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"Asupan makanan berlebih dan rendahnya aktivitas fisik adalah dua faktor risiko obesitas pada remaja. Kurangnya pemahaman akan hubungan antarfaktor risiko ini membuat obesitas remaja sulit ditangani dan cenderung berlanjut ke usia dewasa. Studi ini bertujuan untuk mengetahui hubungan antara tingkat aktivitas fisik (physical activity level/PAL) dengan asupan energi dan makronutrien. Penelitian dilakukan di salah satu fakultas kedokteran di Jakarta dalam periode Juni 2011-Juni 2013, dengan metode total sampling pada populasi mahasiswa berusia 15-18 tahun. Data asupan energi dan makronutrien dari sampel yang terdiri atas laki-laki (n=30) dan perempuan (n=43), dinilai menggunakan Food-Frequency Questionnaire semikuantitatif, sedangkan PAL dengan Bouchard three-days physical activity record. Dengan uji one-way anova, terdapat hubungan antara PAL dengan asupan energi dan lemak (p=0,025 dan 0,019), sedangkan asupan karbohidrat dan protein sebaliknya. Dengan analisis post-hoc LSD, perbedaan bermakna terdapat pada PAL sedang dan tinggi (asupan energi p=0,007; lemak p=0,005), sedangkan rata-rata asupan energi dan makronutrien tetap tinggi pada PAL rendah. Disimpulkan bahwa peningkatan keluaran energi total akan meningkatkan asupan energi, sedangkan PAL rendah tidak akan mengubah kebutuhan energi individual.

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Excessive nutrient intake and low physical activity are two obesity risk factors in adolescent. Lack of understanding in relationship amongst these risk factors has made adolescent obesity become health problems and tends to progress into adulthood. This study aimed to investigate the relationship between physical activity level (PAL) with energy and macronutrient intake. Study was held in one of medical school in Jakarta from June 2011-June 2013, with total sampling on medical students aged 15-18. Energy and macronutrient intake from boys (n=30) and girls (n=43) were assessed using semiquantitative Food-Frequency Questionnaire, while PALs were assessed using Bouchard-three days physical activity record. One-way anova analysis showed significant relationship of PAL toward energy and fat intake (p=0,025 and 0,019), and none of carbohydrate and protein intake. The post-hoc LSD analysis revealed the significant mean difference were found in subjects classified as high and moderate PAL (for energy intake p=0,007; fat intake p=0,005). Meanwhile, energy and all macronutrients intake were found to be persistently high in subject with low PAL. In conclusion, increase in total energy expenditure will subsequently induce increase in energy intake, but low PAL did not change the individual energy requirement."

"Obesitas anak meningkat dua kali lipat dalam 20 tahun terakhir dan terjadi pada negara berkembang seperti Indonesia Pengaruh pengetahuan gizi terhadap asupan remaja masih dalam perdebatan Penelitian ini bertujuan untuk menelusuri hubungan tingkat pengetahuan gizi dengan asupan energi dan makronutrien Pengambilan data berlangsung pada Februari hingga April 2012 pada salah satu fakultas kedokteran di Jakarta Seluruh mahasiswa berusia 15 18 tahun diikutsertakan dalam penelitian potong lintang ini Pengetahuan gizi diukur melalui kuesioner isian Asupan energi dan makronutrien ditelusuri melalui wawancara gizi dengan panduan kuesioner FFQ Sebanyak 75 subyek ikut serta dalam penelitian dengan 62 di antaranya memiliki tingkat pengetahuan gizi sedang dengan rerata skor 21 00 12 00 27 00 Konsumsi rerata energi karbohidrat protein dan lemak harian responden adalah 2443 60 761 30 ndash 5109 00 kkal 316 10 106 50 ndash 734 20 gram 88 89 37 02 gram dan 82 00 14 80 211 30 gram Proporsi karbohidrat protein dan lemak pada responden adalah 53 97 9 31 13 31 7 67 ndash 22 45 dan 31 95 12 59 ndash 53 47 Laki laki mengonsumsi total energi dan makronutrien yang lebih tinggi tetapi komposisi yang serupa dengan perempuan Tidak ada hubungan antara tingkat pengetahuan gizi dengan asupan energi p 0 415 jumlah dan komposisi karbohidrat p 0 715 p 0 323 protein p 0 634 p 0 387 serta lemak p 0 116 p 0 398 Oleh karena itu peningkatan pengetahuan gizi tidak berhubungan dengan asupan energi dan makronutrien yang lebih baik.

