Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Pasien rawat inap di rumah sakit dengan keganasan sering terjadi malnutrisi. Deteksi dini malnutrisi mempercepat terapi awal nutrisi sehingga mengurangi morbiditas dan mortalitas. Penelitian ini merupakan studi uji diagnostik membandingkan MST dan PG-SGA dengan SGA pada pasien kanker ginekologik rawat inap di RSUPN Cipto Mangunkusumo sebanyak 66 orang pada bulan April 2015. Pengumpulan data menggunakan formulir skrining, pemeriksaan fisik, dan pengukuran antropometri. MST memiliki sensitivitas 70%, spesifisitas 88%, PPV 90%, NPV 65%, AUC 0,79. PG-SGA mempunyai sensitivitas 100%, spesifisitas 92%, PPV 95%, NPV 100%, AUC 0,96. Terdapat perbedaan signifikan lama waktu pengerjaan di antara ketiganya, dengan waktu tercepat dimiliki oleh MST. Prevalensi malnutrisi berdasarkan SGA sebesar 60,6%. PG-SGA merupakan alat skrining yang sesuai dalam mendeteksi malnutrisi pasien kanker ginekologik rawat inap. ......Malnutrition is a common problem in hospitalized patients with malignancies. Early recognition of malnutrition leads to appropriate nutritional care plans and reduces rate of both morbidity and mortality. This diagnostic test study which comparing between MST and PG-SGA against SGA, was conducted on 66 hospitalized gynecologic cancer patients in April 2015. Data collection was obtained using screening tool forms, physical examination, and anthropometric measurement. According to SGA, 60.6% of patients were malnourished. MST had a sensitivity of 70% and a specificity of 88%. The PPV of MST was 90%, NPV 65%, and AUC value was 0.79. PG-SGA had a sensitivity of 100% and a specificity of 92%. The PPV of PG-SGA was 95%, NPV 100%, and AUC value was 0.96. There were a significant difference in time spent applying questionnaires between these screening tools, and MST had the quickest among three. PG-SGA is suitable screening tool for detecting risk of malnutrition in hospitalized patients with gynecologic cancer.

Abstrak :
Latar belakang: Kanker saat ini masih menjadi salah satu masalah kesehatan utama di dunia. Insidensi kanker ginekologi di Indonesia masih tinggi. Aspek nutrisi merupakan salah satu aspek yang paling sering mengalami kelainan pada pasien dengan kanker. Patient Generated-Subjective Global Assessment (PG-SGA) merupakan modalitas skrining nutrisi yang mengombinasikan data kualitatif dan semi-kuantitatif. Proses inflamasi sistemik yang terjadi pada pasien kanker dapat mengakibatkan penurunan kadar albumin dan prealbumin. Namun, belum banyak penelitian sebelumnya yang mencari bagaimana korelasi kadar albumin dan prealbumin terhadap skor PG-SGA. Tujuan: Mengetahui parameter yang paling baik dalam mendeteksi malnutrisi untuk pasien dengan onkologi ginekologi di RSUPN Dr. Cipto Mangunkusumo. Metode: Penelitian ini menggunakan metode potong lintang (cross sectional). Subjek dari penelitian ini adalah pasien yang didiagnosis dengan kanker ginekologi yang berobat ke Poliklinik Onkologi Ginekologi RSUPN Dr. Cipto Mangunkusumo dan direncanakan atau telah menjalani terapi pada Oktober 2020 - September 2021. Pasien dengan riwayat keganasan primer selain keganasan ginekologi, menerima terapi kortikosteroid oral atau intravena, riwayat pembedahan saluran cerna yang memengaruhi absorpsi/asupan nutrisi, dan riwayat penyakit liver akut atau kronik dan alkoholisme dieksklusi dari penelitian. Hasil: Didapatkan sebanyak 90 subjek yang diikutsertakan dalam penelitian. Secara keseluruhan, nilai rerata albumin yaitu 4,19 g/dL, rerata prealbumin yaitu 39,1 mg/dL, dan rerata skor PG-SGA yaitu 3 atau kategori A. Terdapat korelasi positif lemah antar kadar albumin dengan prealbumin (r=0,378, p=0,000), Terdapat korelasi negatif lemah antara kadar albumin terhadap skor PG-SGA (r=-0,313, p=0,003), sedangkan tidak terdapat korelasi kadar prealbumin terhadap skor PG-SGA (r=-0,145, p=0,173). Kesimpulan: Didapatkan korelasi antara albumin terhadap skor PG-SGA, namun tidak didapatkan korelasi antara prealbumin terhadap skor PG-SGA. ......Background: Cancer is still one of the major health problems in the world. The incidence of gynecological cancer in Indonesia is still high. Nutritional aspect is one of the most frequent aspects of abnormalities in patients with cancer. Patient Generated-Subjective Global Assessment (PG-SGA) is a nutritional screening modality that combines qualitative and semi-quantitative data. Systemic inflammatory process that occurs in cancer patients can result in a decrease in albumin and prealbumin levels. However, there have not been many previous studies looking