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All Journal journal of internal medicine Jurnal Kedokteran
Ommy Agustriadi
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Health Professions Medicine & Pharmacology

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Penggunaan Modified Sequential Organ Failure Assessment (MSOFA) Sebagai Salah Satu Skoring pada Mortalitas Pasien Kritis Kresnoadi, Erwin; Lestari, Rina; Agustriadi, Ommy
Jurnal Kedokteran Vol 5 No 4 (2016)
Publisher : Faculty of Medicine Universitas Mataram

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Abstract

Sakit kritis adalah penyakit yang menyebabkan ketidakstabilan fisiologi tubuh yang berakibat disabilitas atau kematian dalam hitungan menit atau jam. Sistem skoring pasien kritis sudah banyak dipublikasikan. Sistem skoring ini ditujukan untuk memprediksi prognosis penyakit pasien dan mengevaluasi kinerja ruang perawatan intensif. Skor MSOFA mengeliminasi jumlah trombosit, mengganti tekanan parsial oksigen darah arteri dengan saturasi oksigen yang diukur dengan pulse oksimeter, dan mengganti jumlah bilirubin serum dengan penilaian klinis ikterik.
ASPEK PULMONOLOGIS INFEKSI OPORTUNISTIK PADA INFEKSI HIV/AIDS Agustriadi, Ommy; Sutha, Ida Bagus
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Human Immunodeficiency Virus (HIV) known as etiologic agent for AIDS (Acquired Immunodeficiency Syndrome), inwhich followed or accompanied by certain opportunistic infections and malignancies. Perhaps the most important reason for thefrequent development of diverse pulmonary complications in HIV/AIDS relates to the fact that the lung is chronically exposed toboth infectious or non-infectious airborne agents (exogenously) and hematogenously spread agents (endogenously) through anexpansive surface area consisting of millions of units called alveoli, that infected alveolar macrophages and lymphocytes.The mechanisms that may play role of defected lung defend mechanisms were direct effect of HIV that infected and killcells cause damaged to the effector cells and shifted cells function from immunostimulative to immunosupressive, then impairedmigration capacity of lymphocytes, monocytes or netrophils to lung. In turn, the opportunistic infections easily developed.In almost 65% AIDS patients also accompanied with oppportunistic infections in the lung. Pneumocystis cariniipneumoniae was the most often, followed by M. tuberculosis infection, bacterial and fungal pneumoniae respectively. Whereas,viral pneumoniae was rare
HEPCIDIN PADA ANEMIA OF CHRONIC DISEASE Agustriadi, Ommy; Suega, Ketut
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Anemia of chronic disease (ACD) induce dysregulation of iron homeostasis. A hallmark of anemia of chronic disease is thedevelopment of disturbances of iron homeostasis, with increased uptake and retention of iron within cells of thereticuloendothelial system (RES), that leads to a diversion of iron from the circulation into storage sites of RES, and decreasedintestinal iron absorption, subsequent limitation of the availability of iron for erythroid progenitor cells, and iron-restrictederythropoiesis. A new small peptide called hepcidin was found. It is strongly suggest that hepcidin play role on the pathogenesisof ACD. Hepcidin expression is induced by inflammation/infection (by lipopolysaccharide and interleukin-6) and iron overloadcondition, it is strongly suggest that hepcidin induced dysregulation of iron homeostasis by inhibit iron efflux from macrophagedan RES (causing iron retention in turn) and decrease intestinal iron absorption. In the aggregate, the increase of hepcidinproduction suppress erythropoiesis by iron starvation strongly suggest that hepcidin is the key mediator of ACD. If hepcidinfollows the pattern of other peptide hormones or cytokines, its actions will be mediated by cell surface receptors. Elucidation ofthe receptor and its transduction pathways should lead to the development of hepcidin antagonists, some of which could be usefulin treatment of ACD, along with it's underlying disease.
HUBUNGAN ANTARA PERUBAHAN VOLUME DARAH RELATIF DENGAN EPISODE HIPOTENSI INTRADIALITIK SELAMA HEMODIALISIS PADA GAGAL GINJAL KRONIK Agustriadi, Ommy; Suwitra, Ketut; Raka Widiana, Gde; Sudhana, Wayan; Sidharta Loekman, Jodi; Kandarini, Yenny
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Abstract

Intradialytic hypotension (IDH) is a common complication in chronic hemodialysis (HD) patients, in turn would increase morbidity and mortality. Relative blood volume changes during HD play a role in IDH episode. Those changes can be assessed by total plasma protein measurement before and after HD. To determine relationship between relative blood volume changes (assessed by percentage of total plasma protein changes during HD) and IDH episode during HD in chronic renal failure, an analytical cross-sectional study was perferomed in 51 patients (28 males and 23 females, age 47.8 ±11.6 years) underwent chronic HD at Hemodialysis Unit of Sanglah Hospital Denpasar. Data were collected during single HD session. Blood pressure was measured every 30 minutes and relative blood volume changes assessed by measuring percentage of total plasma protein changes during HD. Among them, IDH episode experienced in 10 (19.6%) patients. Logistic regression analysis revealed a strong and significant relationship between relative blood volume changes and IDH episode during HD in chronic renal failure (Beta = 0.29; OR = 1.35; CI 95%: 1.1 - 1.6; p < 0.01) and it was found that every 1% changes in relative blood volume, would increase risk of hypotension episode by 35%. This relationship was still strong and significant (Beta = 0.46; OR = 1.58; CI 95%: 1.11 -2.25; p = 0.01) after adjusted by hemoglobin levels, intradialytic body weight changes, use of antihypertensive medi¬cations and diabetes melitus. Using ROC curve, found that optimal cut of point of intradialytic total plasma protein changes to predict an IDH episode during HD was 5.56% with 90.0% sensitivity and 80.5% specificity (95% CI: 0.83-0.99; p < 0.01). Our data revealed a strong and significant relationship between intradialytic relative blood volume changes assessed by intradialytic total plasma protein changes and IDH episode during HD in chronic renal failure.
Co-Authors Erwin Kresnoadi, Erwin I Gde Raka Widiana Ida Bagus Sutha Jodi Sidharta Loekman Ketut Suega Ketut Suwitra Rina Lestari Wayan Sudhana Yenny Kandarini