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Perbedaan Kadar serum Liver-Type Fatty Acid Binding Protein (L-FABP) dan Beta Trace Protein (BTP) Dalam Serum Sebelum dan Saat Cedera Ginjal Akut Mona Yuliari; Hani Susianti; Deasy Ayuningtyas Tandio
Intisari Sains Medis Vol. 13 No. 2 (2022): (In Press : 1 August 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.179 KB) | DOI: 10.15562/ism.v13i2.1409

Abstract

Background: The prevalence of Acute Kidney Injury (AKI) varies, ranging from 3% to 20% of hospitalized patients and 25% to 67% of ICU patients, with 5% to 6% of the ICU population requiring renal replacement therapy following AKI. Establishing the diagnosis of AKI with KDIGO criteria using serum creatinine marker. Serum creatinine has a sensitivity of 52.9% and a specificity of 85.7% for AKI. The Sensitivity and specisifity of serum creatinine is not good because it can increase without any real injury or do not change even though acute tubular injury has occurred due to compensation for increased function by the remaining nephrons. L-FABP (Liver type Fatty Acid Binding Protein) and BTP (Beta Trace Protein) serum are newly discovered biomarkers potential for the early diagnosis of acute kidney damage. This study was conducted to determine the change in L-FABP and BTP concentration levels as markers of AKI. Method: This study is a longitudinal observational study with patients suffering from AKI with serum samples taken before and after an increase in serum creatinine level of ≥0.3 mg/dL in 48 hours. Serum levels of L-FABP and BTP were examined by ELISA method, and serum creatinine by enzymatic colorimetric. Differences between levels before and during AKI were analyzed by the Wilcoxon test. Results: The number of research subjects was 40 people. There was significant difference between serum creatinine before and during AKI (1.97 (1.36-2.77) mg/dL vs. 3.52 (2.53-4.91). mg/dL, p<0.001). Indeed there were also significant differences in serum L-FABP before and during AKI (3775.48 (1614.11-5086.68) ng/mL vs. 5427.28 (4562.79-5765.14) ng/mL, p<0.001), and serum BTP levels before and during AKI (456.36 (290.35-591.67) mg/L vs. 518.38 (436.37-691.90) mg/L, p<0.001). Conclusion: Serum levels of L-FABP and BTP increased significantly in the condition of the AKI so that it has the potential to be a marker for the diagnosis of AKI.   Latar belakang: Prevalensi cedera ginjal akut (Acute Kidney Injury/AKI) bervariasi, sekitar 3% hingga 20% dari pasien rawat inap dan 25% hingga 67% dari pasien ICU, dengan 5% hingga 6% dari populasi ICU membutuhkan terapi penggantian ginjal setelah terjadi AKI. Penegakan diagnosis AKI dengan kriteria KDIGO menggunakan marker serum kreatinin. Serum kreatinin mempunyai sensitivitas 52,9% dan spesifisitas 85,7% untuk AKI. Sensitivitas dan spesifisitas serum kreatinin tersebut kurang baik karena kadar serum kreatinin dapat meningkat tanpa ada cedera nyata maupun tidak berubah meskipun telah terjadi cedera tubulus akut karena adanya kompensasi peningkatan fungsi oleh nefron yang tersisa. Serum L-FABP (Liver type Fatty Acid Binding Protein) dan BTP (Beta Trace Protein) adalah biomarker yang ditemukan untuk diagnosis dini AKI. Penelitian ini dilakukan untuk mengetahui perubahan kadar serum L-FABP dan BTP sebagai penanda terjadinya AKI. Metode: Penelitian ini adalah penelitian observasional longitudinal dengan subyek pasien yang menderita AKI dengan sampel serum yang diambil sebelum dan sesudah terjadi peningkatan kadar serum kreatinin ≥0,3 mg/dL dalam 48 jam. Kadar serum L-FABP dan BTP diperiksa dengan metode ELISA, dan serum kreatinin dengan metode enzimatik kolorimetrik. Perbedaan antara kadar sebelum dan saat AKI dianalisis dengan uji Wilcoxon. Hasil: Jumlah subyek penelitian adalah 40 orang. Terdapat perbedaan bermakna antara kreatinin serum sebelum dan selama AKI (1,97 (1,36-2,77) mg/dL vs 3,52 (2,53-4,91), mg/dL, p<0,001. Teradapat juga perbedaan yang signifikan dalam serum L-FABP sebelum dan selama AKI (3775,48 (1614,11-5086,68) ng/mL vs 5427,28 (4562,79-5765,14) ng/mL, p<0,001), dan kadar BTP serum sebelum dan selama AKI (456,36 (290,35-591,67) mg/L vs. 518,38 (436,37-691,90) mg/L, p<0,001). Simpulan: Kadar serum L-FABP dan BTP meningkat signifikan pada kondisi AKI sehingga berpotensi menjadi marker untuk diagnosis AKI.
Differences Between Alpha-Fetoprotein (AFP) and Prothrombin Induced by Vitamin K Absence or antagonist II (PIVKA-II) Values as Early Detection Method for Hepatocellular Carcinoma (HCC) and Cirrhosis Bayu Eka Nugraha; Nugraha Setiawan; Hani Susianti; Bogi Pratomo
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.82 KB) | DOI: 10.24871/1932018153-157

