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All Journal Medical Journal of Indonesia Indonesian Journal of Cancer Chemoprevention Indonesian Journal of Rheumatology Narra J Jurnal Penyakit Dalam Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
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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Rekam Medis Elektronik Berbasis Artificial Intelligence: Sudahkan Saatnya Digunakan? Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 4
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Skoring Risiko Mortalitas pada Pneumonia Komunitas Sedang-Berat Kusuma, Ni Nyoman Indirawati; Singh, Gurmeet; Wulani, Vally; Rumende, Cleopas Martin Martin; Fauzar, Fauzar; Kamelia, Telly; Koesnoe, Sukamto; Susilo, Adityo; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Community Acquired Pneumonia (CAP) is a lung parenchyma infection acquired outside of the hospital and is significantly associated with morbidity and mortality rates. Identifying patients with moderate-severe CAP at high risk of mortality through a combination of these variables is expected to serve as a basis for prompt and appropriate intervention, ultimately improving clinical outcomes for CAP patients. This study aimed to develop a scoring system using clinical characteristics, radiological findings, and serum biomarkers to assess the mortality risk in patients with moderate-severe CAP. Methods. This study employs a retrospective cohort design with moderate-severe CAP patients treated at Dr. Ciptomangunkusumo Hospital, Jakarta. The sample data were secondary, derived from medical records of patients diagnosed with moderate-severe CAP between January 2022 and December 2023. Predictor variables for mortality risk were obtained through multivariate analysis using Cox regression. Results. The study included 277 subjects, with 124 (44.77%) deaths and 153 (55.23%) survivors. Predictor variables consistently influencing mortality risk in moderate-severe CAP patients were low BMI (HR 1.609, 95% CI 1.047 – 2.472), procalcitonin (HR 1.778, 95% CI 1.200 – 2.634), and lactate levels (HR 1.451, 95% CI 0.994 – 2.119). The prediction model’s performance, based on the ROC curve analysis, showed moderate predictive ability (AUC = 0.641), and calibration performance, as assessed by the Hosmer-Lemeshow test, showed good validation (p = 0.082). Conclusions. There is an association between BMI, procalcitonin, and lactate levels with the mortality risk in moderate-severe CAP patients. A mortality risk scoring model for moderate-to-severe CAP patients has been established.
Campak dan Vaksinasi Campak pada Orang Dewasa Sinto, Robert; Koesnoe, Sukamto; Nelwan, Erni Juwita; Widhani, Alvina; Shakinah, Sharifah; Pasaribu, Adeline; Duindrahajeng, Bernadine Gracia; Suwarto, Suhendro; Nainggolan, Leonard; Chen, Lie Khie; Susilo, Adityo; Maria, Suzy; Hasibuan, Anshari Saifuddin; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Measles is a highly contagious viral infection that remains a significant global health problem despite the availability of an effective vaccine. Measles re-emergence is driven by gaps in immunization coverage, waning post-vaccination immunity, and increased population mobility. In adults, measles infection is associated with greater disease severity compared to children. This literature review was conducted by reviewing recent scientific publications addressing the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, complications, and prevention of measles, with a focus on the adult population.  Measles is caused by an RNA virus of the Paramyxoviridae family and is transmitted through respiratory droplets and aerosols. Typical clinical features include fever, cough, coryza, conjunctivitis, and a maculopapular rash with a centrifugal and cephalocaudal distribution. Diagnosis is based on clinical findings and confirmed by laboratory tests such as RT-PCR and measles-specific IgM serology. Measles infection causes significant immunosuppression, including immune amnesia, which increases susceptibility to secondary infections. Management is primarily supportive and vitamin A supplementation has been shown to reduce mortality in certain populations. In adults, complications tend to be more severe, particularly pneumonia as the leading cause of morbidity and mortality, as well as neurological complications such as encephalitis and subacute sclerosing panencephalitis (SSPE). Measles vaccination with the MMR vaccine remains the main prevention strategy. However, its implementation faces challenges, including gaps in immunization coverage, vaccine hesitancy, and limited adult immunization record system. Measles in adults remains a significant health concern with a high risk of severe complication. Strengthening immunization program, improving public education, and developing integrated surveillance system are essential to reduce disease incidence and burden.
