Garuda - Garba Rujukan Digital

EGFR Mutation as a Predictive Factor to Treatment Response ofTKI (Tyrosine Kinase Inhibitor) in Non-Small Cell Lung CancerStage 4: A Case Report Rajabto, Wulyo; Angkasa, Yohana Kusuma
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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

Non-small cell lung cancer (NSCLC) typically presents in patients at an advanced stage, with a poor prognosis. The development of epidermal growth factor receptor (EGFR) – tyrosine kinase inhibitors (TKIs) and the systematic identification of EGFR mutations heralded the advent of targeted therapy in lung cancer, transforming the landscape of its treatment and prognosis. This is a case of 37 years-old female patient presented with metastatic bone disease secondary to pulmonary adenocarcinoma EGFR mutation positive which demonstrated a remarkable result to TKI.

Auto Immune Hemolytic Anemia (AIHA) Patients Profile and Treatment Response to Corticosteroids in Cipto Mangunkusumo Hospital Rajabto, Wulyo; Atmakusuma, Djumhana; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
Publisher : UI Scholars Hub

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

Association of Clinical Features and Hematological Laboratoriesbetween Ph (+)/BCR-ABL (+) Chronic Myeloid Leukemia and Other Type of Ph/BCR-ABL Chronic Myeloid Leukemia Rajabto, Wulyo; Harryanto, A.; Tadjoedin, Hilman; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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

Introduction. Patients with chronic phase Chronic Myeloid Leukemia (CML) at Hematology-Medical Oncology Clinic Department of Internal Medicine dr. Cipto Mangunkusumo National Hospital who haveperformed cytogenetic and RTPCR BCR-ABL examination showed: Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. This study aims to identify the clinical features and hematological laboratories of chronic phase CML, the proportion of Ph (+)/BCR-ABL (+) CML, and association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/ BCR-ABL CML. Methods. This is a cross-sectional study. The samples were taken by consecutive method. We used Chi-square test and logistic regression analysis. Association between variables considered significant when p value <0.05. Results. There were 80 subjects with chronic phase CML. Mean of age was: 39.4 (standard deviation 13.1) years. The comparison of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/ 12 | Jurnal Penyakit Dalam Indonesia | Vol. 5, No. 1 | Maret 2018 Wulyo Rajabto, A. Harryanto, Hilman Tadjoedin, Kuntjoro Harimurti BCR-ABL CML were: Symptomatic 80.6% : 100%; splenomegaly 82% : 92.3%; median of Hb 10,3 g/dL : 10,3 g/dL; median of white blood cell 124.620 : 127.050; median of thrombocyte 455.000 : 487.000. Bivariate and multivariate analysis showed no significant association of clinical features and hematological laboratories between Ph (+)/BCR-ABL (+) CML and other type of Ph/BCR-ABL CML. Conclusion. There was no significant association of clinical features and hematological laboratories between Ph (+)/BCRABL (+) CML and other type of Ph/BCR-ABL CML.

Two-point Compression POCUS sebagai Metode Diagnosis Dini Trombosis Vena Dalam Proksimal Ramadan, Edwin Ti; Maharani, Sausan Hana; Cahyanur, Rahmat; Priantono, Dimas; Rajabto, Wulyo
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
Publisher : UI Scholars Hub

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

Deep vein thrombosis (DVT), especially in the proximal part of the lower extremity, might progress to pulmonary embolism and be fatal. Therefore, it is crucial to prompt the diagnosis of DVT in the emergency room (ER). Due to its efficiency and patient convenience, duplex ultrasound has become the preferred diagnostic method for DVT. Point-of-care ultrasonography (POCUS) was known as a simpler and faster way to use ultrasonography at the bedside. The two-point compression method has become frequently used due to its ability to take less time for examination, yet there are still concerns about its accuracy. This study was conducted to find out whether two-point compression POCUS can be used as an early diagnostic method for proximal DVT. The literature search was carried out in the databases PUBMED, EMBASE, and SCOPUS on March 29, 2023, using keywords “Deep Vein Thrombosis”, “two-point compression POCUS”, and “diagnosis”. Four publications were chosen from the search results. One cross-sectional study was found to have a low validity value because POCUS and Doppler ultrasound operators were not blinded, and the reference test was only performed on positive DVT results on POCUS. All studies had high sensitivity and specificity (>90%) compared to the reference test, except for one cross-sectional study in critical patients in ICU, which had a 63% sensitivity value. In conclusion, the two-point compression POCUS method can be utilized as an early diagnostic method for proximal DVT, with the disclaimer that POCUS operators should get curriculum-based training before doing the examination.

