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"ABSTRAK Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harusdievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukurankekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudahdibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostikKGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapismalnutrisi pasien kanker rawat jalan di RSCM.Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun dipoliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGTdianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai denganmenghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, danmalnutrisi 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 kgfdengan 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 perempuanberturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasienkanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint 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 severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% 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 patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good.;Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint 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 severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% 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 patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good."

"Latar belakang: Peningkatan usia lanjut menimbulkan dampak kesehatan, diantaranya adalah sarkopenia dan kerapuhan. Kekuatan genggam tangan merupakan komponensarkopenia, fenotip sindrom kerapuhan, dan bersifat dinamis. Berbagai studi potonglintang menilai hubungan kekuataan genggam tangan dengan usia, jenis kelamin, statusnutrisi, status fungsional, status mental, dan komorbiditas namun temuan masihberagam. Selain itu, belum ada studi longitudinal untuk mengetahui hubunganperubahan kekuatan genggam tangan dengan usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas di Indonesia.Tujuan: Mengetahui hubungan antara usia, jenis kelamin, status nutrisi, statusfungsional, status mental dan komorbiditas dengan perubahan kekuatan genggamtangan pada pasien usia lanjut.Metode: Penelitian kohort prospektif menggunakan data sekunder pasien usia lanjutyang kontrol rutin di Poliklinik Geriatri RSCM Jakarta dari register studi longitudinalINA-FRAGILE yang telah diobservasi selama 1 tahun (2013-2014). Uji analisismultivariat regresi logistik digunakan untuk menilai hubungan antara usia, jeniskelamin, status nutrisi (skor MNA), status fungsional (skor ADL), status mental (skorGDS-SF), indeks komorbiditas (skor CIRS) dengan perubahan kekuatan genggamtangan.Hasil: Dalam 1 tahun pengamatan dari 162 subjek, didapatkan rerata usia 72,9 (SB 5,9)tahun, jenis kelamin terbanyak perempuan (57,41%), memiliki nutrisi baik (83,9%),mandiri (median ADL 9–20), tidak depresi (median GDS-SF 0–11), rerata indekskomorbiditas 11,8 (SB 3,7), dan 53,1% mengalami penurunan kekuatan genggamtangan. Status nutrisi (OR=2,7; p=0,033) dan indeks komorbiditas (OR 0,3; p<0,002)berhubungan dengan kekuatan genggam tangan.Simpulan: Status nutrisi dan komorbiditas memengaruhi perubahan kekuatan genggamtangan pada pasien usia lanjut dalam 1 tahun di rawat jalan.

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Background: Increasing elderly population throughout the world has been related to

increased prevalence of sarcopenia and frailty. Handgrip strength is a component of

sarcopenia, one of frailty syndrome phenotypes, and a dynamic process. Previous

cross-sectional studies have assessed association of age, sex, nutritional status,

functional status, mental status and comorbodity but the results were varied. That being

said, there was no longitudinal study has been done to determine the correlation of

handgrip strength changes with age, sex, nutritional status, functional status, mental

status, and comorbidity in Indonesia.

Objective: To examine correlation between age, sex, nutritional status, functional

status, depressive symptopms, comorbidity, and handgrip strength changes in elderly

patients.

Methods: A prospective cohort study using secondary data of elderly patients whom

routinely visiting Geriatric Out-Patients Clinic at Cipto Mangunkusumo Hospital,

Jakarta from INA-FRAGILE register that have been observed for 1 year (2013-2014).

The multivariate logistic regression analysis was used to assess correlation between

sex, age, nutrional status (MNA score), functional status (ADL score), depressive

symptoms (GDS-SF score), comorbidities (CIRS score) and handgrip strength changes.

Results: From 162 subjects which were included in the study, the mean age was 72.9

(SB 5.9) years, predominantly female (57.41%), with good nutrition (83.9%),

independent (median 9- 20), not depressed (median 0-11), has average comorbidity

index 11.8 (SB 3.7), and 53.1% experienced decreased handgrip strength. Nutritional

status (OR = 2.7, p = 0.033) and comorbidity index (OR 0.3, p <0.002) correlated with

handgrip strength changes.

