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Sukamto Koesnoe
Faculty of Medicine University of Indonesia, Ciptomangunkusumo Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Faktor-faktor yang Berhubungan dengan Kenaikan CD4 pada Pasien HIV yang Mendapat Highly Active Antiretroviral Therapy dalam 6 bulan Pertama Yogani, Indria; Karyadi, Teguh Harjono; Uyainah, Anna; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
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Pendahuluan: HIV adalah infeksi yang menyerang sistem kekebalan tubuh dengan CD4 sebagai sel targetnya. Ditemukannya Highly Active Antiretroviral Therapy (HAART) diharapkan mampu menurunkan angka morbiditas dan mortalitas HIV. Namun, kenaikan CD4 tidak sama untuk setiap pasien serta terdapat faktor lain yang berhubungan dengan kenaikan CD4 pada pasien HIV. Metode: Studi kohort retrospektif dilakukan pada pasien HIV rawat jalan di Unit Pelayanan Terpadu HIV Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta selama Mei- Juni 2014.. Data penelitian didapatkan dari rekam medis selama Januari 2004-Desember 2013. Analisis data menggunakan program SPSS dengan uji Mann Whitney, uji Chi Square atau Fisher serta analisis multivariat dengan teknik regresi logistik. Hasil: Sebanyak 818 subjek diikutsertakan pada penelitian ini. Sebanyak 368 (45%) subjek tidak mengalami kenaikan CD4 seperti yang diharapkan. Median CD4 awal sebelum terapi 56 sel/mm3 dan setelah 6 bulan terapi 130 sel/mm3. Terdapat hubungan yang bermakna antara jumlah CD4 awal, infeksi tuberkulosis dan tingkat kepatuhan dengan kenaikan CD4 dengan nilai p masing-masing Simpulan: Jumlah CD4 awal, kepatuhan minum obat, dan infeksi tuberkulosis mempengaruhi kenaikan CD4 pada pasien HIV yang mendapat Highly Active Antiretroviral Therapy setelah 6 bulan pertama.
Setelah Pandemi COVID-19: Peran Penggunaan Alat Pelindung Diri bagi Tenaga Medis di Indonesia Koesnoe, Sukamto; Hermanadi, Muhammad Ikrar
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 2
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Perbedaan Serotonin Plasma dan Kortisol Saliva terhadap Gejala Depresi pada Pasien Pasca Sindrom Koroner Akut Firmansyah, Irman; Shatri, Hamzah; Putranto, Rudi; Ardani, Yanuar; Ginanjar, Eka; koesnoe, sukamto; Rizka, Aulia; Isbagio, Harry; Yunir, Em
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
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Introduction. Psychological disorders are closely associated with hormonal factors, including cortisol and serotonin. In patients with acute coronary syndrome (ACS), autonomic dysfunction and dysregulation of the hypothalamic-pituitaryadrenal (HPA) axis can occur, leading to an increase in cortisol levels that may worsen the prognosis of ACS patients. Therefore, it is important to understand the hormonal impact, namely cortisol and serotonin levels, on depressive symptoms, which will be examined in this study. Methods. This was a cross-sectional study to determine the impact of cortisol and serotonin in the incidence of depression in post-treatment ACS patients at the ICCU RSUPN dr. Cipto Mangunkusumo, Jakarta. Data collection from patients meeting the inclusion criteria was carried out 10-14 days post-treatment through interviews, HADS questionnaire completion, physical examinations, and laboratory tests. The Mann-Whitney test was used to examine the differences between serotonin and salivary cortisol levels in patients with and without depression. Results. Among the 73 ACS patients included in this study, the average age was 57.53 (9.97) years, with 68.5% was male. Posttreatment depression was observed in 15.1% of subjects. The median serotonin levels were lower in patients with depression [175 (147 – 227.64) ng/mL vs. 189.31 (152.87-235.44) ng/mL], while cortisol levels were higher in patients with depression [3.09 (1.46-6.26) ng/mL vs. 2.15 (0.92-3.91) ng/mL]. However, the statistical analysis showed no significant differences between plasma serotonin and depression (p=0.482) or saliva cortisol and depression (p=0.275). Conclusions. There were no significant differences in cortisol and serotonin levels concerning depressive symptoms among post-acute coronary syndrome patients. Nevertheless, this study holds clinical importance due to the observed lower plasma serotonin levels and higher saliva cortisol levels in ACS patients with depression.
