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Multiple Autoimmune Syndrome pada Pasien Erupsi Obat Alergi akibat Obat Antituberkulosis dengan Hyper IgE Fandi Triansyah; Raveinal Raveinal
Jurnal Kesehatan Andalas Vol 8, No 4 (2019): Online December 2019
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v8i4.1113

Abstract

Multiple Autoimmune Syndrome (MAS) merupakan koeksistensi dari tiga atau lebih penyakit autoimun. Kejadian MAS ini cenderung tinggi pada pasien dengan riwayat penyakit autoimun sebelumnya. Perkembangan kondisi ini dicurigai berhubungan dengan faktor genetik familial, infeksi, imunologi serta faktor psikologis. Telah dilaporkan pasien laki-laki 49 tahun dengan keluhan utama lemah letih dan pucat yang disertai bercak kemerahan pada leher, dada, perut, kedua lengan dan paha. Keluhan juga disertai telinga berdenging dan rasa tidak nyaman di perut kanan atas. Manifestasi klinis muncul setelah pasien mengkonsumsi obat anti tuberkulosis selama dua minggu. Pasien juga memiliki riwayat transfusi darah berulang sejak satu tahun yang lalu. Pada pemeriksaan penunjang ditemukan adanya anemia berat dengan gambaran hemolitik dengan Cold Autoantibody Hemolytic Anemia (CAHA), eosinofilia dengan limfosistosis, hyper IgE, hepatosplenomegali akibat hepatitis autoimun, sensorineural hearing loss, serta erupsi kulit eksantema makulopapular. Setelah dilakukan penghentian obat anti tuberkulosis selama lebih dari dua minggu, disertai pemberian imunosupresan, tampak perbaikan yang signifikan pada manifestasi kulit dan hematologi. Pasien dilakukan tes provokasi untuk menentukan obat yang menjadi penyebab erupsi obat alergi.
Handgrip Strength: An Early Warning Sign for Mobility Decline? A Meta-Analysis of Diagnostic Accuracy Studies R. Ifan Arief Fahrurozi; Rose Dinda Martini; Roza Mulyana; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1160

Abstract

Background: Mobility limitations significantly impact the quality of life of older adults. Early identification of individuals at risk is crucial for timely intervention. This meta-analysis investigates the diagnostic accuracy of handgrip strength (HGS) in predicting future mobility decline in older adults. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for diagnostic accuracy studies published between 2018 and 2024, evaluating the ability of baseline HGS to predict incident mobility limitations in older adults (≥60 years). Mobility limitations were defined as difficulties in performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs). The primary outcomes were sensitivity, specificity, and diagnostic odds ratio (DOR) of HGS for predicting mobility decline. A bivariate random-effects model was used to pool data. Results: Seven diagnostic studies with a total of 3,870 participants were included. The pooled sensitivity of HGS for predicting mobility decline was 0.72 (95% CI: 0.65-0.78), and the pooled specificity was 0.70 (95% CI: 0.66-0.74). The pooled DOR was 4.85 (95% CI: 3.21-7.32), indicating good discriminatory ability. Conclusion: This meta-analysis demonstrates that HGS has moderate sensitivity and specificity for predicting future mobility decline in older adults. HGS assessment can be a valuable tool for identifying individuals at risk, although further research is needed to determine optimal cut-off points and combine HGS with other risk factors for improved prediction.
Diagnosis and Management of Osteosarcopenia Jersivindo Ranazeri; Rose Dinda Martini; Mulyana, Roza; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 1 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i1.904

Abstract

Osteosarcopenia is a syndrome defined as a combination of low bone density and muscle mass as well as decreased strength and/or functional capacity. Osteoporosis and sarcopenia often coexist in the elderly, leading to a significantly worse prognosis. The epidemiology of osteosarcopenia is quite limited because the term is still new. Osteosarcopenia is more common in women than men and in malnutrition. Age-related immunological changes such as hormonal imbalance, chronic inflammation, increased oxidative stress, imbalance in protein metabolism, increased fat deposition, decreased physical activity, and poor nutritional status contribute to sarcopenia. Decreased bone density in osteoporosis can occur due to an imbalance between osteoblasts and osteoclasts. The diagnosis of osteosarcopenia is made based on the presence of osteoporosis and sarcopenia. Instrument strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC–F) are recommended for assessing sarcopenia and the fracture risk assessment tool (FRAX) for the risk of osteoporotic fracture. Management of osteosarcopenia is carried out holistically, including management of osteoporosis and sarcopenia both non-pharmacologically and pharmacologically.
Diagnosis and Management of Osteosarcopenia Jersivindo Ranazeri; Rose Dinda Martini; Mulyana, Roza; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 1 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i1.904

Abstract

Osteosarcopenia is a syndrome defined as a combination of low bone density and muscle mass as well as decreased strength and/or functional capacity. Osteoporosis and sarcopenia often coexist in the elderly, leading to a significantly worse prognosis. The epidemiology of osteosarcopenia is quite limited because the term is still new. Osteosarcopenia is more common in women than men and in malnutrition. Age-related immunological changes such as hormonal imbalance, chronic inflammation, increased oxidative stress, imbalance in protein metabolism, increased fat deposition, decreased physical activity, and poor nutritional status contribute to sarcopenia. Decreased bone density in osteoporosis can occur due to an imbalance between osteoblasts and osteoclasts. The diagnosis of osteosarcopenia is made based on the presence of osteoporosis and sarcopenia. Instrument strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC–F) are recommended for assessing sarcopenia and the fracture risk assessment tool (FRAX) for the risk of osteoporotic fracture. Management of osteosarcopenia is carried out holistically, including management of osteoporosis and sarcopenia both non-pharmacologically and pharmacologically.
Handgrip Strength: An Early Warning Sign for Mobility Decline? A Meta-Analysis of Diagnostic Accuracy Studies R. Ifan Arief Fahrurozi; Rose Dinda Martini; Roza Mulyana; Fandi Triansyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1160

Abstract

Background: Mobility limitations significantly impact the quality of life of older adults. Early identification of individuals at risk is crucial for timely intervention. This meta-analysis investigates the diagnostic accuracy of handgrip strength (HGS) in predicting future mobility decline in older adults. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for diagnostic accuracy studies published between 2018 and 2024, evaluating the ability of baseline HGS to predict incident mobility limitations in older adults (≥60 years). Mobility limitations were defined as difficulties in performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs). The primary outcomes were sensitivity, specificity, and diagnostic odds ratio (DOR) of HGS for predicting mobility decline. A bivariate random-effects model was used to pool data. Results: Seven diagnostic studies with a total of 3,870 participants were included. The pooled sensitivity of HGS for predicting mobility decline was 0.72 (95% CI: 0.65-0.78), and the pooled specificity was 0.70 (95% CI: 0.66-0.74). The pooled DOR was 4.85 (95% CI: 3.21-7.32), indicating good discriminatory ability. Conclusion: This meta-analysis demonstrates that HGS has moderate sensitivity and specificity for predicting future mobility decline in older adults. HGS assessment can be a valuable tool for identifying individuals at risk, although further research is needed to determine optimal cut-off points and combine HGS with other risk factors for improved prediction.