Non-Severe COVID-19 Complicated by Deep Vein Thrombosis (DVT) Rajabto, Wulyo; Priantono, Dimas
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.263

Background: Coronavirus Disease 2019 (COVID-19) displays various symptoms ranging from asymptomatic to life-threatening. Patients may present with typical respiratory infections or atypical symptoms. Non-severe COVID-19 encompasses mild and moderate cases, characterized by the absence of criteria for severe or critical illness, with mild cases not showing evidence of viral pneumonia or hypoxia and moderate cases maintaining SpO2 levels of at least 90% on room air.Case: We presented a COVID-19 case with the chief complaint of unilateral leg swelling. A 48-year-old male was admitted with the chief complaint of cramps and swelling of the left leg. He had a history of fever, cough, nausea, and vomiting. Laboratory studies showed elevated D-dimer. Doppler ultrasound shows signs of both proximal and distal deep vein thrombosis. CT pulmonary angiography excluded pulmonary embolism while the lung window image supported the diagnosis of COVID-19 pneumonia. Polymerase chain reaction (PCR) obtained from nasopharyngeal and oropharyngeal swabs confirmed COVID-19 infection.Discussion: We treated the patient with parenteral anticoagulation followed by direct oral anticoagulant upon discharge. The swelling improved as well as the patient’s clinical status. Thromboembolic complications have been credited as the culprit of high mortality in COVID-19. Systemic activation of coagulation in pulmonary and peripheral circulation contributed to life-threatening thrombotic complications. Our patient presented with COVID-19-associated proximal and distal DVT without pulmonary embolism.Conclusion: Prompt diagnosis of COVID-19 infection and acute DVT improves patient care. The hallmark of the management of VTE in COVID-19 patients is treatment with therapeutic dose parenteral anticoagulation followed by oral anticoagulant.

Kesintasan Pasien Karsinoma Hepatoselular: Sebuah Studi Komprehensif tentang Pengaruh Awitan Dini versus Lambat dan Faktor Determinannya Achmad, Ibrahim; Jasirwan, Chyntia Olivia Maurine; Rajabto, Wulyo; Abdullah, Murdani; Nababan, Saut Horas H.; Nasution, Sally Aman; Koesnoe, Sukamto; Sari, Nina Kemala
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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

Introduction. The prognosis for patients with Hepatocellular Carcinoma (HCC) is generally poor because most cases are diagnosed at an advanced stage. Several studies indicate that HCC is more prevalent and has a worse prognosis among younger individuals. This study aims to identify and compare the variations in survival rates between early and late-onset HCC patients at Cipto Mangunkusumo Hospital and investigate the factors that impact survival outcomes in both groups. Methods. Retrospective cohort study of HCC patients registered in HCC registry 2015-2022. Survival was visualized using Kaplan-Meier curves. Prognostic factor variables in the Cox Proportional Hazard Regression analysis by backward method in the final model became independent prognostic factors for overall survival. Results. There were 896 subjects. Patients with early onset had a median survival of 2.0 months (95% CI 1.0-2.9), while late-onset patients had a median survival of 4.0 months (95% CI 3.4-4.5) (p=0.021). During the observation period, the incidence of death in early onset was found to be higher compared to late onset (92.9% vs. 87.7%, p 0.032). In the multivariate analysis for early onset, hypertension comorbidity and lack of hepatitis treatment were prognostic factors increasing the risk of death with [HR 3.7 (95% CI: 1.0-12.7)] and [HR 2.4 (95% CI: 0.9-6.2)] (p=0.053). In the multivariate analysis for late onset, prognostic factors increasing the risk of death include AFP levels ≥200 ng/mL [HR 1.2 (95% CI: 1.0-1.5)], liver cirrhosis [HR 1.2 (95% CI: 1.0-1.3)], AJCC stage 4 as the most advanced stage [HR 4.5 (95% CI: 2.2-8.9)], supportive therapy [HR 5.2 (95% CI: 3.9-6.8)], and palliative therapy [HR 1.6 [95% CI: 1.2-2.2)]. Conclusion. The median survival of early-onset HCC patients is lower compared to late-onset ones because the majority are not given curative treatment. Independent prognostic factors in early-onset are hypertension and hepatitis treatment, while in late-onset AFP levels, liver cirrhosis, AJCC stage, and therapy are given.

After Imatinib Treatment Failure in Chronic Phase CML: What Can We Do? Nicholas Wijayanto; Wulyo Rajabto
Cermin Dunia Kedokteran Vol 45 No 10 (2018): Muskuloskeletal
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i10.713

Chronic myeloid leukemia (CML) is characterized by reciprocal translocation between chromosome 9 and 22. This translocation will activate the tyrosin kinase, leads to underlying pathogenesis of CML. Imatinib is the first line of tyrosine kinase inhibitor (TKI) to treat chronic phase of CML, but resistance has been a significant problem. NCCN has announced recommendation to treat imatinib resistance, including high-dose imatinib, the use of nilotinib or dasatinib. Leukemia mielositik kronik(LMK) terjadi karena translokasi resiprokal antara kromosom 9 dan 22. Translokasi ini akan mengaktifkan enzim tyrosin kinase yang mencetuskan LMK. Imatinib adalah terapi lini pertama dari golongan Tyrosin Kinase Inhibitor (TKI) untuk LMK fase kronik. Namun, resistensi terhadap imatinib menjadi masalah yang cukup signifikan. NCCN telah mengeluarkan rekomendasi untuk menangani resistensi imatinib, yaitu pemberian imatinib dosis tinggi, nilotinib atau dasatinib.