Conclusion: Nutritional status and comorbidity correlates with handgrip strength

changes in out-patients elderly within 1 year."

"ABSTRAKMengetahui hubungan antara derajat postur kifosis melalui pengukuran JOD(Jarak oksiput – dinding) dengan risiko jatuh melalui penilaian BBS (Berg Balance Scale)pada usila.Metode: Desain penelitian adalah deskriptif analitik potong lintang. Subjek usila sehatumur 60 tahun dan lebih, binaan lembaga non-panti PUSAKA (Pusat Santunan Keluarga)di Jakarta dengan sistem pengambilan wilayah non-random, selama Desember 2012 hinggaMaret 2013. Pengambilan sampel berdasarkan consecutive sampling. Sampel yangmemenuhi kriteria penerimaan kooperatif, ambulasi mandiri dan menandatangani lembarpersetujuan) diukur derajat kifosisnya dengan JOD dan dinilai risiko jatuhnya dengan BBS.Hasil: Sebanyak 90 usila dianalisis. Didapatkan lebih banyak kelompok usila muda 60 –74 tahun (73,3%) dengan jenis kelamin perempuan (87,8%), rerata IMT 22,3 (5) kg/m2,memiliki status pendidikan dasar (53,3%), tidak bekerja dalam hal ini sebagai ibu rumahtangga (73,3%), tidak depresi (93,3%), aktivitas harian mandiri (88,9 %) dan tidakmemiliki riwayat jatuh (73,3%).Terdapat perbedaan risiko jatuh diantara ketiga kelompok kifosis (p<0,001). Analisis posthoc mendapatkan bahwa risiko jatuh pada kelompok kifosis ringan lebih rendah bermaknadaripada kelompok kifosis sedang dan berat.Terdapat perbedaan risiko jatuh yang bermakna diantara ketiga derajat kifosis padakelompok usila perempuan, tidak ada riwayat jatuh, rentang usia 60 – 74 tahun, IMTkurang, tidak depresi dan aktivitas harian mandiri.Simpulan: Terdapat perbedaan risiko jatuh diantara kelompok derajat kifosis ringan,sedang dan berat.

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ABSTRACTTo know the relationship between the degree of kyphotic posture throughmeasurement of OWD (occiput – wall distance) with the risk of fall through the assessmentof BBS (Berg Balance Scale) in the elderly.Methods: The design of the study was cross sectional analitic descriptive. The subjectswere healthy elderly aged 60 years and above, who became a caring of PUSAKA (PusatSantunan Keluarga) in Jakarta with a non randomized system to took of the areas, duringDecember 2012 to March 2013. Samples obtained upon consecutive sampling. Sampleswho meet the inclusion criterias (cooperative, ambulate independently and signed anapproval sheet) carried out kyphotic measurement with OWD and risk of fall assessmentwith BBS.Results: There were 90 subjects who analized. Researcher found that younger elderly 60 –74 years old about 73,3%, females 87,8%, mean Body mass Index 22,3 (5) kg/m2, basiceducational status 53,3%, as a housewife 73,3%, no depression 93,3%, independent dailyactivity 88,9% and no history of fall 73,3%.There are differences the risk of fall among the three groups of kyphosis (p<0,001). Posthoc analysis has been said that risk of fall in the mild kyphosis are lowest than moderateand severe kyphosis.There are statistically significant in differences of the risk of fall among the three groups ofkyphosis in the elderly who are woman, no risk of fall’s history, age 60 – 74 years old,underweight, no depression and independent daily activity.Conclusions: There are difference risk of fall among mild, moderate and severe degree ofkyphosis"