Kesintasan Pasien Karsinoma Hepatoselular: Sebuah Studi Komprehensif tentang Pengaruh Awitan Dini versus Lambat dan Faktor Determinannya Achmad, Ibrahim; Jasirwan, Chyntia Olivia Maurine; Rajabto, Wulyo; Abdullah, Murdani; Nababan, Saut Horas H.; Nasution, Sally Aman; Koesnoe, Sukamto; Sari, Nina Kemala
Jurnal Penyakit Dalam Indonesia
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Introduction. The prognosis for patients with Hepatocellular Carcinoma (HCC) is generally poor because most cases are diagnosed at an advanced stage. Several studies indicate that HCC is more prevalent and has a worse prognosis among younger individuals. This study aims to identify and compare the variations in survival rates between early and late-onset HCC patients at Cipto Mangunkusumo Hospital and investigate the factors that impact survival outcomes in both groups. Methods. Retrospective cohort study of HCC patients registered in HCC registry 2015-2022. Survival was visualized using Kaplan-Meier curves. Prognostic factor variables in the Cox Proportional Hazard Regression analysis by backward method in the final model became independent prognostic factors for overall survival. Results. There were 896 subjects. Patients with early onset had a median survival of 2.0 months (95% CI 1.0-2.9), while late-onset patients had a median survival of 4.0 months (95% CI 3.4-4.5) (p=0.021). During the observation period, the incidence of death in early onset was found to be higher compared to late onset (92.9% vs. 87.7%, p 0.032). In the multivariate analysis for early onset, hypertension comorbidity and lack of hepatitis treatment were prognostic factors increasing the risk of death with [HR 3.7 (95% CI: 1.0-12.7)] and [HR 2.4 (95% CI: 0.9-6.2)] (p=0.053). In the multivariate analysis for late onset, prognostic factors increasing the risk of death include AFP levels ≥200 ng/mL [HR 1.2 (95% CI: 1.0-1.5)], liver cirrhosis [HR 1.2 (95% CI: 1.0-1.3)], AJCC stage 4 as the most advanced stage [HR 4.5 (95% CI: 2.2-8.9)], supportive therapy [HR 5.2 (95% CI: 3.9-6.8)], and palliative therapy [HR 1.6 [95% CI: 1.2-2.2)]. Conclusion. The median survival of early-onset HCC patients is lower compared to late-onset ones because the majority are not given curative treatment. Independent prognostic factors in early-onset are hypertension and hepatitis treatment, while in late-onset AFP levels, liver cirrhosis, AJCC stage, and therapy are given.
Efektivitas Vaksin COVID-19 mRNA Booster Kedua pada Tenaga Kesehatan di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo dan Faktor yang Memengaruhinya Lubis, Siti Taqwa Fitria; Koesnoe, Sukamto; Yunihastuti, Evy; Shatri, Hamzah; Karjadi, Teguh Harjono; Harimurti, Kuntjoro; Pitoyo, Ceva Wicaksono; Yunir, Em
Jurnal Penyakit Dalam Indonesia
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Introduction. The emergence of the Omicron variant during the pandemic had an impact on the effectiveness of the COVID-19 vaccine. The spread of Omicron increased rapidly even in populations that had been vaccinated with booster doses, causing a high incidence of infection. This study aimed to determine the effectiveness and factors related to the effectiveness of the second mRNA booster vaccine as well as antibody levels after the second mRNA booster vaccine in healthcare workers at Cipto Mangunkusumo National General Hospital. Methods. This study used a cohort design. Total sampling of 271 healthcare workers were obtained from previous research and continued with consecutive sampling. Selected subjects were interviewed, and blood samples were taken to measure IgG sRBD antibody levels. The effectiveness of the vaccine was calculated, and bivariate and multivariate analysis was carried out to assess the factors that influenced the effectiveness of the second mRNA booster vaccine. Results. A total of 9 subjects (5.6%) were infected with COVID-19 in the second booster vaccine group and 11 subjects (9.7%) in the first vaccine group. The effectiveness of the vaccine against COVID-19 infection was 42% (CI 95% -37 – 75%), p = 0,215. Age, gender, hypertension, type 2 DM, obesity, smoking, and COVID-19 infection before booster have no relationship to the effectiveness of the second booster mRNA vaccine. In 48 subjects who had their antibody levels checked during the first and second boosters, there was an increase from 4,743 AU/ml (IQR 6,053.3) to 8,532 AU/ml (IQR 8,040.3). Conclusions. The effectiveness of the second mRNA booster vaccine against COVID-19 infection in healthcare workers was 42%. There were no factors related to the effectiveness of the second mRNA booster vaccine. The sRBD antibody levels after the second booster vaccine were higher than the first booster vaccine.
