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Kadar Prokalsitonin dan Interleukin-6 sebagai Penanda Prognostik pada Pasien Pneumonia dengan Sepsis Siahaan, Sylvia Sagita; Putra, Ngakan Putu; Sugiri, Yani Jane; Rasyid, Harun Al
Jurnal Kedokteran Brawijaya Vol 30, No 4 (2019)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2019.030.04.6

Pneumonia merupakan sepuluh besar kasus rawat inap dengan tingkat kematian 7,6%. Pneumonia dengan sepsis membutuhkan terapi suportif dan perawatan intensif karena tingkat kematian tinggi. Untuk memperbaiki kualitas perawatan dan hasil terapi yang lebih baik, perlu pengkajian dini diagnostik maupun prognostik. Prokalsitonin (PCT) dan Interleukin-6 (IL-6) merupakan penanda infeksi berat dan sepsis. Tujuan penelitian ini untuk menganalisa apakah PCT dan IL-6 dapat digunakan bersama-sama untuk menentukan prognosis pasien pneumonia dengan sepsis dalam hubungannya dengan status mortalitas pada hari ke-30. Penelitian kohort dilakukan pada Oktober 2018 dilakukan di Rumah Sakit Saiful Anwar, Malang, melibatkan 40 pasien pneumonia dengan sepsis tanpa diabetes, kanker, HIV dan kehamilan. Sequential Organ Failure Assesment (SOFA) score dihitung dan sampel darah diambil pada hari ke-0 dan ke-5 perawatan untuk mengukur kadar PCT dan IL-6. Status mortalitas pasien dilihat pada hari ke-30 sejak masuk rumah sakit. Dari 40 pasien, 23 pasien hidup (57,5%) dan 17 pasien meninggal (47,5%). Perbandingan antara kelompok hidup dan meninggal menunjukan perbedaan bermakna dan secara signifikan berhubungan dengan mortalitas pada SOFA score hari ke-5 (p<0,001; OR: 78,75, CI 95% (9,948-623,414)), kadar IL-6 hari ke-5 (p<0,05; OR: 9,208, CI 95% (2,146-39,521)) dan kadar PCT hari ke-5 (p<0,05; OR: 4,190, CI 95% (1,104-15,901)). Hasil uji regresi logistik, didapatkan bahwa IL-6 hari ke-5 dan SOFA score hari ke-5 dapat digunakan sebagai faktor prognostik mortalitas pasien pneumonia dengan sepsis hari ke-30, artinya SOFA score diatas 6 dan kadar IL-6 diatas 332pg/mL pada hari ke-5, merupakan faktor penting dari kematian pasien (AUC: 0,935).

Concomitant Chylothorax and Chyloperitoneum with Newly Diagnosed: B-Cell Lymphoma: A Case Report Siahaan, Sylvia Sagita; Prasetya, Ignatius Bima; Pradhana, Cindy Meidy Leony
Medicinus Vol 12, No 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7367

Chylothorax and Chyloperitoneum are an infrequent condition, characterized by the accumulation of chyle in the pleural and peritoneum cavity. We report an uncommon presentation of concomitant chylothorax and chyloperitoneum caused by diffuse B- cell Lymphoma. A 60-year woman was admitted with progressive shortness of breath, abdominal fullness, cough when lying down on one week duration. She also complains progressive non painful neck lump, night sweats, and weight loss. Chest radiograph showed right pleural effusion. CT scan abdomen with contrast revealed ascites with lobulated mass and multiple lymphadenopathy. Thoracocentesis and paracentesis were performed, revealed exudative with yellow and milky appearance and elevated triglyceride. Histopathologic confirmed diffuse large B-cell lymphoma. Chylothorax concomitant with chylous ascites is rarely encountered. Serous effusion occur often in malignant lymphomas. Management of chylothorax and chyloperitoneum is conservative measures and treat the aetiology. Effusion often becomes a chronic problem that persist although the lymphoma has been treated.

Concomitant Chylothorax and Chyloperitoneum with Newly Diagnosed: B-Cell Lymphoma: A Case Report Siahaan, Sylvia Sagita; Prasetya, Ignatius Bima; Pradhana, Cindy Meidy Leony
Medicinus Vol. 12 No. 3 (2023): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i1.7367

Chylothorax and Chyloperitoneum are an infrequent condition, characterized by the accumulation of chyle in the pleural and peritoneum cavity. We report an uncommon presentation of concomitant chylothorax and chyloperitoneum caused by diffuse B- cell Lymphoma. A 60-year woman was admitted with progressive shortness of breath, abdominal fullness, cough when lying down on one week duration. She also complains progressive non painful neck lump, night sweats, and weight loss. Chest radiograph showed right pleural effusion. CT scan abdomen with contrast revealed ascites with lobulated mass and multiple lymphadenopathy. Thoracocentesis and paracentesis were performed, revealed exudative with yellow and milky appearance and elevated triglyceride. Histopathologic confirmed diffuse large B-cell lymphoma. Chylothorax concomitant with chylous ascites is rarely encountered. Serous effusion occur often in malignant lymphomas. Management of chylothorax and chyloperitoneum is conservative measures and treat the aetiology. Effusion often becomes a chronic problem that persist although the lymphoma has been treated.

Bronchoscopic Balloon Dilatation for Tuberculosis-related Bronchial Stenosis: A Rare Case Wahyuni, Titis Dewi; Alatas, Mohamad Fahmi; Widysanto, Allen; Siahaan, Sylvia Sagita; Muljadi, Rusli; Carolline, Chaifung
Respiratory Science Vol. 4 No. 2 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i2.125

Background: Bronchial stenosis is known as a complication of endobronchial tuberculosis (EBTB). The incidence of stenosis affects quality of life. A minimally invasive therapeutic strategy, bronchoscopic balloon dilatation (BBD), can be chosen to manage the disease. Case: A 29-year-old woman suffered from bronchial stenosis, which appeared after completing treatment for tuberculosis (TB). She was diagnosed with TB around the middle of her pregnancy. She received anti-tuberculosis treatment for six months. Two years later, she complained of a persistent cough for two weeks prior to hospitalization. A complete stenosis of the left main bronchus with atelectatic on the left lung was seen on a chest CT scan. The result was confirmed with a bronchoscopy procedure. There were no mycobacteria or other suspicious organisms found in bronchial washings. Bronchoscopic balloon dilatation action was successful. Discussion: Endobronchial tuberculosis is a tuberculous infection that affects the tracheobronchial tree. It can be treated with minimally invasive procedures like bronchoscopy or surgical interventions. If the stenosis is mild or moderate, several procedures such as balloon dilatation, stents, laser photoresection, argon plasma coagulation, and cryotherapy are often performed. Bronchoscopy balloon dilatation nowadays has become a more preferred treatment option for tracheal and bronchial stenosis because it may be areliable and effective method. Conclusion: The BDD procedure in this patient showed good results. This procedure is fast, easy, safe, minimally invasive, and the symptoms resolve quickly. It can be concluded that BBD is a safe and effective therapy for TB-related bronchial stenosis, but the long-term effects of the procedure remain to be monitored.

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