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Adolescent's obesity increased two times in recent two decades and existed in developing countries like Indonesia Effect of nutrition knowledge on nutrition intake is still debated We investigated the relationship between nutrient knowledge levels and energy and macronutrient intake Data was collected from February to April 2012 at a medical school in Jakarta All students aged 15 to 18 years old enrolled in this cross sectional study Nutrition knowledge was assessed by open ended questions Energy and macronutrient intake was estimated by guidance of FFQ in the interview Among 75 subjects out of 62 students scored lsquo average'in nutrition knowledge with mean of 21 00 12 00 27 00 Mean consumption of energy carbohydrate protein and fat were 2443 60 761 30 ndash 5109 00 kcal 316 10 106 50 ndash 734 20 grams 88 89 37 02 grams and 82 00 14 80 ndash 211 30 grams respectively Proportion of carbohydrate protein and fat in the diet were 53 97 9 31 13 31 7 67 ndash 22 45 and 31 95 12 59 ndash 53 47 Males consumed higher energy and macronutrients intake but had similar diet composition There were no significant correlations between nutrition knowledge levels and energy intake p 0 415 number and composition of carbohydrate p 0 715 p 0 323 protein p 0 634 p 0 387 and fat p 0 116 p 0 398 intake Therefore better nutrition knowledge did not correspond to better energy and macronutrient intake."

"Asupan energi dan komposisi makronutrien pada usia remaja mempengaruhi kesehatan pada usia dewasa. Remaja yang mengalami obesitas berisiko tinggi mengalami penyakit serius di usia dewasa seperti penyakit kardiovaskular dan diabetes mellitus. Lingkar pinggang digunakan dalam penelitian ini sebagai parameter status gizi remaja khususnya untuk menggambarkan obesitas sentral. Penelitian cross sectional ini dirancang untuk mengetahui hubungan asupan energi dan komposisi makronutrien dengan lingkar pinggang remaja usia 15 18 tahun di Jakarta. Data diambil dari 75 orang remaja yang berkuliah di salah satu Fakultas Kedokteran di Jakarta pada periode Maret 2012 Mei 2012. Data diambil secara total sampling dan diperoleh dari wawancara dengan menggunakan instrumen FFQ Food Frequency Questionnaire serta pengukuran lingkar pinggang. Sebanyak 20 dari total subjek mengalami obesitas sentral. Subjek rata rata mengonsumsi energi berlebih dengan nilai tengah sebesar 2443 761 5109 kkal dengan rerata persentase komposisi makronutrien sebagai berikut 53 97 9 31 karbohidrat 13 67 2 65 protein dan 31 41 8 12 lemak. Hubungan antara asupan energi dengan lingkar pinggang remaja menghasilkan nilai p 0 908. Sedangkan hubungan komposisi karbohidrat protein dan lemak dengan lingkar pinggang remaja masing masing menghasilkan nilai p 0 118 p 0 200 p 0 540. Dengan demikian tidak terdapat hubungan antara asupan energi dan komposisi makronutrien dengan lingkar pinggang pada remaja usia 15 18 tahun di Jakarta.

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Energy intake and macronutrients composition in adolescents could affect the health when they become an adult. The obese adolescent have high risk to have serious disease when they become adult such as cardiovascular disease and diabetes mellitus. Waist circumference was used in this study for represent adolescents rsquo nutrition status in particular to describe central obesity. This cross sectional study was design to know the relationship between energy intake and macronutrients composition in adolescents aged 15 18 years in Jakarta. Data were taken from 75 adolescents who study in one of Medical Faculty in Jakarta during March 2012 May 2012. Data were taken by total sampling and obtained from interview by using FFQ Food Frequency Questionnaire and waist circumference measurement 20 of subjects had central obesity. Subjects on average consume excess energy with a median of 2443 761 5109 kkal with a mean percentage of macronutrients composition as follows 53 97 9 31 of carbohydrate 13 67 2 65 of protein and 31 41 8 12 of fat. Relationship between energy intake and waist circumference in adolescents had the p value 0 908. While relationship between carbohydrate protein and fat composition with waist circumference in adolescents had each p value as follows p 0 118 p 0 200 p 0 540. Thus there was no relationship between energy intake and macronutrients composition with waist circumference in adolescents aged 15 18 years in Jakarta."

