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"ABSTRAKStroke tercatat sebagai penyebab kematian kedua tertinggi pada usia 45-54tahun di wilayah perdesaan Indonesia. Stroke merupakan penyakit gangguan fungsiotak akibat kelainan vaskuler yang bersifat multikausal. Penelitian ini bertujuanmengetahui frekuensi dan determinan kejadian stroke berdasarkan faktor risikonyapada penderita hipertensi berusia ≥ 45 tahun di wilayah perdesaan Indonesia.Penelitian ini merupakan analisis lanjut dari data Riskesdas 2013 yangmenggunakan desain studi cross-sectional. Sampel dari penelitian ini adalahpenderita hipertensi yang berusia ≥ 45 tahun, dan tinggal di wilayah perdesaan.Hasil penelitian ini menunjukkan, prevalensi stroke pada penderita hipertensidewasa di perdesaan adalah sebesar 5,3%. Prevalensi stroke tertinggi ditemukan diprovinsi Maluku Utara (7,2%) dan terendah di provinsi Papua (1,7%). Pada variabelyang diteliti, jenis kelamin, stress, aktivitas fisik, konsumsi obat anti-hipertensi,perilaku merokok dan tingkat pendidikan memiliki hubungan bermakna terhadapkejadian stroke pada penderita hipertensi dewasa (≥ 45 tahun) di wilayah perdesaanIndonesia.

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ABSTRACTStroke was recorded as the second-highest mortality cause at the age of 45-54 years in rural areas of Indonesia. Stroke is multicausal brain function disorderdue to vascular abnormalities. This study aimed to determine the frequency anddeterminants of stroke based on risk factors in hypertensive patients aged ≥ 45 yearsin rural areas of Indonesia. This study is a further analysis of the Riskesdas 2013data which used cross-sectional study design. The sample of this study ishypertensive patients who aged ≥ 45 years old and lived in rural areas. The resultsof this study showed that the prevalence of stroke in adult hypertensive patients inrural areas amounted to 5.3%. The highest prevalence of stroke was found in NorthMaluku province (7.2%) and the lowest in Papua province (1.7%). In the studiedvariables, gender, stress, physical activity, consumption of anti-hypertensive drugs,smoking and education have relation to the prevalence of stroke in adulthypertensive patients (≥ 45 years) in rural areas of Indonesia."

"Mild Cognitive Impairment (MCI) adalah masa transisi antara masa menua normal dan masa demensia, namun tidak didapatkan gangguan kemampuan menjalankan aktivitas sehari-hari. MCI dapat diidentifikasi dengan deteksi dini di fasilitas pelayanan kesehatan. Penelitian ini bertujan untuk mengetahui hubungan Hipertensi dengan kejadian MCI pada lansia di wilayah kerja Puskesmas Kecamatan Cipayung Kota Depok. Penelitian dilakukan dengan desain Cross Sectional menggunakan Instrumen MoCA-Ina tervalidasi. Responden dalam penelitian ini berusia 60 tahun keatas non-demensia dan non-depresi. Analisis data menggunakan stratifikasi dan analisis multivariat menggunakan cox regression. Hasil analisis data diperoleh prevalensi MCI sebesar 46,8% dan lansia dengan hipertensi sebesar 68,9%. Selain itu, hasil multivariat menunjukkan bahwa lansia dengan hipertensi kemungkinan berisiko 1,7 kali (PR= 1,70; 95% CI 1,077-2,699) mengalami kejadian MCI dibandingkan lansia normotensi setelah dikontrol variabel lain. Usaha untuk deteksi dini dengan skrining pada orang hipertensi dapat membantu dalam menjaring kasus MCI pada lansia.

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Mild cognitive impairment (MCI) described as a transition phase between healthy cognitive aging and dementia but that does not interfere with activities of daily life. MCI can be detected early in the health facility. The objective of this study was to identified the association between hypertension in elderly and MCI in Cipayung Health center, Depok City.

This is a cross sectional study, utilized the primary data from the early detection using validated Montreal Cognitive test for Indonesia (MoCA-Ina). Participant of this study was non demented and non-depressed elderly people age more than 60 years old. The data analysis was performed with stratification and cox regression multivariate analysis.

