168 research outputs found
Nilai prognostik dispersi QT pasca bedah pintas koroner
Get PDFHubungan antara dispersi QT pascabedah pintas arteri koroner dengan kejadian kardiovaskuler telah diteliti akhir-akhir ini oleh Agustinus dkk dari De-partemen Kardiologi dan Kedokteran Vaskuler FKUI di Rumah Sakit Jantung dan Pembuluh Darah Hara-pan Kita secara restropektif dengan kesimpulan yang menarik perhatian untuk diberikan komentar. Bahwa dispersi QT > 60 milidetik pada subyek pasca BPAK telah meningkatkan risiko terjadinya kejadian kar-diovaskular mayor, gagal jantung akut dan sindroma koroner akut non fatal dalam pemantauan selama 1 tahun.
Melihat desain penelitian yang tidak mengikut sertakan dispersi QT pra BPAK, merupakan kes-engajaan penulis agar lebih fokus pada penelitian prognosis pasca BPAK dengan dengan dispersi QT sebagai tolok ukurnya. Telah diketahui sebelumnya peranan BPAK dalam memperbaiki dispersi QT dalam arti memperpendek dispersi QT
Jantung Sehat?
Get PDFAdalah hak pribadi seseorang untuk menyebut dirinya sehat (klien) atau sakit (pasien) jantung, biarkanlah dokter membantunya untuk beradaptasi dengan lingkungan yang unik (Makna paralel dari Proklamasi Kardiologi Sosial, 25 Juni 1993). Sehat secara keseluruhan yang telah dicanangkan WHO sejak didirikan 1946, yaitu keadaan sehat yang komplit baik fisik, mental, dan sosial, terus dilanjutkan dengan bebas dari sakit atau keterbatasan/cacat. Kemudian dimunculkan konsep Kesehatan untuk semua di Tahun 2010, 2020, dst. Belum ada definisi baru ketika kita sudah memasuki era biologi molekuler, yang dihubungkan dengan masalah individu dan sosial. Semakin kita menyadari pentingnya pengaruh genom dalam suatu penyakit dan menyodorkan konsep sehat, ternyata masih ada yang tidak mungkin, yaitu bebas dari faktor-risiko penyakit jantung. Karena gender pria dan umur lanjut termasuk faktor risiko
Pemulihan Laju Jantung pada Penyakit Jantung Hipertensi
Get PDFPenelitian disfungsi autonom menggunakan tes treadmil pada fase pemulihan laju jantungnya pada fenomena menurunnya heart rate recovery memang lazim.
Kizilbash MA tahun 2006, telah menelitinya pada sindroma metabolik, menyimpulkan terjadinya disfungsi autonom pada komponen metabolik sindrom: tekanan darah, trigliserid, lingkar perut dan LDL-C.
Dengan metode lainnya, yaitu standard deviation of RR intervals (SDNN), Wu JS telah melaporkan penelitiannya bahwa disfungsi parasimpatis telah ada pada normotensi dengan riwayat keluarga hipertensi, juga tampak pada pre-hipertensi dan hipertensi. Perubahan peranan syaraf otonom dengan penguatan simpatis lebih nyata pada kasus pre-hipertensinya
Kejadian Kardiovaskular Mayor pada Perempuan
Get PDFAdalah menarik untuk membagi usia muda dan tua bagi seorang wanita dalam wawasan faktor risiko. Faktor risiko (usia) penyakit jantung koroner untuk pria adalah >45 tahun dan wanita >55 tahun, wanita terlambat 10 tahun dibanding pria karena berbagai teori, antara lain hormonal seperti estrogen dan ferritine. Danny SS membagi wanita dalam penelitiannya sebagai kelompok usia muda bila 55 tahun. Apakah wanita berumur 56 tahun sudah pantas dikelompok kan sebagai usia tua
MANAGEMENT OF RHEUMATIC HEART DISEASE IN LOW-TO-MIDDLE-INCOME COUNTRY
No full textRheumatic heart disease (RHD) remains a global health burden. In 2017, approximately 38–40.8
million cases of RHD were observed all around the world. The prevalence of RHD in non-endemic
regions is 3.4 cases per 100,000, whereas in endemic regions, it is higher than 1,000 cases per
100,000. RHD is also responsible for the premature deaths of 0.15/100000 children and an annual
case-fatality rate of 1.5% per year among the global population ages. In Indonesia, eighty-three
out of 15,608 mine workers in Papua suffered from RHD. A cardiac center in Bandung observed
that 108/4,682 (2.3%) of the patients were diagnosed with RHD. Meanwhile, the Cardiovascular
Centre Harapan Kita, Jakarta, a national cardiovascular disease referral hospital in Indonesia,
stated that 40.5% of 7112 valvular cases during 2016–2019 were RHD cases. Definitive
management of RHD with significant mitral valve stenosis consist of percutaneous balloon mitral
valvuloplasty (PBMV) and mitral valve surgery (MVS). The survival analysis of patient with
rheumatic MS after PBMV compared to MVS in Indonesia revealed that those who underwent
