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POLIFARMASI PADA PASIEN GERIATRI Husna Fauziah; Roza Mulyana; Rose Dinda Martini
HUMAN CARE JOURNAL Vol 5, No 3 (2020): Human Care Journal
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i3.796

Latar belakang: Polifarmasi banyak ditemukan pada populasi geriatri dan berhubungan dengan efek samping dan lama perawatan di rumah sakit. Polifarmasi adalah penggunaan bersamaan enam obat atau lebih oleh seorang pasien. Mengidentifikasi dan menghindari polifarmasi dapat memberikan hasil yang lebih baik pada pasien usia lanjut dan membantu meningkatkan kualitas hidup. Tujuan: Meningkatkan pemahaman dalam mengidentifikasi dan menatalaksana polifarmasi pada pasien geriatri. Tinjauan Pustaka: Polifarmasi banyak ditemukan pada pasien geriatri dan berkaitan dengan kondisi penyakit dan pertambahan usia. Peningkatan penggunaan obat pada geriatri meningkatkan risiko negatif seperti peningkatan biaya perawatan, kejadian efek samping obat, interaksi obat, ketidakpatuhan pengobatan, penurunan status fungsional, dan sindrom geriatri. Beberapa strategi untuk mengurangi polifarmasi di kalangan pasien usia lanjut membutuhkan kerjasama multidisiplin. Penerapan kriteria AGS Beers dan kriteria STOPP / START meningkatkan kesesuaian obat pada pasien usia lanjut dan mengurangi polifarmasi. Kesimpulan: Diperlukan pemahaman yang lebih baik tentang polifarmasi dan konsekuensinya pada pasien geriatri. Diperlukan implementasi instrumen dan metode untuk mengatasi polifarmasi pada praktek klinis sehari-hari pada pasien geriatri.

Diagnosis and Management of Refeeding Syndrome Auliangi Tamayo; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 9 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i9.567

Refeeding syndrome (RFS) is described as a syndrome of electrolyte abnormalities and changes in body fluids with metabolic abnormalities in malnourished patients who receive refeeding either orally, enteral, or parenterally. Patients at risk for RFS are patients who have lost 10% of their previous body weight in the last 3-6 months, cancer patients who are on chemotherapy, geriatric patients with malnutrition, and patients with anorexia. Clinical manifestations are caused by electrolyte changes that affect neurons, heart and muscle disorders with various symptoms, and even death. The specific characteristics of RFS are the presence of hypophosphatemia and accompanied by other symptoms of electrolyte imbalance such as changes in sodium levels, changes in glucose, protein, fat metabolism, vitamin B1 deficiency, hypokalemia, and hypomagnesemia. The principle of management of RFS is to correct biochemical abnormalities and electrolyte and fluid imbalances. Preventive steps that can be taken are identifying individuals at risk for RFS, monitoring refeeding and administering an appropriate diet regimen.

Diagnosis and Management of Refeeding Syndrome Auliangi Tamayo; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 9 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i9.567

Refeeding syndrome (RFS) is described as a syndrome of electrolyte abnormalities and changes in body fluids with metabolic abnormalities in malnourished patients who receive refeeding either orally, enteral, or parenterally. Patients at risk for RFS are patients who have lost 10% of their previous body weight in the last 3-6 months, cancer patients who are on chemotherapy, geriatric patients with malnutrition, and patients with anorexia. Clinical manifestations are caused by electrolyte changes that affect neurons, heart and muscle disorders with various symptoms, and even death. The specific characteristics of RFS are the presence of hypophosphatemia and accompanied by other symptoms of electrolyte imbalance such as changes in sodium levels, changes in glucose, protein, fat metabolism, vitamin B1 deficiency, hypokalemia, and hypomagnesemia. The principle of management of RFS is to correct biochemical abnormalities and electrolyte and fluid imbalances. Preventive steps that can be taken are identifying individuals at risk for RFS, monitoring refeeding and administering an appropriate diet regimen.

