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KONTRIBUSI HIPERTENSI DAN DIABETES MELLITUS TIPE 2 ATAU KEDUANYA TERHADAP STROKE BERULANG Thomas, Novita Silvana; Susanto, Matilda; Sasmita, Poppy Kristina; Wiraharja, AP Regina Satya
Bahasa Indonesia Vol 13 No 2 (2014): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

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Latar Belakang: Stroke berulang merupakan penyebab utama kecacatan hingga kematian di dunia. Hipertensi, diabetes mellitus tipe 2, atau gabungan keduanya dikenal sebagai faktor risiko yang dapat menyebabkan kejadian stroke berulang, namun belum terlalu jelas faktor risiko mana yang paling berperan. Tujuan: Pada penelitian ini akan dibahas dan dievaluasi faktor risiko yang paling memengaruhi kejadian stroke berulang. Metode: Penelitian ini merupakan studi deskriptif analitik yang dilakukan di salah satu rumah sakit swasta di Jakarta Utara tahun 2009-2010. Data diambil dari rekam medis responden stroke menggunakan check list yang terdiri dari identitas responden, riwayat serangan stroke pertama dan terakhir, riwayat faktor risiko, tingkat kesadaran saat pertama kali datang, dan gangguan motorik atau sensorik yang ditimbulkan oleh stroke berulang. Hasil: Dari 152 rekam medis, diperoleh 59 rekam medis responden stroke berulang (38,8%). Analisis menunjukkan pengaruh hipertensi, diabetes mellitus, maupun gabungan keduanya, terhadap kejadian stroke berulang sama (p=0,077). Hasil tersebut terlihat juga pada analisis faktor risiko gabungan atau diabetes mellitus (p=0,714) dan faktor risiko hipertensi atau diabetes mellitus (p=0,157) yang menunjukkan pengaruh yang sama terhadap terjadinya stroke berulang (p=0,714). Namun, perbandingan antara faktor risiko hipertensi dengan faktor risiko gabungan (gabungan hipertensi dan diabetes mellitus) menunjukkan faktor risiko gabungan lebih berpengaruh terhadap terjadinya stroke berulang (p=0,026). Kesimpulan: Faktor risiko hipertensi tunggal kurang berpengaruh, namun dengan adanya kombinasi faktor risiko hipertensi dan diabetes mellitus akan meningkatkan risiko terjadinya stroke berulang.

The Relation between D-Dimer, Hs-CRP, and ACE Inhibitor to Severity, Reinfection, and Mortality of COVID-19 Patients Thomas, Novita Silvana; Aphridasari, Jatu; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44, No 4 (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.v44i4.465

Background: COVID-19 reinfection has been found, although the data is not clear yet. Pandemic conditions bring about limited facilities and infrastructure, so biomarkers are an option. Research on biomarkers and the use of ACE inhibitor drugs in COVID-19 patients has not been widely conducted in Indonesia.Methods: This was a retrospective cohort study that used medical record data of confirmed COVID-19 patients treated at dr. Moewardi General Hospital for the period of January to March 2022. Surviving patients were observed for reinfections until November 2022.Results: This study involved 524 medical records of confirmed COVID-19 patients. After exclusion and inclusion criteria, 517 medical records were obtained. D-Dimer cut-off values of ≥2435 were significantly related to severity (OR=2.05; 95% CI=1.38-3.06; P≤0.001) and mortality (OR=2.89; 95% CI=1.95-4.27; P≤0.001) of COVID-19 patients. Hs-CRP levels ≥4.59 were significantly associated with mortality in COVID-19 patients (OR=1.82; 95% CI=1.23-2.69; P=0.003). The use of ACE inhibitors (OR=0.55; 95% CI=0.33-0.89; P=0.015) was a protective factor from mortality but increased the risk of reinfection (OR=3.11; 95% CI=1.16-8.36; P=0.034). Conclusion: D-Dimer and Hs-CRP biomarkers could be considered as predictor biomarkers for the severity and mortality of COVID-19 patients. Although the use of ACE inhibitors increased the risk of reinfection, it reduced the risk of mortality due to COVID-19.

Thymoma Profile at Dr. Moewardi General Hospital: Does Thymoma Size Really Affect Distant Metastasis? Thomas, Novita Silvana; Fahlevie, Fahlevie; Setijadi, Ana Rima; Widiastuti, Widiastuti; Rakhma, Sastia
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.30-35

Introduction: Size is a predictor factor of a patient's prognosis and metastasis in solid tumors. This study determined the relationship between thymoma size and distant metastasis. Methods: A cohort retrospective study using medical record data was conducted at Dr. Moewardi General Hospital, Surakarta, from January 2019 to August 2021. Of 1,430 thoracic oncology patients, 150 (10%) had mediastinal mass with thymoma as the majority (48.6%). About 73 thymoma patients were included. The size of the thymoma was the dependent variable, and the metastasis (distant and non-distant) was the independent variable. The cut-off point of thymoma size was determined with receiver operating characteristic (ROC) analysis. The correlation of thymoma size with distant metastasis was analyzed with the Chi-Square test, and p < 0.05 was considered significant. Results: Thymoma was predominated by males (53.4%), the mean age was 43 ± 16 years old, and dyspnea was the most common symptom. Metastatic lesions were found in 87.7% of the patients, and the most common metastatic sites were intrathoracic (79.5%), followed by axillary lymph nodes (49.3%), bone (21.9%), liver (20.5%), and brain (1.4%). The cut-off value of thymoma size was 8.25 cm, indicating that >8.25 cm was categorized as large thymoma. Distant metastasis was found in 86.0% of large thymoma patients. The large tumors tend to spread into various sites (OR = 5.39; 95% CI 2.8-32.6; p = 0.002). Conclusion: Thymoma must be taken into account when there are male patients in their forties presented with dyspnea and mediastinal mass. The cut-off point of 8.25 cm for the thymoma size can predict distant metastasis.

The Relation between D-Dimer, Hs-CRP, and ACE Inhibitor to Severity, Reinfection, and Mortality of COVID-19 Patients Thomas, Novita Silvana; Aphridasari, Jatu; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44 No 4 (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.v44i4.465

Background: COVID-19 reinfection has been found, although the data is not clear yet. Pandemic conditions bring about limited facilities and infrastructure, so biomarkers are an option. Research on biomarkers and the use of ACE inhibitor drugs in COVID-19 patients has not been widely conducted in Indonesia.Methods: This was a retrospective cohort study that used medical record data of confirmed COVID-19 patients treated at dr. Moewardi General Hospital for the period of January to March 2022. Surviving patients were observed for reinfections until November 2022.Results: This study involved 524 medical records of confirmed COVID-19 patients. After exclusion and inclusion criteria, 517 medical records were obtained. D-Dimer cut-off values of ≥2435 were significantly related to severity (OR=2.05; 95% CI=1.38-3.06; P≤0.001) and mortality (OR=2.89; 95% CI=1.95-4.27; P≤0.001) of COVID-19 patients. Hs-CRP levels ≥4.59 were significantly associated with mortality in COVID-19 patients (OR=1.82; 95% CI=1.23-2.69; P=0.003). The use of ACE inhibitors (OR=0.55; 95% CI=0.33-0.89; P=0.015) was a protective factor from mortality but increased the risk of reinfection (OR=3.11; 95% CI=1.16-8.36; P=0.034). Conclusion: D-Dimer and Hs-CRP biomarkers could be considered as predictor biomarkers for the severity and mortality of COVID-19 patients. Although the use of ACE inhibitors increased the risk of reinfection, it reduced the risk of mortality due to COVID-19.

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