"Latar Belakang: Pendekatan indeks frailty 40 item (FI-40) dianggap sebagai alat terbaik untuk evaluasi mortalitas dan hospitalisasi sindrom frailty, tetapi sulit diterapkan dalam praktik klinis sehari-hari. Pendekatan dengan sistem skor CHS, SOF, dan FI-CGA lebih mudah diterapkan dalam praktik klinis sehari-hari, namun hingga saat ini belum ada data validasi di Indonesia. Tujuan: Mendapatkan rekomendasi mengenai alat ukur sindrom frailty yang mudah diterapkan dalam praktik klinis sehari-hari di Indonesia. Metode: Penelitian ini merupakan studi potong lintang dengan pendekatan uji diagnostik yang dilakukan pada pasien di poliklinik Geriatri Rumah Sakit Cipto Mangunkusumo, dengan usia ≥60 tahun, pada periode Mei-Juni 2013. Setiap subjek dinilai menggunakan sistem skor CHS, SOF, FI-CGA, dan FI-40. Dilakukan penilaian sensitivitas, spesifisitas, nilai prediksi positif (NPP), nilai prediksi negatif (NPN), rasio kemungkinan positif (RK+), dan rasio kemungkinan negatif (RK-) untuk masing-masing sistem skor CHS, SOF, dan FI-CGA dibandingkan dengan FI-40. Hasil: Proporsi individu yang termasuk dalam kategori frail, pre-frail, dan fit berdasarkan indeks frailty 40 item berturut-turut adalah 25,3%, 71%, dan 3,7%. Untuk membedakan individu frail dengan tidak frail, skor CHS memiliki sensitivitas 41,2%, spesifisitas 95%, NPP 73,7%, NPN 82,7%, RK+ 8,41 dan RK- 0,62. Skor SOF memiliki sensitivitas 17,6%, spesifisitas 99,5%, NPP 92,3%, NPN 78,1%, RK+ 35,2 dan RK- 0,83. Sedangkan skor FI-CGA memiliki sensitivitas 8,8%, spesifisitas 100%, NPP 100%, NPN 76,4%, RK+ tak terbatas, dan RK- 0,91. Kesimpulan: Tidak ada sistem skor yang dapat digunakan sebagai alat skrining yang baik untuk sindrom frailty, namun masing-masing sistem skor dapat digunakan sebagai alat diagnostik yang baik untuk sindrom frailty.

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Background: The Frailty Index 40-item (FI-40) approach is considered the best tool for evaluating mortality and hospitalization outcomes related to frailty syndrome, although it is challenging to implement in daily clinical practice. The CHS, SOF, and FI-CGA scoring systems are easier to use in daily practice, but there is no validation data available in Indonesia.

Aim: To obtain recommendations for a frailty syndrome diagnostic tool that is easy to implement in daily clinical practice in Indonesia.

Methods: This was a cross-sectional study with a diagnostic test approach conducted on patients aged ≥60 years at the Geriatric Outpatient Clinic of Cipto Mangunkusumo Hospital from May to June 2013. Each subject was assessed using the CHS, SOF, FI-CGA, and FI-40 scoring systems. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated for each scoring system compared to FI-40.

Results: The proportions of frail, pre-frail, and robust individuals based on the 40-item frailty index were 25.3%, 71%, and 3.7%, respectively. To differentiate between frail and non-frail individuals, the CHS score showed a sensitivity of 41.2%, specificity of 95%, PPV of 73.7%, NPV of 82.7%, LR+ of 8.41, and LR- of 0.62. The SOF score showed a sensitivity of 17.6%, specificity of 99.5%, PPV of 92.3%, NPV of 78.1%, LR+ of 35.2, and LR- of 0.83. The FI-CGA score showed a sensitivity of 8.8%, specificity of 100%, PPV of 100%, NPV of 76.4%, LR+ infinite, and LR- of 0.91.

Conclusion: No scoring system was found to be suitable as a screening tool for frailty syndrome; however, all scoring systems can be used as effective diagnostic tools for frailty with good predictive ability."