at the correlation between albumin and prealbumin levels on the PG-SGA score. Objective: Knowing the best parameters in detecting malnutrition for gynecological oncology patients at RSUPN Dr. Cipto Mangunkusumo. Methods: This study used a cross-sectional method. The subjects of this study were diagnosed with gynecological cancer who went to the Gynecological Oncology Polyclinic of RSUPN Dr. Dr. Cipto Mangunkusumo and planned or already undergoing therapy during October 2020 - September 2021. Patients with a history of primary malignancy other than gynecological malignancy, receiving oral or intravenous corticosteroid therapy, history of gastrointestinal surgery affecting nutrient absorption/intake, and history of acute or chronic liver disease and alcoholism was excluded from the study. Results: There were 90 subjects who were included in this study. Overall, the average level of albumin was 4.19 g/dL, the average level of prealbumin was 39.1 mg/dL, and the average of scored-PG-SGA was 3 or category A. There was a weak positive correlation between albumin and prealbumin levels (r=0.378, p=0.000). This study showed a weak negative correlation between albumin level and scored-PG-SGA (r=-0.313, p=0.003), whereas there was no correlation between prealbumin levels and scored-PG-SGA (r=-0.145, p=0.173). Conclusion: A weak negative correlation was found between albumin and the scored-PG-SGA, but no correlation was found between prealbumin and the scored-PG-SGA.

Abstrak :
ABSTRAK
Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harus dievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA), namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukuran kekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudah dibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostik KGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapis malnutrisi pasien kanker rawat jalan di RSCM. Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun di poliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGT dianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai dengan menghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN. Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, dan malnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf dengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasien kanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT
Background: Malnutrition has a huge impact on cancer patients and therefore it has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming nature and the need of trained health personnels. Measurement of HGS is faster and easier, but there is no sufficient information regarding its cutoff point and diagnostic accuracy for cancer patients in Indonesia. Aim: defining cut-off point and diagnostic accuracy of HGS as a malnutrition screening modality for outpatient cancer population at RSCM. Method: A cross-sectional study was conducted at RSCM oncology outpatient clinic from May 4 th -October 1 st , 2015. Subjects were 18-59 years old. Cut-off point and diagnostic accuracy of HGS were analyzed to generate sensitivity, specificity, PPV, NPV, LR+, and LR- . Result: The proportion of well nourished, moderately malnourished, and severely malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV 92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a malnutrition screening modality in male and female cancer patients were good and moderately good. ;Background: Malnutrition has a huge impact on cancer patients and therefore it has to be evaluated using PG-SGA, but there are limitations such as the timeconsuming nature and the need of trained health personnels. Measurement of HGS is faster and easier, but there is no sufficient information regarding its cutoff point and diagnostic accuracy for cancer patients in Indonesia. Aim: defining cut-off point and diagnostic accuracy of HGS as a malnutrition screening modality for outpatient cancer population at RSCM. Method: A cross-sectional study was conducted at RSCM oncology outpatient clinic from May 4 th -October 1 st , 2015. Subjects were 18-59 years old. Cut-off point and diagnostic accuracy of HGS were analyzed to generate sensitivity, specificity, PPV, NPV, LR+, and LR- . Result: The proportion of well nourished, moderately malnourished, and severely malnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf respectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV 92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as a malnutrition screening modality in male and female cancer patients were good and moderately good.

