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Tika Muthia
Hubungan Kualitas Tidur dengan Status Prehipertensi pada Perawat Shift Malam di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita = Relationship of Sleep Quality with Prehypertension Status in Night Shift Nurse in National Cardiovascular Center Harapan Kita
"Menjalankan shift malam dalam waktu lama dikatakan dapat menjadi faktor risiko berkembangnya hipertensi karena terjadinya ketidakselarasan irama sirkadian. Hal ini disayangkan karena hipertensi pada perawat berpotensi berdampak pada menurunnya produktivitas kerja dan kualitas asuhan keperawatan. Shift malam tidak bisa dirubah terkait dengan pelayanan, tetapi kualitas tidur dapat dimodifikasi. Tujuan dari penelitian ini adalah untuk mengetahui apakah ada hubungan antara kualitas tidur dan status prehipertensi pada perawat shift malam. Menggunakan desain penelitian cross sectional, pengumpulan data dilakukan dari Mei hingga Juli 2020 dan diperoleh 128 perawat yang menjalani shift malam di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita. Responden diukur tekanan darah mereka sebelum dan setelah shift malam kemudian diminta mengisi kuesioner Pittsburgh Sleep Quality Index (PSQI). Hasil penelitian ini didapatkan sebesar 71,9 % perawat shift malam mengalami kualitas tidur yang buruk, 50,8 % perawat mengalami prehipertensi, dan 50,0 % perawat memiliki kualitas tidur buruk dan mengalami prehipertensi. Setelah dilakukan uji Chi-Square , didapatkan hasil nilai P-value sebesar 0,000 yang nilainya lebih kecil dari α (0,05), sehingga dapat disimpulkan bahwa terdapat hubungan antara kualitas tidur dengan status prehipertensi pada perawat shift malam di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita. Hasil penelitian ini akan bermanfaat untuk pengembangan intervensi dalam pencegahan hipertensi pada perawat yang menjalankan shift malam.
......Running a night shift for a long time is said to be a risk factor for developing hypertension due to the misalignment of circadian rhythms. This is unfortunate because hypertension in nurses has the potential to have an impact on decreasing work productivity and quality of nursing care. The night shift cannot be changed with regard to service, but sleep quality can be modified. The purpose of this study was to determine whether there is a relationship between sleep quality and prehypertension status in night shift nurses. Using a cross sectional research design, data collection is carried out from May to July 2020 and 128 nurses who are undergoing night shifts at the National Cardiovascular Center Harapan Kita was obtained. Respondents were measured for their blood pressure before and after the night shift then filled out the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The results of this study found that 71.9% of night shift nurses experienced poor sleep quality, 50.8% of nurses experienced prehypertension, and 50,0 % nurses had poor sleep quality and prehypertension. After the Chi-Square test, the P-value 0,000 was obtained, smaller than α (0.05), so it can be concluded that there is a relationship between sleep quality and prehypertension status in night shift nurses at the National Cardiovascular Center Harapan Kita. The results of this study will be useful for the development of interventions in the prevention of hypertension in nurses who run the night shift."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
S-pdf
UI - Skripsi Membership  Universitas Indonesia Library
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Arnold Fernando
Relationship of shiftwork and breast cancer = Hubungan Kerja Gilir Dan Kanker Payudara
"Latar Belakang. Kanker payudara adalah salah sat jenis kanker yang paling sering terjadi pada wanita di seluruh dunia, angka insidensi kanker payudara di Indonesia sendiri mencapai 12 orang per 100.000 penduduk wanita berdasarkan Perhimpunan Dokter Spesialis Patologi Indonesia. Sayangnya sebagian besar kanker payudara yang teridentifikasi justru teridentifikasi saat sudah stadium akhir. International Agency for Research on Cancer (IARC) pada tahun 2007 membuatkan kesimpulan bahwa gangguan irama sirkadian mungkin saja dapat menyebabkan kanker pada manusia (group 2A) Tujuan. Tujuan dari penelitian ini adalah untuk menmgetahui seberapa besar hubungan antara kerja shift malam dan insidensi kanker payudara Metode. Pencarian bukti berbasis ilmiah dilakukan dengan membuat pertanyaan klinis dengan teknik “PICO”, kemudian di lanjutkan dengan pencarian literatur dengan database elektronik melalui mesin pencari “PubMed” dan “google