"ABSTRAKLatar Belakang. Lansia merupakan kelompok yang berisiko tinggi untuk terjadinya malnutrisi. Selain merupakan akibat dari penyakit yang diderita, malnutrisi pada lansia juga menjadi penyebab tingginya angka kesakitan pada lansia. Mengingat hal tersebut diperlukan suatu instrumen yang sahih dan dapat diandalkan untuk menilai status gizi lansia yang tinggal di komunitas.Tujuan. Mendapatkan kuesioner MNA-SF berbahasa Indonesia yang sahih dan andal untuk digunakan oleh kader posbindu untuk menapis status gizi lansia di komunitas.Metodologi. Responden berusia ge;60 tahun yang datang ke posbindu menjalani wawancara oleh ahli gizi dan kader posbindu. Wawancara ulang oleh kader posbindu dilakukan satu sampai dua minggu kemudian. Selanjutnya dihitung korelasi antara skor total MNA dengan MNA-SF, skor total MNA-SF pemeriksaan pertama dan kedua, ICC intraclass correlation coefficient MNA-SF hasil penilaian ahli gizi dan penilaian kader serta cronbach rsquo;? MNA-SF.Hasil. Penelitian diikuti oleh 92 responden dengan median usia 67 tahun. Korelasi sedang didapatkan antara skor total MNA-SF IMT indeks massa tubuh penilaian kader dengan skor total MNA r=0,491;p

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ABSTRACTBackground. Eldery is highly succeptible group to suffer from malnutrition. Malnutrition in elderly can be the result of disease that they suffered from. It also become the cause of high morbidity. Along with that matter, we need a valid and reliable instrument to assess nutritional status among community dwelling elderly.Objective. To a get valid and reliable Indonesian MNA SF to be used by social workers to screen nutritional status in community dwelling elderly.Methodology. Respondents aged ge 60 years old who came to ldquo posbindu rdquo were interviewed by nutritionist by using MNA. The interview then continued by social workers by using Indonesian MNA SF. Re interview by social workers was held 1 2 weeks later. After data were collected we calculate corellation between MNA and MNA SF total score, MNA SF total score in the first and second examination and cronbach rsquo s .Result. Ninety two respondents were included in this study. Median age was 67 years old. Moderate corellation was observed between BMI Body Mass Index MNA SF total score assessed by social workers and MNA total score r 0.491 p"

"Latar Belakang: Individu dengan diabetes melitus tipe 2 (DMT2) dilaporkan mengalami peningkatan risiko terjadinya sarkopenia dan juga sebaliknya. Penelitian mengenai DMT2 dengan sarkopenia mayoritas berasal dari populasi geriatri. Sampai saat ini belum ada studi yang membandingkan profil metabolik dan parameter inflamasi di kelompok DMT2 dengan dan tanpa sarkopenia pada usia yang lebih muda.Tujuan: Penelitian ini bertujuan untuk mengetahui adanya perbedaan rerata profil metabolik dan parameter inflamasi pada penyandang DMT2 nongeriatri dengan dan tanpa sarkopenia.Metode: Penelitian potong lintang ini melibatkan individu dengan DMT2 nongeriatri berusia  18-59 tahun yang berobat di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta, Indonesia pada bulan Januari 2021- Januari 2022. Dilakukan pengambilan data sekunder berupa antropometri dan laboratorium yang mencakup Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), HbA1c dan profil lipid. Kadar interleukin (IL)-6 dan IL-10 serum diukur menggunakan teknik ELISA. Kelompok sarkopenia terdiri atas possible dan true sarcopenia berdasarkan kriteria Asian Working Group for Sarcopenia (AWGS) 2019.Hasil: Dari 100 subjek, 35 subjek dikategorikan ke dalam possible sarkopenia dan 4 subjek true sarkopenia. Subjek DMT2 nongeriatri dengan sarkopenia memiliki median (RIK) nilai HOMA-IR dan kadar HbA1c yang lebih tinggi dibanding subjek tanpa sarkopenia yaitu berturut-turut [6,52 (4,05-17,26) vs. 4,66 (2,61-10,14); p=0,025] dan [9,0% (7,3-10,3)% vs. 7,4% (6,6-8,45)%; p=0,002]. Tidak terdapat perbedaan kadar profil metabolik lain dan IL-6 antara kedua kelompok, sementara kadar IL-10 hanya terdeteksi pada 33 sampel sehingga tidak dapat dianalisis lebih lanjut.Kesimpulan: Median nilai HOMA-IR dan kadar HbA1c kelompok DMT2 nongeriatri dengan sarkopenia lebih tinggi dibanding kelompok tanpa sarkopenia. Tidak ditemukan perbedaan kadar profil metabolik lain dan IL-6 sebagai parameter inflamasi antara kedua kelompok tersebut. Tidak dilakukan analisis beda rerata kadar IL-10 karena sedikitnya sampel yang terdeteksi.

