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"Latar Belakang: Sindrom koroner akut (SKA) dapat didefinisikan sebagai aliran darah yang tidak cukup ke miokardium dan salah satu penyakit kardiovaskular yang paling umum di Indonesia yang mempengaruhi 143.000 orang. Skor risiko TIMI adalah penilaian stratifikasi risiko yang dapat menentukan prognosis pasien dan memengaruhi opsi terapi. Tes fungsi ginjal dikaitkan dengan keparahan hipoksia dan faktor-faktor lain yang berkontribusi dalam SKA dan tidak termasuk dalam skor risiko TIMI. Penelitian ini bertujuan untuk melihat hubungan antara tes fungsi ginjal dan skor risiko TIMI pada pasien SKA. Metode: Penelitian ini menggunakan model analitik cross-sectional menggunakan pengumpulan data rekam medis yang meliputi serum kreatinin, serum ureum, dan skor risiko TIMI yang diperoleh dari Rumah Sakit Nasional Cipto Mangunkusumo. 117 sampel diperoleh yang kemudian dianalisis dengan uji chi-square. Hasil: Uji fungsi ginjal terbukti secara signifikan terkait dengan Skor Risiko TIMI. Serum kreatinin dikaitkan dengan skor risiko TIMI (p = 0,0407) serta serum ureum juga dikaitkan dengan skor risiko TIMI (p = 0,036). Kesimpulan: Terdapat hubungan antara serum kreatinin dan serum ureum yang tinggi dengan tingginya skor risiko TIMI.

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Background: Acute coronary syndrome (ACS) is defined as insufficient blood flow to the myocardium and one of the most common cardiovascular disease in Indonesia affecting 143.000 people. TIMI risk score is risk stratification assessment that can determine the prognosis of the patient and affect therapy options. Renal function test is associated with hypoxia severity and other contributing factors in ACS which is not included in TIMI risk score. This research aims to see the association of renal function test and TIMI risk score in ACS patients.

Method: The research uses analytical cross-sectional model using medical records data collection which encompasses serum creatinine, serum ureum, and TIMI risk score obtained from Cipto Mangunkusumo National Hospital. 117 samples are obtained which is then analysed using chi-square test.

Results: Renal function test proved to be significantly associated with TIMI Risk Score. Serum creatinine is associated with TIMI risk score (p=0,0407) as well as serum ureum is also associated with TIMI risk score (p=0,036).

Conclusion: There is an association between high serum creatinine and high serum ureum with TIMI risk score in ACS patients."

"Latar belakang: Insidensi dan faktor risiko karsinoma hepatoseluler (KSH) pada pasien hepatitis C virus (HCV) yang sudah mencapai sustained virological response (SVR) pasca terapi direct acting antiviral (DAA) belum banyak diketahui. Mengingat terdapat perbedaan jenis DAA, genotype virus, dan profil pasien di Indonesia, dilakukan studi untuk menilai insidensi dan faktor-faktor yang memengaruhi KSH pada pasien HCV pasca SVR post terapi DAA.Tujuan: Mengetahui insidensi dan faktor-faktor yang memengaruhi kejadian KSH pada pasien HCV yang mencapai SVR pasca pengobatan DAA.Metode: Desain penelitian kohort retrospektif di RSUPN Cipto Mangunkusumo, sampel pasien HCV yang SVR pasca DAA tahun 2017 – 2019, diikuti hingga 2024. Pasien dilakukan skrining USG abdomen, alpha-fetoprotein (AFP) dan CT Scan abdomen 3 fase apabila terdapat indikasi. Dilakukan analisis deskriptif, bivariat dengan Fisher’s exact, dan multivariat dengan regresi logistik bila terdapat faktor risiko di analisis bivariat (p <0,25).Hasil: Dari 180 subjek penelitian, insidensi dan rasio insidensi KSH pada seluruh populasi mencapai 4,4% (rasio insidens 0,91/100PY). Terdapat hubungan signifikan dari analisis bivariat variabel sirosis hepatis (RR 10,5; IK 95% (1,32 – 83,5); p =0,0073) dan DM tipe 2 (RR 8,47; IK 95% (2,3 – 31,1) p = 0,0048). Terdapat hubungan signifikan dari analisis multivariat variabel DM tipe 2 (aRR 3,1; IK 95% (0,86 – 3,83); p=0,002).Kesimpulan: Insidensi KSH mencapai 4,4% dari total populasi. DM tipe 2 memiliki hubungan yang signifikan terhadap kejadian KSH pada pasien HCV yang mencapai SVR pasca pengobatan DAA.

