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"ABSTRAKTujuan : Untuk mengetahui nilai pembatas indikator kelebihan lemak tubuh pada lansia.Tempat : Puskesmas Kecamatan Kotamadya Semarang yang mempunyai program lansia binaan.Bahan dan cara : Studi cross-sectional pada lansia 60 tahun ke atas(69 pria dan 173 wanita), subyek penelitian dipilih secara acak sederhana pada tingkat Puskesmas. Data yang dikumpulkan meliputi : data non nutrisi, data nutrisi, antropometri, kadar lipid serum data gula darah puasa .Penetapan nilai pembatas indikator kelebihan lemak tubuh (IMT, Lpe, rasioLPe/Lpa ,ML) ditetapkan pada nilai median. Sedangkan nilai indikator metabolik sebagai faktor risiko PJK ditetapkan pada batas diwaspadai (berdasarkan Konsensus Nasional Dislipidemia Indonesia, 1993).Hasil : Profil kol. total dan kol. HDL serum subyek wanita lebih tinggi daripada subyek pria (p = 0,001). Prevalensi faktor risiko PJK seperti dislipidemia pada subyek wanita lebih tinggi dibandingkan subyek pria (p < 0.05). Nilai-nilai pembatas indikator kelebihan lemak tubuh yang diperoleh pada penelitian ini yaitu IMT (pria 21 kg/m2; wanita 23 kg/m2 ), LPe (pria 79 cm; wanita> 80 cm), rasio LPe-LPa (pria) 0,91; wanita > 0,85), massa lemak tubuh (pria > 22 %; wanita > 35 %). Sensitifitasnya dikaitkan dengan profit lipid sebagai faktor risiko PJK yaitu 40 - 60 %, sedangkan spesifisitasnya 70 - 80 %. Terdapat perbedaan determinan komposisi tubuh terhadap gangguan metabolik pada subyek pria dan wanita. Pada subyek pria nilai pembatas indikator kelebihan lemak tubuh berkorelasi dengan TG dan GDP, sedangkan pada subyek wanita berkorelasi dengan kol. HDL, kol. total, kol. LDL dan TO.Kesimpulan : Nilai-nilai pembatas indikator kelebihan lemak tubuh yang didapat pada penelitian ini cenderung memberi spesifisitas yang lebih tinggi dibanding dengan sensitifitasnya (dikaitkan dengan dislipidemia). Pada subyek pria indikator kelebihan lemak tubuh lebih terkait pada TG den GDP. Sedangkan pada subyek wanita indikator kelebihan lemak tubuh lebih terkait pada dislipidemia.

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ABSTRACT

The Cut Off Point Determination Of Overfatness In Relation to Selected CHD Risks In Elderly In Semarang

Objective :

To determine cut off points of overfatness in the elderly using CHD risks factors as the end points.

Place :

Seven public health centers with elderly clubs in Semarang municipal.

Materials and Methods :

This cross-sectional study involved 242 elderly individuals (69 males & 173 females), aged 60 years and over. Simple random sampling was applied at the PHC level. Structured questionnaires were used to collect information on sosiodemography, life styles, food habits and practices Anthropometric assessments were done to estimate body compositional status. Serum lipids and fasting blood glucose were measured to identify metabolic disorders. High body mass index, high abdominal circumference, high abdominal hip ratio and high fat mass values were used as overfatness indicators. The Indonesian National Consensus on Dyslipidemia was used to identify dyslipidemic cut off values.

Results :

Mean serum total cholesterol and high density lipoprotein (HDL) cholesterol in females were higher than those in males (220.99 ± 46.66 vs 199.31 ± 35.71, p = 0.001 and 51.17 ± 11.58 vs 45.22 ± 12.52, p = 0.001, respectively). The prevalence of CHD risks (dyslipidemic profiles) in females were also higher than that in males (p < 0.05). With respect to CHD risks, cut-off points for overfatness using BM1 values were > 21 kglr2 and ) 23 kglm2 for males and females respectively. Cut off points for other overfatness indicators were AC) 79 cm and ) 80 cm; AHR > 0.91 and ) 0.85 and percent body fat 3 22% and ) 35% for males and females, respectively. Using these cut off values, the sensitivity ranged from 40 -- 60% and the specificity ranged from 70 -- 80%. There were gender differences in the determinants of metabolic disorders. In males, overfatness was more related to TG and fasting blood glucose values. On the other hand, in females, overfatness was more related to total cholesterol, HDL cholesterol, LDL cholesterol and TG.

Conclusion :

This study supports the findings reported by other investigators that cut off values for overfatness, in relation to metabolic disorders, are more specific than sensitive. Gender differences in the determinants of metabolic disorders indicate that interpretation on body compositional disorders in the elderly should be taken cautiously."

