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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Mutiara Medika: Jurnal Kedokteran dan Kesehatan Jurnal Gizi Klinik Indonesia

Johan Kurnianda

Division Of Hematology And Medical Oncology, Department Of Internal Medicine, Faculty Of Medicine, Universitas Gadjah Mada / Dr. Sardjito Hospital Yogyakarta

Author-ID : 301448

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation between the Symptoms of Depression and Sexual Function in Breast Cancer Patients Receiving Chemotherapy Rohmawati, Dwi; Siswanto, Agus; Kurnianda, Johan; Sofia, Noor Asyiqah
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTÂ Â Â Â Â Â Â Â Â Â Â Â Symptoms of depression and sexual problems that occur among breast cancer patients are a rarely detected and get good handling. Therefore, an early detection for any psychological problems that may affect the sexual life of patients with breast cancer is needed so that the patients can have better life. This study aims to assess the correlation between symptoms of depression and sexual function in women with breast cancer who undergo chemotherapy at Dr. Sardjito Hospital.Â Â Â Â Â Â Â Â Â Â Â Research design was cross sectional. The study necquited 38 breast cancer patients in Tulip outpatients Cancer Clinic in Dr. Sardjito Hospital. Assessment of depressive symptoms used Beck Depression Inventory questionnaire and Female Sexual Function Index to assess sexual function.Â Â Â Â Â Â Â Â Â Â Â The results showed that the proportion of subjects aged 46-55 years at 55.2% followed by 36-45 years of age at 39.5% and aged 26-35 years by 5.3%. The mean age of subjects was 45.4 + 6.5 years. Correlation between symptoms of depression with sexual function among participants was r=- 0.30 with significance p=0.068. Correlation between symptoms of depression with the domains of sexual function domain of desire (r=-0.296, p=0.072), stimulation (r = -0.470, p = 0.003), lubrication (r=-0.353, p=0.030), orgasm (r=-0.223, p=0.179), satisfaction (r=-0.233, p=0.158), pain (r=-0.186, p=0.262).Â Â Â Â Â Â Â Â Â Â Â The conclusion is that there is no correlation between symptoms of depression with sexual function.Â Keywords: Depression symptoms, Breast Cancer, Sexual Dysfunction

The Accuracy of Wells Clinical Model for Predicting Pretest Probability in Deep Vein Thrombosis (DVT) at Dr. Sardjito Hospital Wulansih, Dwi; Kurnianda, Johan; Widayati, Kartika
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (171.005 KB)

ABSTRACTBackground: The diagnosis of deep vein thrombosis (DVT) is an important issue in the medical fieldÂ because a large number of cases are undiagnosed. The accurate diagnosis of the DVT is essential toÂ prevent complications of acute pulmonary embolism and long-term complications. The complication suchÂ as pulmonary hypertension and post phlebitis syndrome. It also to avoid improper anticoagulant therapyÂ associated with a high risk of bleeding. There are several models of clinical suspicion of DVT includeÂ Hamiltonâs score and Wellsâ score. The Wells clinical model for predicting pretest probability for DVT hasÂ been widely used and tested its validity in several countries in Europe. The accuracy of a Wells clinical modelÂ of pretest probability for DVT has not been done for the races of Asia especially in Indonesia.Objective: This study aimed to test the accuracy and precision (sensitivity, specificity and predictive value)Â of Wells clinical model for predicting pretest probability for diagnose DVT for patients in the Dr. SardjitoÂ Hospital.Methods: This study was a diagnostic study with cross-sectional design. The subjects were patients withÂ DVT symptoms who visited Tulip clinic, outpatient and inpatient in the department of Dr. Sardjito GeneralÂ Hospital during January 2011-May 2012. In this study, a total of 100 patients were participated the WellsÂ clinical model of pretest probability for DVT examination, Doppler ultrasound and D-dimer examination.Â The negative results on the fi rst ultrasound examination will be examined again 1 week later.Results: DVT was confi rmed in 56 patients (56%) from 100 patients. The baseline characteristics showedÂ the number of women more than men and the mean age was 52.98 Â±1.335 years. The 57% of subjectsÂ were women and the median age was â¥60 years. The most frequent risk factors of DVT were cancer 49Â patients (49%), bed ridden 42 patients (42%) and elderly 33 patients (33%). The accuracy of the Wells clinicalÂ model of pretest probability for DVT was 81%, precision was 77.6%, sensitivity was 92.8%, specifi city wasÂ 65.9%, and negative predictive value was 87.9%.Conclusion: The Wells clinical model for predicting pretest probability in DVT has a high accuracy, moderateÂ precision, high sensitivity and poor specifi city to diagnose DVT at Dr. Sardjito Hospital.Keywords: deep vein thrombosis/DVT, the Wells clinical model of pretest probability for DVT, accuracyÂ test, precision

