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Diffuse Large B Cell Lymphoma, Bilateral Lower Extremity Lymphedema, and Ulcerated Inguinal Lymph Node LUGITO, NATA PRATAMA HARDJO; KURNIAWAN, ANDREE; YANTO, THEO AUDI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : "Dharmais" Cancer Center Hospital

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Lymphedema (LE) is a chronic medical condition characterized by lymphatic fluid retention, resulting in tissue swelling. There are two general classifications of LE; primary and secondary which are based on two mechanisms; lymphatic obstruction and lymphatic interruption. The most common cause of LE in the developing world is secondary to an infection known as filariasis. Cancer including Hodgkin and non-Hodgkin lymphomas; and its treatment are some causes of secondary LE. LE also could maintain the persistence of an occult localization of lymphoma. This case illustration describes a female, 57 year-old with stage II lymphedema of both legs, bilateral inguinal lymphadenopathies that were biopsied. The filarial blood examination was negative. Biopsies showed diffuse large B-cell lymphoma.

Koagulasi Intravaskuler Diseminata pada Kanker KURNIAWAN, ANDREE; HARDJO LUGITO, NATA PRATAMA
Indonesian Journal of Cancer Vol 9, No 3 (2015): Jul - Sept 2015
Publisher : "Dharmais" Cancer Center Hospital

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Disseminated Intravascular Coagulation is one of thrombosis manifestation other than venous thromboembolism, which onset is acute and has slight different clinical manifestation that tends to be chronic. Pathogenesis of the DIC in hematology malignancy is caused by the activation of fibrinolytic pathway by tumor cells. In solid tumor the pathogenesis is mainly because of the activation of cogulation factor by tissue factor expressed by tumor cells. Thediagnosis of DIC in cancer still needs further validation from the international society of thrombosis and hemostasisand Japanese society hematology criteria in cancer subjects. The principle of therapy for DIC in cancer patients is management of the cancer itself as the underlying etiology with the target is remission. The uses of anticoagulant therapy needs further clinical trial in the future. Coagulation factor and platelet transfusion can be given if there is significant bleeding.Â Koagulasi intravaskuler diseminata (KID) adalah manifestasi trombosis lain selain tromboemboli vena yang bersifat akut. Pada pasien kanker gambarannya sedikit berbeda, yaitu cenderung bersifat kronik, tergantung pada jenis kankernya. Patogenesis KID pada keganasan hematologi adalah akibat fibrinolisis yang meningkat. Sedangkan pada tumor solid terjadi akibat aktivasi faktor koagulasi oleh faktor jaringan yang diekspresikan oleh sel kanker. Diagnosis KID pada kanker masih memerlukan validasi kriteria dari perhimpunan trombosis hemostasis internasional dan Jepang pada kelompok pasien kanker. Prinsip terapi KID pada kanker adalah tata laksana kanker yang menjadi penyebab, dengan target remisi penyakit. Pemberian antikoagulan memerlukan uji klinis menggunakan populasi pasien kanker. Transfusi faktor koagulasi dan atau trombosit hanya diberikan apabila terdapat perdarahan yang bermakna.

A 21 Year-Old Male Colorectal Cancer Patient with Clostridium Difficile and Intestinal Amebiasis Infection LUGITO, NATA PRATAMA HARDJO; -, SUSANTI; KURNIAWAN, ANDREE
Indonesian Journal of Cancer Vol 8, No 2 (2014): April-Juni 2014
Publisher : "Dharmais" Cancer Center Hospital

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Colorectal cancer is a rare yet aggressive neoplasm in young adult. This cancer was associated with several bacterial and viral infections like Streptococcus bovis, Helicobacter pylori, human papilloma virus, and Clostridium septicum. Here we report a case of Clostridium difficile and Entamoeba histolytica infection in young adult male patient with colorectal cancer. The patient presented with chronic bloody diarrhea since one year prior to diagnosis with histories of antibiotics but no hospitalization, surgery or chemotherapy.

