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All Journal journal of internal medicine Buletin Udayana Mengabdi E-Jurnal Medika Udayana Health Science Journal of Indonesia The Indonesian Biomedical Journal Jurnal Penyakit Dalam Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Penyakit Dalam Indonesia
Ida Bagus Putu Putrawan
Geriatric Division Of Internal Medicine Department, Sanglah General Hospital, Faculty Of Medicine Udayana University, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Journal : journal of internal medicine

 1 
TERAPI 2-ADRENERGIK KERJA PANJANG PADA TATALAKSANA PENYAKIT PARU OBSTRUKTIF KRONIK Putrawan, Ida Bagus; Ngurah Rai, Ida Bagus
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease, characterized by airflow limitationthat is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory responseof the lung to noxious particle or gases. There is a chronic inflammation that leads to fixed narrowing of small airways andalveolar wall destruction (emphysema). This characterized by increased number of alveolar macrophages, neutrophils and cytotoxicT-lymphocytes, and the release of multiple inflammatory mediators. A high level of oxidative stress may amplify thisinflammation. There is also increased elastolysis and evidence for involvement of several elastolytic enzymes, including serineproteases, cathepsins and matrix metalloproteinasses. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelinesrecommend a stepwise approach to disease management, with bronchodilators being the mainstay of treatment. 2-Adrenergicagonists induce bronchodilatation through stimulation of 2-receptors, leading to an increase in cyclic adenosine monophosphate.In addition to prolonged bronchodilatation, long-acting 2-agonists (LABAs) exert other effects that may be of clinicalrelevance. These include inhibition of airway smooth-muscle cell proliferation and inflammatory mediator release, as well asnonsmooth-muscle effects, such as stimulation of mucociliary transport, cytoprotection of the respiratory mucosa, and attenuationof neutrophil recruitment and activation.
HUBUNGAN ANTARA KADAR ADIPONEKTIN PLASMA DAN RESISTENSI INSULIN PADA PENDUDUK ASLI DESA TENGANAN PEGRINGSINGAN - KARANGASEM Putrawan, Ida Bagus Putu; Suastika, Ketut
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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The association between plasma adiponectin level and insulin resistance (IR), diabetes mellitus (DM)-2, hypertension,and cardiovascular disease have been reported previously. Adiponectin is expressed and produced by adipocyte cells, and playscritical role in the glucose metabolism. IR in the adipose cells increases lipolysis and release free fatty acid (FFA). Furthermore,inactivation of mitochondrial pyruvat dehydrogenase and Þ nally decreases glucose uptake through disturbance of insulin receptorsignaling.To investigate the association between plasma adiponectin level and IR that was calculated by HOMA-IR, a cross sectionalanalytic study was conducted in Tenganan region, Bali from December 2007 to January 2008. As many as 80 participants whoseage was 18 ! 65 years old were involved.The study involved 38 (47.5%) males and 42 (52.5%) females whose mean of waist circumference (WC) was 78.03± 10.88 cm, mean of plasma glucosa was 91.73 ± 8.84 mg/dl, median of insulin was 2.70 (2.00 ! 17.90)  IU/ml, median ofHOMA-IR was 0.67 (0.38 ! 3.71), mean of HDL cholesterol was 58.93 ± 13.73 mg/dl, and mean of triglycerides was 145.64± 67.97 mg/dl, systolic blood pressure (SBP) was 70 ! 180 mmHg, and diastolic blood pressure (DBP) was 50 ! 100 mmHg. Inthis study, we found signiÞ cant correlation between plasma adiponectin level and IR (r = -0.370; p < 0.001). IR also signiÞ cantlycorrelation with central obesity (r = 0.361; p < 0.001), body mass index (BMI) (r = 0.381; p < 0.001), plasma HDL level (r =-0.327; p= 0.002), TG (r = 0.255; p = 0.011), and SBP (r = 0.198; p = 0.039). On multivariate analysis with multiple logisticregression, only central obesity has independent association with IR (B = 1.641; p = 0.023). Central obesity and sex weresigniÞ cantly inß uential to the plasma adiponektin level (ß = -1.542; p = 0.035) dan (ß = 2.865; p < 0.001) respectively in whichmean of the plasma adiponectin level in female (5.610 ± 2.815) was signiÞ cantly higher than that of male (3.365 ± 2.365; MD= -2.245; p < 0.001). Mean difference to plasma adiponectin level was signiÞ cantly inß uential of the plasma HDL level dan TG(MD = -10.500; p < 0.001) and (MD = 35.075; p = 0.020) respectively