Abstract

Background: Hepatocellular carcinoma is a common cancer worldwide and has a high mortality. Biomarkers could theoretically help to detect the disease at an earlier stage before symptoms occur and improve the treatment outcomes. The first biomarker found was AFP (not very accurate and 30-40% of HCC may be missed). PIVKA-II can be used as an early detection method to diagnose HCC.Method: A cross sectional study on in-patients or out-patients at Saiful Anwar Malang Hospital from July 2016 to October 2016.Results: The p value (p 0.05) obtained using Kolmogorov-Smirnov was 0.166 for diagnosis of HCC and 0.147 for the diagnosis of hepatic cirrhosis. The p value (p 0.05) obtained using Shapiro-Wilk was 0.103 for diagnosis of HCC and 0.087 for the diagnosis of cirrhosis. Comparative test using the LSD method showed PIVKA-II serum levels in HCC as compared to hepatic cirrhosis as significant with a p-value less than 0.05 (p 0.05), that is 0.025. However comparative test using the Tukey HSD method showed that the results obtained were not significant. According to the PIVKA-II cut off value, the sensitivity and specificity to detect cirrhosis and HCC was as large as 100%. According to the AFP cut off value, the sensitivity to detect cirrhosis and HCC was 93.3% and the specificity was 76.92%.Conclusion: Both PIVKA-II and AFP can be used to detect cirrhosis and HCC. However PIVKA-II exhibited better sensitivity and specificity in the detection of cirrhosis and HCC.
Proteinuria Severity in Lupus Nephritis is Associated with Anti-dsDNA Level and Immune Complex Deposit Location in Kidney Katherina Engli; Kusworini Handono; Mudjiwijono Handaru Eko; Hani Susianti; Atma Gunawan; Handono Kalim
Journal of Tropical Life Science Vol. 8 No. 3 (2018)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.08.03.03

Abstract

Lupus nephritis (LN) is one of the manifestations of Systemic Lupus Erythematosus (SLE), with proteinuria being one of the clinical manifestations. The proteinuria pathogenesis is associated with anti-dsDNA antibody and the location of immune complex deposits within the kidney. This study aims to investigate the correlation of the severity of proteinuria with the location of immune complex deposits and the level of anti-dsDNA antibody in LN. Data were collected in cross-section. Fifty-three patients with LN in Saiful Anwar Hospital Malang, who underwent renal biopsy, were included. Hematoxylin-eosin staining and immunofluorescence analysis were used to assign subjects to different histopathological classes and determine the immune complex deposits. The spot urine samples were evaluated using the dipstick method for semi-quantitative proteinuria. The anti-dsDNA antibody levels were evaluated using the enzyme-linked immunosorbent assay (ELISA). Turbidity and enzymatic tests were conducted to elucidate urine protein and creatinine content, respectively. The level of proteinuria is significantly different among the different locations of immune complex based on the dipstick and protein/creatinine methods (p = 0.021 and p = 0.005, respectively). There was a significant correlation between anti-dsDNA antibody level and the severity of proteinuria (r = 0.326 based on dipstick and r = 0.28 based on protein/creatinine method). Thus, proteinuria in LN is determined by anti-dsDNA level and the location of immune complex deposits in the kidney.
REDUCING LUPUS PATIENTS' HOPELESSNESS THROUGH BEAUTY CLASS IN MALANG CITY IN HONOR OF WORLD LUPUS DAY Cesarius Singgih Wahono; Elvira Sari Dewi; Tri Wahyudi Iman Dantara; Perdana Aditya Rahman; Kusworini Handono; Nurdiana Nurdiana; Hani Susianti; Dian Hasanah; Choirinnisa Meilia Ayu Putri; Nora Ariyanti; Handono Kalim
Caring : Jurnal Pengabdian Masyarakat Vol 2, No 3 (2022): CARING Jurnal Pengabdian Masyarakat (Desember 2022)
Publisher : Caring : Jurnal Pengabdian Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.caringjpm.2022.002.03.4

