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Jodi S Loekman
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Medicine & Pharmacology

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HEMOLYTIC UREMIC SYNDROME Ngurah Wisesa, Ida Bagus; Loekman, Jodi S
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Hemolytic uremic syndrome (HUS) is caused primarily by Shiga toxin–producing Escherichia coli O157:H7. Hemolyticuremic syndrome can occur in adults, and the most common cause of acute renal failure in children. Characteristic features of thesyndrome are microangiopathic anemia, thrombotic thrombocytopenia, and renal failure. Although the presentation of this syndromeis diverse, the classic prodromal illness is bloody diarrhea. Children with HUS generally present with gastroenteritiscomplaints (e.g., abdominal pain or tenderness, nausea or vomiting, fever, anemia); affected adults may be asymptomatic. Complicationsfrom HUS can include intussusception, chronic renal failure, and seizures in severe cases. Because an incubation periodof approximately one week occurs between the start of diarrhea and the onset of HUS, physicians should maintain a high index ofsuspicion; early laboratory testing is important to diagnose and manage this syndrome. Obtaining a complete blood count andstool culture and performing Shiga toxin testing are the first of a series of tests that may help diagnose of HUS.
HUBUNGAN PENYAKIT GINJAL KRONIS PREDIALISIS DENGAN BEBERAPA PARAMETER PENYAKIT ATEROSKLEROSIS ARTERI KAROTIS Sutarka, Nyoma; Suwitra, Ketut; Loekman, Jodi S; Sudhana, Wayan; Kandarini, Yenny; Martadiani, Elysanti Dwi; Margian, Nyoman
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Carotid artery intima media thickness (cIMT) is valid marker of subclinical atherosclerosis because it gives sign of earlyatherosclerosis process. We conduct this study to know the relationship between predialysis chronic kidney disease (CKD) withseveral parameters of carotid arterial atherosclerosis.A cross sectional study was done in patients with predialysis CKD who came to outpatient Clinic of Nephrology inSanglah General Hospital from May 2009. CKD criteria is based on KDQQI 2003. Estimated Glomerular Filtration Rate (eGFR)was calculated with Cockroft-Gault formula. Measurement of cIMT is done by USG B-Mode with USG Logig-5.There were 30 patients (20 with eGFR < 60 ml/mnt and 10 with eGFR 60 ml/mnt). Mean of cIMT in eGFR < 60ml/mnt: right/left cIMT1 0.24445 ± 0.3096/0.3210 ± 0.4006 mm; IMT2 0.2405 ± 0.3138/0.2825 ± 0.3971 mm; IMT3 0.2315 ±0.3026/0.2820 ± 0.3672 mm; bifurkatio IMT 0.3115 ± 0.4069/0.3515 ± 0.4991 mm; total IMT 0.6350 ± 0.1738/0.6938 ± 0.1912mm. For eGFR > 60 ml/mnt: right/left IMT1 0.1120 ± 0.1722/0.1030 ± 0.1398 mm; IMT2 0.0880 ± 0.1103/0.1130 ± 0.1718mm; IMT3 0.1010 ± 0.1408/0.1170 ± 0.1700 mm; bifurcatio IMT 0.1920 ± 0.3545/0.1980 ± 0.3527 mm, total IMT 0.6250 ±0.1269/0.6750 ± 0.1124 mm. There was signiÞ cant difference in eGFR < 60 ml/mnt the left IMT1 (MD: 0.21 CI95% 0.01 ! 0.42;p = 0.038). Five out of 20 patients with eGFR < 60 ml/mnt and 6 among 10 patients of eGFR 60 ml/mnt were found plaques.There are no signiÞ cant difference of plaque location, plaque width, and lumen diameter between carotid arterial with andwithout plaque. As a conclusion we found there is no signiÞ cant difference between predialysis CKD with several parameters ofcarotid arterial atherosclerosis but cIMT tends to be thicker on predialysis CKD patients with eGFR < 60 ml/mnt.
Co-Authors Elysanti Dwi Martadiani Ida Bagus Ngurah Wisesa Ketut Suwitra Nyoma Sutarka Nyoman Margian Wayan Sudhana Yenny Kandarini