Effects of traditional music therapy on the psycho-neuro-immuno-endocrine aspect of burnout syndrome in healthcare workers: A randomized controlled trial Ardani, Yanuar; Shatri, Hamzah; Koesnoe, Sukamto; Yunir, Em; Wiguna, Tjhin; Wibowo, Heri; Sawitri, Dian R.; Sarwono, Sugeng J.; Masyur, Muhtaruddin; Ricardo, William; Katarina, Matilda; Anggono, Rendi F.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1686

Abstract

Burnout syndrome (BOS) is an occupational phenomenon highly prevalent among healthcare workers, particularly physicians and nurses. Despite its prevalence, no single therapy universally addresses all cases of BOS. The aim of this study was to develop a novel approach to managing BOS through traditional music therapy, evaluated from psychosomatic, neurological, immunological, and endocrine perspectives. The study involved 80 participants who were randomly assigned to either the intervention or control group. The intervention group received traditional music therapy for 10–15 minutes, three times a week, over four weeks. Key outcomes were assessed at weeks 2 and 4. Measurements included the Maslach Burnout Inventory (MBI), heart rate variability (HRV), saliva cortisol, saliva β-endorphin, saliva immunoglobulin A (IgA), and serum FOXP3. Instruments included the MBI-HSS questionnaire and HRV measuring devices. Over four weeks, significant improvements were observed in the MBI scores (p=0.001), HRV (p=0.001), and FOXP3 delta (p=0.035) in the intervention group compared to the control group. However, no significant differences were found for cortisol, β-endorphin, or IgA. These findings suggest that traditional music therapy positively impacts the psychological, neurological, and immunological aspects of BOS and potentially influences immunological and endocrine responses. Future research should explore the effects of longer intervention durations, test varying doses, and examine the combination of music therapy with other non-pharmacological treatments to enhance its therapeutic potential.
Safety and immunogenicity of the CoV2-Bio in a healthy population aged 18 years and older in Indonesia Maria, Suzy; Olfriani, Ciho; Koesnoe, Sukamto; Sekartini, Rini; Soedjatmiko; Medise, Bernie Endyarni; Yuniar, Irene; Indawati, Wahyuni; Wirahmadi, Angga; Sari, Rini Mulia; Adi, Nuri Purwito; Retnaningdyah, Windri
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247476

Abstract

BACKGROUND According to the WHO Target Product Profiles for COVID-19 Vaccines, vaccine development should be indicated for active immunization in all populations, in conjunction with other control measures to curtail the pandemic. Several RBD-based COVID-19 vaccines are being evaluated and have shown advantages. CoV2-Bio was developed based on the wild-type SARS-CoV-2 RBD amino acid sequence, representing residues of the spike protein of the Wuhan-Hu-1 isolate. This study aimed to evaluate the safety and immunogenicity of CoV2-Bio when compared to CoronaVac. METHODS This was an observer-blinded, randomized controlled prospective study of safety and immunogenicity of the CoV2-Bio in healthy adult population. A total of 54 healthy participants were randomized to receive either 3 doses of CoV2-Bio or 2 doses of CoronaVac, and 1 dose of placebo, administered 28 days apart. Participants were followed up for safety and immunogenicity. IgG antibody titers (ELISA) and neutralization assay against Wuhan and Delta strains were evaluated at baseline, Days 28, 56, and 84. We assessed seropositive rate, seroconversion, and GMT as parameters. RESULTS Both vaccines were well tolerated and induced good antibody response. The incidence rate and intensity of local and systemic adverse events did not differ between vaccine and control groups. The vaccine group showed a larger proportion of seroconversion (4-fold increase antibody) (87.5% versus 46.2%, p = 0.001) and higher GMT (305.9 AU/ml versus 102.4 AU/ml, p<0.001) when compared to control group. CONCLUSIONS 3 doses of the CoV2-Bio are safe and immunogenic in healthy adult population. 3 doses of the CoV2-Bio COVID-19 vaccine produce a better immunogenicity profile compared to CoronaVac.