scholar” adapun kata kunci yang digunakan adalah “shift work” “night shift” “breast cancer” yang dikombinasikan dengan "MeSH terms" dan "Boolean Operation", literatur yang didapatkan akan disaring menggunakan kriteria inklusi yaitu penelitian pada manusia sedangkan kriteria ekslusi adalah penelitian yang tidak dapat di akses, berupa case report, ataupun suatu artikel yang ditarik kembali. Hasil. Satu artikel paling relevan yang dilakukan penilaian kritis, dengan judul "Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies" oleh Travis RC, et al. Penelitian tersebut berupa meta-analysis dan didapatkan RR rata-rata tertimbang 0,99 (95% CI = 0,95 hingga 1,03) untuk pekerja shift malam dibandingkan yang tidak. Penelitian lebih dari 20 tahun RR 1.01 (95% CI = 0.93 to 1.10). Dan penelitian yang lebih dari 30 tahun memiliki RR gabungan 1,00 (95% CI = 0,87 hingga 1,14, heterogenitas P = 0,067. Interval kepercayaan untuk rasio tingkat insiden pada penelitian ini sempit, bahkan untuk 20 tahun atau lebih kerja kerja gilir malam (RR = 1.01, 95% CI = 0.93 sampai 1.10), jadi temuan ini mengecualikan hubungan sedang antara insiden kanker payudara dengan kerja kerja gilir malam yang lama. Kesimpulan. Tidak didapatkan hubungan yang signfikan antara kanker payudara dengan kerja gilir pada malam hari
......Background. Breast cancer is the most common cancer among women worldwide. 80% of breast cancer that has been identified in Indonesia has progressed into an advanced stage of malignancy. In 2007, the International Agency for Research on Cancer concluded: shift-work that involves circadian disruption is probably carcinogenic to humans (Group 2A) Aim. This study aims to justify the association between night shift work and breast cancer. Methods. Searching literature for the evidence-based has been conducted with a clinical question through "PICO" method. Then continued with literature searching using the electronic database "PubMed" and "google scholar" search engine. The keyword is "shift work" "night shift" "breast cancer" and combined with MeSH terms and Boolean operation. The inclusion criteria are research on humans, and the exclusion is inaccessible studies, case report studies, and retracted articles. Result. All of the ten prospective studies that have been combined, the weighted average RR was 0.99 (95% CI = 0.95 to 1.03) for any night shift work compared with none. There was no statistically significant heterogeneity across studies (P = .052). ). But if based on a study of more than 20 years, the RR was 1.01 (95% CI = 0.93 to 1.10). And if based on a study of more than 30 years, the combined RR was 1.00 (95% CI = 0.87 to 1.14, P heterogeneity = 0.067. Confidence intervals for the incidence rate ratios on this study are narrow, even for 20 or more years of night shift work (RR = 1.01, 95% CI = 0.93 to 1.10), so these findings exclude a moderate association of breast cancer incidence with long duration night shift work Conclusion. There are insignificant associations between night shift work and breast cancer."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tugas Akhir  Universitas Indonesia Library
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Tambunan, Marihot
Perbedaan pola sirkadian tekanan darah pada pasien penyakit ginjal kronik pra dan pasca transplantasi ginjal di RSCM = The difference of circadian pattern of blood pressure in patients with chronic kidney disease before and after kidney transplantation in Cipto Mangunkusumo hospital
"[ABSTRAK
Pola sirkadian tekanan darah (TD) adalah gambaran TD 24 jam berupa kurva TD yang meningkat pada pagi hari, menurun pada siang / sore hari dan terendah pada malam hari / waktu tidur. 24 hours Ambulatory Blood Pressure Monitoring (24 hrs ABPM) merupakan alat pengukur TD yang lebih akurat dan dapat memperlihatkan pola sirkadian TD 24 jam. Turunnya TD 10 - 20% pada malam hari disebut dipper, jika turun < 10% disebut nondipper. Meningkatnya TD 24 jam dan nondipper merupakan faktor risiko morbiditas dan mortalitas kardiovaskular. Prevalensi hipertensi dan nondipper pada Penyakit Ginjal Kronik Stadium 5 dalam Terapi Dialisis (PGK 5D) masih sangat tinggi. Faktor utama penyebab hipertensi pada PGK 5D adalah menurunnya Laju Filtrasi Glomerulus (LFG) dan meningkatnya cairan ekstraselular. Transplantasi ginjal akan memperbaiki TD dan nondipper dengan membaiknya LFG, meningkatnya produksi urin dan menurunnya cairan ekstraseluler. Namun demikian satu bulan Pasca Transplantasi Ginjal kebutuhan dosis obat imunosupresan masih cukup tinggi yang dapat mengakibatkan hambatan penurunan TD.
