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"ABSTRAKPenelitian ini bertujuan untuk mengetahui perbedaan perubahan kadarmalondialdehida plasma pada perawat dan pegawai administrasi yang telahbekerja selama 7 jam berturut-turut dan mendapatkan modifikasi makanan berupamakanan dengan kandungan makronutrien sebesar 65% dari kebutuhan sehari danasupan mikronutrien antioksidan (β-karoten, vitamin C, vitamin E, Cu, Zn, danSe) sebesar 65% dari AKG/DRI. Penelitian ini merupakan suatu penelitianpotong lintang berulang dengan rentang jangka waktu pemeriksaan pertamadengan pemeriksaan kedua adalah satu shift kerja (7 jam). Pengambilan datadilakukan di RSUD Tarakan, Jakarta pada bulan Januari sampai Februari 2013.Sebanyak 39 orang subyek bersedia ikut serta dalam penelitian ini dan sebanyak31 orang subyek (15 perawat dan 16 pegawai administrasi) memenuhi kriteriapenelitian. Data yang dikumpulkan meliputi karakteristik demografi, dataantropometri (berat badan dan tinggi badan), pola asupan makronutrien danmikronutrien antioksidan, serta pemeriksaan kadar malondialdehida plasma.Rerata persentase asupan lemak terhadap energi pada kelompok perawat (37 +5,79 %) dan kelompok pegawai administrasi (36,57 + 6,72 %) melebihi asupanlemak total yang dianjurkan. Sebesar 42,86% subyek pada kelompok perawat danpegawai administrasi memiliki asupan β-karoten yang kurang berdasarkan DRI,14,29% subyek pada kelompok perawat dan 35,71% subyek pada kelompokpegawai administrasi memiliki asupan vitamin C yang kurang berdasarkan AKG.Sebagian besar subyek pada kedua kelompok memiliki asupan vitamin E, Cu, Zndan Se yang kurang dibandingkan AKG/DRI. Terdapat peningkatan bermaknakadar MDA plasma kelompok perawat setelah bekerja dan mendapatkan asupanmakanan (p = 0,001) tetapi tidak pada kelompok pegawai administrasi (p =0,063). Tidak terdapat perbedaan bermakna antara rerata perubahan kadar MDAplasma sebelum dan setelah bekerja serta mendapatkan asupan makanan padakelompok perawat dan pegawai administrasi. Dari penelitian ini dapatdisimpulkan bahwa terdapat peningkatan bermakna kadar MDA plasma setelahbekerja dan mendapatkan asupan makanan pada kelompok perawat yangmenunjukkan peningkatan kerusakan oksidatif setelah bekerja.

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ABSTRACTThe aim of study is to find out the differences of plasma malondialdehydeconcentration in nurses and administrative workers after 7 hours of work and hadmeal modifications which contain 65% of total daily needs macronutrient and65% of AKG/DRI antioxidant (β-carotene, vitamin C, vitamin E, Cu, Zn, and Se).This is a repeated cross-sectional study. The range from first examination tosecond examination is one work shift (7 hours). The data were obtained inTarakan District General Hospital, Jakarta from January to February 2013. Outof 39 people whom signed the consents, 31 people matched the study criteria. Thedata taken in this study include demographic characteristic, anthropometric(weight and height), assessment of macronutrient and antioxidant micronutrientintake, and plasma malondialdehyde. The mean of percentage fat intake perenergy in nurses group were 37 + 5,79 % and in administrative workers groupwere 36,57 + 6,72 %, both of them exceed the recommendation of fat intake. Asmuch as 42,86% subjects in both group had a low β-carotene intake according toDRI, 14,29% subjects in nurses group and 35,71% in administrative workersgroup had a low vitamin C intake according to AKG. Most subjects in both grouphad a low vitamin C, Cu, Zn, and Se intake according to AKG/DRI. There was asignificant increase of plasma MDA concentration after work and mealmodification within nurses group (p = 0,001), but not on administrative workers?(p = 0,063). There were no significant increases of plasma MDA concentrationafter work and meal modification between nurses group and administrativeworkers group. The conclusion of this study is there was a significant increase ofplasma MDA concentration after work and had meal modification within nursesgroup, which implicates an increase of oxidative damage after work."

"[ABSTRAKPendahuluan:Pada traumatic brain injury (TBI) dapat terjadi peningkatan metabolisme sehingga pasien rentan mengalami malnutrisi. Tatalaksana nutrisi yang adekuat sesuai dengan kondisi klinis dan komorbiditas berperan dalam mencegah terjadinya malnutrisi, menurunkan morbiditas dan mortalitas, serta mengoptimalkan outcome neurologis.Presentasi Kasus:Keempat pasien dalam serial kasus ini adalah laki-laki berusia antara 31?60 tahun dengan TBI dan berbagai faktor penyulit. Pasien pertama dengan obesitas dan mengalami hiponatremia berulang selama perawatan, pasien kedua memiliki status gizi malnutrisi, pasien ketiga dengan riwayat kemoradiasi pada astrositoma, amiloid angiopati dan disfagia, sementara pasien keempat dengan hipertensi dan fibrilasi atrium. Skrining gizi dengan MST pada keempat pasien menunjukkan skor dua. Pemberian energi pada keempat pasien adalah sebesar 140?150% dari kebutuhan energi basal yang dihitung dengan Harris-Benedict, dengan target pemberian protein sebesar 1,5?1,9 g/kg BB/hari atau setara dengan 20% energi. Selama pemantauan asupan protein pada keempat pasien adalah sebesar 0,55?1,67 g/kg BB/hari atau setara dengan 13,1?19,5% energi. Restriksi cairan dilakukan pada pasien pertama sebagai tatalaksana hiponatremia yang diperkirakan terjadi akibat SIADH. Pemberian natrium pada pasien keempat tidak direstriksi meskipun pasien mengalami hipertensi karena hipertensi adalah salah satu mekanisme kompensasi pada TBI. Pasien ketiga mengalami disfagia jika mengasup air putih sehingga dilakukan latihan menelan. Asupan per oral dimulai pada hari ke 6?15 pasca trauma.Hasil:Keempat pasien menunjukkan perbaikan outcome neurologis yang tampak berdasarkan peningkatan skor GCS disertai peningkatan kapasitas fungsional. Kesimpulan: Tatalaksana nutrisi yang adekuat pada pasien TBI dengan mempertimbangkan komorbiditas pasien diperlukan untuk menunjang penyembuhan dan memperbaiki outcome pasien.