"Perubahan gaya hidup remaja menyebabkan ketidakseimbangan asupan energi dan aktivitas fisik yang berujung pada obesitas, mempengaruhi kesehatanya di usia dewasa. Obesitas dini dapat menyebabkan penyakit degeneratif terjadi secara lebih cepat. Penelitian ini ingin mencari faktor asupan energi dan komposisi makronutrien dalam mempengaruhi status gizi berdasarkan tebal lipatan kulit. Seluruh mahasiswa tingkat pertama usia 15-18 tahun pada juni 2011-Juni 2013 (n=75) diwawancara asupan makanannya dalam satu bulan terakhir, kemudian dicari asupan energi harian, komposisi karbohidrat, protein dan lemaknya. Subjek juga diukur tebal lipatan kulit di empat lokasi (bisep, trisep, subskapula dan suprailiaka), kemudian dicari persentase lemak tubuh dan digolongkan kedalam status obesitas dan tidak obesitas. 25,8% remaja pria dan 38,6% remaja wanita tergolong obesitas dengan kadar lemak tubuh ≥25(♂) dan ≥35%(♀) pada usia 15-18 tahun. Baik remaja dengan obesitas maupun tidak obesitas kebanyakan mengonsumsi asupan energi secara berlebih 2443(761-5109)kkal atau sebanding dengan 104(35-230)% AKG dimana laki-laki lebih banyak dibandingkan perempuan. Asupan gizi rerata dengan komposisi 53.97±9.31% karbohidrat, 13.67±2.65% protein dan 31.41±8.12 % lemak. Kadar lemak pada pria (30,6±3,7%) lebih besar daripada pada wanita (21,4±5,3%). Hubungan antara asupan energi, komposisi karbohidrat, protein dan lemak dengan tebal lipat kulit masing masing dengan p=0,703; p=0,189; p=0,319; p=0,804. Asupan energi yang berlebihan maupun komposisi karbohidrat, protein dan lemak tidak secara langsung berpengaruh terhadap status gizi berdasarkan tebal lipatan kulit. Status gizi berdasarkan tebal lipatan kulit dapat dipengaruhi oleh berbagai faktor lain di luar itu sehingga perlu diperhatikan hal-hal lain dalam memberikan intervensi kesehatan untuk memperbaiki kondisi obesitas.

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Adolescent lifestyle changes led to an imbalance energy intake and physical activity lead to obesity which led to premature degenerative diseases. This study wanted to find energy intake and macronutrient composition as a factor influence skinfold thickness. The entire freshman aged 15-18 years (n=75) on June 2011were interviewed to exam the past month food intake, carbohydrates, protein and fat composition using FFQ questionnaire.

Subject were also had skinfold thickness at four sites examined, those measurement would lead to body fat percentage and had categorized into obesity and non-obesity. 25,8% male and 38,6 female adolescent were classified as obese with body fat percentage ≥ 25 (♂) and ≥ 35% (♀) at the age of 15-18 years. Both adolescents with obese and non-obese mostly consume excess energy intake 2443(761-5109) kcal equivalent to 104(35-230)% RDA, while male consumed 113(65-197)% RDA on average and female 107±39% RDA. The macronutrient diet compositions consist of 53.97±9.31% carbohydrate, 13.67±2.65% protein and 31.41±8.12% fat. Body fat percentages in male (30.6±3.7%) were greater than women (21.4±5.3%).

Relations between energy intake, carbohydrate, protein and fat composition with skinfold thickness is p = 0.703, p = 0.189, p = 0.319, p = 0.804 respectively. Excessive energy intake and carbohydrates, protein and fats composition do not directly affect the nutritional status based on skinfold thickness. Nutritional status based on skinfold thickness could be affected by other factors that need to be considered, especially in delivering health interventions to improve the adolescent obesity condition."