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Background: Individuals with type 2 diabetes mellitus (T2DM) are at increased risk for sarcopenia and vice versa. Studies in T2DM with sarcopenia mostly came from the geriatric population. To date, no study has compared the metabolic profile and inflammatory parameters in younger T2DM subjects with and without sarcopenia.

Aim: This study aimed to assess the mean differences in the metabolic profile and inflammatory parameters of nongeriatric T2DM individuals with vs. without sarcopenia.

Method: This cross-sectional study involved nongeriatric T2DM individuals aged 18-59 years old visiting Cipto Mangunkusumo Hospital, Jakarta, Indonesia between January 2021 and January 2022. Secondary data was obtained, namely anthropometric and laboratory data including Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), HbA1c and lipid profile. Serum levels of interleukin (IL)-6 and IL-10 were measured using the ELISA technique. The sarcopenia group consists of individuals with possible and true sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria.

Results: From 100 subjects, 35 was categorized as possible sarcopenia and 4 as true sarcopenia. Nongeriatric T2DM subjects with sarcopenia had significantly higher median (interquartile range) HOMA-IR and HbA1c compared to nonsarcopenic subjects [6.52 (4.05-17.26) vs. 4.66 (2.61-10.14); p=0.025] and [9.0% (7.3-10.3)% vs. 7.4% (6.6-8.45)%; p=0.002]. There were no differences in other levels of metabolic profile and IL-6 between the two groups, while IL-10 levels were only detected in 33 samples and could not be analyzed further.

Conclusion: Median HOMA-IR and HbA1c nongeriatric T2DM subjects with sarcopenia was higher than those without sarcopenia. There was no difference in other metabolic profile and IL-6 level as inflammation parameter between the two groups. IL-10 was not analysed further due to the small sample number that were detected."

"Latar belakang : Pruritus kronis adalah sensasi tidak menyenangkan yang mencetuskan keinginan untuk menggaruk, berlangsung enam minggu atau lebih. Pruritus sering dihubungkan dengan sejumlah kelainan sistemik. Salah satu kelainan sistemik tersering yang disertai pruritus kronis adalah kelainan hati hepatobilier kolestasis. Patofisiologi terjadinya pruritus kolestasis dihubungkan dengan peningkatan akumulasi mediator pruritogenik salah satunya yaitu asam empedu serum total (AEST) di darah perifer begitu juga di jaringan lunak termasuk kulit, yang secara normal diekskresikan ke empedu. Masih sedikit yang mengetahui kemungkinan peran peningkatan kadar AEST dengan kejadian pruritus. Tujuan : mengetahui perbedaan rerata kadar AEST pada pasien geriatri tanpa dermatosis primer yang mengalami pruritus kronis dan tanpa pruritus kronis Metode : penelitian ini merupakan penelitian potong lintang, dengan subyek penelitian sejumlah 80 orang, terdiri atas perempuan dan laki-laki usia ≥ 60 tahun. Subyek penelitian dibagi menjadi dua kelompok, yaitu kelompok pruritus terdiri atas 40 pasien pruritus kronis, dan kelompok kontrol yang terdiri atas 40 pasien tanpa pruritus kronis. Kadar AEST dinilai menggunakan metode enzimatik kolorimetri, kemudian dianalisis perbedaan kadar AEST antar kedua kelompok. Hasil: kadar AEST pada kelompok pruritus didapatkan median 4,5 μmol/L, dengan nilai minimum-maksimum yaitu 3-51 μmol/L. Kadar AEST pada kelompok non-pruritus didapatkan median empat μmol/L, dengan nilai minimum-maksimum 3-22 μmol/L, perbedaan ini tidak bermakna (p = 0,095). Kesimpulan: Kadar AEST pada kelompok pruritus lebih tinggi dibandingkan kelompok non-pruritus, namun tidak bermakna secara statistik.

