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Performa Diagnostik Global Leadership Initiative on Malnutrition (GLIM) dibandingkan dengan Malnutrition Nutritional Assessment (MNA) dalam Pengkajian Malnutrisi pada Pasien Geriatri di Rawat Inap Performa Diagnostik全球营养不良领导倡议(GLIM)与营养不良营养评估(MNA)在Inap治疗中老年患者营养不良研究中的比较
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1104
Introduction. As many as 76.6% of patients aged 60 years and above (elderly) are malnourished or at risk of malnutrition based on MNA within the first 48 hours of hospital admission. The prevalence of malnutrition varies widely depending on the population studied, the healthcare setting and the tools used for the assessment. To date, SGA is widely used in the diagnosis of malnutrition for adults and MNA for elderly patients. Recently, experts proposed empirical consensus of GLIM criteria for determining the diagnosis of malnutrition in adults. This study aimed to investigate the diagnostic performance of GLIM criteria as a new consensus in determining the diagnosis of malnutrition in comparison to MNA as a semi-gold standard for nutritional assessment in the elderly. Methods. A cross-sectional study was conducted from January to April 2022 on 103 consecutively recruited elderly patients aged ≥60 years in the Internal Medicine Wards at Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. Results. There were 91.3%, 57.3% and 54.4% malnourished elderly patients upon admission to the hospital, based on GLIM criteria, MNA-SF and MNA-LF, respectively. GLIM has good accuracy compared to both MNA-SF and MNA-LF, as long as the category of malnourished in MNA is a combination of malnutrition and at risk of malnutrition. GLIM had 97.9% sensitivity, 87.5% specificity, AUC 0.93, 98.9% PPV, 77.8% NPV, 7.83 positive LR and 0.02 negative LR towards MNA-SF, and a sensitivity value of 98.9%, specificity 88.9%, AUC 0.94, PPV 98.9%, NPV 88.9%, positive LR 8.91, and negative LR 0.01 towards MNA-LF. Conclusion. GLIM showed good diagnostic accuracy to determine nutritional status in the elderly, especially upon admission to the hospital, so that appropriate early nutritional interventions can be given.
介绍根据MNA,多达76.6%的60岁及以上患者(老年人)在入院后的前48小时内营养不良或有营养不良的风险。营养不良的患病率因研究人群、医疗环境和评估工具的不同而有很大差异。迄今为止,SGA广泛用于成人营养不良的诊断和老年患者MNA的诊断。最近,专家们提出了GLIM标准的经验共识,以确定成人营养不良的诊断。本研究旨在调查GLIM标准的诊断性能,与MNA作为老年人营养评估的半金标准相比,GLIM标准是确定营养不良诊断的新共识。方法。2022年1月至4月,在印度尼西亚雅加达Cipto Mangukusumo医生医院(RSCM)内科病房对103名年龄≥60岁的连续招募的老年患者进行了一项横断面研究。后果根据GLIM标准、MNA-SF和MNA-LF,入院时营养不良的老年患者分别为91.3%、57.3%和54.4%。与MNA-SF和MNA-LF相比,GLIM具有良好的准确性,只要MNA中营养不良的类别是营养不良和营养不良风险的组合。GLIM对MNA-SF的敏感性为97.9%,特异性为87.5%,AUC为0.93,PPV为98.9%,NPV为77.8%,阳性LR为7.83,阴性LR为0.02,对MNA-LF的敏感性值为98.9%、特异性为88.9%、AUC为0.9 4,PPV 98.9%、NPV为88.9%,阳性LR 8.91,阴性LR 0.01。结论GLIM在确定老年人营养状况方面显示出良好的诊断准确性,尤其是在入院时,因此可以给予适当的早期营养干预。
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引用次数: 1
Sensitisasi Alergen Makanan pada Pasien Kolitis Eosinofilik: Laporan Kasus 致病性结肠炎患者的食物过敏防御:病例报告
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1425
Agnes Dina Irene Dorithy Zagoto, Deshinta Putri Mulya, Neneng Ratnasari
Eosinophilic colitis is a very rare disease that can occur in the bimodal population (neonates and young adults) with a prevalence was 2.1/100,000 in overall population and 2.3/100,000 in adults. However, only about 0.1% of cases were diagnosed from biopsy results obtained during colonoscopy. The lack of precise histological criteria for the quantity of eosinophils in the colon mucosa creates a distinct challenge in diagnosing eosinophilic colitis. Eosinophilia in the gastrointestinal tract can be mediated by IgE and non-IgE, but non-IgE tends to be dominant in adults. This report discusses about a case of a 64-year-old male with bloody diarrhea that has been occur for two years. The anamnesis revealed symptoms suggestive of eosinophilic colitis, including complaints of diarrhea with abdominal pain and weight loss. Laboratory tests revealed an increase in peripheral eosinophil count and elevated levels of IgE. A positive skin prick test supported the presence of food allergen sensitization. The endoscopy revealed signs of ulcerative colitis, but the biopsy showed evidence of eosinophilic colitis. Initially, the patient was treated for ulcerative colitis but did not show improvement. Following treatment for eosinophilic colitis, the patient’s clinical status showed improvement. Since eosinophilic colitis can be chronic and recur, an accurate diagnosis and proper management are crucial for achieving complete remission.
