Laurentius Aswin Pramono
Peserta Program Magister Epidemiologi Fakultas Kesehatan Masyarakat Universitas Indonesia

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Paradigm on Chronic Constipation: Pathophysiology, Diagnostic, and Recent Therapy Pramono, Laurentius Aswin; Fauzi, Ahmad; Syam, Ari Fahrial; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

ABSTRACTChronic constipation is a medical gastrointestinal problem which can degrade patient’s quality of life. So far, the shifting pathophysiologic mechanism to colonic neuropathology has not been supported by diagnostic facility and therapy. Target therapy for chronic constipation related to enteric nervous system is still limited to study. Currently, the discovery of neurotrophin-3 has not shown any significant development needed in daily clinical practice. Until now study related to endoscopic full-thickness biopsy has not been done in human and waiting for its applications in daily practice. Targeted therapy for chronic constipation which is related to enteric nervous system is still limited to study. The discovery of neurotrophin-3, although currently on clinical trial phase II, still not showing any significant contribution in daily clinical practice. New pathophysiologic mechanism shifting the ‘idiopathic’ paradigm or ‘functional’ to colonic neuropathology has not been met with diagnostic modalities and therapy based on this knowledge. Study regarding endoscopic full-thickness biopsy to help revealing this novel mechanism has not been done in human. Henceforth, until now applied studies pertinent to this subject are longing in order for enteric neuron etiology can be firmly established Thus, in the future, translational study is demandingly needed for a firm establishment of diagnostic and therapeutic modalities to its currently evolving pathophysiology.  Keywords: chronic constipation, colon, enteric nervous system, neurotophin-3
Permasalahan Lanjut Usia di Daerah Perdesaan Terpencil Pramono, Laurentius Aswin; Fanumbi, Cornellesi
Jurnal Kesehatan Masyarakat Nasional Vol. 6 No. 5 April 2012
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (298.594 KB) | DOI: 10.21109/kesmas.v6i5.85

Abstract

Dalam kurun waktu 35 tahun sejak tahun 1990, jumlah lanjut usia (lansia) di Indonesia meningkat 414% dan akan berada pada peringkat kelima negara dengan lansia terbesar pada tahun 2025. Seperti umumnya di negara berkembang, lebih dari dua per tiga lansia hidup di wilayah perdesaan terpencil. Penelitian ini bertujuan untuk mendeskripsikan dan membahas berbagai masalah gangguan kesehatan, sosial budaya, pelayanan, dan program-program kesehatan lansia di Kepulauan Tanimbar Provinsi Maluku. Penelitian dengan metode kualitatif melalui observasi, partisipasi, dan wawancara terhadap 30 lansia di dua wilayah semiurban dan 6 wilayah perdesaan terpencil di kepulauan Tanimbar Provinsi Maluku pada bulan April-Juni 2010. Pengumpulan data, diskusi, dan wawancara dilakukan terhadap pemegang program lansia di dinas kesehatan dan puskesmas. Gangguan kesehatan yang banyak dialami lansia adalah artralgia genu, gastritis kronis, nyeri pinggang bawah, katarak, hipertensi, dan diabetes melitus. Masalah sosial budaya akibat urbanisasi membuat para lansia ting- gal sendiri tanpa perawatan anak atau cucu. Pelayanan kesehatan terlihat belum optimal, sarana/prasarana terbatas, aspek promosi kesehatan terabaikan, serta tenaga kesehatan yang memperhatikan kesehatan lansia masih kurang. Pos pelayanan terpadu (posyandu) lansia belum efektif, informasi minimal, kader belum optimal menunjang kebutuhan lansia. Ke de- pan, perlu memperkuat sistem pelayanan kesehatan lansia; peningkatan perhatian dan kemitraan dengan lembaga eksekutif dan legislatif; serta melakukan inovasi strategi pendidikan, pelayanan, dan penelitian di bidang kesehatan lansia di daerah terpencil dan perdesaan Indonesia.Kata kunci: Kesehatan, lanjut usia, perdesaanAbstractIndonesia is a country with the highest increase numbers of elderly in the world. In the range 35 years since 1990, the increase number of the elder- ly will be 414% that will set Indonesia in the fifth rank of the highest elderly in the world by the year of 2025. In most developing countries on the world, more than two third elderly live in remote and rural area. The aim of this study is to descript and discuss statistic data, health, health services, and programs for elderly in remote and rural Indonesia represented by Tanimbar Islands Maluku Province. The study use qualitative method by observation, participation, and interview with 30 elderly from 2 semiurban and 6 rural area in remote, rural, new developing administration district, and outer is lands of Republic Indonesia, Tanimbar Islands, Maluku Province in April to June 2010. We also interview and discuss elderly problems with elderly section program in health department West-Southeast Maluku region and el- derly program personnel in public health center. From the study, we found major health problems of the elderly in Tanimbar are genus artralgia, chronic gastritis, lower back pain, cataract, hypertension, and diabetes mellitus. Social and culture problems are urbanization which make elderly living alone. Integrated service section for elderly aren’t effective, minimal infor- mation, and the human resources aren’t optimal enough to support elderly needs. In the future, we must strengthen our health services system for elderly; expands the concern and networking with executive and legislative board; do education, service, and research innovations and strategies in the field of elderly health in remote rural Indonesia.Key words: Health, elderly, rural areas
Gangguan Akibat Kekurangan Iodium di Indonesia: Tinjauan Epidemiologis dan Kebijakan Kesehatan Pramono, Laurentius Aswin
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 2 Oktober 2009
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (221.368 KB) | DOI: 10.21109/kesmas.v4i2.190