"Pola asupan makanan yang tidak seimbang banyak dijalani kaum remaja saat ini. Hal tersebut menyebabkan ancaman status gizi berlebih semakin mengintai para remaja. Status gizi remaja dapat tercermin melalui pengukuran Indeks Massa Tubuh (IMT). Tujuan penelitian ini ialah mengetahui hubungan antara asupan energi dan komposisi makronutrien dengan IMT pada remaja usia 15-18 tahun. Penelitian menggunakan desain penelitian potong lintang analitik. Pengambilan data dilaksanakan di Jakarta terhadap 75 mahasiswa kedokteran, laki-laki (n=31) dan perempuan (n=44), tingkat 1 tahun 2012 yang diminta untuk menjawab wawancara mengenai asupan hariannya memakai kuisioner Food Frequency Questionnaires (FFQ) semikuantitatif dan menjalani pemeriksaan fisik, berupa tinggi dan berat badan.Dari penelitian ini, hasilnya, yakni sebaran subjek berdasarkan asupan energi , yaitu kurang (24%), cukup (30,7%), lebih (45,3%). Untuk asupan karbohidrat ialah kurang (10,7%), cukup (77,3%), dan lebih (12%). Sementara itu, asupan lemak yang kurang ada 24%, cukup sebanyak 44%, dan lebih sebesar 32%. Terakhir, sebaran subjek berdasarkan asupan protein, yakni kurang (1,3%) dan cukup (98,7%). Tidak ada responden yang asupan proteinnya lebih. Distribusi subjek berdasarkan IMT, yaitu pada laki-laki 9,7% kurang, 61,3% normal, dan 29% lebih sedangkan pada perempuan 90,9% normal dan 9,1% lebih. Kesimpulan pada penelitian ini ialah tidak terdapat adanya hubungan (p>0,05) antara asupan energi dan komposisi makronutrien dengan IMT pada remaja usia 15-18 tahun.

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Unbalance pattern of food intake become trend for many young people at this time. This causes overweight and obesity risk threaten the teens. Adolescent nutritonal status can be defined by Body Mass Index (BMI) measurement. The purpose of this study is to determine the relationship between energy intake and macronutrient composition with BMI in adolescents aged 15-18 years old. Study used cross-sectional analytical study design. Data collection was conducted in Jakarta on 75 first grade medical students, boys (n=31) and girls (n=41), in 2012 who were asked to answer the interview about her daily intake using Food Frequency Questionnaires (FFQ) semiquantitative and underwent a physical examination, such as height and weight.

The results from this study were the respondent distributions of energy intake were less (24%), adequate (30,7%), over normal (45,3%). For carbohydrate intake were less (10,7%), adequate (77,3%), and over normal (12%). Meanwhile, there were 24% respondents with less intake of fat, 44% adequate. and 32% over normal. Last, the distributions of protein intake were less (1,3%) and adequate (98,7%). No respondent with over normal protein intake. Subject distributions of BMI, were in boys 9,7% less, 61,3% normal, and 29% over normal while in girls, 90,9% normal and 9,1% over normal. The conclusion of this study is there is no relationship (p>0,05) between energy intake and macronutrient composition with BMI in adolescents aged 15-18 years old."

"Studi serial kasus ini bertujuan untuk mengetahui pengaruh tata laksana nutrisi perioperatif pada pasien kanker saluran cerna yang menjalani pembedahan elektif dalam menurunkan angka morbiditas dan lama rawat di rumah sakit. Tindakan pembedahan yang dilakukan pada pasien kanker saluran cerna yang sudah mengalami malnutrisi berkaitan dengan serangkaian reaksi inflamasi yang berpotensi memperberat kondisi malnutrisi yang pada akhirnya memperberat gangguan sistem imun. Studi kasus dilakukan terhadap empat pasien dewasa dengan malnutrisi yang direncanakan menjalani pembedahan elektif akibat kanker saluran cerna di divisi Bedah Digestif Departemen Bedah RSUPN dr. Cipto mangunkusumo. Dukungan nutrisi diberikan semenjak periode pra pembedahan sampai dengan periode pasca pembedahan. Penentuan kebutuhan dihitung dengan menggunakan rumus Harris Benedict. Protein diberikan sebesar 1,8?2 g/kgBB kecuali pada satu orang pasien diberikan sebesar 0,8 g/kgBB/hari karena adanya gagal ginjal kronis. Lemak diberikan sebesar 25% dan sisanya berupa karbohidrat. Mikronutrien yang diberikan berupa kapsul multivitamin-multimineral. Hasil studi ini mendapatkan bahwa bahwa pemberian dukungan nutrisi perioperatif yang optimal dapat mempertahankan fungsi fisiologis, berat badan dan kapasitas fungsional serta memberikan kontrol glikemik yang baik pada periode pra pembedahan dan memperbaiki berbagai parameter status nutrisi termasuk fungsi imun pasca pembedahan walaupun tidak didapatkan peningkatan berat badan.