Abstract

Lupus is a systemic autoimmune rheumatic disease with mild to severe clinical features and can lead to hopelessness if not treated properly. The purpose of this activity is to give a beauty class and see how it affects the hopelessness of lupus patients in honor of World Lupus Day. Methods: Organizing World Lupus Day activities such as experts seminars on lupus at a glance, being friendly with lupus, and staying beautiful with lupus; a musical drama and dance performance by a lupus support group with the theme “You Are Beautiful”; and a lupus beauty class. The activity was completed in one day in May 2018 by collecting pre-test and post-test data on the incidence of hopelessness in lupus patients using the Beck Hopelessness Scale (BHS). A total of 100 lupus patients participated in the activity, and all of them underwent pre- and post-testing. The Wilcoxon Signed Rank Test with α=0.05 was used to analyze the collected data. Results: All participants expressed delight and satisfaction with their participation in this activity. The mean BHS scores before and after the beauty class were 8.62+2.68 and 6.36+1.59, respectively, with a significant difference (p=0.000). Conclusion: Beauty class is a fun way for lupus patients to feel less hopeless about their illness. Every year, an activity to commemorate World Lupus Day is required, which is beneficial for lupus patients.
The Role of Soluble Costimulatory Molecules as the Biomarkers for Aging Predictors Kusworini Handono; Mirza Zaka Pratama; Hani Susianti; Cesarius Singgih Wahono; Nimas Eka Firdaningrum; Siti Roziah Ria Famuji; Norma Hanifah Sumarta; Ade Wildan Rizky Fachry; Levrita Nindya Poetri; Handono Kalim
Jurnal Kedokteran Brawijaya Vol. 32 No. 3 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.03.4

Abstract

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.
Diagnostic Test of PIVKA-II as A Tumor Marker for Hepatocellular Carcinoma I Putu Adi Santosa; Dwi Priyadi Djatmiko; Elvin Richela Lawanto; Bogi Pratomo; Hani Susianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1436

Abstract

Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in 35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is abnormal prothrombin secreted in HCC and is expected to be used as a diagnostic marker of HCC. The objective of this study was to compare serum PIVKA-II levels in the patients with HCC, cirrhosis, and healthy control and determine the diagnostic value of PIVKA-II for hepatocellular carcinoma. This was a cross-sectional, analytical observational study to identify the diagnostic value ofPIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by using medical history, physical examination, and additional tests according to the diagnosis criteria. A group of 12 individuals with normal liver function was used as healthy control subjects. Serum PIVKA-II levels were analyzed with the immunoassay method. For the comparison study, the independent-samples Kruskal Wallis test was used. Also, to determine sensitivity, specificity,positive and negative predictive value (PPV and NPV), ROC curve analysis, and 2x2 contingency table was used. The serum PIVKA-II levels in the patients with HCC were significantly higher than in cirrhotic patients (p=0.000) and healthy control (p=0.000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of 140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC=0.87).PIVKA-II had a high diagnostic value for HCC diagnosis. Diagnostic tests that compare serum PIVKA-II levels in any size of HCC nodules might be needed in thefuture.
Evaluation of MicroRNA-451a Expression in Lupus Nephritis Emanuel Hananto; Laura Christiani; Dominica Pita Sari; Hani Susianti; Umi Kalsum; Kusworini Handono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2070

