Iman Supandiman
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung

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ANEMIA PADA PENDERITA HIV-AIDS DI POLIKLINIK TERATAI RS HASAN SADIKIN- BANDUNG Sumantri, Rachmat; Wicaksana, Rudi; Ariantan, Agnes R; Supandiman, Iman; Idjradinata, Ponpon; Creven, Reinout van-; der Ven, Andre van
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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The prevalence of anemia in HIV-infection ranging between 1.3 ? 95% depend on the stadium of infection. Anemiamakes bad impact on morbidity and mortality, and anemia is an independent risk factor for death in HIV-infected patients. Across-sectional study has been done in Teratai Clinic Hasan Sadikin Hospital to evaluate the prevalence and the etiology ofanemia between 1 January to 30 June 2008. Inclusion criteria were all patients who signed the informed consent. There were534 patients, 222 were anemic, prevalence of anemia was 41.6% (95% CI: 37.4 ? 45.8%), men 167 (72.2%). 188 were mildanemia (Hb 10 ?12/14 g/dl), 26 moderate anemia (Hb 8 ? 10 g/dl), and severe anemia in 6 patients (Hb < 8 g/dl). Anemia ofchronic disease or anemia of in! ammation were found in 142 (64.5%) cases, zidovudine related anemia 32 (14.5%) cases, ironde" ciency 14 (6.4%), hemolytic anemia 15 (6.8%) cases, thallassemia 8 (3.6%) cases, and megaloblasic 9 (4.1%) cases. All ofanemic patients showed low (< 2) reticulocyt index, high ferritin, low sTfR, and high hs-CRP.
PERBEDAAN EKSPRESI VASCULAR ENDOTHELIAL GROWTH FACTOR DAN EKSPRESI TISSUE FACTOR BERDASARKAN RESPONS TERAPI KEMORADIASI CISPLATIN PADA PENDERITA KARSINOMA NASOFARING STADIUM LANJUT Hendarsih, Een; Oehadian, Amaylia; Sumantri, Rachmat; Supandiman, Iman; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Vascular endothelial growth factor (VEGF) merupakan faktor angiogenik yang berperan dalam angiogenesis tumor. Tissue factor (TF) merupakan inisiator utama pembekuan darah dan merangsang protein yang mengatur angiogenesis. Penelitian bertujuan mengetahui perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. Dilakukan penelitian kohort prospektif pada penderita KNF stadium III, IVa, dan IVb berdasarkan AJCC edisi ke-7 tahun 2010. Ekspresi TF dan VEGF diperiksa dengan imunohistokimia dan respons kemoradioterapi dievaluasi dengan memakai Response Evaluation Criteria in Solid Tumours (RECIST) revisi versi 1.1 tahun 2009. Analisis statistik yang digunakan adalah Uji eksak Fisher. Selama penelitian Oktober 2012?Oktober 2013 didapatkan 35 penderita KNF yang memenuhi kriteria inklusi dan 5 orang dikeluarkan dari penelitian. Pada kelompok respons didapatkan 17 dari 23 penderita ekspresi VEGF ? 25%; 6 dari 23 penderita ekspresi VEGF <25%; 16 dari 23 penderita ekspresi TF ? 33%; 7 dari 23 penderita ekspresi TF <33% (p=1,000) serta pada kelompok tidak respons 5 dari 27 penderita ekspresi VEGF ?25%; 2 dari 7 penderita ekspresi VEGF <25%; 4 dari 7 penderita ekspresi TF ? 33%; 3 dari 7 penderita ekspresi TF <33% (p=0,657). Simpulan, tidak terdapat perbedaan ekspresi VEGF dengan ekspresi TF pada penderita KNF stadium lanjut berdasarkan respons terapi kemoradiasi. [MKB. 2015;47(1):49?54]Kata kunci: Karsinoma nasofaring, respons kemoradiasi, tissue factor, vascular endothelial growth factorDifferences between Vascular Endothelial Growth Factor Expression and Tissue Factor Expression Based on Cisplatin Chemoradiation Therapy Response in Advanced Stage Nasopharyngeal CancerVascular endothelial growth factor (VEGF) is a proangiogenic factor involved in the angiogenesis of NPC. Tissue factor (TF), the main initiator of blood coagulation, also signals protein that regulates angiogenesis. This study  analyzed the differences between VEGF expression and TF expression in tumor tissue based on chemoradiation therapy response. Prospective cohort study was performed in NPC patients stage III, IVa and IVb according to the AJCC VII staging system. TF expression and VEGF expression were measured by immunohistochemistry, and chemoradiotherapy responses was evaluated by RECIST version 1.1 2009. Statistical analysis was performed using Fisher Exact test. From October 2012 to October 2013, 35 NPC patients were eligible for this study and 5 patients were excluded. In response group, there were 73.9% patients with VEGF expression ?25%, 26.1% patients with VEGF expression <25%; 69.6% patients with TF expression ?33%, 30.4% patients with TF expression <33% (p=1,000) and in no response group, there were 71,4% patients with VEGF expression ? 