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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Tropical and Infectious Disease
Gatoet Ismanoe
Laboratorium/Bagian Ilmu Penyakit Dalam FK Unibraw / RS dr. Saiful Anwar Malang
Earth & Planetary Sciences Health Professions Medicine & Pharmacology Public Health

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Terapi ARV Meningkatkan Kadar IL-17 Serum pada Pasien HIV Wahyudi, Hendrik; Candradikusuma, Didi; B, Niniek Budiarti; Ismanoe, Gatoet
Jurnal Kedokteran Brawijaya Vol 27, No 4 (2013)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (529.47 KB) | DOI: 10.21776/ub.jkb.2013.027.04.8

Abstract

Penurunan jumlah atau fungsi Th-17 mempengaruhi produksi IL-17 sehingga virus HIV lebih mudah mengalami replikasi. Pemberiaan ARV yang dapat menekan replikasi virus HIV diharapkan dapat memperbaiki produksi IL-17 dan menyebabkan pulihnya fungsi Th-17. Penelitian dilakukan untuk mengetahui rerata kadar IL-17 serum pada pasien HIV sebelum dan setelah 3 bulan mendapat terapi ARV. Survei pre dan post tes dilakukan pada  pasien infeksi HIV yang baru terdiagnosa di RSU Dr. Saiful Anwar-Malang. Diagnosa HIV berdasarkan  kriteria WHO, dan IL-17 serum diukur dengan metode ELISA. Hitung limfosit T-CD4 absolut menggunakan metode flowcytometry. Analisa statistik yang digunakan untuk komparasi numerik  adalah uji t berpasangan dan  analisa korelasi menggunakan uji Spearman. Kadar IL-17 serum penderita HIV sebelum dan sesudah 3 bulan mendapat terapi ARV adalah 44,17±12,56 pg/mL dan 52,91±9,90 pg/mL (p=0,005). Hitung sel limfosit T-CD4 absolut  sebelum dan sesudah 3 bulan mendapat terapi ARV adalah 69,41±95,06 cells/mL dan 180,72±73,15 cells/mL (p=0,000). Kadar IL-17 serum didapatkan tidak berkorelasi dengan hitung sel T-CD4 absolut (p=0,914, r=-0,024). Dapat disimpulkan kadar IL-17 serum dan CD4 penderita HIV setelah 3 bulan mendapat terapi ARV lebih tinggi dibandingkan sebelum mendapat terapi ARV, namun, kadar IL-17 tidak berhubungan dengan hitung sel limfosit T-CD4.Kata Kunci: CD4, infeksi HIV, IL-17 serum, Th-17
PERAN LABORATORIUM DALAM DIAGNOSIS DAN PENATALAKSANAAN KASUS KASUS PENYAKIT TROPIK DAN INFEKSI Sardjono, Teguh Wahju; Ismanoe, Gatoet; Widjayanto, Edi
Jurnal Kedokteran Brawijaya Vol 20, No 1 (2004)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.874 KB) | DOI: 10.21776/ub.jkb.2004.020.01.4

Abstract

Infectious disease is still a health problem in theworld, especially in tropical and developing countries, including Indonesia. The diagnosis of tropical disease cases mostly are still based on the main of clinical symptoms, that is fever. Among 900 fever patients, 21% of the disease were diagnosed by clinical examinations, 35% by laboratory tests and 40% were diagnosed as fever of unknown origin (FUO). One forth of the FUO patients were definitively diagnosed after specific laboratory tests, but the use of the specific tests in daily practice were relatively rare. The tests ordered by physicians to the Department of Central Clinical Laboratory Dr. Saiful Anwar Hospital Malang, are mostly hematology and blood chemical tests (59.54% and 21.52%). Specific tests for microbiology and parasitology were only 3.15% and 0.46% respectively. Fever patients who not definitively diagnosed, often received unnecessary treatments or medications (over-treatment), those are actually dangerous to them. To improve the quality of clinical management, the traditional laboratory service should be changed tobe the interactive laboratory service. It needs a  role, understanding and good collaboration between clinical practitioners who know the basic sciences and the pre/para-clinical scientists who interest to the clinical phenomenon. The aim of the change is to get the more scientific, ethical and professional medical services. Key words:Laboratory medicine, diagnosis,management, infectious disease
Infeksi HIV Bersamaan dengan Systemic Lupus Erythematosus Sariningsih, Fajar; Suryana, Bagus Putu Putra; Ismanoe, Gatoet
Jurnal Kedokteran Brawijaya Vol 29, No. 3 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.03.14