嗜酸性结肠炎是一种非常罕见的疾病,可发生在双峰人群(新生儿和年轻人)中,患病率为总人口的2.1/10万,成人的2.3/10万。然而,只有约0.1%的病例是通过结肠镜检查中获得的活检结果诊断出来的。结肠粘膜嗜酸性粒细胞数量缺乏精确的组织学标准,这给诊断嗜酸性结肠炎带来了明显的挑战。胃肠道嗜酸性粒细胞增多可由IgE和非IgE介导,但在成人中非IgE倾向于占主导地位。本文报告一例64岁男性带血性腹泻,已发生2年。健忘症显示了嗜酸性结肠炎的症状,包括腹泻、腹痛和体重减轻。实验室检查显示外周嗜酸性粒细胞计数增加,IgE水平升高。皮肤点刺试验阳性证实存在食物过敏原致敏。内窥镜检查显示溃疡性结肠炎的迹象,但活检显示嗜酸性结肠炎的证据。最初,患者接受溃疡性结肠炎治疗,但未见好转。治疗嗜酸性结肠炎后,患者的临床状况有所改善。由于嗜酸性结肠炎可以是慢性和复发的,准确的诊断和适当的管理是实现完全缓解的关键。
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引用次数: 0
Vaksin Influenza sebagai Modalitas Pencegahan Kejadian Rawat Inap Akibat Penyakit Kardiovaskular 流感疫苗作为预防吸入性心血管疾病发生的一种方法
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1424
Penyakit kardiovaskular merupakan salah satu penyakit terbanyak penyebab perawatan pasien di rumah sakit. Pada pasien dengan penyakit kardiovaskular, infeksi virus seperti influenza dapat menjadi pencetus terjadinya sindrom koroner akut dan gagal jantung akut. Beberapa studi menunjukkan keterkaitan kuat antara infeksi influenza dan kejadian kardiovaskular
心血管疾病是医院病人护理的主要原因之一。在心血管疾病患者中,流感等病毒感染可能是急性冠状动脉综合症和急性心脏衰竭的诱因。一些研究表明,流感感染与心血管事件之间存在着密切的联系
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引用次数: 0
Gambaran Risiko Post-Traumatic Stress Disorder (PTSD) pada Penyintas COVID-19 di Rumah Sakit Universitas Andalas
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1032
Introduction. The COVID-19 pandemic has a negative impact on life where sufferers can experience emotional problems such as despair, deep sadness, helplessness, anxiety, and depressive symptoms. Especially in hospitalized COVID-19 survivors, there are sequelae in the form of anxiety, depression, and Post-traumatic Stress Disorder (PTSD). PTSD experienced by COVID-19 survivors will affect the patient’s quality of life in the future. This study aimed to assess the risk of PTSD in COVID-19 survivors who had been hospitalized at Andalas University Hospital. Methods. A cross-sectional descriptive study was conducted among COVID-19 survivors aged ≥15 years who had been hospitalized at Andalas University Hospital. Samples were selected by using total sampling method with inclusion criteria included experiencing mild, severe, or critical clinical symptoms during COVID-19 infection, being discharged from Andalas University Hospital for six months or more, and willing to participate in the study by signing an informed consent. Samples who have met the inclusion criteria completed the Bahasa Indonesia version of PCL-5 (PTSD Checklist for DSM-5) questionnaire which has been tested for its validity and reliability. Respondents were categorized as having PTSD risk if the questionnaire results showed a score of ≥23. The collected data were subsequently analyzed using univariate analysis. Results. A total of 75 respondents were included in the study, of which 9.3% (7) were found to be potentially or at risk of PTSD. The group of respondents who were at risk of PTSD was mostly comprised of females, and all of them experienced the four PTSD symptoms (intrusion/re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal). The most common trigger that causes PTSD among respondents was the experience of a previous life-threatening traumatic event (71.43%). In addition, the most frequent clinical symptoms of COVID-19 in the PTSD risk group were severe clinical symptoms (71.43%). Conclusions. COVID-19 survivors who have the potential to experience PTSD are predominantly female survivors with severe clinical symptoms, experiencing all four PTSD symptoms, and having a traumatic life-threatening experience during COVID-19 hospitalization.