Abstrak :
[ABSTRAK
Malnutrisi sering dialami oleh pasien kanker dan dapat menyebabkan penurunan kualitas hidup. Oleh karena itu, identifikasi awal pasien yang berisiko malnutrisi harus dilakukan pada semua pasien kanker, namun hingga saat ini, belum ada baku emas alat skrining yang digunakan di bagian rawat jalan radioterapi. Penelitian ini merupakan studi potong lintang yang dilakukan untuk membandingkan skrining malnutrisi Malnutrition Screening Tool (MST) dan Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) pada 144 pasien kanker yang akan menjalankan radioterapi di RSUPNCM, dengan Patient- Generated Subjective Global Assessment (PG-SGA) sebagai baku emas. Didapati sebanyak 41% pasien berisiko malnutrisi (PG-SGA). Skrining MST dinilai mudah dan cepat dengan rerata waktu pengerjaan 21 detik, dan memiliki nilai sensitivitas 84,75%, spesifisitas 77,65%, nilai prediksi positif (NPP) 0,73, nilai prediksi negatif (NPN) 0,88, dan nilai area under the ROC curve (AUC) 0,812. Skrining abPG-SGA memiliki sensitivitas 98,31%, spesifisitas 92,94%, NPP 0,91, NPN 0,99, AUC 0,956, dan rerata waktu pengerjaan 2 menit 24 detik. Kesimpulan yang dapat diambil adalah abPG-SGA merupakan alat skrining yang lebih baik dan akurat untuk digunakan di bagian rawat jalan radioterapi.

---

ABSTRACT
Malnutrition is common among cancer patients and can lead to decreased quality of life. Therefore, early identification of patients at risk of malnutrition should be performed in all cancer patients, but until now, there is no gold standard of nutrition screening tool that should be used in outpatient radiotherapy setting. This study was a cross-sectional study conducted to compare Malnutrition Screening Tool (MST) and Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) as nutrition screening tools in 144 radiotherapy outpatients against Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Forty-one percent of patients were at risk of malnutrition (PG- SGA). The MST was a simple and quick tool with an average of 21 seconds. It had 84.75% sensitivity, 77.65% specificity, positive predictive value (PPV)=0.73, negative predictive value (NPV)=0.88, and area under the ROC curve (AUC)=0.812. The abPG-SGA yielded 98.31% sensitivity, 92.94% specificity, PPV=0.91, NPV=0.99, AUC=0.956, and it took an average of 2 minutes 24 seconds. In conclusion, the abPG-SGA is a better and more accurate screening tool in outpatient radiotherapy setting., Malnutrition is common among cancer patients and can lead to decreased quality of life. Therefore, early identification of patients at risk of malnutrition should be performed in all cancer patients, but until now, there is no gold standard of nutrition screening tool that should be used in outpatient radiotherapy setting. This study was a cross-sectional study conducted to compare Malnutrition Screening Tool (MST) and Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) as nutrition screening tools in 144 radiotherapy outpatients against Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Forty-one percent of patients were at risk of malnutrition (PG- SGA). The MST was a simple and quick tool with an average of 21 seconds. It had 84.75% sensitivity, 77.65% specificity, positive predictive value (PPV)=0.73, negative predictive value (NPV)=0.88, and area under the ROC curve (AUC)=0.812. The abPG-SGA yielded 98.31% sensitivity, 92.94% specificity, PPV=0.91, NPV=0.99, AUC=0.956, and it took an average of 2 minutes 24 seconds. In conclusion, the abPG-SGA is a better and more accurate screening tool in outpatient radiotherapy setting.]