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This case series study aimed to investigate the effect of perioperative nutritional support in gastrointestinal cancer patients who underwent elective surgery in reducing morbidity and and length of hospitalization. Surgery which was performed in patients with gastric cancer who had experienced malnutrition associated with a series of inflammatory reactions that could potentially aggravate the condition of malnourished which in turn aggravate the immune system disorders. The case study was carried out on four adult patients suffer from malnutrition due to elective surgery for gastric cancer at the Surgical Division of The Department of Digestive Surgery RSUPN dr. Cipto Mangunkusumo. The nutritional support was gave since the preoperative to postoperative period. Determination of energy needs was calculated using the Harris benedict equation. Protein was given by 1.8 to 2 g/kg body weight/day except in one patient given at 0.8 g/kg body weight/day due to chronic renal failure. Fats were given by 25% and the rest were given as carbohydrate. Micronutrient was given in the form of multivitamin-multimineral capsule. The results of this study found that the provision of perioperative nutritional support could maintain optimal preoperative physiological function, body weight and functional capacity as well as provide good glycemic control and improve the nutritional status parameters including immune function after surgery althought there were not increased in body weight."

"Luka bakar berat berhubungan dengan tingginya angka morbiditas dan mortalitas. Tatalaksana nutrisi pada luka bakar berat diutamakan pada pemberian nutrisi enteral dini (NED). Nutrisi enteral dini diberikan sedini mungkin setelah resusitasi tercapai, bermanfaat sebagai trophic feeding yang terbukti mencegah terjadinya atrofi vili-vili mukosa sebagai upaya mengatasi dampak hipoperfusi splangnikus. Pemberian nutrisi ditingkatkan bertahap sesuai asupan, toleransi, dan keadaan klinis pasien. Serial kasus ini terdiri dari tiga kasus dengan penyebab api dan satu yang disebabkan oleh listrik. Dua kasus dengan trauma inhalasi dan dua kasus dengan kegagalan ginjal akut (AKI). Dua kasus masuk pada hari pertama pasca trauma, dan dua kasus pada hari ke enam dan delapan pasca trauma. Keempat kasus masih dalam keadaan resusitasi cairan, sehingga pemberian nutrisi ditujukan untuk pemberian NED. Monitoring dilakukan pada klinis, asupan dan toleransi, dan laboratorium terutama darah perifer lengkap, elektrolit, analisis gas darah, laktat, albumin, dan fungsi ginjal. Asupan keempat kasus tidak pernah mencapai total karena berulang kali dipuasakan untuk pembedahan. Aliran balik yang tinggi menunjukkan intoleransi saluran cerna sehingga perlu diberikan prokinetik. Pemberian antibiotik sebagai suatu kebutuhan mutlak perlu memperhatikan interaksinya dengan nutrien. Pemberian analgetika dan sedatif perlu memperhatikan interaksi dan efek terhadap kebutuhan nutrisi. Trombositopenia yang terjadi pada tiga kasus berhubungan dengan sepsis dan mortalitas. Koagulopati bersama dengan hipotermia dan asidosis menjadi komponen Triad of Death. Hiperlaktatemia harus dinilai bersamaan dengan parameter lain untuk menilai adanya hipoksia jaringan. Dua kasus berkomplikasi menjadi AKI, tatalaksana nutrisi memperhatikan terapi yang didapat pasien. Pemberian medikamentosa untuk perbaikan sirkulasi juga memperhatikan interaksi obat.

