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All Journal Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Respirologi Indonesia Jurnal Aisyah : Jurnal Ilmu Kesehatan
Gatot Sudiro Hendarto, Gatot Sudiro
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Hubungan Kadar D-Dimer Dan Jenis Histopatologi Kanker Paru Karsinoma Bukan Sel Kecil Terhadap Respons Kemoterapi Berdasarkan Recist 1.1 Firdaus, Elman Dani; Infianto, Andreas; Windarti, Indri; Soemarwoto, Retno Ariza S; Ekawati, Diyan; Sinaga, Fransisca T.Y.; Hendarto, Gatot Sudiro; Lyanda, Apri; Kusumajati, Pusparini; Ajipurnomo, Adhari
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 7 (2025): Volume 12 Nomor 7
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i7.20247

Abstract

Kanker paru tetap menjadi penyebab utama kematian terkait kanker secara global, terutama pada pria di Indonesia. Sekitar 80 % kasus  didiagnosis sebagai Kanker Paru Bukan Sel Kecil (KPKBSK), terutama Adenokarsinoma dan Karsinoma Sel Skuamosa. Kadar D-Dimer yang meningkat, yang menunjukkan keadaan hiperkoagulasi, dapat menjadi penanda potensial untuk memprediksi hasil pengobatan dan prognosis keseluruhan.  Metode: Dalam penelitian ini, 61 pasien KPKBSK yang menjalani tiga siklus kemoterapi lini pertama dilibatkan. Sebelum pengobatan, kadar D-Dimer diukur, dan jenis histopatologi ditentukan melalui pemeriksaan patologi anatomi. Respons kemoterapi dinilai menggunakan RECIST 1.1. Distribusi respons: Partial Response (27,9 %), Stable Disease (19,7 %), dan Progressive Disease (52,5 %). Terdapat perbedaan signifikan secara statistik dalam kadar D-Dimer antar kelompok tersebut (p = 0,001). Kelompok Partial Response memiliki median kadar D-Dimer 1.229 ng/mL (Mean Rank = 18,32), kelompok Stable Disease menunjukkan mean 1.335,67 ng/mL (SD = 624,30; Mean Rank = 21,13), dan kelompok Progressive Disease memiliki median 2.586 ng/mL (Mean Rank = 41,44). Kadar D-Dimer ≥1.654 ng/mL secara signifikan terkait dengan peningkatan risiko Progressive Disease, dengan sensitivitas 78,1 % dan spesifisitas 76 %. Subtipe histopatologi (Adenokarsinoma vs. Karsinoma Sel Skuamosa) tidak berkorelasi signifikan dengan respons kemoterapi (p = 0,717). Kadar D-Dimer berkorelasi dengan respons kemoterapi pada pasien KPKBSK, menunjukkan potensi penggunaannya sebagai prediktor, sedangkan jenis histopatologi tidak memengaruhi hasil terapi.
EVALUATION OF THE SENSITIVITY AND SPECIFITY OF THE TUBERCULOSIS SIGN AND SYMPTOM (TBSS) SCORE IN COMPARISON WITH CHEST RADIOGRAPHY AND RMT FOR DIAGNOSING TUBERCULOSIS AMONG BRICK KILN WORKERS Soemarwoto, Retno Ariza; Listiandoko, Raden Dicky; Valentiene Messah,, Anse Diana; Dilangga, Pad; Didiek Herdarto, Mohammad Junus; Hendarto, Gatot Sudiro; Febrihartati, Isura
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 10, No 1 (2025): March
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/jika.v10i1.3076

Abstract

This cross-sectional study aimed to evaluate the sensitivity and specificity of the Tuberculosis Sign and Symptom (TBSS) score in comparison to chest radiography and the Rapid Molecular Test (RMT) among brick kiln workers. The study employed a total sampling method, involving 92 participants. Data collection was conducted from February to March 2024 in a brick kiln located in Saribumi Village, Gading Rejo District, Pringsewu Regency, Lampung Province. The majority of participants were female (77.3%), while males accounted for 22.8%. The most common age range was 41–60 years, representing 48.9% of the total sample. Regarding job categories, most workers were employed in the molding section. Screening with the TBSS score and chest radiography showed a sensitivity of 0.25, a specificity of 0.93, a positive predictive value of 0.14, and a negative predictive value of 0.96. The sensitivity and specificity of the RMT compared to the TBSS score could not be assessed as all RMT results were negative for TB. This limitation may be attributed to suboptimal sputum sample quality. The study concludes that while the TBSS score demonstrates high specificity and a strong negative predictive value, the diagnostic utility of the RMT could not be evaluated due to uniformly negative results.
The Contribution Hypoalbumin Status on Diagnosing LF-LAM TB Ag Versus Xpert MTB/Rif in Patients Pulmonary Tuberculosis Eksa, Dwi Robbiardy; Hendarto, Gatot Sudiro; Sinaga, Fransisca Tarida Yuniar; Dilangga, Pad; Herdato, M. Junus Didiek; Infianto, Andreas; Ekawati, Diyan; Gozali, Achmad; Ajipurnomo, Adhari
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 10, No 1 (2025): March
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/jika.v10i1.3092

