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"The increasing interest in the bio-impedance analysis in various fields has increased the demand for portable and low-cost impedance analyzers that can be used in the field. Simplifying the hardware is crucial to maintaining low-cost and portability, but this is not an easy task due to the need for accurate phase and magnitude measurements. This book discusses different portable impedance analyzers design techniques. Additionally, complete designs using two different approaches are reported. The first approach utilizes a commercially available single chip solution while the second one is based on a new measurement technique that eliminates the need to measure the phase by using a software algorithm to extract it from the magnitude information. Applications to the measurement of fruit bio-impedance are emphasized and compared with measurements from professional stand-alone impedance analyzers."

"Latar Belakang : Malnutrisi energi protein sering terjadi pada penyakit ginjal kronik, terutama stadium lanjut (prevalensi 11-54% pada stadium 3 sampai 5). Phase angle (PA) pada BIA menggambarkan integritas membran sel yang nilai rendahnya dapat menjadi prediktor kuat malnutrisi di tingkat seluler.

Tujuan Mengetahui sebaran nilai phase angle pada masing-masing stadium lanjut PGK yaitu stadium 3-5 non-dialisis, mengetahui gambaran komposisi tubuh meliputi indeks massa lemak, indeks massa bebas lemak, cairan tubuh, dan indeks edema yang bermanfaat untuk deteksi dini malnutrisi dan kelebihan cairan.

Metode Penelitian ini menggunakan desain potong lintang di Rumah Sakit Cipto Mangunkusumo (RSCM), RSUP Fatmawati, dan RSUP Persahabatan pada Maret sampai Juli 2023. Pengambilan sampel menggunakan consecutive sampling pada pasien PGK stadium 3-5 non-dialisis, usia 18-60 tahun, tanpa keganasan, sirosis hati, infeksi, maupun autoimun, dengan ADL normal. Kemudian dilakukan pemeriksaan BIA dan SGA pada seluruh subjek.

Hasil Didapatkan 138 sampel, dengan dominasi wanita (58%) kategori obesitas derajat 1, dengan median eLFG 23,2  ml/menit. Proporsi malnutrisi berdasarkan SGA sebesar 19,5%. Profil phase angle mengalami tren penurunan seiring dengan meningkatnya stadium tanpa kemaknaan statistik (p=0,072). Indeks massa lemak menurun dengan p=0,038. Sedangkan ECW dan TBW meningkat bermakna (p=0,001 dan 0,031).

Kesimpulan Profil phase angle pada PGK non-dialisis cenderung sedikit menurun seiring dengan peningkatan stadium PGK. Profil ECW dan TBW mengalami peningkatan signifikan seiring dengan meningkatnya stadium PGK, tanpa disertai perubahan indeks edema (ECW/TBW). Profil FM dan FM-I mengalami penurunan seiring peningkatan stadium PGK.

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Background Chronic kidney disease, especially in its advanced stages, often coincide with protein and energy malnutrition with a prevalence of 11-54% in stages 3 to 5. The phase angle (PA) in BIA describes the integrity of cell membranes whose low values can be a strong predictor of malnutrition at the cellular level.

Objective Firstly, to determine the distribution of phase angle values in each advanced stage of CKD, namely the non-dialysis stages 3-5. Secondly, to identify the profile of body composition including fat mass index, fat-free mass index, body fluids, and oedema index which are useful for early detection of malnutrition and fluid excess.

Method This research is a cross sectional study. It was carried out at Cipto Mangunkusumo Hospital (RSCM), Fatmawati Hospital, and Persahabatan Hospital between March and July 2023. Consecutive sampling method was used with non-dialysis stages 3-5 CKD patients, aged 18-60 years, without malignancy, liver cirrhosis, infection, nor autoimmune, with normal ADLs. Then BIA and SGA examinations were performed on all subjects.

Results 138 samples were collected, which dominated by women (58%) and stage 1 obesity with a median eGFR of 23.2 ml/minute. The proportion of malnutrition based on SGA is 19.5%. Phase angle profile shows a decreasing trend with increasing stage of CKD without a statistical significancy (p=0.072). Fat mass index decreased significantly (p=0.038). ECW and TBW increased significantly (p=0.001 and 0.031) as the increasing stage of CKD.

