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"ABSTRAKTujuan : Koreksi transatrial-transpulmonary tanpa transannular patch (TA-TP tanpaTAP) memiliki keuntungan berupa preservasi annulus katup pulmonal dan fungsiventrikel kanan, Namun sering terjadi gradien RV-PA dan pRV/LV ratio yang masihtinggi sehingga terjadi low cardiac output syndrome (LCOS). Penelitian ini bertujuanuntuk mencari batasan gradien RV-PA dan pRV/LV ratio yang merupakan nilai prediktifterbaik terhadap kejadian LCOS pascakoreksi tetralogi Fallot TA-TP tanpa TAP.Metode : Pada bulan Oktober 2012 sampai Maret 2013, sebanyak 30 pasien TF menjalanikoreksi TF TA-TP tanpa TAP (mean usia 8,37±7,90 tahun). Dilakukan pengukurangradien RV-PA dan pRV/LV ratio intraoperatif dan postoperatif di ICU. Evaluasi kejadianLCOS dilakukan selama perawatan di ICU. Sebelum pasien pulang, dilakukanpemeriksaan ekokardiografi untuk menilai gradien RV-PA, fungsi ventrikel kanan, defekseptum ventrikel residual, derajat regurgitasi katup pulmonal dan katup trikuspid.Hasil : Sebanyak 30 (100%) subjek penelitian memiliki z-value ≥ -1, menjalani koreksiTF TA-TP tanpa TAP. Mean gradien RV-PA intraoperatif adalah 21,13±10,60 mm Hgdan mean pRV/LV ratio intraoperatif adalah 0,53±0,14. Mean gradien RV-PA di ICUadalah 20,83±7,10 mmHg dan mean pRV/LV ratio di ICU adalah 0,49±0,10. Tidak terjadiLCOS pada 30 (100%) subjek penelitian sehingga tidak dapat dilakukan analisis untukmencari batasan nilai gradien RV-PA dan pRV/LV ratio sebagai nilai prediktif terbaikterhadap kejadian LCOS pascakoreksi TF TA-TP tanpa TAP. Mean gradien RV-PAsebelum subjek penelitian rawat jalan adalah 23,47±6,95 mmHg. Regurgitasi katuppulmonal ringan pada 15 (50%) subjek penelitian dan regurgitasi katup trikuspid trivialmildpada 16 (53%) subjek penelitian. Disfungsi ventrikel kanan ringan 3 (10%), sedang20 (67%) dan berat pada 7 (23%) subjek penelitian. Mean TAPSE postoperatif adalah1,03±0,19. DSV residual tidak dijumpai, aritmia tidak dijumpai, reoperasi dan mortalitastidak ada.Simpulan : Koreksi TF TA-TP tanpa TAP memberikan hasil operasi dini yang baik padapasien TF dengan z-value katup pulmonal ≥ -1, pRV/LV ratio < 0,5 dan gradien RV-PA <25 mmHg pascakoreksi.

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ABSTRACTObjective : The benefits of the transatrial-transpulmonary (TA-TP) without transannularpatch (TAP) correction of tetralogy of Fallot (TOF) are preservation of pulmonary valveannulus and right ventricular function. However, TA-TP without TAP correction of TOFhad a higher incidence of low cardiac output syndrome (LCOS) because of the high rightventricle and pulmonary artery (RV-PA) pressure gradient and right ventricle and leftventricle pressure (pRV/LV) ratio. The purpose of this study were to analyze the cut offvalue of RV-PA pressure gradient dan pRV/LV ratio as the best predictor value forpostoperative LCOS in TA-TP without TAP correction of TOF.Methods : Between Oktober 2012 and Maret 2013, 30 patients with TOF underwent TATPwithout TAP correction (mean age 8,37±7,90 years, range 1-27 years). At the end ofcorrection, all patients underwent intraoperative direct measurement of RV-PA pressuregradient and pRV/LV ratio. The patients were evaluated for postoperative LCOS at theIntensive Care Unit (ICU). All the patients underwent echocardiographic examinationbefore hospital discharge. This included investigation of the presence RV-PA pressuregradien, RV function, residual VSD, pulmonary and tricuspid valve insufficiency.Results : Thirty patients with pulmonary valve annulus z-value ≥ -1, underwent TA-TPwithout TAP correction of TOF. Mean intraoperative RV-PA pressure gradient was21,13±10,60 mmHg and mean intraoperative pRV/LV ratio was 0,53±0,14. Mean RV-PApressure gradient measured 24 hours after correction at the ICU was 20,83±7,10 mmHgand mean pRV/LV ratio measured at 24 hours after correction at the ICU was 0,49±0,10.No patient had LCOS, we could not analyze the cut off value of RV-PA pressure gradientand pRV/LV ratio as the best predictor value for postoperative LCOS in this study. Nopatient had residual VSD. Mean RV-PA pressure gradient before hospital discharge was23,47±6,95 mmHg. Fifteen (50%) patients had mild pulmonary valve insufficiency and16 (53%) patients had trivial-mild tricuspid valve insufficiency. Three (10%) patients hadmild RV dysfunction. Postoperative mean TAPSE was 1,03±0,19. No patient hadarrhythmia, reoperation and mortality in this study.Conclusions : The TA-TP without TAP correction of TOF was applied successfully in 30patients with pulmonary valve annulus z-value ≥ -1, post-correction RV-PA pressuregradient < 25 mmHg and pRV/LV ratio < 0,5."

