2024-03-28T21:25:13Z
https://jurnal.ugm.ac.id/index/oai
oai:jurnal.ugm.ac.id:article/3845
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"140630 2014 eng "
2541-5441
2303-131X
dc
Ex vivo Generation of Platelets from Umbilical Cord Blood Hematopoietic Stem Cells with Amniotic Membrane Mesenchymal Stem Cells Support
Hardianti, Mardiah Suci
ABSTRACT
Background: Platelet refractoriness is a major problem among patients requiring repeated transfusion. Production of less immunogenic platelets is required to overcome this problem. Umbilical cord blood (UCB) is rich in hematopoietic stem cells (HSC), which may serve as a potential source of less immunogenic ex vivo generated platelet. Development of methods to generate platelet from HSC in UCB with additions of various growth factors made a very high production cost. Amniotic membrane is widely known as the best source of mesenchymal stem cells (MSC), which may support the growth of platelet from HSC in UCB due to its abundant productions of cytokines and low cost .
Aim: This study aimed to generate platelet from UCB co-cultured with MSC derived from amniotic membrane.
Methods: Gradient density separation was performed to obtain mononuclear cells from UCB. The resulted mononuclear (MN) cells were selected for CD34+ by magnetic sorter beads. CD34+ HSC and non-CD34+ MN cells were each cultured in standard medium plus 10 ng/ml thrombopoietin (TPO), 50 ng/ml stem cell factor (SCF), and 25 ng/ml interleukin-11 (IL-11), with or without co-cultured with MSC. The MSC was also cultured alone with the addition of the above mentioned cytokines. Cultures were incubated in 37o C with 5% CO2 and half of the medium was changed twice a week. Formations of platelets were confirmed by flowcytometry after two weeks culturing.
Results: Total number of CD34+ HSC was 1x106, the non-CD34+ MNC was 1.78x107 and the MSC was 3x105. Following the culture systems, the number of platelets produced from CD34+ HSC with and without MSC were 1.17% and 0.84%, respectively. The numbers of platelets produced from non-CD34+ MN cells with and without MSC were 7.94% and 8.85%, respectively. The number of platelets produced from 105 MSC was 1.43%.
Conclusions: There was a greater increment in ex vivo production of platelets in CD34+ HSC isolated from UCB co-cultured with MSC, compared to that of without MSC. Further study to evaluate the significancy of the increament and the platelet function produced by this system is warranted.
Keywords: platelet, hematopoietic stem cells, - mesenchymal stem cells
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
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https://jurnal.ugm.ac.id/jain/article/view/3845
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3846
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Mazayyanah, Siti
Background. Chronic complications of diabetes mellitus (DM) include microangiopathy and macroangiopathy. Microangiopathy includes retinopathy, nephropathy and neuropathy, while macroangiopathy includes coronary heart disease, stroke and peripheral arterial disease. When the diagnosis is established in Type 2 Diabetes Mellitus (DM), approximately 25% had suffered non‐proliferative diabetic retinopathy. Within one to three years of non-proliferative retinopathy progresses to proliferative diabetic retinopathy can eventually be leading to retinal detachment, glaucoma and blindness. Diabetic nephropathy occurs in 20‐40% of patients with diabetes mellitus. Diabetic nephropathy is the leading cause of End Stage Renal Disease (ESRD) and is a high risk of Cardiovascular Disease (CVD). Endothelial dysfunction underlies all of this. Markers of endothelial dysfunction endothelin‐1 are assessed in patients with type 2 diabetes with retinopathy or nephropathy and without retinopathy and nephropathy.
Aim of the study. The aim of the study is to show the differences between the level of Endothelin-1 on female patients Type-2 Diabetes Mellitus with retinopathy or nephropathy compared to those without retinopathy and nephropathy.
Method and subjects. This study uses a cross sectional design which was conducted on subjects from outpatient type 2 diabetes mellitus women with retinopathy or nephropathy compared without retinopathy and nephropathy at endocrinology clinic, Dr. Sardjito General Hospital, Yogyakarta. ELISA sandwich’s method was used to measure plasma levels of endothelin‐1 from veins blood. Differences between groups were compared by student’s unpaired t‐test and Mann‐Whitney test (significant when p<0.05). Diabetic retinopathy is enforced through inspection fundoscopy. Diabetic nephropathy is diagnosed by albumin creatinine ratio (ACR) ≥ 30ug/mg.
Result. The results showed that there were 52 female subjects with type 2 DM is composed of them 26 (50%) subjects with retinopathy or nephropathy and 26 (50%) subjects without retinopathy and nephropathy. Median age was 54 (44‐59) years. The mean level(s) of endothelin‐1 obtained (was higher) in women with type‐2 diabetes mellitus with retinopathy or nephropathy (was) 19,47 ± 9,94 ng / ml (and) (compared) with no retinopathy and nephropathy (was) 17,64 ± 11,63 ng / ml (with) (although the difference was not statistically significant) p = 0,944.
Conclusion. (Endothelin‐1 levels were higher in women with type‐2 diabetes mellitus with retinopathy or nephropathy than without retinopathy and nephropathy, but the difference was not statistically significant.) No significant difference in endothelin-1 level between type 2 diabetic female patients with and without microangiopathy complications).
Key words: endothelin‐1, diabetic retinopathy, diabetic nephropathy, type 2 diabetes mellitus.
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
https://jurnal.ugm.ac.id/jain/article/view/3846
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3847
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Rajendran, Puvaneswary
ABSTRACT
Background: High titer of rheumatoid factor (RF) in the serum of patients with rheumatoid arthritis (RA) is mostly associated with more severe disease and presence of extra-articular features. To choose the best treatment of RA need the combination of science and art.
Objective: the aim of the study was to find the comparison of pharmacological treatment patterns in rheumatoid arthritis patients according to the presence of rheumatoid factor in the serum.
Method: This study was a retrospective quantitative observational. The data was collected from medical records of new patients with rheumatoid arthritis who came to the appointment at Rheumatology Clinic Dr. Sardjito Hospital, Yogyakarta in 2010.
Results: The total of 39 new patients was eligible in this study. A corticosteroid was the most commonly prescribed (93% of the sero-positive and 84% of the sero-negative patients). Disease modifying anti rheumatic drugs (DMARDs) were used in 92% sero-positive and 84% sero-negative patients (p=0.827; df=6). In choosing the DMARDs, Chloroquine was the most commonly prescribed (29% of sero-positive and 44% of sero-negative patients), followed by methotrexate (21% of sero-positive and 24% of sero-negative) and suphasalazine (21% of sero-positive and 0% of sero-negative). Leflunomide, doxycycline and combined DMARDs were some time prescribed. Non steroidal anti-inflammatory drugs (NSAIDs) were used in 64% sero-positive and 68% sero-negative patients.
Conclusion: Corticosteroid was the most commonly prescribed drug. There was no difference between the sero-positive and sero-negative of total patients using DMARDs.
Keywords: Rheumatoid arthritis, rheumatoid factor, corticosteroid, diseases modifying anti-rheumatic drugs, non-steroidal anti-inflammatory drugs.
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
https://jurnal.ugm.ac.id/jain/article/view/3847
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3848
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Aini, Nurul
ABSTRACT
Introduction. Arterial hypertension affects the heart tissue composition which leads to structural remodeling of the myocardium. The imbalance between synthesis and degradation of type I collagen leading to myocardial fibrosis in a form of type I collagen fiber accumulation in the interstitial and perivascular myocardium. Collagen fiber accumulation reduces relaxation stage, diastolic suction, myocardial stiffness and diastolic dysfunction which affect systolic dysfunction leading to heart failure. Concentration of carboxy-terminal pro peptide of pro collagen type I (PIP) in peripheral blood am a synthesis index of type I collagen in HHD. Thus, the measurement of PIP is useful to monitor myocardial fibrosis stage in heart failure and to determine the therapeutic strategy that aims not only to reduce arterial pressure and left ventricular mass but also to prevent myocardial remodeling.
Aim of the study. The aim of the study was to ascertain the difference PIP level in patients with the heart failure stage A, B, and C which are caused by hypertension. The serum concentration of PIP was measured by enzyme immunoassay. This research was a cross sectional research designed for cardiology policlinic’s outpatients at Dr. Sardjito General Hospital Yogyakarta from August 2009 until the calculated sample number is fulfilled.
Method. One-way ANOVA was used to analyze the differences between the three groups of heart failure stages after being tested for the normality using Kolmogorov-Smirnov normality test. If the result did not show a normal value, a non-parametric test would be undergone using Kruskal-Wallis test followed by Mann-Whitney U test. The differences considered as significant if p < 0.05 with a confidence interval of 95%.
Result. The research was performed in 64 patients heart failure caused by hypertension consisted of 22 stages A, 19 stage B and 23 stage C. PIP mean levels of the group stage B 819.78 ± 91,03 ng/ml was higher compared stage A 808.47± 80.8 ng/ml and PIP mean level stage C 852 ± 55.51 ng/ml was higher compared stage B. The PIP mean levels did not differ statistically significantly (p=0. 317).
Conclusion. There were no significant differences in serum level of PIP on the stage heart failure A, B and C.
Keywords: Collagen, fibrosis, hypertension, heart failure, carboxy-terminal pro peptide
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3848
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3850
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Charisma, Tiwi
INTRODUCTION
Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed medication.1 The gastrointestinal tract and kidneys are important targets of clinical events associated with the use of NSAIDs.2 Selective COX-2 inhibitors have minimal gastrointestinal side effects. However, the newer NSAIDs also has nephrotoxic effects remain as nonselective NSAIDs.1
The kidneys are the major organ for drug excretion, so that the renal arterioles and glomerular capillaries are especially vulnerable to the effects of drugs. 3 The spectrum of NSAID-induced nephrotoxicity includes acute tubular necrosis, acute tubulointerstitial nephritis, glomerulonephritis, renal papillary necrosis, chronic renal failure, salt and water retention, hypertension, and hyperkalemia. 1
Among the various clinical complications, the effects on the kidney are probably the most common and severe due to the use of NSAIDs.4 Fifty million US citizens report NSAIDs use, and it has been estimated that 500.000 – 2,5 million people will develop NSAID nephrotoxicity in the US annually. 5 It has been reported that 37% of drug-associated acute renal failure is associated with the use of NSAIDs, and NSAID-induced acute renal failure accounts for 7% of overall cases of acute renal failure. 4
This review discusses the NSAIDs, mechanisms and clinical manifestations of NSAID-induced renal impairment and some NSAID options that can be used in patients with renal failure.
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3850
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3851
2014-06-30T07:28:08Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Bonendasari, Agni
ABSTRACT
Introduction. Hemodialysis patients experience major changes in lifestyle and suffer various physical and emotional symptoms, especially symptoms of depression and sexual dysfunction in more than half of patients. Sexual dysfunction in women is often not identified because of lack of attention, especially by the clinician. Symptoms of depression limit intimacy, and affect sexual arousal and orgasm.
Aim : the aim of the study was to determine the correlation between depressive symptoms and female sexual function index (FSFI) in women hemodialysis patients in the Hemodialysis Unit of Dr. Sardjito General Hospital Yogyakarta.
Methods. The method of this study was cross-sectional. Research was conducted at the Hemodialysis Unit by Dr. Sardjito General Hospital Yogyakarta from 10 April to 24 April 2012.
Result. There were 42 female patients undergone routine hemodialysis who met the criteria. The median age was 49 years old and had undergone hemodialysis for a median duration of 40 months.
Conclusion. There was a negative correlation of depression symptoms and female sexual dysfunction with a moderate strength (r = -0.421) and statistical significantly (P <0.05). Age and prolactin had a negative correlation with a moderate strength of FSFI score. HDL levels and menstrual status had a positive correlation with FSFI, with weak and strong correlation respectively.
Key Words: Female sexual function index, depression, hemodialysis
Faculty of Medicine Universitas Gadjah Mada
2014-06-30 14:28:08
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3851
Acta Interna: The Journal of Internal Medicine; Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3853
2014-03-19T02:01:46Z
jain:ART
nmb a2200000Iu 4500
"121201 2012 eng "
2541-5441
2303-131X
dc
Sofia, Noor Asyiqah
ABSTRACT
Background. Non alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with obesity and insulin resistance. Leptin is an adipokine which plays role in decreasing food intake and controlling energy utilization. The role of leptin pathogenesis of NAFLD remains unclear. Former studies associated with the role of leptin in NAFL were never conducted in diabetic patients. Therefore we aimed to analyze the difference of leptin level in non diabetic population between subjects with and without non alcoholic fatty liver disease.
Method. This was a non matching case control study in general check up polyclinic Dr.Sardjito Hospital Yogyakarta. The inclusion criteria were aged 30-60 years old, no history of alcohol consumption > 20 gr/day, no diabetes mellitus. The exclusion criteria were viral hepatitis (B and C), rapid weight loss, steroid therapy, and pregnancy. Diagnosis of NAFL was based on bright liver imaging from ultrasonography.
Result. There were 48 subjects consist of 23 subjects with NAFL and 25 subjects without NAFL. Mean of leptin level in NAFL group was higher than non NAFL group and this difference was statistically significant (20.29 + 15.73 ng/ml and 12.27 + 10.1 ng/ml; p=0.040).
Conclusion. The conclusion of this study was leptin level significantly higher in non diabetic population with NAFL compared with non NAFL.
Keywords: leptin, non diabetic, non alcoholic fatty liver
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:46
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3853
Acta Interna: The Journal of Internal Medicine; Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3854
2014-03-19T02:01:46Z
jain:ART
nmb a2200000Iu 4500
"121201 2012 eng "
2541-5441
2303-131X
dc
Arshanti, Pudya Lestari
ABSTRACT
Background. Blood transfusion can save lives, patients get the benefit but also the risk of transfusion-related. Febrile non-haemolytic transfusion reaction (FNHTR) most frequently found and have similar symptoms of other transfusion reactions, causing delays in transfusion and decrease the quality of life. Platelet recipients have a higher incidence risk FNHTR than recipients of other blood products. Medications pre-transfusion acetaminophen and diphenhydramine reduce the incidence FNHTR.
Methods. The study was conducted from May to November 2010 Internal Medicine Wards, Dr. Sardjito Hospital, Yogyakarta using the method of double-blind randomized controlled trial. Inclusion criteria were first recipient of random donor non leucodepleted platelets in thrombocytopenia malignant patients and willing to participate. Exclusion criteria were fever is when will transfusions or in 2x24 hours, allergies of acetaminophen and diphenhydramine, acetaminophen and diphenhydramine consumption in the last 6 hours, the consumption of continuous corticosteroids, history of transfusion reactions and critical conditions/sepsis. Assessment of the incidence FNHTR 15 minutes before transfusion to 4 hours after transfusion. Medication group will receive a capsule containing 650 mg acetaminophen and 25 mg diphenhydramine dissolved in 5 ml 0.9% NaCl intravenously. The control group received a placebo. Drugs are given 30 minutes before the first transfusion bag. Data were analyzed using Chi-square test and p <0.05 was considered statistically significant.
Results. Thirty-two patients met the criteria, 15 patients (46.87%), medication group and 17 (53.13%) patients of control group. Eleven (31.43%) patients had FNHTR, 8 (47.06%) patients of control group and 3 (20%) patients. There are differences in the proportion of incident FNHTR in both groups although not statistically significant (P = 0.04). Every patient has different risk factors on parity, history of transfusion, history of FNHTR and the long of platelet storage.
Conclusion. As pre-transfusion medications, Acetaminophen 650 mg and diphenhydramine 25 mg reduced the incidence of FNHTR compared to placebo in the first platelet recipients in malignancy
Key words: Acetaminophen, diphenhydramine, medication pretransfusion, FNHTR.
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:46
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3854
Acta Interna: The Journal of Internal Medicine; Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3855
2014-03-19T02:01:46Z
jain:ART
nmb a2200000Iu 4500
"121201 2012 eng "
2541-5441
2303-131X
dc
Walewangko, Olivia Cicilia
ABSTRACT
Background. The nutritional problem is a significant role factor in determine of health, mortality and quality of life of people with HIV&AIDS. Therefore, it is very important to provide the nutritional assessment, nutritional management, counseling and education which are very useful to upgrade the quality of life of people with HIV&AIDS.
Objective. This study was designed to analyze the correlation between anthropometric measurement with quality of life of people with HIV&AIDS.
Method. The study design was a cross sectional study. The subjects were HIV&AIDS patients who came to outpatient clinic in Dr. Sardjito General Hospital Yogyakarta, from November 2009 – January 2010. Subjects eligible with inclusion criteria were examined for anthropometric measurement and fill the WHOQOL-bref questioner.
Result. There were 53 subjects eligible to the study criteria from November 2009 to January 2010. Majority of the subjects were man (73.6%), single (62.3%) and live alone (58.5%), last education was high school (41.5%) and employed (73.6%). Mean of ages was 33 years old, weight 53.67±10.3kg, height 161.28±7.68cm, BMI 20.57± 3.48 Kg/m2, MUAC 24.40 ± 3.23 cm, waist circumference 76.17 ± 8.10 cm, hip circumference 87.04 ± 8.03 cm , ST 11.17 ± 8.10 mm. Mean score of total WHOQOL-bref was 75.68 ± 10.3, Domain 1 (physics) 21.32 ± 3.07, Domain 2 (psychology) 19.75 ± 3.62 , Domain 3 (social) 10.04 ± 1.87, Domain 4 (environment) 24.75 ± 4.58. There was a very weak correlation between anthropometric measurements with quality of life; with the p value was statistically insignificant.
Conclusion. There was no significant correlation between nutritional statuses which is measured by the anthropometric value with the quality of life in people with HIV&AIDS.
Keywords: HIV, nutrition, anthropometric, QOL
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:46
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3855
Acta Interna: The Journal of Internal Medicine; Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3856
2014-03-19T02:01:46Z
jain:ART
nmb a2200000Iu 4500
"121201 2012 eng "
2541-5441
2303-131X
dc
Sofia, Noor Asyiqah
ABSTRACT
Background. Non alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with obesity and insulin resistance. Leptin is an adipokine which plays role in decreasing food intake and controlling energy utilization. The role of leptin pathogenesis of NAFLD remains unclear. Former studies associated with the role of leptin in NAFL were never conducted in diabetic patients. Therefore we aimed to analyze the difference of leptin level in non diabetic population between subjects with and without non alcoholic fatty liver disease.
Method. This was a non matching case control study in general check up polyclinic Dr.Sardjito Hospital Yogyakarta. The inclusion criteria were aged 30-60 years old, no history of alcohol consumption > 20 gr/day, no diabetes mellitus. The exclusion criteria were viral hepatitis (B and C), rapid weight loss, steroid therapy, and pregnancy. Diagnosis of NAFL was based on bright liver imaging from ultrasonography.
Result. There were 48 subjects consist of 23 subjects with NAFL and 25 subjects without NAFL. Mean of leptin level in NAFL group was higher than non NAFL group and this difference was statistically significant (20.29 + 15.73 ng/ml and 12.27 + 10.1 ng/ml; p=0.040).
Conclusion. The conclusion of this study was leptin level significantly higher in non diabetic population with NAFL compared with non NAFL.
Keywords: leptin, non diabetic, non alcoholic fatty liver
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:46
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3856
Acta Interna: The Journal of Internal Medicine; Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3857
2014-03-19T02:01:46Z
jain:ART
nmb a2200000Iu 4500
"121201 2012 eng "
2541-5441
2303-131X
dc
Sutedjo, Isbianto
ABSTRACT
Background: Cardiac enlargement or cardiomegaly always found in chronic heart failure (CHF). Progressivity of cardiac enlargement relates with pulmonal function changes in CHF. This study examined the influence of increased cardiac enlargement on pulmonal function.
Methods: This is a cross sectional study on 63 CHF patient of New York heart Association (NYHA) class I and II that fulfilled inclusion criteria. Definitions of CHF based on Framingham criteria. Cardiac enlargement measured by Danzer’s methods through postero anterior chest radiography. Spirometry used to evaluate FVC and FEV1.
Results: Male subjects have an equal proportion (49.21%) with female subjects (50.79%) with mean of CTR 59.47 ± 5.57%. Spirometry test showed mean predicted FVC (%) 61.83 ± 9.62, predicted FEV1 (%) 75.27 ± 12.55, and FEV1/FVC mean ratio 95.53 ± 2.19%. Coefficient correlations between cardiomegaly and FVC (%) and FEV1 (%) predicted are -0.537 (p <0.001) and -0.460 (p <0.001). duration of diseased has a negative correlation with FVC (%) and FEV1 (%) predicted (-0.329; p= 0.008 and -0.341; p=0.006).
Conclusions: Cardiomegaly on CHF showed a restriction type and has a negative correlation with pulmonal function.
Keywords: cardiomegaly, pulmonal dysfunction, chronic heart failure
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:46
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3857
Acta Interna: The Journal of Internal Medicine; Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3858
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
Kertia, Nyoman
Akhadiono, Deddy Nur Wachid
Paramaiswari, Ayu
Fadlilah, Arina Syarifa
Harinawantara, Hangga
ABSTRACT
Background: The prevalence of osteoarthritis (OA) in the community is high. This disease is the second most common cause of physical disability worldwide. Pain in OA is caused by several factors, such as inflammation. Non steroidal anti-inflammatory drugs (NSAIDs) were the most common drugs given worldwide to reduce pain in OA. NSAIDs were also associated with a high incidence of gastrointestinal side effects. An alternative to manage this problem is by using the combination of Curcuma xantorrhyza Roxb. (commonly known as temulawak) extract, ginger (Zingiber officinale) extract, soybean (Glycine max), and shrimp shell. Curcuma xantorrhyza contains curcumin which has anti-inflammatory effect by suppressing cyclo-oxygenase (COX-2) enzyme activity, suppressing lipo-oxygenase enzyme activity, and play a role as a free radical scavenger. Ginger can inhibit COX-2 activity in PGE-2 production. Shrimps shell contains glucosamine and chondroitin which can increase proteoglycan in articular chondrocytes and inhibit COX-2 synthesis. Isoflavone in soybean can inhibit articular cartilage degradation and COX-2 synthesis.
Study Aims: The purpose of this study is to compare the effect of the combination to diclofenac sodium in reducing synovial fluid leukocyte count and joint pain in patients with osteoarthritis.
Study Method:This study was a prospective randomized open end blinded evaluation (PROBE). Twenty one patients with knee osteoarthritis diagnosed by American College of Rheumatology criteria were included in this study. Patients were randomized into two groups to receive either diclofenac sodium 25 mg (control group) or the combination of Curcuma xantorrhyza extract 50 mg, ginger extract 100 mg, shrimp shell 100 mg, and soy bean flour 50 mg (treatment group) three times daily for 14 days. Independent t-tests and Mann-Whitney-Wilcoxon tests were used to evaluate changes between prior and post intervention.
Results: There were significantly reduction of synovial fluid leukocyte count in both control group (p=0.017) and treatment group (p=0.008) respectively. The reduction of synovial fluid leukocyte count was not significantly different between control group and treatment group (p=0.929). There were significant improvement of joint pain (VAS score) in both control group (p=0.012) and treatment group (p<0.001). The reduction of VAS score was not significantly different between diclofenac group and treatment group (p=0.607).
