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All Journal Paediatrica Indonesiana Indonesian Journal of Rheumatology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Makara Journal of Health Research
Marcel Prasetyo
Departemen Radiologi, Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Diagnostic values of DAS28 and DAS28-squeeze in evaluating Rheumatoid Arthritis disease Santosa, David; Hidayat, Rudy; Prasetyo, Marcel; Nugroho, Pringgodigdo
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.827 KB)

Abstract

Background : In recent years, rheumatoid arthritis (RA) uses a “treat to target”  treatment strategy. This strategy requires a valid and accurate tool for assessing disease activity. The most widely used tool is DAS28, which was developed from DAS with the omission of ankle and foot joints. There has been many critization aboutthe accuracy of DAS28 in classifying the state of RA disease. Most importantly, when an active disease state was misclassified as an inactive state (false negative)which lead to under treat and subsequently to disability. The difference between DAS28 and DAS lies mainly in the exclusion of ankle and foot joints, thus DAS28-squeeze, a new and simple tool has been proposed. It comprises the same 28 joints in DAS28 added with a sqeeze test on both metatarsophalangeal joints. However, this new tool has never been validated with any imaging techniques.Objective : To assess the diagnostic values of DAS28 and DAS28-squeeze.Methods : This study comprised a cross-sectional diagnostic study, using Power Doppler sonography as a standard reference in evaluating the diagnostic value ofDAS28 and DAS28-squeeze. This study uses the most sringent sonography criteria of active disease which is an active Doppler signal with a moderate synovial hypertrophy on B-mode. Results : Over the study period, 56 subjects underwent diagnostic tests using DAS28, DAS28-squeeze and Power Doppler sonography. There were 4 false negativecases in DAS28 and 1 case in DAS28-squeeze. The sensitivities of DAS28 and DAS28-squeeze to identify active disease using Power Doppler sonography as reference standard were 73.3% (95%CI ± 11.59) and 93.3% (95%CI ± 6.55), respectively. While the specificities of DAS28 and DAS28-squeeze were 36.6% (95%CI ± 12.62) and 34.1% (95%CI ± 12.42), respectively. Furthermore the negative likelihood ratioof DAS28 and DAS28-squeeze were 0.73 and 0.19, respectively.Conclusion : This study is the first to validate DAS28- squeeze using imaging techniques. From this study the false negative rate of DAS28-squeeze is lower thanDAS28. DAS28-squeeze has a better sensitivity and negative likelihood ratio than DAS28 in identifying RA disease state.Keywords : Rheumatoid Arthritis, DAS28, DAS28-squeeze, treat to target, Power Doppler, squeeze test
Bleeding outcomes and musculoskeletal function in adolescents having severe hemophilia A: a case series Primacakti, Fitri; Prasetyo, Marcel; Fauzia, Sri Novia; Sarita, Raisa Cecilia; Chozie, Novie Amelia
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.268-72

Abstract

As an emerging country, Indonesia is still in the process of implementing prophylaxis as a standard of care for managing hemophilia with limited real-world evidence in Indonesian patients. This case series details the effects of tertiary prophylaxis with an intermediate dose of factor VIII concentrate on bleeding outcomes and musculoskeletal function in three Indonesian adolescents suffering from severe haemophilia A and associated arthropathy.
Ratio of Vascular Pedicle Width and Thoracic Diameter to Differentiate Cardiogenic and Non-Cardiogenic Pulmonary Edema Afifi, Rahmi; Fachri, Achmad; Madjid, Amir Sjarifuddin; Prihartono, Joedo; Prasetyo, Marcel; Christian, Andreas
Makara Journal of Health Research Vol. 26, No. 3
Publisher : UI Scholars Hub