"ABSTRAKTelah dilakukan penelitian secara retrospektif terhadap 260 penderita yang menjalani bedah pintas koroner di Rumah Sakit Jantung Harapan Kita antara bulan Maret 1986 sampai dengan 31 Maret 1990 untuk mencari variabel prognostik mortalitas bedah.Tiga puluh satu variabel prabedah yang terdiri dart 24 variabel klinis, 7 variabel kateterisasi-angiografi; dan 6 variabel intrabedah, telah diuji secara univariat dengan analisa "Kai-kuadrat" atau "Fisher's exact" dan selanjutnya secara multivariat dengan "Forward stepwise selection".Dari 24 variabel klinik yang dianalisa secara univariat hanya 4 variabel yang bermakna yaitu kelas angina, riwayat CHF, aritmia dan kreatinin. Dari 7 variabel kateterisasi-angiografi tidak satupun yang bermakna. Dari 6 variabel bedah hanya 3 variabel yang bermakna secara univariat yaitu prioritas bedah, lama klem aorta dan endarterektomi. Dari 4 variabel klinik dan 3 variabel bedah yang bermakna tersebut, dengan analisa multivariat hanya 3 variabel yang bermakna yaitu prioritas bedah (p=0,0002), lama klem aorta (p=0,019) dan kreatinin serum (p=0,049).Mortalitas bedah meningkat dengan tindakan urgensi--emergensi (mortalitas elektif 5,7%, mortalitas urgensi 28,0% dan mortalitas emergensi 57,1%). Lama klem aorta juga mempengaruhi mortalitas (mortalitas lame klem aorta < 52 menit 2%, antara 52-70 menit 4,9%, antara 71-96 menit 10,0% dan > 96 menit 22,9%). Kadar kreatinin > 2 mg% menyebabkan mortalitas meningkat (pada kadar kreatinin serum > 2 mg% mortalitasnya 60%).Sebagai kesimpulan bahwa kadar kreatinin serum yang tinggi, pernbedahan secara urgensi-emergensi, dan lama klem aorta yang panjang akan meningkatkan mortalitas bedah.

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ABSTRACTA retrospective study on 260 patients who underwent bypass surgery at the Harapan Kiita National Cardiac Center from March 1986 up to March 1990 was undertaken to determine the prognostic variable in surgical mortality.Thirty one preoperative variables comprising of 24 clinical, 7 coronary angiographies and 6 intraoperative variables were tested using univariate analysis with chi-square or Fisher's exact followed by multivariate analysis using Forward Stepwise Selection.Of 24 variables analyzed using univariate analysis only 4 were significant, namely angina class, history of CHF, arrhythmias and creatinine.Of the 7 angiographies variables, not even one was significant ; whereas of 6 surgical variables, only 3 were significant, that is priority of surgery, duration of aortic clamp and endarterectomy.From 4 clinical and 3 surgical variables which were significant, using multivariate analysis, only 3 were significant: priority of surgery (p=0,0002), duration of aortic clamp (p=0,019), and serum creatinine (p=0,049).Surgical mortality increased with urgency-emergency procedures (elective mortality 5,7%, urgency mortality 28,0% and emergency mortality 57,1%). Duration of aortic clamp also influenced mortality (aortic cross clamp < 521,2%; between 71-96',10,0% ; and > 96',22,9%). 96',22,9%). Serum creatinine level exceeding 2 mg% increased mortality (at a serum creatinine level of > 2 mg%, mortality was 60%).In conclusion, a high serum creatinine level, an urgency-emergency surgical procedure, and the duration of aortic clamp time will increase surgical mortality."

"ABSTRAKPenelitian ini mengembangkan Computer Aided Diagnose (CAD) CT jantung pasiendewasa dengan menggunakan metode segmentasi deformable dan Frangi filter. Metode segmentasi deformable dan Frangi filter untuk mendapatkan posisi kalsifikasi di dalam maupun di luar arteri koroner. Setelah itu, kalsifikasi yang terdapat di dalam arteri koroner dihitung skor kalsium menggunakan metode skor Agatson dan dihitung persentase luasannya terhadap luaspembuluh darah untuk mengetahui korelasi antara skor kalsium, persentase penyempitan pembuluh darah dengan tingkat keparahan risiko penyakit jantung. Metode segmentasi deformable dan Frangi filter dapat menunjukan secara visual posisi kalsifikasi yang terdapat pada pembuluh darah arteri koroner untuk 4 cabang utama, yaitu left main (LM), left circumflex (LCx), left anterior descending (LAD), and right coronary arteries (RCA). Pada pengukuran persentase plak pada pembuluh darah, nilai persentase terendah adalah 20% sedangkan nilai persentase tertinggi adalah 75%. Tingkat risiko penyakit jantung koroner dapat diprediksi sebanding dengan nilai persentase plak pada pembuluh darah. Sementara itu, Perhitungan skor kalsium sesuai dengan hasil evaluasi dokter dalam penentuan stadium risiko penyakit jantung

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ABSTRACTThis research developed Computer Aided Diagnose (CAD) CT heart of adult patients by using deformable segmentation method and Frangi filter. Method of deformable segmentation and Frangi filter to obtain the position of calcification inside and outside the coronary artery. Furthermore, calcification found in the coronary artery was calculated by calcium score using Agatson score method and calculated percentage of extent to blood vessel area to know correlation between calcium score, percentage of narrowing of bloodvessels with the severity of risk of heart disease. The deformable segmentation method and Frangi filter can show visually the position of calcification contained in coronary artery vein for 4 main branches, ie left main (LM), left circumflex (LCx), left anterior descending (LAD), and right coronary arteries (RCA ). In calculating the percentage of plaque on blood vessels, the lowest percentage value is 20% while the highest percentage value is 75%. Therisk of coronary heart disease is proportional to the percentage of plaque in blood vessels. Meanwhile, calcium score calculation is accordance with the results of the evaluation of the doctor in determining the stage of risk of heart disease"