Conclution: These results indicate that the evicacy of this combiation was not significantly different with diclofenac sodium in reducing the synovial fluid leukocyte count and joint pain in patients with osteoarthritis.
Keywords: osteoarthritis, Synovial fluid leukocyte count, Pain, VAS, Diclofenac sodium,Combinaion of curcuma, ginger, shrimp shell and soybean.
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3858
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
https://jurnal.ugm.ac.id/jain/article/download/3858/9730
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3859
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
ANEMIA AS RISK FACTOR OF HANDGRIP STRENGTH DECREASED ON ELDERLYIN YOGYAKARTAPROVINCE'S PANTI WERDHA
Hidayat, Ganda
Kurnianda, Johan
Pramantara, I Dewa Putu
ABSTRACT
Background: According to the WHO, by the end of 20 th century, the more the world population grow, the more the elderly population will be. Yogyakarta province has a 13.72% of Indonesian elderly. The anemia prevalence increased as the age added. Aging process resulted in strength muscle reduced. Handgrip strength test is a valid and consistent as well as simple alternative to value the muscle strength decreased advanced age. Purpose of this study is to know whether anemia is a risk factor against muscle strength decreased measured by handgrip strength test on elderly population in nursing house.
Method: This study used cross sectional study design to the advanced ages in DIY province’s nursing house. The study time was in August 2010. The advance ages fullfilling the inclusion and exclusion criteria were conducted physical examination, routine blood test and handgrip strength measurement.
Result: This study involved 118 elderly participants. There was difference of mean handgrip strenght in: age (14.52 kg vs 19.64 kg; p=0.001), gender (13.39 kg vs 22.47 kg; p=0.001), activity level (7.94 kg vs 16.75 kg; p=0.001) and anemia status (13.60 kg vs 17.84 kg; p=0.001); for women even in mild anemia group, there was difference with non anemia group (12.36 kg vs 14.68 kg ; p=0.027).
Conclusion: According to multivariable analysis,. There are 3 factors involving of handgrip strength in elderly, namely; Age, activity levels, and anemia which are statistically significant. In this study, it was conclude anemia is a risk factor of handgrip strength decreased in elderly, for women even in mild anemia, there was statistically significant different with non anemia group.
Keywords : Elderly, anemia, handgrip strength
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3859
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3860
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
Mulya, Deshinta Putri
Nurdjanah, Siti
Ratnasari, Neneng
ABSTRACT
Background. Renal dysfunction is a serious problem and it provides a poor prognosis for patients with advanced liver cirrhosis, where this condition can progress to kidney failure. This condition is known as hepatorenal syndrome. Cystatin C utilization as a marker of decreased kidney function in patients with liver cirrhosis has been widely proven. Data on how far the severity of liver cirrhosis can affect the decline in renal function has not been widely known.
Objective. This study aimed is to verify correlation between the severity degree of the liver (Child Pugh/CP score) with levels of Cystatin C serum.
Methods. This study was a cross sectional study. Population studied were patients with liver cirrhosis who visited the clinic of Gastroentero-hepatology and treated in the department of Internal Medicine ward Dr. Sardjito Hospital - Yogyakarta during October 2009 - March 2010. Data were analyzed with a computer; the analyzed of the CP score correlation with increased levels of Cystatin C using Spearman correlation for data not normally distributed.
Result. We found 48 research subjects during the month of October 2009 - March 2010. The subjects were 35 male (72.9%) and 13 female (27.1%) with average age 53.1 ± 11.9 years old. Subjects with CP-A were 9 patients (18.8%), CP-B were 14 patients (29.2%) and CP-C were 25 patients (52.1%). The range value of Cystatin C between CP class shows CP-A 0.7 - 0.97 mg/L, CP-B 0.7 - 0.49 mg/L, and CP-C 0.7 – 2.49 mg/L (statistically significant difference with p <0.05). Liver cirrhosis patients who had Cystatin C levels <0.96 mg/L were 22 patients (45.83%) and 26 patients (54.1%), had higher levels of Cystatin C> 0.96 mg/L. Child score was positively correlated to increased levels of Cystatin C (p= 0.000; r= 0.566) linear regression equation with Cystatin was = 0.37 + 0.08 * Child score (r square 0.32).
Conclusion. This study concluded that the Child score had a moderate positive correlation with Cystatin C serum level.
Key words: Liver Cirrhosis – Child Pugh score - Cystatin C
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3860
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3861
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
Safitri, Nedya
Riyanto, Bambang Sigit
Asdie, H. Ahmad Husain
ABSTRACT
Background. Obesity is one of the risk factor for type 2 diabetes mellitus characterized by insulin resistance, decrease insulin secretion and hyperglycemia. Chronic inflammation has been proposed to have an important role in the pathogenesis of obesity related insulin resistance. A number of studies have indicated that several humoral markers of inflammation are elevated in people with obesity and type 2 diabetes mellitus, because adipose tissue secretes a number of proinflammatory cytokines, including interleukin-6. The level of plasma IL-6 is increase in obese people.
Objective. To investigate the mean of difference in the level of IL-6 in obese people with and without insulin resistance.
Subjects and Method. The study design was cross-sectional. It was conducted in obese people with BMI ≥ 25 kg/m2. Insulin resistance were measured with HOMA-IR methode, calculated using the following formula: fasting serum glucose X fasting plasma insulin/22,5. Insulin resistance was defined when HOMA-IR > 2,77. Interlukin-6 was measured with Quantikine High Sensitivity human IL-6 ELISA. Difference of mean of IL-6 level was analyzed by student’s t-test for normal distribution and Mann- Whitney U-test if distribution was not normal.
Results. There were 56 subjects, 24 (42,9%) subjects with insulin resistance and 32 (57,1%) subjects without insulin resistance. Obese people with insulin resistance had higher mean level of IL-6 than obese people without insulin resistance, although the difference was not significant (20,05±8,59 vs 18,98±8,15 pg/ml; p=0,639; 95% CI -5,58-3,46).
Conclusion. There was no difference in the mean of IL-6 level in obese people with and without insulin resistance.
Keywords. IL-6, obese, insulin resistance
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3861
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3862
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
Hamra, Muhammad Yusuf
Sumardi, Sumardi
Siswanto, Agus
Sofia, Noor Asyiqah
ABSTRACT
Background. Depression is more common in persons with chronic illnesses such as diabetes, epilepsy and infection of Human Immunodeficiency Virus (HIV). Depression can make HIV worse. Antidepressant may need, but there can be interaction and side effect when use Antiretroviral (ARV) and antidepressant in combination. Complementary and alternative medicine (CAM) include Latihan Pasrah Diri(LPD) may seem safe to treat depression in HIV patient.
Methods. This is a quasi experimental study, participant include outpatient dan inpatient at RSUP Dr. Sardjito, Yogyakarta. They were aged >18 years. After scoring with Zung Self Rating Scale for depression, participants allocated into two groups, with dan without Latihan Pasrah Diri program. Zung Self Rating Scale for depression was evaluated after 1 cycle of program.
Result. The means of Zung Self-Rating Depression Scale score before and after LPD were 42,21 ± 9,3 and 35 ± 10,73 (p 0,003). While in control group (without LPD / brief psychotherapy) the means of Zung Self-Rating Depression Scale score before and 3 weeks after brief psychotherapy were 42,93 ± 7.45 and 39,36 ± 7,69 (p 0,019). Statistically there was no significancy in the means of delta Zung Self-Rating Depression Scale in LPD group and control group.
Conclusion. It was concluded from this study that there is an influence on the improvement of depressive symptoms post- Latihan Pasrah Diri program to people with HIV / AIDS.
Key words: depression, HIV, Latihan Pasrah Diri, Zung Self-Rating Scale
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
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application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3862
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3863
2014-03-19T02:00:11Z
jain:ART
nmb a2200000Iu 4500
"110601 2011 eng "
2541-5441
2303-131X
dc
Hariadi, Kartika Widayati Taroeno
ABSTRACT
Acute pulmonary embolisms is a major cause of complications and death associated in surgery, medical illnesses, injury, and also may occurs after a long-distance air travel. It is often originating from deep-vein thrombosis and has a wide spectrum of clinical manifestation ranging from asymptomatic, incidentally discovered emboli, to massive embolism causing immediate death. Incidence of pulmonary embolism ranges from 23-69 cases per 100,000 populations. Case fatality rates vary widely depending on the severity of the cases; at an average case fatality rate within 2 week of diagnosis of approximately 11%. It may have chronic sequele as post thrombotic syndrome and chronic thromboembolism pulmonary hypertension.
Acute pulmonary embolism is often difficult to diagnose. The predisposing factors for pulmonary embolisms consist of hereditary factors, acquired factors, and probable factors. Patients with symptoms of dyspnea, chest apnea, tachypnea or tachycardia arise suspiciousness of pulmonary embolisms therefore should be screened their probability for developing the disease. Low risk patients will then be evaluated for d-dimer test. Treatment should be initiated promptly in high risk patients, followed by imaging procedure evaluation. Chest radiographs, CT scan arteriography, VQ scan are performed to either include or exclude diagnosis of pulmonary embolisms.
Treatments consist of thrombolysis for acute and unstable massive pulmonary embolisms, and anticoagulation with heparin for stable acute pulmonary embolism. A meta-analysis of several major trials showed that low molecular weight heparin is at least as effective as unfractionated heparin in preventing the recurrence of venous thromboembolism events and at least as safe with respect to the rate of major bleeding.
This review will further describe in detail the pathomechanisms, diagnosis, and management of acute pulmonary embolisms.
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:00:11
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3863
Acta Interna: The Journal of Internal Medicine; Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3864
2015-01-29T05:06:55Z
jain:ART
nmb a2200000Iu 4500
"111201 2011 eng "
2541-5441
2303-131X
dc
Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score
Gunadi, Heribertus
Bayupurnama, Putut
Nurdjanah, Siti
ABSTRACT
Background. Cirrhosis patients with renal failure are at high risk for death and reduced survival as compared with those without renal failure and poor prognosis. Some studies have suggested that cystatin C did more accurate than creatinine to detect glomerulus filtration rate (GFR) in patients with cirrhosis. Model of End Stage Liver Disease (MELD) score can be used in patients with cirrhosis with variously widely severity disease and etiologies. Until now, there is no study about correlation between levels of cystatin C to disease severity in cirrhosis based on MELD score.
Objective. This present study was to investigate the correlation between levels of cystatin C with disease severity in cirrhosis based on MELD score.
Method. Study design was cross sectional study. This study was conducted at Gastoenterohepatology clinic and Internal Medicine at Dr Sardjito General Hospital, Yogyakarta. Inclusion criteria were patient with diagnosed cirrhosis based on clinical criteria, laboratory and USG finding, age ≥ 18 years, had complete medical record and obtained informed consent. Exclusion criteria were chronic kidney disease, sepsis, hepatocellulare carcinoma, used high doses of steroid, have thyroid dysfunction, hypertension and diabetes mellitus.
Result. The mean of cystatin C based on MELD score categorical were MELD <10 = 0.93±0.19 mg/l; MELD 10-19=1.08±0.26 mg/l; MELD 20-29 = 1.25±0.27 mg/l; MELD 30-39 = 2.49 mg/l and MELD >40 = 2.43 mg/l; (p=0.013; 95% CI 0.000-0.061). There was a significant correlation between cystatin C to MELD score were demonstrated p=0.000 and r=0.485.
Conclusion. Our data suggested a significant correlation with medium strength between cystatin C to severity disease of cirrhosis based on MELD score.
Keywords: cirrhosis, cystatin C, MELD score
Faculty of Medicine Universitas Gadjah Mada
2015-01-29 12:06:55
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3864
Acta Interna: The Journal of Internal Medicine; Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3865
2015-01-29T05:06:55Z
jain:ART
nmb a2200000Iu 4500
"111201 2011 eng "
2541-5441
2303-131X
dc
Ruchanihadi, Ruchanihadi
Setianto, Budi Yuli
Hariawan, Hariadi
ABSTRACT
Background. The pathophysiology of acute coronary syndromes (ACS) is now accepted as the rupture or erosion of an atherosclerotic plaque, initially occurs at the shoulder of the plaque and is followed by intra-plaque thrombosis then spread to the vascular lumen and cause total partial vascular occlusion. MMP-9 is an extracellular matrix degrading enzyme that plays a crucial role in the breakdown of the fibrous cap of plaque and subsequent rupture in the pathogenesis of ACS. Cardiac troponins are currently the most sensitive and specific biochemical markers of myocytes necrosis.
Objective. To know the correlation between serum level MMP-9 and serum level of Troponin-I in patients with ACS
Method. Study design was cross sectional. Data were collected by consecutive sampling from patients in ICCU board of RSUP Dr. Sardjito Yogyakarta, in June 2008-August 2010. A questionnaire was used to collect information from patient. After admission, peripheral venous blood was drawn once and measuring concentration of serum level of MMP-9 and Troponin-I before definitive thrombolysis. Data are expressed as means ± standard deviation (SD). Correlation between serum level of MMP-9 and serum level of Troponin-I were assessed using Spearman’s rank correlations test. A value of p<0.05 was considered statistically significant.
Result. There were 139 patients with ACS and comprising 63 patients with STEMI, 27 patients with NSTEMI, and 49 patients with UAP. Means±SD of Troponin-I from all of samples was 9.49±10.47 ng/dL. Mean±SD of MMP-9 from all of samples was 1296.06±729.97 ng/dL. There were significant correlations between MMP-9 and Troponin-I in patients with ACS (r=0.34, p=0.000).
Conclusion. There were significant correlations between MMP-9 and Troponin-I in ACS patients in ICCU RSUP Dr. Sardjito Yogyakarta.
Keywords: ACS, MMP-9, Troponin-I
Faculty of Medicine Universitas Gadjah Mada
2015-01-29 12:06:55
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3865
Acta Interna: The Journal of Internal Medicine; Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3866
2015-01-29T05:06:55Z
jain:ART
nmb a2200000Iu 4500
"111201 2011 eng "
2541-5441
2303-131X
dc
Yonarko, Grendi Faneri
Atmojo, Suhardi Darmo
Hisyam, Barmawi
ABSTRACT
Background: Magnesium Serum in some previous studies had been related to asthma events and severity levels. Correlation between magnesium serum levels and severity of asthma was controversies. It might be influenced by race, genetic pattern, diet and demography factor.
Objective: The objective of this study was to know relationship between magnesium serum levels and predictive PEF (Peak Expiratory Flow) in chronic asthma patients in Yogyakarta.
Method: This was a cross-sectional study; subjects were asthma patients who visited Pulmonology Outpatient Department in Dr. Sardjito General Hospital Yogyakarta, from September 2004 - March 2005. We performed clinical evaluation, magnesium serum levels (normal 0.65 mmol/L-1.04 mmol/L), predictive PEF and medications. Correlation between magnesium serum levels and PEF were analyzed by Pearson correlation test. This study used analysis of variance (anova) to analyze mean difference among more than 2 groups and multiple regressions to know the variables which influenced serum magnesium levels.
Result: There were 62 asthma patients in this study. There was no hypomagnesaemia. The mean of magnesium was 0.89 ± 0.08 mmol/L. Results showed that serum magnesium levels and predictive PEF had weak correlation (r= 0.281; p=0.027). There was no significant correlation between admission rate to Emergency Room due to asthma by magnesium levels (r=0.029 p= 0.8).
Conclusion: Results showed weak relationship serum magnesium levels and PEF in chronic asthma patients.
Keywords: bronchial asthma; serum magnesium levels, Peak Expiratory Flow rate
Faculty of Medicine Universitas Gadjah Mada
2015-01-29 12:06:55
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3866
Acta Interna: The Journal of Internal Medicine; Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3867
2015-01-29T05:06:55Z
jain:ART
nmb a2200000Iu 4500
"111201 2011 eng "
2541-5441
2303-131X
dc
Kurniaatmaja, E.R, Kurniaatmaja, E.R
Priambodo, Doni
Humardewayanti, Rizka
Loeheri, Soebagjo
Background: Leptospirosis, an infectious disease that affects humans and animals, is a common zoonosis with a variety of clinical manifestations. Yogyakarta is one of the cities with a high incidence of leptospirosis. It is important to recognize the clinical features and prognostic factors of this disease. Severe disease can be fatal, although majority of cases are mild and self-limited.
Objective: To determine the prognostic factors for leptospirosis that associated with mortality in patients with leptospirosis in Dr. Sardjito General Hospital, Yogyakarta.
Methods: We conducted a retrospective study of data collected in our hospital between Jan 2010 until May 2011, from whom the diagnosis of leptospirosis was confirmed based on pertinent clinical and epidemiological data and positive serology.
Result: Thirty two patients were included in this study, including 29 survivors (90.62%) and 3 non-survivors (9.38%). Of these 32 patients, 26 patients (81.25%) were admitted to the medical ward and 6 patients (18.75 %) were admitted to the ICU. Multivariate logistic regression demonstrated that three factors were independently associated with mortality: oliguria (OR 0.75; CI 0.541–1.04; p<0.05); urea nitrogen > 74.7 mmol/L (OR 0.813; CI 0.642-1.028; p<0.05), and neurological symptoms (altered mentation or seizure) (OR 30; CI 4.367–206.07; p<0.05)
Conclusion: The mortality of leptospirosis remains high despite improvements in patients care. In order to improve the early treatment of high-risk patients, these 2 clinical and 1 laboratory criteria which are associated with mortality, can be used at the time of admission as prognostic factors.
Keywords : Leptospirosis, prognostic factors, mortality
Faculty of Medicine Universitas Gadjah Mada
2015-01-29 12:06:55
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https://jurnal.ugm.ac.id/jain/article/view/3867
Acta Interna: The Journal of Internal Medicine; Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3868
2015-01-29T05:06:55Z
jain:ART
nmb a2200000Iu 4500
"111201 2011 eng "
2541-5441
2303-131X
dc
Sendjaja, Sukendro
Purwanto, Ibnu
Kurnianda, Johan
ABSTRACT
Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.
Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.
Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.
Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy.
Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline
Faculty of Medicine Universitas Gadjah Mada
2015-01-29 12:06:55
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3868
Acta Interna: The Journal of Internal Medicine; Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2011 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3869
2014-03-19T02:01:23Z
jain:ART
nmb a2200000Iu 4500
"120601 2012 eng "
2541-5441
2303-131X
dc
Husni, Niko Adhi
Rochmah, Wasilah
Atmodjo, Suhardi Darmo
ABSTRACT
Introduction. Old ages are associated with physiologic deteriorations of all organs and tissues, such as involution of thymus and decreased function of gastrointestinal tract which lead to malnutrition. Involution of thymus will caused reduction of T cell subset for instance T cell CD4+. Prevalence of nutrient deficiency in old age was high, according to a survey that 35% of subjects with age above 50 years old showed deficiency for one or more vitamins and trace-elements. Zinc as one of trace-elements has vital role for immune system.
Aim. Aims of this study are to know the mean of zinc serum level, proportions of zinc deficiency in elderly and correlation between zinc and CD4+ count.
Methods and Subjects. Design of this study is cross sectional, with study subjects including healthy elderly women from Aisyiah elderly club at Kota Gede Yogyakarta. Elderly who were eligible with study criteria were measured height, weight, zinc serum level, and CD4+ count. Correlation test was performed to know correlation between ages, weight, body mass index (BMI), and zinc serum level with CD4+ count. Significant variables will be tested with multiple linier regressions. Level of significance is p < 0.05.
Results. A total healthy elderly women subjects were 60 persons with median of age 63.5 years old. Median zinc serum level was 5.47 umol/L with range between 3.25- 7.95 umol/L. Zinc deficiency (zinc serum level < 7.65 umol/L) occured in 95% of subjects. Mean of CD4+ count was 767.22±232.95 count/mm3. There were correlations between age, weight, and zinc serum level with CD4+ count (r= -0.296; 0.345; 0.324; 0.792, respectively). Results from linear regression model showed zinc serum level was the only variable that affect to CD4+ count (adjusted R2 = 0.622).
Conclusion. Ninety five percent of healthy elderly women at elderly club Aisyiah Kota Gede Yogyakarta suffer from zinc deficiencies, and there is strong correlation between zinc serum level and CD4+ count.
Keyword: zinc serum, CD4+ count, elderly
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3869
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3870
2014-03-19T02:01:23Z
jain:ART
nmb a2200000Iu 4500
"120601 2012 eng "
2541-5441
2303-131X
dc
Rohmawati, Dwi
Siswanto, Agus
Kurnianda, Johan
Sofia, Noor Asyiqah
ABSTRACT
Symptoms of depression and sexual problems that occur among breast cancer patients are a rarely detected and get good handling. Therefore, an early detection for any psychological problems that may affect the sexual life of patients with breast cancer is needed so that the patients can have better life. This study aims to assess the correlation between symptoms of depression and sexual function in women with breast cancer who undergo chemotherapy at Dr. Sardjito Hospital.
Research design was cross sectional. The study necquited 38 breast cancer patients in Tulip outpatients Cancer Clinic in Dr. Sardjito Hospital. Assessment of depressive symptoms used Beck Depression Inventory questionnaire and Female Sexual Function Index to assess sexual function.
The results showed that the proportion of subjects aged 46-55 years at 55.2% followed by 36-45 years of age at 39.5% and aged 26-35 years by 5.3%. The mean age of subjects was 45.4 + 6.5 years. Correlation between symptoms of depression with sexual function among participants was r=- 0.30 with significance p=0.068. Correlation between symptoms of depression with the domains of sexual function domain of desire (r=-0.296, p=0.072), stimulation (r = -0.470, p = 0.003), lubrication (r=-0.353, p=0.030), orgasm (r=-0.223, p=0.179), satisfaction (r=-0.233, p=0.158), pain (r=-0.186, p=0.262).
The conclusion is that there is no correlation between symptoms of depression with sexual function.
Keywords: Depression symptoms, Breast Cancer, Sexual Dysfunction
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3870
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3871
2014-03-19T02:01:23Z
jain:ART
nmb a2200000Iu 4500
"120601 2012 eng "
2541-5441
2303-131X
dc
Priambodo, Rosa
ABSTRACT
Background: C-Reactive Protein (CRP) levels were found increase in ST elevation myocardial infarction (STEMI) patients, before and after STEMI. Increase of CRP levels were able to activate complement pathway to induce inflammation by attracting neutrophil and macrophage to enter to infarcted myocardial. Infarct expansion followed by remodeling process, led to left ventricular dysfunction and decrease of ejection fraction.
Aim: This study aimed to investigate a correlation between CRP plasma levels and left ventricular ejection fraction (LVEF) in anterior STEMI patients.
Subject and method: This study was conducted cross-sectionally. Subjects were new anterior STEMI patients, with maximum onset of 48 hours. Exclusion criteria included evidence of infection, inflammation, history of surgery or stroke in last three months, malignancy, congestive heart failure and inferior STEMI. There were 30 subjects who met the eligible criteria. CRP blood samples were collected at least 48 hours after onset. LVEF measurement was done during hospitalization. The correlation between CRP levels and LVEF was analyzed by Spearman rank correlation test.