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Background: The incidence and risk factors for hepatocellular carcinoma (HCC) in hepatitis C (HCV) patients who have achieved sustained virological response (SVR) after direct-acting antiviral (DAA) therapy are not well established. Considering there are differences in DAA types, virus genotypes, and patient profiles in Indonesia, this study was conducted to assess the incidence and factors influencing HCC in HCV patients after SVR post DAA therapy.

Objective: To determine the incidence and factors influencing HCC in HCV patients achieving SVR after DAA treatment.

Method: Retrospective cohort study conducted at Cipto Mangunkusumo National General Hospital, sample of HCV patients had SVR after DAA therapy in 2017 – 2019, followed until 2024. Patients were screened for abdominal ultrasound, alpha-fetoprotein (AFP) and 3-phase abdominal CT scan, if indicated. Descriptive, bivariate analysis with Fisher's exact, and multivariate analysis with logistic regression were conducted.

Results: Among 180 subjects, the incidence and incidence ratio of HCC is 4.4% (0.91/100PY). Significant correlation in bivariate analysis from the variables liver cirrhosis (RR 10.5; CI 95% (1. 32 – 83.5); p = 0.0073) and type 2 DM (RR 8.47; CI 95% (2, 3 – 31.1) p = 0.0048). In multivariate analysis, there was significant correlation from type 2 DM variable (aRR 3.1; CI 95% (0.86 – 3.83); p=0.002).

Conclusion: The incidence of HCC reaches 4.4% of the total population. Type 2 DM has significant correlation with the incidence of HCC in HCV patients who achieve SVR after DAA treatment."

"ABSTRAK Latar Belakang: Kematian pada Penyakit Jantung Koroner (PJK) terutama akibat tindakan revaskularisasi yang tertunda atau lesi koroner kompleks yang biasanyalebih buruk pada populasi pasien PGK. Skor Modified ACEF merupakan sebuahperangkat yang memiliki peran penting dalam prognosis mortalitas PJK. SkormACEF belum pernah digunakan untuk mengevaluasi kompleksitas lesi koroner.Informasi tersebut berguna dalam menentukan prioritas tindakan angiografikoroner. Tujuan: Mendapatkan nilai diagnostik dan titik potong skor mACEF sebagaiprediktor kompleksitas lesi koroner pada pasien PGK stadium 3 dan 4 yangmengalami sindrom koroner akut (SKA). Metode: Penelitian ini merupakan uji diagnostik secara retrospektif terhadap 179subjek PGK stadium 3 dan 4 yang mengalami SKA yang dirawat di ICCU RSCMtahun 2012 hingga 2014. Analisis titik potong skor mACEF dilakukan denganmenggunakan Receiver Operating Characteristic (ROC) curves dengan intervalkepercayaan (IK) sebesar 95%. Akurasi diagnostik skor mACEF dinilai dengancara menghitung sensitivitas, spesifisitas, RKP, dan RKN. Hasil: Titik potong skor mACEF yang optimal adalah 2,288 dengan sensitivitas90,9%, spesifisitas 63,7%, RKP 2,5, RKN 0,14 dan prevalens 55,3%. Kesimpulan: Titik potong yang optimal skor mACEF pada populasi pasien PGKstadium 3 dan 4 yang mengalami SKA adalah 2,288. Akurasi diagnostik skor mACEF dinilai baik.ABSTRACT Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively."

