<p><strong>Pendahuluan: </strong>Disfagia atau kondisi kesulitan menelan makanan dari rongga mulut ke lambung merupakan salah satu komplikasi dari stroke. Disfagia merupakan komplikasi yang sangat mempengaruhi luaran klinis pasien stroke. Adanya kesulitan menelan akan memperumit kondisi neurologis pasien stroke. Manajemen disfagia merupakan hal yang sangat penting untuk dipahami oleh tenaga kesehatan sehingga dapat meningkatkan kualitas hidup pasien.</p><p><strong>Metode: </strong>Pelatihan manajemen disfagia dilakukan dengan metode presentasi yang dilanjutkan dengan sesi diskusi bersama pemateri. Untuk menilai pengetahuan peserta mengenai manajemen disfagia, peserta menjalani <em>pretest </em>dan <em>posttest</em>. Hasil <em>pretest</em> dan <em>posttest</em> kemudian dibandingkan dengan uji T-berpasangan untuk mengetahui efektivitas pelatihan terhadap pengetahuan tenaga kesehatan mengenai manajemen disfagia pasca stroke</p><p><strong>Hasil dan pembahasan: </strong>Pelatihan ini diikuti oleh 72 orang tenaga kesehatan di RSUD Dr Moewardi yang terdiri dari 27 (37.5%) orang perawat, 22 (30.5%) orang dietisien, dan 23 (32.0%) orang fisioterapis. Hasil uji korelasi menunjukkan perbedaan yang signifikan antara nilai <em>pretest</em> dan <em>posttest</em> perawat (r=0.812, p=0.021), nutrisionis (r=0.792, p=0.038), dan fisioterapis (r=0.649, p=0.002)</p><p><strong>Kesimpulan: </strong>Terdapat peningkatan pengetahuan tentang manajemen disfagia pada tenaga kesehatan di RSUD Dr. Moewardi.</p><p><strong>Kata Kunci: disfagia, stroke, tenaga kesehatan, pelatihan</strong></p>
Case Report: A 50-year-old man was referred to Dr. Moewardi General Hospital with history of right chest pain that radiate to the right back and hand for 2 months. His complaint did not improve with medication and physical therapy. On physical examination we observed multiple nodules on the right axilla, scapula, and colli region. Neurological examination revealed right sided partial ptosis, anisocoria, ipsilateral weakness, and ipsilateral allodynia, and anhidrosis T1 dermatome. CT-scan showed a right lung mass in the superior lobe of the apical segment. The diagnosis of Horner syndrome is then established caused by multiple lymphadenopathies. His symptoms then relieved after lymphadenectomy. Conclusion: Horner syndrome, characterized by ipsilateral pupillary anisocoria, ptosis and anhidrosis, is one of the complications of Pancoast tumor invasion to the sympathetic nervous system in the C8, T1, and T2 nerve territory.
<p>Kegiatan ini bertujuan untuk untuk meningkatkan pengetahuan dan kesadaran para tenaga kesehatan di fasilitas kesehatan tingkat pertama (FKTP) tentang pentingnya cara pengisian kedua instrumen tersebut dalam rangka deteksi dini demensia Alzheimer. Kegiatan ini juga bertujuan mengarahkan para tenaga kesehatan di FKTP untuk melakukan skrining pada pasien yang memiliki faktor risiko mengalami demensia Alzheimer sehingga tatalaksana dini yang lebih baik dapat diterapkan pada penderita demensia Alzheimer yang tentunya dapat meningkatkan kualitas hidup pasien tersebut. Target yang dicapai adalah peningkatan pemahaman dan informasi terkait cara pengisian MMSE dan AD8 dan manfaat skrining demensia Alzheimer. Metode pelaksanaan kegiatan pemberdayaan dan pengabdian masyarakat pada mitra berupa pemetaan demografi tenaga kesehatan FKTP potensial yang dilanjutkan dengan koordinasi dan kolaborasi dengan bagian Diklit RSUD Dr. Moewardi Surakarta untuk promosi dan pelaksanaan pelatihan daring. Selanjutnya, peneliti melakukan pelatihan dengan cara menjelaskan cara pengisian MMSE dan AD8 serta manfaat skrining demensia Alzheimer, simulasi interaktif cara pengisian MMSE dan AD8 dengan probandus, diskusi dan tanya jawab, serta evaluasi. Hasil pengabdian ini menunjukkan bahwa para tenaga kesehatan memiliki pemahaman yang meningkat dibandingkan sebelum pelatihan tentang cara dan manfaat pengisian MMSE dan AD8 dalam skrining demensia Alzheimer, sehingga meningkatkan kesadaran para tenaga kesehatan di FKTP akan dampak buruk peningkatan kejadian demensia Alzheimer yang dapat timbul akibat keterlambatan diagnosis.</p><p> </p><p><strong>Kata kunci</strong>: demensia Alzheimer; pelatihan; tenaga kesehatan; MMSE; AD8</p>
Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine associated with insulin resistance (IR), obesity, and inflammation. Serum vaspin role and significant alteration in its levels in type 2 diabetes mellitus (T2DM) and atherosclerotic disease have been severally reported. Nevertheless, these immense changes and this role have been studied, and different results were observed across several atherosclerosis and glucose tolerance disordersassociated studies due to differences in design, sample size and baseline parameters, and population race. Hence, we performed a systematic review to establish and summarize the latest results of serum vaspin level alteration and its role in atherosclerosis and glucose tolerance disorders. The studies from databases such as PubMed, ScienceDirect, Scopus, and Google Scholar were employed. The keywords included vaspin, atherosclerosis, coronary heart disease, ischemic heart disease, stroke, insulin, diabetes, glucose intolerance, metabolic syndrome, and obesity. Boolean Logic "AND" was used to combine each keyword and specify the results. Twenty-three articles were selected based on the suitability of their title/abstract and the inclusion criteria for this review topic. Two review authors independently evaluated the risk of bias based on the Cochrane risk of bias tool. Furthermore, we used RevMan 5.3 to present and synthesize the results. Critical appraisal of each obtained article showed that high vaspin levels were associated with a lower risk of atherosclerosis. Meanwhile, 10 articles about vaspin and glucose tolerance disorders showed that high vaspin levels were associated with a higher risk of developing T2DM. Meta-analysis showed atherosclerotic diseases and glucose tolerance disorders versus normal healthy (MD −0.43; 95% CI: −1.35 to 0.50 and MD −0.07; 95% CI: −0.38 to 0.25, respectively), which indicated higher vaspin levels in the disease group were favored. High serum vaspin levels in arterial plaque diseases were considered a protective mechanism to prevent further endothelial inflammation, injury, and atherosclerosis. This similar observation was found in obesity or T2DM patients as a compensatory mechanism for IR conditions.
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