Conclusion The phase angle profile in non-dialysis CKD tends to decrease slightly with increasing CKD stage. ECW and TBW profiles increased as the CKD stage increased, but there was no change in oedema index (ECW/TBW). The FM and FM-I profiles decreased as the CKD stage increased."

"Latar Belakang: Dengan adanya hemodialisis, angka harapan hidup pasien penyakit ginjal tahap akhir (PGTA) meningkat. Akan tetapi, kualitas hidupnya semakin lama semakin menurun. Kualitas hidup pasien PGK dinilai dengan KDQOL SF-36 yang memiliki 3 komponen, yaitu PCS (fisik), MCS (mental), dan KDCS (berhubungan dengan penyakit ginjalnya). Status nutrisi merupakan salah satu faktor penentu kualitas hidup. Belum jelas apakah massa otot atau massa lemak yang berpengaruh terhadap peningkatan kualitas hidup pasien PGTA.Tujuan. Penelitian ini bertujuan mengidentifikasi hubungan antara persentase massa bebas lemak (FFM) dengan kualitas hidup pasien PGTA.Metode. Studi potong lintang ini dilakukan di Unit Hemodialisis, Divisi Ginjal hipertensi Rumah Sakit Cipto Mangunkusumo pada bulan Juni-Juli 2018. Sebanyak 102 pasien diteliti pada studi ini. Sampel darah diambil untuk pemeriksaan laboratorium. Persentase massa bebas lemak dihitung menggunakan Bioimpedance Analysis (BIA). Kualitas hidup dievaluasi menggunakan kuesioner KDQOL SF-36 versi 1.3. Analisis statistik dilakukan menggunakan uji korelasi Pearson. Analisis kualitas hidup berdasarkan klasifikasi persentase lemak dilakukan dengan uji Anova.Hasil. Pada penelitian ini, rerata skor KDQOL keseluruhan adalah 47,86+6,56, dengan rerata skor PCS 40,97+9,66, median skor MCS 46,6 (22,05-59,95), dan KDCS 55,98+9,02. Persentase FFM subjek 74,21+1% dengan rerata massa 43,06+8,16 kg. Hasil uji korelasi Pearson antara skor keseluruhan KDQOL dan persentase FFM mendapatkan nilai r 0,032 dan p 0,750. Hasil signifikan didapatkan antara subkomponen PCS dengan FFM (r 0,223, p 0,024). Persentase massa otot didapatkan berhubungan dengan KDCS (r 0.23, p 0.041) dengan usia sebagai faktor perancu dalam hubungan persentase massa otot dan KDCS.Kesimpulan. Terdapat hubungan positif lemah antara FFM (dalam kg) dengan kualitas fisik pasien PGTA. Terdapat hubungan positif lemah antara persentase massa otot dengan komponen KDCS pada pasien PGTA .

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Background. Due to the occurrence of hemodialysis, the life expectancy of end stage renal disease (ESRD) patients are lengthening. However, their quality of life (QoL) are decreasing. The QoL of ESRD patients are composed of physical (PCS), mental (MCS), and kidney-related (KDCS) components. Nutritional status is one of the influencing factors of QoL. It is not clear whether free fat mass (FFM) or fat mass that contribute to the increase of QoL of ESRD patients.Objectives. This study aims to identify the correlation of FFM percentage and quality of life of ESRD patients.Method. This cross-sectional study was conducted in Hemodialysis Unit, Division of Kidney and Hypertension Cipto Mangunkusumo General Hospital Jakarta from June-July 2018. 102 subjects were included in this study. Blood samples were collected for laboratory examination. FFM percentage was measured using bioimpedance analysis (BIA). Meanwhile, QoL was evaluated using KDQOL SF-36 version 1.3. Statistical analysis was done using Pearson correlation test. Analysis of QoL based on fat percentage was done using Anova test.Result. In this study, the overall KDQOL score was 47,86+6,56 with PCS 40,97+9,66, MCS 46,6 (22,05-59,95), and KDCS 55,98+9,02. FFM percentage was 74,21+1% with mean mass of 43,06+8,16 kg. Statistical analysis showed no correlation between FFM percentage and overall KDQOL score (r 0,032, p 0,750). However, there was a significant correlation between PCS and FFM (r 0,223, p 0,024). Muscle mass percentage also shows a positive correlation with KDCS (r 0.23, p 0.041) with age as confounding factor between this two variables.Conclusion. There is a weak positive correlation between FFM in kg and physical quality of ESRD patients. There is also a weak positive correlation between muscle mass percentage and KDCS."