"Latar Belakang : Kejadian AKI di unit perawatan intensif berhubungan dengan peningkatan mortalitas, morbiditas pasca AKI dan biaya perawatan tinggi. Penelitian mengenai faktor-faktor yang berhubungan dengan mortalitas pasien AKI di unit perawatan intensif di Indonesia khususnya RSUPN dr. Cipto Mangungkusumo belum pernah dilakukan.Tujuan: Mengetahui prevalensi AKI, angka mortalitas pasien AKI, dan faktor- faktor yang berhubungan dengan peningkatan mortalitas pasien AKI di unit perawatan intensif di ICU RSUPN dr. Cipto Mangunkusumo.Metode : Penelitian kohort retrospektif terhadap seluruh AKI di unit perawatan intensif di RSUPN Cipto Mangunkusumo periode Januari 2015 ndash; Desember 2016. Dilakukan analisis hubungan bivariat saampai dengan multvariat dengan STATA Statistics 15.0 antara faktor usia >60 tahun, sepsis, ventilator, durasi ventilator, dialisis, oligoanuria, dan skor APACHE II saat admisi dengan mortalitas. Hasil : Prevalensi pasien AKI di unit perawatan intensif didapatkan 12,25 675 dari 5511 subjek dan sebanyak 220 subjek 32,59 dari 675 subjek yang dianalisis meninggal di unit perawatan intensif. Faktor-faktor yang berhubungan dengan peningkatan mortalitas pada analisis multivariat adalah sepsis OR 6,174; IK95 3,116-12,233 , oligoanuria OR 4,173; IK95 2,104-8,274 , ventilator OR 3,085; IK95 1,348-7,057 , skor APACHE II saat admisi 1/2 [OR 1,597; IK95 1,154-2,209], dan durasi ventilator OR 1,062; IK95 1,012-1,114 . Simpulan : Prevalensi pasien AKI dan angka mortalitasnya di unit perawatan intensif RSUPN dr. Cipto Mangunkusumo didapatkan sebesar 12,25 dan 32,59 . Sepsis, oligoanuria, ventilator, skor APACHE II saat admisi 1/2, dan durasi ventilator merupakan faktor-faktor yang berhubungan bermakna dengan peningkatan mortalitas pasien AKI di unit perawatan intensif. Kata Kunci : Acute Kidney Injury, Faktor Risiko, Mortalitas, Unit Perawatan Intensif

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Background Acute kidney Injury AKI in ICU associated with increased mortality rate, morbidity post AKI, and high health care cost. There is no previous study about factors associated with mortality of AKI patients in ICU in Indonesia, especially at dr. Cipto Mangunkusumo National Central General Hospital.Aim To identify prevalence, mortality rate, and factors associated with mortality of AKI patients in ICU.Method This is a retrospective cohort study. Data were obtained from all of medical records of AKI patients period January 2015 until December 2016 in ICU at Cipto Mangunkusumo hospital. Association of risk factors age 60 years old, sepsis, ventilator, duration of ventilator, oligoanuria, and APACHE II score at admission and mortality will be analyzed using STATA Statistics 15.0. Results AKI prevalence in ICU was 12,25 675 subjects from total 5511 subjects . A total of 220 subjects out of 675 subjects AKI died at ICU. Sepsis OR 6,174 95 CI 3,116 12,233 , oligoanuria OR 4,173 95 CI 2,104 8,274 , ventilator OR 3,085 95 CI 1,348 7,057 , APACHE II score at admission 1 2 OR 1,597 95 CI 1,154 2,209 , and duration of ventilator OR 1,062 95 CI 1,012 1,114 . were significant factors associated with mortality of AKI patients in ICU. Conclusion AKI prevalence and mortality rate in ICU at dr. Cipto Mangunkusumo National Central General Hospital were 12,25 and 32,59 . Sepsis, oligoanuria, ventilator, APACHE II score at admission 1 2, and duration of ventilator were significant factors associated with mortality of AKI patients in ICU. Keywords Acute Kidney Injury, Intensive Care Unit, Mortality, Risk Factor "