Abstract

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Padamasa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi ter-hadap permasalahan GAKI di Indonesia masih rendah. Demikian pula, publikasi ilmiah yang mengkaji GAKI dari sudut pandang epidemiologi dan aplikasinya bagi kebijakan kesehatan. Artikel ini diharapkan dapat memberi gambaran dan perspektif epidemiologi yang luas bagi para klinisi dan ahli kesehatan masyarakat.Kata kunci: GAKI (Gangguan Akibat Kekurangan Iodium), penanggulangan, epidemiologi, kebijakan kesehatan.AbstractIDD (Iodine Deficiency Disorders) is the most common cause of preventable mental retardation in the world. Nowadays, IDD still one of the most important public health problems in Indonesia. Up to now, Indonesia has not yet reached the target of IDD elimination as expected. National IDD Survey at 2003 and National Health Survey at 2007 show the achievement of IDD control program in Indonesia is still below the target of Universal Salt Idozation and Indonesia Health 2010 (RAN KPP GAKI strategy). Cross-sectoral commitment is very important for the elimination of IDD in the future. Clinicians and epidemiologist concern for IDD elimination in Indonesia is still low, so does the publications in the field of IDD from epidemiology and health policy perspective. It is expec-ted that this literature review can give broad description and epidemiological perspective for clinicians and public health experts. Key words: IDD (Iodine Deficiency Disorders), control program, epidemiology, health policy.
Paradigm on Chronic Constipation: Pathophysiology, Diagnostic, and Recent Therapy Pramono, Laurentius Aswin; Fauzi, Ahmad; Syam, Ari Fahrial; Makmun, Dadang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/1332012174-180

Abstract

ABSTRACTChronic constipation is a medical gastrointestinal problem which can degrade patient’s quality of life. So far, the shifting pathophysiologic mechanism to colonic neuropathology has not been supported by diagnostic facility and therapy. Target therapy for chronic constipation related to enteric nervous system is still limited to study. Currently, the discovery of neurotrophin-3 has not shown any significant development needed in daily clinical practice. Until now study related to endoscopic full-thickness biopsy has not been done in human and waiting for its applications in daily practice. Targeted therapy for chronic constipation which is related to enteric nervous system is still limited to study. The discovery of neurotrophin-3, although currently on clinical trial phase II, still not showing any significant contribution in daily clinical practice. New pathophysiologic mechanism shifting the ‘idiopathic’ paradigm or ‘functional’ to colonic neuropathology has not been met with diagnostic modalities and therapy based on this knowledge. Study regarding endoscopic full-thickness biopsy to help revealing this novel mechanism has not been done in human. Henceforth, until now applied studies pertinent to this subject are longing in order for enteric neuron etiology can be firmly established Thus, in the future, translational study is demandingly needed for a firm establishment of diagnostic and therapeutic modalities to its currently evolving pathophysiology.  Keywords: chronic constipation, colon, enteric nervous system, neurotophin-3
Gangguan Akibat Kekurangan Iodium di Indonesia: Tinjauan Epidemiologis dan Kebijakan Kesehatan Pramono, Laurentius Aswin
Jurnal Kesehatan Masyarakat Nasional Vol. 4 No. 2 Oktober 2009
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (221.368 KB) | DOI: 10.21109/kesmas.v4i2.190

