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All Journal Indonesian Journal of Cancer The Indonesian Journal of Public Health Public Health of Indonesia Medicinus : Jurnal Kedokteran Journal of Epidemiology and Public Health Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Narra J Cermin Dunia Kedokteran Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Andree Kurniawan
Bagian Penyakit Dalam, Fakultas Kedokteran Universitas Pelita Harapan Siloam General Hospital
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Poor Sleep Quality of Hospitalized Geriatric Patients in General Hospital in Karawaci, Tangerang, Banten Province, Indonesia Hardjo Lugito, Nata Pratama; Yanto, Theo Audi; Kurniawan, Andree; Wijaya, Indra; Tjiang, Margaret Merlyn; Setiadinata, Resa; Sumantri, Stevent; Seto, Euphemia
Medicinus Vol. 6 No. 1 (2016): October 2016 - January 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i1.1136

Abstract

Background: In Indonesia, geriatric population in the year 2005 was 15.8 million (7.2 % population), and expected to reach 11.34% in the year 2020. There was growing evidence for poor sleep as an independent risk factor for poor physical and mental health. Geriatric population may be particularly vulnerable to effects of sleep disturbance due to significant age-related changes in both sleep and inflammatory regulationObjective: To study the epidemiological (gender, age group) and health status (co-morbidities), sleep quality according to Pittsburgh Sleep Quality Index (PSQI) and its associations in geriatric population hospitalized in General Hospital in Karawaci, Tangerang, Banten Province, Indonesia.Materials and Methods: A hospital based cross sectional study was conducted from January to June 2014. A total of 92 subjects aged 60 years and above were selected consecutively from hospitalized geriatric patients for this study. The data was analyzed by means and proportions.Results: The male and female subjects were 51.1% and 48.9%. Mean age was 66.79 + 5.448 years. The age group of 60 - 75 years and above 75 years was 92.4% and 7.6% consecutively. Subjects with diabetes, hypertension, allergy, asthma, cardiac failure and chronic kidney disease were 30.4%, 62.0%, 18.5%, 21.7%, 21.7%, 20.7% consecutively and 63.0% with more than 2 co-morbidities. According to PSQI 72.8% subjects have poor sleep quality. Associations between poor sleep quality to epidemiological and health status were not significant except for diabetes (RR= 3.208 [95% CI: 1.045 - 9.848], p = 0.022) and chronic kidney disease (RR= 6.247 [95% CI: 0.902 - 43.279], p = 0.017)Conclusions: Seventy two percents of subjects have poor sleep quality, and associations between poor sleep quality to epidemiological and health status were not significant except for diabetes.
Pendekatan Diagnostik Terhadap Leukemia Akut Hartoyo, Vinson; Kurniawan, Andree
Medicinus Vol. 6 No. 1 (2016): October 2016 - January 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i1.1138

Abstract

Acute leukemia is the most common form of cancer in children, comprises approximately 30 percents of all childhood malignancies, with acute lymphoblastic leukemia (ALL) being five times more common than acute myeloid leukemia (AML)1. Despite the advance in the treatment of acute lymphobalstic leukemia, five-year event free survival rate still remain quite low in group of patient with advanced age of onset (40% or below in later age)2,3,4. A case of 17 year old girl presented with 3 day onset of profuse bleeding from her nostril, ear, gums and gastrointestinal tract (melena and hematemesis). Blood count and peripheral blood smear revealed a pancytopenia with 26% blast count lymphocyte dominant, and reticulocyte percentage of 0.26% which is signalling a bone marrow failure. The patient was planned to undergo a bone marrow transplant before finally died on third day of care.
Hemofilia Susanto, Michael; Kurniawan, Andree
Medicinus Vol. 6 No. 1 (2016): October 2016 - January 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i1.1140

Abstract

Hemophilia A and B are X-linked recessive diseases that are caused by gene mutations in factors VIII adan IX of the blood clotting cycle. Hemophilia C is an autosomal recessive disease caused by a mutation in factor XI, and acquired hemophilia is largely is an autoimmune process. Hemophilia A and B cannot be distinguished clinically, and severe cases can cause bleeding in the joints and lead to chronic hemophilic arthropathy. The main treatment of hemophilia is infusions of factor VIII and IX, and DDAVP in less severe cases. The main complication that can rise from the use of clotting factors is the appearance of specific inhibitor antibodies that can neutralize the work of the factors. Severe cases of hemophilia A and B by itself carries a poor prognosis, but proper treatment throught the use of clotting factors can give a very good prognosis
Heart Involvement in Systemic Lupus Erythematosus Kurniawan, Andree; Lugito, Nata Pratama Hardjo
Medicinus Vol. 6 No. 2 (2017): February 2017 - May 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i2.1143