"Latar Belakang. Jumlah penyandang diabetes melitus terus meningkat sementara kendali glikemik masih sulit tercapai. Edukasi perlu berkelanjutan untuk mencapai kendali glikemik yang baik, sayangnya terdapat kendala waktu yang terbatas. Aplikasi telepon seluler merupakan sarana pemberian edukasi berkelanjutan dan berperan pada kendali glikemik tetapi manfaatnya di Indonesia belum diketahui. Tujuan. Mengetahui manfaat edukasi berbasis aplikasi telepon seluler dalam pengendalian glikemik penyandang DM tipe 2 dengan terapi insulin dosis multipel harian. Metode. Desain uji acak tersamar. Total 29 subjek pada kelompok intervensi (aplikasi DM educorner + edukasi standar) dan 31 subjek pada kelompok edukasi standar yang memenuhi kriteria inklusi yaitu DM tipe 2 berusia 30-60 tahun dengan insulin dosis multipel harian, memiliki A1C ≥ 7%, dan dapat menggunakan telepon pintar. Dilakukan pemeriksaan A1C saat awal dan setelah intervensi 3 bulan. Uji Wilcoxon digunakan untuk menganalisis perbedaan perubahan A1C setelah intervensi di kelompok edukasi dan aplikasi. Perbedaan perubahan A1C antar kelompok dianalisis dengan uji Mann Whitney. Perbedaan proporsi penurunan A1C ≥ 1% menggunakan uji kai kuadrat. Hasil. Perubahan A1C signifikan pada kelompok intervensi (edukasi + aplikasi) pasca 3 bulan evaluasi yaitu dari 9,5 (7,8-13)% menjadi 8,3 (5,8-10,5)%, p < 0,001. Tidak terdapat perbedaan perubahan signifikan A1C antara kelompok intervensi dengan kelompok kontrol, p = 0,103. Proporsi penurunan A1C ≥ 1% tidak berbeda bermakna antar kelompok, p = 0,427. Kesimpulan. Terdapat perbedaan nilai A1C penyandang DM tipe 2 dengan terapi insulin dosis multipel harian sebelum dan setelah pemberian edukasi dan aplikasi. Tidak terdapat perbedaan penurunan A1C maupun proporsi penurunan A1C ≥ 1% penyandang DM tipe 2 dengan terapi insulin dosis multipel harian antara kelompok yang mendapatkan edukasi secara tatap muka dan aplikasi dengan kelompok yang hanya mendapatkan edukasi secara tatap muka.

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Background. The number of people with diabetes mellitus increases while glycemic control is still difficult to achieve. Education needs to be given continuously to achieve good glycemic control, unfortunately there are time limited. The mobile phone application provides continuous education and plays a role in glycemic control but its benefits in Indonesia are still unknown. Objective. To know the benefit of mobile phone application-based education on glycemic control for people with type 2 diabetes on multiple daily dose insulin Methods. Randomized controlled trial. 29 subjects on the intervention group (education + smartphone application) and 31 subjects on the control group (education) who fulfill the inclusion criterias: type 2 diabetes, age 30-60 years old, using multiple daily dose insulin, A1C ≥ 7%, and operating smartphone. A1C was measured at the beginning and 3 months after intervention. Wilcoxon test was performed to analyze the difference of A1C before and after 3 months after intervention. Mann Whitney test was performed to analyze the difference change of A1C between groups. Chi square was performed to analyze the difference of proportion A1C ≥ 1% decrease between groups. Results. A1C change significantly in the intervention group after 3 months evaluation from 9,5 (7,8-13)% to 8,3 (5,8-10,5)%, p < 0,001. A1C change between groups is no difference, p = 0,103. There is no differemce of proportion A1C ≥ 1% decrease between groups, p = 0,427. Conclusion. There was a difference in A1C value of people with type 2 diabetes with multiple daily dose insulin therapy before and after the provision of education and application. There is no difference in A1C reduction and the proportion of A1C reduction ≥ 1% of people with type 2 diabetes mellitus with multiple daily dose insulin therapy between intervention (education + application) group and control (education only) group."