KORELASI ANTARA GERIATRIC NUTRITIONAL RISK INDEX DENGAN LAMA RAWAT PASIEN GERIATRI DI RUMAH SAKIT SANGLAH, DENPASAR Andriyasa, K; Kuswardhani, RA Tuty; Aryana, IGP Suka; Astika, N; Putrawan, IB
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Patients at risk of malnutrition are associated with a poor outcome. There are several tools that we can use to assess thenutritional status. European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines and the French Program NationalNutrition Sante (PNNS) recommend Mini Nutritional Assessment (MNA) to detect the risk of under nutrition among elderlysubjects. The MNA which based on a Questionnaire does not use biological indicators. It is more adapted to the elderly at homeor nursing home setting than hospitalization. We want to evaluate the new tool Geriatric Nutritional Risk Index (GNRI) that moresimple than MNA to assess nutritional status and predict hospitalization outcomes in geriatric patients.This is a cohort study to evaluated correlation between GNRI score with length of stay in elderly patients. We evaluatednutritional status using Geriatric Nutritional Risk Index (GNRI) and Mini Nutritional Assessment (MNA) for elderly patientsthat admitted in Sanglah Hospital (Internal Department, class III) between February 2010 and April 2010. The patients werenutritionally assessed within 48 hours of hospital admission and studied in correlation to length of stay and in-hospital mortality.Fifty complete assessments were available for analysis. There are 32 male (62%) and 18 female (38%) with mean age are67.2 (60 ? 82) years old. GNRI score and MNA correlated inversely with length of stay in elderly patients (r = -0.67; p < 0.000)and (r = -0.44; p = 0.004) respectively. There are three fatal outcome (death) and all of cases with GNRI score grade 4 (majorrisk, GNRI score < 82) . GNRI score has a significant correlation with MNA score (r = 0.72; p < 0.000).In conclusion: Poor nutritional status as measured by GNRI was associated with a longer length of stay and increased inhospitalmortality. GNRI is a simple tool and has more significant correlation with hospitalization outcomes than MNA.
FAKTOR-FAKTOR YANG MENENTUKAN KEKUATAN GENGGAMAN TANGAN PADA PASIEN LANJUT USIA DI PANTI WREDHA TANGTU DAN POLIKLINIK GERIATRI RSUP SANGLAH - DENPASAR Putrawan, IB Putu; Kuswardhani, RA Tuty
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Handgrip strength is necessary for performing activities of daily living, which, in turn, are required to maintain functionalactivity. The purpose of this study was to determine anthropometric and personal factors that affect handgrip strength in groupsof nursing home and out patients of Sanglah Teaching Hospital Denpasar-Bali. Body weight and height, Waist Circumference(WC), Mid-Upper-Arm Circumference (MUAC) and triceps skinfold, scapula skinfold and supra iliaca skinfold were obtainedusing standard techniques. Body height was estimated from kneeheight. Handgrip was measured using a mechanical handgripdynamometer. A total of 38 male and 53 female aged 60 ? 82 years participated in the study. Both groups were statistically similarregarding all factors studied. Bivariate analyses showed that handgrip strength was associated with sex, age, WC, hemoglobin,albumin and body mass index in both of groups. Multiple linear regression analysis identified sex and WC (r = 0.39; p = 0.00),sex and age (r = 0.71; p = 0.00), as independent determinants of handgrip strength in both of groups. We conclude that womenhave a smaller handgrip strength than men. In addition, handgrip strength decreases with increasing age and decreasing WC.
Co-Authors Alvi Laili Zahra Anak Agung Mas Putrawati Triningrat Anak Agung Wiradewi Lestari Aryana, I Gust Putu Suka Astika, I Nyoman Desak Made Cittarasmi Saraswati Seputra Dian Pritasari Jeger Dwi Kristian Adi Putra I Gusti Agung Wilaja Putra I Gusti Putu Suka Aryana I Ketut Suastika I Made Jawi I Made Jawi I Nyoman Astika I Nyoman Wande I Nyoman Wande I Nyoman Wande I Putu Gede Adiatmika I. N. Astika I.D. G.A.E. Putra Ida Bagus Ngurah Rai K Andriyasa Mia Felina Prasetya N Astika N. K.S. Diniari Ni Ketut Rai Purnami Purnami, Ni Ketut Rai Putu Shely Prihastuti Rudy R. A.T. Kuswardhani Semaradana, Wayan Giri Putra Sri Kayati Widyastuti Tjokorda Gde Dharmayuda Wayan Giri Putra Wira Gotera Yosef Samon Sugi