Abstract

Pericardial effusion is considered as one of criteria to diagnose systemic lupus erythematosus (SLE) based on American Rheumatism Association (ARA) criteria. There is limited data about the incidence and characteristic pericardial effusion in SLE patients in our country. The aim of this study is to report and assess the incidence of and characteristic heart involvement in SLE. This is cross-sectional study conducted in secondary referral hospital in Tangerang county, west part of Jakarta, capital city of Indonesia. We evaluated from medical record and echocardiogram data from 2013-2015 patients diagnosed with SLE according to ARA criteria. From 33 SLE medical records reviewed, we found 13 patients (40%) with pericardial effusions. All patients were in active stage. Clinical assessment and transthoracic echocardiogram were used to diagnose pericardial effusions. Eighty percent pericardial effusion positive patients had minimal effusion. The others had moderate effusion. No tamponade patients were recorded. Ninety six percent patients were female with median age 24(13-51) years old. Three patients were reported having pulmonary arterial hypertension. One patient had thrombus in left ventricle. All patients had clinical symptoms of cardiac such as heart failure and chest pain. For the conclusion, the incidence of pericardial effusion in SLE patient was 40 percent. Eighty percent patients had minimal effusion. All patients had cardiac symptoms related.
Disseminated Intravascular Coagulation Lorens, Jane Olivia; Kurniawan, Andree
Medicinus Vol. 6 No. 2 (2017): February 2017 - May 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i2.1146

Abstract

Disseminated Intravascular Coagulation (DIC) is an acquired pathological syndrome, featured by a hypercoagulable state, bleeding symptoms, and multiple organ failure. Based by these very distinct features, DIC is classified into four types namely Bleeding type, Organ failure type, Massive bleeding type, and Asymptomatic type. Diagnosing DIC is a challenge to the health practitioner, considering that DIC is a multifactorial syndrome, which always is a complication of some underlying diseases. To diagnose DIC, it is necessary to do a comprehensive evaluation of clinical symptoms and laboratory results. The necessary laboratory results include platelets count, fibrin degradation products (FDPs), fibrinogen, and PT-aPTT.
Prevalensi Infeksi Clostridium difficile Pada Pasien Neutropenia dengan Kanker Kurniawan, Andree
Medicinus Vol. 5 No. 2 (2016): February 2016 - May 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i2.1164

Abstract

Clostridium difficile (C. difficile) infection mostly found in immunocompromised patient. Most of the patients with neutropenia had hematologic malignancy and come with multiple risk factors for C. difficile infection. The aim of this study is to know the prevalence and characteristic of C. difficile infections in cancer neutropenia patients. This cross-sectional study was done in secondary referral hospital in suburban Karawaci, Tangerang, Banten, Indonesia from June 2014 until Mei 2015. Adult cancer patients hospitalized with neutrophil count less than 1500 106 cell/L were included. All patients were checked for antigen and toxin C. difficile in faeces. From 25 patients were evaluated for C. difficile infection in neutropenia. C. difficile antigen only found in one patient or 4% sample.Key words: C. difficile, cancer, neutropenia
PENDEKATAN DIAGNOSTIK TERHADAP LEUKEMIA AKUT Hartoyo, Vinson; Kurniawan, Andree
Medicinus Vol. 4 No. 8 (2015): February 2015 - May 2015
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v4i8.1184

