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Journal : journal of internal medicine

HUBUNGAN ANTARA OBESITAS SENTRAL DENGAN ADIPONEKTIN PADA PASIEN GERITARI DENGAN PENYAKIT JANTUNG KORONER Gotera, Wira; Suastika, Ketut; Santoso, Anwar; Kuswardhani, Tuty
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Abstract

Obesity is rapidly becoming a global problem not only in developed countries but also in developing countries such asIndonesia. Visceral obesity (central obesity) is an importance risk for cardiovascular disease and recognition that adipose tissuecan be regarded as a large endocrine organ that secreted inflammatory and anti inflammatory molecules (adiponectin). This studyaims to know the correlation between central obesity and adiponectin in geriatric coronary heart disease (CHD) patients. Thisstudy was cross sectional analytic study of geriatric CHD at out and in patients in Sanglah hospital. Data are presented as groupmean ± SD and analyzed by t-test, chi-square, and Pearson correlation with SPSS 12 software. Forty five patients (35 males and10 females), 23 patient unstable angina pectoris, 14 patient acute myocardial infarction, and 8 patient stable angina pectoris wererecruited and examined. There was high prevalence of central obesity 51.1% (23 patients). Mean of log adiponectin weresignificantly difference between central obese and non central obese (1.80 ± 0.61 vs 1.09 ± 0.41 with p). Central obesity increasedrisk of hypoadiponectinemia 5 times than non central obesity (p=0.011, CI 95% 1.4-17.8). Waist circumference has negativecorrelation with log plasma adiponectin (R=-0.663, p<0.001). There was high prevalence of central obesity in geriatric coronaryheart disease patients. Central obesity increased risk of hypoadiponectinemia 5 times than non central obesity. Waistcircumference has negative correlation with plasma adiponectin. Increased of waist circumference will decrease of adiponectin(cardioprotective protein) and will increase risk of acute coronary syndrome in geriatric patients.
HUBUNGAN ANTARA ACTIVITIES SPECIFIC BALANCE CONFIDENCE SCALE DENGAN UMUR DAN FALLS PADA LANSIA DI POLIKLINIK GERIATRI RSUP SANGLAH DENPASAR Yuna Ariawan, IW; Kuswardhani, RA Tuty; Astika, IN; Suka Aryana, IGP
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Falls are a major health problem for elderly. Apart from the direct injuries resulting from falls, other long-term consequencesmay include disability, fear of falling, and loss of independence, which can have serious effects on people?s health and qualityof life. These risk factors are categorized into two distinct groups: intrinsic and extrinsic factors. Psychological factors, morecommonly referred to the ?fear of falling syndrome?, have been linked to signi! cant reductions of daily activities in fallersresulting in a loss of independence. The Activities-Speci! c Balance Con! dence (ABC) scale was used to measure con! dence incarrying out speci! c activities without falling or becoming unsteady. We conduct an analytic cross-sectional study to determineassociation between ABC scale with age and falls in elderly. Fifty two elderly outpatient, age over 60 years at Geriatric ClinicSanglah Hospital Denpasar on January 2010 recruited for this study. All subjects were asked questionnaire of ABC scale andhistory of falls. Health status was taken from physical examination and medical records. Data were analyzed using SPSSsoftware 17 version.There were 52 elderly outpatient consisted of 26 (50%) men, 26 (50%) women, age range 61 ? 87 years, mean 70.6 ±6.5 years, and 17.3% of them have history of falls. Total ABC scale mean were signi! cantly difference between women andmen (81.2 ± 14.1 vs 90 ± 12.8 p < 0.05); OA and without OA (80.5 ± 18.1 vs 88.6 ± 10.3 p < 0.05); and between faller and nonfaller(73.5 ± 13.6 vs 88.2 ± 12.9 p = 0.01). There was no signi! cant correlation between ABC scale and age. The ABC scalewith cut off 82.9 has signi! cantly association with falls p = 0.01; prevalence ratio = 7.0 95%CI 1.6 ? 49.8; 74.4% sensitivity,78% speci! city. As a conclusion we found lower total ABC scale has signi! cantly association with falls in elderly and has goodsensitivity and speci! city on scale below 82.9%.