Tujuan : Mengetahui perbedaan pola sirkadian TD, data dipper / nondipper dan rerata TD 24 jam pada pasien PGK Pra dan satu bulan Pasca Transplantasi Ginjal. Metode Penelitian : Studi Pre experimental dengan before and after design. Subjek penelitian pasien PGK 5D / Pra Transplantasi Ginjal berusia 18 ? 60 tahun, dilakukan di RSCM pada bulan Oktober sampai dengan Desember 2014. Jumlah subjek sebanyak 15 orang. Dilakukan pengumpulan urin 24 jam, pemeriksaan LFG, pengukuran TD 24 jam dengan 24 hrs ABPM, Pra dan satu bulan Pasca Transplantasi Ginjal. Analisis statistik dengan uji McNemar dan uji t dependen.
Hasil : Terdapat 12 subjek nondipper dan 3 subjek dipper pada pasien PGK Pra Transplantasi Ginjal. Satu bulan Pasca Transplantasi Ginjal seluruh subjek (15 orang) memperlihatkan keadaan nondipper. Uji McNemar tidak dapat dilakukan karena seluruh subjek PGK satu bulan Pasca Transplantasi Ginjal nondipper (homogen). Terdapat penurunan rerata TD sistolik 24 jam pasien PGK satu bulan Pasca Transplantasi Ginjal yang tidak signifikan (p > 0,05) dan penurunan rerata TD diastolik 24 jam yang signifikan (p < 0,05).
Simpulan : Belum terdapat perbaikan nondipper pada pasien satu bulan Pasca Transplantasi Ginjal. Terdapat penurunan rerata TD sistolik 24 jam yang tidak signifikan dan penurunan rerata TD diastolik 24 jam yang signifikan pada pasien satu bulan Pasca Transplantasi Ginjal.
ABSTRACT
The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation.;Background: The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation., Background: The circadian pattern of blood pressure (BP) is a 24 hours blood
pressure (24hrs BP) curve which increases in the morning, decreases in the
afternoon/evening and the lowest state is at night/bedtime. 24 hrs Ambulatory
Blood Pressure Monitoring (ABPM) is a BP measuring device that is
accurate and can exhibit a circadian pattern of 24 hrs BP. The fall of BP 10-􀀃20%
at night is called as a dipper, while less than 10% is called as a nondipper. The
increasing of 24 hrs BP and nondipper are the risk factor for
cardiovascular morbidity and mortality. The prevalence of
hypertension and nondipper in Chronic Kidney Disease stage 5 on Dialysis
(CKD 5D) are still very high. The main factors causing hypertension in CKD 5D
are decreased Glomerular Filtration Rate (GFR) and increased extracellular
fluid. Kidney transplantation will improve BP and nondipper
by GFR improvement, increases urine production and decreases extracellular
fluid. However, one month after kidney transplantation, the dose
of immunosuppressant drugs is relatively high, which is an obstacle to decrease
BP.