25%; 28.6% patients with VEGF expression <25%, 57.1% patients with TF expression  ?33%, 42.9% patients with TF expression <33% (p=0.657). In conclusion, there are differences between VEGF expression and TF expression based on the chemoradiation therapy response, but they are not significantly different. [MKB. 2015;47(1):49?54]Key words: Nasopharyngeal carcinoma, chemoradiation response, tissue factor, vascular endothelial growth factor DOI: 10.15395/mkb.v47n1.397   
Peluang Kematian Penderita Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome berdasarkan Gabungan Derajat Anemia, Indeks Massa Tubuh, dan Jumlah Cluster Differentiation 4 Sumantri, Rachmat; Supandiman, Iman; Indjradinata, Ponpon; van der Ven, Andre; van Crevel, Reinout
Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Prevalensi anemia pada infeksi human immunodeficiency virus (HIV) cukup tinggi, berkisar antara 1,3% sampai 95% bergantung pada stadium penyakitnya. Anemia, cluster differentiation 4 (CD4), dan viral load (VL) merupakan faktor risiko independen untuk kematian. Indeks massa tubuh (IMT) merupakan faktor risiko yang penting untuk anemia dan progresivitas penyakit. Dilakukan penelitian kohor untuk mengevaluasi respons pengobatan selama follow-up 6 bulan dengan endpoint kematian, serta menghitung peluang kematian penderita acquired immunodeficiency syndrome (HIV-AIDS) berdasarkan gabungan derajat anemia, IMT, dan jumlah CD4. Subjek penelitian adalah penderita HIV-AIDS di klinik Teratai Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung, periode Januari−Juni 2008, studi kohor dilakukan pada periode Juli−Desember 2008. Tercatat 534 penderita HIVAIDS yang masuk dalam data di klinik Teratai RSHS, sampai akhir penelitian terdapat 458 penderita yang masih aktif berobat, 38 penderita drop-out, 8 penderita pindah ke tempat lain, dan 28 penderita meninggal. Prevalensi anemia kelompok yang sama pada penelitian sebelumnya yaitu 41,6%. Dalam follow-up selama 6 bulan terdapat 26 kematian pada kelompok anemia dan hanya 2 kematian pada kelompok nonanemia. Gabungan antara derajat anemia sedang-berat, dengan CD4 ≤50/mm3, dan IMT <18,5 menunjukkan peluang kematian terbesar, dalam penelitian ini sebesar 80%. Simpulan, faktor risiko yang penting untuk kematian pada penderita HIV-AIDS yaitu jumlah CD4, derajat anemia, dan IMT. [MKB. 2012;44(1):50–6].Kata kunci: Anemia, CD4, indeks massa tubuhOpportunity of Death in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome Patients by Combining Degree of Anemia, Body Mass Index, and Cluster Differentiation 4 CountThe prevalence of anemia in human immunodeficiency syndrome (HIV) infection was quite high, ranging from 1.3 to 95% depending on the stadium of HIV infection. Anemia, cluster differentiation 4 (CD4), and viral load were known as the independent risk factors for death. Body mass index (BMI) is an important risk factor for anemia and progression of the HIV infection. A cohort study had been conducted to evaluate the response of therapy, and deaths as the end point, and to calculate the opportunity of death  by combining the degree of anemia, BMI, and CD4 in HIV-AIDS patients. The subjects were patients in Teratai Clinic Dr. Hasan Sadikin General Hospital-Bandung from  January to June 2008. During 6 months of follow-up from  July−December 2008, there were 534 patients in the database of Teratai Clinic, with only 458 continuing the therapy, thirty eight  patients were dropped-out, eight patients moved to other hospital and 28 patients died. The prevalence of anemia from previous study of those 534 patients was 41.6%. After 6 months of follow-up, there were 26 deaths among anemic patients and 2 deaths in non-anemic patients. The combination of moderate-severe anemia, CD4 ≤50/mm3 and BMI <18.5 showing the highest opportunity of death in this study was 80%. In conclusion, the important risk factors of deaths in HIV-AIDS patients were CD4, grade of anemia, and BMI. [MKB. 2012;44(1):50–6].Key words: Anemia, body mass index, CD4DOI: http://dx.doi.org/10.15395/mkb.v44n1.212