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Severe burns associated with high morbidity and mortality. Nutritional management of severe burns priority on early enteral nutrition (EEN). Early enteral nutrition is given as early as possible after resuscitation achieved, useful as trophic feeding are proven to prevent the occurrence of mucosal villous atrophy as the effort to overcome the effects of splanchnic hypoperfusion. Providing appropriate nutrition intake gradually increased, due to tolerance, and clinical condition of patients. This case series consisted of three cases the cause of the fire and one caused by electricity. Two cases with inhalation injury and two cases with acute renal failure (ARF). Two cases admitted on the first day after trauma, and two cases in the sixth and eighth days after trauma. The four cases are still in a state of fluid resuscitation, thus giving nutrition aimed at giving EEN. Monitoring conducted in clinical condition, caloric intake and tolerance, and laboratories especially equipped peripheral blood, electrolytes, blood gases analysis, lactate, albumin, and kidney function.

Intake of four cases never reach the total due to repeated fasting for surgery. High-flow indicates that gastrointestinal intolerance should be given prokinetic agent. Giving antibiotics as an absolute necessity need to consider interactions with nutrients. Giving analgesics and sedatives need to consider interactions and effects on nutritional requirements. Thrombocytopenia occurred in three cases and mortality associated with sepsis. Coagulopathy with hypothermia and acidosis become components Triad of Death. Hyperlactatemia should be assessed in conjunction with other parameters to assess the presence of tissue hypoxia. Two cases complicated to AKI, nutritional management of patients gained attention therapy. Giving drug therapy for improved circulation also consider drug interactions."

"[Latar Belakang: Lama puasa prabedah mempengaruhi outcome pascabedah. Saat ini, pasien bedah anak masih dipuasakan lebih lama dari yang direkomendasikan. Sementara itu, belum ada rekomendasi dimulainya pemberian nutrisi enteral pascabedah.Metode: Dilakukan penilaian pada pasien anak yang menjalani pembedahan intraabdomen. Hal yang dinilai meliputi skrining gizi dengan berbagai metode, status gizi prabedah, lama puasa prabedah, jenis pembedahan, dimulainya nutrisi enteral pascabedah, pencapaian kalori total dan asupan protein, serta perbaikan kapasitas fungsional.Hasil: Pembedahan terdiri atas nonreseksi dan reseksi usus, masing-masing 2 kasus. Status gizi prabedah pasien pertama dan kedua malnutrisi ringan, sementara pasien ketiga dan keempat malnutrisi sedang. Rerata lama puasa prabedah berturut-turut 16 dan 7,5 jam untuk nonreseksi usus serta 17 dan 7 jam untuk reseksi usus. Semua pasien berada memiliki ASA 2. Pemberian nutrisi enteral dimulai berturut-turut 6 dan 4 jam pascabedah pada nonreseksi, serta hari ke-3 pascabedah pada kasus reseksi usus. Asupan kalori total tercapai berturut-turut pada hari ke-5 dan ke-9 pascabedah pada kasus nonreseksi, serta hari ke-5 dan ke-7 pada reseksi usus. Kebutuhan protein para pasien tercapai berturut-turut pada hari ke-3, 5, 7, dan 9 pascabedah untuk pasien terakhir. Perbaikan kapasitas fungsional pasien terjadi berturut-turut pada hari ke-6, 3, 6, dan ke-8 pascabedah pada pasien pertama, kedua, ketiga, dan keempat.Kesimpulan: Dengan tatalaksana komprehensif terapi medik gizi klinik perioperatif pasien bedah anak, dapat mencegah komplikasi bedah dan mempercepat pemulihan kapasitas fungsional.Background: Presurgery fasting time affects the surgery outcome. Nowadays, fasting in pediatric surgery patients are longer than recommended. However, there is no recommendation of the enteral feeding initiation after surgery.Method: The serial case assessed pediatric intarabdominal surgery patients. They were reviewed for nutritional scorings, presurgery nutritional status, presurgery fasting time, type of surgery, the time the enteral feedings intiatiation, the time to meet the requirement of total calories and protein intake, and the improvement of functional capacity.Results: Four cases were divided to non- and intestinal resection, 2 cases each. The nutritional status of the first and second patient were mild malnutrition, while the third and the fourth were moderate malnutrition. Mean fasting time were 16 and 7.5 hours in nonresection, while the other were 17 and 7 hours. All patients had 2 ASA scores. The enteral feeding were initiated at 6 and 4 hours after surgery in nonresection, and at day 3 and 4 after surgery in resection case. The total calories were fulfilled at day 5 and 9 after surgery in nonresection, at day 5 and 7 in the other case. The protein intake met total requirement in patients at day 3, 5, 7, and 9 after surgery, respectively. The improvement of maximal functional capacity occured at day 6, 3, 6, and, respectively.Conclusion: Comprehensive perioperative medical clinical nutrition management results in improving wound healing process and the functional capacity.;Background:Presurgery fasting time affects the surgery outcome. Nowadays, fasting inpediatric surgery patients are longer than recommended. However, there is norecommendation of the enteral feeding initiation after surgery.Method:The serial case assessed pediatric intarabdominal surgery patients. They werereviewed for nutritional scorings, presurgery nutritional status, presurgery fastingtime, type of surgery, the time the enteral feedings intiatiation, the time to meetthe requirement of total calories and protein intake, and the improvement offunctional capacity.Results:Four cases were divided to non- and intestinal resection, 2 cases each. Thenutritional status of the first and second patient were mild malnutrition, while thethird and the fourth were moderate malnutrition. Mean fasting time were 16 and7.5 hours in nonresection, while the other were 17 and 7 hours. All patients had 2ASA scores. The enteral feeding were initiated at 6 and 4 hours after surgery innonresection, and at day 3 and 4 after surgery in resection case. The totalcalories were fulfilled at day 5 and 9 after surgery in nonresection, at day 5 and7 in the other case. The protein intake met total requirement in patients at day 3,5, 7, and 9 after surgery, respectively. The improvement of maximal functional capacity occured at day 6, 3, 6, and, respectively., Background:Presurgery fasting time affects the surgery outcome. Nowadays, fasting inpediatric surgery patients are longer than recommended. However, there is norecommendation of the enteral feeding initiation after surgery.Method:The serial case assessed pediatric intarabdominal surgery patients. They werereviewed for nutritional scorings, presurgery nutritional status, presurgery fastingtime, type of surgery, the time the enteral feedings intiatiation, the time to meetthe requirement of total calories and protein intake, and the improvement offunctional capacity.Results:Four cases were divided to non- and intestinal resection, 2 cases each. Thenutritional status of the first and second patient were mild malnutrition, while thethird and the fourth were moderate malnutrition. Mean fasting time were 16 and7.5 hours in nonresection, while the other were 17 and 7 hours. All patients had 2ASA scores. The enteral feeding were initiated at 6 and 4 hours after surgery innonresection, and at day 3 and 4 after surgery in resection case. The totalcalories were fulfilled at day 5 and 9 after surgery in nonresection, at day 5 and7 in the other case. The protein intake met total requirement in patients at day 3,5, 7, and 9 after surgery, respectively. The improvement of maximal functional capacity occured at day 6, 3, 6, and, respectively.]"