Abstrak :
[ABSTRAK
Subjective Global Assessment (SGA) dan Nutritional Risk Screening (NRS) 2002 merupakan alat skrining malnutrisi yang bertujuan untuk mendeteksi passien yang mengalami malnutrisi maupun berisiko malnutrisi. Dampak malnutrisi terhadap pasien dan rumah sakit, antara lain memperpanjang lama perawatan, meningkatkan morbiditas dan mortalitas pasien, serta bertambahnya biaya pengobatan rumah sakit. Dalam penelitian ini dilakukan pengujian terhadap alat skrining tersebut pada pasien bedah rawat inap di Ruang Rawat Bedah Gedung A RSUP Nasional Dr. Cipto Mangunkusumo (RSUPNCM ) dan membandingkan kedua hasilnya. Penelitian ini bertujuan untuk mengetahui prevalensi malnutrisi pasien bedah dewasa rawat inap dan mengetahui metode skrining yang tepat dan praktis untuk mendeteksi pasien berisiko malnutrisi. Secara khusus, penelitian ini bertujuan mengetahui spesifisitas dan sensitivitas metode skrining NRS-2002, serta waktu pelaksanaan skrinng tersebut. Penelitian ini merupakan studi potong lintang pada pasien bedah dewasa rawat inap di RSUPNCM yang memenuhi kriteria penelitian dengan jumlah sampel 75 orang. Seluruh instrumen penelitian divalidasi sebelum pengambilan data. Pengumpulan data meliputi wawancara menggunakan kuesioner dan formulir metode skrining malnutrisi, pengukuran berat badan dan tinggi badan estimasi serta penilaian indeks masa tubuh. Didapatkan prevalensi malnutrisi sebesar 40% pada pasien bedah dewasa rawat inap di RSUPNCM dengan sensitivitas NRS 83,3% dan spesifisitas 100%. Jumlah penderita malnutrisi yang tertinggi berada pada kelompok umur >60 tahun ( p = 0,04) dengan kasus bedah gastrointestinal yang malnutrisi lebih banyak signifikan (p = 0,008) dibandingkan dengan kasus bedah non gastrointestinal serta waktu pelaksanaan berbeda signifikan antara SGA dan NRS 2002 (p = 0,00).

---

ABSTRACT
The Subjective Global Assessment (SGA) and Nutritional Risk Screening (NRS) 2002 are screening tools aimed at detecting malnourished individuals and those at risk for malnutrition. The consequences of malnutrition for both patient and hospital include prolonged hospital length of stay, increased morbidity and mortality rate, and high hospital expenses. In this study we examined the applicability of those screening tools in surgery hospitalized patients at Gedung A RSUP Nasional Dr. Cipto Mangunkusumo (RSUPNCM ) and compared the result. The aim of this study is to investigate the prevalence of malnutrition in Dr. Cipto Mangunkusumo general hospital and to determine which screening tools is more appropriate and practical for identifying the risk of malnutrition. Particularly, this study is to determine specificity, sensitivity and time consuming of the NRS 2002. The study is a cross-sectional study at surgery hospitalized patient in RSUPNCM and icluded 75 patients. All of the instruments will be validated prior to data collection, which includes interview using questionnaire and malnutrition tools form, , weight and height estimated measurements and the assessment of body mass index. The prevalence of malnutrition at surgery hospitalized patient in RSUPNCM was 40% with the sensitivity and the specificity of the NRS 2002 were 83,3% and 100% consecutively. The malnourished patients were significantly higher in the age group >60 years old (p= 0,04) with cases of gastrointestinal surgery more significant (p=0,08) compared with the case of non-gastrointestinal surgery as well as the time consuming significantly different between SGA and NRS 2002 (p=0,00)., The Subjective Global Assessment (SGA) and Nutritional Risk Screening (NRS) 2002 are screening tools aimed at detecting malnourished individuals and those at risk for malnutrition. The consequences of malnutrition for both patient and hospital include prolonged hospital length of stay, increased morbidity and mortality rate, and high hospital expenses. In this study we examined the applicability of those screening tools in surgery hospitalized patients at Gedung A RSUP Nasional Dr. Cipto Mangunkusumo (RSUPNCM ) and compared the result. The aim of this study is to investigate the prevalence of malnutrition in Dr. Cipto Mangunkusumo general hospital and to determine which screening tools is more appropriate and practical for identifying the risk of malnutrition. Particularly, this study is to determine specificity, sensitivity and time consuming of the NRS 2002. The study is a cross-sectional study at surgery hospitalized patient in RSUPNCM and icluded 75 patients. All of the instruments will be validated prior to data collection, which includes interview using questionnaire and malnutrition tools form, , weight and height estimated measurements and the assessment of body mass index. The prevalence of malnutrition at surgery hospitalized patient in RSUPNCM was 40% with the sensitivity and the specificity of the NRS 2002 were 83,3% and 100% consecutively. The malnourished patients were significantly higher in the age group >60 years old (p= 0,04) with cases of gastrointestinal surgery more significant (p=0,08) compared with the case of non-gastrointestinal surgery as well as the time consuming significantly different between SGA and NRS 2002 (p=0,00).]

