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Santoso, Antonius Gunawan
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Stent angioplasti pada anak hipertensi akibat stenosis arteri renalis di RSUP dr. Kariadi Muryawan, Muhammad Heru; Santoso, Antonius Gunawan; Mellyana, Omega
Medica Hospitalia : Journal of Clinical Medicine Vol. 6 No. 2 (2019): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (262.73 KB) | DOI: 10.36408/mhjcm.v6i2.396

Abstract

Background : Renal artery stenosis (RAS) causes 5-10% of all secondary hypertension (HT) in children. Percutaneous transluminal angioplasty (PTA) has proven beneficial for adult patients, but for a children there are varying result. This paper is to report the management of PTA in HT children due to RAS in Dr. Kariadi Hospital. Case report: Nine years 8 months boy with stage II HT since 4 years old, in a good nutritional status, complaints headaches, no family history of hypertension. Treatment with of nifedipine, captopril, valsartan and furosemide has not improved. Four months ago, the patient was treated by the Children's Nephrology and Radiology Division in Dr. Kariadi Hospital for 4 days. initial blood pressure 150/100 mmHg (stage II HT), normal eye examination, heart and kidney function, the angiographic results obtained severe right middle renal artery stenosis.teh stenosis reduced by PTA with dilated balloons up to 30%. One day after the procedure, blood pressure decreased to stage I HT, no complication involved, and the patient was discharged on day 4, with nifedipine, valsartan to control HT and aspilet as anti platelet aggregation. Evaluation 4 months after PTA obtained normal blood pressure. Discussion: HT renovascular children e.c. unilateral RAS performed by PTA has a good prognosis. Unilateral RASre-stenosis rates are less than 30%. Anti-hypertensive therapy is needed after ballooning or angioplasty stents. PTA in Dr. Kariadi Hospital can managed patient to make blood pressure normal. Conclusion: PTA management is an option in children with HT renovasculere.c SAR. Dr. Kariadi Hospital can be a referral to manage the case. Keywords: pediatric hypertension, RAS, PTA, Dr. Kariadi Hospital Latar belakang : Stenosis arteri renalis (SAR) menyebabkan 5-10% dari seluruh hipertensi (HT) sekunder pada anak. Percutaneous transluminal angioplasty (PTA) terbukti bermanfaat untuk pasien dewasa, namun pada anak hasilnya bervariasi. Tujuan makalah ini melaporkan tatalaksana PTA pada anak HT akibat SAR di RSUP dr Kariadi. Laporan kasus : Anak laki laki 9 tahun 8 bulan dengan HTderajatII sejak usia 4 tahun, status gizi baik, keluhan kadang-2 sakit kepala, tidak ada riwayat keluarga hipertensi. Pengobatan nifedipin, kaptopril, valsartan dan furosemid belum membaik. Empat bulan yang lalu pasien di rawat oleh Divisi Nefrologi Anak dan Radiologi di RSUP dr Kariadi selama 4 hari. Tekanan darah saat masuk 150/100 mmHg, pemeriksaan mata, fungsi ginjal dan jantung normal, Hasil angiografi didapatkan stenosis berat arteri renalis kanan pertengahan, dilanjutkan PTA dengan stent post dilatasi dengan balon, stenosis mejadi 30%. Satu hari paska tindakan, tekanan darah menurun menjadi HT derajat I, tidak ada kelainan dan dipulangkan pada hari ke 4, mendapat nifedipin, valsartan dan aspilet sebagai anti agregasi trombosit. Evaluasi 4 bulan paska PTA didapatkan tekanan darah normal. Pembahasan : HT renovaskuler anak e.c.SAR unilateral yang dilakukan PTA mempunyai prognosis baik. Angka re-stenosis SAR unilateral kurang dari 30%. Terapi anti-hipertensi diperlukan setelah pemasangan balon atau stent angioplasti. PTA di RSUP dr Kariadi berhasil membuat tekanan darah menjadi normal. Kesimpulan :Manajemen PTA merupakan pilihan pada anak dengan HT renovaskuler e.c SAR. RSUP dr Kariadi dapat menjadi rujukan dalam tatalaksana kasus tersebut. Kata kunci : hipertensi anak, SAR, PTA, RSUP dr Kariadi
KORELASI ANTARA DIMENSI VENA PORTA DENGAN KEKAKUAN HEPAR PADA PASIEN SIROSIS HEPATIS DI CHILD PUGH A Santoso, Antonius Gunawan; Mubarok, Nala Khodlil; Widyasari, Maya Nuriya; Purnomo, Hery Djagat
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.899