Result: CRP levels in female subjects were higher than males [CRP median 23.4 mg/l (5.73 – 61.4 mg/l) vs. 12. 2 mg/l (5.6 – 66.5 mg/l)], but with no significance (P= 0.297). The thrombolytic therapy group had lower CRP levels than non thrombolytic therapy group [10. 7 mg/l (5.6 – 44.5 mg/l) vs. 14.7 mg/l (8.7 – 66.5 mg/l), also with no significance (P= 0.178). There was a non-significantly negative correlation between CRP level and LVEF (r = - 0.100, P= 0.597).
Conclusion: There was no correlation between CRP level and LVEF in anterior STEMI.
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3871
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3872
2014-03-19T02:01:23Z
jain:ART
nmb a2200000Iu 4500
"130601 2013 eng "
2541-5441
2303-131X
dc
Ariadno, Etra
ABSTRACT
Background. Hypertension is a major risk for the development and progressivity complication of macro and microvascular of diabetes mellitus. Renin-angiotensin-aldosteron system (RAAS), insulin resistance, endothelial dysfunction and autonomic nervous dysfunction play an important part in the pathogenesis of hypertension and type 2 diabetes mellitus. In RAAS, increased angiotensin II constricts arterioles, raises total peripheral resistance and blood volume. The rise in intravascular volume increases risk of hypertension. Glucotoxicity or hyperglycemia in type 2 diabetes mellitus can increases angiotensin II levels.
Aim. To evaluate plasma angiotensin II levels in type 2 diabetes mellitus women with or without hypertension.
Methods. Cross sectional design was conducted on subjects from outpatients’ women with type 2 diabetes mellitus at endocrinology clinic, Dr. Sardjito General Hospital, Yogyakarta. Hypertension was assessed using criteria from Seventh Joint National Committee (2003). ELISA sandwich method was used to measure plasma angiotensin II levels from blood vein. Differences between groups were compared by student’s unpaired t-test and Mann-Whitney test.
Results. Among 60 subjects, there are 30 with hypertension (50%) and 30 without hypertension (50%). Mean age were 54.11 ± 3.36 years old. Plasma angiotensin II levels was higher in women with type 2 diabetes mellitus with hypertension than without hypertension although significance was not reached (0.30 ± 0.15 ng/mL vs. 0.28 ± 0.18 ng/mL, p= 0.93).
Conclusion. The plasma angiotensin II levels are not significantly different between type 2 diabetes mellitus women with or without hypertension.
Key words: hypertension, plasma angiotensin II, type 2 diabetes mellitus, women
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3872
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3873
2014-03-19T02:01:23Z
jain:ART
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"120601 2012 eng "
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Hudiyanti, Vivin
ABSTRACT
Background. Tumor Necrosis Factor-α (TNF-α), a pro-inflammatory cytokine produced by monocyte is increased in osteoarthritis synovial fluid. Curcuminoid from Curcuma domestica Val. suppresses the secretion of TNF-α.
Objective. The purpose of this study was to investigate the suppression effect of curcuminoid from Curcuma domestica Val on synovial fluid monocyte’s TNF-α secretion compared to diclofenac sodium in knee osteoarthritis
Methods. A prospective randomized open end blinded evaluation (PROBE) method was applied. Subjects were patients with knee osteoarthritis visiting Rheumatology Clinic Dr. Sardjito Hospital and Wirosaban Hospital Yogyakarta. Curcuminoid 30 mg three times daily or diclofenac sodium 25 mg three times daily were administered for 4 weeks. The level of TNF-α secreted by synovial fluid’s monocytes were measured by ELISA before and after treatment.
Results. A total of 80 subjects were enrolled, 39 subjects on curcuminoid treatment groups and 41 subjects on diclofenac sodium group. Seven subjects were dropped out, 5 from the curcuminoid group and 2 from the diclofenac sodium group. There was a significant decrement of TNF-α level during 4 weeks treatment in both groups (p< 0.001 respectively). There was no significant difference on TNF-α levels between groups (p= 0,237), neither in 50% decrement of TNF-α levels (p= 518).
Conclusion. The effect of curcuminoid in decreasing TNF- α level on patients with osteoarthritis is similar with sodium diclofenac.
Keywords: osteoarthritis-monocyte-TNF-α-curcuminoid-diclofenac sodium
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/3873
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/3874
2014-03-19T02:01:23Z
jain:ART
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Humardewayanti, Rizka
INTRODUCTION
The word sepsis is derived from the Greek term for rotten or “to make putrid”. Sepsis, defined as the systemic host response to microorganisms in previously sterile tissues, is a syndrome related to severe infections and is characterized by end-organ dysfunction away from the primary site of infection. To meet the definition of sepsis, patients need to satisfy at least two of the Systemic Inflammatory Response Syndrome (SIRS) criteria in association with having a suspected or confirmed infection. The severity and mortality increase when this condition is complicated by predefined organ dysfunction (severe sepsis) and cardiovascular collapse (septic shock). The normal host response to infection is complex, aiming to both identify and control pathogen invasion and start immediate tissue repair. Both the cellular and humoral immune systems are activated, giving rise to anti-inflammatory and proinflammatory responses. Exacerbating these mechanisms can cause a chain of events that leads to sepsis, promoting massive liberation of mediators and the progression of multiple organ dysfunction1.
Sepsis remains a critical problem with significant morbidity and mortality even in the modern era of critical care management. Despite intense efforts, sepsis remains a serious clinical problem and still associated with a high mortality rate. Septic shock and sequential multiple organ failure/dysfunction syndrome (MOF/MODS) correlate with poor outcome, and septic shock is the most common cause of death in intensive care units. A recent review by Angus et al estimated the 1995 incidence of sepsis in the United States to be 751,000 cases, resulting in 215,000 deaths. The average cost per case of sepsis was $22,100 with total costs of $16.7 billion nationally. A more recent analysis of hospital records indicates that the total number of patients who are dying is actually increasing. This study also confirmed the work of Angus et al that the incidence of sepsis is increasing and projected to continue to grow as the population ages. These studies concluded that “severe sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction2,3.
The immunological cascade resulting in the sepsis response can be initiated by tissue injury, ischemia reperfusion injury, gram-positive organisms, and fungi as well as gram-negative organisms and their constituent endotoxin. The sepsis response may begin with an infectious nidus, which may either invade the bloodstream, leading to dissemination and positive blood cultures, or proliferate locally and release various microbial products into the bloodstream3.
Multiple derangements exist in sepsis involving several different organs and systems, although controversies exist over their individual contribution to the disease process. Septic patients have substantial, life-threatening alterations in their coagulation system. Previously, it was believed that sepsis merely represented an exaggerated, hyperinflammatory response with patients dying from inflammation-induced organ injury. More recent data indicate that substantial heterogeneity exists in septic patients’ inflammatory response, with some appearing immuno-stimulated, whereas others appear suppressed. Cellular changes continue the theme of heterogeneity. Some cells work too well such as neutrophils that remain activated for an extended time. Other cellular changes become accelerated in a detrimental fashion including lymphocyte apoptosis2.
The role that apoptosis plays in sepsis syndromes and in the development of CARS and MODS has not been adequately explored, but there is rapidly developing evidence to suggest that increased apoptotic processes may play a determining role in the outcome to sepsis syndromes. In particular, increased apoptosis, particularly in lymphoid tissues and potentially in some parenchymal tissues from solid organs, may contribute to the sepsis-associated MODS3
Faculty of Medicine Universitas Gadjah Mada
2014-03-19 09:01:23
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https://jurnal.ugm.ac.id/jain/article/view/3874
Acta Interna: The Journal of Internal Medicine; Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
ind
Copyright (c) 2012 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/4999
2014-11-05T03:53:52Z
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Relationship between plasma fi brinogen levels with model of end stage liver disease score in patients with liver cirrhosis
Nasir, Moch. Abdul
Ratnasari, Neneng
Bayupurnama, Putut
ABSTRACT
Introduction. One of the complications which often occur in the liver cirrhosis is bleeding. Closely associated with weighing of bleeding were disturbance haemostatic homeostasis disorders that commonly associated with impaired liver function. Therefore certain biomarkers are needed to objectively measure the severity of liver cirrhosis. Fibrinogen is one of the clotting factors that can be used to determine the severity of liver cirrhosis.
The model of end-stage liver disease (MELD) score is most excellent alternative of the Child-Pugh score. It can be used in patients with liver cirrhosis spacious ranges severity of disease and etiology even in patients whose cirrhosis etiology are not clear. Currently, there was not any data showing the correlation between the level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis. Aims. This study aimed to determine the correlation between level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis.
Method. This study was cross-sectionally conducted used consecutive sampling. Study population were eligible patients with liver cirrhosis who visited outpatient and inpatient clinic in the Division of Gastroentero-hepatology, Dr. Sardjito general hospital, between November 2011 to October 2012. Correlation between the level of plasmatic fibrinogen and MELD score was statistically assessed using correlation test with fi nal result stated as correlation coefficient (r).
Result. There were 40 subjects that met criteria, 28 male and 12 female, with average age of 53 ± 12,51 years. Etiology of cirrhosis was viral hepatitis B in 16 (40,0%) subjects, hepatitis C in 11 (27,5%) subjects and non viral in 13 (32,5%) subjects. Subjects with ascites were 19 (47, 5%) and without ascites were 20 (52.5%). Bleeding was experienced by 30 (80.0%) subjects while 10 (20,0%) subjects did not present with bleeding. Mean of plasma fibrinogen was 198 ± 102, 89 mg/dl, and mean of the MELD score was 17,05 ± 8.79. Spearman correlation coefficients between fi brinogen and MELD score was r = -0,404 (p = 0,010).
Conclusion. There was a negative correlation between plasma fi brinogen and the MELD score in liver cirrhosis patients visiting our local setting.
Keywords: liver cirrhosis, fi brinogen, MELD score
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/4999
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 1970 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5000
2014-11-05T03:53:52Z
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Effects of latihan pasrah diri in quality of life in chronic kidney disease-dialysis patients with depression symptoms
Widyaningrum, Widyaningrum
Siswanto, Agus
Djarwoto, Bambang
ABSTRACT
Background: Patients with chronic kidney disease (CKD) suffering from various physical and emotional symptoms show depression and disturbance in quality of life. Patients with chronic kidney disease have a decreased quality of life, and mortality rate about 22% in every year. Depression in patients with CKD must be managed properly because a large effect on HRQOL (Health Related Quality of Life) and the potential side effects on the management of patients with CKD. Latihan pasrah diri (LPD) is a method combining relaxation and remembrance with a focus on breathing exercises and words contained in the dhikr (relaxation and repetitive prayer). The rise of the relaxation response is expected to improve the symptoms of stress or depressive symptoms, which is expected to improve HRQOL.
Objective: This study aimed to determine the effect of LPD on quality of life in hemodialysis patients with depressive symptoms that was compared with controls.
Methods: The research constituted the study of Randomized Control Trial. The research was measured the KDQOL-SF scores (Kidney Disease Quality of Life-SF) in subjects with LPD treatment during 21 days, compared with controls. The research was conducted at the Hemodialysis Unit of Dr. Sardjito Hospital, Yogyakarta, from May to June 2012. A total of 36 patients who met the inclusion criteria were randomized and divided into LPD group (n = 18) and control group (n = 18).
Results: Found a statistically signifi cant decrease in BDI scores in both groups, 23.00 ± 5.34 to 15.00 ± 8.55 (p = 0.001) in the LPD group and 23.00 ± 5.34 to18.33 ± 6, 66 (p = 0.022) in the control group. KDQOL-SF scores after treatment when compared between the LPD and control groups experienced different changes were statistically signifi cant in domains effects of kidney disease 59.65 ±23.52 compared to 39.41 ± 20.03 (p = 0.022), sleep 69 ± 13.17 compared to 46.53. (p = 0.000), overall health 73.89 ± 16.85 compared to 57.22 ± 19.04 (p = 0.009), pain 64.86 ± 20.80 compared to 42.36 ± 24.90 (p = 0.005), general health 53.88 ±16.05 compared to 47.78 ± 20.74 (p = 0.014), and the physical component scale 35.98 ± 6, 83 compared to 29.12 ± 6.46 (p = 0.004). Despite increased KDQOL-SF domain scores, but there were 2 domains that Δ KDQOL-SF score changes were statistically signifi cantly different compared with the control group, which was the domain of sleep and overall health.
Conclusion: Latihan pasrah diri twice a day during 21 days (3 weeks) can improved the quality of life of patients with symptoms depression in CKD patients undergoing hemodialysis in domains of sleep and overall health.
Keywords: CKD, depression, latihan pasrah diri, KDQOL-SF.
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5000
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5001
2014-11-05T03:53:52Z
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The effects of albumin concentration to outcome of acute respiratory distress syndrome (ARDS) patients in intensive care unit RSUP Dr. Sardjito Yogyakarta
Parmawati, Novia Etty
ABSTRACT
Background: Hipoproteinemia mostly happened in critically ill patients, including ARDS, and usually comes to
worst clinical appearance. Early ARDS is characterized by a rising of the permeability in the alveolar-capillary
barrier, leading to an infl ux of fl uid into the alveoli, and albumin also has a major role to control the osmolatory
of plasma.
Aim: The aim of the study was to know about the effect of the albumin concentration to outcome (survivor/nonsurvivor) of the ARDS patient in the Intensive Care Unit (ICU) RSUP Dr. Sardjito.
Methods: This study used cross-sectional method. The samples of this study were the patients at the ICU RSUP
Dr. Sardjito Yogyakarta, from January 2009 until December 2011. The diagnosed of ARDS based on EACC
criteria. The inclusion criteria were people with age ≥ 18 years old, fulfi ll diagnostic criteria of ARDS, and treated
in ICU. The demography, laboratory result, and curing process, have been tested statistically in SPSS 17. The
variable was analyzed by chi-square and Mann-Whitney test, signifi cantly considered if p < 0,05.
Results: The samples who fulfi ll these criteria were 61 patients. Mostly women (54,1%) with 49 years-old range
and the result were 34 patients (55,7%) died. The biggest cause of ARDS was pneumonia (60,7 %) and the
biggest Comorbid was malignant (21,6%). The mortality rate of ARDS was 5,75%. The result of univariat analysis
was the increased of transaminase enzyme (p 0,007), COPD Co morbid (p 0, 02) and length of stay in the ICU (p
= 0,021) which was signifi cantly given effect to the outcome of the patients. The survivors have higher albumin
concentration (2, 6) than in non survivors (2, 4), although not statistically signifi cant (p = 0,621).
Conclusion:The albumin concentration did not have a statistically signifi cant effect to the outcome of the ARDS
patient in ICU RSUP Dr. Sardjito Yogyakarta. The main factor was the increase of transaminase enzyme, Co
morbid COPD, and length of stay in the ICU.
Keywords: ARDS, albumin concentration, ICU
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
https://jurnal.ugm.ac.id/jain/article/view/5001
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 1970 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5002
2014-08-19T08:34:17Z
jain:ART
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Impact of irrational antibiotic therapy to hospital cost of care of pneumonia in patients in Dr. Sardjito Hospital
Sutrisno, Edi
ABSTRACT
Background: The mortality rate from pneumonia remains very high, reaching 15% in the United States while in
Indonesia pneumonia is the second leading cause of death. Antibiotics improve outcomes in those with bacterial
pneumonia. Irrational antibiotic therapy impacts to bacteria resistance, potentially increasing side effects of drugs,
prolonged patient’s length of stay and higher total hospital costs.
Aim: This study aimed to improve the service quality by calculating the percentage of irrational antibiotic therapy
based on Gyssens workfl ow and the additional total of consumables antibiotics costs.
Methods: The study design was retrospective, including 57 pneumonia inpatients in internal medicine department
wards in Dr. Sardjito Hospital, from November 2011 to January 2012. Statistical analyses were conducted by
using Mann-Whitney U test.
Results: From 57 pneumonia inpatients, irrational antibiotic therapy reached 68,4% (39 of 57 patients).
Azithromycin was misused and overused antibiotic. Total excess cost of daily antibiotic were Rp 294,000.00
and consumables antibiotics were Rp 215,000.00
Conclusion: Irrational antibiotic therapy in pneumonia is associated with and an overall impacts on healthcare
costs.
Keywords: irrational antibiotic therapy, health-care cost, and customer satisfaction.
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5002
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5003
2014-11-05T03:53:52Z
jain:ART
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JAK2 mutation and treatment of JAK2 inhibitors in Philadelphia chromosome-negative myeloproliferative neoplasms
Hutajulu, Susanna Hilda
Kurnianda, Johan
ABSTRACT
The Philadelphia chromosome-negative (Ph-negative) myeloproliferative neoplasms (MPNs) polycythaemia vera (PV), essential thombocythaemia (ET) and primary myelofi brosis (PMF) are clonal disorders of multipotent haematopoietic progenitors. The genetic cause of these disorders was not fully defi ned until a somatic activating mutation in the JAK2 non-receptor tyrosine kinase, JAK2V617F, was identifi ed in most patients with PV and a considerable proportion of patients with ET and PMF. The discovery of JAK2 mutation has changed the molecular reclassification of MPNs and served as a genomic target for therapeutic implication. A number of JAK2 inhibitors have been developed and tested for MPNs. Several JAK2 inhibitors have reached the phases of clinical trial and included patients with intermediate-risk or high-risk MF. This population of MF is the best candidate for trials because currently it has no effective therapy besides patients’ poor survival. Considering all clinical data on Ph negative MPNs, JAK2 inhibitors have shown a clinical benefi t and reduced symptoms in the vast majority of MF cases. The most developed among JAK2 inhibitors is Ruxolitinib, which has demonstrated clinical improvement with well tolerated toxicities. However, JAK2 inhibitor was equally active in patients with and without JAK2 mutation. Other JAK2 inhibitors are less developed, but showed a similar clinical benefi t. Furthermore, its effect on the natural course of MPNs in treating patients needs to be investigated.
Keywords: myeloproliferative neoplasms – JAK2 mutation – JAK2 inhibitors.
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5003
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5016
2014-08-19T08:34:18Z
jain:ART
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Differences of lung function in elderly patients with and without hypertension in RSUP Dr. Sardjito Yogyakarta
Sutriningsih, Bungsu Wahyu
Sumardi, Sumardi
Pramantara, I Dewa Putu
ABSTRACT
Background: In the elderly, there is a decrease in lung vital capacity to 68%. The prevalence of hypertension is at the age above 65 years with 13% of the population. The Incidence of lung function decline in chronic heart failure and hypertension was found mainly in the elderly.
Aims: The aim of the study was to know the differences ilung function in elderly patients with and without hypertension.
Methods: The Study was cross-sectional, a study in November 2012 until January 2013 of the elderly population over 60 years of research with a sample of 58 people (29 people and 29 groups of hypertensive people without hypertension). Inclusion criteria for the study subjects were elderly patients over 60 years of signing the informed consent, can perform spirometry maneuvers correctly. Data were analyzed by T-test to examine some differences in the mean or median, between the two groups.
Results: In this research, there were no signifi cant difference in lung function as measured by FVC and FEV1 in the elderly with hypertension and without hypertension (p = 0.984, 95% CI-0, 13-0,139 for FVC and p = 0.83, 95 IK-0, 14-0,116% for FEV1).
Conclusion: There is no signifi cant difference in lung function in the elderly with and without hypertension.
Keywords: elderly, hypertension, pulmonary function
1Speciality
Faculty of Medicine Universitas Gadjah Mada
2014-08-19 15:34:18
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https://jurnal.ugm.ac.id/jain/article/view/5016
Acta Interna: The Journal of Internal Medicine; Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2013 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5324
2015-01-29T05:23:58Z
jain:ART
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Correlation between Depressive Symptom Score and Geriatric Handgrip Strength at Nursing Home Province of Yogyakarta
Syahri, Ahmad
Siswanto, Agus
Pramantara, I Dewa Putu
ABSTRACT
Background: By the year of 2020, Indonesia’s elderly population will be expected to the fourth highest number in the world after China, India and USA. Special Region of Yogyakarta has the highest percentage that is equal to 13.72%. Depression may increase the risk of mortality, disability and motivation of physical Low grip strength would increase mortality and morbidity in the elderly.
Objective: This study aimed to assess the correlation between depressive symptoms and handgrip strength in the elderly population in nursing homes at province of Yogyakarta.
Methods: This study was a cross-sectional study that conducted in October 2010 at the nursing home residents. Depression was assessed by the Geriatric Depression Scale Cronbach’s alpha 0.88. Handgrip strength was measured by a handgrip dynamometer. Data of age, education and gender was collected by questionnaire. The study performed statistical tests to assess the correlation of symptoms depression and grip strength.
Results: The mean age of subjects was 73.84 ± 8.36 years with 36 subjects (35.3%) were between 60-69 years and 66 subjects (64.7%) were over 70 years. There were 33 men (32.4%) and 69 women (67.6%). Mean
GDS score was 12.76 ± 3.22. Handgrip strength in the depression group 16.94 ± 6.96 kg was higher than the non-depressed group 15.23 ± 6.79. There was correlation between severity of depression symptom by
handgrip strength with r = 0.235 (weak correlation) and statistically signifi cant with p = 0.017.
Conclusion: The severity of depressive symptom scores was correlated significantly to the handgrip strength in elderly nursing homes in the province of Yogyakarta.
Keywords: elderly, nursing homes, depression, handgrip strength.
confi dent interval.
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5324
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
https://jurnal.ugm.ac.id/jain/article/download/5324/0
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5329
2015-01-29T05:23:58Z
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The Accuracy of Wells Clinical Model for Predicting Pretest Probability in Deep Vein Thrombosis (DVT) at Dr. Sardjito Hospital
Wulansih, Dwi
Kurnianda, Johan
Widayati, Kartika
ABSTRACT
Background: The diagnosis of deep vein thrombosis (DVT) is an important issue in the medical field because a large number of cases are undiagnosed. The accurate diagnosis of the DVT is essential to prevent complications of acute pulmonary embolism and long-term complications. The complication such as pulmonary hypertension and post phlebitis syndrome. It also to avoid improper anticoagulant therapy associated with a high risk of bleeding. There are several models of clinical suspicion of DVT include Hamilton’s score and Wells’ score. The Wells clinical model for predicting pretest probability for DVT has been widely used and tested its validity in several countries in Europe. The accuracy of a Wells clinical model of pretest probability for DVT has not been done for the races of Asia especially in Indonesia.
Objective: This study aimed to test the accuracy and precision (sensitivity, specificity and predictive value) of Wells clinical model for predicting pretest probability for diagnose DVT for patients in the Dr. Sardjito Hospital.
Methods: This study was a diagnostic study with cross-sectional design. The subjects were patients with DVT symptoms who visited Tulip clinic, outpatient and inpatient in the department of Dr. Sardjito General Hospital during January 2011-May 2012. In this study, a total of 100 patients were participated the Wells clinical model of pretest probability for DVT examination, Doppler ultrasound and D-dimer examination. The negative results on the fi rst ultrasound examination will be examined again 1 week later.
Results: DVT was confi rmed in 56 patients (56%) from 100 patients. The baseline characteristics showed the number of women more than men and the mean age was 52.98 ±1.335 years. The 57% of subjects were women and the median age was ≥60 years. The most frequent risk factors of DVT were cancer 49 patients (49%), bed ridden 42 patients (42%) and elderly 33 patients (33%). The accuracy of the Wells clinical model of pretest probability for DVT was 81%, precision was 77.6%, sensitivity was 92.8%, specifi city was 65.9%, and negative predictive value was 87.9%.