Profil Anafilaksis di RSU Hasanah Graha Afiah, Depok pada Januari 2023 – April 2024 Koesnoe, Sukamto; Wulandari, Risky; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia
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Introduction. Anaphylaxis is a severe hypersensitivity reaction that occurs rapidly and can be life-threatening. This reaction disrupts the respiratory, cardiovascular, digestive, and/or integumentary systems. The global prevalence of anaphylaxis is 1-2%, with a mortality rate of 0.3%. However, data on anaphylaxis in Indonesia is very limited. The aim of this study was to obtain anaphylaxis profile at Hasanah Graha Afiah Hospital, Depok. Methods. This study used a cross-sectional descriptive study from January 2023 to April 2024 at Hasanah Graha Afiah Hospital, Depok, Jawa Barat. Inclusion criteria include patients aged ≥17 years, diagnosed with anaphylaxis in medical records in inpatient and/or emergency units. Data was collected from electronic medical records. Demographic variables include gender, age, marital status, occupation, education, comorbidities, causes of anaphylaxis, diagnostic criteria, severity, initial therapy, and mortality. Results.This study found an anaphylaxis incidence rate of 0.8%, with the highest occurrence in the 26-35 age group (28%). Most anaphylaxis cases were in females (59%). The most common triggers were NSAIDs (34.4%), followed by antibiotics (28.1%), paracetamol (9.4%), anti-bleeding agents (9.4%), and anti-tuberculosis drugs (6.2%). Interestingly, we found food, blood products, and cold as other causes. Anaphylactic shock occurred in 19% of cases. The most used therapies were methylprednisolone (43%), diphenhydramine (28%), epinephrine (17%), and dexamethasone (12%). There were no anaphylaxis-related mortalities. Conclusions. The incidence of anaphylaxis at RSU Hasanah Graha Afiah, Depok, was 0.8%. Most cases occurred in females aged 26–35 years, with medications being the primary trigger. Vigilance in selecting disease treatment, early recognition of anaphylaxis, and prompt and appropriate management are essential instruments in the successful handling of anaphylaxis.
Hubungan Hiperurisemia dengan Penurunan LFG pada Pasien Penyakit Ginjal Diabetes di RSCM Jakarta Adna, Rury Maharani; Marbun, Maruhum Bonar Hasiholan; Rinaldi, Ikhwan; Yunir, Em; Koesnoe, Sukamto; Singh, Gurmeet; Sinto, Robert
Jurnal Penyakit Dalam Indonesia
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Introduction. Elevated serum uric acid levels are associated with the progression of kidney disease in patients with type 2 diabetes mellitus (DM), through mechanisms involving endothelial dysfunction, oxidative stress, and chronic inflammation. Research in Indonesia on the relationship between uric acid levels and the decline of glomerular filtration rate (GFR) in diabetic patients remains limited. This study aimed to determine the association between serum uric acid (SUA) levels and decline in glomerular filtration rate among patients with diabetes mellitus diagnosed with diabetic kidney disease at Cipto Mangunkusumo Hospital, Jakarta, over a one-year period. Methods. This retrospective cohort study analyzed medical records of 192 type 2 diabetes melitus patients attending the Endocrinology and or Kidney Hypertension Clinics at Cipto Mangunkusumo National General Hospital , Jakarta. Inclusion criteria were baseline glomerular filtration rate ≥60 mL/min/1.73 m², available baseline serum uric acid, and follow-up glomerular filtration rate after one year. Bivariate and multivariate analyses were performed, adjusting for confounders including age, sex, hypertension, body mass index (BMI), triglycerides, HDL, LDL, total cholesterol, HbA1c, fasting blood glucose, and albuminuria. Results. Hyperuricemia prevalence was 85.94%. Multivariate analysis revealed that elevated SUA levels (≥6 mg/dL in women, ≥7 mg/dL in men) were associated with a 13.5% higher risk of GFR decline compared to normal serum uric acid (RR 1.135; 95% CI 1.015–1.268) after adjustment. Higher Body mass index was protective against glomerular filtration rate decline, while lipid profile, HbA1c, and fasting blood glucose were not significantly associated with diabetic kidney disease progression. Conclusions. Hiperuricemia is an independent risk factor for diabetic kidney disease progression in type 2 diabetes mellitus. Regular monitoring and management of serum uric acid may be crucial in preventing kidney function decline in this population.