Abstrak :
Latar belakang: Sekitar 10,6% persalinan di seluruh dunia adalah persalinan prematur. Pemantauan pertumbuhan yang adekuat dalam perawatan bayi prematur penting untuk mencegah kelebihan atau kekurangan asupan nutrisi, yang saat ini dapat dilakukan menggunakan kurva Fenton 2013 atau kurva INTERGROWTH-21st. Karena perbedaan metodologi dan populasi yang terlibat pada proses penyusunan kedua kurva, hasil yang didapatkan dapat berbeda. Oleh karena itu, dibutuhkan penelitian untuk membandingkan penggunaan kedua kurva tersebut pada populasi bayi prematur di Indonesia. Metode: Penelitian kohort prospektif ini melibatkan subjek bayi prematur dengan usia gestasi lahir 28–36 minggu di RSUPN Dr. Cipto Mangunkusumo selama Juni–September 2022. Seluruh subjek dipantau dengan kurva Fenton dan kurva INTERGROWTH-21st selama 2 minggu, dan dievaluasi perbedaan persentil berat badan, panjang badan, dan lingkar kepala, proporsi SGA, AGA, dan LGA, dan perbandingan proporsi subjek dengan EUGR pada usia 2 minggu. Hasil: Dari 131 subjek yang memenuhi kriteria inklusi, didapatkan persentil berat badan, panjang badan, dan lingkar kepala lebih tinggi secara bermakna pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Sebanyak 17 dari 36 (47,2%) subjek yang tergolong SGA berdasarkan kurva Fenton pada saat lahir didapatkan lebih sesuai dengan AGA berdasarkan kurva INTERGROWTH-21st, dan 30 dari 89 (33,7%) subjek yang tergolong AGA berdasarkan kurva Fenton saat lahir didapatkan lebih sesuai dengan LGA berdasarkan kurva INTERGROWTH-21st. Subjek yang lahir sesuai AGA tetapi mengalami EUGR pada usia 2 minggu didapatkan lebih tinggi secara bermakna pada kurva Fenton (14,7%) dibandingkan kurva INTERGROWTH-21st (8,9%, p <0,001). Kesimpulan: Insidens SGA didapatkan lebih tinggi pada kurva Fenton dibandingkan INTERGROWTH-21st, sedangkan LGA lebih tinggi pada kurva INTERGROWTH-21st dibandingkan kurva Fenton. Pada usia kronologis 2 minggu, insidens subjek dengan EUGR lebih tinggi secara bermakna dengan kurva Fenton dibandingkan kurva INTERGROWTH-21st. ......Background: Approximately 10.6% of all deliveries worldwide are premature. Adequate growth monitoring is essential in the care of preterm infants to prevent excessive or undernutrition, which can currently be performed using the Fenton 2013 curve or the INTERGROWTH-21st curve. Due to differences in the methods and study population involved in the development of these two curves, there is a high possibility of obtaining different results. Therefore, a study is warranted to compare the two curves in the Indonesian premature infant population. Methods: This prospective cohort study involves premature neonates with gestational age of 28–36 weeks born in Cipto Mangunkusumo Hospital during June–September 2022. The growth of all subjects were plotted on the Fenton and INTERGROWTH-21st curves for 2 weeks, and differences in weight, height, and head circumference percentiles, proportion of SGA, AGA, and LGA, and proportion of infants with weight below the 10th percentile between the two curves at 2 weeks were also compared. Results: Among 131 subjects meeting the inclusion criteria, the weight, height, and head circumference percentiles were significantly higher on the INTERGROWTH-21st curve compared to the Fenton curve. As many as 17 of 36 (47.2%) subjects classified as SGA on the Fenton curve were AGA on the INTERGROWTH-21st curve, and 30 of 89 (33.7%) subjects classified as AGA on the Fenton curve were LGA on the INTERGROWTH-21st curve. The prevalence of infants without SGA at birth but classified as EUGR at 2 weeks was significantly higher on the Fenton curve (14.7%) than the INTERGROWTH-21st curve (8.9%, p <0.001). Conclusion: The incidence of SGA was significantly higher with the Fenton curve, whereas LGA was significantly higher with the INTERGROWTH-21st curve. At 2 weeks, the proportion of subjects with EUGR was significantly higher with the Fenton curve compared to the INTERGROWTH-21st curve.