Short-Term Survival and Prognostic Factors in Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study Bundjali, Muhammad Trihatmowijoyo; Marbun, Maruhum Bonar Hasiholan; Rajabto, Wulyo; Rinaldi, Ikhwan; Shatri, Hamzah; Partiningrum, Dwi Lestari; Makmun, Dadang; Nugroho, Pringgodigdo; Koesnoe, Sukamto; Soewondo, Pradana
Kesmas Vol. 21, No. 1
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Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic blood pressure <110 mmHg (hazard ratio [HR] 3.354; 95% confidence interval [CI]: 2.346–4.795; p-value <0.001) and interdialytic weight gain ≥5% (HR 1.685; 95% CI: 1.125–2.521; p-value <0.011) as significant predictors of decreased survival. Other variables, including age, urea, albumin, vascular access, baseline creatinine, and cancer stage, were not significantly associated with short-term survival. These findings underscore the critical role of salt and fluid management, adherence to dietary and dialysis regimens, and close monitoring of weight in improving outcomes. Interventions targeting modifiable factors may improve the survival of cervical cancer patients who require HD. Such approaches, therefore, warrant further investigation.
Variabel dan Model Prediktor Perdarahan Varises Esofagus Berulang pada Pasien Sirosis Hati di RSUPN Dr. Cipto Mangunkusumo Sari, Ifani Media; Kurniawan, Juferdy; Kalista, Kemal Fariz; Rizka, Aulia; Ginanjar, Eka; Nasution, Sally Aman; Nainggolan, Leonard, MD. Internal medicine, Tropic-Infection spesialist; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia
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Introduction. Liver cirrhosis is a chronic condition associated with severe complications, including esophageal variceal bleeding, which carries high morbidity and mortality rates. Approximately 60% of patients with cirrhosis experience recurrent bleeding within one year, with a mortality rate of 20–60% within six weeks after the initial bleeding episode. Therefore, identifying predictors of recurrent bleeding is essential for improving preventive strategies. This study aimed to identify predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis and to develop a predictive model. Methods. This retrospective study included 220 patients with liver cirrhosis and a history of esophageal variceal bleeding based on medical record data. The variables analyzed included age, platelet count, red color sign, spontaneous bacterial peritonitis, splenomegaly, number of endoscopic variceal ligation (EVL) bands, portal hypertensive gastropathy, and Child–Pugh score. Statistical analyses were performed to identify independent predictors and to develop a prediction model. Results. Recurrent esophageal variceal bleeding occurred in 33.6% of patients. Patients with recurrent bleeding were more likely to be male, younger, have hepatitis B as the underlying etiology, a Child–Pugh score ≥7, a platelet count <150,000/µL, and ≥3 EVL bands placed during treatment. Bivariate analysis demonstrated that a Child–Pugh score ≥7, platelet count <150,000/µL, ≥3 EVL bands, the presence of a red color sign, and splenomegaly were significantly associated with recurrent esophageal variceal bleeding in patients with liver cirrhosis. The final prediction model consisted of three variables: Child–Pugh score, platelet count, and number of EVL bands, with a maximum total score of 4 points. The model demonstrated good predictive performance, with an area under the receiver operating characteristic curve (AUC) of 0.81. Conclusions. The predictors of recurrent esophageal variceal bleeding in patients with liver cirrhosis were Child–Pugh score, platelet count, and the number of EVL bands. The resulting prediction model demonstrated good statistical performance and may be useful for risk stratification in clinical practice.