Aim: To determine differences in the circadian pattern of BP, the data
of dipper and nondipper, and the mean of 24 hrs BP in CKD before, and one
month after kidney transplantation.
Methods: Design of the study is before and after design. Subjects of the study
were patients with CKD 5D before kidney transplantation, aged 18-60 years,
were conducted in Cipto Mangunkusumo Hospital during October to
December 2014. 15 subjects were included in the study. 24 hrs urine
collection, GFR, 24 hrs BP measurement with 24 hrs ABPM were recorded in all
subjects, before and one month after kidney transplantation. McNemar test and t
dependent test were used in statistical analysis.
Results: Before kidney transplantation, 12 of 15 subjects were nondippers while
the others 3 subjects were dippers. After kidney transplantation, all subjects (15
patients) were nondippers. McNemar test can not be used because all subjects one
month after kidney transplantation were nondippers (homogeneous). The
decreasing of the mean of 24 hrs systolic BP was found in all CKD one
month after kidney transplantation, but statistically not significant (p>0.05),
while decreasing of the mean of 24 hrs diastolic BP was statistically significant
(p<0.05).
Conclusion: There were still no improvement in nondipper patients
one month after kidney transplantation. There were a decrease in the mean of 24
hrs systolic BP but statistically not significant and a decrease in the mean of 24
hrs diastolic BP which is statistically significant in patients one month after
kidney􀀃transplantation.]"
2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Bhayu Hanggadhi Nugroho
Hubungan antara variasi sirkadian aritmia ventrikular idiopatik dengan fungsi sistolik intrinsik ventrikel kiri melalui speckle tracking ekokardiografi = Correlation between circadian variation of idiopathic ventricular arrhytmia and left ventricular intrinsic systolic function assessed by speckle tracking echocardiography
"Latar belakang: Aritmia ventrikular idiopatik, baik kompleks ventrikel prematur (KVP) maupun takikardia ventrikel (TV), dapat menyebabkan terjadinya penurunan fungsi sistolik ventrikel kiri (VKi) yang akan menimbulkan kardiomiopati dan meningkatkan mortalitas. Banyak faktor yang berkontribusi menyebabkan terjadinya kardiomiopati akibat KVP (KA-KVP) meskipun mekanisme terjadinya belum sepenuhnya dipahami. Variasi sirkadian KVP dilaporkan berhubungan dengan terjadinya penurunan fraksi ejeksi VKi. Deteksi dini adanya disfungsi sistolik intrinsik Vki dapat dilakukan melalui pemeriksaan speckle tracking ekokardiografi dengan mengukur nilai global longitudinal strain (GLS). Sampai saat ini belum diketahui apakah variasi sirkadian KVP berhubungan dengan penurunan fungsi sistolik intrinsik ventrikel kiri.
Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan antara variasi sirkadian aritmia ventrikular idiopatik dengan fungsi sistolik intrinsik ventrikel kiri melalui speckle tracking ekokardiografi.
Metode: Penelitian ini adalah studi potong lintang dengan total subjek 67 pasien (17 laki-laki [25,4%]; usia rata-rata 46.5 + 9.8 tahun; fraksi ejeksi ventrikel kiri 63,2% + 7,5%) dengan KVP yang berasal dari jalur keluar ventrikel dari pemeriksaan elektrokardiogram 12 sadapan. Semua pasien menjalani pemeriksaan Holter monitoring 24 jam dan speckle tracking ekokardiografi. Dilakukan perhitungan variasi sirkadian beban KVP dan nilai global longitudinal global (GLS) kemudian dilakukan analisis statistik untuk menilai hubungan kedua variabel tersebut.