Abstract

The pathogenesis of Lupus Nephritis (LN) is still unclear, causing difficulties in diagnosis and therapeutic management. Recent studies have suggested that microRNAs (miRNAs) may play an important role in the pathogenesis of LN. However, the role of miRNA-451a in LN has not been widely studied and known, and there is controversy in the results of studies that have been done. This study aimed to analyze the expression of miRNA-451a in LN and lupus without nephritis and to evaluate its correlation with hemoglobin levels, leukocyte count, leukocyturia, and erythrocyturia. Samples from 45 lupus participants were collected, consisting of 22 with LN and 23 without nephritis. The expression of microRNA 451a was determined by reverse transcriptase real-time PCR. Renal disorder criteria based on ACR criteria. Statistical analysis using Mann-Whitney, Spearman correlation, ROC curve, and table 2X2. MiRNA-451a expression in LN (median 0.31; range 0.06-7.21) was lower than in lupus without nephritis (median 1.31; range 0.07-13.26) with a significant difference (p=0.041). The cut-off value for comparing the two groups was 0.7531 with an accuracy of 75%. The correlation between miRNA 451a expression and hemoglobin levels, blood leukocyte count, erythrocyturia, and leukocyturia showed no significant correlation (p > 0.05). MicroRNA-451a expression in lupus nephritis was lower than in lupus without nephritis.
Exploring Systemic Lupus Erythematosus Pathogenesis through Animal Models: A Systematic Review of Humanized and Pristane-Induced Lupus Mice Airlangga, Dimas Ikhsan; Rahmawati, Hanifa Rizky; Susianti, Hani; Handono, Kusworini
Journal of Biomedicine and Translational Research Vol 9, No 3 (2023): December 2023
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v9i3.19434

Abstract

Studies involving experimental animals to explore the pathogenesis of systemic lupus erythematosus (SLE) which leads to the selection of optimal therapy have been widely conducted. The well-known model used to study SLE includes the pristane-induced mouse model and the more recently developed humanized mouse model that implants human immune cells into immunodeficient mice. The current state of the research has yet to provide a systematic review that analyzes both model and its contribution to our understanding of SLE pathogenesis. This systematic review-based study aims to provide a comprehensive overview of the development and application of pristane-induced and humanized mouse models. We obtained several relevant article sources include: (1) Search Strategy, on databases such as PubMed, MEDLINE, ScienceDirect, and Cochrane by adjusting the protocols listed in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA); (2) Eligibility based on exclusion and inclusion criteria; and (3) Data Extraction. The findings show that 30 articles are relevant to the subject matter. Several strains of mice were used in the model of the 0.5 pristane injection method and the humanized mice model. All studies showed similar patterns in the onset and manifestation of SLE in mice models with slight variations. The purpose of using the pristane injection method and humanized mice model is adjusted to the output of each study. A variety of research preferences can be used as a reason for choosing pristane and humanized cells transplanted SLE methods in making lupus model mice.
Congenital Analbuminemia Santosa, Putu Adi; Widijanti, Anik; Susianti, Hani; Intanwati, Sherly; Meilani, Rossy
MEDICINUS Vol. 33 No. 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.628 KB) | DOI: 10.56951/medicinus.v33i2.50

Abstract

Congenital analbuminemia (CAA) is a rare autosomal recessive disorder, characterized by the absence or very low level of serum albumin (human serum albumin/HSA) as a result of defect on chromosome 4 which encodes albumin. It is defined as albumin level <1 g/l with normal liver function and the absence of protein loss.1,2 Estimated CAA prevalence is less than 1 in 1 million.A 10-year-old boy suffered from generalized edema that got worsened since last month. The patient had been misdiagnosed with nephrotic syndrome 2 years earlier, and then became protein-losing enteropathy. Neither cough nor diarrhea were reported. The patient had history of food allergy. Physical examination showed moderately ill condition, Glasgow Coma Scale (GCS) score E4 V5 M6, blood pressure 90/50 mmHg, pulse 120 x/min, respiratory rate 30x/min, palpebral edema, shifting dullness, undulation (+), with nonpitting edema on the extremities. Laboratory findings: leukocytosis (neutrophilia), peripheral blood smear showed hypochromic microcytic anisositosis erythrocyte. AAT serum 246 mg/dl, GGT serum: 88 U/l, iron serum 28 µg/dl, TIBC 411 µg/dl, transferrin saturation 7%, total IgE 775,90 U/ml. Serum Protein Electrophoresis (SPE) results were hypoalbuminemia (1,4 g/dl), hypogammaglobulinemia (0,21 g/dl), and total protein 2,91 g/dl. Chest X-ray showed pneumonia with minimal right pleural effusion. Overestimation of serum albumin level was caused by alpha and beta globulin that were detected as albumin in bromocresol green (BCG) methods. CAA aggravated with by allergy caused malnutrition in this patient. These data support the diagnosis of CAA with sepsis and iron deficiency anemia. Suggestion for the management consist of blood culture, procalcitonin level measurement, inguinal lymph node biopsy, DNA sequence analysis, also analysis of pleural and ascites fluid.
Pubertas Prekoks Perifer Isoseksual akibat Juvenille Granulosa Cell Tumor Santosa, Putu Adi; Widijanti, Anik; Susianti, Hani; Engli, Katherina Alfa
MEDICINUS Vol. 33 No. 3 (2020): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (572.213 KB) | DOI: 10.56951/medicinus.v33i3.66

