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Renal Artery Stenosis: Diagnostic and Management Problems Samsu, Nur; Waafi, Affa Kiysa
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.6

Abstract

Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology with 3 most common clinical syndromes, ischemic nephropathy, hypertension, and cardiac destabilization syndrome. Aim: To date there was not any specific diagnostic criteria for renal artery stenosis. Method: Clinicians only used some clinical syndromes to guide the diagnostic possibility of renal artery stenosis. RADUS as one sensitive and specific diagnostic method, still had some disadvantages. Results: it gives false negative results in 10-20% of patients due to confounding factors such as operator capability, obesity, or abdominal gas distribution. CTA and MRA was excellent, but possessed some risks for the patient. Therefore, CTA was mostly recommended in patient with the planning of revascularization. Management of renal artery stenosis was still debated between optimal medical management and revascularization because the complexities of mechanisms underlying the renal artery stenosis. Because of the complicated pathophysiology of renal artery stenosis, revascularization could not entirely improve renovascular hypertension and nephropathy. Revascularization offered best results in fibromuscular dysplasia, although procedure related complication was still high. Revascularization, even though it might have high success rate in atherosclerotic renal artery stenosis, but the incidence of re-stenosis was also fairly high. Conclusion: Overall, revascularization was recommended in FMD, but should only be preserved for atherosclerotic renal artery stenosis after the failure of optimal medical management.
Perceived Family Functionality among Elderly Patient with Covid-19 Infection: A Perspective from Developing Country Sunarti, Sri; Candradikusuma, Didi; Indiastari, Dewi; Prehatiningsih, Siti Fatma; Wibowo, Bogi Pratomo; Waafi, Affa Kiysa
Jurnal Kedokteran Brawijaya Vol. 32 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.02.8

Abstract

Family is a basic social unit of senior citizen. Relationship among family members considered as source of emotional comfort. Meanwhile, economic, political, and social changes during pandemic has an impact on the family, the support provided can be manifested among vulnerable groups such as the elderly. Prolonged stress due to isolation care of Covid-19 infection increase psychological distress by reducing family support. This study aimed to explore perceived family function among elderly patients after Covid-19 infection. A cross sectional study was conducted among 33 elder patients with history of Covid-19 infection in Saiful Anwar General Hospital, Indonesia. Perceived family functionality was evaluated using APGAR family score. Data was analyzed using descriptive analyses, independent T test, correlation and regression. Mean total APGAR score was 9.610.70 with joint pain had significant association with APGAR score (p 0.021) indicating full family support in elder person with symptoms. Gender female was associated with 'Resolve' (p 0.038) which might correlate with bigger role of elder female in Indonesian family. Length of stay was significantly associated with 'Partnership' (p 0.012) and 'Growth' (0.043) with inverse correlation. It showed how prolonged hospital stay affected family relationship especially in terms of communication. Perceived family supports remained high in elderly during Covid-19 isolation in Indonesia. Specific symptoms such as joint pain, even strengthen the family support for elder member of family. Prolonged stay in the hospital during Covid-19 infection, might become a communication barrier between elder person and the family which affect decision sharing and emotional expression.