The results of study showed the prevalence of MCI is 46,8% and Elderly with hypertension is 68,9%. The result of multivariable analysis showed that elderly people with hypertension probably had 1,7 risk to get MCI with PR=1,705 (95% CI 1,077 - 2,699) than elderly with normotension after adjusted with other variable. For the purpose of early detection of dementia, screening should be taken seriously as a possible pre-stage of MCI in elderly. "

"Depresi merupakan penyakit yang terbanyak didapati baik pada praktik spesialis maupun umum. Gangguan psikiatrik ini dapat bersifat ringan atau penyakit yang berat. Gangguan penyakit yang berat dapat fatal, karena biasanya penderita mencoba untuk bunuh diri (suicidium). Diagnosis penyakit tidak mudah. Gangguan yang ringan, sering bermanifestasi sebagai penyakit fisik, dan gangguan emosional tersamar oleh keluhan somatiknya. Pada masa akut sering gangguan yang berat menyerupai gangguan lain seperti skizofrenia. Banyak sarjana di bidang psikiatri mencari markah biologik sebagai alat untuk membantu diagnosis depresi. Salah satu markah biologik adalah gambaran poligrafik tidur. Hasil yang positif dari laboratorium tidur sulit dipakai di klinik, karena mahal dan sangat memakan waktu, baik penilaian maupun interpretasi. Kelompok Studi Psikiatri Biologik Jakarta (KSPBJ) telah melakukan modifikasi dari teknik standar dengan teknik yang dinamakan Teknik KSPBJ. Pada teknik ini hanya merekam satu menit dari lima menit selama perekaman yang berlangsung tujuh jam. Dari penelitian kami dengan sukarelawan normal dan pasien depresi didapatkan bahwa Teknik KSPBJ mempunyai agreement yang tinggi dengan teknik standar. Lebih lanjut didapatkan bahwa dengan teknik itu, seperti juga pada teknik standar didapatkan markah biologik untuk depresi. Penderita depresi mempunyai latensi REM yang rendah, yang berbeda dengan normal (P<0,001). Selaln itu ternyata pula pada penderita depresi terjadi shifting p-REM ke 1/3 awal malam dan pada perbaikan depresi terjadi shifting ke 1/3 akhir malam. Penelltian ini konsisten dengan hipotesis adanya ketidak-seimbangan sistem kolinergik - noradrenergik pada mekanisme latency REM, dan ketidak-seimbangan noradrenergik-serotonergik pada phasic REM.

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Sleep In Depressed Patient (A Study On Sleep, REM, and Phasic REM In Depressed Patients)Up to 10 % of all patients seeing a doctor are depressed. This conclusion emerged from an enquiry conducted in 1973 by over 10.000 physicians practicing in Austria, Federal Republic of Germany, France, Italy and Switzerland. Approximately 15% of the severely depressed commit suicide, whereas the moderate and mild forms usually cause reduction in the quality of life of these patients. The diagnosis of depression is not easy. Depressive states often escape diagnosis because these patients are so overwhelmed by the impact of their physical symptoms, particularly since they can more easily accept the idea that their illness is of physical, as opposed to mental origin. By referring only to their physical complaints, and deliberately failing to disclose their slate of mind, they lead the unwary physician up the wrong diagnostic path. In most mental hospitals, or departments of psychiatry, the diagnosis of depression is also not easily made. In the acute and severe forms these condition sometimes are wrongly diagnosed as schizophrenia. Numerous scientists are presently searching for a biological marker of depression. The Ideal biological marker must be sensitive, specific, easy to identify and relatively Inexpensive In its operation. Research over the past two decades has led to the development of a standardized sleep EEG methodology, which has been proven useful for the identification of characteristic sleep abnormalities of depressed patients. Application of REM abnormalities as a biological marker has produced an accurate, reliable and objective laboratory method for a diagnostic aid in the identification of depression. Even though this is proven to be a useful tool, in clinical practice it is not presently practical as a routine screening test in depressed patients. One of the drawbacks of these methods is the limited number of and the access to standard sleep laboratories. Expenses of EEG sleep studies run high, approximately US$ 500.00 per night. The other factor is that it is time consuming to evaluate 1200 pages of EEG sleep records. In 1980 KSPBJ (Study Group for Biological Psychiatry) developed a modification of the Rechtschaffen and Dales method. The KSPBJ technique records only one minute in every five minutes. That is one minute on and four minutes off for a period of seven hours. In this dissertation a comparison was made between the KSPRJ technique and the standard technique. With 18 normal volunteers, 14 new cases of depression, and 13 medicated depressed patients, the conclusion can be made that the KSPBJ technique has a statistically high agreement with the standard technique. (Po m 0.78 - 0.82, Kappa - 0.71 - 0.75). Another result of these studies with 91 depressed patients and 50 normal volunteers is finding that depressed patients have shortened REM Latency (<60 minutes). This shortened REM Latency could be used in predicting the diagnosis of depression with a quite high level of sensitivity (73-76%), and specificity (over 90%). Yet another conclusion with this KSPBJ technique is that in depressed patients, there seem to be a shifting to the left of phasic REM (to one third of initial night), and on recovery a shifting to the right (to one third of terminal night). These findings are consistent with the hypothesis, of choilnergic - noradrenergic balance mechanism in the forming of latency REM, and the balance of noradrenergic - serotonergic mechanism in the forming of phasic REM. When comparing this technique with the standard technique, there is an 80% reduction of the cost of sleep EEG recording, and an 80% saving in time for evaluation. In conclusion, the KSPBJ technique can be considered as a biological marker for depression which is reasonably sensitive and specific, easy to identify, and in addition relatively inexpensive."