Conclusion: The Wells clinical model for predicting pretest probability in DVT has a high accuracy, moderate precision, high sensitivity and poor specifi city to diagnose DVT at Dr. Sardjito Hospital.
Keywords: deep vein thrombosis/DVT, the Wells clinical model of pretest probability for DVT, accuracy test, precision
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5329
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5351
2015-01-22T07:39:33Z
jain:ART
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Reactivation and Flare of Chronic Hepatitis B: Natural History, Diagnosis, Therapy and Prevention
Cahyono, Suharjo Broto
Neneng Rasari, Neneng Rasari
Bayupurnama, Putut
Maduseno, Sutanto
Nurdjanah, Siti
ABSTRACT
Almost 30% of the world population has been exposed to hepatitis B virus (HBV) and 400 million
of these are chronically infected. 20–30% of HBsAg carriers may develop reactivation or fl are (acute
exacerbation) of chronic hepatitis B with elevation of biochemical levels, high serum HBV DNA level with or
without sero-coversion to HBeAg. In countries with intermediate or high endemicity for HBV, compounded
in use cytotoxic or immunosuppressive therapy for the treatment of a wide variety of clinical disease,
reactivation or fl are may be the fi rst presentation of HBV infection. Sometime it is diffi cult to differentiate
between acute hepatitis B and reactivation (fl are). Accurate diagnosis in these cases is very important for
deciding whether to start treatment or not, because acute hepatitis B does not require treatment, while
reactivation or fl are may take benefi t from it. Effort to early detect, to treat and to prevent the reactivation
or fl are of chronic hepatitis B is very crucial to reduce morbidity and mortality.
Keywords: Reactivation, fl are (acute exacerbation) of chronic hepatitis B, acute hepatitis B, nucleos(t)ide
analogues
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5351
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5728
2015-01-22T07:39:33Z
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Acute Coronary Syndrome in Young Patients at Dr. Sardjito General Hospital
Setianto, Budi Yuli
Sari, Julia
Hartopo, Anggoro Budi
Ra Gharini, Putrika Prastuti
ABSTRACT
Background: The incidence of acute coronary syndrome in the young patients is increased recently. Several studies reported that young patients have distinct clinical characteristics as compare with older patients.
Objective: To assess the prevalence, risk factors and clinical presentation of acute coronary syndrome(ACS) in young patients at Dr. Sardjito Hospital, Yogyakarta.
Methods: We conducted a cross sectional study between September 2008-May 2009 at intensive cardiovascular care unit (ICCU) of Dr. Sardjito Hospital. We enrolled consecutive patients admitted with acute coronary syndrome. We divided the patients as young ACS (age ≤ 45 years) and older ACS (age >45 years). We compared cardiovascular risk factors, clinical presentation and clinical spectrums from both groups. Statistics analysis was performing using chi-square test, p value < 0.05 was considered significantly different.
Results: In our study there were 20 (13.5%) young ACS and 128 (86.5%) older ACS patients. Most young ACS patients are male (90%). Proportion of diabetes mellitus in young ACS was not different from that in older ACS patients (20% vs. 18.8%; p=0.55). Hypertension was not different either (50% vs. 53.1%; p=0.49). Sixty percent of young ACS patients were smoker, however its proportion did not differ from older ACS patients (p=0.84). There were no signifi cant differences of dyslipidemia. The young ACS patients mostly experienced STEMI than NSTEMI and unstable angina (55% vs. 15% vs. 30%), but there were no signifi cant differences when compared to older ACS patients (p=0.65). Thirty percent of young ACS patients presented with Killip class II or higher, however there were no significant differences between groups (p=0.40).
Conclusion: In this study we found that there were no signifi cant differences in risk factors, clinical presentation and spectrums between young ACS and older ACS patients. The need for prevention program in both groups should not be difference.
Keywords: ACS– young– older– clinical presentation.
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5728
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5729
2015-01-22T07:39:33Z
jain:ART
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2303-131X
dc
Relationship Between Systemic Lupus Activity Measurement (SLAM) Score and Mortality in Systemic Lupus Erytemathosus (SLE) Inpatients
Paramaiswari, Ayu
Kertia, Nyoman
Achadiyono, Deddy Wachid
ABSTRACT
Background: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder that can be severe and life threatening. Mortality in SLE may due to lupus activity or long-term sequel. Systemic Lupus Activity Measurement (SLAM) score is a tool that can count lupus disease activity inpatients.
Aims: To analyze the relationship between SLAM score and mortality in lupus inpatients.
Methods: Retrospective cohort study used for reaching objective of the study. Lupus inpatients was used as research population. Medical record was used as study data collection over periods of 2006 until 2011. Independent variable was a SLAM score. The cut point of SLAM score was made based on the mean of SLAM score (16.7 point score). Dependent variable was mortality.
Results: There were differences between number of ACR criteria fi ndings, pneumonia, heart rate with SLAM score (p value 0.001; 0.001; 0.002 respectively).There was a difference of median survival between less and more than 16.7 point score, 45 and 28 respectively (p 0.034). There was a relationship between SLAM score (more than 16.7 point score) and mortality HR 2.78 (96% CI 1.01-7.53). There was a difference of mortality incidence between more and less than 16.7 point score, 0.35 and 0.10 respectively. There was a relationship between SLAM score (more than 16.7 point score) and mortality RR 3.5 (95% CI). Mortality in lupus inpatients was 23%.
Conclusion: There was a relationship between SLAM score and mortality on lupus inpatients.
Keywords: SLE, SLAM, Mortality
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5729
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/5731
2015-01-22T07:39:33Z
jain:ART
nmb a2200000Iu 4500
"140601 2014 eng "
2541-5441
2303-131X
dc
The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy
Oktariani, Siswi
Pramono, Raden Bowo
Sinorita, Hemi
ABSTRACT
Background: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.
Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.
Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.
Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.
Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR
Faculty of Medicine Universitas Gadjah Mada
2014-11-05 12:19:48
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/5731
Acta Interna: The Journal of Internal Medicine; Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16572
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"141201 2014 eng "
2541-5441
2303-131X
dc
Correlation of thirst with ejection fraction and plasma sodium level in elderly with chronic heart failure
Lestari, Sri
Putu Pramantara, I Dewa
Mumpuni, Hasanah
Internal Medicine; Geriatric, cardiology
ABSTRAK
Latar Belakang: Haus merupakan simptom yang umum dan mengganggu bagi pasien gagal jantung.
Banyak pasien gagal jantung usia lanjut mengeluh rasa haus berlebihan. Perjalanan alamiah gagal jantung,
terapi farmakologi dan non farmakologi dapat meningkatkan rasa haus. Cardiac output yang rendah dan
peningkatan aktivasi sistem neurohormonal seperti sistem renin-angiotensin aldosteron akan merangsang
pusat haus di hipotalamus. Hubungan antara rasa haus dengan fraksi ejeksi dan kadar natrium plasma pada
pasien gagal jantung kronis usia lanjut belum diketahui.
Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara derajat rasa haus dengan
fraksi ejeksi dan kadar natrium plasma pada gagal jantung kronis usia lanjut.
Metode: Penelitian menggunakan metode potong lintang, dilakukan di Bagian Penyakit Dalam dan Bagian
Kardiologi RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien usia lanjut penderita gagal jantung
kelas fungsional III-IV sesuai dengan kriteria NYHA, usia ≥60 tahun. Pengukuran rasa haus dilakukan
dengan menggunakan skor VAS. Pemeriksaan fraksi ejeksi dilakukan dengan ekokardiografi . Karakteristik
subyek penelitian disajikan dalam bentuk rerata dan simpangan baku. Hubungan antara derajat rasa haus
dengan fraksi ejeksi dan kadar natrim plasma dianalisis dengan menggunakan uji korelasi Pearson. Nilai p
<0.05 dianggap signifi kan.
Hasil: Didapatkan 30 subyek sebanyak 63.3% laki-laki dengan median usia 69.5 tahun. Diperoleh rerata rasa
haus 63.67±17.5 mm dan rerata fraksi ejeksi sebesar 41.93±15.5%. Rerata hasil pemeriksaan kadar natrium
adalah 139.7±4.1 mmol/l sedangkan rerata osmolalitas plasma 296.4±10.1 mOsm/kg.
Kesimpulan: Pada uji korelasi Pearson didapatkan korelasi antara rasa haus dengan fraksi ejeksi adalah
korelasi negatif lemah namun tidak signifi kan secara statistic (r=-0.314, p=0.091). Tidak didapatkan korelasi
antara rasa haus dengan kadar natrium plasma (r=-0.04 p=0.833).
Kata kunci: usia lanjut, rasa haus, gagal jantung kronis, fraksi ejeksi, natrium plasma
ABSTRACT
Background: Thirst is a common symptom that disturbs patient with heart failure. Many elderly patients with
heart failure get severe thirst. Natural history of heart failure, pharmacological and non-pharmacological therapies
could increase the thirst level. Low cardiac output and activation of neuro-hormonal system e.g. renin angiotensinaldosterone
system, would stimulate the thirst center in hypothalamus. Correlations of thirst with ejection fraction
and plasma sodium level in elderly with chronic heart failure have not been known yet.
Aims: The aims of this study are to investigate the correlations of thirst with ejection fraction and plasma
sodium level in elderly with chronic heart failure. Cross sectional design has been conducted on elderly patients
(age of ≥60 years) with heart failure of functional class of III-IV (based on NYHA criteria) in Department
of Internal Medicine and Department of Cardiology, Dr. Sardjito General Hospital, Yogyakarta.Method: Measurement of thirst was done using VAS score, while the investigation of ejection fraction was
performed using echocardiography. Characteristics of subjects were presented in the average and standard
deviation values. Correlations between thirst with ejection fraction and plasma sodium level were analyzed
by using Pearson correlation test with p < 0.05 considered to be signifi cant.
Result: There were 30 subjects, 63.3% male, median of age of 69.5 years. The average of thirst value was
63.67} 17.5 mm and the ejection fraction was 41.93} 15.5%. The averages of plasma sodium level and
plasma osmolality were respectively 139.7} 4.1 mmole/l and 296.4} 10.1 mOsm/kg.
Conclusion: Pearson correlation test has revealed a weak negative correlation of thirst and ejection fraction
(r= -0.314, p=0.091). On the other hand, there was no correlation between thirst and plasma sodium level
(r=-0.04 p=0.833).
Keywords: thirst, elderly, chronic heart failure, ejection fraction, plasma sodium level
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
https://jurnal.ugm.ac.id/jain/article/view/16572
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16575
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"141201 2014 eng "
2541-5441
2303-131X
dc
Differences in lung function in various degrees of pulmonary tuberculosis sequale
Sepmeitutu, Iwandheny
Sumardi, Sumardi
Budiono, Eko
Internal Medicine; Pulmonology;
Latar belakang: Tuberkulosis masih menjadi masalah kesehatan global untuk negara berkembang khususnya
di Indonesia yang merupakan urutan kelima tertinggi di dunia. Sekuele tuberkulosis dapat terjadi pada
sebagaian besar pasien yang mengalami penyembuhan setelah mendapatkan pengobatan. Perubahan sekuele
tuberkulosis menimbulkan perubahan pada paru sehingga mengalami penurunan fungsi paru.
Tujuan: Penelitian ini bertujuan mengetahui perbedaan fungsi paru forced expiratory volume in one second
(FEV1) dan forced vital capacity (FVC) pada berbagai derajat sekuele tuberkulosis.
Metode: Desain penelitian ini adalah potong lintang pada pasien rawat jalan poliklinik BP4 Yogyakarta dari
September 2013 hingga sampel terpenuhi. Perbedaan dianalisis dengan uji t dan analisis normalitas dengan
uji Shapiro-Wilk. Perbedaan bermakna bila p< 0.05 dengan interval kepercayaan 95%.
Hasil: Hasil penelitian didapatkan subyek penelitian sebanyak 44 pasien yang terdiri dari 29 (65,9%)
laki-laki dan 15(34,1%) perempuan. Subyek yang memenuhi kriteria dilakukan pemeriksaan foto thorak
posteroanterior (PA). Derajat keparahan foto thorak dinilai menurut indeks Willcox. Tes spirometri dilakukan
untuk mendapatkan gambaran fungsi paru berupa FEV1 dan FVC. Karakteristik dasar subyek penelitian
menurut fungsi paru menunjukkan kelainan restriksi yang paling banyak yaitu 28 (60,9%). Perbedaan fungsi
paru FEV1 bermakna pada derajat ringan dengan derajat berat (p= 0,024) dan bermakna pada fungsi paru
FVC pada derajat ringan dengan derajat berat (p= 0,031).
Kesimpulan: terdapat perbedaan bermakna fungsi paru FEV1 dan FVC pada derajat ringan dengan derajat
berat.
Kata kunci: Sekuele tuberkulosis, fungsi paru, indeks Willcox.
ABSTRACT
Background: Tuberculosis remains a global health problem to developing countries, especially in Indonesia
which is the fi fth highest in the world. Tuberculosis sequelae can occur on most patients who experienced
healing after treatment. Tuberculosis sequelae changes cause changes in the lungs so that the decline in
lung functions.
Objective: This study was to determine differences in lung function, forced expiratory volume in one second
(FEV1) and forced vital capacity (FVC) at various degrees of sequelae tuberculosis.
Method: This is a cross-sectional study in an outpatient BP4 Yogyakarta from September 2013 until the
sample met. Differences were analyzed by t-test and analysis of normality with Shapiro-Wilk test. Signifi cant
difference is when P <0.05 with 95% confi dence intervals.
Result: The study subjects were 44 patients consisted of 29 (65.8%) males and 15 (34.1%) women. Subjects
who met the criteria examined thoracic images posteroanterior (PA). The degrees of severity of thoracic
images were assessed by Willcox index. Spirometry tests performed to get an overview of lung function
such as FEV1 and FVC. Basic characteristics of the study subjects according to pulmonary function
abnormalities restriction showed at most that 28 (63.6%). Signifi cant differences in FEV1 lung function in mild degree with severe degree (p = 0024) and FVC signifi cantly in lung function in mild degree with
severe degree (p= 0.031).
Conclusion: There are signifi cant differences in lung function, FEV1 and FVC at mild degree by severe
degree.
Keywords: Tuberculosis sequelae, pulmonary function, index Willcox
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
https://jurnal.ugm.ac.id/jain/article/view/16575
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16851
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"141201 2014 eng "
2541-5441
2303-131X
dc
Changes in Anthropometry Measurement among Human Immunodefi ciency Virus/Acquired Immune Defi ciency Syndrome (HIV/AIDS) Patients Received Antiretroviral Treatment
Irawan, Adi
Wijisaksono, Doni Priambodo
Humardewayanti, Rizka
WIjayanti, Yanri
Internal Medicine; Tropical Medicine; HIV; acquired immune deficiency syndrome
ABSTRACT
Background: Estimated nearly 38.6 million people infected by HIV and 2.8 million died in 2005. Evidence suggests the existence of a very important relationship between the output and improved nutritional status
in HIV/AIDS patients. Poor nutritional status in HIV/AIDS can be caused by several factors, namely the intake and absorption of inadequate nutrition, metabolic changes, hyper metabolism, or a combination of these, changes in the gastrointestinal tract as well as interactions between drugs and nutrients. Losing weight remains on the HAART (Highly Active Antiretroviral Therapies) era, but the problems are the side effects of HAART and lipodystrophy.
Objective: The purpose of this study is to determine the provision of anti- retroviral effect on changes in anthropometric values people with HIV/AIDS. Method: The study is using the one group pre-posttest design (quasi-experimental), by assessing changes in anthropometric values in subjects with HIV before and after the administration of ARVs. Analysis of the data is computerized by a computer program Result: Obtained 30 samples of the study with anthropometric changes pre and post ARVs 6 months. The
weight was 51.4 ± 9.12 to 53.6 ± 8.68 with a p-value 0.001. Body Mass Index (BMI) was 19.98 ± 3.47 into 20.84 ± 3.35 with a p-value 0.001 and upper arm circumference 24.13 ± 3.62 into 24.95±3.48 with a p-value 0.003. The provision of antiretroviral drugs for 6 months infl uences the change in nutritional status of HIV patients are assessed by anthropometric measure. Signifi cant changes in the changes body weight, BMI
and upper arm circumference. Changes in anthropometric values ARV Efavirenz group and non-Efavirenz meaningful change signifi cant in skinfold thickness obtained at the value of p 0.010.
Conclusion: There were no signifi cant changes in anthropometric values compared to patients with early stage HIV and advanced stage after 6 months of antiretroviral therapy.
Keywords: HIV, antiretroviral drugs, anthropometric, nutritional status
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/16851
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16926
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"161201 2016 eng "
2541-5441
2303-131X
dc
Correlation of Ferritin Level to The Quality of Life
Nugroho, Ariyanto
Kuswadi, Iri
Djarwoto, Bambang
chronic renal failure; hemodialysis; ferritin; KDQOL-SF; Internal Medicine; Nefrology
ABSTRACT
Background: Chronic kidney disease is a worldwide health problem. Circumstances that caused the condition of end-stage renal failure causes a decrease in quality of life with a high mortality rate ranging from 22% per year. Many ways to assess the quality of life, form-36 (SF-36) has undergone several revisions refi nement. Serum ferritin continues to be the focus of attention. Nearly half of all hemodialysis patients had serum ferritin > 500 ng/ml. Serum ferritin is a marker of infl ammation that is a good, low levels correlated with iron defi ciency and high levels correlated with infl ammation.
Objective: To determine the correlation of high levels of serum ferritin to decline in the quality of life in patients with CRF who had been undergoing hemodialysis
Methods: This study was a cross sectional study to determine whether high levels of serum ferritin may have an impact on the decline in the quality of life in patients with chronic renal failure (CRF) who had undergone regular hemodialysis. The study was conducted at Hospital Hemodialysis Unit Dr. Sardjito,Yogyakarta. Result: A total of 61 patients who met the inclusion criteria to undergo research. Score KDQOL-SF in this study, negative correlations (weak) significant in sleep (sleep disorders) 58.79 ± 1.95 (r = -0.306) and (p = 0.017). On the Role Physical scores (physical activity) 24.59 ± 3.21 obtained a negative correlation (weak) signifi cant (r = -0.268) and (p = 0.037). For Emotional Well Being scores (emotional condition) 70.85 ± 1.39 (r = -0.374) and (p = 0.003). On the score of Energy Fatigue (physical fatigue) 62.29 ± 1.61 (r = -0.261) and (p = 0.043).
Conclusion: Overall, this study shows the lack of statistically signifi cant results showed a high correlation ferritin directly on quality of life.
Keywords: chronic renal failure, hemodialysis, ferritin, KDQOL-SF
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/16926
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2016 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16928
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"161201 2016 eng "
2541-5441
2303-131X
dc
Telomere and telomerase in hematological disorders Focusing on bone marrow failure syndromes and hematological malignancies
Hardianti, Mardiah Suci
Purwanto, Ibnu
Kurnianda, Johan
telomere; telomerase; bone marrow failure syndromes; hematological malignancies; hematology and medical oncology; internam medicine
ABSTRACT
We review the present knowledge of telomeres and telomerase with special attention to their role in hematological disorders especially bone marrow failure syndromes including acquired aplastic anemia and myelodysplastic syndromes, as well as acute and chronic myeloid leukemia. The current understanding on the role of telomere and telomeres dysfunctions in hematological disorders leads us to a better understanding on the pathology of the diseases as well as considering some possibilities to employ the measurement of telomere length and telomere activity in disease prognostication. Several treatment options targeting telomere and telomerase being developed are also reviewed.
Keywords: telomere- telomerase- bone marrow failure syndromes- hematological malignancies
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/16928
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2016 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/16956
2015-05-25T03:44:50Z
jain:ART
nmb a2200000Iu 4500
"141201 2014 eng "
2541-5441
2303-131X
dc
Evaluating Indications and Diagnostic Yield of Colonoscopy in Sardjito General Hospital
Cahyono, Suharjo Broto
Bayupurnama, Putut
Ratnasari, Neneng
Triwikatmani, Catharina
Indrarti, Fahmi
Maduseno, Sutanto
Nurdjanah, Siti
colonoscopy; diagnostic yield; colonic indications; appropriateness of colonoscopy; Internal Medicine
ABSTRACT
Background: Colonoscopy is the gold standard procedure which is widely used in the diagnosis and treatment of colonic mucosal disorder. Inappropriate colonoscopy indications increase rate of complications.
Aim: The main aims of our study were to evaluate indications, fi ndings and diagnostic yield at colonoscopy.
Methods: A retrospective study of all colonoscopy was conducted from January 2012 through August 2013, at Dr. Sardjito General Hospital, Yogyakarta and there were 688 colonoscopy reports. Seven colonoscopy indications were documented and presented: rectal bleeding or hematochezia, chronic diarrhea, abdominal pain, constipation, screening and surveillance for colonic neoplasia, change in bowel habit and anemia. Diagnostic yield was defi ned as the ratio between signifi cant fi ndings detected on colonoscopy and the total number of procedures performed for the indication. In our study, diagnostic yield was established by colonoscopy, not confirmed by biopsy.
Results: Overall diagnostic yield was 72.53%. The leading indication for colonoscopies was rectal bleeding or hematochezia (36.19%), followed by chronic diarrhea (23.11%), abdominal pain (14.09%), constipation (13.37%), screening and surveillance (5.66%), change in bowel habit (5.52%) and anemia (2.02%). Diagnostic yields according colonoscopies examination were normal (37.14%), colorectal cancer (19.33%), proctitis (14.24%), infl ammatory bowel disease (12.50%), polyps (11.19%),hemorrhoid (10.03%), and diverticel(3.78%). Colorectal cancers were found in patients with hematochezia (74 patients, 29.71%), chronic diarrhea (34 patients, 21.38%), constipation (13 patients, 14.13%). Of 249 patients presenting with hematochezia were found colorectal cancer (74 patients), hemorrhoid (50 patients), proctitis (30 patients), normal (30 patients). Our study showed that diagnostic yield was far lower in patients below 50 years (38.48%) compared > 50 years (61.52%), especially for colorectal cancer (p < 0.001), polyps (p = 0.004) and diverticular (p < 0.001).
Conclusions: Hematochezia was the leading indication for colonoscopy and the diagnostic yield was 72.53%. The leading of colonoscopy fi ndings were normal colonoscopies, followed by colorectal cancer, proctitis,
infl ammatory bowel disease, polyps and diverticel. Colonoscopy indications should be based on the available guidelines to minimize as much as possible the number inappropriate procedures and complications.
Keywords: Colonoscopy, diagnostic yield, colonic indications, appropriateness of colonoscopy
Faculty of Medicine Universitas Gadjah Mada
2015-05-25 10:44:50
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/16956
Acta Interna: The Journal of Internal Medicine; Vol 4, No 2 (2014): The Journal of Internal Medicine
eng
Copyright (c) 2014 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22350
2017-02-24T02:52:21Z
jain:ART
nmb a2200000Iu 4500
"170224 2017 eng "
2541-5441
2303-131X
dc
The Differences of Average Level Serum N Terminal Prob-Type Natriuretic Peptide (NTPROBNP) in Hypertension Patients with and without Left Ventricular Hypertrophy At Cardiology Outpatients Dr. Sardjito General Hospital Yogyakarta
Maulana, Gusti Hariadi
Krisdinarti, Lucia
Hariawan, Hariadi
Array
Introduction. Hypertension cause changes in the structure and function of cardial as triggers neurohormonal and vascular changes that concentric cardiac hypertrophy. Myocyte volume expansion or increased pressure will trigger the synthesis of pre-proBrain Natriuretic Peptide (BNP) in the ventricular myocardium. Pre-proBNP will be converted into proBNP and proBNP will be converted into the form of BNP and N-terminal proBNP (NT proBNP).