"Tenaga kesehatan memiliki tuntutan kerja yang berat dan perlu bekerja dalam sistem shift sehingga seringkali memiliki waktu yang terbatas untuk beristirahat. Gaya kerja tersebut membuat tenaga kesehatan rentan mengalami stres. Tuntutan kerja dan stres yang dialami ditemukan membuat tenaga kesehatan seringkali kesulitan untuk menjalankan perilaku sehat di kehidupan sehari-harinya. Penelitian ini bertujuan untuk mengetahui hubungan antara perceived stress dan perilaku latihan fisik pada tenaga kesehatan. Metode penelitian ini adalah kuantitatif korelasional dengan desain penelitian cross sectional. Peneliti mengukur tingkat perceived stress dengan alat ukur Perceived Stress Scale (PSS-14) dan perilaku latihan fisik dengan melihat frekuensi latihan fisik. Partisipan pada penelitian ini terdiri dari 115 tenaga kesehatan yang bekerja di rumah sakit tipe A/B di DKI Jakarta. Hasil penelitian menunjukkan bahwa terdapat hubungan negatif yang signifikan antara perceived stress dan perilaku latihan fisik pada tenaga kesehatan (rs = 0,316, p < 0,01). Dengan kata lain, semakin tinggi tingkat perceived stress tenaga kesehatan, maka semakin rendah frekuensi latihan fisik yang dilakukan.

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Healthcare workers have heavy work demands and need to work in shifts, so it is not uncommon for them to have limited time to rest. This work style makes healthcare workers susceptible to stress. The work demands and stress experienced by healthcare workers have been found to make it difficult for healthcare workers to engage in healthy behaviors in their daily lives. This study aims to determine the relationship between perceived stress and exercise behavior among healthcare workers. The method used in this study is quantitative correlational with a cross-sectional research design. The researcher measured the level of perceived stress using the Perceived Stress Scale (PSS-14) and exercise behavior by looking at the frequency of exercise in a week. The participants in this study consisted of 115 healthcare workers working in type A/B hospitals in DKI Jakarta. The results of the study showed that there is a significant negative relationship between perceived stress and exercise behavior among healthcare workers (rs = 0.316, p < 0.01). In other words, the higher the perceived stress level of healthcare workers, the lower the frequency of exercise they perform."

"This paper aims to review some highlights on the effects of environmental stresses on the non-human primate population, particularly, climate change and food limitation that may have resulted in their poor reproductive performance. The International Union for Conservation of Nature (IUCN) lists more than a third of the world’s primates as critically endangered or vulnerable. Non-human primates, which are the closest biological relatives of humans, are threatened with extinction from human activities and environmental stress. Deforestation is the main problem that intercalates with climate change. Either, indirectly or directly, those extinction factors could interrupt the physiological basis of reproduction among non-human primates. Researches on other species showed that high ambient temperature causing heat stress had harmed there productive performance by interfering with the hypothalamic-pituitary-gonadal axis. Therefore, the survival, conservation and sustainability of nonhuman primates growing in captivity and in the wild, require more works and researches to be done"

"Exercise-lnduced Bronchoconstriction (EIB) adalah penyempitan bronkus bersifat sementara yang timbul 5-8 menit setelah latihan fisik. Prevalensi EIB pada atlet remaja mencapai 35% di negara yang memiliki empat musim. Di Indonesia yang merupakan negara tropik, prevalensi EIB pada atlet remaja belum diketahui. Penelitian ini bertujuan untuk mengetahui prevalensi EIB pada siswa-siswi SLTP dan SMU Ragunan dengan menggunakan exercise stress test (EST). Peneliti juga ingin mencari hubungan antara prevalensi EIB dengan jenis kelamin, riwayat hipersensitivitas dan cabang olahraga. Subyek melakukan uji ergometer sepeda dengan intensitas 85% laju jantung maksimal (220-umur) atau lebih selama 6 menit. Pemeriksaan spirometri dilakukan sebelum uji, menit ke 0, 5, 10, dan 20 setelah uji. EIB adalah penurunan FEVi 10% atau lebih setelah EST. Subyek terdiri dari 168 atlet remaja yang merupakan siswa-siswi SLTP dan SMU Ragunan. Prevalensi EIB yang didapat adalah 13,7%(23 subyek) terdiri dari 17 atlet perempuan dan 6 atlet laki-laki. Uji Chi-square menunjukkan tidak ada hubungan kejadian EIB dengan jenis kelamin subyek (p=0,09). Uji Fisher menunjukkan EIB tidak berhubungan dengan riwayat hipersensitivitas (p=0,4). Cabang olahraga (cabor) terbanyak memiliki atlet EIB adalah taekwondo, bolavoli dan atletik. Dilihat dari sifatnya ketiga cabor tersebut termasuk olahraga yang kurang asmogenik."