Abstract

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Padamasa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi ter-hadap permasalahan GAKI di Indonesia masih rendah. Demikian pula, publikasi ilmiah yang mengkaji GAKI dari sudut pandang epidemiologi dan aplikasinya bagi kebijakan kesehatan. Artikel ini diharapkan dapat memberi gambaran dan perspektif epidemiologi yang luas bagi para klinisi dan ahli kesehatan masyarakat.Kata kunci: GAKI (Gangguan Akibat Kekurangan Iodium), penanggulangan, epidemiologi, kebijakan kesehatan.AbstractIDD (Iodine Deficiency Disorders) is the most common cause of preventable mental retardation in the world. Nowadays, IDD still one of the most important public health problems in Indonesia. Up to now, Indonesia has not yet reached the target of IDD elimination as expected. National IDD Survey at 2003 and National Health Survey at 2007 show the achievement of IDD control program in Indonesia is still below the target of Universal Salt Idozation and Indonesia Health 2010 (RAN KPP GAKI strategy). Cross-sectoral commitment is very important for the elimination of IDD in the future. Clinicians and epidemiologist concern for IDD elimination in Indonesia is still low, so does the publications in the field of IDD from epidemiology and health policy perspective. It is expec-ted that this literature review can give broad description and epidemiological perspective for clinicians and public health experts. Key words: IDD (Iodine Deficiency Disorders), control program, epidemiology, health policy.
Permasalahan Lanjut Usia di Daerah Perdesaan Terpencil Pramono, Laurentius Aswin; Fanumbi, Cornellesi
Jurnal Kesehatan Masyarakat Nasional Vol. 6 No. 5 April 2012
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (298.594 KB) | DOI: 10.21109/kesmas.v6i5.85

Abstract

Dalam kurun waktu 35 tahun sejak tahun 1990, jumlah lanjut usia (lansia) di Indonesia meningkat 414% dan akan berada pada peringkat kelima negara dengan lansia terbesar pada tahun 2025. Seperti umumnya di negara berkembang, lebih dari dua per tiga lansia hidup di wilayah perdesaan terpencil. Penelitian ini bertujuan untuk mendeskripsikan dan membahas berbagai masalah gangguan kesehatan, sosial budaya, pelayanan, dan program-program kesehatan lansia di Kepulauan Tanimbar Provinsi Maluku. Penelitian dengan metode kualitatif melalui observasi, partisipasi, dan wawancara terhadap 30 lansia di dua wilayah semiurban dan 6 wilayah perdesaan terpencil di kepulauan Tanimbar Provinsi Maluku pada bulan April-Juni 2010. Pengumpulan data, diskusi, dan wawancara dilakukan terhadap pemegang program lansia di dinas kesehatan dan puskesmas. Gangguan kesehatan yang banyak dialami lansia adalah artralgia genu, gastritis kronis, nyeri pinggang bawah, katarak, hipertensi, dan diabetes melitus. Masalah sosial budaya akibat urbanisasi membuat para lansia ting- gal sendiri tanpa perawatan anak atau cucu. Pelayanan kesehatan terlihat belum optimal, sarana/prasarana terbatas, aspek promosi kesehatan terabaikan, serta tenaga kesehatan yang memperhatikan kesehatan lansia masih kurang. Pos pelayanan terpadu (posyandu) lansia belum efektif, informasi minimal, kader belum optimal menunjang kebutuhan lansia. Ke de- pan, perlu memperkuat sistem pelayanan kesehatan lansia; peningkatan perhatian dan kemitraan dengan lembaga eksekutif dan legislatif; serta melakukan inovasi strategi pendidikan, pelayanan, dan penelitian di bidang kesehatan lansia di daerah terpencil dan perdesaan Indonesia.Kata kunci: Kesehatan, lanjut usia, perdesaanAbstractIndonesia is a country with the highest increase numbers of elderly in the world. In the range 35 years since 1990, the increase number of the elder- ly will be 414% that will set Indonesia in the fifth rank of the highest elderly in the world by the year of 2025. In most developing countries on the world, more than two third elderly live in remote and rural area. The aim of this study is to descript and discuss statistic data, health, health services, and programs for elderly in remote and rural Indonesia represented by Tanimbar Islands Maluku Province. The study use qualitative method by observation, participation, and interview with 30 elderly from 2 semiurban and 6 rural area in remote, rural, new developing administration district, and outer is lands of Republic Indonesia, Tanimbar Islands, Maluku Province in April to June 2010. We also interview and discuss elderly problems with elderly section program in health department West-Southeast Maluku region and el- derly program personnel in public health center. From the study, we found major health problems of the elderly in Tanimbar are genus artralgia, chronic gastritis, lower back pain, cataract, hypertension, and diabetes mellitus. Social and culture problems are urbanization which make elderly living alone. Integrated service section for elderly aren’t effective, minimal infor- mation, and the human resources aren’t optimal enough to support elderly needs. In the future, we must strengthen our health services system for elderly; expands the concern and networking with executive and legislative board; do education, service, and research innovations and strategies in the field of elderly health in remote rural Indonesia.Key words: Health, elderly, rural areas