The relationship between System of classification, Selection of symbols, And system of prohibitions.

Key words: System of classification, Selection of Symbols, System of Prohibitions

ANALISIS PENGARUH KEKUATAN TARIK DAN IMPACT PADA KOMPOSIT DENGAN PENGUAT SERAT SISAL (AGAVE SISALANA) DAN POLYESTER PADA FRAKSI VOLUME 35%, 45%, 55%

Pemanfaatan material komposit pada saat ini semakin berkembang, seiring dengan meningkatnya penggunaan bahan tersebut. Pemanfaatan material komposit tersebut juga meluas mulai dari yang sederhana seperti alat-alat rumah tangga sampai sektor industri. Serat daun sisal yang dikombinasikan dengan polyester sebagai matrik dapat menghasilkan komposit alternatif. Penelitian ini bertujuan untuk mengetahui kekuatan tarik dan kekuatan impact komposit serat sisal (agave sisalana) dengan menggunakan model serat secara acak (random) dengan variasi fraksi volume serat (35%, 45%, 55%). Dari hasil penelitian diperoleh komposit yang memiliki kekuatan tarik tertinggi pada fraksi volume serat 55% dan matriks 45% sebesar 861,31 N/mm 2 dengan nilai regangan sebesar 7,25%. sedangkan nilai yang terendah pada fraksi volume serat 45% dan matrik 55% sebesar 722,36 N/mm 2 . Komposit yang memiliki energi dan harga impact rata-rata yang tertinggi adalah fraksi volume serat 55% dan matrik 45% yaitu 1,2521 Joule dan harga impact 0,0125 J/mm 2 sedangkan yang terendah adalah fraksi volume serat 35% dan matrik 65% yang mempunyai energi rata-rata sebesar 1,0767 Joule dan harga impact ratarata 0,0107 J/mm². Hal ini dapat disimpulkan bahwa penambahan fraksi volume serat tidak selalu berpengaruh pada kekuatan tarik dan kekuatan impact karena serat daun sisal memiliki gelembung udara (void)

The Effect of Disease Duration on the Incidence of Peripheral Arterial Disease in Young Adults with Systemic Lupus Erythematosus

Background: Peripheral arterial disease is a chronic complication that affects morbidity and mortality in SLE patient. However, there were only a few of researches studying the relationship of disease duration and peripheral arterial disease event overseas and it hasnever been studied in Indonesia.Objectives: To obtain information about the increased event of peripheral arterial disease in women of 40 years old or younger with SLE's duration of five years or longer compared with less than five years.Methods: This was a case control study conducted between June - August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subjects were women of 40 years old or younger with SLE who visited Rheumatolgy and Allergy-Immunlogy outpatient clinic. They were assignedto case and control groups and traced retrospectively using interview and medical record. The relationship between disease duration and peripheral arterial disease was estimated using OR and the role of confounding factors was analysed using logistic regression one byone, resulted in fully adjusted OR.Results: A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group.Traditional risk factors were similiar in both groups. In multivariat analysis, there was a relationship between disease duration 5 years or longer and peripheral arterialdisease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy were the confounding factors.Conclusion: There was an increased event of peripheral arterial disease in women of 40 years old or younger with SLE's duration five years or longer compared withsubjects having the disease duration less than five years, but this increase was not statistically significant

Recurrent Bilateral Staghorn Stones as a Manifestation of Primary Hyperparathyroidism due to Parathyroid Adenoma

Primary hyperparathyroidism is a medical condition caused by overactive of parathyroid gland. It is most commonly caused by solitary adenoma of the parathyroid gland. Other causes of this condition are hyperplasia, multiple adenomas, and parathyroid cancer. Primary hyperparathyroidism has some metabolic consequences in the calcium metabolism. Hypercalcemia in patient with primary hyperparathyroidism will resulted to the most important comorbidity that is chronic deposition of calcium in the kidney forming nephrolithiasis or other urolithiasis. It is not uncommon, patient with parathyroid adenoma come to health care professionals with the chief complain of recurrence nephrolithiasis

The effect of disease duration on the incidence of peripheral arterial disease in young adults with systemic lupus erythematosus

Background: Peripheral arterial disease is a chronic complication that affects morbidity and mortality in SLE patient. However, there were only a few of researches studying the relationship of disease duration and  peripheral arterial disease event overseas and it hasnever been studied in Indonesia.Objectives: To obtain information about the increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration of five years or longer compared with less than five years.Methods: This was a case control study conducted between June - August 2012 at Cipto Mangunkusumo hospital, Jakarta. Subjects were women of 40 years old or younger with SLE who visited Rheumatolgy and Allergy-Immunlogy outpatient clinic. They were assignedto case and control groups and traced retrospectively using interview and medical record. The relationship between disease duration and peripheral arterial disease was estimated using OR and the role of confounding factors was analysed using logistic regression one byone, resulted in fully adjusted OR.Results: A total of 90 subjects were recruited, 18 subjects in case group and 72 subjects in control group.Traditional risk factors were similiar in both groups. In multivariat analysis, there was a relationship between disease duration 5 years or longer and peripheral arterialdisease with fully adjusted OR 1,9 (95%CI 0,575-6,543). Older age and steroid therapy were the confounding factors.Conclusion: There was an increased event of peripheral arterial disease in women of 40 years old or younger with SLE’s duration five years or longer compared withsubjects having the disease duration less than five years, but this increase was not statistically significant.Keywords: Peripheral arterial disease, lupus erythematosus systemic, disease duratio