Nutritional Status and Quality of Life in Breast Cancer Patients in Karawaci General Hospital KURNIAWAN, ANDREE; LUGITO, NATA PRATAMA HARDJO
Indonesian Journal of Cancer Vol 10, No 1 (2016): Jan - Mar 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTCancer is related to a deterioration of nutritional status and quality of life (Qol), but the extent of these conditions in patients with breast cancer has not been studied well. Malnutrition is prevalent among cancer patients and maybe correlated with altered quality of life. The aim of this study is to evaluate the association of QoL and nutritional status after breast cancer diagnosed. Nutritional status was evaluated with Patient Generated Subjective Global Assessment and QoL using Short form 36 (SF-36) and also with the specific module for breast cancer patients. A consecutive sampleof twenty two patients diagnosed with breast cancer was evaluated. The associations of QoL with stadium and nutrition status were evaluated using T-test analysis. The mean of body mass index was 21.3 kg/m2. Fifty percent patient have menopause. Most patients were stage II (77.3%), the others stage III (18.2%) and stage I (4.5%). Sixty eight point two percent had risk of malnutrition. The stadium of tumor was significantly related to physical functioning (p < 0.000), physical limitation (p < 0.024), emotional limitation (p < 0.013), well-being (p < 0.020), health changes (p < 0.010). Thestatus of nutrition was significantly related to physical functioning (p < 0.001), loss of energy (p < 0.010) and general health (p <0.005). For Conclusion, the status of nutrition breast cancer patients were related to QoL especially physical functioning, loss of energy and general health after they were diagnosed.ABSTRAKKanker sangat terkait dengan perburukan status nutrisi dan kualitas hidup. Namun demikian, belum banyak studi yang yang melaporkan masalah nutrisi dan kulitas hidup pada kanker payudara. Malnutrisi sering ditemukan pada kanker dan mungkin terkait dengan perubahan kulaitas hidup. Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara kualitas hidup dengan status nutrisi setelah kanker payudara terdiagnosis. Evaluasi status nutrisi dilakukan dengan Patient Generated Subjective Global Assessment dan kualitas hidup dengan Short form 36 (SF-36) sertakarakteristik pada kanker payudara. Sampel diambil dengan teknik konsekutif terhadap 22 pasien yang terdiagnosis kanker payudara. Hubungan kualitas hidup dengan stadium kanker dan status nutrisi dinilai menggunakan analisis T-test. Indeks massa tubuh rata-rata adalah 21,3 kg/m2. Lima puluh pasien telah menopause. Terbanyak adalah stadium 2 (77,3%), stadium 3 (18,2%), dan stadium 1 (4,5%). Enam puluh dua koma dua persen berisiko malnutrisi. Stadium tumor secara bermakna berhubungan dengan fungsi fisik (p <0,000), keterbatasan fisik (p<0,024), keterbatasan emosi(p<0,013), rasa nyaman (p<0,020), dan perubahan kesehatan (p<0,000). Status nutrisi berhubungan secara bermakna dengan fungsi fisik (p<0,001), kehilangan energi (p<0,010), dan kesehatan secara umum (p<0,005). Simpulan, status nutrisi pasien kanker payudara berhubungan dengan kualitas hidup, terutama fungsi fisik, kehilangan energi, status kesehatan umum setelah mereka terdiagnosis.

Diffuse Large B Cell Lymphoma, Bilateral Lower Extremity Lymphedema, and Ulcerated Inguinal Lymph Node LUGITO, NATA PRATAMA HARDJO; KURNIAWAN, ANDREE; YANTO, THEO AUDI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.521 KB)

Lymphedema (LE) is a chronic medical condition characterized by lymphatic fluid retention, resulting in tissue swelling. There are two general classifications of LE; primary and secondary which are based on two mechanisms; lymphatic obstruction and lymphatic interruption. The most common cause of LE in the developing world is secondary to an infection known as filariasis. Cancer including Hodgkin and non-Hodgkin lymphomas; and its treatment are some causes of secondary LE. LE also could maintain the persistence of an occult localization of lymphoma. This case illustration describes a female, 57 year-old with stage II lymphedema of both legs, bilateral inguinal lymphadenopathies that were biopsied. The filarial blood examination was negative. Biopsies showed diffuse large B-cell lymphoma.