Abstract

Munculnya Systemic Lupus Erythematosus (SLE) dan Human Immuno Deficiency Virus (HIV) yang terjadi secara bersamaan merupakan hal yang eksklusif. Tulisan ini melaporkan kasus HIV dan SLE yang terjadi bersamaan pada seorang wanita usia 50 tahun. Pasien mengalami keluhan yang mendukung adanya infeksi HIV dengan ditemukannya gejala diare kronis, penurunan berat badan, batuk-batuk, demam-demam, kelelahan badan, sariawan, nyeri sendi, dan allopesia. Pemeriksaan laboratorium yang mendukung diagnosis HIV pada pasien ini adalah peningkatan LED, tes determinan yang reaktif, dan penurunan CD4+. Pasien juga menderita SLE yang ditunjukkan dengan ditemukannya gejala allopesia (kerontokan rambut), sariawan yang tidak nyeri, sering menderita sakit sendi-sendi, demam yang hilang timbul tanpa penyebab jelas, riwayat trombositopenia (penurunan jumlah trombosit), penurunan berat badan. Hasil pemerikaan laboratorium immunologi yang mendukung diagnosis SLE adalah ANA test yang positif, ds DNA yang positif dan coombs test +2. Pemberian terapi antiretroviral dan chloroquin yang diberikan menunjukkan hasil perbaikan gambaran laboratorium dan gejala klinis pada bulan keempat pengobatan.Kata Kunci: Human Immuno Deficiency Virus (HIV), Systemic Lupus Erythematosus (SLE)
Correlation between soluble urokinase plasminogen activator receptor with CD4 T lymphocyte and WHO clinical staging of HIV infection Wardhani, Shinta Oktya; Burhan, Niniek; Ismanoe, Gatoet; Yudani, Tri
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (476.276 KB) | DOI: 10.20473/ijtid.v1i1.3720

Abstract

The urokinase-type plasminogen activator (uPA) and its receptor play a key role in pericellular proteolysis, cell migration and signal transduction. Previous study showed that suPAR could be used as an independent prognostic marker of disease progression in HIV-1 patients.1,17 Immune status of HIV patient and progressivity of disease are important parameters used as clinical concideration before initiating anti retroviral treatment and for monitoring treatment effectivity. Recently immune status of HIV patients is determined by CD4 T lymphocyte counting which represents the remaining healthy lymphocyte T expressing CD4 that very expensive and need special laboratory equipment. Destruction and shedding of T lymphocyte, macrophage and natural killer cell will deliver soluble urokinase plasminogen activator receptor, a surface protein which is expressed by those cells and can be measured by ELISA8,9,11. This study objective is to determine correlation between suPAR plasma concentration and CD4 T lymphocyte and WHO clinical stagging of HIV infection. Study subjects. Fifty four naieve HIV-1-infected patients (32 males, and 22 females) are participant in a cross sectional study enrolled on 22 November 2007 until 31 july 2008 at the department of infectious disease Saiful Anwar Hospital, Malang, Indonesia. Blood sampling. Two blood samples were drawn before treatment, CD4 counts were measured with an Epics XL-MCL Coulter flowcytometer. EDTA plasma for suPAR measurement was stored at -80°C. Data are presented as mean±standart deviation. P<0.05 is considered significant. Statistical calculations were done using SSPS 15. Patients (n = 54) enrolled and clustered according to WHO clinical stage ( I - IV) at inclusion. All HIV-infected patients had measurable levels of plasma suPAR with a median value of 8,9 ng/mL(range 1,65-29,7 ng/mL). Pearson correlation demonstrated a weak but significant negative between suPAR and CD4 T lymphocyte count (p=-0.634, p<.0005). suPAR level positively correlated with the WHO-defined clinical stages (P< .0005, spearman correlation test, r=0,87). There were significant difference between each stage i.e I(1,6± o,61ng/mL), II(3.04±1.03 ng/mL), III (10.53±7.1ng/mL) and IV (20.42±10.81ng/mL) (P< .0005, Spearman test). In addition pearson correlation demonstrated a weak but significant negative correlation between suPAR and CD4 count (p=-0.66; P<.0005). There were negative significant correlatio between CD4 count and suPAR level, suggested that suPAR could provide as a complementary biological marker for HIV-1 although it can not replace the CD4 count. SuPAR plasma concentration and clinical stage give significantly correlation with WHO clinical staging of HIV infection.
Co-Authors Burhan, Niniek Didi Candradikusuma Edi Widjayanto Hendrik Wahyudi Niniek Budiarti B Sariningsih, Fajar Shinta Oktya Wardhani, Shinta Oktya Suryana, Bagus Putu Putra Teguh Wahju Sardjono Yudani, Tri