Poster Session : PS 0297 ; Geriatrics : The Relationship of Metformin and Frailty Syndrome in Elderly with Type 2 Diabetes Mellitus

( Stevent Sumantri ),( Siti Setiati ),( Esthika Dewiasty ),( Dyah Purnamasari ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Type 2 diabetes (T2DM) was characterised with insulin resistance and defi ciency, furthermore with advancing age the was also an increase in insulin resistance. Clinical studies has proven that insulin resistance and T2DM increase the incidence of frailty syndrome in the elderly. Oral antidiabetics metformin was associated with the inhibition of aging process. Eventhough, there was no data that showed the relationship of metformin therapy to frailty syndrome. Methods: This was a case control study conducted in subjects =60 years old who visited the Geriatrics and Diabetes outpatient clinic of Cipto Mangunkusumo National Referral Hospital between March and June 2013. Diagnosis of frailty was established using the fi-40 item criteria. Statistical analysis was done with SPSS 20. 0, where chisquare method was used in bivariate and logistic regression method in multivariate analysis. Results: Frailty syndrome was found in 25% of subjects (n=59), with median age of 72 years old (SD 6. 27) and median of fi-40 item score was 0. 18 (SD 0. 085). Metformin was found to have a signifi cant relationship with frailty syndrome in the elderly diabetics, which retained signifi cant value after multivariate analysis (adjusted OR 0. 043; 95% CI 0. 019-0. 099; p<0. 001). Conclusions: Metformin was associated with independently lower risk of frailty syndrome in elderly diabetics.

Poster Session : PS 0298 ; Geriatrics : Diagnostic Test of Cardiovascular Health Study(CHS), Study of Osteoporotic Fracture (SOF) and Frailty Index- Comprehensive Geriatric Assessment (FI-CGA) Scoring System for the Diagnosis of Frailty Syndrome Compared

( Euphemia Seto ),( Siti Setiati ),( Purwita Wijaya Laksmi ),( Tirza Tamin ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Type 2 diabetes (T2DM) was characterised with insulin resistance and defi ciency, furthermore with advancing age the was also an increase in insulin resistance. Clinical studies has proven that insulin resistance and T2DM increase the incidence of frailty syndrome in the elderly. Oral antidiabetics metformin was associated with the inhibition of aging process. Eventhough, there was no data that showed the relationship of metformin therapy to frailty syndrome. Methods: This was a case control study conducted in subjects =60 years old who visited the Geriatrics and Diabetes outpatient clinic of Cipto Mangunkusumo National Referral Hospital between March and June 2013. Diagnosis of frailty was established using the fi-40 item criteria. Statistical analysis was done with SPSS 20. 0, where chisquare method was used in bivariate and logistic regression method in multivariate analysis. Results: Frailty syndrome was found in 25% of subjects (n=59), with median age of 72 years old (SD 6. 27) and median of fi-40 item score was 0. 18 (SD 0. 085). Metformin was found to have a signifi cant relationship with frailty syndrome in the elderly diabetics, which retained signifi cant value after multivariate analysis (adjusted OR 0. 043; 95% CI 0. 019-0. 099; p<0. 001). Conclusions: Metformin was associated with independently lower risk of frailty syndrome in elderly diabetics.

Free Paper Session : Upper Gastrointestinal Tract 1 ; Symptomatic Improvement Of Dyspepsia After Helicobacter Pylori (H. Pylori) Eradication

( Khaira Utia ),( Ari Fahrial Syam ),( Marcellus Simadibrata ),( Siti Setiati ),( Chudahman Manan ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: In most studies eradication of H. pylori has resolved the symptoms of dyspepsia in patient with or without peptic ulcer. But the symptomatic improvement of dyspepsia after eradication treatment remains unclear. The aim of this study was to find symptom characteristics of dyspepsia after eradication treatment of H. pylori and to see the association between symptom of dyspepsia and H. pylori findings. Methods: This was the cross sectional study in H. pylori patients with history of dyspepsia that had been administered eradication treatment of H. pylori for 1 week in 5 years period (2002-2007). Patients were invited to be interviewed about current symptoms of dyspepsia and then underwent urea breath test (UBT) examination to identify H. pylori. Global overall symptom of dyspepsia scale was used to assess the symptoms of dyspepsia. Results: There were 22 patients (13 male and 9 female) fulfilled the eligibility criteria for this study, 36.4% patients with eradication treatment history less than 1 year, and 63.6% patients more than 1 year. The symptoms of dyspepsia, the symptoms of dyspepsia were evaluated and as much as 77.3% (17/22) of patients, the symptoms of dyspepsia were subsided, and 22.7% (5/22) of patients with persistent symptoms after eradication. After eradication treatment, 72.7% (16/22) of patients appeared with negative Helicobacter pylori finding, and 27.3% (6/22) of patients remains positive. In negative group, 75% (12/16) of patients had relieved symptoms, and 25% (4/16) of patients with persistent symptom, and in positive group, as much as 83.8% (5/6) of patients the symptoms were relieved, and 16.7% (1/6) of patient remains persistent. We didn`t find any significant association between symptoms of dyspepsia and Helicobacter pylori status (p-0.581). Conclusions: In majority of patients, symptoms of dyspepsia after eradication treatment were resolved, but no significant association between symptoms of dyspepsia and Helicobacter pylori status.