Hasil: Sebanyak 31 pasien (46.3%) mengalami gangguan fungsi sistolik Vki (GLS lebih buruk dari -18%). Pasien dengan gangguan fungsi sistolik VKi memiliki GLS yang kurang negatif (-15.1% + 1.8% vs -21.3% + 2.0%; p=<0,001), beban KVP yang lebih tinggi (22.2% + 11.1% vs 13.9% + 8.3; p=0,001), variasi sirkadian beban KVP yang rendah (koefisien variasi beban KVP per 6 jam 26.8% + 15.6 vs 52.0 % + 28.2%; p=<0,001), dan episode TV non-sustained yang lebih sering (10 pasien [76.9%] vs 3 pasien [23.1%]; p=0,019). Sebanyak 70.6% pasien dengan jenis kelamin laki-laki mengalami gangguan disfungsi sistolik VKi (p=0,002). Pada analisis multivariat didapatkan beberapa prediktor terhadap gangguan fungsi sistolik Vki antara lain variasi sirkadian beban KVP yang rendah dengan [(koefisien variasi beban KVP per 6 jam < 35%), odds ratio (OR)=3.89 interal kepercayaan (IK)95%=1.09-13.80 p=0.036], episode TV non-sustained (OR=14.4, IK 95%=2.36-88.55, p=0.008), beban KVP > 9% (OR=6.81, IK 95%=1.35-34. Kesimpulan: Variasi sirkadian aritmia ventrikular idiopatik yang rendah berhubungan dengan penurunan fungsi sistolik intrinsik ventrikel kiri melalui speckle tracking ekokardiografi. Variasi sirkadian beban KVP per 6 jam < 35% memiliki risiko 3.89 kali lebih tinggi untuk terjadinya disfungsi sistolik ventrikel kiri
......Background: Idiopathic ventricular arrhythmias (AVI) including premature ventricular complex (PVC) or ventricular tachycardia (VT) can cause left ventricular (LV) dysfunction which may lead to cardiomiopathy. The mechanisms of this cardiomyopathy remain elusive, many factors are believed to contribute. PVC burden is influenced by circadian rhythmicity and lack of PVC circadian variability was proposed as one mechanism of LV dysfunction. Since early detection of LV systolic dysfunction can be done by speckle tracking echocardiography examination, further studies are needed to assess intrinsic left ventricular systolic function and its correlation with PVC circadian variation in patients with idiopathic ventricular arrhythmias.
Objective: This study aimed to investigate the correlation between circadian variation of IVA and left ventricular intrinsic systolic function assessed by speckle tracking echocardiography.
Methods: The subjects of this cross sectional study were 67 consecutive patients (17 men [25.4%]; mean age 46.5 + 9.8 years; left ventricular ejection fraction 63.2% + 7.5%) with PVC originated from ventricular outflow tract based on 12 lead electrocardiogram. All patients underwent 24-hour Holter monitoring and speckle tracking echocardiography examinations. The circadian variation of PVC burden and global longitudinal strain (GLS) were determined and statistical analysis was conducted to evaluate their correlation. Results: A total 31 patients (46.3%) had impaired LV systolic function by GLS ( worse than -18%). Patients with impaired LV systolic function had a less negative GLS (-15.1% + 1.8% vs -21.3% + 2.0%; p=<0.001), a higher PVC burden ((22.2% + 11.1% vs 13.9% + 8.3; p=0,001), less variation in circadian PVC distribution (coefficient of variation 6 hourly 26.8% + 15.6 vs 52.0 % + 28.2%; p=<0.001), and more frequent episode of non-sustained VT (10 patients [76.9%] vs 3 patients [23.1%]; p=0.019). Total 70.6% patient with male gender experienced impaired LV systolic function (p=0.002). Independent predictors for impaired systolic LV function were less variation in circadian PVC distribution [(coeficient of variation < 35%), odds ratio (OR)=3.89, 95% confidence interval (CI)= 1.09-13.80, p=0.036)], episode of non-sustained VT (OR=14.4, 95%CI=2.36-88.55, p=0.008), PVC burden > 9% (OR=6.81, CI 95%=1.35-34.41, p=0.020), and male gender (OR=14.4, CI 95%=2.02-101.1, p=0.004).
Conclusion: Lack of circadian variation of IVA is associated with impaired LV systolic function by GLS. Coefficient of variation PVC burden < 35% has 3.89 times higher risk for development of left ventricular systolic dysfunction."