PENATALAKSANAAN HIPERTENSI PADA LANJUT USIA Kuswardhani, RA Tuty
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Abstract

The more increasing of life expectancy is more complex disease in elderly. One of cause disease in elderly is hypertension Theisolated systolic hypertension (ISH) the most risk factor in stroke, coronary failure, and coronary heart disease, their role ispredicted more their in the youth. The definition of hypertension is not change in the age : systolic blood pressure (SBP) 140mmHg, and or diastolic blood pressure (DBP) 90 mmHg. The Joint National Committee on Prevention, Detection, Evaluationand Treatment of high blood pressure (JNC VI) and WHO or International society of hypertension guidelines sub committeesagree that SBP and DBP, both are used to classify the hypertension. Patophysiology of blood pressure is not clear. The most effectof the mortal aging in the cardio vascular system includes the changing of compliance aorta and systemic vessels. The thickeningof aorta wall are major vessels are increasing while the elasticity of vessel is decreasing in aging. This changing brings thecompliance of aorta is decreasing and the major vessel, it causes the increasing of peripheral vascular resistance. Baroreceptorsensitivity is also changing in aging. The changing in the metabolism of baroreceptor reflex possibly can explain the existence thevariability pressure. The changing of vasodilatation adrenergic and vasoconstriction of adrenergic a in balance will tendvasoconstriction are will bring the increasing of peripheral vessel resistance and blood pressure. The management of hypertensionin the elderly includes behavior, exercise, and pharmacology therapy.
HUBUNGAN ANTARA SUDUT KELENGKUNGAN THORAK DAN SELISIH TINGGI BADAN UKUR DAN TINGGI BADAN HITUNG BERDASARKAN TINGGI LUTUT PADA PASIEN USIA LANJUT DI POLIKLINIK GERIATRI RUMAH SAKIT SANGLAH DENPASAR Wiryani, Cilik; Kuswardhani, Tuty; Aryana, Suka; Astika, Nyoman; -, Yanson; Widana, K
journal of internal medicine Vol. 11, No. 1 Januari 2010
Publisher : journal of internal medicine

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Abstract

Anthropometric measurements are part of the nutritional assessment which is an important component of health care.Measuring the individual!s stature with accuracy is very important because it is a basis for estimating basal energy expenditureand consequent nutrient needs and to calculate indices of nutrient status. However, common methods of nutritional anthropometricassessment are not entirely satisfactory for all elderly persons. Certain measurements such as stature may be difÞ cult to obtainbecause of postural changes, thinning of the disks of the spinal column, and diminution in the height of the vertebrae, all of whichare associated with aging.This study conducted to investigate the correlation between thoracic hyperkyposis with the difference of height calculatedwith WHO formula and actual height measurements in elderly patients among geriatric outpatient clinic, Sanglah hospital. Thisis a descriptive study at August 2008. Height was calculated with WHO formula. For men 59.01 + (2.08 x knee height) and forwomen 75 + (1.91 X knee height) - (0.17 X age) and compared with actual height measurements. Data analyzed with analyticdescriptive Spearman!s correlation.There were 91 elderly patients included, male 38 (41.8%), female 53 (58.2%). Mean of age was 70.61 years ± 5.75 SD,actual height measurements was 155.30 cm ± 9.37 SD, height calculated with formula was 160.35 cm ± 8.59 SD, knee heightwas 49.60 ± 3.39 SD, thoracic hyperkiposis was -17.210 ± -11.7 SD and the difference between height formula and actual heightmeasurements was 4.99 cm ± 5.84 SD.There were no correlation between thoracic hyperkyposis and the difference of heightcalculated with WHO formula and actual height measurement with r = 0.001, p = 0.993. There were no correlations betweenbetween thoracic hyperkyposis with the difference of height calculated with speciÞ c formula and actual height measurements inelderly patients among geriatric outpatient clinic, sanglah hospital
KORELASI ANTARA GERIATRIC NUTRITIONAL RISK INDEX DENGAN LAMA RAWAT PASIEN GERIATRI DI RUMAH SAKIT SANGLAH, DENPASAR Andriyasa, K; Kuswardhani, RA Tuty; Aryana, IGP Suka; Astika, N; Putrawan, IB