Profil Pasien Kaki Diabetes yang Menjalani Reamputasi di Rumah Sakit Cipto Mangunkusumo Tahun 2008 -2012

Pendahuluan. Prevalensi diabetes global diprediksi akan meningkat sebesar dua kali lipat pada tahun 2030 dari 2,8% menjadi 4,4% (berkisar 366 juta) dengan angka komplikasi kaki diabetes berkisar 10%. Ulkus diabetes dan amputasi ekstremitas bawah merupakan komplikasi diabetes yang akan meningkatkan mortalitas dan morbiditas Setelah lima tahun amputasi pertama, 28-51% pasien akan menjalani amputasi kedua. Penelitian ini dilakukan untuk mengetahui proporsi dan profil pasien yang mengalami reamputasi di Rumah Sakit Cipto Mangunkusumo tahun 2008-2012. Metode. Disain studi ini adalah potong lintang dengan 80 subjek pasien kaki diabetes yang dirawat di RSCM tahun 2008 sampai 2012. Dilakukan pencatatan data yang didapat dari rekam medik berupa data demografis (jenis kelamin, rerata usia, pendidikan, pekerjaan, pembiayaan) dan klinis (rerata lama diabetes, hipertensi, merokok, neuropati, Peripheral Artery Disease (PAD), anemia, komorbid dan gagal ginjal kronik). Hasil. Angka amputasi pada kaki diabetes dari tahun 2008-2012 sebanyak 128 subjek (20,3%) pasien dan dari 128 subjek terdapat 80 subjek yang statusnya lengkap dan yang menjalani reamputasi sebanyak 47 subjek (58,7%). Subjek yang menjalani reamputasi lebih sering pada perempuan sebanyak 25 orang (53,2%), dengan rerata usia 58,2 tahun, memiliki pendidikan SMA kebawah 97,8%, menggunakan biaya gakin (72,6%). Lama menderita DM rata-rata 7 tahun, kadar HbA1C ≥ 7% sebesar 46,8%, hipertensi pada 63,8% subyek, merokok sebanyak 14 orang (29,7%), neuropati sebanyak 41 orang (87,2%), PAD sebesar 27,6%,, anemia sebanyak 46 orang (97,8%), kadar albumin rerata 2,5 gr/dl dan terdapat 19 orang (40,45%) dengan eGFR<60 dan proteinuria sebanyak 19 orang (40,4%). Komorbid yang ada pada subjek yang menjalani reamputasi adalah pneumonia (34%), penyakit arteri koroner (21,2%), penyakit ginjal kronik (17%), stroke (10,6%), keganasan (8,6%) dan gagal jantung kongestif (8,6%) Simpulan. Proporsi reamputasi pada kaki diabetes di RSCM tahun 2008 – 2012 sebesar 58,7%. Angka reamputasi pada kaki diabetes lebih tinggi pada perempuan, usia lebih lanjut, pendidikan SMA kebawah, menggunakan biaya umum dan gakin, kadar HbA1C ≥ 7%, hipertensi, neuropati, PAD, anemia, kadar albumin rendah, dengan eGFR<60 dan proteinuri dan komorbid yang lebih banya

Practical Guidelines Management of Graves Ophthalmopathy

Graves’ ophthalmopathy is the most common extra-thyroid manifestation in patients with Graves’ disease, based on inflammatory and autoimmune conditions in orbital tissue. This practical guideline was formed by a multidiciplinary team, and is intended to provide guidance for diagnosis and management of Graves’ ophthalmopathy in daily clinical practice to improve quality of care and treatment outcome

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment

Background High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods We used data for exposure to risk factors by country, age group, and sex from pooled analyses of populationbased health surveys. We obtained relative risks for the eff ects of risk factors on cause-specifi c mortality from metaanalyses of large prospective studies. We calculated the population attributable fractions for- each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the eff ects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specifi c population attributable fractions by the number of disease-specifi c deaths. We obtained cause-specifi c mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the fi nal estimates. Findings In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10\ub78 million deaths, 95% CI 10\ub71\u201311\ub75) of deaths from these diseases in 2010 were attributable to the combined eff ect of these four metabolic risk factors, compared with 67% (7\ub71 million deaths, 6\ub76\u20137\ub76) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined eff ects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing eff ect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the globalresponse to non-communicable diseases

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the combined effects of these four risk factors surpassed 925 deaths per 100 000 for men in Belarus, Kazakhstan, and Mongolia, but were less than 130 deaths per 100 000 for women and less than 200 for men in some high-income countries including Australia, Canada, France, Japan, the Netherlands, Singapore, South Korea, and Spain. Interpretation: The salient features of the cardiometabolic disease and risk factor epidemic at the beginning of the 21st century are high blood pressure and an increasing effect of obesity and diabetes. The mortality burden of cardiometabolic risk factors has shifted from high-income to low-income and middle-income countries. Lowering cardiometabolic risks through dietary, behavioural, and pharmacological interventions should be a part of the global response to non-communicable diseases. Funding: UK Medical Research Council, US National Institutes of Health. © 2014 Elsevier Ltd