"[Pendahuluan: Acute decompensated heart failure (ADHF) adalah penyebabutama rawat inap di RS karena morbiditas dan mortalitasnya yang tinggi.Perubahan metabolisme, pengaruh kongesti sistemik pada gastrointestinal, danefek samping terapi medikamentosa ADHF menyebabkan pasien ADHF rentanmengalami malnutrisi. Perbedaan faktor risiko ADHF juga mempengaruhi tatalaksana nutrisi. Tata laksana nutrisi yang adekuat sesuai dengan faktor risiko dankondisi klinis dibutuhkan untuk mencegah malnutrisi, menurunkan morbiditas danmortalitas.Presentasi Kasus: Pasien dalam serial kasus ini adalah dua perempuan dan dualaki-laki berusia 32–62 tahun dengan ADHF dan berbagai faktor risiko. Pasienpertama dengan diabetes melitus tipe 2, pasien kedua dengan dilatedcardiomyopathy, pasien ketiga dengan hipertensi, sedangkan pasien keempatdengan stenosis aorta. Target kebutuhan energi keempat pasien adalah sebesar130–140% kebutuhan energi basal yang dihitung dengan Harris-Benedict. Targetpemberian protein sebesar 0,8–1,4 g/kg BB/hari, kebutuhan lemak 25% darienergi total dengan komposisi lemak sesuai therapeutic lifestyle changes.Kebutuhan natrium 2400 mg/hari dengan restriksi cairan rata-rata sebesar 1500mL/hari. Pemberian mikronutrien dan nutrien spesifik berupa vitamin Bkompleks, C, B12, asam folat, seng, dan omega 3 disesuaikan dengan kondisipasien. Hasil: Pada keempat pasien didapatkan perbaikan kondisi klinis dan kapasitasfungsional.Kesimpulan: Tata laksana nutrisi yang adekuat pada pasien ADHF sesuai dengan faktor risiko dan kondisi klinis dibutuhkan untuk perbaikan outcome, menurunkan morbiditas dan mortalitas., Background: Acute decompensated heart failure (ADHF) is a leading cause forhospitalization due to its high morbidity and mortality. Metabolic changes,congestion effects on gastrointestinal, and side effects of therapy result inincreased risk of malnutrition in ADHF patients. Various risk factors and clinicalstatus also have great impact on nutritional management. An adequate nutritionalmanagement based on risk factor and clinical status is required to preventmalnutrition, reduce morbidity and mortality. Case Presentation: Two female and two male patients were included in this caseseries, aged 31–60 years old, and diagnosed as ADHF with various risk factors.The risk factor of ADHF for first patient was diabetes mellitus type 2, the secondpatient was dilated cardiomyopathy, the third patient was hypertension, and thefourth patient was aortic stenosis. Total energy requirement was 130–140% ofestimated basal energy requirement. Target of protein was 0.8–1.4 g/kg BW/day.Fat requirement was 25% of total energy with composition based on therapeuticlifestyle changes. Sodium intake was 2400 mg/day with fluid restriction averagedto 1500 mL/day. Micronutrient and specific nutrient supplementation such asvitamin B complex, C, B12, folic acid, zinc, and omega 3 were provided topatients based on clinical status. Result: There was improvement of clinical status and functional capacity in allpatients.Conclusion: An adequate nutritional management in ADHF patients based on risk factor and clinical status leads to better outcome and reduction of morbidity and mortality. ]"