Aim. This study aimed to determine differences in BT pro BNP in hypertensive patients without LVH and hypertensive patients with LVH. The study design was cross-sectional in cardiology polyclinic`s outpatient at Dr. Sardjito General Hospital Yogyakarta from August 2009 until the sample number is fulfi lled.
Method. To analyze the difference between the two groups of hypertensive patients using the t-test for normal distribution, while for abnormal distribution were analyzed with the Mann-Whitney U test. To analyze the normality of data conducted by Kolmogorov-Smirnov. The differences of two groups of hypertensive patients considered as signifi cant if p < 0.005 with confi dence interval of 95%.
Results. The results showed 73 study subjects grouped subjects into 2 groups: hypertensive subjects without LVH (31 subjects) and with LVH (42 subjects) based on echocardiography parameters (IVSD, LVPWd, LVIDd, LVM, and LVMI) consisting of 24 males and 49 females. The baseline characteristics between the study groups of hypertensive subjects with and without LVH did not differ signifi cantly either in age, BMI, blood pressure, duration of hypertention therapeutic characteristics of the use of drugs such as ACEI, ARB, β-blocker, CCB, spironolactone and furosemide. Mean NT proBNP levels in hypertensive group without LVH (46.60 ± 45.51) and hypertention with LVH group (201.60 ±192.30 ng/ml). From the results of the Kolmogrov-Smirnov test result that the data distribution was not normal then used Mann-Whitney U test, obtained a statistically significant differences.
Conclusion. There were significant differences in the mean levels of serum NT proBNP in hypertensive patients without LVH and hypertensive patients with LVH.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/22350
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22356
2017-02-24T02:52:21Z
jain:ART
nmb a2200000Iu 4500
"170224 2017 eng "
2541-5441
2303-131X
dc
The Difference Plasma Levels of Endotelin-1 in Type 2 Diabetes Mellitus Women with and without Hypertension
Kurniatmaja, Enita Rahmawati
Sinorita, Hemi
Purnomo, Lutfan Budi
Array
Background. Diabetes and hypertension are related to each other and have a strong pre-disposition on the incidence of atherosclerosis. The incidence of hypertension 2 times greater in patients with DM than non DM. Endothelial dysfunction underlies these events. Endothelial markers, endothelin-1 is known to affect blood pressure.
Aim. The aim of this study is to determine the difference plasma levels of endothelin-1 in type 2 diabetes mellitus in women with and without hypertension.
Methods. The cross sectional design was conducted on women with type 2 diabetes mellitus with and without hypertension at metabolic and endocrinology clinic, Dr. Sardjito General Hospital Yogyakarta from July 2010 until the sample met the criterias. Subjects were divided into two groups, type 2 DM woman with hypertension groups and without hypertension. ELISA sandwich’s method was used to measure plasma levels of endothelin-1. Characteristics of the study are presented in the form of mean Kurniaatmaja et al.
Results. In this research, the plasma levels of endothelin-1 in in type 2 diabetes mellitus in women with hypertension (n=32) and without hypertension (n=32) respectively 19.17±7.53 ng/ml and 13.75±6.19 ng/dl, and this difference was stastistically signifi cant with p= 0.003 CI 95% -8.87 to -1.97.
Conclusion. Plasma levels of endothelin-1 in type 2 diabetes woman with hypertension higher than without hypertension.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/22356
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22384
2017-02-24T02:52:21Z
jain:ART
nmb a2200000Iu 4500
"170224 2017 eng "
2541-5441
2303-131X
dc
Maximum Tolerated Volume in Nutrient Drinking Test for Diagnosis of Functional Dyspepsia
Cahyono, Suharjo Broto
Ratnasari, Neneng
Bayupurnama, Putut
Nurdjanah, Siti
Array
Background. Methods to evaluate pathophysiology of functional dyspepsia (FD) such as barostat are invasive, expensive and not readily available. Nutrient drink test was developed as noninvasive, safe and low cost means to assess impaired gastric accommodation in FD patients. The aim of this study is to evaluate whether this test could be used for diagnostic tool for FD patients.
Method. A cross sectional study was conducted from July 2014 to December 2014, at Sardjito General Hospital, Yogyakarta, Indonesia. Twenty FD patients (according Rome III criteria with normal gastroscopy) were matched by age, gender and body mass index with 20 healthy controls. All of FD patient and healthy controls ingested nutrient drink tests (UltraMilk contain 0.6 kcal /mL). Maximum tolerated volume (MTV) of each subject was recorded. Sensitivity, specifi city, positive predictive value (PPV) and negative predictive value (NPV) were analyzed.Results. Using ≤ 950 mL of maximum tolerated volume as cut off point, sensitivity, specificity, PPV and NPV were 95%, 100%, 100% and 95%.
Conclusions. A nutrient drinking test can discriminate between FD patients and healthy controls with high sensitivity and specifi city. This test could be used as objective, safe and non-invasive diagnostic tool for FD patients.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
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https://jurnal.ugm.ac.id/jain/article/view/22384
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22386
2017-02-24T02:52:21Z
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Characteristic Patients with Multiple Myeloma at Dr. Kariadi Hospital Semarang
Iva, Santosa
Soeharti, Catharina
Tobing, Mika Lumban
Suyono, Suyono
Pangarsa, Eko Adhi
Array
Background. Multiple myeloma (MM) is a malignancy of differentiated B-lymphocytes characterized by accumulation of clonal plasma cells in the bone marrow (BM), the presence of a monoclonal immunoglobulin (Ig) in the serum and/or urine, and osteolytic bone lesions. Complications of this disease consist of recurrent bacterial infection, anemia, osteolytic lesion and decreased renal function. 2-5 MM is the cause of death in 1% of cancer death in Western countries. MM incidence is 1% of all malignancies and 10% of hematologic malignancies in Caucasian race and 20% in the Afro American race.
Aim. The aim of the study is to know the descriptive data of characteristic of patients with MM at dr. Kariadi Hospital Semarang.
Method. Despite of development in patient management, MM is still an incurable disease, with 5-year survival rates lower than 40%. There are many differences in myeloma and its clinical manifestations. Some patients can survive in the months until over than 10 years.5, 6, 7 The median survival was 33 months, this number is similar in Asian studies.
Results. There are several prognostic factors in myeloma management, such as β2-Microglobulin (β2m), serum albumin, serum creatinine, plasma cell percentage in marrow, bone lytic lesion, anemia.10-13 β2m is a prognostic factor used by the International Staging System (ISS)11 to determine stadium and prognosis in MM. β2m correlates with other prognostic factors, such as serum creatinine, anemia, mechanism of bone destruction in MM patients.11,13
Conclusion. MM in Indonesia has not been studied comprehensively and the β2m measurement is expensive and not widely available.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/22386
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22392
2017-02-24T02:52:21Z
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The Difference of Average Mean Platelet Volume (MPV) Values in Stable Angina Pectoris Patients with Symptoms of Depression and without Symptoms of Depression
Wibawa, Arief
Siswanto, Agus
Hariawan, Hariadi
Array
Background: Depression is an independent predictor of cardiovascular events. Increased platelet reactivity is one of several possible mechanisms proposed to explain the relationship between psychosocial factors to coronary heart disease. Mean platelet volume (MPV) is an indicator of platelet activation. MPV associated with major cardiovascular events in coronary heart disease.
Objective: This study aimed to determine the average difference of mean platelet volume (MPV) in stable angina pectoris patients with symptoms of depression and without symptoms of depression.
Methods: The study design was a cross-sectional study. Sampling was carried out in sequence from Stable Angina Pectoris patients who were treated in the internal medicine department of Dr. Sardjito hospital Yogyakarta. MPV and HAD score were measured once on admission. Data presented as a descriptive analysis of the subjects' characteristics on average and standard deviation. The difference average of MPVbetween Stable Angina Pectoris patients with symptoms, depression and without symptoms depression assessed with Pearson's correlation. The results were considered at the signifi cance level of p <0.05.
Results: There were 40 subjects, consisting of 20 Stable Angina Pectoris patients with symptoms, depression and 20 Stable Angina Pectoris without symptoms depression. The difference average of MPV in this study was 7.56 ± 0.95 fl . Average MPV in Stable Angina Pectoris patients with symptoms depression was 8.45 ± 0.82 fl and without symptoms depression was 7.68 ± 0.99 fl with p = 0.009.
Conclusion: In this study, there was a statistically signifi cant difference of average MPV values in stable angina pectoris patients with symptoms of depression and patients without symptoms of depression.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/22392
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/22393
2017-02-24T02:52:21Z
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Prolonged Survival in a Non-Small Cell Lung Cancer with Brain Metastasis Treated with a Brain Mass Evacuation and Gefi tinib
Hardianti, Mardiah Suci
Kurnianda, Johan
Array
The incidence of brain metastasis (BM) is reported to be increase about 20-40% over the last few years in patients with non-small-cell lung cancer (NSCLC).1 The use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) in NSCLC patients with BM, especially those harboring EGFR mutations have been reported.
Faculty of Medicine Universitas Gadjah Mada
2017-02-24 09:52:21
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/22393
Acta Interna: The Journal of Internal Medicine; Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/26997
2017-07-27T06:56:10Z
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Relationship between the Degrees of Severity Sequelae after Treatment with Quality of Life in Patients of Pulmonary Tuberculosis Patients
Wachid Achadiono, Deddy Nur
Retnowulan, Heni
Utami, Tiara Putri
Array
ABSTRACT
Background: Tuberculosis remains a global health problem, especially for developing countries.
Tuberculosis can cause permanent deformity of the lung parenchyma, airways, pleura, mediastinum,
chest wall, and vascular. This deformity is residual symptoms or sequelae. Tuberculosis sequelae may
occur in most patients although has completed treatment. These sequelae can affect lung function
and will ultimately influence patient’s quality of life.
Objective: This study aims to determine the relationship between the severities of sequelae after
tuberculosis based index Willcox with patient’s quality of life.
Methods: The study design was cross-sectional at patients of outpatient clinic BP4
Yogyakarta from September 2013 until the samples are met. The relationship between the
severities of the degree of sequelae after treatment with the quality of life in patients with pulmonary
tuberculosis will be analyzed using t test. Relationship is significant if p <0.05 with 95% confidence
intervals.
Results: The total of the subjects are 37 consist of 24 patients (64.9%) males and 13 (35.1%) women.
Subjects who met the criteria will be examined the thoracic x-ray poster anterior (PA). Severity of tuberculosis sequelae will be assessed according to the index Willcox. Subjects also completed a SGRQ questionnaire as a tool for assessing their quality of life. There is a significant correlation
between the severity of tuberculosis sequelae with the quality of life in the activity (ρ = 0.031) and total (ρ = 0.037) domain.
Conclusions: There is a relationship between the severities of the quality of life in patients with pulmonary tuberculosis sequelae.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/26997
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/26999
2017-07-27T06:56:10Z
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The Relationship between 12MWD and Quality of Life in Tuberculosis Sequelae Patients
Retnowulan, Heni
Wachid Achadiono, Deddy Nur
Rahmatullah, Andika Ilham
Array
Background: The incidence of TB cases in Indonesia is very high. Although it was undergoing treatment and was declared cured the infection, but it does not mean that the infection does not leave sequelae.
Patients TB sequelae decreased functional capacity and quality of life.
Aim: The purpose of this study is to determine the relationship between functional capacity (12MWD) and quality of life (SGRQ) in tuberculosis sequelae patients.
Method: Patients with TB sequelae aged 18-59 years without comorbid examined functional capacity with a 12-minute walking distance test and assessment of quality of life using the SGRQ questionnaires. Statistical analysis is using correlation and regression.
Result: There were significant negative correlation (p<0.05) between the 12 minute walking distance and activity domain (r -.336). In other domains, there is a negative relationship but not significant at the total
domain (r -.152), impacts (-.124), and symptoms (-.043).
Conclusion: There is a significant negative relationship between the 12 minute walking distance and quality of life as assessed by questionnaire SGRQ in activity domain, in other domains there is also a negative correlation but was not statistically significant. The higher of functional capacity patients with tuberculosis sequelae, the quality of life also become higher.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/26999
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/27002
2017-07-27T06:56:11Z
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Type of Psychosocial Stressor as Risk Factor of Depressive Symptom in Metabolic Syndrome
Fauziati, Ana
Siswanto, Agus
Purnomo, Luthfan Budi
Array
Background: Metabolic syndrome and depression are two major diseases over the world, which are increasing in prevalence over time. Depression is major mental health burden over the world. In long time, depression can lead to metabolic syndrome, while metabolic syndrome is risk factor for developing depression. Chronic stress that induced by psychosocial
stressor lead to the development of both metabolic syndrome and depression. Further research is important to identify which type of psychosocial stressor is the risk factor for depression symptom in patient with metabolic syndrome.
Aims: This study is to identify the type of psychosocial stressor which could be the risk factor for depressive symptom.
Method: The study design was case control. The case group consisted of metabolic syndrome patients with depressive symptom, while the control group consisted of metabolic syndrome patients without depressive symptom. Metabolic syndrome was diagnosed based on International Diabetes Federation (IDF) criteria. Depressive symptom was measured by Beck Depression Inventory (BDI). Psychosocial stressors were measured by Stressful Life Events (SLE) questionnaire. Dependent variable was depressive symptom, while independent variables were type of psychosocial stressors (finance, work, social relationship, health and housing). Analysis methods that used in this study were independent t test, Pearson/Spearman correlation analysis, chi square and logistic regression.
Result: There were 54 patients in this study, consisted of 24 in case group and 30 incontrol group. There was no significant difference in most basic characteristics between two groups. There was significant difference of SLE score between two groups. Chi square analysis showed that housing, finance, health, social relationship, and work stressors were risk factors for
developing depressive symptom in metabolic syndrome (OR 24.5; 9.7; 8.4; 5.4; 3.9 respectively, significant). Demographic factor which also influenced depressive symptoms was salary less than 1 million per month (OR 45, significant). According to logistic regression analysis, psychosocial stressors which most influenced the depressive symptom were finance and housing.
Conclusion: The study showed that housing, finance, health, social relationship and work stressors were risk factors for developing depressive symptomp in metabolic syndrome.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/27002
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/27003
2017-07-27T06:56:11Z
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Correlation Between Neutrophil To Lymphocyte Ratio With Child Turcotte Pugh In Liver Cirrhosis Patients
Probowati, Wiwiek
Bayupurnama, Putut
Ratnasari, Neneng
Array
Background: Neutrophil to lymphocyte ratio (NLR) is an index that iswidely used these days. RNL has been widely studied as a predictor of poor survival and outcome in patients with liver cirrhosis, hepatocellular carcinoma, coronary heart disease, rheumatoid arthritis, sepsis and malignancy.
Objective: To determine whether there is a correlation between NLR with a score of Child turcotte pugh (CTP) in patients with liver cirrhosis in Dr. Sardjitogeneral Hospital.
Methods :The study design was cross-sectional study. The study began in December 2014 until the number of samples are met. The subjects of this study were patients with liver cirrhosis at affordable populations undergoing inpatient and outpatient care in the Dr. Sardjito Hospital that meet the inclusion and exclusion criteria. Venous blood test to measure neutrophils,
lymphocytes, albumin, total bilirubin, INR (Internationale normalized ratio). Data presented in the form of descriptive analysis of the characteristics of the study subjects such as the mean and standard deviation values of lymphocyte and neutrophil ratio scores CTP. For analyze the correlation between NLR with CTP scores Spearman nonparametric analysis p <0.05.
Results : There are 33 subjects in the study. Based on the results of this study found a positive significant correlation between the ratio of neutrophils to lymphocytes CTP with r = 0.749 and
p= <0.0001 and obtained the formula Y = 7.797 + 0,067x. Thus increasing of neutrophils to lymphocytes ratio positive correlated with the severity of liver cirrhosis.
Conclusion. There are positive correlation between the neutrophil to lymphocyte ratio with CTP scores in patients with liver cirrhosis.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/27003
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/27006
2017-07-27T06:56:11Z
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Prognostic Value Of Chemotherapy-Induced Neutropenia In Metastatic Colorectal Cancer At Rsup Dr Sardjito Yogyakarta
Qomaruzzaman, Muhammad Ihsan
Kurnianda, Johan
Hardianti, Mardiah Suci
Array
Background: Colorectal cancer is the third largest incidence of cancer in the world and is the third most common cause of death in women and men . Five-year overall survival (OS) in colorectal cancer who have undergone metastasis was 10 % . Hematologic toxicity may be a marker of biological activity of cytotoxic drug on various types of cancer . Neutropenia
after chemotherapy known to be associated with increased patient survival .
Objective : To establish whether chemotherapy-induced neutropenia is predictive of better outcome in patients with metastatic colorectal cancer (mCRC).
Methods: This research was a case-control study. Subjects were patients with metastatic colorectal cancer in the Cancer Instalation Center Tulip RSUP dr. Sardjito who meet the inclusion and exclusion criteria. Data were analyzed by bivariate analysis using chi square test and multivariate analysis with logistic regression.
Results: Neutropenia present in 26 patients (32.5%) of the total 80 patients of the study. Neutropenia were significantly affect OS ( p = 0.001 and OR 7.73, 95% CI: 2.51-23.80). Multivariate logistic regression analysis showed neutropenia and the number of metastases affect OS with p <0.001 and p <0.003.
Conclusion: Neutropenia occurring during the two first lines of chemotherapy for metastases colorectal cancer is associated with better survival. Variables that affect OS is the number of metastases and incidence of neutropenia after chemotherapy.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/27006
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/27007
2017-07-27T06:56:12Z
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Treating depression in diabetic patients: Latihan pasrah diri (LPD) revisited
Siswanto, Agus
Siregar, Arief Kurniawan
Asdie, Ahmad Husain
Array
The condition accompanying depression will always be progressing into poor prognosis if the depression itself is not recognized and treated properly. Among diabetic patients, depression was associated with increased mortality and poor quality of life . It was observed that diabetes and depression has a bidirectional relationship, where the clinical course of both conditions are affecting each other. Despite the effectiveness of psychological and psychopharmacological interventions in treating depressive symptoms in diabetic patients, the effect of such interventions on glycemic control is still inconsistent. Complementary alternative medicine (CAM) alone or in combination with standard medical treatment, targeting both depression and diabetes, appears to be promising. Latihan Pasrah Diri (LPD) has been recognized as a type of relaxation technique under CAM. It is initially directed to provide adequate relieve of depression using both religious and relaxative approach. Among patients with comorbid diabetes and depression, this approach has long been known and utilized over the counter, but its formal practice is seldom advocated, whereas, many clinical trials has been conducted locally to reveal its potential use. Combined with standard therapy, LPD is expected to show its beneficial effects.
Faculty of Medicine Universitas Gadjah Mada
2017-07-27 13:56:12
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/27007
Acta Interna: The Journal of Internal Medicine; Vol 6, No 1 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2017 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35840
2018-05-27T07:52:34Z
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The relationship between six minutes walking distance and quality of life in pulmonary tuberculosis sequelae patients
Retnowulan, Heni
The Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Achadiono, Deddy Nur Wachid
The Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Rengganis, Anggraeni Ayu
Bachelor Degrees, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Array
ABSTRACT
Background: Tuberculosis is an infectious disease that affects the lung and has high incidence. It could leave sequelae in the patient that has been declared cured. Tuberculosis sequelae results in changes of lung function that could lead to deteriorating of functional capacity and quality of life.
Aim: The study aim to determine the relationship between functional capacity (6MWD) and quality of life (SGRQ) within pulmonary tuberculosis sequelae patients.
Method: This study used cross sectional design and performed on pulmonary tuberculosis sequelae patient in pulmonary clinic of Dr. Sardjito General Hospital and BP4 Yogyakarta. Functional capacity was assessed with six minutes walking distance and assessment of quality of life using SGRQ questionnaire. Distribution of data was tested using the Shapiro-Wilk statistical test. Spearman correlation test and regression test was used to analyze the correlation between 6-minute walking distance test and assessment of quality of life using the SGRQ questionnaire.
Result: The 6 minutes walking distance was 257.02±64.56 m. There were significant negative correlation between 6 minutes walking distance and SGRQ score activity domain (r=-.333, p<0.05). The others domains in SGRQ, there were no significant negative correlation at domain symptoms (r-.062), impacts (-.114), and total (-.135).
Conclusion: There were negative correlation between the 6 minutes walking distance (6MWD) and SGRQ score. There was significant negative correlation between 6 minutes walking distance (6MWD) and activity domain in the SGRQ score.
Keywords: tuberculosis sequelae, functional capacity, 6MWD, quality of life, SGRQ.
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/35840
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35841
2018-05-27T07:52:34Z
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Relationship between Degrees of Dyspnea with Functional Capacity in Pulmonary Tuberculosis Sequelae Patients
Achadiono, Deddy Nur Wachid
The Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Retnowulan, Heni
The Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Nugroho, Eko
Bachelor Degree, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital
Array
ABSTRACT
Background: TB disease is still a serious health problem. Due to the changes that occur because of TB infection, appears sequelae in patients with pulmonary tuberculosis. TB sequelae will have an impact on the patient’s life, especially to do with the degree of dyspnea and functional capacity.
Objective: To know the relationship between degree of dyspnea with functional capacity in pulmonary tuberculosis sequelae patients.
Method: The design of this study is cross-sectional observational study. Subjects were patients with TB who have had at least 6 months of therapy that has been declared cured by leaving sequelae in Dr. Sardjito Hospital and BP4 Yogyakarta in September 2013. The sample was selected based on the selection criteria. Statistical analysis is using One-Way ANOVA.
Results: From the 42 patients, there were 78.6% of patients with MRC scale 0, 11.9% of patients with MRC scale 1, and 4.8% respectively of patients with MRC scale 2 and 3. The mean of 6-minute walk test distance is 257.02±64.56 meters. There is a significant relationship on comparison of the mean of 6-minute walk test distance on each MRC scale (p = 0.028).
Conclusion: There is a relationship between degrees of dyspnea with functional capacity in pulmonary tuberculosis sequelae patients.
Keywords: tuberculosis sequelae, degrees of dyspnea, functional capacity
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/35841
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35842
2018-05-27T07:52:34Z
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EFFECT OF NARROW BAND ULTRA VIOLET B (NBUVB) PHOTOTHERAPY TO DECREASE SERUM FERRITIN LEVELS IN URAEMIC PRURITUS PATIENTS WHOSE UNDERGOING REGULAR HEMODIALYSIS IN DR. SARDJITO HOSPITAL YOGYAKARTA
Nugroho, Muhammad Himawan
Specialty of training program, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada
Ikhsan, Muhammad Robikhul
Endocrine Metabolic and Diabetes Division, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada
Kuswadi, Iri
Nephrology and Hypertension Division, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada
Array
ABSTRACT
Background. Uraemic pruritus is the complaint most often found in patients with terminal renal failure (15-49 %) and hemodialysis patients (50-90%). Mikroinflamasi role as ferritin be one cause. Phototherapy NBUVB theoretically can lower serum ferritin, thereby reducing the intensity of pruritus in patients .