"Latar Belakang. Peningktan prevalensi kanker kolon proksimal menjadi perhatian di beberapa dekade terakhir. Fenomena yang sering disebut “ Right Shifting ” ini mulai muncul dibanyak negara maju. Telah diketahui pula terdapat perbedaan di tingkat molekular antara kanker kolon proksimal dan kanker kolorektal distal yang membuat para ahli menganggap dua penyakit ini merupakan dua entitas penyakit yang berbeda. perbedaan ini memunculkan perbedaan karakteristik antara keduanya. Maka timbul pertanyaan apakah terdapat perbedaan faktor-faktor yang berhubungan dengan kanker kolorektal pada umumnya mulai dari faktor genetik maupun lingkungan.Tujuan. Mengetahui hubungan usia, jenis kelamin indeks massa tubuh, riwayat keluarga kebiasan merokok, konsumsi alkohol, gejala klinis dan jenis diferensiasi lesi terhadap kejadian kanker kolon proksimal.Metode. Desain potong lintang. Menggunakan data sekunder dari registri Pusat Endoskopi Saluran Cerna dan unit rekam medis Rumah Sakit Cipto Mangunkusumo yang melibatkan 261 subjek kanker kolorektal yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pencatatan data usia, jenis kelamin, indeks massa tubuh, riwayat keluarga, konsumsi rokok, alkohol, jenis diferensiasi lesi dan manifestasi klinis. Analisis bivariat dan multivariat dilakukan pada faktor – faktor tersebut.Hasil. Didapatkan proporsi kanker kolon proksimal dan kanker kolorektal distal berturut – turut adalah 39% dan 61%. Sebagian besar subjek adalah laki-laki dengan proporsi 55,9% dengan rerata usia 51,9 (SB 13,2). Tidak didapatkan hubungan antara usia tua, jenis kelamin wanita, riwayat keluarga, indeks massa tubuh yang tinggi, konsumsi rokok, alkohol dan lesi diferensiasi buruk dengan kanker kolon proksimal. Terdapat hubungan bermakna antara anemia (OR 1,903; 95% IK 1,15 – 3,15; P = 0,012), penurunan berat badan (OR 2,04; 95% IK 1,23 – 3,38; P = 0,001), nyeri perut (OR 8,55; 95% IK 4,08 – 17,89; P = <0,001), massa abdomen (OR 8,85; 95% IK 4,54 – 12,21 ; P = <0,001), dan gejala kluster proksimal (OR 2,37; 95% IK 1,43 – 3,95; P = <0,001) dengan kanker kolon proksimal. Analisis multivariat didapatkan hubungan antara gejala kelompok kluster proksimal (AUC 0,829; 95% IK; 0,781 – 0,876) dan gejala individual seperti nyeri perut, massa abdomen, hematoskezia, diare, tenesmus (AUC 0,907; 95% IK 0,867 – 0,946) dengan kanker kolon proksimal.Kesimpulan. Beberapa gejala klinis (gejala indivisual maupun gejala kelompok) berhubungan dengan kanker kolon proksimal. Gejala kluster proksimal dan gejala individu seperti nyeri perut dan massa abdominal berhubungan dengan kanker kolon proksimal.

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Background. Increasing the prevalence of proximal colon cancer has been a concern in the past few decades. This phenomenon which is often called "Right Shifting" is starting to emerge in many developed countries. It is also known that there are differences in the molecular level between proximal colon cancer and distal colorectal cancer which makes experts consider these two diseases to be two different disease entities. this difference raises characteristic differences between the two. So the question arises whether there are differences in factors associated with colorectal cancer in general, starting from genetic and environmental factors.

Objective. Knowing the association between age, sex, body mass index, family history, smoking habits, alcohol consumption, clinical symptoms, and types of lesion differentiation in proximal colon cancer.

Methods. Cross-sectional design. Using secondary data from the Central Gastrointestinal Endoscopy Center and the Cipto Mangunkusumo Hospital medical record unit involving 261 colorectal cancer subjects who met the inclusion and exclusion criteria. Data on age, sex, body mass index, family history, cigarette consumption, alcohol consumption, type of lesion differentiation and clinical manifestations were recorded. Bivariate and multivariate analyzes were carried out on these factors.