Abstract

In 2023, the global prevalence of tuberculosis (TB) reached 8.2 million cases. This represents the highest recorded figure associated with delayed diagnostics and a rising incidence of tuberculosis cases. Tuberculosis prevalence is elevated among individuals with compromised immune systems, including those with HIV and hypoalbuminemia, who exhibit increased vulnerability to infection. The challenge of sputum ejection impedes diagnosis, highlighting the need for a rapid and economical early detection method. The LF-LAM TB-Ag assay provides an alternative method for determining the presence of Lipoarabinomannan in urine, which is a component of the Mycobacterium tuberculosis cell wall. This study evaluated the efficacy of the LF-LAM TB-Ag assay compared to the Xpert MTB/RIF method for diagnosing tuberculosis. A comparative cross-sectional study was conducted at Abdoel Moeloek Hospital in Lampung Province, Indonesia, between January 2023 and June 2024. A total of 52 suspected pulmonary tuberculosis patients, who were HIV-negative and had hypoalbumin status, were evaluated using both the LF-LAM TB-Ag and Xpert MTB/RIF assays. The Wilcoxon and Chi-square tests have been utilised to assess the efficacy of LF-LAM TB-Ag in comparison to Xpert MTB/RIF. A p-value below 0.002 was considered statistically significant. Xpert MTB/RIF demonstrated improved diagnostic accuracy for tuberculosis in individuals with hypoalbuminemia. This study emphasises the necessity for early detection of pulmonary tuberculosis in patients with hypoalbuminemia. The combining of LF-LAM TB-Ag with Xpert MTB/RIF improves detection, especially among high-risk populations, thereby enabling prompt treatment and enhanced disease management.
Analysis of Respondent Characteristics Regarding The Severity of Community-acquired Pneumonia Patients at Dr. H. Abdul Moeloek Hospital, Lampung. Sanjaya, Rizki Putra; Herdato, M. Junus Didiek; Ajipurnomo, Adhari; Herliyana, Lina; Dilangga, Pad; Soeprihatini, Retno Ariza; Lyanda, Apri; Hendarto, Gatot Sudiro; Sinaga, Fransisca Tarida Yuniar; Kusumajati, Pusparini
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 10, No 1 (2025): March
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/jika.v10i1.3096

Abstract

Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality worldwide, particularly among the elderly and immunocompromised patients. Various factors, including age, gender, bacterial pattern, comorbidities, and Pneumonia Severity Index (PSI) score, influence CAP severity. Understanding these characteristics is crucial for optimizing treatment strategies and predicting clinical outcomes. This descriptive-analytical cross-sectional study was conducted at Dr. H. Abdul Moeloek Hospital, Lampung, from December 2022 to January 2023. A total of 102 CAP patients were analyzed based on their age, gender, bacterial pattern, comorbidities, and PSI score. Data were processed using IBM SPSS 21.0, with Pearson correlation applied to assess relationships between variables. A statistically significant correlation was found between age and PSI score (p = 0.018), with a low-strength positive correlation (R = 0.234). This suggests that as age increases, CAP severity also increases (p = 0.011). However, no significant correlations were found between PSI score and gender, bacterial pattern, or diabetes mellitus. This study confirms that age is a significant factor influencing CAP severity, emphasizing the need for early screening and intervention in elderly patients. Although gender, bacterial pattern, and diabetes mellitus were not significantly correlated with CAP severity. 
PERANAN KURVA DISOSIASI KARBON DIOKSIDA PADA PROSES PERNAFASAN : KAJIAN PUSTAKA Rusmini, Hetti; Lyanda, Apri; Hendarto, Gatot Sudiro; wibowo, adityo; Saputra, Tetra Arya; Morfi, Chicy Widia; Azka, Laisa
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 8 (2025): Volume 12 Nomor 8
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i8.22216

Abstract

Karbon dioksida (CO₂) merupakan produk akhir metabolisme aerobik yang memiliki peran vital dalam fisiologi pernapasan dan keseimbangan asam-basa tubuh. Artikel tinjauan ini membahas mekanisme pertukaran CO₂ mulai dari difusi alveolar, transportasi dalam darah (terlarut, sebagai bikarbonat, dan terikat hemoglobin), hingga kurva disosiasi CO₂. Efek Bohr dan Haldane dijelaskan sebagai mekanisme adaptif yang mendukung efisiensi pengangkutan gas respirasi. Selain proses fisiologis normal, artikel ini juga mengulas kondisi patologis yang mengganggu pertukaran CO₂, seperti hipoventilasi, gangguan ventilasi-perfusi, dan difusi terbatas. Pemahaman yang mendalam mengenai dinamika CO₂ memiliki implikasi klinis penting, khususnya dalam penatalaksanaan penyakit seperti PPOK, asma, dan ARDS. Dengan pendekatan ilmiah yang humanis, artikel ini bertujuan memperkuat pemahaman tenaga medis dan pembaca umum terhadap peran esensial CO₂ dalam menjaga homeostasis dan kehidupan.
Comparative Diagnostic Accuracy of LF-LAM TB Antigen and Xpert MTB/RIF in Pulmonary Tuberculosis among Underweight Patients Eksa, Dwi Robbiardy; Hendarto, Gatot Sudiro; Sinaga, Fransisca TY; Dilangga, Pad; Herdato, M. Junus Didiek; Infianto, Andreas; Ekawati, Diyan; Gozali, Achmad; Ajipurnomo, Adhari
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/7brxv447