Hubungan Penggantian Imunosupresan Tidak Terencana dengan Aktivitas Penyakit Lupus Eritematosus Sistemik: Studi Kohort Retrospektif di RSUPN Dr. Cipto Mangunkusumo, Jakarta Amanda, Rosvitha; Koesnoe, Sukamto; Widhani, Alvina; Rinaldi, Ikhwan; Susilo, Adityo; Kurniawan, Juferdy; Putranto, Rudi; Karim, Birry
Jurnal Penyakit Dalam Indonesia
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Introduction. Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease with diverse clinical manifestations. Treatment stabilization is crucial for optimal disease control, but the consistency of immunosuppressive therapy may be affected by non-ideal conditions, including drug unavailability or adverse effects. This study aimed to assess the association between unplanned immunosuppressant switching and increased disease activity in SLE patients. Methods. A retrospective cohort study of SLE patients meeting the inclusion criteria, whose disease activity was evaluated using the MEX-SLEDAI score during immunosuppressant substitution. Participants were grouped into an exposed group undergoing unplanned immunosuppressant switching due to drug unavailability and a comparison group continuing maintenance therapy without switching. Disease activity was assessed using the MEX-SLEDAI score during follow-up. Results. A total of 213 SLE patients were included; 45 patients (21.1%) experienced increased disease activity. Unplanned immunosuppressant substitution was significantly associated with increased disease activity (RR 2.06; 95% CI 1.18–3.60; p=0.011), and remained significant after adjustment for confounders (aRR 1.82; 95% CI 1.05–3.15; p=0.034). Subgroup analysis showed most flares occurred within the first three months after substitution, and mycophenolate-containing replacement regimens were associated with a lower risk of increased disease activity (p=0.025). Conclusions. Unplanned immunosuppressant substitution is associated with increased disease activity in SLE patients. Close monitoring following switching is essential to maintain disease stability.
Co-Authors Achmad, Ibrahim Adityo Susilo, Adityo Adli, Mizanul Adna, Rury Maharani Aldy Heriwardito Alvina Widhani, Alvina Amanda, Rosvitha 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 Birry Karim Buharman, Borries Foresto Bundjali, Muhammad Trihatmowijoyo Ceva W. Pitoyo Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cosphiadi Irawan Dadang Makmun Dewanta, Widhi Dian R. Sawitri, Dian R. Duindrahajeng, Bernadine Gracia Dwi Lestari Partiningrum E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Eka Ginanjar Ekanara, Nabilla Gita Em Yunir, Em Erni Juwita Nelwan, Erni Juwita Esthika Dewiasty, Esthika Evy Yunihastuti Fauzar, Fauzar Ferliani Ferliani, Ferliani Gurmeet Singh Harry Isbagio Hasibuan, Anshari Saifuddin Heri Wibowo Hermanadi, Muhammad Ikrar Heru Sundaru Ika Prasetya Wijaya Ikhwan Rinaldi Indria Yogani, Indria Irene Yuniar, Irene Irman Firmansyah Johan, Alvin Juferdy Kurniawan Katarina, Matilda Kemal Fariz Kalista, Kemal Fariz Khie Chen Kuntjoro Harimurti Kusuma, Ni Nyoman Indirawati Leonard Nainggolan Marbun, Maruhum Bonar Hasiholan Masyur, Muhtaruddin Muhadi Muhadi, Muhadi Muhammad Alkaff Murdani Abdullah Nababan, Saut Horas H. Nainggolan, Leonard, MD. Internal medicine, Tropic-Infection spesialist Nuri Purwito Adi Olfriani, Ciho Pasaribu, Adeline Pradana Soewondo Pringgodigdo Nugroho, Pringgodigdo R.R., Aditia Retnaningdyah, Windri Ricardo, William Rini Mulia Sari Rini Sekartini Robert Sinto Rudi Putranto Rudy Hidayat Rumende, Cleopas Martin Martin Sally Aman Nasution, Sally Aman Samsuridjal Djauzi Sari, Ifani Media Sari, Nina Kemala Sarwono, Sugeng J. Saskia Aziza Nursyirwan, Saskia Aziza Shakinah, Sharifah Siti Taqwa Fitria Lubis, Siti Taqwa Fitria Soedjatmiko Suhendro Suwarto, Suhendro Sulaiman, Andri S Suzy Maria Teguh Harjono Karjadi, Teguh Harjono Teguh Harjono Karyadi, Teguh Harjono Telly Kamelia Tjhin Wiguna Ummu Habibah, Ummu Wahyuni Indawati, Wahyuni Wicaksana, Bramantya Wirahmadi, Angga Wulandari, Risky Wulani, Vally Wulyo Rajabto Yulidar Yulidar