Abstract

Leukemia akut merupakan jenis kanker yang paling sering ditemukan pada anak-anak, dengan angka kejadian sekitar 30 persen dari keseluruhan kasus keganasan pada anak-anak, dengan leukemia limfoblastik akut (LLA) memiliki angka kejadian lima kali lebih sering daripada leukemia mieloblastik akut (LMA). Meskipun tata laksana dan regimen pengobatan untuk leukemia limfoblastik akut sudah lebih maju, angka harapan hidup pasien masih cukup rendah terutama pada kelompok pasien dengan usia awitan yang lebih tua (berkisar pada angka 40% pada kelompok umur lebih tua). Dilaporkan sebuah kasus pada seorang anak perempuan berusia 17 tahun yang datang dengan pendarahan dari hidung, telinga, gusi dan saluran cerna (melena dan hematemesis) sejak 3 hari sebelum masuk rumah sakit. Pemeriksaan darah dan apus darah tepi menunjukkan pansitopenia dengan hitung jenis 26% dominan limfosit, dan dengan persentase retikulosit 0.26% yang menunjukkan adanya kegagalan fungsi sumsum tulang. Pasien ini direncanakan untuk menjalani biopsi sumsum tulang sebelum akhirnya meninggal pada hari ketiga perawatan.
EMBOLI PARU Octaviani, Fidelia; Kurniawan, Andree
Medicinus Vol. 4 No. 9 (2015): June 2015 - September 2015
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v4i9.1191

Abstract

Emboli paru merupakan salah satu kegawatdaruratan pada bidang kardiovaskular yang cukup sering terjadi dengan berbagai manifestasi klinis dari keadaan yang asimptomatik hingga keadaan yang mengancam nyawa. Insidensi terjadinya emboli paru pada populasi mencapai 23 per 100,000 penduduk dengan tingkat mortalitas mecapai 15%. Emboli paru dapat disebabkan oleh tromboemboli vena, emboli udara, lemak, cairan amnion, fragmen tumor, dan sepsis. Pemeriksaan ventilation-perfusion scintigraphy masih menjadi baku emas untuk menegakkan diagnosis emboli paru. Sedangkan pemeriksaan lain dapat dilakukan untuk membantu klinisi mendiagnosis kejadian emboli paru. Tatalaksana pada emboli paru akut harus dilakukan dengan segera dengan menggunakan antikoagulan seperti unfractioned heparin, LMWH atau vitamin K antagonis, dilanjutkan dengan trombolitik atau embolektomi apabila trombolitik tidak dapat dilakukan. 
Risk Factors of Non-Typhoidal Salmonella Bacteremia Versus Typhoidal Salmonella Bacteremia in Patients from a General Hospital in Karawaci, Tangerang, Indonesia: A Five-Year Review Lugito, Nata; Cucunawangsih, Cucunawangsih; Kurniawan, Andree; Purnamasari, Dewi
Medicinus Vol. 9 No. 1 (2019): October:2019
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i6.2593

Abstract

Salmonella infections including Non-typhoidal Salmonella (NTS) and enteric fever are important global public health problem, causing approximately 94 million human cases of gastroenteritis with 150,000 deaths annually around the globe. The aim of this study was to determine risk factors for NTS bacteremia patients compared to Typhoidal patients in Indonesia, area with high incidence of enteric fever. This retrospective descriptive study was conducted in Siloam Hospital in Karawaci, Indonesia, from January 2011 to December 2015. Logistic regression model was used to determine independent predictors of NTS bacteremia including demographic and epidemiologic characteristics, clinical presentations, and laboratory results. Out of 129 positive isolates for Salmonella with complete medical records, 18 (13.9%) were positive for NTS. Patients with NTS bacteremia were more likely to belong in the age group below 5 or above 60 year-old, more frequent to have anemia and abnormal leucocyte count. The susceptibility patterns against antimicrobial of NTS bacteremia and Typhoidal bacteremia were similar. In logistic regression analysis, age below 5 or above 60 year-old, hemoglobin level below 12 g/dL and leucocyte count below 4,000/µL or above 12,000/µL were independent risk factors for NTS bacteremia.
Management of Autoimmune Hemolytic Anemia in the Midst of Coronavirus Disease 2019 Pandemic: A Case Report Kurniawan, Andree; Halim, Devina Adella
Medicinus Vol. 9 No. 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2761