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Patients at risk of malnutrition are associated with a poor outcome. There are several tools that we can use to assess thenutritional status. European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines and the French Program NationalNutrition Sante (PNNS) recommend Mini Nutritional Assessment (MNA) to detect the risk of under nutrition among elderlysubjects. The MNA which based on a Questionnaire does not use biological indicators. It is more adapted to the elderly at homeor nursing home setting than hospitalization. We want to evaluate the new tool Geriatric Nutritional Risk Index (GNRI) that moresimple than MNA to assess nutritional status and predict hospitalization outcomes in geriatric patients.This is a cohort study to evaluated correlation between GNRI score with length of stay in elderly patients. We evaluatednutritional status using Geriatric Nutritional Risk Index (GNRI) and Mini Nutritional Assessment (MNA) for elderly patientsthat admitted in Sanglah Hospital (Internal Department, class III) between February 2010 and April 2010. The patients werenutritionally assessed within 48 hours of hospital admission and studied in correlation to length of stay and in-hospital mortality.Fifty complete assessments were available for analysis. There are 32 male (62%) and 18 female (38%) with mean age are67.2 (60 ? 82) years old. GNRI score and MNA correlated inversely with length of stay in elderly patients (r = -0.67; p < 0.000)and (r = -0.44; p = 0.004) respectively. There are three fatal outcome (death) and all of cases with GNRI score grade 4 (majorrisk, GNRI score < 82) . GNRI score has a significant correlation with MNA score (r = 0.72; p < 0.000).In conclusion: Poor nutritional status as measured by GNRI was associated with a longer length of stay and increased inhospitalmortality. GNRI is a simple tool and has more significant correlation with hospitalization outcomes than MNA.
FAKTOR-FAKTOR YANG MENENTUKAN KEKUATAN GENGGAMAN TANGAN PADA PASIEN LANJUT USIA DI PANTI WREDHA TANGTU DAN POLIKLINIK GERIATRI RSUP SANGLAH - DENPASAR Putrawan, IB Putu; Kuswardhani, RA Tuty
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Handgrip strength is necessary for performing activities of daily living, which, in turn, are required to maintain functionalactivity. The purpose of this study was to determine anthropometric and personal factors that affect handgrip strength in groupsof nursing home and out patients of Sanglah Teaching Hospital Denpasar-Bali. Body weight and height, Waist Circumference(WC), Mid-Upper-Arm Circumference (MUAC) and triceps skinfold, scapula skinfold and supra iliaca skinfold were obtainedusing standard techniques. Body height was estimated from kneeheight. Handgrip was measured using a mechanical handgripdynamometer. A total of 38 male and 53 female aged 60 ? 82 years participated in the study. Both groups were statistically similarregarding all factors studied. Bivariate analyses showed that handgrip strength was associated with sex, age, WC, hemoglobin,albumin and body mass index in both of groups. Multiple linear regression analysis identified sex and WC (r = 0.39; p = 0.00),sex and age (r = 0.71; p = 0.00), as independent determinants of handgrip strength in both of groups. We conclude that womenhave a smaller handgrip strength than men. In addition, handgrip strength decreases with increasing age and decreasing WC.
KORELASI ANTARA OBESITAS SENTRAL DENGAN ADIPONEKTIN PADA LANSIA DENGAN PENYAKIT JANTUNG KORONER Aryana, IGPS; Kuswardhani, RA Tuty; Suastika, K; Santoso, A
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Obesity is rapidly becoming a global problem not only in developed countries but also in developing countries such asIndonesia. Visceral obesity (central obesity) is an importance risk for cardiovascular disease and recognition that adipose tissuecan be regarded as a large endocrine organ that secreted inflammatory and anti inflammatory molecules (adiponectin). This studyaims to know the correlation between central obesity and adiponectin in geriatric Coronary Heart Disease (CHD) patients.Thisstudy was cross sectional analytic study of geriatric CHD at out and in patients in Sanglah Hospital. Data are presented as groupmean ± SD and analyzed by t-test, chi-square, and Pearson correlation with SPSS 12 software.Forty five patients (35 males and 10 females), 23 patient unstable angina pectoris, 14 patient acute myocardial infarction,and 8 patient stable angina pectoris were recruited and examined. There was high prevalence of central obesity 51.1% (23patients). Mean of log adiponectin were significantly difference between central obese and non central obese (1.80 ± 0.61 vs 1.09± 0.41 with p). Central obesity increased risk of hypoadiponectinemia 5 times than non central obesity (p = 0.011, CI 95% 1.4- 17.8). Waist circumference has negative correlation with log plasma adiponectin (R = -0.663, p < 0.001).There was high prevalence of central obesity in geriatric coronary heart disease patients. Central obesity increased risk ofhypoadiponectinemia 5 times than non central obesity. Waist circumference has negative correlation with plasma adiponectin.Increased of waist circumference will decrease of adiponectin (cardioprotective protein) and will increase risk of Acute CoronarySyndrome in geriatric patients.