Unusual Metastases of Hepatocellular Carcinoma to the Heart KURNIAWAN, ANDREE; LUGITO, NATA PRATAMA HARDJO
Indonesian Journal of Cancer Vol 10, No 4 (2016): October - December 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTHepatocellular carcinoma (HCC) is the sixth most prevalent cancer worldwide. Metastasis of HCC to the heart is rare with prevalence on autopsy of less than 6%. There is still limited study evaluated the metastasis of hepatocellular carcinoma to the heart. The aim of this study is to know the prevalence and characteristic of metastasis of HCC to theheart in Indonesia. This retrospective study was conducted in secondary referral hospital in Tangerang county, Indonesia. We evaluated from medical record included baseline characteristic, survival and treatment of HCC and echocardiogram data for diagnosing metastasis to the heart from 2013-2015. There were 5 HCC patients recorded in thelast 3 years. All patients were male with median age 56(53-61) years old. Four patients were diagnosed using transthoracic echocardiograph and the rest using multi sliced CT scan. All patients were having continuous thrombus from inferior cava vein until right atrial. For the conclusion Hepatocellular carcinoma were reported as the cause ofintra-heart metastases in Indonesia. All patients were in late stage.ABSTRAKKarsinoma hepatoselular adalah kanker keenam terbanyak di seluruh dunia. Metastasis karsinoma hepatoselular ke jantung jarang, prevalensi yang ditemukan pada otopsi kurang dari 6 persen. Masih amat jarang studi yang mengevaluasi metastasis karsinoma hepatoselular ke jantung. Tujuan dari studi ini adalah ingin mengetahui prevalensi dankarakteristik metastasis karsinoma hepatoselular ke Jantung di Indonesia. Studi retrospektif ini dilakukan di rumah sakit rujukan tipe B di daerah Tangerang, Indonesia. Kami mengevaluasi dari rekam medis, meliputi karaktersitik dasar, kesintasan, dan terapi karsinoma hepatoselular; serta data ekokardiografi untuk mendiagnosis metastasis ke jantung dari 2013-2015. Terdapat 5 pasien hepatoselular karsinoma pada 3 tahun terakhir. Semua pasien laki-laki dengan usia median 56 (53-61) tahun. Empat pasien terdiagnosis menggunakan ekokardiografi trans torakal dan sisanya menggunakan CT scan. Semua pasien memiliki trombus kontinu dari vena cava inferior hingga atrium kanan. Sebagai simpulan, karsinoma hepatoselular dilaporkan sebagai penyebab metastasis ke jantung di Indonesia. Semua pasien datang pada stadium lanjut.

Tuberkulosis Payudara Primer sebagai Diagnosis Banding Massa Payudara Pratama Hardjo Lugito, Nata; Gunawan, Edy; Chandra, Margaret; Kurniawan, Andree; Isbandiarti, Darti
Cermin Dunia Kedokteran Vol 43, No 1 (2016): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Dilaporkan kasus seorang pasien perempuan berusia 40 tahun dengan TB payudara primer, suatu bentuk TB ekstra-paru yang jarang dijumpai. Keluhan berupa benjolan payudara kanan sejak 2 minggu dan pembesaran kelenjar getah bening aksila kanan. Ultrasonografi menemukan abses dan pembesaran kelenjar getah bening. Biopsi abses menemukan gambaran infeksi Mycobacterium tuberculosis. Setelah pengobatan anti-TB selama 6 bulan, abses membaik. Gambaran klinis TB payudara bervariasi dan memiliki kemiripan dengan beberapa penyakit lainnya. TB payudara merupakan salah satu diagnosis alternatif massa payudara di daerah dengan insidens TB tinggi.

Comparison of Early Postoperative Pain between Lightweight Mesh and Heavyweight Mesh in Lichtenstein Hernia Repair for Geriatric Patients at Rumah Sakit Siloam Karawaci from January 2018 - December 2019 Nicholas Axel Sidharta; Andry Irawan; Jeremia Immanuel Siregar; Nata Pratama Hardjo Lugito
Medicinus Vol 10, No 1 (2022): February 2022 - May 2022
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i1.5332

Background: Inguinal hernias are one of the most often cases in surgery. Inguinal hernias are usually found in males rather than females. There are two types of meshes in inguinal hernia repairs: heavyweight and lightweight mesh. There were still a lot of differences in the outcome of each mesh that was used. Therefore, with various postoperative pain results from past research, the author expresses an interest to research this topic for geriatric patients.Methods: In this cross-sectional comparative study, 45 patients using heavyweight mesh and 45 patients using lightweight mesh herniorrhaphy with Lichtenstein technique in inguinal hernias at RS Siloam Karawaci Lippo Village and RSU were reviewed retrospectively. Patient data were taken from the medical records using the purposive sampling method. Early Postoperative pain from day 1 until 7 was classified following the Visual Analogue Scale (VAS). Incidence of postoperative infection and seroma were assessed in both groups. Collected samples will be processed using Pearson's Chi-Squared test.Result: This study shows that there is a significant difference between the use of lightweight mesh in reducing moderate early postoperative pain for men above the age of 60 years old (p = 0.025) rather than the use of heavyweight mesh. Incidence of other postoperative complications such as infection and seroma have no statistical difference between both groups.Conclusions: The use of lightweight mesh has the advantage of reducing early postoperative pain from herniorrhaphy using the Lichtenstein technique rather than heavyweight mesh in men above 60 years old.

Poor Sleep Quality of Hospitalized Geriatric Patients in General Hospital in Karawaci, Tangerang, Banten Province, Indonesia Nata Pratama Hardjo Lugito; Theo Audi Yanto; Andree Kurniawan; Indra Wijaya; Margaret Merlyn Tjiang; Resa Setiadinata; Stevent Sumantri; Euphemia Seto
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

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.

Heart Involvement in Systemic Lupus Erythematosus Andree Kurniawan; Nata Pratama Hardjo Lugito
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

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.

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