Objective. The main objective to determine the effect of phototherapy NBUVB to decrease serum ferritin levels of uremic pruritus patients undergoing regular hemodialysis. The next goal NBUVB know the influence of phototherapy to decrease the intensity of itch (VAS).
Methods. Quasi experimental with pre-post comparison design, comparing the reduction in serum ferritin levels before and after phototherapy NBUVB, here p < 0.05 is said to be significant.
Results. A total of 29 subjects who underwent the study protocol, 18 were male, the average age was 55.7 years, the largest cause of kidney disease is hypertension (48.3%), average 4.2 years old undergoing hemodialysis. There was a decrease which signifkan where median serum ferritin levels before phototherapy 1693 ng/mL (12.05 to 6000) and after phototherapy 275 ng/mL (12.55-6000) with p 0.001. The degree of intensity of pruritus also decreased significantly where the median VAS before phototherapy 7 (4-10) and after phototherapy 4 (2-8) with p 0.001.
Conclusions. Phototherapy NBUVB lowering serum ferritin levels and degrees of intensity of pruritus (VAS) of uraemic pruritus in patients undergoing regular hemodialysis.
Keywords : CRF (Chronic Renal Failure), Hemodialysis, Uraemia pruritus, Serum Ferritin, Phototherapy NBUVB
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/35842
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35843
2018-05-27T07:52:34Z
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ASSOCIATION BETWEEN NUTRITIOUS STATUS AND LIFE QUALITY OF ELDER PEOPLE VISITING GERIATRIC CLINIC AT DR. SARDJITO HOSPITAL
Muhipah, Muhipah
Specialty Training Program, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General
Pramantara, I Dewa Putu
Geriatric Division, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General
Achadiono, Deddy Nur Wachid
Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General
Array
ABSTRACT
Background. Successful development in health sector cause shift in world population to older age. Yogyakarta Special Territory reveals highest percentage in amount of elderly people in Indonesia (13.7%). Prevalence of decrease in nutritional status rise along with age. Individual with low nutritional status is vulnerable to some diseases such as depression, cognitive disturbance and dementia progressivity. Nutritional status on elderly people is subject ignored in clinical practice. Prevention and early intervention is the best approach to obtain optimal nutrition.
Objective. To identify association between nutritional statuses measured using MNA score and life quality measured with WHOQOL-BREF at elderly patient visiting geriatric clinic in Dr. Sardjito Hospital.
Method. This research used cross-sectional design on elderly population in Dr. Sardjito Hospital. The research was conducted in October 2014. It includes elderly persons meeting inclusion and exclusion criteria, nutritional status assessed with MNA score and measurement of life quality with QHOQOL-BREF including four domains: physical aspect, psychological aspect, social relationship and environment.
Result: There is significant correlation with p<0.001 between MNA and domain 1 (physical aspect) where Pearson correlation of 0.546 indicates positive correlation with weak correlation. Association of MNA and domain 2 (physical aspect) indicates significant correlation with p =0.006 with Pearson correlation of 0.435 indicating positive correlation with moderate correlation. There is significant correlation between MNA and domain 3 (social aspect) with p=0.005 and Pearson correlation of 0.437 indicating weak correlation. Association of MNA and domain four (environment aspect) indicate significant correlation with p=0.007 and Pearson correlations core of 0.426 indicating positive correlation with moderate correlation.
Conclusion. The results indicate significant association between nutritional status (MNA) and life quality based on WHOQOL viewed from physical aspect (domain 1), psychological aspect (domain 2), social aspect (domain 30 and environmental aspect (domain 4) on elderly person.
Keywords: Geriatrics, MNA, quality of life
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/35843
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35844
2018-05-27T07:52:34Z
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"180527 2018 eng "
2541-5441
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The Effects of Aerobic Exercise on Functional Capacity of Geriatric Chronic Heart Failure Patients
Rouf, Muhammad Khalimur
Specialty Training Program of Internal Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta
Arso, Irsad Andi
Cardiology division of Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta
Pramantara, I Dewa Putu
Geriatric division of Internal Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta
Array
Background: Chronic heart failure, a condition predominantly affecting the elderly, is a major clinical burden and cause death in admission patients especially the elderly population. The focus of cardiac rehabilitation recently is exercise used as one of the modality of therapy designed for stable heart failure patients. Exercise is recommended as one of modality in management of heart failure to improve prognosis, increase physical activity tolerance and quality of life of heart failure patients.
Aim: The objective of this study is to understand is aerobic exercise program can improve functional capacity in geriatric heart failure patients.
Methods: The design of this study is randomized controlled trial. Twenty subjects were cardiology outpatient clinic at Dr Sardjito hospital men and women with chronic heart failure functional class I-II of NYHA age > 60 years and agreed to be included to the study. Subjects were divided into two group randomly, which were the exercise group (10 subjects) and the control group (10 subjects). To compare the functional capacity of both groups, t-test independent is used with condition of normal data range and Mann Whitney test is used if abnormal data range is found. The level of significance was set at p<0,05 with confidence interval 95%
Result : Comparison of the mean increase in the six minute walk test distance between aerobic exercise group 107.9 ± 22.153 meters compared with the control group 21.3 ± 16.166 was significantly better in the aerobic exercise group (p <0.001)
Conclusion : Aerobic exercise can improve the functional capacity of patients with chronic heart failure in the elderly.
Keyword: chronic heart failure, elderly, aerobic exercise, functional capacity.
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
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https://jurnal.ugm.ac.id/jain/article/view/35844
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/35845
2018-05-27T07:52:34Z
jain:ART
nmb a2200000Iu 4500
"180527 2018 eng "
2541-5441
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Overlap in Patient with Functional Dyspepsia and Unspecified Functional Anorectal Pain
Cahyono, Suharjo B
Department of Internal Medicine, Charitas Hospital, Palembang
Ratnasari, Neneng
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Gadjah Mada University-Sardjito General Hospital, Yogyakarta
Nurdjanah, Siti
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Gadjah Mada University-Sardjito General Hospital, Yogyakarta
Array
Functional gastrointestinal disorders (FIGD) represent a common and important class of disorders within gastroenterology. FIGD are a cause of great anxiety, distress and morbidity. FIGD disorders maybe manifest as overlapping syndrome. Patients with functional dyspepsia (FD) show frequent overlapping of other gastrointestinal disease, such as functional anorectal pain. These overlap patients have more frequent or more severe symptoms, poor health related quality of life and higher somatization scores, and they are more likely to experience anxiety, depression or insomnia compared to non-overlap patients. These disorders were diagnosed according Rome III criteria and excluded structural diseases. Multimodalities approach should be used during treatment patient with FGID. It was reported a male patient with functional dyspepsia and unspecified functional anorectal pain overlap.
Keywords: Functional gastrointestinal disorders, functional dyspepsia, functional anorectal pain
Faculty of Medicine Universitas Gadjah Mada
2018-05-27 14:52:34
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/35845
Acta Interna: The Journal of Internal Medicine; Vol 6, No 2 (2016): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2018 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48160
2019-08-02T02:59:26Z
jain:ART
nmb a2200000Iu 4500
"190802 2019 eng "
2541-5441
2303-131X
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Relationship between the MELD score with severity erectile dysfunction in cirrhotic patients
Afprianto, Doddy
Nurdjanah, Siti
Ikhsan, Muhammad Robikhul
Array
Background. Liver cirrhosis is a pathological condition that describes the end stage of hepatic fibrotic which progressively ongoing that signed by distortion from hepar architecture and the formation of the regenerative modulus. Liver cirrhosis causes impairment in most of the liver function including the hormonal balance and metabolism of steroids. In the male patients, liver cirrhosis causes hypogonadism and feminization. Sexual dysfunction in cirrhotic patients is still underestimated and underdiagnosed. The most common sexual dysfunction in male cirrhotic patients is impotence or erectile dysfunction. Erectile dysfunction (ED) is define as a persistence inability to reach and/ or maintain enough erection to satisfy the sexual activity. International Index of Erectile Function 5/IIEF-5 could mark erectile dysfunction. Despite the prevalence of erectile dysfunction is high in patients with liver cirrhosis, only a few studies revealing the relationship between severity of liver cirrhosis and severity of erectile dysfunction.
Objective. The purpose of this study is to determine the correlation between MELD score and severity of erectile dysfunction (IIEF-5 score) in cirrhosis patients.
Methods. This study is observational with a cross-sectional method. Subjects were patients with liver cirrhosis, male, age 18 to 65 years old, married, have a partner, and agreed participated to this study. We used Pearson the correlation to assess correlation between severity of liver cirrhosis (Child Pugh score) and severity of erectile dysfunction (IIEF-5 score) if the data were distributed normally and Spearman correlation if the distribution is abnormal.
Conclusion. There is negative correlation with the moderate strength degree between MELD score (the degreee of severity in liver cirrhosis) with the IIEF-5 score (the degree of erectile dysfunction).
Keywords: liver cirrhosis, MELD score, erectile dysfunction, IIEF-5, correlation.
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
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https://jurnal.ugm.ac.id/jain/article/view/48160
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48161
2019-08-02T02:59:26Z
jain:ART
nmb a2200000Iu 4500
"190802 2019 eng "
2541-5441
2303-131X
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Interleukin-8 expression differences in chronic and active chronic inflammation gastric mucosa biopsy with helicobacter pylori infection
Arif, Muhammad
Nurdjanah, Siti
Ratnasari, Neneng
Array
Background: Infection with Helicobacter pylori (HP) estimated to occur in 50% of the population in the world. Helicobacter pylori infection causes inflammation of the gastric mucosa and gastric epithelial release of interleukin-1β, interleukin-6, interleukin-8 and tumor necrosis factor α. Interleukin-8 plays a role in the degree of chronic inflammation of the gastric mucosa and gastric cancer risk. There has been no research on differences in the expression of interleukin-8 is based on chronic and chronic active inflammation on biopsy of the gastric mucosa with Helicobacter pylori infection in Hospital Dr. Sardjito.
Objective: To prove the differences in the expression of interleukin-8 of chronic inflammation and gastric mucosal biopsy active chronic infection with Helicobacter pylori.
Methods: This study used a cross-sectional design. Examined the expression of interleukin-8 on the rest of the biopsy sample HP (+) in August 2009 to March 2014. Classification of chronic inflammatory and chronic active obtained through histopathology report. Categorical numerical data from the two groups, unpaired, the distribution is not normal: Mann-Whitney test. Differences were considered significant if it was obtained p <0.05 with a confidence interval of 95%.
Results: There were 41 samples of gastric mucosa biopsy preparations, comprising 9 samples of chronic inflammation and 32 samples of chronic inflammatory active of the gastric mucosa. The median value of the expression of IL-8 eptitel surface on chronic inflammation by 83 (40-94)% and the active chronic inflammation by 82 (19-94). Comparison test with Mann Whitney U test. From the statistical calculations p value = 0.887 with p> 0.05
Conclusion: There is no difference in the expression of interleukin-8 in inflammatory chronic active and chronic inflammation of the gastric mucosa with Helicobacter pylori infection.
Keywords: Helicobacter pylori, interleukin-8, chronic inflammation and chronic inflammatory active.
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
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https://jurnal.ugm.ac.id/jain/article/view/48161
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48402
2019-08-02T02:59:26Z
jain:ART
nmb a2200000Iu 4500
"190802 2019 eng "
2541-5441
2303-131X
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Effect Of Latihan Pasrah Diri (Lpd) Plus Fluoxetin Compared With Fluoxetin Alone To Improve Fructosamine Level In Tipe 2 Diabetes Mellitus Patients With Depression Symptoms
Muin, Natsir
Siswanto, Agus
Asdie, Ahmad Husain
Array
ABSTRACT
Background. Depression is a risk factor for diabetes and diabetes increase the risk for depression. Depression contributes to progression of diabetes mellitus. Examination of fructosamine is used to monitor blood sugar control for 2-3 weeks (according to age albumin). LPD evoke the relaxation response, which expected to improve symptoms of stress or depression.
Objective. To determine the decrease in fructosamine levels in the group of patients with diabetes mellitus with depression symptoms after administration of fluoxetine alone compared with a combination of fluoxetine and LPD.
Methods. This research conducted in Dr.Soeradji Tirtonegoro General Hospital, in May to August 2014. Distribution of data tested using the Shapiro-Wilk test. The differences between fructosamine and BDI (Beck Depression Inventory) before and after treatment tested with a pair t-test if normally distributed or Wilcoxon test if it was not normally distributed. The decrease in fructosamine and BDI both groups compared by independent t-test if normally distributed or Mann Whitney U test if not normally distributed. Differences were considered significant if p <0.05 with a confidence interval of 95%.
Result. There was a significant decrease in fructosamine levels in treatment group from 293.90±140.042 to 239.01±133.13 after treatment with p value 0.017 (p <0.05). Control group from 263.13±163.65 to 219.01±149.33 with p value 0.001 (p<0.05). The decrease of fructosamine levels not differ in the treatment group 67.24±102.71 than the control group 71.14 ± 72.77 with p value = 0.902 (p> 0.05).
Conclusion. LPD had no effect on fructosamine levels of type 2 diabetes mellitus patients with depression symptoms.
Keywords: LPD, symptoms of depression, fructosamine, BDI (Beck Depression Inventory)
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/48402
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48403
2019-08-02T02:59:26Z
jain:ART
nmb a2200000Iu 4500
"190802 2019 eng "
2541-5441
2303-131X
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Effect of Metformin and Valsartan Toward Homa-IR in Metabolic Syndrome Patient with Non-Alcoholic Fatty Liver Disease (NAFLD)
Kirmawanto, Prasetio
Nurdjanah, Siti
Ikhsan, Muhammad Robikhul
Array
ABSTRACT
Background: Insulin sensitizer drugs such as metformin has suggested giving in metabolic syndrome patient and NAFLD, which both pathogeneses were insulin resistance. Angiotensin II receptor blocker (ARB), anti-hypertension drugs, has the similar properties to improve regulation of Proliferator-Activated Receptor Gama (PPARɤ). This aim of the study is to prove the improvement of insulin resistance which examined by HOMA-IR method on metabolic syndrome patient with NAFLD after receiving metformin and valsartan medication.
Method: This study was conducted to the patient in Endocrinology Clinic Sardjito General Hospital aged 35-36 years who meet diagnostic criteria for metabolic syndrome based on the IDF in 2006 and NAFLD. Convenience sampling method is done for 11 months (May 2012 – March 2013) and was expected sample size 35. HOMA-IR examination made before and after administration of metformin and valsartan for 12 weeks. Cut off value for HOMA –IR on pathological metabolic syndrome and NAFLD was ≥ 2. Medical and Health Research Ethics Committee (MHREC) Faculty of Medicine Universitas Gadjah Mada approved this study protocol.
Result: Subject of study retrieved 15 (43%), six males (40%) and nine females (60%) aged 43-63 years old. Median HOMA-IR baseline was 2.8 (0.6-14.5) and at the end of therapy was 3.8 (1.72-14.1). Eleven (74%) have increased HOMA-IR value and four (26%) experience declined but none of them reach the value below 2. In general clinical improvement occurs in the form of AST and ALT reduction but not statistically significant.
Conclusion: This study does not prove that administration of metformin and valsartan in-patient with metabolic syndrome with NAFLD would improve insulin resistance assessed by the HOMA-IR method.
Keywords: Metformin, valsartan, metabolic syndrome, NAFLD, HOMA-IR
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
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https://jurnal.ugm.ac.id/jain/article/view/48403
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48406
2019-08-02T02:59:27Z
jain:ART
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"190802 2019 eng "
2541-5441
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Effectiveness Combination of Ginger Extract (Zingiber officinale) and Ranitidine Compared with Combination of Ranitidine and Placebo against Severity of Functional Dyspepsia
Prapti, Dite Ari
Ratnasari, Neneng
Nurdjanah, Siti
Array
ABSTRACT
Background: Efficacy ranitidine as dyspepsia functional treatment was 8-35 % and ginger extracts as a traditional recipe in various countries for generations could be used as a therapy dyspepsia, antinausea, spasm, colic, and other stomach complaints. Ginger therapeutic effectiveness could reach 68-77% in vivo studies (animal models).
Objective: To determined how much influence combination of ginger extract and ranitidine could improve severity of dyspepsia compared with combination of ranitidine and placebo in patients with functional dyspepsia.
Method: This study was a quasi experimental. The research was conducted from December 2015 until April 2016 with 26 participants.
Results: After getting therapy for 2 weeks in group I, mean SODA score in the pain scale decreased (8.4 %) of 29.07 ± 7.29 to 25.08 ± 8.22, statistically significant (p <0.046). Mean SODA score in the pain scale group II decreased (7.2%) of 25.38 ± 6.19 to 24 ± 6.01 (p=0.302). Mean SODA score in the non pain scale in group I decreased (7.7%) of 16.84 ± 2.44 to 15.15 ± 2.64 (p=0.074), while in the group II decreased (1.6%) of 15.77 ± 2.71 to 15.23 ± 2.94 (p=0.470). Mean SODA score in the satisfaction scale in group I increased (19.9%) of 7.77 ± 3.63 to 10.08 ± 3.59 (p=0.053) while in the group II increased (8.4%) of 9.62 ± 2.72 to 10.92 ± 2.46 (p=0.072). Comparison decline of SODA score in the pain scale between group I was 4.31 ± 6.3 and in group II is 1.23 ± 4.91, greater in group I but not significantly (p=0.178) at baseline to week 2nd. Comparison decline of SODA score in the non pain scale between group I was 1.69 ± 3.11 and in group II was 0.54 ± 2.6, greater in group I but not significantly (p=0.316) at baseline to week 2nd. Comparison increasing of SODA score in the satisfaction scale between group I was – 2.31 ± 3.88 and in group II was -1.31 ± 2.39, greater in group I but not significantly (p=0.437).
Conclusion: Combination of ginger extract and ranitidine could decrease pain scale, non pain scale and increase satisfaction scale more effective clinically than plasebo and ranitidine for functional dyspepsia patient, but not statistic significantly
Keywords: ginger extract, severity of dyspepsia, and functional dyspepsia
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
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https://jurnal.ugm.ac.id/jain/article/view/48406
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/48439
2019-08-02T02:59:25Z
jain:ART
nmb a2200000Iu 4500
"190802 2019 eng "
2541-5441
2303-131X
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Effects of Erdosteine Administration in Serum C-Reactive Protein Level in Stable Chronic Obstructive Pulmonary Disease Patients
Budiono, Eko
Ratnasari, Neneng
Tjandra, Lina
Array
Background. Systemic inflammation contributes to the development of intrapulmonary and extra pulmonary disorders, and as an independent risk factor for exacerbation of chronic obstructive pulmonary disease (COPD) has proven. The use of corticosteroids as anti-inflammatory agents has limitation for their undesirable side effects and different efficacy among the patients. Erdosteine, a mucolytic agent widely used in COPD, has been proven to be able to inhibit several mediators such as reactive oxygen species (ROS) and eicosanoids, which are involved in oxidative stress and inflammation.
Objective. This study aimed to discover the effects of erdosteine administration in serum C - reactive protein (CRP) level in stable COPD patients.
Methods. The research was a randomized controlled trial, which compared add-on therapy used erdosteine 300 mg bid versus placebo, for 10 days, combined with COPD standard treatments. The patients was recruited at RSKP Respira Yogyakarta outpatient clinics. Diagnoses were confirmed used spirometry based on GOLD criteria. Evaluation of CRP levels was hold before treatment and on the eleventh day, used highly sensitive quantitative immunometric assay.
Result. Thirty-eight legible COPD patients recruited and randomly assigned to either erdosteine group or placebo group. One patient in erdosteine group was drop out because of exacerbation and one patient from each group were lost to follow up. There are 35 subjects (97.1% men, age range 40-77 years, median FEV1 0.83 (0.50-10.08) L, hs-CRP 0.84 (0.18-18) mg/L) who completed the study, 19 subjects in erdosteine and 16 subjects in placebo group. Baseline characteristics were similar between two groups. There were no significant decreases in median hs-CRP level in erdosteine vs. placebo group at day 11 (-0.10 (-16.16-+4.31) vs. 0.005 (-11.7-+11.03) mg/L; p 0.275). In COPD GOLD 3 sub-population, hs-CRP serum level decline was greater in erdosteine group compared to placebo (-0.56 (-16.16-+0.44) vs. 0.11 (-11.7- +11.03) mg/L; p 0.03) this might be related to greater oxidative stress in severe COPD that makes antioxidative effects of erdosteine reduce CRP more significantly in severe COPD.
Conclusion. Effects of erdosteine supplements, 300 mg bid for 10 days, could decrease hs-CRP level in erdosteine insignificantly compared to placebo.
Keywords: table COPD, C-reactive protein, erdosteine, FEV1, GOLD
Faculty of Medicine Universitas Gadjah Mada
2019-08-02 09:59:27
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/48439
Acta Interna: The Journal of Internal Medicine; Vol 7, No 1 (2017): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/50889
2019-11-11T07:10:47Z
jain:ART
nmb a2200000Iu 4500
"191111 2019 eng "
2541-5441
2303-131X
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Relationship between Interleukin-6 Expression with the Progressive and Severity of Ulcerative
Widodo, Arif Nur
Ratnasari, Neneng
Nurdjanah, Siti
Array
Background. Based on international statistics, the incidence of Inflammatory Bowel Disease (IBD) is about 2.2-14.3 cases per 100.000 people per year for Ulcerative Colitis (UC). In Indonesia, there is no epidemiological study of IBD. To assess the degree of severity associated with the ulcerative colitis disease can be used a variety
of tools, including the Truelove Witts score which has sensitivity and specificity that high enough for UC in the phase of active disease. Interleukin-6 (IL-6) is a pro-inflammatory cytokine that plays a very important role in the self-defense mechanism and acts as an acute-phase protein. Serum levels of IL-6 and increased expression in the colonic mucosa of active IBD patients indicate the level of IBD disease activity.
Aims. The aim of the study was to determine the relationship between Interleukin-6 expression (IL-6) and the severity of UC disease using Truelove Witts classification.
Methods. This study used a cross-sectional method that analyzed the relationship between IL-6 expression and UC weighing based on Truelove Witts classification using colon tissue biopsy results from UC patients who met inclusion and exclusion criteria.
Results. Th ere were 26 subjects studied and performed an endoscopic analysis and anatomical pathology. Mean age of research subjects were 52.73 + 11.11 years with men's favored subjects (n = 15). Subjects were severe UC 16 (61.5%), moderate 7 (26.9%) and mild 3 (11.5%). More male subjects in mild UC, 12 vs. 3 and more female subjects in moderate-severe UC, 4 vs. 7 (p 0.032). Signifi cant diff erences in IL-6 expression in defecation were > 4 times/day, IL-6 300 (285-400) versus defecation < 4 times/day, IL-6 295 (212.1-340) p 0.039. Signifi cant diff erence in IL-6 expression between mild UC 295 (212.1-340) with moderate- severe UC 301.66 (235.57-400) with p value 0.032.