Abstrak :
Tujuan penelitian ini adalah untuk mengetahui korelasi antara penilaian risiko malnutrisi menggunakan skor PG-SGA dengan kadar CRP serum sehingga dapat digunakan untuk memprediksi tingkat inflamasi pada pasien kanker kepala dan leher stadium I_IV guna mencegah terjadinya kaheksia. Malnutrisi hingga kaheksia pada kanker terjadi karena interaksi faktor tumor, faktor pejamu dan faktor-faktor lainnya. Faktor tumor berupa sitokin pro-inflamasi akan memicu respons pejamu untuk memproduksi protein fase akut seperti CRP. Protein fase akut memerlukan sejumlah substrat yaitu asam amino yang berasal dari otot rangka. Otot rangka akan mengalami degradasi sehingga menyebabkan wasting otot rangka. Oleh karena itu, CRP selain dapat digunakan sebagai marker inflamasi sistemik juga dapat digunakan sebagai salah satu indikator faktor risiko yang berperan dalam terjadinya malnutrisi dan kaheksia. Efek wasting otot rangka yang ditimbulkan secara tidak langsung oleh CRP dapat dinilai dengan terdapatnya penurunan BB maupun berkurangnya massa otot yang juga merupakan komponen dalam penilaian PG-SGA. Penelitian ini merupakan studi potong lintang dengan menggunakan consecutive sampling yang melibatkan 51 subjek kanker kepala dan leher stadium I_IV yang belum mendapatkan terapi. Hasil penelitian didapatkan rerata usia 46,6 13,9 tahun, sebanyak 76,5 berjenis kelamin laki-laki. Kanker nasofaring merupakan kanker terbanyak 80,4 , dan stadium terbanyak yaitu stadium IVA. Rerata indeks massa tubuh IMT yaitu 20,6 4,0 kg/m2, dan sebanyak 37,3 subjek berada pada IMT normal. Berdasarkan skor PG-SGA sebanyak 64,7 subjek berisiko tinggi malnutrisi dengan rerata skor PG-SGA 11,7 6,2. Nilai median CRP yaitu 6,4 0,4_170,4 . Penelitian ini memperoleh korelasi positif yang signifikan antara skor PG-SGA dengan kadar CRP serum dengan kekuatan korelasi lemah r = 0,372; p = 0,007. ......The purpose of this study was to determine the correlation between the malnutrition risk assessment using PG SGA score with serum CRP levels so that it can be used to predict the levels of inflammation in head and neck cancer patients stage I IV to prevent cachexia. Malnutrition and cancer cachexia occurs due to the interaction of tumor factors, host factors and other factors. Tumor factors such as pro inflammatory cytokines will trigger a response of the host to produce acute phase proteins such as CRP. Acute phase protein which require a number of amino acids derived from skeletal muscle. Skeletal muscles will be degraded, causing skeletal muscle wasting. Therefore, CRP can be used as a marker of systemic inflammation and can be used as one indicator of the risk factors also that contribute to malnutrition and cachexia. Effect of skeletal muscle wasting which caused indirectly by the CRP can be assessed by the weight loss and reduced muscle mass which is a component in the assessment of PG SGA also. This study is a cross sectional study using consecutive sampling, 51 subjects head and neck cancer stage I IV who had not received treatment participated in this study. Data showed the mean age of subjects was 46.6 13,9 years, and 76 were male. Most cancer sites were as nasopharyngeal 80,4, and mostly in stage IVA. The mean body mass index BMI is 20,6 40 kg m2, with most of the BMI is normal 37,3. Based on PG SGA score 64,7 of the subjects at high risk of malnutrition, and the PG SGA mean score is 11,7 6,2. The median value of CRP is 6,4 0,4 170,4. The result of this study showed a significant positive correlation between PG SGA score with serum CRP levels with the strength of correlation is weak r 0,372 p 0,007.