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ABSTRACTBackground:Hypermetabolism in traumatic brain injury (TBI) increase the risk of malnutrition. Adequate nutritional management based on clinical status and comorbidity reduces the risk of malnutrition, therefore reduces morbidity and mortality rate and improves neurological outcomes.Case Presentation:The four patients included in this serial case were male, 31?60 years old. All patients were diagnosed with TBI complicated by various comorbidities.The first patient was obese with reccurrent episode of hyponatremia during hospitalization, the second patient was malnourished, the third patient had history of chemoradiation due to astrocytoma and was diagnosed with angiopathy amyloid and dysphagia, while the fourth patient was diagnosed with hypertension and atrial fibrilation. The MST scores in all four patients were two. Target of energy provision were between 140?150% of predicted basal energy requirement and target of protein provision were 1,5?1,9 g/kg BW/day or equal to 20% of energy. The protein intake during monitoring were 0,55?1,67 g/kg BW/day or equal to 13,1?19,5% energy. The fluid intake was restricted in first patient due to SIADH- related hyponatremia. Sodium intake was not restricted for the forth patient eventhough the patient was diagnosed with hypertension. In TBI, hypertension could occur due to compensational mechanism. The third patient was having difficulties consuming water due to dysphagia, and was conducted to multiple swallowing therapy exercises. Oral intake in four patients were initiated in day 6? 15 post trauma.Result:There were improvement of neurological outcome shown by the higher GCS score and improvement of the functional capacity in all four patients Conclusion: Adequate nutritional management in TBI patient can support the recovery and improve patient?s outcome. Nutritional management should consider patient?s comorbidities.;Background:Hypermetabolism in traumatic brain injury (TBI) increase the risk of malnutrition. Adequate nutritional management based on clinical status and comorbidity reduces the risk of malnutrition, therefore reduces morbidity and mortality rate and improves neurological outcomes.Case Presentation:The four patients included in this serial case were male, 31–60 years old. All patients were diagnosed with TBI complicated by various comorbidities.The first patient was obese with reccurrent episode of hyponatremia during hospitalization, the second patient was malnourished, the third patient had history of chemoradiation due to astrocytoma and was diagnosed with angiopathy amyloid and dysphagia, while the fourth patient was diagnosed with hypertension and atrial fibrilation. The MST scores in all four patients were two. Target of energy provision were between 140–150% of predicted basal energy requirement and target of protein provision were 1,5–1,9 g/kg BW/day or equal to 20% of energy. The protein intake during monitoring were 0,55–1,67 g/kg BW/day or equal to 13,1–19,5% energy. The fluid intake was restricted in first patient due to SIADH- related hyponatremia. Sodium intake was not restricted for the forth patient eventhough the patient was diagnosed with hypertension. In TBI, hypertension could occur due to compensational mechanism. The third patient was having difficulties consuming water due to dysphagia, and was conducted to multiple swallowing therapy exercises. Oral intake in four patients were initiated in day 6– 15 post trauma.Result:There were improvement of neurological outcome shown by the higher GCS score and improvement of the functional capacity in all four patients Conclusion: Adequate nutritional management in TBI patient can support the recovery and improve patient’s outcome. Nutritional management should consider patient’s comorbidities., Background:Hypermetabolism in traumatic brain injury (TBI) increase the risk of malnutrition. Adequate nutritional management based on clinical status and comorbidity reduces the risk of malnutrition, therefore reduces morbidity and mortality rate and improves neurological outcomes.Case Presentation:The four patients included in this serial case were male, 31–60 years old. All patients were diagnosed with TBI complicated by various comorbidities.The first patient was obese with reccurrent episode of hyponatremia during hospitalization, the second patient was malnourished, the third patient had history of chemoradiation due to astrocytoma and was diagnosed with angiopathy amyloid and dysphagia, while the fourth patient was diagnosed with hypertension and atrial fibrilation. The MST scores in all four patients were two. Target of energy provision were between 140–150% of predicted basal energy requirement and target of protein provision were 1,5–1,9 g/kg BW/day or equal to 20% of energy. The protein intake during monitoring were 0,55–1,67 g/kg BW/day or equal to 13,1–19,5% energy. The fluid intake was restricted in first patient due to SIADH- related hyponatremia. Sodium intake was not restricted for the forth patient eventhough the patient was diagnosed with hypertension. In TBI, hypertension could occur due to compensational mechanism. The third patient was having difficulties consuming water due to dysphagia, and was conducted to multiple swallowing therapy exercises. Oral intake in four patients were initiated in day 6– 15 post trauma.Result:There were improvement of neurological outcome shown by the higher GCS score and improvement of the functional capacity in all four patients Conclusion: Adequate nutritional management in TBI patient can support the recovery and improve patient’s outcome. Nutritional management should consider patient’s comorbidities.]"