Results. The proportion of proximal colon cancer and distal colorectal cancer was 39% and 61%, respectively. Most subjects were men with a proportion of 55.9% with an average age of 51.9 (SB 13.2). There was no association between old age, female gender, family history, high body mass index, cigarette consumption, alcohol, and poorly differentiated lesions with proximal colon cancer. There was a significant association between anemia (OR 1.903; 95% CI 1,15 – 3,15; P = 0,012), weight loss (OR 2.04; 95% CI 1.23 – 3.38; P = 0,001), abdominal pain (OR 8.55; 95% CI 4.08 – 17.89; P = <0,001), abdominal mass (OR 8.85; 95% CI 4.54 – 12.21 ; P = <0,001 ), and proximal cluster symptoms (OR 2.37; 95% CI 1.43 – 3.95; P = <0,001) with proximal colon cancer. Multivariate analysis found an association between symptoms of the proximal cluster group (AUC 0.829; 95% IK; 0.781 - 0.876) and individual symptoms such as abdominal pain, abdominal mass, hematochezia, diarrhea, tenesmus (AUC 0.907; 95% IK 0.867 - 0.946) and colon cancer proximal.

Conclusions. Some clinical symptoms (individual symptoms and group symptoms) are associated with proximal colon cancer. Proximal cluster symptoms and individual symptoms such as abdominal pain and abdominal mass are associated with proximal colon cancer."

"Latar Belakang. Artritis reumatoid merupakan penyakit autoimun yang menyebabkan inflamasi kronik artikular dan non-artikular yang  dapat menimbulkan komplikasi berupa gangguan fungsi kognitif. Beberapa studi menunjukkan pemberian terapi Metotreksat mempengaruhi penurunan fungsi kognitif pada pasien AR. Belum ada studi di Indonesia yang menilai hubungan dosis MTX dengan fungsi kognitif pada pasien AR.Tujuan. Penelitian ini bertujuan untuk mengetahui perubahan fungsi kognitif sesudah pemberian terapi MTX selama 3 bulan dan mengetahui hubungan antara dosis MTX dengan fungsi kognitif pada pasien dengan AR.Metode. Desain studi ini adalah kohort prospektif yang melibatkan 39 pasien baru terdiagnosis Artritis reumatoid berusia <60tahun di Poliklinik Reumatologi RSCM. Karakteristik demografi, parameter klinis dan penilaian kognitif didokumentasikan secara lengkap. Penilaian fungsi kognitif dilakukan dengan tes Montreal Cognitive Assessment versi Indonesia (MoCA-Ina) yang sudah tervalidasi. Studi ini menggunakan analisis statistik uji Wilcoxon, analisis bivariat dan korelasi Spearman untuk menganalisis data dengan menggunakan software Stata 15.1.

Hasil. Terdapat 28% subjek dengan penurunan fungsi kognitif. Tidak ditemukan perbedaan bermakna terhadap fungsi kognitif global sesudah pemberian MTX selama 3 bulan. Analisis korelasi Spearman menunjukkan adanya korelasi negatif antara kadar dosis MTX dengan domain fungsi memori (r=-0,4,  p =0,01).

Kesimpulan. Tidak terdapat perbedaan bermakna terhadap fungsi kognitif global sesudah pemberian MTX selama 3 bulan. Namun, terdapat korelasi negatif antara kadar dosis metotreksat dengan domain fungsi memori

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Background. Rheumatoid arthritis is an autoimmune disease causes chronic articular and non-articular inflammation with cognitive impairment as one of its complication. Several studies have shown that Methotrexate affects the decline of cognitive function in RA patients. There are no studies in Indonesia that have assessed the relationship between MTX and cognitive function in Indonesia. Aim. We aimed to know and to investigate the association between cumulative dose of MTX and cognitive function in patient with RA.

Methods. This is a prospective cohort study involving 39 subject with newly diagnosed Rheumatoid arthritis. Demographics characteristics, clinical parameters, and cognitive assessment were documented. Cognitive assessment was assessed based on validated Indonesian version of Montreal Cognitive Assessment (MoCA-Ina) test. This study used Wilcoxon, bivariate analysis and Spearman correlation to analyse the data.

Results. A total of 39 patients with RA, 28% were classified as cognitively impaired. There was no significant difference in global cognitive function after administration of MTX in 3 months. Spearman correlation analysis showed negative correlation between cumulative dose of MTX and memory function domain (r=-0.4, p=0.01).

Conclusion. There was no significant difference in global cognitive function after administration of MTX in 3 months. Cumulative dose of MTX negatively correlated with memory function domain."