"Latar Belakang: Dermatitis seboroik (DS) merupakan kelainan inflamasi kronik pada area kulit yang kaya kelenjar sebasea. Hingga saat ini patogenesis DS terus berkembang, termasuk dikaitkan dengan kejadian sindrom metabolik. Oleh karena sindrom metabolik terjadi akibat resistensi insulin yang diperankan oleh jaringan lemak viseral, maka diduga kedua hal tersebut juga memiliki peran terhadap kejadian DS.Tujuan: mengetahui rerata HOMA-IR dan skala jaringan lemak viseral pada pasien DS, serta menilai perbedaannya dibandingkan dengan kontrol.Metode: Penelitian kasus-kontrol berpasangan ini dilakukan di Poliklinik Dermato-venereologi RSCM selama Juli-Agustus 2022. Kelompok kasus ialah pasien berusia ≥18 tahun, tidak hamil, IMT ≥18,5 kg/m2 yang terdiagnosis DS secara klinis, serta tidak memiliki penyakit imunokompromais, infeksi kronis, kanker, autoimun, atau degeneratif lainnya. Kelompok kontrol ialah pasien non-DS yang match berdasarkan usia, jenis kelamin, dan kategori IMT. Seluruh subjek menjalani pemeriksaan klinis, laboratorium, dan pengukuran skala lemak viseral menggunakan alat BIA TANITA® SC330.Hasil: Masing-masing kelompok DS dan kontrol berjumlah 36 subjek pada studi ini. Median(min-maks) usia kelompok DS ialah 26,5(20-45) tahun, jenis kelamin laki-laki 52,8%, dan median(min-maks) IMT sebesar 24,2(18,5-38,8) kg/m2. Median HOMA-IR ditemukan lebih tinggi pada kelompok DS dibandingkan kontrol (1,54[0,72-4,09] VS. 1,22[0,53-2,73]; p=0,031). Namun, tidak terdapat perbedaan yang bermakna secara statistik untuk skala lemak viseral antara kelompok DS dengan kontrol (6,5[1-14] VS. 6,0[1-12]; p=0,149).Kesimpulan: Nilai median HOMA-IR dan skala jaringan lemak viseral pada pasien DS adalah masing-masing 1,54 (IK95% 0,72-4,09) dan 6,5 (IK95% 1-14). Nilai HOMA-IR pada pasien DS lebih tinggi dibandingkan dengan kontrol dan bermakna secara statistik, tetapi tidak terdapat perbedaan bermakna secara statistik untuk skala lemak viseral.

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Background: Seborrheic dermatitis (SD) is a chronic inflammatory disorder in sebaceous gland-rich skin. Until today the pathogenesis of SD continues to develop, including investigation about the link association between SD and metabolic syndrome. Metabolic syndrome is a disease caused by insulin resistance in which visceral fat tissue may play important role, therefore insulin resistance and visceral fat tissue are hypothesized to influence the development of SD.

Objective: To measure the HOMA-IR and visceral fat rating scale in SD patients, and to investigate the differences compared to the control group.

Methods: A matched case-control study was conducted in Dermatovenereology Clinic Cipto Mangunkusumo General Hospital in July-August 2022. Case group was non-pregnant patients aged ≥18 years old and BMI ≥18,5 kg/m2 which were clinically diagnosed with SD, and did not have any of immunocompromise, chronic infection, cancer, autoimmune, or degenerative disease. Control group was non-SD patients that were matched according to the age, gender, and BMI categories. All the subjects assigned for clinical and laboratory examination, and visceral fat measurement using BIA TANITA® SC330.