Correlation between Plasma Soluble CD36 Levels with Body Mass Index of Breast Cancer Patients in the Indonesian Population Rachman, Andhika; Irawan, Cosphiadi; R.R., Aditia; Koesnoe, Sukamto; Wijaya, Indra
Indonesian Journal of Cancer Chemoprevention Vol 14, No 1 (2023)
Publisher : Indonesian Society for Cancer Chemoprevention

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14499/indonesianjcanchemoprev14iss1pp12-21

Abstract

The cluster of differentiation 36 (CD36) is a multiligand receptor protein that plays a role in lipid metabolism. Its biological functions involve lipid uptake, immune recognition, inflammation, molecular adhesion, and tumor metastasis. Soluble CD36 (sCD36) is the circulating form of CD36 in plasma. Research on the role of sCD36 in breast cancer is limited. This study aimed to investigate sCD36 concentration and evaluate the correlation between sCD36 concentration and BMI in breast cancer patients. This is a multi-center cross-sectional study done from June 2018 to February 2019 in Indonesia. Consecutive sampling was done for women with invasive breast cancer aged 18-70. Patients with locoregional recurrences, multiple comorbidities, diabetes, stroke, or liver impairment were excluded. Patients were grouped based on their BMI into normo-weight and overweight/obese. Plasma sCD36 was analyzed using Bioassay Laboratory™ ELISA. The correlation between plasma sCD36 and the patient's characteristics (metastasis status and molecular subtype) were then analyzed. A total of 76 patients were enrolled, 36 of whom were categorized into the overweight/obese group and 40 of them in the normo-weight. Plasma levels of sCD36 in breast cancer patients were higher than controls at 0.24±0.163 ng/mL and 0.46±0.175 ng/mL, respectively (p=0.006). However, no difference in plasma sCD36 levels was found between the overweight/obese group and the normo-weight breast cancer subjects (p>0.05). Plasma sCD36 increased significantly in breast cancer patients, but no significant difference was found based on body mass index. Further research is needed to determine the role of sCD36 in determining clinical outcomes and prognosis in breast cancer patients.Keywords: Soluble CD36, body mass index, breast cancer, indonesia.
Co-Authors Achmad, Ibrahim Adli, Mizanul Adna, Rury Maharani Aldy Heriwardito Andhika Rachman Anggono, Rendi F. Anindito, Bagus Anna Uyainah Ardani, Yanuar Ariadno, Aru Arif Mansjoer Astrid Citra Padmita, Astrid Citra Aulia Rizka, Aulia Bernie Endyarni Medise Buharman, Borries Foresto Ceva W. Pitoyo Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cosphiadi Irawan Dadang Makmun Dewanta, Widhi Dian R. Sawitri, Dian R. E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Eka Ginanjar Ekanara, Nabilla Gita Em Yunir, Em Esthika Dewiasty, Esthika Evy Yunihastuti Ferliani Ferliani, Ferliani Gurmeet Singh Harry Isbagio Heri Wibowo Hermanadi, Muhammad Ikrar Heru Sundaru Ika Prasetya Wijaya Ikhwan Rinaldi Indria Yogani, Indria Irene Yuniar, Irene Irman Firmansyah Johan, Alvin Katarina, Matilda Kuntjoro Harimurti Marbun, Maruhum Bonar Hasiholan Maria, Suzy Masyur, Muhtaruddin Muhadi Muhadi, Muhadi Muhammad Alkaff Murdani Abdullah Nababan, Saut Horas H. Nuri Purwito Adi Olfriani, Ciho R.R., Aditia Retnaningdyah, Windri Ricardo, William Rini Mulia Sari Rini Sekartini Robert Sinto Rudi Putranto Rudy Hidayat Sally Aman Nasution, Sally Aman Samsuridjal Djauzi Sari, Nina Kemala Sarwono, Sugeng J. Saskia Aziza Nursyirwan, Saskia Aziza Siti Taqwa Fitria Lubis, Siti Taqwa Fitria Soedjatmiko Sulaiman, Andri S Teguh Harjono Karjadi, Teguh Harjono Teguh Harjono Karyadi, Teguh Harjono Tjhin Wiguna Ummu Habibah, Ummu Wahyuni Indawati, Wahyuni Wicaksana, Bramantya Wijaya, Indra Wirahmadi, Angga Wulandari, Risky Wulyo Rajabto Yulidar Yulidar