer ekstremitas bawah. Disarankan agar latihan ini diberikan kepada pasien diabetes mellitus tipe 2.
Patient with diabetes mellitus have high risk of peripheral arterial disease. The risk increased on Palu City due to high prevalence of diabetes mellitus type 2 and food culture with high amount of fats. The Buerger-Allen exercise studies showed positive effect to improve lower extremity perfusion among patients with type 2 diabetes mellitus. However, this exercise gradually has been dropped in recent decades due to lack of published study in Indonesia. The study aimed to identify the effectiveness of this exercise to improve peripheral circulation of lower extremity. This study is the quasi-experimental with a pretest-posttest nonequivalent control group model, which enrolled 12 experimental and 12 control participants. Exercise had provided for 4 days, 3 times a day, and 2 cycles exercise for 22 minutes. The result showed significant difference of ankle-brachial index between the experiment and control group (p = .045; α .05). This study recommends Buerger-Allen exercise to be applied to patients with type 2 diabetes mellitus."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2016
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UI - Skripsi Membership  Universitas Indonesia Library
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Khaula Sahida
Analisis praktik keperawatan kesehatan masyarakat perkotaan: intervensi ankle range of motion pada pasien diabetes mellitus tipe 2 dengan komplikasi peripheral arterial disease = The analysis of clinical practice on urban health nursing impact of ankle range of motion on type 2 diabetes melitus patient with peripheral arterial disease
"ABSTRAK
Kondisi pasien diabetes mellitus DM tipe 2 dengan peripheral arterial disease PAD yang tidak ditangani dengan tepat dapat memicu terjadinya neuropati, ulkus pedis diabetik, bahkan amputasi. Intervensi latihan ankle range of motion ROM dipercaya dapat mengurangi gejala dan mencegah progresifitas PAD pada pasien DM tipe 2. Namun pada praktiknya, intervensi ini masih jarang dilakukan. Studi kasus dalam Karya Ilmiah Akhir Ners KIAN ini bertujuan untuk mengidentifikasi pengaruh pemberian intervensi ankle ROM pada pasien DM tipe 2 dengan komplikasi PAD. Hasil analisis menunjukkan bahwa terdapat pengurangan gejala PAD dan peningkatan aliran darah ekstremitas yang ditandai dengan peningkatan saturasi oksigen, kekuatan pulsasi, dan penurunan skala nyeri. Edukasi dan pendampingan latihan ankle ROM pada pasien DM tipe 2 dengan PAD diperlukan agar perfusi jaringan perifer pasien dapat tercapai dengan optimal.
ABSTRACT The conditions of type 2 diabetes mellitus T2DM patient with peripheral arterial disease PAD that is not handled properly can lead to neuropathy, diabetic pedis ulcer, even amputation. Intervention of ankle range of motion ROM exercise is believed to reduce symptoms and prevent the PAD progression. However, in clinical practice, this intervention still rarely done. Therefore, this case report aims to identify the impact of ankle ROM in T2DM patients with PAD complications. The results showed that there was a reduction in PAD symptoms and an increase in limb blood flow characterized by increased oxygen saturation, pulsation, and decreased pain scale. In brief, education and advisory of ankle ROM in T2DM patient with PAD is required to optimize the peripheral perfusion."
Fakultas Ilmu Keperawatan Universitas Indonesia, 2017
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UI - Tugas Akhir  Universitas Indonesia Library
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Fitri Astriana Lestari
Analisis Asuhan Keperawatan pada Pasien Diabetes Melitus dengan Penerapan Pemeriksaan Ankle Brachial Index (ABI) dan Senam Kaki Diabetes = Analysis of nursing care in patient with diabetes mellitus using the application of ankle brachial index (ABI) examination and diabetic foot exercises.
"Diabetes melitus merupakan salah satu dari penyakit kronis penyebab kematian tertinggi di dunia. Kondisi hiperglikemia akan menyebabkan berbagai komplikasi baik akut maupun kronis mencakup komplikasi mikrovaskuler dan makrovaskuler. Salah satu diantaranya yang paling berbahaya yaitu munculnya peripheral arterial  disease (PAD) yang menyebabkan terjadinya foot ulcers. Penulisan karya tulis ilmiah ini bertujuan untuk menganalisis asuhan keperawatan pada pasien diabetes melitus serta efektivitas pemeriksaan ankle brachial index (ABI) dan senam kaki diabetes untuk mengatasi ketidakefektifan perfusi jaringan perifer. Pemeriksaan ABI dan senam kaki diabetes merupakan intervensi yang dapat digunakan untuk meningkatkan sirkulasi perifer dengan mengidentifikasi terjadinya gangguan pada sirkulasi perifer,  meningkatkan aliran kolateralisasi darah pada kaki dan meningkatkan fungsi insulin. Intervensi pemeriksaan ABI dan senam kaki diabetes dilakukan pada pasien diabetes melitus selama 7 hari perawatan. Hasilnya menunjukkan bahwa penerapan pemeriksaan ABI dan senam kaki diabetes dapat meningkatkan sirkulasi perifer dan mencegah timbulnya luka kaki. Melihat keefektifan pemeriksaan ABI dan senam kaki diabetes untuk meningkatkan sirkulasi perifer maka diharapkan intervensi ini dapat digunakan sebagai perawatan rutin pada pasien diabetes melitus.

Diabetes mellitus is one of the highest chronic disease causes of death in the world. The condition of hyperglycemia will cause various complications either acute and chronic including microvascular and macrovascular complications. One of the most dangerous is the emergence of peripheral arterial disease (PAD) which causes foot ulcer. The scientific paper aims to analyze nursing care in patient with diabetes mellitus and the effectiveness of measuring the ankle brachial index (ABI) and diabetic foot exercises to overcome the ineffectiveness of peripheral tissue perfusion. The examination of ABI and diabetic foot exercises are interventions that can be used to improve peripheral circulation by identifying disturbances in peripheral circulation, increasing the flow of blood collateralisation in the foot and improving insulin function. Intervention of ABI examination and diabetic foot exercises were carried out in patient with diabetes mellitus for 7 days treatment. The results show that the application of ABI examination and diabetic foot exercises can improve peripheral circulation and prevent foot injuries. Reviewing the effectiveness of ABI examination and diabetic foot exercises to improve peripheral circulation, then it is hoped that this interventions can be used as a routine treatment in patients with diabetes mellitus."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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