Analyze, design, develop, implement, and evaluate approach to develop a pelvic floor muscle training guidebook to treat stress urinary incontinence in women

Surahman Hakim,Budi Iman Santoso,Harrina Erlianti Rahardjo,Siti Setiati,Widjajalaksmi Kusumaningsih,Erwinanto,Joedo Prihartono,Nurhadi Ibrahim,Wresti Indriatmi 대한산부인과학회 2024 Obstetrics & Gynecology Science Vol.67 No.3

Objective Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. Methods A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. Results The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. Conclusion The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.

Retraction: Denosumab’s Therapeutic Effect for Future Osteosarcopenia Therapy: A Systematic Review and Meta-Analysis

I Gusti Putu Suka Aryana,Sandra Surya Rini,Siti Setiati 대한노인병학회 2023 Annals of geriatric medicine and research Vol.27 No.4

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Denosumab's Therapeutic Effect for Future Osteosarcopenia Therapy : A Systematic Review and Meta-Analysis

I Gusti Putu Suka Aryana,Sandra Surya Rini,Siti Setiati 대한노인병학회 2023 Annals of geriatric medicine and research Vol.27 No.1

Background: Osteosarcopenia, a combination of osteopenia/osteoporosis and sarcopenia, is a common condition among older adults. While numerous studies and meta-analyses have been conducted on the treatment of osteoporosis, the pharmacological treatment of osteosarcopenia still lacks evidence. Denosumab, a human monoclonal antibody, has shown encouraging results for the treatment of osteosarcopenia. Our systematic review and meta-analysis aimed to investigate the potential dual role of denosumab as an anti-resorptive agent and for other beneficial muscle-related effects in patients with osteosarcopenia, and to evaluate whether denosumab can be a treatment of choice compared to bisphosphonate. Methods: Relevant literature was collated from the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Google Scholar databases. The primary outcome was denosumab’s effect on lumbar spine bone mineral density (LS BMD), handgrip strength, and gait speed change. The secondary outcome was the effect of denosumab on appendicular lean mass (ALM). The outcomes were presented as mean difference (MD). A random effects model was used in the analysis to represent the population. The risk of bias was assessed using funnel plots. Results: Out of the 3,074 studies found, four full-text studies met the inclusion criteria, including 264 and 244 participants in the intervention and control groups, respectively. Regarding a primary outcome, our meta-analysis showed that denosumab showed no significant differences in LS BMD and gait speed changes compared to other agents—MD=0.37, 95% confidence interval (CI), -0.35 to 0.79; p=0.09 and MD=0.11; 95% CI, -0.18 to 0.40; p=0.46, respectively. Denosumab had a significant effect on handgrip strength change compared to standard agents—MD=5.16; 95% CI, 1.38 to 18.94; p=0.007, based on the random effects model. Conclusions: Denosumab was better than bisphosphonate and placebo in improving muscle strength (handgrip strength). Therefore, denosumab may be favored in individuals with osteosarcopenia to improve muscular performance and reduce fall risk.

Convalescent Plasma in Older Adults with COVID-19: A Systematic Review and Meta-Analysis

I Gusti Putu Suka Aryana,Dian Daniella,Ivana Beatrice Paulus,Sandra Surya Rini,Siti Setiati 대한노인병학회 2022 Annals of geriatric medicine and research Vol.26 No.3

Background: Among all patients infected with coronavirus disease 2019 (COVID-19), the older adult population was the most affected, with 80%–90% of fatalities occurring in this group. The effectiveness of convalescent plasma (CP) in older adults is considerably more restricted than that in adults, resulting in a demand for data on the efficacy of therapeutic CP in older adults. This meta-analysis of updated literature examined the effect of CP in older adults with COVID-19. Methods: Relevant literature was identified from studies indexed in the Cochrane, PubMed, and Google Scholar databases between December 2019 and April 2022. The primary outcome was all-cause mortality. Risk estimates were pooled using a random-effects model. The risk of bias was assessed by regression-based Egger test using the relative risk (RR) and upper and lower confidence intervals (CIs) of the three included studies. Results: Among 377 studies identified, three full-text studies that included 1,038 patients met the inclusion criteria. The results of our meta-analysis showed that CP administration lowered the mortality risk in older adults with COVID-19 (RR=0.47; 95% CI, 0.26–0.86; p=0.01; I2=0%, p<0.81). CP therapy was more useful if delivered early in the course of the disease (within 72 hours of onset) and in less severe stages of the disease. Mortality tended to be lower in the high-titer group. Conclusions: CP treatment was significantly associated with a lower risk of mortality in older adults with COVID-19 than in patients not administered CP. The timing of CP administration is critical since earlier treatment after disease onset was associated with a better prognosis.