"Latar Belakang. Cedera kepala merupakan salah satu masalah kesehatan masyarakat yang serius yang dapat menyebabkan kematian, kecacatan fisik dan kecacatan mental. Cedera kepala dapat menyebabkan sel astrosit rusak sehingga mengeluarkan protein S 100B yang dapat dideteksi didalam darah perifer, sehingga dapat dipakai untuk memprediksi tingkat keparahan cedera kepala yang terjadi. Penelitian ini bertujuan untuk mencari hubungan antara kadar protein S 100B dengan tingkat keparahan cedera kepala. Metode. Desain penelitian adalah potong lintang untuk mengetahui kadar protein S 100B pada pasien cedera kepala akut onset kurang dari 24 jam. Subyek penelitian sejumlah 85 pasien yang datang berobat ke Instalasi Gawat Darurat RSCM sejak bulan maret ? juni 2015. Dilakukan penilaian GCS, lamanya tidak sadarkan diri, lamanya amnesia pasca trauma dengan bantuan alat TOAG, pemeriksaan CT Scan dan pemeriksaan serum protein S 100B. Hasil. Didapatkan kadar rerata protein S 100B serum 0,77 μg/L, rerata durasi amnesia 21,22 jam, rerata nilai GCS 13. Terdapat perbedaan kadar protein S 100B pada CKR (rerata 0,4175) dibandingkan dengan pada CKS dan CKB (1,0722) (p=0,020), nilai titik potong kadar protein S 100B pasien yang meninggal 0,765 μg/L (p= 0,002). Simpulan. Kadar rerata protein S 100B pada cedera kepala ringan lebih rendah dibandingkan dengan kadar protein S 100B pada cedera kepala sedang dan berat, semakin tinggi kadar protein S 100B akan semakin tidak baik keluaran pasien cedera kepala.

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Background. Traumatic brain injury is still a serious community health problem can cause death, physical and mental disability. Protein S 100B release from destructive astrocyte from brain injury and detected in the peripheral blood, so that protein S 100B can serve as predictor of severity traumatic brain injury. This research aimed to find association between protein S 100B with traumatic brain injury severity.

Method. This was a cross sectional study focusing to protein S 100B value from acute traumatic brain injury patients with onset < 24 hours. Eighty five patients were recruited from emergency room RSCM. GCS value, duration of post traumatic amnesia with TOAG tools, duration loss of consciousness, brain CT scan and concentration serum protein S 100B were record.

Results. The mean concentration serum Protein S 100B were 0.77, mean PTA duration were 21,22 hours, and the mean GCS were 13. There is a significant differentiation value of concentration protein S 100B from mild trumatic brain injury compare moderate and severe traumatic brain injury (p=0,020), cut off point for death patients was 0,765 μg/L.

Conclusion. The mean serum Protein S 100 B from mild trumatic brain injury lower than moderate and severe traumatic brain injury higher consentration of protein S 100B have bad outcome."