JAK2 mutation and treatment of JAK2 inhibitors in Philadelphia chromosome-negative myeloproliferative neoplasms Hutajulu, Susanna Hilda; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACTThe Philadelphia chromosome-negative (Ph-negative) myeloproliferative neoplasms (MPNs) polycythaemia vera (PV), essential thombocythaemia (ET) and primary myelofi brosis (PMF) are clonal disorders of multipotent haematopoietic progenitors. The genetic cause of these disorders was not fully defi ned until a somatic activating mutation in the JAK2 non-receptor tyrosine kinase, JAK2V617F, was identifi ed in most patients with PV and a considerable proportion of patients with ET and PMF. The discovery of JAK2 mutation has changed the molecular reclassification of MPNs and served as a genomic target for therapeutic implication. A number of JAK2 inhibitors have been developed and tested for MPNs. Several JAK2 inhibitors have reached the phases of clinical trial and included patients with intermediate-risk or high-risk MF. This population of MF is the best candidate for trials because currently it has no effective therapy besides patientsâ poor survival. Considering all clinical data on Ph negative MPNs, JAK2 inhibitors have shown a clinical benefi t and reduced symptoms in the vast majority of MF cases. The most developed among JAK2 inhibitors is Ruxolitinib, which has demonstrated clinical improvement with well tolerated toxicities. However, JAK2 inhibitor was equally active in patients with and without JAK2 mutation. Other JAK2 inhibitors are less developed, but showed a similar clinical benefi t. Furthermore, its effect on the natural course of MPNs in treating patients needs to be investigated.Keywords: myeloproliferative neoplasms â JAK2 mutation â JAK2 inhibitors.

THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sendjaja, Sukendro; Purwanto, Ibnu; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 â October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08Â±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28Â±1.20, 28.60Â±1.69, 28.18Â±1.89, and 27.85Â±2.03, respectively. The mean MMSE score changes (ÎT0-T1), (ÎT0-T2), and (ÎT0-T3) were 0.68Â±0.80, 1.10Â±1.06, and 1.43Â±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy.Â Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, AnthracyclineÂ

ANEMIA AS RISK FACTOR OF HANDGRIP STRENGTH DECREASED ON ELDERLY IN YOGYAKARTA PROVINCEâS PANTI WERDHA Hidayat, Ganda; Kurnianda, Johan; Pramantara, I Dewa Putu
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar

ABSTRACTBackground: According to the WHO, by the end of 20 th century, the more the world population grow, the more the elderly population will be. Yogyakarta province has a 13.72% of Indonesian elderly. The anemia prevalence increased as the age added. Aging process resulted in strength muscle reduced. Handgrip strength test is a valid and consistent as well as simple alternative to value the muscle strength decreased advanced age. Purpose of this study is to know whether anemia is a risk factor against muscle strength decreased measured by handgrip strength test on elderly population in nursing house.Method: This study used cross sectional study design to the advanced ages in DIY provinceâs nursing house. The study time was in August 2010. The advance ages fullfilling the inclusion and exclusion criteria were conducted physical examination, routine blood test and handgrip strength measurement.Result: This study involved 118 elderly participants. There was difference of mean handgrip strenght in: age (14.52 kg vs 19.64 kg; p=0.001), gender (13.39 kg vs 22.47 kg; p=0.001), activity level (7.94 kg vs 16.75 kg; p=0.001) and anemia status (13.60 kg vs 17.84 kg; p=0.001); for women even in mild anemia group, there was difference with non anemia group (12.36 kg vs 14.68 kg ; p=0.027). Conclusion: According to multivariable analysis,. There are 3 factors involving of handgrip strength in elderly, namely; Age, activity levels, and anemia which are statistically significant. In this study, it was conclude anemia is a risk factor of handgrip strength decreased in elderly, for women even in mild anemia, there was statistically significant different with non anemia group.Â Keywords : Elderly, anemia, handgrip strength