Abstract

Background: In 2023, the global incidence of tuberculosis (TB) reached 8.2 million cases. It is the highest on record due to delayed diagnoses and a rising number of TB patients. Tuberculosis is more prevalent among patients with compromised immune systems, including those with HIV and malnutrition (BMI <18.5 kg/m2), who exhibit increased vulnerability to infection. The challenge of sputum expulsion impedes diagnosis, requiring a rapid, cost-effective early-detection technique. The lateral flow lipoarabinomannan TB antigen (LF-LAM TB-Ag) assay provides an alternate method for identifying lipoarabinomannan in urine, a constituent of the Mycobacterium tuberculosis cell wall. This study assessed the effectiveness of the LF-LAM TB-Ag assay compared with the Xpert MTB/RIF assay for TB diagnosis. Methods: A comparative cross-sectional study was conducted at Abdul Moeloek Hospital, Lampung Province, from January 2023 to June 2024. A total of 52 suspected pulmonary TB patients with HIV-negative status and underweight BMI were evaluated using both the LF-LAM TB-Ag and Xpert MTB/RIF assays. Results: Chi-square tests were used to compare the performance of LF-LAM TB-Ag with Xpert MTB/RIF. The LF-LAM TB-Ag test had a sensitivity of 79.59% and a specificity of 100% (P=0.002). Conclusion: This study underscores the necessity for early detection of pulmonary TB in underweight individuals. The integration of LF-LAM TB-Ag with Xpert MTB/RIF improves detection, especially in high-risk populations, enabling prompt treatment and enhanced disease management.
Meningitis Tuberkulosis Pada Pasien Dewasa : Kajian Pustaka Rusmini, Hetti; Dilangga, Pad; Theng, Luther; Lyanda, Apri; Hendarto, Gatot Sudiro
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 11 (2025): Volume 12 Nomor 11
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i11.20467

Abstract

Meningitis tuberkulosis (MTB) pada dewasa memiliki mortalitas tinggi akibat inflamasi kompleks, gejala awal yang tidak spesifik, dan keterbatasan diagnostik. Tantangan semakin besar di Indonesia karena keterbatasan fasilitas molekuler dan neuroimaging. Merangkum bukti terbaru mengenai imunopatogenesis, diagnosis modern, dan tantangan klinis MTB pada dewasa, serta implikasinya bagi praktik di Indonesia. Tinjauan literatur naratif melalui PubMed, Scopus, dan Google Scholar menggunakan rentang tahun 2010–2024. Kata kunci meliputi “tuberculous meningitis,” “adult TBM,” “immunopathogenesis TBM,” “CSF biomarkers TB,” dan “Xpert Ultra.” Artikel yang memuat data patofisiologi, diagnosis, atau tatalaksana dewasa disertakan; laporan yang tidak relevan disingkirkan. MTB ditandai aktivasi mikroglia, respons sitokin, dan peningkatan MMP yang menyebabkan kerusakan BBB dan komplikasi neurologis. Analisis CSF dan kultur memiliki sensitivitas rendah, sedangkan GeneXpert/Xpert Ultra dan MRI meningkatkan akurasi diagnosis namun belum tersedia luas. Terapi tetap mengandalkan OAT jangka panjang dan kortikosteroid, sementara regimen lini kedua diperlukan pada resistensi obat. Pendekatan multimodal yang menggabungkan pemahaman patogenesis, pemeriksaan molekuler, dan neuroimaging diperlukan untuk deteksi dini. Peningkatan akses diagnostik dan pengembangan biomarker CSF serta strategi rifampisin dosis tinggi menjadi arah penelitian penting untuk memperbaiki luaran MTB dewasa.
Co-Authors Adityo Wibowo, Adityo Ajipurnomo, Adhari Apri Lyanda Azka, Laisa Didiek Herdarto, Mohammad Junus Dilangga, Pad Ekawati, Diyan Eksa, Dwi Robbiardy Febrihartati, Isura Firdaus, Elman Dani Gozali, Achmad Herdato, M. Junus Didiek Herliyana, Lina Indri Windarti Infianto, Andreas Kusumajati, Pusparini Listiandoko, Raden Dicky Morfi, Chicy Widia Rizki Putra Sanjaya Rusmini, Hetti Saputra, Tetra Arya Sinaga, Fransisca T.Y. Sinaga, Fransisca Tarida Yuniar Sinaga, Fransisca TY Soemarwoto, Retno Ariza Soemarwoto, Retno Ariza S Soeprihatini, Retno Ariza Theng, Luther Valentiene Messah,, Anse Diana