Nata Pratama Hardjo Lugito
Bagian Penyakit Dalam, Fakultas Kedokteran Universitas Pelita Harapan Siloam General Hospital

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v43i1.10

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.521 KB) | DOI: 10.33371/ijoc.v8i1.294

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.789 KB) | DOI: 10.33371/ijoc.v10i1.413

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (71.395 KB) | DOI: 10.14414/ijoc.v10i4.491

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (920.543 KB) | DOI: 10.33371/ijoc.v9i3.388

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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.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.
Complications of Biliary Atresia in a 27-Year-Old Male Patient Nata Pratama Hardjo Lugito; I Gede Resmino Tyasto; Purwita Wijaya Laksmi
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (501.69 KB) | DOI: 10.24871/141201344-48

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Biliary atresia (BA) is a disease of the extrahepatic biliary tree that presents with biliary obstruction in the neonatal period, which is caused by fibro-obliterative process. Kasai procedure, a hepatoportoenterostomy(HPE) as an attempt to restore bile flow from the liver to the proximal small bowel, has been shown to improve survival in BA patients. Many BA survivals who had undergone Kasai HPE will have slowly progressive liverdisease and the majority of patients will ultimately require liver transplantation. In spite of many experimental treatments, cirrhosis still occurs in BA patients survival.This case report presents a male patient with biliary atresia that has survived for 27 years after Kasai procedure. He had been repeatedly admitted to hospital with complications caused by cirrhosis, such as repeated variceal and hemorrhoid bleeding and also refractory ascites. These complications are indications for liver transplantation. Although Kasai HPE procedure improves survival in BA patients in Indonesia, long-termcomplications of cirrhosis makes the patient awaits for liver transplantation. Keywords: biliary atresia, Kasai procedure, hepatoportoenterostomy, cirrhosis, liver transplantation
The clinical features of COVID-19 patients with positive viral RNA stool test results and possibility of fecal-oral transmission : A Systematic Review Selina Natalia; Felicia Imanuella Thorion; Luky Adlino; Clifford Eltin John; Andree Kurniawan; Nata Pratama Hardjo Lugito
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (580.557 KB) | DOI: 10.24871/221202142-51

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Objective : Coronavirus disease 2019 (COVID-19) has been declared as an international public health emergency by the World Health Organization (WHO), with outbreaks in over 200 countries and causing over 390,000 deaths globally. ACE-2 receptors are highly expressed in the upper and lower gastrointestinal system, providing a prerequisite for SARS-CoV-2 infection in the gastrointestinal tract. In addition, over half of the COVID-19 patients have viral nucleic acid detected in their feces and almost one-quarter of the cases, the stool samples test positive even when respiratory samples are negative. The aim of this systematic review is to summarize literature and to evaluate the clinical characteristics of patients with positive viral RNA stool test for COVID-19 and if there is a possibility of fecal-oral transmission of SARS-CoV-2 virus.Method : This systematic review has been registered in PROSPERO (CRD42020183049). A systematic search of the literature for observational study and randomized control trial was conducted in PubMed central and Google Scholar through May 5th, 2020. Three reviewers independently searched and selected. The risk of bias was evaluated using Newcastle-Ottawa Quality assessment tool.Results : 340 articles were screened, then from which eight articles were selected. Of eight articles that were included in this study, we sought for three main categories of the clinical manifestation; gastrointestinal, respiratory, and others. Each study was reviewed systematically to gain demographic data and evidence regarding the possibility of fecal oral transmission in SARS-CoV-2. Two studies reported prolongation of positive stool test results after the respiratory specimen conversion to negative which support the theory of fecal oral transmission.Conclusion : In conclusion, diarrhea, cough, and fever are the most common clinical manifestations in COVID-19 patients with positive RNA stool test results. Fecal oral transmission may be possible due to the ACE-2 receptors in the lining of the gastrointestinal tract. RNA stool test should be used as addition in discharging COVID-19 patients.
Clinical Characteristics and Microbiological Profiles of Community-Acquired Intra-Abdominal Infections Nata Pratama Hardjo Lugito; Cucunawangsih Cucunawangsih; Andree Kurniawan; Margaret Merlyn Tjiang
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4941.531 KB) | DOI: 10.24871/151201420-4

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Background: Intra-abdominal infections (IAIs) have different aspects to consider. One important aspectis the microbiological analyses, especially in the era of broad spread of resistant microorganisms. The studywas designed to describe the clinical characteristics and microbiological profiles of community acquired IAIs. Method: An observational study was performed on medical records of 12 months period (January toDecember 2013) in a General Hospital, Karawaci, Tangerang. Adult patients undergoing surgery for IAIs with positive microbiological culture and identification of microorganisms were included. Data collected were clinical characteristics and microbiological profiles and wereanalyzed statisticallyusing the SPSS version 17. Results: In 12 months period of study, 17 patients of IAIs with a total of 17 intra peritoneal specimens were collected. A total of six microorganisms were cultured. All the IAIs were monomicrobial, with aerobicmicroorganism dominantly Gram-negative bacilli. The dominant microorganism was Escherichia coli (E.coli), found in 58.8% of IAIs. The most common site was appendix (41.2%), and none from small intestine. Thesusceptibility test found that piperacillin tazobactam, tigecycline, meropenem and amikacin were the most activeantimicrobial against E. coli. Multi-drug resistant (MDR) E. coli in this study was 40%. The MDR E. coli had66.6% resistance to levofloxacin and ciprofloxacin, 66.6% susceptibility to ceftriaxone and ceftazidime, and100.0% susceptibility to amikacin. Conclusion: The most common site of community-acquired IAIs was appendix (41.2%). E. coli is still adominant microorganism with the MDR E. coli proportion of 40%.Keywords: intra-abdominal infections, clinical characteristics, microbiological profiles
Pengaruh Status Nutrisi terhadap Kesintasan 30 Hari Pasien Geriatri yang Dirawat di Rumah Sakit Lugito, Nata Pratama Hardjo; Soejono, Czeresna Heriawan; Wahyudi, Edy Rizal; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 3
Publisher : UI Scholars Hub