ANEMIA AS RISK FACTOR OF HANDGRIP STRENGTH DECREASED ON ELDERLY IN YOGYAKARTA PROVINCE’S PANTI WERDHA Ganda Hidayat; Johan Kurnianda; I Dewa Putu Pramantara
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Background: According to the WHO, by the end of 20 th century, the more the world population grow, the more the elderly population will be. Yogyakarta province has a 13.72% of Indonesian elderly. The anemia prevalence increased as the age added. Aging process resulted in strength muscle reduced. Handgrip strength test is a valid and consistent as well as simple alternative to value the muscle strength decreased advanced age. Purpose of this study is to know whether anemia is a risk factor against muscle strength decreased measured by handgrip strength test on elderly population in nursing house. Method: This study used cross sectional study design. The study time was in August 2010. The advance ages fullfilling the inclusion and exclusion criteria followed physical examination, routine blood test and handgrip strength measurement. Result: This study involved 118 elderly participants. There was difference of mean handgrip strenght in: age (14.52 kg vs 19.64 kg; p=0.001), gender (13.39 kg vs 22.47 kg; p=0.001), activity level (7.94 kg vs 16.75 kg; p=0.001) and anemia status (13.60 kg vs 17.84 kg; p=0.001); for women even in mild anemia group, there was difference with non anemia group (12.36 kg vs 14.68 kg ; p=0.027). Conclusion: According to multivariable analysis,. There are 3 factors affecting handgrip strength in elderly, namely; Age, activity levels, and anemia which are statistically significant. In this study, it was concluded that anemia is a risk factor of handgrip strength decreased in elderly, for women even in mild anemia, there was statistically significant different with non anemia group. Keywords : Elderly, anemia, handgrip strength

THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sukendro Sendjaja; Ibnu Purwanto; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy. Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline

Correlation between the Symptoms of Depression and Sexual Function in Breast Cancer Patients Receiving Chemotherapy Dwi Rohmawati; Agus Siswanto; Johan Kurnianda; Noor Asyiqah Sofia
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACT Symptoms of depression and sexual problems that occur among breast cancer patients are a rarely detected and get good handling. Therefore, an early detection for any psychological problems that may affect the sexual life of patients with breast cancer is needed so that the patients can have better life. This study aims to assess the correlation between symptoms of depression and sexual function in women with breast cancer who undergo chemotherapy at Dr. Sardjito Hospital. Research design was cross sectional. The study necquited 38 breast cancer patients in Tulip outpatients Cancer Clinic in Dr. Sardjito Hospital. Assessment of depressive symptoms used Beck Depression Inventory questionnaire and Female Sexual Function Index to assess sexual function. The results showed that the proportion of subjects aged 46-55 years at 55.2% followed by 36-45 years of age at 39.5% and aged 26-35 years by 5.3%. The mean age of subjects was 45.4 + 6.5 years. Correlation between symptoms of depression with sexual function among participants was r=- 0.30 with significance p=0.068. Correlation between symptoms of depression with the domains of sexual function domain of desire (r=-0.296, p=0.072), stimulation (r = -0.470, p = 0.003), lubrication (r=-0.353, p=0.030), orgasm (r=-0.223, p=0.179), satisfaction (r=-0.233, p=0.158), pain (r=-0.186, p=0.262). The conclusion is that there is no correlation between symptoms of depression with sexual function. Keywords: Depression symptoms, Breast Cancer, Sexual Dysfunction

JAK2 mutation and treatment of JAK2 inhibitors in Philadelphia chromosome-negative myeloproliferative neoplasms Susanna Hilda Hutajulu; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTThe Philadelphia chromosome-negative (Ph-negative) myeloproliferative neoplasms (MPNs) polycythaemia vera (PV), essential thombocythaemia (ET) and primary myelofi brosis (PMF) are clonal disorders of multipotent haematopoietic progenitors. The genetic cause of these disorders was not fully defi ned until a somatic activating mutation in the JAK2 non-receptor tyrosine kinase, JAK2V617F, was identifi ed in most patients with PV and a considerable proportion of patients with ET and PMF. The discovery of JAK2 mutation has changed the molecular reclassification of MPNs and served as a genomic target for therapeutic implication. A number of JAK2 inhibitors have been developed and tested for MPNs. Several JAK2 inhibitors have reached the phases of clinical trial and included patients with intermediate-risk or high-risk MF. This population of MF is the best candidate for trials because currently it has no effective therapy besides patients’ poor survival. Considering all clinical data on Ph negative MPNs, JAK2 inhibitors have shown a clinical benefi t and reduced symptoms in the vast majority of MF cases. The most developed among JAK2 inhibitors is Ruxolitinib, which has demonstrated clinical improvement with well tolerated toxicities. However, JAK2 inhibitor was equally active in patients with and without JAK2 mutation. Other JAK2 inhibitors are less developed, but showed a similar clinical benefi t. Furthermore, its effect on the natural course of MPNs in treating patients needs to be investigated.Keywords: myeloproliferative neoplasms – JAK2 mutation – JAK2 inhibitors.