Perbedaan Kadar Insulin-Like Growth Factor-1 dan Tumor Necrosis Factor-α Serum pada Berbagai Derajat Sarkopenia Pasien Lanjut Usia: Studi Potong Lintang Tamayo, Auliangi; Mulyana, Roza; Martini, Rose Dinda
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Sarcopenia is a phenomenon of progressive decline in muscle function that occurs due to the aging process. Insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α) have an important role in the occurrence of sarcopenia as a positive and negative regulator of muscle mass. Research shows differences in IGF-1 and TNF-α levels between sarcopenia and non-sarcopenia groups, but research on differences in severity of sarcopenia remains unclear. The purpose of this study was to determine the difference in levels of IGF-1 and TNF-α in various degrees of sarcopenia in elderly patients. Methods. This was an analytical observational study with a cross-sectional approach involving 45 subjects of elderly patients who came to the internal outpatient clinic of RSUP dr. M. Djamil Padang and met the criteria for inclusion and exclusion. Subjects were grouped into possible sarcopenia, sarcopenia, and severe sarcopenia. Then, serum IGF-1 and TNF-α examinations were performed using the enzyme linked immunosorbent assay (ELISA) method. Data was analyzed using SPSS 26.0. Results. Median of serum IGF-1 levels in the total sample were 41.36 ng/mL. The highest levels of IGF-1 were found in the possible sarcopenia group (55.28 ng/mL), while the lowest level was in the severe sarcopenia group (31 ng/mL). Median of serum TNF-α levels in the total sample were 157.63 ng/L with the lowest was found in the possible sarcopenia group (111.41 ng/L) and the highest was in the severe sarcopenia group (241.1 ng/L). There was a significant difference in serum levels of IGF-1 and TNF-α in the three sarcopenia groups (p= 0.001). IGF-1 levels decreased according to the severity of sarcopenia, while TNF-α levels increased according to the severity of sarcopenia. Conclusions. There are differences in serum levels of IGF-1 and TNF-α between possible sarcopenia, sarcopenia, and severe elderly sarcopenia.

Handgrip Strength: An Early Warning Sign for Mobility Decline? A Meta-Analysis of Diagnostic Accuracy Studies R. Ifan Arief Fahrurozi; Rose Dinda Martini; Roza Mulyana; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1160

Background: Mobility limitations significantly impact the quality of life of older adults. Early identification of individuals at risk is crucial for timely intervention. This meta-analysis investigates the diagnostic accuracy of handgrip strength (HGS) in predicting future mobility decline in older adults. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for diagnostic accuracy studies published between 2018 and 2024, evaluating the ability of baseline HGS to predict incident mobility limitations in older adults (≥60 years). Mobility limitations were defined as difficulties in performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs). The primary outcomes were sensitivity, specificity, and diagnostic odds ratio (DOR) of HGS for predicting mobility decline. A bivariate random-effects model was used to pool data. Results: Seven diagnostic studies with a total of 3,870 participants were included. The pooled sensitivity of HGS for predicting mobility decline was 0.72 (95% CI: 0.65-0.78), and the pooled specificity was 0.70 (95% CI: 0.66-0.74). The pooled DOR was 4.85 (95% CI: 3.21-7.32), indicating good discriminatory ability. Conclusion: This meta-analysis demonstrates that HGS has moderate sensitivity and specificity for predicting future mobility decline in older adults. HGS assessment can be a valuable tool for identifying individuals at risk, although further research is needed to determine optimal cut-off points and combine HGS with other risk factors for improved prediction.

Kekuatan Genggaman Tangan Sebagai Marker Klinis Keterbatasan Mobilitas Fahrurozi, R. Ifan Arief; Mulyana, Roza; Martini, Rose Dinda; Triansyah, Fandi
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i1.56211

Adanya penurunan fungsi organ tubuh secara alamiah pada lansia menimbulkan berbagai gangguan fungsional tubuh seperti gangguan mobilitas mulai dari penurunan kecepatan berjalan, fungsi keseimbangan, kemampuan fungsional dan kemandirian dalam aktivitas kehidupan sehari – hari. Salah satu prediktor penting dari mobilitas adalah kekuatan otot. Kekuatan genggaman tangan digunakan sebagai indikator dalam evaluasi frailty dan sarkopenia yang terkait dengan berbagai luaran klinis negatif pada lansia. Penelitian ini merupakan penelitian kuantitatif deskriptif dengan pendekatan cross-sectional, yang bertujuan untuk menganalisis hubungan antara kekuatan genggaman tangan, massa otot, dan kinerja fisik pada individu lanjut usia. Terdapat korelasi yang signifikan antara pengukuran kekuatan genggaman tangan dengan keterbatasan mobilitas. Temuan ini mengindikasikan bahwa kekuatan genggaman tangan dapat digunakan sebagai alat skrining yang efektif dan marker klinis untuk mengidentifikasi lansia dengan risiko tinggi terhadap keterbatasan mobilitas sehingga dapat membantu dalam perencanaan intervensi dan pengelolaan lansia dengan frailty dan sarkopenia.