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Abstract

Background: Excess intravascular volume evaluation is essential in the intensive care unit (ICU); however, clinical information to differentiate cardiogenic and non-cardiogenic pulmonary edema has been proven ineffective. Thus, this study aimed to distinguish cardiogenic from non-cardiogenic pulmonary edema using the ratio of vascular pedicle width (VPW) to thoracic diameter (VPTR). Methods: This cross-sectional study was conducted based on secondary data from chest radiographs of 100 patients with clinical symptoms of pulmonary edema in the ICU from January 2013 to December 2015. Cardiogenic and non-cardiogenic pulmonary edema were distinguished using VPW and cardiothoracic ratio measurements (CTR). VPTR was measured to differentiate between the two types of pulmonary edema, and the cut-off value was obtained using a receiver operating characteristic curve. Results: This study revealed a prevalence of 21% and 79% for cardiogenic and non-cardiogenic pulmonary edema, respectively. A VPTR cut-off value of 25.1% with a sensitivity of 90% and specificity of 86%, may distinguish cardiogenic from non-cardiogenic pulmonary edema. Conclusions: VPTR is an alternative method to differentiate between cardiogenic and non-cardiogenic pulmonary edema, and this ratio measurement is useful in cases where radiograph films are not standardized.
Nilai Diagnostik Sonografi Saraf Median Pada Kasus Carpal Tunnel Syndrome Fase Kronis Di Indonesia Prasetyo, Marcel; Widya, Widya; Safri, Ahmad Yanuar; Prihartono, Joedo; Setiawan, Stefanus Imanuel
Majalah Kedokteran Indonesia Vol 72 No 4 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.4-2022-550

Abstract

Background. Ultrasound evaluation on the median nerve in carpal tunnel syndrome (CTS) patients by measuring cross-sectional area (CSA) is widely known. However, studies have shown that CSA of the median nerve could vary in different demographical factors. Therefore, the cut-off CSA value for CTS in the Indonesian population could be significantly different. Purpose. To compare mean CSA of the median nerve between normal and CTS populations and establish a cut-off point of CSA to diagnose CTS. Materials and Methods. A comparative cross-sectional study was conducted involving 40 people divided equally into CTS and normal groups. Normal and CTS subjects are determined by Electrodiagnostic study (EDx) using EMG and Nerve Conduction Study (NCS). The CSA measurement was performed at the level of the carpal tunnel inlet. Results. The mean CSA value at the level of tunnel inlet of the normal group was 8.3 ± 1.4 mm2 and for the CTS group is 15.4 ± 4.4 mm2. The receiver operating characteristics (ROC) analysis showed 10.6 mm2 as the cut-off point with 95% sensitivity and 95% specificity (P less than 0.001). Conclusion. The median nerve CSA at the tunnel inlet is significantly larger in the CTS population and the cut-off point can be recommended in detecting CTS in the Indonesian population.
Co-Authors Achmad F. Kamal Achmad F. Kamal Achmad, Harry R. Adrian Situmeang Afifi, Rahmi Amir S. Madjid Anak Agung Gde Yuda Asmara Andreas Christian Angela BM Tulaar Bambang Setyohadi Bambang Setyohadi Chozie, Novie A. Dharma, Rahayuningsih Djajadiman Gatot Elida Ilyas Evelina Kodrat Evelina Kodrat Fachri, Achmad Fauzia, Sri Novia Findy Prasetyawaty Findy Prasetyawaty, Findy Fitri Primacakti, Fitri Joedo Prihartono Joedo Prihartono Lugyanti Sukrisman Madjid, Amir Sjarifuddin Muhammad Wahyudi N. D. Yulisa Novie Amelia Chozie Nurjati C. Siregar Pringgodigdo Nugroho, Pringgodigdo Rahmi Afifi Rommy Zunera Rudy Hidayat Safri, Ahmad Yanuar Santosa, David Saptawati Bardosono Sari, Teny T. Sarita, Raisa Cecilia Setiawan, Stefanus Imanuel Siregar, Trifonia P. Siti Setiati Siti Setiati THARIQAH SALAMAH, THARIQAH Vally Wulani Wahyu Widodo Widya Widya, Widya