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Background : Chronic pruritus is defined as an unpleasant sensation of the skin leading to the desire to scratch, which lasting six weeks or more. Pruritus is associated with numerous systemic disorders, and it is a common symptom of any cholestatic hepatobiliary disease. Its pathophysiology is attributed to progressive accumulation of pruritogenic mediators such as bile acid in the peripheral blood as well as in soft tissues including the skin, which are normally excreted into the bile. Little is known about the potential contribution of elevated total serum bile acids (TSBA) levels to pruritus.

Objective : to differentiate TSBA levels in geriatrics patients with chronic pruritus and without chronic pruritus.

Methods : this is a cross-sectional study comprising 80 patients men and women aged ≥ 60 years old, consist of 40 patients in chronic pruritic group, and 40 patients in non-pruritic group. The serum levels of bile acid were measured by enzymatic colorimetric methods, and the level TSBA were analyzed from the two groups.

Results : TSBA levels were detected higher in chronic pruritic group patients (median 4,5 μmol/L, minimum-maximum range 3-51 μmol/L), than in the non-pruritic group (median 4 μmol/L, range 3-22 μmol/L), the difference was insignificant (p = 0,095).

Conclusions : the serum bile acid levels are elevated in chronic pruritic patients but statistically insignificant."

"ABSTRAKProses penuaan dan munculnya berbagai penyakit pada lanjut usia (lansia)menyebabkan penurunan massa dan kekuatan otot. Penyebab sarkopeniamultifaktorial, salah satunya adalah stres oksidatif. Defisiensi vitamin antioksidanC, E dan β-karoten umum terjadi pada lansia. Penelitian potong lintang inibertujuan untuk melihat korelasi asupan β-karoten dan kadar β-karoten serumdengan massa dan kekuatan otot lansia. Pengambilan subjek dilakukan denganconsecutive sampling, didapatkan 52 lansia memenuhi kriteria penelitian. Dataasupan β-karoten menggunakan metode food frequency questionnaire (FFQ)semikuantitatif. Dilakukan penilaian status gizi dengan Mini NutritionalAssessment-Short Form (MNA-SF), pemeriksaan massa otot dan kekuatangenggam tangan serta pemeriksaan kadar β-karoten serum. Didapatkan asupan β-karoten yang kurang pada 76,9% subjek dengan rerata 1,5 (0,68) mg. Nilaimedian kadar β-karoten 0,17 (0,03?0,84) μmol/L dan 71,2% subjek tergolongrendah. Rerata massa otot 37,41 (7,61) kg dan 100% subjek kategori normal. Nilaitengah kekuatan genggam tangan 22,0 (12?42) kg, sebagian besar (56,25%)kategori normal. Didapatkan korelasi positif lemah signifikan antara asupan β-karoten dengan massa otot (r = 0,3, p = 0,03) dan kekuatan genggam tangan (r =0,39, p = 0,004). Tidak terdapat korelasi antara kadar β-karoten serum denganmassa otot (r = ?0,19, p = 0,188) dan kekuatan genggam tangan (r = ?0,19, p =0,167).

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ABSTRACTThe aging process and the emergence of various diseases in elderly caused decrease in muscle mass and strength. The etiology of sarcopenia is multifactorial and one of the causes is oxidative stress. Deficiency vitamin C, E and β-carotene is common in elderly. The aim of this study was to determined whether dietary intake and serum levels of β-carotene are correlated with mass and muscle strength in elderly. We conducted cross-sectional analyses in 52 institutionalized elderly during April?Mei 2016. The assesment of β-carotene intake with food frequency questionnaire (FFQ) semiquantitative, nutritional status by the Mini Nutritional Assessment-Short Form (MNA-SF), muscle mass measurement, handgrip strength and β-carotene serum level. β-carotene intake in 76.9% subjects was less with mean 1.5 (0.68) mg. The median value of β-carotene serum was 0.17 (0.03 to 0.84) mol/L which 71.2% o subjects categorized low. Muscle mass mean 37.41 (7.61) kg which 100% subjects were normal. Median handgrip strength was 22.0 (12-42) kg, with 56,25% in normal category. A weak positive correlation between the intake of β-carotene with muscle mass (r = 0.3, p = 0.03) and hand grip strength (r = 0.39, p = 0.004). No correlation found between serum levels of β-carotene with muscle mass (r = -0.19, p = 0.188) and hand grip strength (r = ?0.19, p = 0.167)."