PBMV, 1.8% died within 24 months, while 3.5% of those who underwent mitral valve replacement
died within 27 months. The occurrence of rehospitalization did not differ between the two groups,
with acute decompensated heart failure being the leading cause. PBMV is the first choice for
patients with rheumatic heart disease without contraindications because it provides faster relief
compared to mitral valve replacement. In terms of cost, PBMV is more affordable and less
invasive, which is more beneficial for patients with rheumatic heart disease in low- to middleincome countries. Thereafter, a cohort retrospective study was conducted to assess the
improvement of exercise capacity after early phase II cardiac rehabilitation in patients who
undergo rheumatic mitral valve surgery. The study revealed that 6MWD and VO2 peak increased
significantly in these patients after the early phase II CR program (p = 0.001). On the other hand,
the use of ACE inhibitors as anti-fibrotic treatment is now being considered to address the fibrotic
process in rheumatic mitral stenosis valve as a non-intervention management. It has been
demonstrated that ACE inhibitors can break the inflammatory cycle that leads to fibrosis in the
valve. Thus, we developed a research protocol to determine the anti-fibrotic effects of ACEI and
designed an RCT in which patients received ramipril (5 mg) for at least 3 months preoperatively.
Ramipril 5mg could be a breakthrough in the management of rheumatic heart disease, improving
patient outcomes and proving highly beneficial in low- to middle-income countries. In conclusion,
rheumatic heart disease, specifically rheumatic mitral stenosis, is the most common valvular
disorder that occurs and should be comprehensively addressed through primary prevention,
secondary prevention, non-intervention management, intervention management, and
rehabilitation. Each approach is valuable and helpful in providing advancements in the
management of rheumatic mitral stenosis
ASSESSMENT OF PERSONNEL NEEDS FOR INPATIENT NURSES AT RSI A.YANI SURABAYA USING THE WISN METHOD
No full textNursing staff is a priority in providing services to patients. If the number of nurses and patients is not balanced, this will result in workload problems and the lack of staff will result in less than optimal service to patients. In this study, the method used to calculate staffing needs was WISN (Workload Indicators of Staffing Need) for Mekkah inpatient nurses (adult inpatients). The WISN method has five stages: finding available work time, finding work units and human resources categories, making work load standards, making allowance standards, and calculating labor requirements for each work unit. The aim is to analyze the need for nursing staff based on the workload in the Mekkah inpatient unit (adult inpatient unit). The time motion study method is to be able to understand more deeply the phenomena that occur and are felt by the informants through observations and interviews. The results of research on staff requirements using the WISN method were 35 nurses with real conditions of 20 nurses so there was a shortage of 10 nurses
Analisis Modus dan Efek Kegagalan pada Prosedur Penilaian Kinerja Karyawan Rumah Sakit Islam Ahmad Yani Surabaya Menggunakan Pendekatan Failure Modes and Effect Analysis (FMEA)
Get PDFPenilaian kinerja karyawan sebagai salah satu kegiatan yang penting dilakukan di rumah sakit untuk menilai kinerja para karyawannya. Dilakukan minimal setahun sekali dan setiap ada tujuan atau kepentingan tertentu seperti halnya pengangkatan karyawan, penentuan prestasi kerja karyawan, penentuan promosi jabatan dan lainnya. Tujuan penelitian ini adalah untuk mengidentifikasi dan menganalisis modus dan efek kegagalan yang dapat menghambat pelaksanaan proses penilaian kinerja karyawan Rumah Sakit Islam Ahmad Yani Surabaya (RSIAS). Metode yang digunakan dalam penelitian ini adalah observasional deskriptif dan untuk menganalisis modus dan efek kegagalan adalah dengan metode Failure Modes and Effect Analysis (FMEA). Berdasarkan hasil brainstorming dan indepth interview bersama dengan Kepala Unit dan Staf bagian Sumber Daya Manusia dan Pengembangan Karir RSIAS pada tahapan-tahapan FMEA didapatkan bahwa perlu adanya perbaikan pada sistem penilaian kinerja karyawan di RSIAS dapat juga dilakukan dengan memilih metode penilaian kinerja yang tepat dan sesuai dengan kondisi rumah sakit seperti metode BARS yang dapat mengatasi masalah penilaian kinerja karyawan yang cenderung subjektif. Atau juga metode MBO yang dapat mengakomodasi kebutuhan rumah sakit atau pihak instansi terkait dengan standar dan feedback yang diberikan dari hasil penilaian kinerja karyawan untuk pelaksanaan penilaian kinerja yang lebih baik kedepannya