Conclusion. IL-6 expression in moderate-severe UC subjects was higher than mild UC subjects based on Truelove Witts criteria.
Keywords: Inflammatory Bowel Disease, Ulcerative Colitis, Truelove Witts classification, Interleukin-6.
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
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https://jurnal.ugm.ac.id/jain/article/view/50889
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/50900
2019-11-11T07:10:48Z
jain:ART
nmb a2200000Iu 4500
"191111 2019 eng "
2541-5441
2303-131X
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Validation of the Palliative Prognostic Score (PaP score) in Patients with Metastatic Cancers in Dr. Sardjito General Hospital Yogyakarta
Dewanti, Prafita Cahya
Kurnianda, Johan
Widayati, Kartika
Array
Background. The mortality burden of cancer continues to increase in developing countries, most likely because of a late-stage at diagnosis. Identify the terminal stage is important in patients with advanced cancer because no longer aggressive therapy in patients with terminal cancer. Palliative prognostic score (PaP score)
is a scoring system to predict the probability of survival within 30 days in patients with advanced cancer. PaP score divided into the heterogeneous patient sample into three iso-prognostic groups related to the chance of 30-days survival. Group A, score: 0 to 5.5 (the probability of survival within 30 days > 70%); Group B, score: 6-11 (the probability of survival in 30 days 30-70%) and group C, the score: 11.5 to 17.5 (the probability of survival in 30 days <30%).
Aims. The aim of this study was to validate and to evaluate the prognostic accuracy of the palliative prognostic (PaP score) to predict 30-days survival in patients with metastatic cancers in Dr. Sardjito General Hospital Yogyakarta.
Methods. The design of this prognostic study was cohort, including patients with metastatic cancers who were visited in Tulip Hematology and Medical Oncology Clinic, inpatient and outpatient care in Dr. Sardjito General hospital during May 2015 until May 2016. The PaP score calculated in 159 consecutive patients with metastatic cancers. The positive predictive value of the PaP score was evaluated and survival analysis was performed to compare the survival of the three prognostic groups.
Results. PaP score tested on 159 subjects with overall median survival was 90 days, 76 subjects categorized into group A, 22 subjects into group B and 61 patients into group C. The 30-day survival probability was 98.7% for group A (median survival could not be assessed), 63.6 % probability of 30-day survival for the group B with median survival was 35 days and for group C with 3.3% probability of 30-day and median survival was 6 days. These survival differences were highly significant (log-rank test of trends, X =203.97; P<0.0001).
The positive predictive value of the PaP score in predicting 30-day mortality was 96.7% with an accuracy of PaP the score was 93.1%.
Conclusion. PaP score was a valid test tool in determining prognosis in patients with metastatic cancers with high accuracy and precision in predicting 30-days survival.
Keywords: PaP score, validation, survival, prognostic, metastatic cancers.
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/50900
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/50901
2019-11-11T07:10:48Z
jain:ART
nmb a2200000Iu 4500
"191111 2019 eng "
2541-5441
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Infl uence of Pursed-Lips Breathing to Improve Quality of Life in Chronic Obstructive Pulmonary Disease Patients
Elfa, Meldy Muzada
Budiono, Eko
Retnowulan, Heni
Array
Background. Worsening of Chronic Obstructive Pulmonary Disease (COPD) may decrease the quality of life of patients. Rehabilitation of patients with COPD may increase exercise tolerance and improve quality of life. Pursed-Lips Breathing (PLB) activates abdominal muscles during expiration for improving gas exchange and oxygen saturation in the arteries, increasing the tidal volume and reduce shortness of breath, anxiety, and tension thus improving the quality of life. St George's Respiratory Questionnaire (SGRQ) was a tool to measure the quality of life of patients with COPD, which has been validated. Patients with improved quality of life were characterized by a decrease in the SGRQ score after PLB training.
Aims. Analyze the effect of improved quality of life in patients with stable COPD using PLB + standard therapy compared to standard therapy only.
Methods. This research used an open-label Randomized Controlled Trial (RCT) design and conducted in patients with COPD stages 2 and 3. It was performed in Rumah Sakit Khusus Paru (RSKP) Respira Bantul, Yogyakarta. The study group was composed of 47 subjects, who continued the previous standard therapy
and performed PLB 8 minutes once a day for 28 days. The placebo group (44 samples) continued the previous standard therapy alone. Measuring the quality of life using the SGRQ performed in both groups
before and after the experiment. Statistical analysis included independent t-test and Mann Whitney U-test.
Results. Th ere were improvements in the quality of life that clinically characterized by a decrease in SGRQ total score of 12.19 points out of 100 points total in the PLB group. Th ere was a very significant difference in the decline in total SGRQ score between the study group and placebo groups (p <0.001).
Conclusion. Pursed-Lips Breathing (PLB) improves the quality of life of patients with stable COPD was characterized by a decrease in SGRQ of 12.19 points out of 100 points total.
Keywords. COPD (Chronic Obstructive Pulmonary Disease), PLB (Pursed-Lips Breathing), SGRQ (St George’s Respiratory Questionnaire), quality of life
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/50901
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/50906
2019-11-11T07:10:48Z
jain:ART
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"191111 2019 eng "
2541-5441
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Th e Accuracy of Delta Neutrophil Index as a Marker of Sepsis Severity Level Compare to Serum Amyloid A
Halim, Silvikarina Erfanti Dewi
Asdie, Rizka Humardewayanti
Priambodo, Doni
Array
Background. Early diagnosis of infection before its progression to become organ dysfunction or circulation failure has an important clinical effect and critical patient outcome. Diagnostic modality used as a gold standard on diagnosing sepsis condition still relies on microbe culture. Microbial culture needed a long duration to grow bacteria in high numbers be identified. The upcoming alternative diagnostic modality used as a marker of sepsis severity level was Delta Neutrophil Index (DNI) and Serum Amyloid A (SAA). There were no references to compare the accuracy of DNI and SAA as a marker of sepsis severity level.
Methods. 45 study subjects were patients with sepsis and severe sepsis or septic shock first known when first come to the ER or underwent treatment in the inpatient unit, ICU (Intensive Care Unit) or IMC (Intermediate Care) Sardjito’s Hospital that fulfilled the inclusion and exclusion criteria. The independent variable was DNI and the dependent variable was sepsis severity level. All of blood samples from septic patient undergo DNI and SAA test. Distributed data used the Kolmogorov-Smirnov test. DNI and SAA accuracy used sensitivity, specificity, positive predictive value, negative predictive value, like hood ratio and receiver-operating characteristics (ROC) curve.
Results. The study consisted of 45 study subjects. The mean age was 52.98 years. The mean of SAA in this study was 54.39 ± 45.53 mg/L, while the mean of DNI in this study was 12.47 ± 8.79 %. Cut off point DNI 6.85% with value of sensitivity 93%, specificity 70%, positive predictive value (PPV) 79.31%, and negative predictive value (NPV) 87.5%, like hood ratio for a positive test result (LR+) (PLR) 14.28 and like hood ratio for a negative test result (LR-) (NLR) 3.3. Cut off for SAA 54.93 mg/L with value of sensitivity 60%, specificity 56%, positive predictive value (PPV) 52%, negative predictive value (NPV) 64%, like hood ratio for a positive test result (LR+) (PLR) 1.36 and likelihood ratio for a negative test result (LR-) (NLR) 0.71.
Conclusions. DNI has better diagnostic accuracy value as a marker of sepsis severity level than SAA.
Keywords. Sepsis, sepsis severity level, Delta Neutrophil Index (DNI), Serum Amyloid A (SAA)
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
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https://jurnal.ugm.ac.id/jain/article/view/50906
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/51362
2019-11-11T07:10:49Z
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Cisplatin Desensitization in a Patient with Nasopharyngeal Carcinoma Experiencing Urticarial Allergic to Cisplatin
Nugraha, Doddy Rizqi
Specialty Training Program in Internal Medicine, Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada, Yogyakarta
Mulya, Deshinta Putri
Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Public Health
and Nursing, Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta
Hutajulu, Susanna Hilda
Array
Background. Allergic reactions to cisplatin are not uncommon situations with an incidence of 5-20%. In general, allergic reactions to cisplatin is a type 1 hypersensitivity with manifestations of itching, redness, papules, urticaria, chest pain, and anaphylactic symptoms. Desensitization methods are needed for patients who have no alternative medication.
Case Report. A 59-year-old woman with nasopharyngeal carcinoma experienced urticaria because of cisplatin in her first cycle of chemotherapy. In the second cycle, chemotherapy desensitization program was applied using a 12-step Castell protocol. We measured vital signs and symptoms every 15 minutes. Administration of cisplatin was completed in 2 hours and the patient tolerated the whole program very well.
Discussion. Risk factors of hypersensitivity to cisplatin include age <70 years, previous allergy history, history of carboplatin use with dose >650 mg, mutation of BRACA1/2 gene, and administration of combined regimens with taxane groups or liposomal inhibitor. Desensitization uses 3 solutions with 12 steps. Solution is 100 times the dilution of the target dose. Solution 2 is 10 times the dilution of the target dose and solution 3 uses the appropriate target dose. Each solution is administered for 15 minutes using an infusion pump. Strict monitoring of vital signs and patient symptoms are done every 15 minutes during the program.
Conclusion. Doctors should be aware of allergies to cisplatin. Currently, the allergic reaction to cisplatin can be overcome using the desensitization method when no alternative drug is not available.
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/51362
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/51364
2019-11-11T07:10:47Z
jain:ART
nmb a2200000Iu 4500
"191111 2019 eng "
2541-5441
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Th e eff ect of Providing Food Made from Resistant Starch Fiber (Dioscorea Esculenta, Maranta Arundinaceae L, Cucurbita Moschata, Manihot Utilissma) on the Improvement of Glycated Albumin in Type 2 Diabetes Mellitus Patients at Dr. Sardjito General Hospital
Adyarini, Dwita Dyah
Speciality Training Program in Internal Medicine, Faculty of Medicine, Public Health and Nursing,
Universitas Gadjah Mada/Dr. Sardjito General Hospital
Sinorita, Hemi
Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Public Health and
Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Ikhsan, Muhammad Robikhul
Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Public Health and
Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Background. One of the characteristics of the Diabetes diet is giving food with a high complex carbohydrates, particularly fiber. The benefit of resistant starch fiber includes maintaining blood glucose and increasing insulin sensitivity.
Aims. This study aimed to find the effect of providing food made from resistant starch fiber (Dioscorea esculenta, Maranta arundinaceae L, Cucurbita moschata, Manihot utilissma) on the improvement of blood glucose control in diabetes patients based on glycated albumin test.
Methods. The Quasi-experimental study was used in diabetes type-2 patients who visited endocrinology polyclinic at Dr Sardjito Hospital, during 1 November 2015-31 January 2016. Food made from the resistant starch fiber was served as a daily snack for one month. Blood glycated albumin was examined before and after food providence. SPSS was used for statistical analyses.
Results. We recruited 17 subjects in the control group and 17 subjects in the treatment group. In the control group, the index of albumin was significantly deteriorated from 15.1% to 18.13%. In the treatment group, the index of albumin was reduced from 29.71% to 18.73% showing an improvement of 10.97% (p= 0.01).
Conclusion. There was a significant improvement of blood glycated albumin (10.97%) after consuming food that was made from resistant to starch fiber (p=0.01).
Faculty of Medicine Universitas Gadjah Mada
2019-06-01 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/51364
Acta Interna: The Journal of Internal Medicine; Vol 9, No 1 (2019): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2019 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61290
2020-11-17T03:45:54Z
jain:ART
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"201117 2020 eng "
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The Correlation between Thyroid Hormone Levels with Functional Mobility Performance among the Geriatric Patients in Dr. Sardjito General Hospital
Rumaropen, Henny
Ikhsan, M Robikhul
Pramono, Raden Bowo
Array
Background. Alteration of the endocrine system in the elderly people may be caused by changes in secreted hormone levels or decreased sensitivity of target organs. These changes also apply to thyroid function, which can cause disability, cognitive impairment, cardiovascular risk, and decreased muscle mass and strength in the elderly. Physiologically, there are several changes in the concentration of thyroid hormone Concentrations due to aging process, such as reduced TSH (Thyroid Stimulating Hormone), total T3 (Triiodothyronine) and free T levels, and increased rT3 (Reverse triiodothyronine), which is an inactive T (Thyroxine) metabolite in the serum. Even so,the free T4 and the total T44 remain unchanged, except for the sick. As a result, proper diagnosis and management are expected to minimize the deprivation experienced by the subjects due to a decrease in functional mobility.
Aims. The aim of the study was to assess the correlation between the levels of thyroid hormones and functional mobility among the elderly at Dr. Sardjito General Hospital, Yogyakarta.
Method. Observational descriptive and analytical study with cross-section design was performed. Subjects were recruited used a consecutive sampling method for subjects who met the inclusion and exclusion criteria. The statistical analysis used to find a correlation between the levels of the thyroid hormone and the performance of the functional mobility by Pearson Correlation test. Here the study used Spearman Correlation test if the conditions were not met the criteria. Significance limit with p < 0.05.
Results. A total of 36 research subjects who met the inclusion and exclusion criteria. The mean age was 69.67±6.164 years. Consisted of 16 (44.4%) male and 20 (55.6%) were female. The median of TSH (Thyroid Stimulating Hormone) was 1.170 (0.19-3.64) μIU/mL and the median free T was 1.280 (0.80-2.34) ng/dL. TSH level in male was more than female with same time in gait speed. The male median TSH level was 1.370 (0.60-3.64) μIU/mL and women 0.980 (0.19-3.17) μIU/mL. Slow gait speed more than thirty second (high risk of falling), the TSH mean in mas was 2.690 μIU/mL and women 1.150 μIU/mL. The test results indicate thyroid hormone level has no significant effect on functional mobility performance (timed up and go test score) in the elderly subjects (p value=0.531) and with level Free T4 (p value=0.721).
Conclusion: In this study population, thyroid hormones did not have a statistically significant correlation with functional mobility in the elderly. Males with higher serum levels and females with lower serum TSH (Thyroid Stimulating Hormone) were at increased risk of frailty.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
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https://jurnal.ugm.ac.id/jain/article/view/61290
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61292
2020-11-17T03:45:55Z
jain:ART
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"201117 2020 eng "
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Transient Elastography Changes on Patient with Hepatic Cirhossis who were Treated by Simvastatin 20 Mg Compared to Simvastatin 10 mg
tanoyo, Endro
Ratnasari, Neneng
Maduseno, Sutanto
Array
Background. Liver cirrhosis is a pathological condition that describes the end stage of liver fibrosis. Fibrosis is currently a two-way process. The process of returning from fibrosis now is a clinical reality. According to Abraldes et al. (2009), administration of simvastatin for one month will increase liver cell regeneration and improve endothelial dysfunction. Liver biopsy is still the gold standard for assessing liver cirrhosis, but this procedure is invasive and has the potential to cause life-threatening complications. Liver biopsy is complicated by sampling errors (reaching 30%) and different abilities between observers. Transient elastography (Fibro scan) is a non-invasive modality for diagnosing liver fibrosis that has high sensitivity and specificity.
Aim. The aim of the study was to discover the difference in effect, of simvastatin 20 mg compared to 10 mg for 3 months to improve liver stiffness in patients with liver cirrhosis.
Method. The study design used a double blind, randomized clinical trial. The subjects of the study consisted of a group given simvastatin 10 mg / day and the group given simvastatin 20 mg / day for 3 months. Routine medications for cirrhosis were still made according to the original dose. During the study, an initial and final transient elastography examination was carried out and monthly supervision of medication compliance and side effects. Data analysis for statistical tests was carried out by t-test, Mann Whitney test, fisher’s-exact test, and ANOVA test.
Result. A total of 21 subjects underwent thorough research and transient elastography. The simvastatin 10mg group (n = 12) experienced a decrease in liver stiffness, with a delta mean of liver stiffness of -4.97+7.09 (p <0.023) compared to the simvastatin 20 mg group (n = 9) with a heart stiffness of -4.09 + 10.06 (p= 0.982). Changed liver stiffness in the two groups were not statistically significant differences. Etiology and confounding drugs showed statistically no significant effect.
Conclusion. Both simvastatin 10 mg and 20 mg can reduce liver stiffness. The effect of the two doses of the drug in reducing liver stiffness was not statistically significant different.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
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https://jurnal.ugm.ac.id/jain/article/view/61292
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61296
2020-11-17T03:45:56Z
jain:ART
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"201117 2020 eng "
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Comparison of Prognostic Scores in Chronic Myeloid Leukemia (Cml) Patients with Bcr-Abl Mutation Types B3a2 and B2a2 in Dr. Sardjito General Hospital
Mulyani, Nina
Kurnianda, Johan
Hardianti, Mardiah Suci
Array
Background. Chronic Myeloid Leukemia (CML) is a myeloproliperative malignancy that is caused byreciprocal translocation between chromosomes 9 and 22 which form the BCR-ABL fusion gene. Most CML patients have a major type of BCR-ABL mutation. There are b3a2 and b2a2 types, which produce different oncoproteins in 25 amino acid elements. The expression of different proteins is thought to cause differences in clinical manifestations, laboratory, and prognosis. In CML, there are several prognostic scoring systems, including Sokal, Hasford, andEUTOS scores which combine clinical and laboratory parameters. The effect of this genomic breakpoint location on clinical and biological characteristics is still controversial.
Aims. The aim of this study was to determine the comparison of prognostic scores between CML patients with b3a2 and b2a2 BCR-ABL mutation types in Dr. Sardjito General Hospital.
Methods. This study was a cross sectional retrospective study used secondary data from medical records of Dr. Sardjito General Hospital, from March 2014 to April 2016. The prognostic score of Sokal, Hasford, and EUTOS was calculated in the BCR-ABL mutation type groups b3a2 and b2a2. Data were analyzed by Chi Square test.
Results. A total of 113 CML patients were analyzed with 74 (65.5%) b3a2 mutation type groups and 39 (34.5%) b2a2 mutation type groups. Hemoglobin levels, leukocytes, platelets, basophils, and eosinophils did not differ significantly between the two groups of mutation types. Meanwhile, the statistical test for the phase of disease when the patient was first diagnosed in both types of mutations showed a significant difference (p = 0.005). More patients with types of b2a2 mutations came in the acceleration and blast crisis phases than b3a2 types. However, Sokal, Hasford, and EUTOS prognostic scores in the b3a2 mutation type group were not significantly different from the b2a2 group (p> 0.05).
Conclusions. There was no significant difference in prognostic scores of CML patients with the b3a2 BCRABL mutation type compared with the b2a2 mutation type in Dr. Sardjito General Hospital Yogyakarta.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
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https://jurnal.ugm.ac.id/jain/article/view/61296
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61297
2020-11-17T03:45:57Z
jain:ART
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"201117 2020 eng "
2541-5441
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The Effect of Pursed-Lip Breathing on Functional Capacity of Stable Chronic Obstructive Pulmonary Disease Patient Assessed by Six Minutes Walk Test
Ariadie, Dimas Hudy
Sumardi, Sumardi
Retnowulan, Herni
Array
Background. The number of people with Chronic Obstructive Pulmonary Disease (COPD) in Indonesia isestimated to continue grow and currently has reached 4.8 million sufferers resulting in a large socio-economic burden. Management of COPD requires a comprehensive approach involving rehabilitation activities such as Pursed Lip Breathing (PLB) in order to increase the functional capacity of sufferers. Assessment of physical functional capacity of COPD patients can be evaluated through the Six Minute Walk Test / 6-minutes walk test, which can also assess changes in post-intervention functional capacity such as pulmonary rehabilitation
programs.
Aims. This study aimed to determine the effect of pulmonary rehabilitation with PLB technique for 4 weeks on the achievement of distance through a six-minute road test in COPD patients who received standard therapy.
Methods. An experimental, Randomized Controlled Trial (RCT) study was conducted on stable COPD patients with classification of Global Initiative for Chronic Obstructive Lung Disease stage II (GOLD 2) and GOLD 3 ( Stage III). The study was conducted at the Rumah Sakit Khusus Paru (RSKP) Respira Bantul, Yogyakarta. Subjects were taken randomly as a treatment Pursed Lips Breathing (PLB) or control group. The treatment group consisted of 38 subjects, doing PLB 8 minutes for 28 days (4 weeks) in a row. The placebo group consisted of 37 subjects only continuing the previous standard therapy. Six-minute walking test measurements were carried out in both groups before and after treatment and compared between the PLB and control groups. The difference in average delta range between groups that received PLB and controls was tested by unpaired t-test.
Results. There was a difference increase in the average delta range of the six-minute walk test which was not significant between the two study groups. The increase delta mean range in the six-minute walk test treatment group was greater (22.19 ± 45.54 meters) compared to the control group (18.54 ± 42.57 m), with a P = 0.720.
Conclusion. There was an improvement in functional capacity in the form of increased performance distance in the six-minute walk test for COPD patients who received standard therapy and pulmonary rehabilitation by pursed-lip breathing (PLB) technique.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
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https://jurnal.ugm.ac.id/jain/article/view/61297
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61344
2020-11-17T03:45:58Z
jain:ART
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"201117 2020 eng "
2541-5441
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Incorporation of Brentuximab Vedotin in the Treatment of Lymphoma: Current Evidence and Potential Use in Indonesia
Purwanto, Ibnu
Universitas Gadjah Mada/Dr Sardjito General Hospital
Array
Although scientific advances have resulted in significantly improved survival among lymphoma patients, certain subsets of lymphoma patients still have poor prognosis, which includes relapsed and treatment refractory patients. Brentuximab vedotin, an anti-CD30 targeted therapy has shown remarkable results given in both Hodgkin and non-Hodgkin lymphoma, even in cases without CD30 expression. Unfortunately, evidence of its effectiveness in Indonesian patient is still limited as there is only 1 case report of such subject published.
Conclusion: Brentuximab vedotin, an anti-CD30 targeted therapy presents as an effective therapeutic option for relapsed and treatment refractory lymphoma patients.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
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https://jurnal.ugm.ac.id/jain/article/view/61344
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/61348
2020-11-17T03:45:57Z
jain:ART
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"201117 2020 eng "
2541-5441
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Persistent Lymphopenia as a Predictor of in-Hospitality in Septic Patients at Dr. Sardjito Hospital
Kurniawan, Juvita
Universitas Gadjah Mada
Array
Background: Sepsis, a life-threatening organ dysfunction caused by deregulation of body response to an infection with a high mortality rate. Pro-inflammatory cytokines are related to early mortality related sepsis, and immune dysfunction and suppression characterized by lymphocyte loss are related to late mortality. Persistent lymphopenia is a good biomarker for immunosuppression and predicts mortality in sepsis patients. Lymphocyte counts are easily measured and cheaper than other inflammation marker for sepsis.
Aims: The objective of this study was to determine whether persistent lymphopenia has a predictive value for mortality in septic patients at Dr. Sardjito General Hospital.
Methods: This study was a retrospective cohort study, sepsis and lymphogenic patients admitted to Internal Medicine ward between January 1, 2016 and December 31, 2017. Lymphocytes were count at day 1 and 4 following the diagnosis of sepsis. Persistent lymphopenia was defined as an absolute lymphocyte count of 1.62x10/μL or less on day 4. The primary outcome was mortality at the end of hospitalization.