Depok: Fakultas Kedokteran Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Novita Gemalasari Liman
Analisis Ritme Sirkadian Kortisol dan Ritme Sirkadian Aktivitas Sistem Saraf Autonom serta Skala Kesehatan Subjektif pada Kompleks Ventrikel Prematur Idiopatik = Analysis of Cortisol, Autonomic Nervous System, and Subjective Health Scale Circadian Rhythms in Idiopathic Premature Ventricular Complex
"Beban kompleks ventrikel prematur (KVP) memiliki tiga jenis ritme sirkadian, yaitu tipe cepat, tipe lambat, dan tipe independen. Nukleus suprakiasmatikus merupakan bagian dari hipotalamus dan berperan sebagai pusat yang mengatur ritme sirkadian tubuh. Nukleus suprakiasmatikus berhubungan dengan sumbu hipotalamus-pituitari-adrenal (HPA), sistem saraf autonom, dan aspek psikologis. Hubungan ketiga sistem ini dengan ritme sirkadian beban KVP belum diketahui. Oleh karena itu, perlu dilakukan penelitian untuk menganalisis hubungan sumbu HPA, sistem saraf autonom, dan aspek psikologis dengan ritme sirkadian beban KVP. Studi observasional potong lintang ini merekrut subjek penelitian di RS Jantung dan Pembuluh Darah Harapan Kita, RSUD Pakuhaji, dan RS Bun. Waktu penelitian adalah dari Juli 2022 sampai Desember 2022. Kriteria inklusi adalah pasien KVP idiopatik dengan beban ≥ 5%. Sebanyak 23 subjek KVP tipe-cepat, 20 subjek KVP tipe-lambat, 22 pasien KVP tipe-independen, dan 5 subjek kontrol diikutsertakan pada penelitian. Setiap subjek menjalani pemeriksaan Holter 24 jam untuk evaluasi beban KVP dan heart rate variability, mengumpulkan saliva untuk pemeriksaan kortisol dan norepinefrin pada pukul 06:00–07:00, 10:00–11:00, dan 22:00–23:00, serta mencatat skala kesehatan subjektif. Selanjutnya, dilakukan analisis univariat dan regresi linier multipel untuk menganalisis hubungan antara ritme sirkadian variabel independen dan ritme sirkadian beban KVP. Hasil pemeriksaan Holter menunjukkan bahwa rerata beban KVP idiopatik tipe-cepat adalah 15,7%; tipe-lambat 8,4%; dan tipe-independen 13,6%. Regresi liner multipel menunjukkan bahwa tingginya beban KVP idiopatik-tipe-cepat berhubungan dengan kadar kortisol yang lebih tinggi dan tonus sistem saraf parasimpatis yang lebih rendah. Di samping itu, tingginya beban KVP idiopatik-tipe-lambat berkaitan dengan kadar kortisol dan tonus sistem saraf simpatis yang lebih rendah atau tonus sistem saraf parasimpatis yang lebih tinggi. Sementara itu, pada KVP idiopatik-tipe-independen tingginya beban KVP berhubungan dengan kadar kortisol dan tonus sistem saraf simpatis yang lebih tinggi atau tonus sistem saraf parasimpatis yang lebih rendah serta skala kesehatan subjektif yang lebih rendah. Disimpulkan bahwa pola sirkadian beban KVP idiopatik tipe cepat, lambat, dan independen masing-masing berhubungan secara khas dengan sumbu HPA, sistem saraf autonom dan mekanisme psikologis. Penilaian tipe ritme sirkadian KVP idiopatik perlu dilakukan secara rutin mengingat perbedaan mekanisme yang mendasarinya dan kemungkinan perbedaan pada prognosisnya.