Abstract

Introduction : The novel coronavirus disease 2019 (COVID-19) has become a pandemic involving all people and can be severe and life-threatening in a certain population such as those with comorbidity. Autoimmune hemolytic anemia (AIHA) is an autoimmune hematologic disease characterized with antibodies production that binds to red cell surface antigens. In this pandemic, several concerns have been raised by autoimmune disease clinicians and patients regarding the use of immunosuppressive drugs. In this case report, we illustrate the problems of autoimmune hemolytic anemia patient when she got active case.Case Illustration : A 28 years old lady was admitted to the hospital owing to fatigue and tiredness during exercise for two weeks. She had been diagnosed with autoimmune hemolytic anemia before and did not comply with the treatment. This patient has been reevaluated of having AIHA from the symptoms of fatigue, enlarged spleen, low hemoglobin, increased reticulocytes, signs of hemolytic in blood smear examination, increased indirect bilirubin, LDH and the Combs’ test result was given positive. She received methylprednisolone 2 mg/kg of body weight intravenously, washed packed red cells (PRC), calcium and proton pump inhibitor. She was discharged at the seventh day since admission and she was prescribed oral methylprednisolone equal to 1 mg/kg body weight.Conclusion : This is an educated case of non-compliance of AIHA that should be given high dose steroid and blood transfusion during hospitalization amid the COVID-19 pandemic. The recommendation of treatment for AIHA was still the same as before the pandemic occured.
Co-Authors ACHMAD FAUZI Achmad Fauzi Agatha, Cindy Monika Agatha, Lisa Agung, Fransisca Handy Allen Widysanto Andhika Rachman Andri Sanityoso Sulaiman Angelina, Stella Anurantha, Jonathan Juniard Argo, Teresa Mika Ari Fahrial Syam Armen Armen Arshita Auliana Audrey Hamdoyo Billy Susanto Ceva W. Pitoyo Chandra, Margaret Chintya Marcella Cindy Sidarta Claudia Jodhinata Cucunawangsih Cucunawangsih, Cucunawangsih Daniel Chung Darien Alfa Cipta Darti Isbandiarti Devina Adella Halim Devina Adella Halim Dewi Purnamasari Diah Martina, Diah Edy Gunawan Edy Gunawan, Edy Elizabeth Marcella Euphemia Seto Euphemia Seto, Euphemia Evangelista, Nadya Nathalia Fajar L. Gultom Febby Hutomo Felix Wijovi Felix Wijovi Fidelia Octaviani Halim, Devina Adella Hamdoyo, Audrey Hariyanto, Timotius I. Hartoyo, Vinson Heriyanto, Rivaldo Steven Heryadi, Nadia Khoirunnisa Imanuelly, Michelle Indrawan, Michele Isbandiarti, Darti Ivana Dewi Mulyanto Jane Olivia Lorens Jeremia Imanuel Siregar Jodhinata, Claudia Johan Wibowo Johan Wibowo Jonathan Juniard Anurantha Jovita Jovita Khie Chen Liem, Jean Andrina Lorens, Jane Olivia Lucas, Brian Lugito, Nata P H Marcella, Chintya Marcella, Elizabeth Marcellus Simadibrata Marcellus Simadibrata Margaret Chandra Margaret Merlyn Tjiang, Margaret Merlyn Maria, Eva Michael Susanto Michael Susanto Michael, Rafael Jonathan Michele Indrawan Michelle Imanuelly Monica, Moryella Nadia Ayu Mulansari, Nadia Ayu Nadia Khoirunnisa Heryadi Nadya Nathalia Evangelista NATA LUGITO, NATA Nata P H Lugito Nata P Hardjo Lugito, Nata P Nata Pratama Nata Pratama Hardjo Lugito Novia Lauren Sieto Nugroho Prayogo Octaviani, Fidelia Orlin, Sisilia Patricia Budimulia Prima Yuriandro Rahmat Cahyanur Ralph Girson Gunarsa Resa Setiadinata Resti Mulya Sari Rivaldo Steven Heriyanto Rivami, Dwi Savitri Rizki Yaruntradhani Rizki, Saraswati Anindita Ryan Yudistiro Saraswati Anindita Rizki Saraswati Anindita Rizki Setiadinata, Resa Sharfina, Ratuafni Sidarta, Cindy Sieto, Novia Lauren Sinaga, Terry Devita Siregar, Jeremia Imanuel Sisilia Orlin Soputri, Christin Stella Angelina Stevent Sumantri Stevent Sumantri, Stevent Sugianto, Jeremy Octavian Susanti - Susanto, Billy Tan, Christine Tanuwijaya, Nathania Victoria Stevina Terry Devita Sinaga THEO AUDI YANTO, THEO AUDI Timotius Ivan Hariyanto Veli Sungono Vinson Hartoyo Wijaya, Indra Wijovi, Felix Wilson Matthew Raffaello Winata, Sharleen Wong, Clarinda Wonsono, Beverley Yohanes Deo Fau