Co-Authors A Santoso Adi Dharma, Ignasius Anak Agung Ayu Ratih Hapsari Anak Agung Gede Angga Puspa Negara Anak Agung Mas Putrawati Triningrat Anak Agung Wiradewi Lestari Andreany Kusumowardani Anwar Santosa Anwar Santoso Aryana, I Gust Putu Suka Astika, I Nyoman Baskoro Tri Laksono Budiana, I Nyoman Catarina Budi P Cilik Wiryani Cok I. I. Purwaningsih Cokorda Agung Wahyu Purnamasidhi Darta, I Wayan Dewianti Dewianti Dewianti, Dewianti Diah Pradnya Paramita Dian Pritasari Jeger Dyah Pradnyaparmita Duarsa Gede Sukrawan Helen Widiani I Gusti Agung Gede Utara Hartawan I Gusti Agung Wilaja Putra I Gusti Putu Suka Aryana I Ketut Suastika I Made Ady Wirawan I Made Bakta I Made Dharma Atmaja I Made Jawi I Made Jawi I MADE MULIARTA . I Made Siswadi Semadi I Nyoman Adi Putra I Nyoman Astika I Nyoman Wande I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I Putu Gede Adiatmika I Wayan Gede Artawan Eka Putra, I Wayan Gede Artawan Eka I Wayan Mustika I Wayan Mustika I Wayan Mustika I Wayan Wita I. N. Astika I.D. G.A.E. Putra Ida Bagus N Maharjana Ida Bagus Putu Putrawan Ida Bagus Udayana Hanggara IGP Adiatmika IN Astika Iswara, Ni Putu Ayu Astri Prana IW Yuna Ariawan J. A. Pangkahila K Andriyasa K Widana Kadek Tresna Adhi Ketut Tirtayasa Lanawati Lanawati, Lanawati Luh Putu Ratna Sundari M. Ali Imron Made Nopriantha Made Nopy Diah Sundari Made Oka Widyantara, Made Oka Muhammad Irfan N Astika N. Adiputra N. K.S. Diniari Ngakan Ketut Wira Suastika, Ngakan Ketut Wira Ni Ketut Rai Purnami Ni Putu Ayu Astri Prana Iswara Ni Wayan Tianing Nyoman Kertia Paramita, Diah Pradnya Purnami, Ni Ketut Rai Purwaningsih, Cok I. I. Putra, I Komang Wisuda Dwija Putu Ayu Indrayathi Putu Ayu Sani Utami Putu Mulya Kharismawan Putu Shely Prihastuti Rudy Rina Listyowati Rina Listyowati, Rina S. Indra Lesmana Saktivi Harkitasari, Saktivi Sawitri, Anak Agung Sagung Semaradana, Wayan Giri Putra Shelvy Florence Gousario Siti Nadhir Ollin Norlinta Sri Kayati Widyastuti Sriwijayanti, Luh Putu Eka Sundari, Made Nopy Diah Suparna, I Ketut Surya Rini, Sandra Susy Purnawati Trisna Yuliharti Tersinanda Wahyuddin, Wahyuddin Wayan Giri Putra Wimpie I Pangkahila Wira Gotera Wirawan, I Made Budi Wisnu Wardhana Yanson - Yosef Samon Sugi