......Recent data show that premature ventricular complex (PVC) burden exhibits one of the three circadian patterns, namely fast-type, slow-type, and independent-type PVC. The suprachiasmatic nucleus is part of the hypothalamus and serves as the center of circadian rhythm regulation. The suprachiasmatic nucleus is related to the hypothalamus-pituitary-adrenal (HPA) axis, the autonomic nervous system, and psychological aspects. The relationship between these three systems and the circadian rhythm of PVC is unknown. Therefore, it is important to evaluate the relationship between the HPA axis, the autonomic nervous system, and psychological aspects with the circadian rhythm of PVC burden. This cross-sectional observational study recruited 23 fast-, 20 slow-, and 22 independent-type idiopathic PVC subjects, as well as 5 control subjects. Each subject underwent a 24-hour Holter to examine PVC burden and heart rate variability, collected saliva for cortisol and norepinephrine level measurement at 6–7 am, 10–11 am, and 10–11 pm, and recorded their self-rated health scales. Furthermore, univariate and multiple linear regression were conducted to investigate the associations between circadian rhythms of the independent variables and circadian rhythms of PVC burden. The results of the Holter monitor showed that the average PVC burden was 15.7%, 8.4%, and 13.6% respectively in fast-, slow-, and independent-type idiopathic PVCs. Multiple linear regression showed that the high burden of fast-type idiopathic PVC was assosciated with higher cortisol levels and lower parasympathetic nervous system tone. On the other hand, the high burden of slow-type idiopathic PVC was associated with lower cortisol levels and lower sympathetic nervous system tone. Meanwhile, in independent-type idiopathic PVC, the high burden was associated with higher cortisol levels and sympathetic nervous system tone as well as lower self-rated health scales. The results of this study indicate that each circadian pattern of idiopathic PVC burden is uniquely related to the HPA axis, the autonomic nervous system and psychological mechanisms. Assessment of idiopathic PVC circadian rhythm types needs to be carried out routinely considering the differences in the underlying mechanisms and the possible differences in the prognosis."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Disertasi Membership  Universitas Indonesia Library
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Chairunnisa Luthfya Nurifana
Peran pencahayaan pada interior fasilitas kesehatan khusus geriatri dalam mendukung penderita demensia beraktivitas = The role of lighting in interior spaces of geriatric healthcare facilities on supporting people with dementia's activities
"ABSTRAK
Penderita demensia memiliki kebutuhan terhadap kualitas pencahayaan yang optimal di sekitar mereka karena kualitas cahaya yang diterima oleh tubuh mereka akan berdampak pada ritme biologis yang mana berpengaruh terhadap kualitas hidup mereka. Dengan kebutuhan mereka yang lebih banyak dilakukan di fasilitas kesehatan, maka tata cahaya yang baik akan memudahkan mereka untuk beraktivitas dan menghindari ketidaknyamanan pada mata mereka. Faktor utama yang memengaruhi dan dibutuhkan pada ruang-ruang yang digunakan penderita demensia adalah intensitas dan warna cahaya yang akan memberikan efek kepada ruang interior. Kriteria untuk mendapatkan kualitas cahaya yang optimal pada fasilitas kesehatan adalah dengan melakukan analisis terhadap kebutuhan visual penderita demensia pada ruang interior. Hal itu membantu menemukan jawaban terhadap dampak dari kualitas cahaya yang menentukan kualitas kinerja fasilitas kesehatan dalam meningkatkan kualitas hidup pada penderita demensia.
ABSTRACT
People with Dementia have an innate need of optimal lighting quality around them because the intensity and quality of light perceived by their body affects their bodys circadian rhythm, which in turn plays a vital role in maintaining their physical and psychological well-being. They are likely to spend considerably longer period of time in healthcare facilities, so properly designed lighting aids them to enjoy their activities, thereby helps them to pursue a better quality of life. Assuming that factors affecting the amount of light appropriately needed in a location for People with Dementia are mainly defined by elements of intensity, color, and its effect to the spatial atmosphere, this paper compared one example of geriatric healthcare facility with the standardized criteria for People with Dementia by quantitative observation. Then, the observed criteria were analyzed to help in finding out the impact of light quality affecting the performance of healthcare facilities to promote well-being to People with Dementia."
2019
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UI - Skripsi Membership  Universitas Indonesia Library