Abstract

BACKGROUND: Liver cirrhosis is an end-stage liver disease characterized by pathologic fibrosis and regenerative nodules with resultant liver dysfunction. The diagnostic hallmark of portal hypertension is slow flow velocities in addition to the increased caliber of the mean portal vein. That is, the diagnosis of portal hypertension requires the measurement of mean portal velocity and portal diameter, and the correlation between cirrhosis and mean portal velocity and port diameter is the correlation between liver cirrhosis and its complications.OBJECTIVE: To analyze the correlation between portal vein dimensions and liver stiffness in patients of Child-Pugh A cirrhosis.METHOD: This study was a cross-sectional study on 30 subjects with Child-Pugh A liver cirrhosis. The subjects of this research are patients who come to the Radiology Department of the Dr. Kariadi Hospital in Semarang for point shear wave elastography and abdominal ultrasound examination from January to December 2022. Spearman test correlation was used for the analysis.RESULT: Spearman test showed no correlation between liver stiffness and portal vein diameter (p=0.250, r= -0.217), liver stiffness and mean portal vein velocity (p=0.883, r= -0.028), and portal vein diameter with mean venous velocity in Child-Pugh A liver cirrhosis (p = 0.979, r = 0.005)
Correlation Between Brixia Score Imaging and Clinical Laboratory Results In Severe-Critical Covid-19 Patients Receiving Standard Therapy Compared To Tocilizumab Fitriani, Aulia; Wahyuni, Frederica Mardiana; Satoto, Bambang; Handoyo, Thomas; Santoso, Antonius Gunawan; Nawangsih, Christina Hari; Baskoro, Nurdopo
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.991

Abstract

Background. Coronavirus infection disease 19 (COVID-19) is a global health issue. Brixia score and inflammatory markers can assess COVID-19 severity. Severe-critical phase becomes the main concern of clinicians in the management of COVID-19 to reduce mortality. Standard therapy for moderate to severe COVID-19 is convalescent plasma which functions as an antiviral and immunomodulator, while tocilizumab is an IL-6 antagonist which underlies the occurrence of cytokine storms in severe-critical COVID-19. Aims. To examine the correlation between the Brixia score and clinical laboratory results in patients with severe-critical degree of Covid-19 who received both standard therapy and tocilizumab Method. A retrospective cohort study of Brixia score, with clinical laboratory results of D-dimer, fibrinogen, ferritin, and CRP (C-reactive protein) COVID-19 patients with severe-critical phase who were administered standard therapy and tocilizumab who were treated at RSUP DR Kariadi Semarang, then a correlation was carried out between the Brixia score and clinical laboratory results using a correlation test Spearman. Results. The research data consisted of 72 subjects divided into groups that were adiminstered tocilizumab therapy (36 subjects) and standard therapy (36 subjects). There was a significant correlation between the Brixia score and the D-dimer result with p = 0.024 (p <0.05), correlation coefficient = 0.377 in the standard pre-therapy and post therapy. A p-value of less than 0.05 indicates no significant correlation between the Brixia score and clinical laboratory results before or after tocilizumab therapy. Conclusion. There is a significant correlation between the Brixia score results and the D-dimer results in COVID-19 patients who are adiministered standard therapy, but not significant correlation in tocilizumab
Significant Relationship Between Brixia Score And The Degree Of Acute Respiratory Distress Syndrome In Covid 19 Patients Ibrahim, Irni Dwi Aprianty; Satoto, Bambang; Handoyono, Thomas; Santoso, Antonius Gunawan; Sukmaningtyas, Hermina; NINGRUM, FARAH HENDARA
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.993

Abstract

BACKGROUND: Chest X-ray has an important role in detecting early features of COVID-19. To improve risk stratification, a scoring system in chest x-ray called Brixia Score was developed. The Brixia score is designed to measure the severity of lung abnormalities in COVID-19, with an 18-point severity scale. Deaths in COVID-19 occur mainly due to Acute Respiratory Distress Syndrome (ARDS). ARDS is classified into mild, moderate, and severe degrees. If the degree can be predicted earlier, patients can receive earlier therapy and death rate can be reduced. AIMS:  to analyze relationship between Brixia Score and degree of ARDS in COVID-19 patients. METHOD: the research used an observational analytic method with a cross-sectional approach to 95 subjects who are positive for COVID-19 and diagnosed with ARDS, in January to December 2021. Brixia Score data was collected based on chest X-ray expertise, ARDS degree was based on medical records and blood gas analysis. Analysis of relationship between Brixia score and degree of ARDS was carried out using the Kruskal-Wallis test. RESULT:  There was a significant difference in Brixia score based on degree of ARDS (p value <0.05). The highest Brixia score was obtained in severe ARDS, while the low Brixia score was obtained in mild ARDS. This proves that there is a relationship between Brixia score and degree of ARDS. CONCLUSION: Brixia score has a significant relationship to the degree of ARDS in COVID-19 patients.
Co-Authors Aulia Fitriani, Aulia Bambang Satoto, Bambang Christina Hari Nawangsih Farah Hendara Ningrum Handoyo, Thomas Handoyono, Thomas Hermina Sukmaningtyas Hery Djagat Purnomo Ibrahim, Irni Dwi Aprianty Mubarok, Nala Khodlil Muhammad Heru Muryawan Nurdopo Baskoro Omega Mellyana, Omega Wahyuni, Frederica Mardiana Widyasari, Maya Nuriya