"Lead editor of Braunwald's Heart Disease, Dr. Douglas L. Mann, and nationally and internationally recognized heart failure expert Dr. G. Michael Felker, bring you the latest, definitive state-of-the art information on heart failure in this outstanding Braunwald's companion volume. Heart Failure, 3rd Edition, keeps you current with recent developments in the field, improved patient management strategies, and new drug therapies and implantable devices that will make a difference in your patients' lives and in your practice. Braunwald's Heart Failure Companion also has an on-line version that is."

"Gagal jantung fraksi ejeksi rendah merupakan salah satu permasalahan kardiovaskular yang memiliki prognosis buruk dan dapat mempengaruhi kualitas hidup pasien. Permasalahan yang dihadapi pasien gagal jantung fraksi ejeksi rendah diantaranya adalah gangguan tidur dan stres. Perawatan diri merupakan faktor kunci untuk meningkatkan kualitas hidup, mengurangi angka rehospitalisasi dan menurunkan angka kematian. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara tingkat stres dan kualitas tidur dengan perawatan diri pada pasien gagal jantung fraksi ejeksi rendah. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan pendekatan cross-sectional melibatkan 110 responden yang direkrut menggunakan flyer rekrutmen responden sesuai dengan kriteria inklusi yang telah ditetapkan. Instrumen untuk mengukur tingkat stres, kualitas tidur dan perawatan diri digunakan dalam penelitian ini. Analisis data menggunakan analisis deskriptif, uji chi square dan regresi logistik. Hasil penelitian didapatkan sebagian besar responden berjenis kelamin laki-laki, berkisar pada usia 59 tahun, memiliki pendidikan tinggi, penghasilan berkisar 3,5 juta rupiah, menderita gagal jantung 3 tahun atau lebih, dan memiliki komorbid. Sebagian besar responden memiliki tingkat stres rendah, kualitas tidur buruk dan perawatan diri adekuat. Tidak terdapat hubungan antara tingkat stres dengan perawatan diri. Terdapat hubungan yang signifikan antara kualitas tidur dengan perawatan diri dengan variabel kovariatnya adalah pendidikan. Namun, perlu dilakukan penelitian lanjutan untuk mengeksplor variabel lain yang memengaruhi perawatan diri pasien gagal jantung fraksi ejeksi rendah. 

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Heart Failure reduced Ejection Fraction (HFrEF) is a cardiovascular problem that has a poor prognosis and can affect the patient's quality of life. Issues of patients with heart failure reduced ejection fraction include sleep disorder and stress. Self-care is a key to improved quality of life, reduced rehospitalitation rates, and reduced deaths. This study aimed to identify the correlation between stress levels and sleep quality with self-care in heart failure reduced ejection fraction. This study is quantitative research used a cross-sectional design involved 110 respondents who were recruited using a respondent recriutment flyer in accordance with the inclusion criteria that have been set. Stress level, sleep quality and slf-care were used in this study. Data analysis used descriptive analysis, chi-square test and logistic regression. The result showed that the majority of respondents were male, aged 59 years, had higher education, had an income of around 3.5 million rupiahs, had suffered from heart heart failure for 3 years or more, had NYHA functional calss II, and had comorbidities. Most respondent had low stress levels, poor sleep quality and adequate self-care. There was a significant relationship between sleep quality and self-care with the covariate variable being education. However, future research is needed to explore other variables that affect the self-care of patients with heart failure reduced ejection fraction."

"As a broadcaster and medical columnist, Dr Smith receives many letters each year, asking questions about coping with stress, and in this book he sets out to answer the most common ones. In doing so, he offers advice, information and reassurance."

"Stress proof the heart presents a general picture of behavioral cardiology while focusing in depth on critical specifics. Leading experts in the field explore the psychological aspects of living with arrhythmia, intracardiac device, heart failure, and heart transplant, relating them to psychological characteristics such as pessimism and the feeling of overcommitment. Mainstream treatments, such as stress management and smoking cessation, and emerging interventions, such as computer-based therapies and personality-based techniques."

"Buku yang berjudul "Stress and medical procedures" ini membahas tentang prosedur medis untuk menangani stress."