Abstrak :
Latar Belakang. Anak dengan Spektrum Gangguan Autisme (SGA) seringkali mengalami gangguan gerak halus, yang dapat menimbulkan hambatan dalam melakukan aktivitas sehari-hari serta mengganggu performa sekolah. Hingga saat ini belum ada data mengenai prevalens maupun gambaran gangguan gerak halus pada anak SGA di Indonesia, termasuk dampaknya terhadap performa sekolah. Tujuan. Mengetahui prevalens gangguan gerak halus anak SGA, mengetahui gambaran gangguan gerak halus anak SGA, mengetahui dampak gangguan gerak halus terhadap performa sekolah anak SGA. Metode. Penelitian analitik potong lintang dilakukan sejak bulan Januari sampai Mei 2014. Subjek anak SGA didapatkan dari Klinik Anakku CMC Kayu Putih. Subjek pada kelompok kontrol dari sebuah sekolah swasta yang telah dilakukan matching usia dan jenis kelamin dengan kelompok SGA. Terhadap subjek penelitian dilakukan pemeriksaan keterampilan gerak halus dengan BOT-2 dan penilaian performa fungsional sekolah melalui pengisian kuesioner SFA oleh guru atau terapis. Hasil. Subjek penelitian pada kelompok SGA dan kelompok kontrol masing- masing berjumlah 43 anak. Prevalens gangguan gerak halus pada kelompok SGA sebesar 91%. Jumlah subjek pada kelompok SGA yang mengalami gangguan gerak halus pada komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper- limb coordination lebih besar dibanding kelompok kontrol, dengan median skor kelompok SGA yang lebih rendah pada semua komposit/subtes dibandingkan dengan kelompok kontrol. Terdapat hubungan bermakna antara gangguan gerak halus kelompok SGA dengan performa fungsional sekolah. Simpulan. Prevalens gangguan gerak halus anak SGA pada penelitian ini adalah 91%. Gangguan gerak halus yang dialami anak SGA berdasarkan pemeriksaan dengan BOT-2 mencakup komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper-limb coordination. Pada anak SGA, gangguan gerak halus berhubungan dengan gangguan pada performa fungsional sekolah. ......Background. Children with Autism Spectrum Disorders (ASD) often have fine motor impairment, which may present barriers in performing their daily activities and interfere with their school performance. Until now there has been no data on the prevalence and description of fine motor impairment in children with ASD in Indonesia, including its impact on the children’s school performance. Objective. To determine the prevalence of fine motor impairments in children with ASD, to provide the description of fine motor impairments in children with ASD, and to determine the impact of fine motor impairments on the school performance of children with ASD. Method. A cross-sectional analytic study conducted from January to May 2014. Subjects were children with ASD from Klinik Anakku CMC Kayu Putih. Subjects in the control group were students from a private school matched by age and sex with the ASD group. Fine motor examination was performed using BOT-2 and assessment of school functional performance was conducted through SFA questionnaires filled by teachers or therapists. Result. There were 43 subjects each on ASD and control groups. Prevalence of fine motor impairments in children with ASD in this study was 91%. The number of subjects in the ASD group having fine motor impairement on the fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests are greater than the control group, with median score of all the composites/subtests lower on ASD group compared to that in the control group. There was a significant correlation between fine motor impairments in ASD children with their school function performance. Result. Prevalence of fine motor impairments in children with ASD in this study was 91%. Fine motor impairments experienced by children with ASD based on examination using BOT-2 covers fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests. In children with ASD, fine motor impairment was associated with disturbances in the school function performance.