介绍。新冠肺炎疫情对生活产生了负面影响,患者可能会出现绝望、极度悲伤、无助、焦虑、抑郁症状等情绪问题。特别是在住院的COVID-19幸存者中,会出现焦虑、抑郁和创伤后应激障碍(PTSD)等后遗症。COVID-19幸存者经历的创伤后应激障碍将影响患者未来的生活质量。本研究旨在评估在安达拉斯大学医院住院的COVID-19幸存者患PTSD的风险。方法。对在Andalas大学医院住院的年龄≥15岁的COVID-19幸存者进行了横断面描述性研究。采用全抽样方法选择样本,纳入标准为在感染新冠病毒期间出现轻度、重度或危重临床症状,已从安达拉斯大学医院出院6个月及以上,并签署知情同意书愿意参加研究。符合纳入标准的样本填写印尼语版的PTSD -5 (DSM-5 PTSD Checklist for DSM-5)问卷,并对其效度和信度进行检验。如果问卷结果显示得分≥23分,被调查者被归类为有PTSD风险。随后使用单变量分析对收集的数据进行分析。结果。共有75名受访者被纳入研究,其中9.3%(7)被发现有潜在的或有创伤后应激障碍的风险。有PTSD风险的被调查者大多为女性,她们都经历了四种PTSD症状(入侵/再体验、逃避、认知和情绪的负面改变和过度觉醒)。在受访者中,导致PTSD最常见的触发因素是之前威胁生命的创伤事件的经历(71.43%)。此外,PTSD风险组中最常见的临床症状是重症临床症状(71.43%)。结论。有可能患上创伤后应激障碍的COVID-19幸存者主要是女性幸存者,她们有严重的临床症状,经历了所有四种创伤后应激障碍症状,并在COVID-19住院期间经历了创伤性威胁生命的经历。
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引用次数: 0
Vaksinasi Influenza sebagai Prediktor Terjadinya Kejadian Rawat Inap Akibat Kejadian Kardiovaskular pada Pasien dengan Riwayat Penyakit Jantung Koroner: Suatu Laporan Kasus Berbasis Bukti 流感疫苗接种作为冠心病史患者失眠事件心血管事件的预测因素:一份基于证据的病例报告
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1357
Influenza is known to worsen cardiovascular events in patients with a history of coronary heart disease. However, the effectiveness of influenza vaccination in reducing hospitalization due to cardiovascular disease is not clearly known. We aim to determine the effect of influenza vaccination on hospitalization rates due to cardiovascular disease in patients with a history of coronary heart disease. Relevant literature was searched on four electronic databases: MEDLINE, EMBASE, SCOPUS, and Cochrane Library, using predetermined keywords. Critical review of the studies was done using the Center of Evidence Based Medicine (CEBM) University of Oxford assessment tool. The search yielded six articles, and critical review was done based on validity, importance, and applicability. Three studies showed that influenza vaccination in patients with coronary heart disease would reduce hospitalization rates due to cardiovascular disease within 12 months after vaccination. Three studies did not show any effect of influenza vaccination on hospitalization rates due to cardiovascular disease. The samples in the three studies that found a protective effect of the influenza vaccine were older and at higher risk of experiencing cardiovascular events. Based on our review, we conclude that influenza vaccination can be given to prevent hospitalization due to cardiovascular disease in patients with a history of coronary heart disease, especially in high-risk patients.