Abstract

A 16-month-old girl with peripheral isosexual precocious puberty due to juvenile granulosa cell tumor underwent unilateral salpingo-oophorectomy procedure to stop the symptoms of precocious puberty. The diagnosis was established based on the patient’s medical history, physical findings, laboratory and other examinations which demonstrated secondary sexual characteristics according to Tanner scale M3P2, presence of abdominal mass, elevated serum estradiol, and a histological finding of juvenile granulosa cell tumor. Karyotyping results was normal. Left salpingo-oophorectomy successfully reduced estradiol concentration and stop the menstruation, while the other secondary sexual characteristics is monthly assessed at the clinic.
Co-Authors Abd. Rasyid Syamsuri Ade Wildan Rizky Fachry Agustina Tri Endharti Airlangga, Dimas Ikhsan Anik Widijanti Antonius Johanes Ati Rastini Atma Gunawan Atma Gunawan Atma Gunawan Bayu Eka Nugraha Bogi Pratomo Bogi Pratomo Bogi Pratomo Choirinnisa Meilia Ayu Putri Chomsin Sulistya Widodo Dany Farida Deasy Ayuningtyas Tandio Deasy Ayuningtyas Tandio desy wulandari Dewi Purnama Sari Dian Hasanah Dian Sukma Hanggara Dian Sukma Hanggara Dian Sukma Hanggara Dimas Ikhsan Airlangga Dominica Pita Sari Dwi Priyadi Djatmiko Eko, Mudjiwijono Handaru Ekowati Retnaningtyas Elvin Richela Lawanto Elvira Sari Dewi Emanuel Hananto Engli, Katherina Engli, Katherina Alfa Esther Mayrita Gonius, Andry Handono Kalim Handono Kalim Handono Kalim Handono Kalim Hari Oki, Hambiah I Komang Adi Widana I Putu A.S I Putu Adi Santosa I Putu Adi Santosa Indah Adhita Wulandari Intanwati, Sherly Kalsumy, Umi Katherina Engli Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Laura Christiani Levrita Nindya Poetri Lisyani Suromo Meilani, Rossy Mona Yuliari Mudjiwijono Handaru Eko Muhammad Anshory, Muhammad Nelly Ismayasih Nimas Eka Firdaningrum Nora Ariyanti Norma Hanifah Sumarta Nugraha Setiawan Nugraha Setiawan Nugraha, Bayu Eka Nurdiana Nurdiana Nurdiana Nurdiana Perdana Aditya Rahman Pratama, Mirza Zaka Purwanto Adipireno Putri, Laily Ardhianti Putu Adi Santosa, Putu Adi R.I R.I Rahmawati, Hanifa Rizky Raymond Poeng Rossy Meilani Sari, Atika Windra Sari, Tita Luthfia Shahdevi Nandar Kurniawan, Shahdevi Nandar Singgih Wahono Siti Roziah Ria Famuji Solly Aryza Susanto Nugroho Syahrul Chilmi Thiba Dina Merdikaningsih Torajasa Achamar Tri Wahyudi Iman Dantara Wahono, Cesarius Singgih Wisnu Barlianto Wisnu Barlianto Wisnu Barlianto Yuliana Salman