Abstrak :
Latar Belakang. Lupus Eritematosus Sistemik merupakan suatu penyakit inflamasi sistemik kronik yang banyak terjadi pada usia reproduktif. Kehamilan pada LES adalah kehamilan risiko tinggi dengan kemungkinan luaran kehamilan buruk pada maternal dan fetal/neonatal. Belum ada data dalam 5 tahun terakhir di RSCM mengenai proporsi luaran kehamilan buruk tersebut. Tujuan. Mengetahui proporsi luaran kehamilan buruk maternal dan fetal/neonatal pada pasien LES di RSUPN Cipto Mangunkusumo serta faktor-faktor yang berhubungan Metode. Dilakukan studi cohort retrospective melalui telaah rekam medis pada pasien LES mulai 1 Januari 2015-Mei 2021. Dilakukan analisis bivariat dengan chi square untuk variabel kategorik. Variabel yang bermakna selanjutnya dilakukan analisis multivariat menggunakan uji regresi logistik. Analisis bivariat dan multivariat dilakukan dengan menggunakan SPSS. Hasil. Dari 173 subjek dengan 150 kehamilan, didapatkan luaran kehamilan buruk maternal sebanyak 47,4% (flare 43,3%, preeklamsia/eklamsia 12,1%, kematian maternal 3,6%). Luaran kehamilan buruk fetal/neonatal 65,3% (kelahiran prematur 31,2%, BBLR 32%, still birth 8,1%, SGA 34%, IUGR 16,2%, abortus 19,5%). Berdasarkan analisis multivariat terdapat 2 faktor yang berhubungan dengan kejadian luaran kehamilan buruk maternal yaitu aktivitas LES tinggi OR: 2,25 (IK95% [1,199-4,225], p=0,012) dan hipertensi OR 3,007 (IK95% [1,425-6,341), p=0,004). Sedangkan hasil analisis multivariat pada luaran kehamilan buruk fetal/neonatal, ditemukan aktivitas LES tinggi OR: 2,40 (IK95% [1,041-5,534], p=0,040) dan hipertensi OR: 5,988 (IK95% [1,640-21,870], p=0,007) berhubungan dengan kejadian luaean kehamilan buruk fetal/neonatal. Kesimpulan. Proporsi luaran kehamilan buruk maternal dan fetal/neonatal pada pasien LES di RSUPN Cipto Mangunkusumo cukup tinggi. Aktivitas LES tinggi dan hipertensi merupakan faktor yang berhubungan dengan luaran kehamilan buruk maternal dan fetal/neonatal. ......Background. Systemic Lupus Eritematosus is a chronic systemic inflamatory disease found in reproductive age. Pregnancy in SLE patients is a high risk pregnancy mainly with the possibility of adverse outcome in maternal and fetal/neonatal. There is no data in last 5 years about proportion of adverse pregnancy outcome at Cipto Mangunkusumo Hospital. Aim. To determine proportions of adverse pregnancy outcomes of maternal and fetal/neonatal in Systemic Lupus Eritematosus patients at Cipto Mangunkusumo Hospital and it’s related factors. Method. A retrospective cohort study was done through medical records study in medical record installation at SLE Patient from 1 January 2015 to Mei 2021. Bivariate analysis was done with chi square for categorical variable. Statistically significant variable then analyzed with multivariate analysis with logistic regression analysis. Bivariat and Multivariate analysis was done using SPSS. Result. Of the 173 subjects with 150 pregnancies, the maternal outcome was 47.4% (43.3% flare, 12.1% preeclampsia/eclampsia, 3.6%). Fetal/neonatal poor pregnancy outcome was 65.3% (31.2% premature birth, 32% LBW, 8.1% still birth, 34% SGA, 16.2% IUGR, 19.5% abortion). Based on multivariate analysis, there were 2 factors associated with maternal adverse pregnancy outcomes, namely high LES activity OR: 2.25 (CI 95% [1.199-4.225], P = 0.012) and hypertension OR 3.007 (CI 95% [1.425-6.341), p =0.004). Meanwhile, the results of multivariate analysis on the outcome of poor fetal/neonatal pregnancy, found high LES activity OR: 2.40 (CI 95% [1.041-5.534], P=0.040) and hypertension OR: 5.988 (CI 95% [1.640-21.870], p= 0.007) associated with fetal/neonatal pregnancy outcome. Conclusion. The proportion of maternal and fetal/neonatal adverse pregnancy outcomes in SLE patients at Cipto Mangunkusumo General Hospital is quite high. High SLE disease activity and hypertension are factors associated with poor maternal and fetal/neonatal outcomes.