This study involved 36 subjects in each SD and control group. Median(min-max) of age in SD group was 26.5(20-45) yo, male 52.8%, and median(min-max) of BMI was 24.2(18.5-38.8) kg/m2. Median HOMA-IR was significantly higher in SD group compared to the control group (1.54[0.72-4.09] VS. 1.22[0.53-2.73]; p=0.031). However, there was no significant difference for visceral fat rating scale between SD and control group (6.5[1-14] VS. 6.0[1-12]; p=0.149).

Conclusion: The median HOMA-IR and visceral fat rating scale in SD were 1.54 (95%CI 0.72-4.09) and 6.5 (95%CI 1-14). HOMA-IR in SD group is higher to the control group and statistically significant, but there is no significant difference for visceral fat rating scale."

"Latar Belakang. Obesitas merupakan faktor risiko luaran buruk pada pasien COVID-19. Sampai saat ini studi penilaian hubungan parameter obesitas berupa nilai lemak viseral, lingkar pinggang (LP), indeks massa tubuh (IMT), dan persentase lemak tubuh secara bersamaan dengan luaran COVID-19 menggunakan metode sederhana berupa bioimpedance analyzer (BIA) masih terbatas. Keempat variabel tersebut akan dinilai kemampuannya untuk memprediksi luaran buruk selama perawatan pasien COVID-19.Metode. Penelitian ini merupakan kohort prospektif dari 261 pasien COVID-19 ringan-sedang di RSUPN Cipto Mangunkusumo rawat inap sejak Desember 2020 hingga Maret 2021. Pasien dilakukan pemeriksaan BIA, LP, dan IMT saat admisi. Dilakukan analisis multivariat regresi logistik untuk menilai kemampuan nilai lemak viseral, persentase massa tubuh, IMT dan LP untuk memprediksi luaran buruk komposit yang mencakup ARDS dan mortalitas.Hasil. Didapatkan median nilai lemak viseral 10 (setara 100 cm2 ), lingkar pinggang 93 cm, IMT 26,1 kg/m2 , dan persentase lemak tubuh 31,5%. Berdasarkan multivariat regresi logistik, lingkar pinggang secara statistik bermakna sebagai faktor yang berpengaruh terhadap luaran buruk pada pasien COVID-19 [RR 1,04 (IK 95% 1,01-1,08)] bersama dengan derajat COVID-19 [RR 4,3 (IK 95% 1,9- 9,9)], skor NEWS [RR 5,8 (IK 95% 1,1-31)] saat admisi, dan komorbiditas [RR 2,7 (IK 95% 1,1-6,3)].Kesimpulan. Luaran buruk COVID-19 selama perawatan pasien COVID-19 terkonfirmasi dapat dipengaruhi oleh lingkar pinggang.

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Background. Obesity is a risk factor for adverse outcomes in COVID-19 patients. Until now, studies on assessing the relationship between obesity parameters in the form of visceral fat, waist circumference (WC), body mass index (BMI), and body fat percentage simultaneously with COVID-19 outcomes using a simple method such as bioimpedance analyzer (BIA) are still limited. The four variables will be assessed for their ability to predict adverse outcomes during the treatment of COVID-19 patients.

Method. This study is a prospective cohort of 261 mild-moderate COVID-19 subjects at Cipto Mangunkusumo General Hospital who were hospitalized from December 2020 to March 2021. Patients underwent BIA, WC, and BMI examinations upon admission. Multivariate logistic regression analysis was performed to assess the ability of visceral fat, body mass percentage, BMI, and WC to predict poor composite outcomes, including ARDS and mortality.

Results. The median value of visceral fat was 10 (equivalent to 100 cm2 ), WC was 93 cm, BMI was 26.1 kg/m2 , and body fat percentage was 31.5%. Based on multivariate logistic regression, WC was statistically significant as a factor influencing poor outcomes in COVID-19 patients [RR 1.04 (95% CI 1.01-1.08)] along with COVID-19 degree of severity [RR 4.3 (95% CI 1.9-9.9)], NEWS score [RR 5.8 (95% CI 1.1-31)] at admission, and comorbidities [RR 2.7 (95% CI 1.1) - 6.3)].

Conclusion. During the hospitalization of confirmed COVID-19 patients, poor outcomes can be affected by waist circumference."