"[ABSTRAKLatar belakang: Prevalensi Diabetes Melitus Tipe (DM) tipe 2 semakin meningkat setiap tahun. Kontrol glisemik yang buruk, hipertensi, dislipidemia, dan kebiasaan merokok serta menopause dapat meningkatkan risiko komplikasi penyakit kardiovaskular. Komplikasi kardiovaskular merupakan komplikasi paling sering ditemukan dengan angka mortalitas yang tinggi. Oleh karena itu, untuk menekan progresivitas komplikasi kardiovaskular diperlukan suatu terapi nutrisi medik yang adekuat sesuai dengan kondisi klinis dan edukasi dalam memodifikasi gaya hidup.Metode: Pasien pada serial kasus berusia 55-65 tahun. Tiga pasien didiagnosis DM tipe 2 dengan gagal jantung, satu pasien dengan penyakit jantung hipertensi. Semua pasien memiliki skor skrining malnutrition screening tools (MST) ≥ 2. Dua pasien mempunyai status gizi obesitas, satu pasien berat badan dan pasien lainnya dengan berat badan normal. Kebutuhan energi basal (KEB) berdasarkan rumus Harris-Benedict dengan faktor stress 1,3-1,4 tergantung kondisi klinis dan penyakit penyerta. Komposisi makronutrien sesuai dengan rekomendasi American Diabetes Association dan Dietary Approach to Stop Hypertension. Pemberian mikronutrien dan nutrient spesifik diberikan pada satu dua kasus. Pasien dipantau selama 5-17 hari, meliputi keluhan subyektif, hemodinamik, toleransi dan analisis asupan, antropometri, pemeriksaan laboratorium, imbang cairan, dan kapasitas fungsional.Hasil: Selama pemantauan di RS, keempat pasien menunjukkan perbaikan klinis yaitu tekanan darah turun dan kapasitas fungsional membaik. Satu pasien kadar glukosa darah dipertahankan < 200 mg/dL.Kesimpulan: Terapi nutrisi medik yang adekuat dapat memperbaiki kondisi klinis pasien DM tipe 2 dengan komplikasi sistem kardiovaskular.

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ABSTRACTBackground: The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method: Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results : All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion: Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications., Background:The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method:Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results :All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion:Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications.]"