众所周知,流感会使有冠心病病史的患者的心血管事件恶化。然而,流感疫苗接种在减少心血管疾病住院方面的有效性尚不清楚。我们的目的是确定流感疫苗接种对有冠心病病史的患者因心血管疾病住院率的影响。相关文献在MEDLINE、EMBASE、SCOPUS和Cochrane Library四个电子数据库中使用预先确定的关键词进行检索。使用牛津大学循证医学中心(CEBM)评估工具对这些研究进行了批判性审查。搜索产生了六篇文章,并根据有效性、重要性和适用性进行了批判性审查。三项研究表明,在冠心病患者中接种流感疫苗将在接种疫苗后12个月内降低因心血管疾病导致的住院率。三项研究没有显示流感疫苗接种对心血管疾病住院率有任何影响。三项研究中发现流感疫苗具有保护作用的样本年龄较大,发生心血管事件的风险较高。根据我们的综述,我们得出结论,在有冠心病病史的患者,特别是高危患者中,接种流感疫苗可以预防因心血管疾病住院。
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引用次数: 0
Profilaksis Pasca Paparan Virus HIV pada Petugas Kesehatan 卫生官员艾滋病病毒展示的预防
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1418
T. Karjadi
Health workers (HCWs) are prone to get infected by HIV infection when carrying out their duties. The injuries can be caused by needle sticks, sharp objects (scalpels, lancets, or other) that have been exposed to body fluids or splashes of body fluids onto the body’s mucosa (eyes, nose, mouth) and non-intact skin have the potential to transmit the HIV infection. Post-exposure transmission due to contamination of body fluids to health workers can be prevented by providing post-exposure prophylaxis therapy. Post-exposure prophylaxis (PEP) is given as soon as possible and no later than 72 hours after exposure. Prophylaxis is given to HCWs who are significantly exposed using three antiretroviral drugs. In Indonesia, for adolescents and adults ≥ 10 years old, the main choice is Tenofovir (TDF) + Lamivudine (3TC) + Dolutegravir (DTG). Simultaneously with the administration of ARV drugs, counseling is also carried out regarding side effects of ARV, medication adherence, drug interactions, the possibility of seroconversion, and if necessary, management of anxiety that may arise. ARVs will be given for 28 days. After being given post-exposure prophylactic therapy, monitoring for side effects of ARV drugs must be carried out which are given in the 2nd and 4th week. Re-examination of HIV testing to see the effectiveness of treatment was carried out at 12 weeks and 6 months after exposure.
卫生工作者在履行职责时容易感染艾滋病毒。这些伤害可能是由接触体液的针头、尖锐物体(手术刀、柳叶刀或其他)或体液溅到身体粘膜(眼睛、鼻子、嘴巴)引起的,而不完整的皮肤有可能传播艾滋病毒感染。可以通过提供暴露后预防治疗来防止由于体液污染而导致的暴露后传播给卫生工作者。暴露后预防(PEP)应在暴露后72小时内尽快进行。对严重接触三种抗逆转录病毒药物的HCW进行预防。在印度尼西亚,对于≥10岁的青少年和成年人,主要选择替诺福韦(TDF)+拉米夫定(3TC)+多卢替格拉韦(DTG)。在服用抗逆转录病毒药物的同时,还就抗逆转录病毒的副作用、药物依从性、药物相互作用、血清转换的可能性以及必要时可能出现的焦虑管理进行咨询。抗逆转录病毒药物将使用28天。在接受暴露后预防性治疗后,必须在第2周和第4周监测抗逆转录病毒药物的副作用。在暴露后12周和6个月对HIV检测进行重新检查,以了解治疗的有效性。
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引用次数: 0
Modulasi Mikrobiota untuk Memperbaiki Laju Filtrasi Glomerulus, Toksin Uremik, dan Penanda Inflamasi pada Gagal Ginjal Kronik: Telaah Sistematik dan Meta-Analisis 慢性肾功能衰竭肾小球滤过层、尿毒症毒素和炎症信号的微生物调节:系统损失和荟萃分析
Pub Date : 2023-03-31 DOI: 10.7454/jpdi.v10i1.1036
Burhan Gunawan, R. Purwata, S. Hidayat, Roy Akur Pandapotan, Jennifer Jennifer
Introduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitative effect of microbiota modulation for estimated Glomerular Filtration Rate (eGFR), uremic toxin (total-p cresyl/total pCS), and inflammatory marker (hs-CRP) outcome among CKD patients. Methods. Article searches were conducted from PubMed, ScienceDirect, and Cochrane Library data sources from 2010-2022. Assessment of article quality follows the rules of PRISMA (Preferred Reporting Items in Systematic Review and Meta-Analysis). Only randomized controlled trial (RCT) articles investigating the effect of symbiotic, prebiotic, of probiotic for CKD were included in the analysis. Effect size quantify from Standardized Mean Difference (SMD), using a continuous random effect model and described in the forest plot model. Results. A total of 17 RCT studies with a total 867 CKD stage 1-5 subjects (440 subjects in the intervention group and 427 subjects in the control group). The intervention duration ranging from 1-12 months. The studies included had varied on methodologies, with significant heterogenicity (I296,96%, p Conclusions. The administration of probiotic/prebiotic/symbiotic supplements to CKD patients resulted in significant improvements in e-GFR and reductions in total pCS. These results suggest the potential of symbiotic, prebiotic, and probiotic supplementation to improve CKD outcome.
介绍微生物群失调被认为是慢性肾脏病(CKD)患者高尿毒症毒素的后果和影响之一,这可能导致进展和死亡的风险增加。本系统综述和荟萃分析的目的是对CKD患者的肾小球滤过率(eGFR)、尿毒症毒素(总对甲酚/总pCS)和炎症标志物(hs-CRP)结果进行微生物群调节的定量影响。方法。文章检索来自PubMed、ScienceDirect和Cochrane图书馆2010-2022年的数据来源。文章质量评估遵循PRISMA(系统综述和荟萃分析中的首选报告项目)的规则。只有随机对照试验(RCT)文章研究了益生菌的共生益生元对CKD的影响。使用连续随机效应模型,从标准化平均差(SMD)量化效应大小,并在森林小区模型中进行描述。后果共有17项随机对照试验研究,共有867名CKD 1-5期受试者(干预组440名受试者,对照组427名受试人)。干预时间为1-12个月。纳入的研究方法各不相同,具有显著的异质性(I296,96%,p结论。CKD患者服用益生菌/益生元/共生补充剂可显著改善e-GFR,降低总pCS。这些结果表明,共生、益生元和益生菌补充剂有可能改善CKD结果。
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引用次数: 0
Association between Early Antibiotic Administration and In-Hospital Mortality in Moderate and Severe COVID-19 Patients 中重度新冠肺炎患者早期抗生素用药与院内死亡率的关系
Pub Date : 2022-12-31 DOI: 10.7454/jpdi.v9i4.1019
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引用次数: 0
Cutaneous Adverse Drug Reaction Among HIV-Infected Patients Starting Antituberculosis Treatment 开始抗结核治疗的HIV感染患者的皮肤药物不良反应
Pub Date : 2022-12-31 DOI: 10.7454/jpdi.v9i4.1020
{"title":"Cutaneous Adverse Drug Reaction Among HIV-Infected Patients Starting Antituberculosis Treatment","authors":"","doi":"10.7454/jpdi.v9i4.1020","DOIUrl":"https://doi.org/10.7454/jpdi.v9i4.1020","url":null,"abstract":"","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41766060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Value of Heart Rate Variability, Neutrophil-Lymphocyte Ratio and Quality of Life of Patients with Depressive Symptoms in Acute Myocardial Infarction 急性心肌梗死抑郁症状患者心率变异性、中性粒细胞-淋巴细胞比率和生活质量的价值
Pub Date : 2022-12-31 DOI: 10.7454/jpdi.v9i4.1023
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引用次数: 0
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