The Accuracy of Wells Clinical Model for Predicting Pretest Probability in Deep Vein Thrombosis (DVT) at Dr. Sardjito Hospital Dwi Wulansih; Johan Kurnianda; Kartika Widayati
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTBackground: The diagnosis of deep vein thrombosis (DVT) is an important issue in the medical field because a large number of cases are undiagnosed. The accurate diagnosis of the DVT is essential to prevent complications of acute pulmonary embolism and long-term complications. The complication such as pulmonary hypertension and post phlebitis syndrome. It also to avoid improper anticoagulant therapy associated with a high risk of bleeding. There are several models of clinical suspicion of DVT include Hamilton’s score and Wells’ score. The Wells clinical model for predicting pretest probability for DVT has been widely used and tested its validity in several countries in Europe. The accuracy of a Wells clinical model of pretest probability for DVT has not been done for the races of Asia especially in Indonesia.Objective: This study aimed to test the accuracy and precision (sensitivity, specificity and predictive value) of Wells clinical model for predicting pretest probability for diagnose DVT for patients in the Dr. Sardjito Hospital.Methods: This study was a diagnostic study with cross-sectional design. The subjects were patients with DVT symptoms who visited Tulip clinic, outpatient and inpatient in the department of Dr. Sardjito General Hospital during January 2011-May 2012. In this study, a total of 100 patients were participated the Wells clinical model of pretest probability for DVT examination, Doppler ultrasound and D-dimer examination. The negative results on the fi rst ultrasound examination will be examined again 1 week later.Results: DVT was confi rmed in 56 patients (56%) from 100 patients. The baseline characteristics showed the number of women more than men and the mean age was 52.98 ±1.335 years. The 57% of subjects were women and the median age was ≥60 years. The most frequent risk factors of DVT were cancer 49 patients (49%), bed ridden 42 patients (42%) and elderly 33 patients (33%). The accuracy of the Wells clinical model of pretest probability for DVT was 81%, precision was 77.6%, sensitivity was 92.8%, specifi city was 65.9%, and negative predictive value was 87.9%.Conclusion: The Wells clinical model for predicting pretest probability in DVT has a high accuracy, moderate precision, high sensitivity and poor specifi city to diagnose DVT at Dr. Sardjito Hospital.Keywords: deep vein thrombosis/DVT, the Wells clinical model of pretest probability for DVT, accuracy test, precision

Co-Authors A. Harijadi Agus Siswanto Astuti, Herni David Dwi Putera Diah Ari Safitri Dwi Rohmawati Dwi Wulansih Eiji Tatsumi Ganda Hidayat Herni Astuti Hiroyuki Sakoda I Dewa Putu Pramantara I Dewa Putu Pramantara I Ketut Suada I Wayan Dwija Karyasa Ibnu Purwanto Jamhari Jamhari Jarir At Thobari Kaho Furuta Kartika W. Taroeno-Hariadi Kartika Widayati Taroeno Hariadi Karyasa, I Wayan Dwija Katsuyasu Saigo Kayoko Masuda Ken-Ichi Nagai Mardiah Suci Hardianti Meilani Syampurnawati Muhammad Ihsan Qomaruzzaman Nina Mulyani Noor Asyiqah Sofia Nugroho Wiyadi Prafita Cahya Dewanti Puntodewo Puntodewo Qomaruzzaman, Muhammad Ihsan Sagiri Mangunsudirjo Seiji Kawano Selvyana, Dita Ria Setsuki Isono Shin-Ichi Kondo Shunichi Kumagai Sofia M. Haryana Sukendro Sendjaja Susetyowati Syahru Agung Setiawan Takayuki Takahashi Teguh Triyono Wahyu Wulaningsih Yenita . Yenita Yenita Yoshitaka Hayashi

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