Results: 126 adult patients, 101 with persistent lymphopenia, 25 non-persistent lymphopenia, 47 patients died (37.3%). Patients with persistent lymphopenia significantly at risk of death (P=0.003, OR 5.66, 95% CI 1.59-20.13) than non-persistent lymphopenia. Logistic regression was used to account for potential confounding factors, persistent lymphopenia (p = 0.003, OR 8.01, 95% CI 2.04-31.45) and skin and soft tissue infection (p= 0.017, OR 2.94, 95% CI 1.21-7.14) were significantly associated with mortality in sepsis patients at Dr. Sardjito General Hospital.
Conclusion: Persistent lymphopenia predicts mortality in adult patients with sepsis at Dr. Sardjito GeneralHospital.
Faculty of Medicine Universitas Gadjah Mada
2020-11-17 10:45:58
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/61348
Acta Interna: The Journal of Internal Medicine; Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2020 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62838
2021-01-05T00:10:58Z
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The Combination Effects of Physical Exercise and Dzikr for Anxiety Symptoms Improvement in the Elderly Hajj Pilgrim Candidates in Sragen
Setyanigsih, Arfik
Universitas Gadjah Mada
Probosuseno, Probosuseno
Sofia, Noor Asyiqah
Array
Background. Anxiety disorders often occur in prospective elderly hajj pilgrims during preparation for departure. Physical exercise and dzikr are recommended as one of the non pharmacological efforts in reducing anxiety disorders.
Method. Quasi-experimental one group pretest and post-test with research subjects elderly hajj pilgrim candidates in Sragen in 2019 with symptoms of anxiety that were assessed using the Beck Anxiety Inventory (BAI) score. The intervention was carried out in the form of a combination of forty minutes of physical exercise and thirty minutes of dzikr, 4 times during two weeks and assessed differences in BAI scores before and after the intervention.
Aims. To find out the improvement of the BAI score after the combined intervention of physical exercise and remembrance, the Paired t-test was performed if the data distribution was normal and the Wilcoxon test if the data distribution was not normal. Differences were considered significant if p <0.05.
Result. There were significant differences in the overall BAI score (p-value <0.001, p <0.05), mild anxiety BAI score (p-value 0.001; p <0.05), systolic blood pressure (p-value 0.002, p<0.05), and pulse frequency (p-value 0.012, p <0.05) before and after the intervention. Obtaining a decrease in systolic blood pressure and a decrease in pulse frequency are parameters for achieving a relaxation response.
Conclusions. Significant anxiety symptom improvements were demonstrated as the effect of a combination of physical exercise and dzikr in the elderly hajj pilgrim candidates in Sragen.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
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https://jurnal.ugm.ac.id/jain/article/view/62838
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62840
2021-01-05T00:10:58Z
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The Difference of Depression Score of Patients Failed Ultrafiltration Compared to Successful at Continuous Peritoneal Dialysis Patients in RSUP Dr. Sardjito Yogyakarta
Lestari, Padmi Bekti
Sofia, Noor Asyiqah
Kuswadi, Iri
Array
Background. High mortality and morbidity in patients with Chronic Kidney Disease (CKD) are associated with psychological problems and poor quality of life. Depression is a psychological problem most often found in groups of CKD patients undergoing renal replacement therapy. Specific research that links the failure of ultrafiltration in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients with depression does not yet exist today. So that further research is needed regarding this matter so that various depression intervention approaches can be carried out in the group of patients undergoing CAPD.
Aims. This study aimed to determine the difference in depressive score of patients who failed ultrafiltration compared to those who did not fail in patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) in RSUP dr. Sardjito Yogyakarta.
Method. A cross-sectional analytic study to assess differences in depressive score of CAPD patients with ultrafiltration failure compared to those who did not fail ultrafiltration in CAPD Clinic of RSUP dr. Sardjito Yogyakarta. The research subjects consisted of 41 people who fulfilled the inclusion and exclusion criteria. Depression assessment was carried out by calculating the total score of the BDI-II questionnaire and analyzing it using the Mann-Whitney method.
Result. The average value of BDI-II in this study was 12 ± 8. 1. Depression scores based on BDI-II are if the score is equal to or more than 17. In this study 7 research subjects (17.1%) are depression. BDI –II values in the non-ultrafiltration failure group 10.96±7.25 and in the failed group 13.38±9.73 with p= 0.633.
Conclusion. There were no significant differences in BDI-II score between groups that failed and those that did not fail ultrafiltration.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
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https://jurnal.ugm.ac.id/jain/article/view/62840
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62843
2021-01-05T00:10:59Z
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Correlation Between Tp-Te Interval With the Degree of Disfunction in Liver Cirrhosis Based on Child Pugh Turcotte Score in Dr. Sardjito General Hospital
Puruhita, RA Aditya Adhi
Mumpuni, Hasanah
Ratnasari, Neneng
Array
Background. Hyperdynamic syndrome due to portal hypertension in cirrhosis of the liver leads to failure of
contractions and cardiac structures that result in complications of cardiomyopathy cirrhosis. The incidence
of arrhythmias was reported in various non- cardiac diseases including liver cirrhosis. We aim to evaluate
the T peak wave - T end (Tp-Te) as a parameter for suspected arrhythmias that occur in liver cirrhosis.
Aims. To determine the correlation between the Tp-Te interval with dysfunction in the degree of liver
cirrhosis, which was assessed using the Child Pugh Turcotte score.
Methods. This research is a cross-sectional study. Data taken from liver cirrhosis patients who has been met
the inclusion and exclusion criteria were admitted to the Inpatient and Outpatient Hospital Dr. Sardjito until
May 2020, an assessment of the degree of dysfunction of liver cirrhosis with Child Pugh score Turcotte, and
electrocardiographic examination to assess Tp-Te wave. The independent variable was the Child Pugh Turcotte
score, the dependent variable was the Tp-Te wavelength. Analysis of correlation data using the Spearman test.
Results. Subjects included 51 patients with liver cirrhosis, correlation analysis found a strong correlation,
the higher the Child Pugh Turcotte score was linearly correlated with the Tp-Te wavelength (r = 0.692; p
<0.05). Wavelength Tp-Te at Child Pugh to any group showed a significant (p <0.001) , the wavelength
of Tp-Te Child Pugh A group 67.94 ± 7.80 ms, the Child Pugh B group 77.26 ± 8.38 ms, whereas in
the Child Pugh C group 92.31 ± 11.36 ms.
Conclusion. There was a strong positive correlation between the Tp-Te interval with the degree of liver
cirrhosis dysfunction which was assessed using the Child Pugh Turcotte score.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
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https://jurnal.ugm.ac.id/jain/article/view/62843
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62844
2021-01-05T00:10:59Z
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Association between Serum Vitamin D Level and Clinical Manifestations of Systemic Lupus Erythematous Patients in Dr. Sardjito General Hospital
Nugroho, Anggi Wahyu
Paramaiswari, Ayu
Achadiono, Deddy Nur Wachid
Array
Background. Vitamin D played a role in the pathogenesis of systemic lupus erythematosus (SLE). Vitamin D made dendritic cells more tolerogenic to autoantigens and inhibited B cells from producing autoantibodies. Vitamin D deficiency would make dendritic cells intolerant, increased production of interferons, and B cells produce excessive autoantibodies. These excessive autoantibodies and interferons would have caused severe clinical manifestations in SLE patients.
Aims. This study was to find out vitamin D deficiency would increase the proportion of severe clinical manifestations in SLE patients in the Dr. Sardjito General Hospital.
Methods. We conducted a cross-sectional study. Data was taken from medical records of SLE patients who went to Dr. Sardjito General Hospital in 2018. The independent variable was serum 25(OH) D levels, which were divided into deficiency (≤12 ng/ml) and not deficiency (>12ng/ml). The dependent variable was the clinical manifestations of SLE patients, which were divided into mild-moderate and severe. Association between two variables was analyzed using Chi-Square.
Results. Vitamin D deficiency was observed in 19(54%) and not deficiency in 16(46%) subjects. SLE patients who underwent vitamin D deficiency more often experienced severe clinical manifestations than those without (52.6% versus 12.5%), prevalence ratio 4.2 CI 1.1-16.5 p=0.015. SLE patients who underwent vitamin D deficiency were more likely to suffer mucocutan, musculoskeletal, and kidney disorders. Also more likely to suffer more than 2 organ disorders than those without (57.9% versus 12.5%), prevalence
ratio 4.6 CI 1.2-17.9 p=0.007.
Conclusions. Vitamin D deficiency increased the proportion of severe clinical manifestations in SLE patients at Dr. Sardjito General Hospital. It also increased the proportion of mucocutan disorder, musculoskeletal disorder, and kidney disorder. Also, it increased the proportion of occurrence of more than 2 organ disorders in SLE patients at Dr. Sardjito General Hospital.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
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https://jurnal.ugm.ac.id/jain/article/view/62844
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62845
2021-01-05T00:11:00Z
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"210105 2021 eng "
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Maxillary Reconstruction Timing in Severe Systemic Lupus Erythematous (SLE) Patient with Bone Destruction due to Invasive Aspergillosis: Case Report
Werdhiningsih, Yulyani
Subspecialty Training Program of Internal Medicine, Division of Rheumatology, Department of Internal Medicine Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital
Paramaiswari, Ayu
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital
Achadiono, Deddy Nur Wachid
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital
Kertia, Nyoman
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr. Sardjito General Hospital
Array
Severe Systemic Lupus Erythematosus patient was in the third of 28-days-cycle cyclophosphamide chemotherapy when the early symptoms of aspergillus infection occurred. This developed into extensive cranial bone damage. It was planned to get a biopsy and debridement for bone and soft tissue to diagnose and therapy palate osteonecrosis, followed by reconstruction surgery. This case report aimed to report the successful management of a severe patient on chemotherapy undergoing several operations so that the SLE aspergillosis is optimally managed.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/62845
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/62846
2021-01-05T00:11:00Z
jain:ART
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"210105 2021 eng "
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Impressive Result of Gemcitabine and Cisplatin Combination Therapy in Post-Operative Residual Cholangiocarcinoma Patient Presenting with Hyperbilirubinemia, an Experience in Indonesian Tertiary Hospital
Purwanto, Ibnu
Hematology and Medical Oncology Division, Internal Medicine Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Barmawi, Agus
Digestive Surgery Department, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Utomo, Bambang Purwanto
Radiology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Ghozali, Ahmad
Anatomical Pathology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Introduction: Cholangiocarcinoma (CCA) often presents at an inoperable or an advanced stage in which complete resection is not possible. In such scenario, chemotherapy often is the only option to improve patient’s survival. Severe hyperbilirubinemia, often associated with higher risk of developing chemotherapy-related adverse event, might complicates one’s decision in choosing chemotherapy regimen. Case Report: We present a case of 63-year-old post-operative CCA patient with residual mass and severe hyperbilirubinemia. The patient completed six cycles of gemcitabine (1000 mg/m2, day 1 and 8) and cisplatin (70 mg/m2, day 1) every 3 weeks with tolerable side effect. No sign of residual tumor was observed on CT-Scan performed one-month post chemotherapy. Conclusion: Combination of cisplatin and gemcitabine may offer safe treatment option for post-operative residual CCA patient presenting with hyperbilirubinemia.
Faculty of Medicine Universitas Gadjah Mada
2021-01-05 07:11:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/62846
Acta Interna: The Journal of Internal Medicine; Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94627
2024-03-05T06:17:53Z
jain:ART
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"210630 2021 eng "
2541-5441
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Prognostic Nutritional Index (PNI) as a Prognostic Factor in Stage IV Lung Adenocarcinoma
Subroto, Subroto
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Budiono, Eko
Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Sumardi, Sumardi
Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Background. Based on nutritional and immunological indicators, the Prognostic Nutritional Index (PNI) is one of the prognostic indicators besides the Platelet-to-Lymphocyte Ratio (PLR) and Glasgow Prognostic Score (GPS). PNI can serve as a biomarker to help guide clinical practice and promote clinical outcomes for lung cancer patients. PNI was superior to Neutrophil- to- Lymphocyte Ratio (NLR) in the prediction of progression-free survival (PFS) and overall survival (OS).
Objectives. To analyze the association between a low PNI score (PNI <40) and increased risk of mortality among stage IV pulmonary adenocarcinoma patients.
Methods. A cohort-retrospective study was performed by extracting PNI data from medical records and the mortality of patients with stage IV pulmonary adenocarcinoma. A total of 265 patients met the inclusion and exclusion criteria, based on the medical records of patients with stage IV pulmonary adenocarcinoma who were hospitalized at Dr. Sardjito hospital Yogyakarta between January 1st, 2016 and July 1st, 2019. PNI score were calculated as follows: 10 x serum albumin (g/dl) + 0.005 x lymphocyte count (per mm3). Mortality was considered six months since the diagnosis. Chi-square tests were used to analyze the proportions of mortality and confounders. Multiple logistic regression tests were used to analyze the association between PNI and mortality.
Results. Subjects with PNI score <40 were at risk of mortality three times higher than subjects with PNI score ≥40 (adjustedOR 3.356, 95% CI 1.165 - 9.670, p = 0.025).
Conclusion. PNI score significantly affected the mortality in patients with stage IV pulmonary adenocarcinoma.
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/94627
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2021 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94630
2024-03-05T06:18:36Z
jain:ART
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"210630 2021 eng "
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Comparison of the Effectiveness of Subcutaneous Insulin Injection between Upper Arm and Abdominal Sites in Type II Diabetes Mellitus Patients with Normal and Above Normal Body Mass Index
Khairina, Ana
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Ihsan, Mohammad Robikhul
Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Susanti, Vina Yanti
Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Background. Type II Diabetes Mellitus (DM) has high morbidity and mortality. One of DM therapy is insulin. Insulin effectiveness is affected by the injection site and the thickness of the fat in the injection site. Several studies on the effectiveness of insulin injection sites have been conducted, but the results still vary.
Objective. To determine the difference in the effectiveness of subcutaneous insulin injections between the upper arm and abdominal sites on changes in capillary glucose levels in type II diabetes mellitus patients with normal and above-normal body mass index (BMI).
Methods. The research design used a quasi-experimental repeated measure design. The research subjects were patients diagnosed with type II DM, age ≥ 40 years, hospitalized in the ward of Dr. Sardjito Hospital Yogyakarta. The effectiveness of insulin injection is described by the difference between 2-hours postprandial glucose (2hPPG) minus fasting blood glucose (FBG) (Δ2hPPG-FBG). Δ2hPPG-FBG was taken on the site of the upper arm and abdomen. Patients were classified based on normal and above normal BMI. Statistical analysis was performed using paired T-tests.
Result. There were 14 patients with normal BMI and 11 patients with above normal BMI. Paired T-test showed a significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in normal BMI patients (p=0.028) with a mean of Δ2hPPG-FBG for the upper arm site of 26,14±38.18 mg/dL, and a mean of Δ2hPPG-FBG of the abdominal site -0.64±50,62 mg/dL. Paired T-test showed no significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in patients with an above-normal BMI (p = 0.239).
Conclusion. The effectiveness of subcutaneous insulin injection in the abdominal site was better than in the upper arm site in patients with normal BMI. There was no difference in the effectiveness of subcutaneous insulin injection between the upper arm and abdominal sites in patients with an above-normal BMI.
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/94630
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2024 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94631
2024-03-05T06:18:39Z
jain:ART
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"210630 2021 eng "
2541-5441
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HALP Score as a Prognostic Factor of Mortality in Septic Patients at Dr. Sardjito General Hospital
Anjani, Alindina
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Asdie, Rizka Humardewayanti
Division of Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Wijisaksono, Doni Priambodo
Division of Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Background. Sepsis is still an important health problem with a high mortality rate, an average of 44.5% in Asian countries. An easy and early biomarker is needed to determine the prognosis of sepsis. The HALP inflammation index can be used to predict mortality in malignancy conditions, yet has not been studied for sepsis.
Objective. This study aimed to determine whether HALP score has a prognostic value for mortality in non malignant septic patients at Dr. Sardjito General Hospital.
Methods. This was a retrospective cohort study of septic patients admitted to Internal Medicine wards between January 1, 2016 and December 31, 2018. The prognostic accuracy was evaluated by assessing the area under the receiver operating characteristic (AUC) curve. The primary outcome was mortality at the end of hospitalization.
Results:. There were 125 adult patients, 104 with high HALP score (≥54,34), 21 low HALP score (<54,34), 45 patients died (36%). Patients with low HALP score were significantly at risk of death (p=0.007, OR 3.66, 95% CI 1.38-9.68) than high HALP score. Logistic regression was used to account for potential confounding factors. Low HALP score (p = 0.004, OR 4.74, 95% CI 1.63-13.76), sepsis diagnosed with quick SOFA (p = 0.006, OR 0.25, 95% CI 0.09-0.68), and multiple infections (p = 0.011, OR 2.93, 95% CI 1.28-6.73) were significantly associated with mortality in sepsis patients at Dr. Sardjito General Hospital.
Conclusion. HALP score has a prognostic value of mortality in adult patients with sepsis at Dr. Sardjito General Hospital
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
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https://jurnal.ugm.ac.id/jain/article/view/94631
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2024 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94632
2024-03-05T06:18:37Z
jain:ART
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"210630 2021 eng "
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Association Between Irregular Eating Behavior, High Fat Intake, and Dyspepsia Syndrome of Male Adolescents at Selected Senior High School in Yogyakarta
Nugraha, Adityansyah Irendra
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Maduseno, Sutanto
Division of Gastroenterology Hepatology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hopsital
Ratnasari, Neneng
Division of Gastroenterology Hepatology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hopsital
Array
Background. Dyspepsia syndrome is a group of symptoms consisting of epigastric discomfort, nausea, vomiting, bloating, early satiety, abdominal fullness, and belching. Dyspepsia syndrome is common in male adolescents. The causes of dyspepsia are multifactorial, one of the most common is diet and lifestyle changes.
Objective. The aim of this study is to determine the association between irregular eating behavior, high fat intake, and dyspepsia syndrome of male adolescents in Yogyakarta senior high school.
Methods. A cross-sectional study was performed among 255 male adolescents aged 15-19 years in Yogyakarta senior high school. The data were obtained using Gastrointestinal Symptoms (GIS) questionnaire, irregular eating behavior questionnaire, and Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Nominal variables were analyzed statistically by chi-square test and logistic regression test, numerical variables were analyzed by Mann-Whitney test and linear regression test.
Result. Dyspepsia syndrome is positive in 54.9% of the subject. Seventy-four percent of subjects with irregular eating behavior had dyspepsia, p<0.001, OR 3.58 (CI 95%, 2.05-6.26). Seventy-five percent of subjects with high fat intake had dyspepsia, p= 0.005, OR 2.86 (CI 95%, 1.33-6.15). The median GIS score of the high fat and normal fat intake group are two to one (p=0.005). Median GIS scores of irregular and regular eating behavior groups are two to zero (p<0.001). The coefficient of determination (R2) from multivariate analysis is 0.065.
Conclusion. There is a significant association between eating irregularities and high fat consumption patterns with the incidence of dyspepsia syndrome in male adolescents in Yogyakarta high school.
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
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https://jurnal.ugm.ac.id/jain/article/view/94632
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
https://jurnal.ugm.ac.id/jain/article/download/94632/344284
Copyright (c) 2024 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94634
2024-03-05T06:18:38Z
jain:ART
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"210630 2021 eng "
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The Effect of Weight Gain on Recurrence During Hormonal Therapy in Breast Cancer with Positive Estrogen Receptor and Negative Her2 Subtype
Nugraha, Doddy Rizqi
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada/Dr. Sardjito General Hospital
Taroeno-Hariadi, Kartika Widayati
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Hardianti, Mardiah Suci
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Background. Weight gain is found in patients with positive estrogen subtype breast cancer. The effect of weight gain on breast cancer recurrence is still being debated and associated with a poor prognosis. Being overweight is associated with an increase in estrogen production by adipose tissue.
Methods. A retrospective and prospective cohort study with data collection was conducted from July 2018 - June 2019 at the outpatient unit of Dr. Sardjito Hospital. We reviewed medical records of patients who came from January 2013 - July 2018. Three categories of weight gain: weight loss, increase 0 - 5%, and increase > 5% from baseline will be evaluated.
Statistical Analysis. The relationship between weight gain and some risk factors of recurrence was analyzed with cox regression and multivariate logistic regression tests. The Kaplan Meier method is used to show lifetime data.
Result. Weight gain in breast cancer patients with positive Her2-negative estrogen receptor subtypes was not associated with recurrence (p = 0.264; HR 0.637; 95% CI 0.289 - 1.405). Patients with body mass index ≥ 25 kg / m2 at diagnosis had a lower risk of relapse than patients with body mass index < 25 kg / m2 (p = 0.026; HR 0.461; 95% CI, 0.234 - 0.912).
Conclusions Weight gain after diagnosis in breast cancer patients with positive estrogen receptor-negative Her2 subtypes receiving hormonal therapy is not associated with recurrence.
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
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https://jurnal.ugm.ac.id/jain/article/view/94634
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2024 Acta Interna: The Journal of Internal Medicine
oai:jurnal.ugm.ac.id:article/94635
2024-03-05T06:20:10Z
jain:ART
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"210630 2021 eng "
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Anti-Tuberculosis Therapy after DRESS: Case Report
Wahyuni, Dwi
Internal Medicine Residency Program, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Mulya, Deshinta Putri
Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Retnowulan, Heni
Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Array
Introduction.Anti-tuberculosis-induced DRESS (drug reaction with eosinophilia and systemic symptoms) is uncommon, and usually delayed in diagnosis. The patient has minor complain and the clinical presentation involves the side effect on their heart and skin. Antituberculosis-related DRESS may have been present, but it has been underdiagnosed and underreported for several years. Management including discontinuation of the suspected drugs and changing it with second line treatment become less effective. Identifying the causative drug in DRESS is very difficult, especially in antituberculosis drugs.
Case. A 34-year-old woman complains of having itch and redness throughout the body and fever. Two months before hospitalization, the patient was diagnosed with tuberculosis based on GeneXpert examination. Patients were given anti-tuberculosis drug therapy (OAT) which was 4 fixed drug combinations (FDC). Two weeks after taking the drugs, complains appeared. After 3 weeks the drug was stopped and in the next 1 week the patient's condition got worse, with itching and redness of the whole body accompanied by fever. Patients received treatment for 13 days with 125 mg/24-hour methylprednisolone therapy gradually reduced with OAT therapy levofloxacin 500 mg/24 hours and streptomycin 1 gram/24-hour IM (intramuscular).
Conclusion. DRESS triggered by OAT was very rare and underreported. The choice of therapy after DRESS needed to be well considered, because it increased the risk for a DRESS to return with more severe manifestations when re-administering the same drug. The management in tuberculosis patients with a history of DRESS was given with second-line OAT with treatment options based on the clinician's experience.
Faculty of Medicine Universitas Gadjah Mada
2021-06-30 00:00:00
application/pdf
https://jurnal.ugm.ac.id/jain/article/view/94635
Acta Interna: The Journal of Internal Medicine; Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
eng
Copyright (c) 2024 Acta Interna: The Journal of Internal Medicine