"Peningkatan kasus diabetes melitus tipe 2 (DMT2) dengan berbagai komplikasinya memberikan dampak gangguan fungsional seseorang dalam bentuk gangguan kognitif dan kapasitas fisik. Keduanya masih reversibel dan baru diketahui berhubungan sehingga disebut sebagai PhysioCognitive Decline Syndrome (PCDS). Kondisi PCDS baru dipelajari pada lansia dan belum spesifik pada penyandang DMT2.TujuanMengetahui korelasi antara kendali glikemik dengan komponen physiocognitive decline syndrome pada penyandang DMT2 dewasa usia pertengahan.Metode Studi potong lintang menggunakan consecutive sampling dari pasien di poliklinik metabolik endokrin dan poli jantung terpadu sejak Januari 2021 – November 2022. Subjek DMT2 berusia 40 – 59 tahun diinklusi. Pemeriksaan kekuatan genggam tangan, dan kecepatan berjalan 6-meter diperiksakan di ruangan standar. MoCA-Ina dilakukan oleh dokter yang telah dilatih. Data HbA1c subjek yang diperiksa adalah HbA1c 3 bulan terakhir. Analisis korelasi Pearson’s atau Spearman’s pada SPSS 20.0 dilakukan sesuai sebaran data.Hasil Sebanyak 133 subjek telah dianalisis. Usia median mencapai 53 tahun dengan proporsi laki-laki dan perempuan serta komplikasi pada masing-masing kateori kendali glikemik (batas HbA1c 7,0%) serupa. Subjek didominasi dengan pendidikan SMA dan Sarjana/Diploma. Median durasi terdiagnosisnya diabetes melitus mencapai 7 tahun dengan HbA1c median 7.6%. Nilai MoCA-Ina pada subjek mencapai nilai median 24 dengan kecepatan berjalan rerata 1.02 + 0.23 m/detik dan median kekuatan genggam tangan 24 kg. Terdapat korelasi bermakna hanya pada HbA1c dengan kekutan genggam tangan (r = -0.24, R2 = 0.06, p value <0.01), terutama pada perempuanKesimpulanTerdapat korelasi bermakna antara kendali glikemik dan kekuatan genggam tangan.

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Increasing cases of type 2 diabetes melitus (T2DM) including its complication have caused functional dysfunction consisted of cognitive decline and physical incapacity. Both cognitive decline and physical incapacity had been just known to be reversible and related to each other, so it is termed as PhysioCognitive Decline Syndrome (PCDS). However, it had been just evaluated in geriatric and not specific to T2DM patient.

To investigate the correlation between glycaemic correlation and component of physiocognitive decline syndrome in middle-aged adult with T2DM.

A cross sectional study with consecutive sampling in our metabolic and endocrine clinic and integrated heart centre in January 2021 – November 2022 had been conducted. Inclusion criteria was 40 – 59 years old subjects with T2DM. Measurement of HbA1c in the last 3 month were analysed, while hand grip strength and gait speed were done in standard room. MoCA-Ina had been conducted by trained doctor. Correlation analysis using Pearson’s or Spearman’s in SPSS 20.0 was done according to data distribution.

133 subjects were analysed. Median age was 53 years old with both sex and complication within each glycaemic control category (HbA1c 7,0% cut off) were similar. Subjects were dominated by high school and undergraduate/diploma education level. Most subjects were diagnosed in up to 7 years of T2DM. Median of HbA1c levels in our study was 7.6%. MoCA-Ina score was 24 in median with mean of gait speed was 1.02 + 0.23 m/s. Our median for hand grip was 24 kg. Significant correlation was only found in relationship of HbA1c and hand grip strength (r = -0.24, R2 = 0.06, p value <0.01).

There was significant correlation between glycaemic control and hand grip strength.

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