Predictive Value of Terminal QRS Distortion in Anterior Wall Acute Myocardial Infarction
Get PDFBackground. The initial ECG at patients with Acute Coronary Syndrome, especially STEMI can predict size of infarction, response to reperfusion therapy and long term prognosis. A new classification, the QRS distortion have increased mortality rates and larger infarct size and less limitation of their infarct size by thrombolytic therapy. QRS distortion is the emergence of J point = 50% of R wave in leads with qR configuration (I, aVL, V4-V6), or disappearance of the S wave in leads with Rs configuration (V1-V3).
Methods and results.This study is cohort-retrospective to patients with anterior IMA treated by thrombolytic at National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia, during January 2003 September 2004, that fulfill inclusion and exclusion criterias. They were divided into two group, with QRS distortion (+) and without QRS distortion (-); each group consist of 30 patients. Correlation between the two groups were ana-lyzed by t test, chi-square test, Mann Whitney u test and logistic regres-sion. Patients age range is 40 69 years, and mostly man. There is no difference between baseline characteristic in the two groups, except cho-lesterol LDL which is higher in the group with QRS distortion. Patients with QRS distortion have a higher tendency of thrombolytic therapy fail-ure compare to patients without QRS distortion, (p=0,003). As the con-sequence they also have a higher rate of arrhythmia events, low ejection fraction and re-hospitalization due to congestive heart failure.
Conclusions. The prognosis of patients with anterior IMA associated with QRS distortion is worse than without QRS distortion
Buku Saku Jantung Dasar
No full textDAFTAR ISI :
Penyakit jantung bawaan
Krisis hipertensi di pelayanan primer
Diabetes dan penyakit jantung
Penyakit katup jantung
Aritmia
Gagal jantung akut
Gagal jantung kronis
Penyakit jantung dan manifestasi sistem saraf pusat
Penyakit jantung dan kehamilan
Obat jantung dalam kehamila
Age, body posture, daily working load, past antihypertensive drugs and risk of hypertension: A rural Indonesian study
Get PDFIndonesia has about 210 million inhabitans and most of them live in rural areas, therefore in rural community it is estimated that a big number of hypertensive people can be found. However, few rural community-based studies have been conducted to identify hypertensive risk factors. This study aims to identfy some risk factors related to hypertension in rural areas. The data for this study came from the result of the field study done by the second year medical students of the Faculty of Medicine, University of Indonesia, Jakarta. The study was conducted on July 12, 2000 at 10:00 AM to 1:00 PM in a rural area, the Cijeruk subdistrict in Bogor regency. The subjects were selected randomly using neighborhood cluster. Interviews and blood pressure were taken at the houses of the subjects. The results of this study showed that people aged 40 years or over had an increase risk to suffer hypertension compared to the 17-39 year old group, and the risk was most prominent among the 55-59 year group (adjusted odds ratio = 21.62; 95% confidence intervals (CI) = 4.10-113.97). Compared to the subjects with normal body posture, those who were obese had more than 6.3-folds increase in the risk to be hypertensive (adjusted OR = 6.33: 95% CI = 2.62-15.29). In addition, those who discontinued antihypertensive drugs had almost 12-fold increase in the risk to be hypertensive relative to subjects who never take antihypertensive drugs (adjusted OR = 11.92; 95% CI = 4.61 -30.80). This study concluded that special attention should be taken to the elderly aged 40 years and over, to some one who discontinued antihypertensive drugs, and whom had light daily working load to prevent hypertension. (Med J Indones 2001; 10:29-33)
Keywords: hypertensive, risk factor, adjusted odds ratio, elderly
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