Pengaruh Heart Rate Variability terhadap Kesintasan Pasien dengan Kanker: Laporan Kasus Berbasis Bukti Kosasih, Kartika Anastasia; Raniah, Nida; Putranto, Rudi; Rajabto, Wulyo; Shatri, Hamzah; Faisal, Edward; Poespitasari, Vinandya Irvianita
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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

Depression, anxiety, and poor outcomes in cancer are possibly mediated by autonomic dysfunction. Autonomic disfunction found in cancer patients can cause increase in sympathetic tone and decrease in cardiac muscle vagal tone. Heart rate variability (HRV) is a non-invasive index for measuring vagal response and a potential stress response in autonomic dysfunction. In patients with cancer, high vagal tone measured by HRV is significantly correlated with increased overall survival. This evidence-based case report aims to investigate the role of HRV as a prognostic factor in cancer patients. Literature search was done by two authors on five databases: Pubmed, Cochrane Library, EMBASE, ProQuest dan MEDLINE (EbscoHost) in accordance with clinical question. Articles were selected using inclusion and exclusion criteria, then critical review was performed. Quality of the studies was evaluated using the Center of Evidence-Based Medicine, University of Oxford guideline. Two systematic review and four cohort study was included. Increased HRV index is consistently correlated with increased overall survival (OS) in cancer patients. One meta-analysis study found that OS is significantly longer in group with higher HRV (Hazard ratio, HR = 0.70, IK95% 0.60 – 0.82, p < 0.001, I2 = 27%). In conclusion, HRV can be used as a prognostic factor in advanced stage cancer patients. Increased HRV is associated with better OS.

Effects of Early Hospital-Based Palliative Care Consultation on Length of Stay and Costs of Care at Indonesian Tertiary Hospital Putranto, Rudi; Shatri, Hamzah; Rajabto, Wulyo; Sumariyono, Sumariyono; Faisal, Edward; Sihwastuti, Sihwastuti
Kesmas Vol. 18, No. 3
Publisher : UI Scholars Hub

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

Despite the numerous benefits of palliative care for cancer patients, there have been few studies on palliative care services for terminal cancer patients, particularly near the end of life. This study aimed to evaluate whether there were differences in length of stay and cost of care associated with how early or late a patient received palliative care intervention. Another objective was to compare the length of stay and cost of care of those who received palliative care intervention and those who did not. This study used a cohort retrospective design at Hospital A, Jakarta, Indonesia, from January to December 2019. The diagnosis of terminal cancer was based on medical records. Data on length of stay and costs of care were based on medical records and finance billing. The hospitalized terminal cancer patients (392) were recruited by consecutive sampling. The length of stay and costs of care for patients with advanced cancer who received palliative care consultations were longer and higher than for patients who did not receive them. However, if palliative care consultation is provided early, the increase in length of stay and costs are less.

Non-Severe COVID-19 Complicated by Deep Vein Thrombosis (DVT) Rajabto, Wulyo; Priantono, Dimas
Jurnal Respirologi Indonesia Vol 44 No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.263

Background: Coronavirus Disease 2019 (COVID-19) displays various symptoms ranging from asymptomatic to life-threatening. Patients may present with typical respiratory infections or atypical symptoms. Non-severe COVID-19 encompasses mild and moderate cases, characterized by the absence of criteria for severe or critical illness, with mild cases not showing evidence of viral pneumonia or hypoxia and moderate cases maintaining SpO2 levels of at least 90% on room air.Case: We presented a COVID-19 case with the chief complaint of unilateral leg swelling. A 48-year-old male was admitted with the chief complaint of cramps and swelling of the left leg. He had a history of fever, cough, nausea, and vomiting. Laboratory studies showed elevated D-dimer. Doppler ultrasound shows signs of both proximal and distal deep vein thrombosis. CT pulmonary angiography excluded pulmonary embolism while the lung window image supported the diagnosis of COVID-19 pneumonia. Polymerase chain reaction (PCR) obtained from nasopharyngeal and oropharyngeal swabs confirmed COVID-19 infection.Discussion: We treated the patient with parenteral anticoagulation followed by direct oral anticoagulant upon discharge. The swelling improved as well as the patient’s clinical status. Thromboembolic complications have been credited as the culprit of high mortality in COVID-19. Systemic activation of coagulation in pulmonary and peripheral circulation contributed to life-threatening thrombotic complications. Our patient presented with COVID-19-associated proximal and distal DVT without pulmonary embolism.Conclusion: Prompt diagnosis of COVID-19 infection and acute DVT improves patient care. The hallmark of the management of VTE in COVID-19 patients is treatment with therapeutic dose parenteral anticoagulation followed by oral anticoagulant.

Title

Found 20 Documents
Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title Search

Found 20 Documents Search

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Title

Found 20 Documents
Search