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

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Pendahuluan: Dengan meningkatnya jumlah populasi usia lanjut, masalah kesehatan yang dialami juga semakin banyak, salah satunya malnutrisi. Studi di luar negeri menunjukkan malnutrisi pada pasien geriatri yang dirawat di rumah sakit menurunkan kesintasan. Pasien usia lanjut di Indonesia mempunyai karakteristik yang berbeda dengan pasien usia lanjut di luar negeri. Di Indonesia belum ada studi tentang status nutrisi pasien usia lanjut yang dirawat di rumah sakit dan pengaruhnya terhadap kesintasan. Penelitian ini bertujuan mengetahui pengaruh status nutrisi terhadap kesintasan 30 hari pasien usia lanjut yang dirawat di ruang rawat akut geriatri dan ruang rawat penyakit dalam rumah sakit. Metode: Penelitian kohort retrospektif, dengan pendekatan analisis kesintasan, dilakukan terhadap 177 pasien geriatri yang dirawat di ruang rawat akut geriatri dan ruang rawat penyakit dalam Rumah Sakit Cipto Mangunkusumo selama bulan April–September 2011. Data demografis, diagnosis medis, kadar albumin, indeks ADL Barthel, geriatric depression scale, status nutrisi dengan mini nutritional assessment (MNA) dikumpulkan, dan diamati selama 30 hari sejak mulai dirawat untuk melihat ada tidaknya mortalitas. Perbedaan kesintasan kelompok pasien dengan status nutrisi baik, berisiko malnutrisi dan malnutrisi ditampilkan dalam kurva Kaplan-Meier, diuji dengan uji Log-rank, serta analisis multivariat dengan Cox proportional hazard regression model untuk menghitung adjusted Hazard Ratio dan interval kepercayaan 95% terjadinya mortalitas 30 hari dengan memasukkan variabel-variabel perancu sebagai kovariat. Hasil: Kesintasan antara subyek yang status nutrisinya baik, berisiko malnutrisi dan malnutrisi ialah 94,7% dengan 89,0% dan 80,7%, namun perbedaan kesintasan 30 hari tak bermakna dengan uji Log-rank (p=0,106). Pada analisis multivariat didapatkan adjusted HR setelah penambahan variabel perancu sebesar 1,49 (IK 95% 0,29 – 7,77) untuk kelompok berisiko malnutrisi dan 2,65 (IK 95% 0,47 – 14,99) untuk kelompok malnutrisi dibandingkan dengan pasien nutrisi baik. Simpulan: Perbedaan kesintasan 30 hari pasien geriatri yang dirawat di rumah sakit yang menderita malnutrisi dan berisiko malnutrisi dibandingkan dengan status nutrisi baik pada awal perawatan belum dapat dibuktikan.
Factors related to Post Traumatic Stress Symptoms in Indonesian adults during quarantine of the COVID-19 pandemic Evangelista, Nadya Nathalia; Wijovi, Felix; Orlin, Sisilia; Angelina, Stella; Halim, Devina Adella; Jodhinata, Claudia; Hamdoyo, Audrey; Cipta, Darien Alfa; Kurniawan, Andree; Lugito, Nata Pratama Hardjo
Public Health of Indonesia Vol. 8 No. 1 (2022): January - March
Publisher : YCAB Publisher & IAKMI SULTRA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v8i1.564

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Background: COVID-19 is an unprecedented public health event. It started from Wuhan, China, in late December of 2019 and later spread worldwide. During the pandemic, negative impacts on mental health were found in all groups, including adults of their productive age. Objective: This study aimed to search for factors related to Post Traumatic Stress Symptoms (PTSS) during the quarantine due to the COVID-19 pandemic in Indonesia, specifically about the demographic background of respondents and its relation to PTSS. Methods: This study employed a cross-sectional design involving 257 Indonesian adults aged 26-67 years from 26 out of 34 provinces in Indonesia. The questionnaire used in this study consists of demographic questions and an Indonesian version of the Impact of Event Scale-Revised (IESR). The questionnaire was distributed through a link attached to the social media platform from 17 September to 5 October 2020. Data were analyzed using t-test, one-way ANOVA, and multiple linear regression using SPSS 25.0. Results: The data analysis showed a significant relationship between age and mean IES-R score during quarantine time in Indonesia (p-value 0.001). Other demographic factors such as gender, education level, marital status, work from home, income during the pandemic, and pandemic effects to income showed no significant relation to the IES-R score of the respondents. Adults aged 25-44 years old tend to have higher IES-R scores than those aged 45-64 and 65+ years old. Conclusion: Age was related to the IES-R score, while the other five independent variables included in the linear regression analysis were found to be confounders in this study.