The Gut-Muscle Axis in Sarcopenia: A Meta-Analysis of Gut Microbiome Compositional Features and Their Correlation with Muscle Mass, Strength, and Physical Performance in Older Adults Vyora Ulvyana; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1384

Background: Sarcopenia, the age-related decline in muscle mass and function, is a major geriatric syndrome. The gut-muscle axis has emerged as a key area of investigation, yet the association between gut microbiome composition and sarcopenic parameters in humans remains quantified by a collection of studies with varied methodologies. This meta-analysis aimed to synthesize the existing correlational evidence linking gut microbiome features to the core components of sarcopenia in older adults. Methods: We performed a systematic search of PubMed, Scopus, Web of Science, and Embase for observational studies published between January 2015 and July 2025 that assessed gut microbiome composition and sarcopenia metrics in adults aged ≥60. Correlation coefficients (r) were pooled using a random-effects model. We assessed heterogeneity using the I² statistic, conducted pre-specified subgroup and sensitivity analyses, and evaluated study quality with the Newcastle-Ottawa Scale (NOS). Results: Six cross-sectional studies (N=1,189) met the inclusion criteria. The methodological quality was high (median NOS score = 8). The pooled analysis revealed a significant, small positive correlation between gut microbial alpha diversity and muscle strength (handgrip strength) (pooled r = 0.19, 95% CI: 0.11-0.27; I² = 41%). The relative abundance of the genus Faecalibacterium, known for its potential to produce butyrate, was significantly correlated with physical performance (pooled r = 0.24, 95% CI: 0.16-0.32; I² = 28%). A non-significant negative correlation was found between the family Enterobacteriaceae and muscle mass (pooled r = -0.14, 95% CI: -0.29-0.01; I² = 62%). Subgroup analysis suggested this heterogeneity was partly explained by the diagnostic criteria used for sarcopenia. Conclusion: This meta-analysis provides quantitative evidence of a modest but significant association between gut microbiome composition and muscle health in older adults. A microbial profile with higher diversity and greater abundance of putative beneficial taxa is correlated with better muscle function. These associative findings, while limited by the cross-sectional nature of the data and the potential for reverse causality, reinforce the clinical relevance of the gut-muscle axis and underscore the need for longitudinal, multi-omic studies to elucidate mechanisms and test microbiome-targeted therapies.

The Gut-Muscle Axis in Sarcopenia: A Meta-Analysis of Gut Microbiome Compositional Features and Their Correlation with Muscle Mass, Strength, and Physical Performance in Older Adults Vyora Ulvyana; Roza Mulyana; Rose Dinda Martini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1384

Background: Sarcopenia, the age-related decline in muscle mass and function, is a major geriatric syndrome. The gut-muscle axis has emerged as a key area of investigation, yet the association between gut microbiome composition and sarcopenic parameters in humans remains quantified by a collection of studies with varied methodologies. This meta-analysis aimed to synthesize the existing correlational evidence linking gut microbiome features to the core components of sarcopenia in older adults. Methods: We performed a systematic search of PubMed, Scopus, Web of Science, and Embase for observational studies published between January 2015 and July 2025 that assessed gut microbiome composition and sarcopenia metrics in adults aged ≥60. Correlation coefficients (r) were pooled using a random-effects model. We assessed heterogeneity using the I² statistic, conducted pre-specified subgroup and sensitivity analyses, and evaluated study quality with the Newcastle-Ottawa Scale (NOS). Results: Six cross-sectional studies (N=1,189) met the inclusion criteria. The methodological quality was high (median NOS score = 8). The pooled analysis revealed a significant, small positive correlation between gut microbial alpha diversity and muscle strength (handgrip strength) (pooled r = 0.19, 95% CI: 0.11-0.27; I² = 41%). The relative abundance of the genus Faecalibacterium, known for its potential to produce butyrate, was significantly correlated with physical performance (pooled r = 0.24, 95% CI: 0.16-0.32; I² = 28%). A non-significant negative correlation was found between the family Enterobacteriaceae and muscle mass (pooled r = -0.14, 95% CI: -0.29-0.01; I² = 62%). Subgroup analysis suggested this heterogeneity was partly explained by the diagnostic criteria used for sarcopenia. Conclusion: This meta-analysis provides quantitative evidence of a modest but significant association between gut microbiome composition and muscle health in older adults. A microbial profile with higher diversity and greater abundance of putative beneficial taxa is correlated with better muscle function. These associative findings, while limited by the cross-sectional nature of the data and the potential for reverse causality, reinforce the clinical relevance of the gut-muscle axis and underscore the need for longitudinal, multi-omic studies to elucidate mechanisms and test microbiome-targeted therapies.

