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All Journal Cermin Dunia Kedokteran Cermin Dunia Kedokteran
Hardika, Putu Stephanie Apriliana
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Health Professions Medicine & Pharmacology Public Health

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Sindrom Felty – Diagnosis dan Tata Laksana Hardika, Putu Stephanie Apriliana
Cermin Dunia Kedokteran Vol 49, No 1 (2022): Bedah
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (198.122 KB) | DOI: 10.55175/cdk.v49i1.1638

Abstract

Sindrom Felty merupakan kondisi medis dengan karakteristik trias yaitu artritis reumatoid, neutropenia, dan splenomegali; terjadi pada beberapa kasus artritis reumatoid erosif yang sudah berlangsung lama. Hanya 1 – 3% pasien artritis reumatoid akan berkembang menjadi Sindrom Felty. Peran genetik (HLA-DR4) dan faktor lingkungan berperan dalam terjadinya kondisi ini. Neutropenia persisten dengan hitung neutrofil absolut umumnya kurang dari 1500/mm3 merupakan ciri khas diagnosis Sindrom Felty. Kondisi medis ini biasanya asimtomatik, infeksi lokal serius atau sistemik bisa menjadi petunjuk awal. Terapi farmakologi menggunakan disease-modifying anti-rheumatic drugs (DMARDs); methotrexate oral dosis rendah menjadi modalitas terapi lini pertama. Splenektomi merupakan upaya terakhir dalam algoritma penatalaksanaan Sindrom Felty. Felty Syndrome is a medical condition characterized by triad of rheumatoid arthritis, neutropenia, and splenomegaly; occurs in few cases of longstanding erosive rheumatoid arthritis. Only 1 – 3% rheumatoid arthritis patient developed Felty Syndrome. Genetic (HLA-DR4) and environmental factors are involved in its pathophysiology. Persistent neutropenia with absolute neutrophil count less than 1500/mm3 is a diagnosis hallmark. Felty syndrome may be asymptomatic, but local serious or systemic infections may be the first clue to the diagnosis. Pharmacological therapy as the first-line therapy use disease-modifying anti-rheumatic drugs (DMARDs) such as oral low dose methotrexate. Surgical approach (splenectomy) is the last resort in Felty Syndrome management.
Lanjut Usia dengan Infark Miokard Akut yang Diduga Dicetuskan oleh Hospital-Acquired Pneumonia - Laporan Kasus: Laporan Kasus Hardika, Putu Stephanie Apriliana; Purnami, Ni Ketut Rai
Cermin Dunia Kedokteran Vol 53 No 04 (2026): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i04.1866

Abstract

Introduction: Pneumonia can trigger acute cardiovascular events (CVE) in elderly. Risk for subsequent CVE can occur even years after pneumonia. Case: A 75-year-old male was hospitalized with chief complaint of diarrhea. During hospitalization, he complained of black stools, accompanied by cough with white phlegm, fever, and shortness of breath. As he developed into Hospital-Acquired pneumonia (HAP), he was also diagnosed as atypical angina. His electrocardiography (ECG) underwent evolution into ST elevation at lead II, III, and aVF, as well as the increasing cardiac biomarker level. The patient was diagnosed with inferior ST elevation myocardial infarction (STEMI) Killip III, intestinal amoebiasis, melena suspected caused by peptic ulcer dd/ colitis amoebiasis, moderate normochromic normocytic anemia, late onset hospital-acquired pneumonia (HAP), and acute kidney injury (AKI) stage II dd/ prerenal acute on chronic kidney disease (ACKD) caused by suspected chronic pyelonephritis dd/ nephrosclerosis. Discussion: The suspicion of pneumonia as a trigger for STEMI can be seen from the clinical manifestation of infection and the presence of significant increase in leucocytes as a marker of infection. Afterseveral days of treatment He was treated in an intensive cardiac care unit with antiplatelet and anti- angina therapy, the patient’s condition improved. Conclusion: The mechanisms underlying cardiovascular events triggered by pneumonia remain unclear. Adequate therapy playsa crucial role in the management of pneumonia.
Co-Authors Purnami, Ni Ketut Rai