FAKTOR RISIKO PENYEBAB KEJADIAN COVID-19 PADA PETUGAS DI RSUP. DR. M. DJAMIL PADANG PERIODE JANUARI-DESEMBER TAHUN 2022 Martini, Rose Dinda; Semiarty, Rima; Yanti, Mendhel
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 8 No. 1 (2024): APRIL 2024
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v8i1.24577

Coronavirus merupakan penyakit menular jenis baru yang menular dari manusia ke manusia. Petugas kesehatan bekerja sebagai garda terdepan dalam menangani pasien ditengah pandemi merupakan orang yang berisiko terpapar Covid-19. Pada tahun 2020, petugas RSUP Dr. M. Djamil Padang terkonfirmasi sebanyak 443 orang dan meningkat pada tahun 2021 menjadi 1072 orang dengan lokasi penularan 58,90% di dalam rumah sakit. Tujuan penelitian ini adalah untuk mengetahui faktor penyebab terpapar Covid-19 pada petugas di RSUP Dr. M. Djamil. Penelitian ini merupakan penelitian kuantitatif dengan desain cross sectional. Populasi dan sampel penelitian ini adalah petugas kesehatan RSUP Dr. M. Djamil sebanyak 375 responden. Untuk mengetahui faktor yang berhubungan dengan terpaparnya petugas dengan Covid-19 dilakukan uji statistik dengan menggunakan chi-square dengan hasil ada hubungan yang signifikan antara jenis pekerjaan, zona pekerjaan, pemakaian APD lengkap, pemakaian APD sesuai dengan protokol, melepaskan APD sesuai dengan protokol, dan waktu yang biasa dihabiskan untuk berjalan, serta menilai kesehatan mental dan kesejahteraan secara keseluruhan (p < 0.05). Diharapkan manajemen rumah sakit dapat menerapkan pendekatan berbasis risiko yang berfokus pada kriteria-kriteria lain sebagai bahan pertimbangan untuk menentukan aturan atau prosedur pencegahan dan pengendalian Covid-19 pada petugas kesehatan di RSUP Dr. M. Djamil.

The Correlation Between Sarcopenia And Transthyretin Levels Among Community-Dwelling Older Adults In Padang, West Sumatra Arief Fahrurozi, R. Ifan; Martini, Rose Dinda; Mulyana, Roza; Triansyah, Fandi
Eduvest - Journal of Universal Studies Vol. 4 No. 11 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i11.49959

The objective of this study was to evaluate the correlation between sarcopenia and transthyretin levels among community-dwelling older adults in Padang. This study employed a cross-sectional design and included 45 community-dwelling individuals aged 60 years and above who visited Andalas Primary Health Care in Padang, West Sumatra, Indonesia. Characteristics of sociodemographic and lifestyle habits were collected using a general questionnaire. Sarcopenia was defined in accordance with the criteria set forth by the Asian Working Group for Sarcopenia (AWGS) criteria encompass three components: low muscle mass, as determined by an index of appendicular skeletal mass/height2 less than 7,0 kg/m2 for males and less than 5,7 kg/m2 for females; low physical performance, as indicated by a gait speed less than 1,0 m/s; low muscle strength, defined as handgrip strength less than 26 kg for males and less than 18 kg for females. Accordingly, sarcopenia was defined as the presence of low muscle mass in conjunction with low physical performance and/or low muscle strength. Transthyretin levels were considered as independent variables in order to evaluate the potential correlation between transthyretin and sarcopenia status using bivariate analysis. The overall prevalence of sarcopenia was 51.1%, with four cases (40%) observed in males and 19 cases (54.3%) in females classified as having sarcopenia. The prevalence of sarcopenia was significantly lower among participants with normal nutritional status. A comparison of the participants with and without sarcopenia revealed that the former exhibited higher levels of transthyretin (p = 0,000).

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