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Jurnal Penyakit Dalam Indonesia
Published by Universitas Indonesia
ISSN : 24068969     EISSN : 25490621     DOI : https://doi.org/10.7454/
Core Subject : Health,
Medicine & Pharmacology
Jurnal Penyakit Dalam Indonesia contains the publication of scientific papers that can fulfill the purpose of publishing this journal, which is to disseminate original articles, case reports, evidence-based case reports, and literature reviews in the field of internal medicine for internal medicine and general practitioners throughout Indonesia. Articles should provide new information, attract interest and be able to broaden practitioners insights in the field of internal medicine, as well as provide alternative solutions to problems, diagnosis, therapy, and prevention.
Arjuna Subject : Kedokteran - Kedokteran Internal
Articles 414 Documents
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Correlation between Disease Duration, Disease Activity Scoreand Disability Score with Diastolic Dysfunction in RheumatoidArthritis Women in Dr. Cipto Mangunkusumo Hospital Antono, Dono; Dhaki, Bernard Agus Sakti; Isbagio, Harry; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. There are only few studies about correlation between non traditional risk factor and diastolic dysfunction in RA patients. This study aims to determinate the correlation between non traditional risk factors, including disease duration, disease activity and disability score with the diastolic dysfunction of women with RA. Methods. A cross-sectional, consecutive sampling study was conducted to 52 RA women without any previous cardiovascular disease history. All participants underwent an echocardiography to assess diastolic dysfunction and other findings associated. Duration of disease was assesed by direct interview, while the disease activity by calculating DAS28 and disability score by HAQ-DI. Results. Diastolic dysfunction was found in 30.8 % of study participants (13.5 % for each low and moderate grade, while severe was 3.8% ). Median duration of disease was 26.5 months (range 2-240), mean DAS28-CRP score was 2.69±1.11 while median DAS28-ESR score was 3.65 (range 1.13-7.5), and median HAQ-DI score was 0.29 (range 0-2.38). LV hypertrophy was found in 34.61% participants. Mean EF was 66.7±5.76%. Valve abnormality was found in 34.6% study participants. Correlation between duration of disease, DAS28-CRP, DAS28-ESR and HAQ-DI score with E/A in sequence was r= -0.065 (p=0.89), r=0.393 (p=0.38), r=0.357 (p=0.43), r=0.630 (p=0.12); while with E/E’ in sequence was r=0.136 (p=0.77), r= - 0.536 (p=0.21), r= - 0.393 (p=0.38), r=0.374 (p=0.41). Conclusions. Duration of the disease, disease activity score, and disability score in rheumatoid arthritis women had no correlation with diastolic dysfunction.
The Changes of Amino Terminal Pro B-type Natriuretic Peptide(NT-proBNP) Concentration and Left Ventricular EjectionFraction on Doxorubicin Chemotherapy Patients Kamelia, Telly; Waspadji, Sarwono; Makmun, Lukman Hakim; Effendi, Shufrie; Ramli, Muchlis; Timan, Ina Susanti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Cancer patients who received chemotherapy regimen containing doxorubicin has been known to have serious side effect in heart, called as cardiotoxicity. The measurement of NT-proBNP proposed to be used as a new parameter to identify and evaluate cardiotoxicity in cancer patients earlier before it has been manifested, superior than measurement of left ventricle ejection fraction (LVEF). The aims of this study to examine the changes of NT-proBNP concentration and LVEF on patients with cancer who receive chemotherapy regimen containing doxorubicin. Methods. The study used pre and post test design to observe the changes of NT-proBNP concentration and LVEF on the patients who receive naïve doxorubicin chemotherapy and after chemotherapy-cycle I to cyce IV at the Ciptomangunkusumo hospital, Jakarta. Echocardiography and NT-proBNP were examined on naïve chemotherapy and after chemotherapy each cycle. Statistical analysis was performed by using two way Anova and Friedman nonparametric test. Results. During the period of October 2007 to June 2008, a total of 29 consecutive patiets receiving doxorubicin chemotherapy regimen CHOP (Cyclophosphamide, doxorubicin, Vincristine, Prednisone and FAC-5 Fluorouracil, doxorubicin, Cyclophosphamide) were collected. The increase of median NT-proBNP concentration between naïve chemotherapy and: post chemotherapy cycle I was 32 pg/mL (12,5-124,6 pg/mL), post chemotherapy cycle II was 135 pg/mL (44-275,2 pg/mL), post chemotherapy cycle III was 275,1 pg/mL (97,8-907,2 pg/mL), post chemotherapy cycle IV was 514,6 pg/mL (80,6-6458,2 pg/mL). With Friedman test, p< 0,000. With Anova two way test, it was found the difference between naïve LVEF and LVEF: post chemotherapy cycle I was 5,1% (p 0,000), post chemotherapy cycle II 8,9% (p 0,000), post chemotherapy cycle III 11,2% (p 0,000), post chemotherapy cycle IV 12,5% (p 0,000). Conclusions. Elevated NT-proBNP concentration and LVEF reduction had been observed in doxorubicin chemotherapy patients.
The Association between Elevated Levels of Erythropoietin andEndothelial Progenitor Cell with Improvement of EndothelialFunction in Renal Failure Patients 3 Months after KidneyTransplantation Armelia, Linda; Susalit, Endang; HM, Maruhum Bonar; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Endothelial progenitor cell (EPC) is considered possible to reduce asymmetric dimethylarginine (ADMA) levels, which is a marker of improved endothelial function. However, clinically, there is still a debate about the role of EPC. This study was conducted to determine the correlation of elevated levels of erythropoietin (Epo) and the number of EPC CD34 + and CD133 + with improvement of endothelial function in renal failure patients 3 months after kidney transplantation. Methods. A cross-sectional study was conducted in prior and 3 months after kidney transplantation of renal failure patients who underwent a kidney transplant in Cipto Mangunkusumo hospital. The study included 21 subjects who enrolled from July 2013 to February 2014. Blood samples prior and 3 months after kidney transplantation were collected to evaluate the level of Epo, numbers of EPC CD34+ and CD133+ and level of assymetric dimethylarginine (ADMA). Statistical analysis was performed using Pearson or Spearman correlation test. Results. Results of this study showed that prior to kidney transplantation, level of Epo was increased but not statistically significant (p>0.05). The EPC numbers of CD34+ and CD133+ were significantly increased (p0.05). There was no association between the elevated level of Epo and the numbers of EPC CD34+ and CD133+ with the improvement of endothelial function three months after kidney transplantation. Conclusions. In three months after kidney transplantation, there is an elevated level of Epo, the numbers of EPC CD34+ and CD133+ and decrease level of ADMA. However, there was no association between the elevated level of Epo and the numbers of EPC CD34+ and CD133+ with the improvement of endothelial function in patients 3 months after kidney transplantation.
A 30 Years Old Woman with Sepsis, Skin and Soft TissueInfection, and Obesity Widinartasari, Franzeska ADM; Sodiq, Muhammad Ali; Sofro, Muchlis AU
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Obesity increases morbidity and mortality through its multiple efects on nearly every human system. Obesity has efect on the immune response which leads to susceptibility to infections. ß lactamases are bacterial enzymes that inactivate ß-lactam antibiotics by hydrolysis. One group of ß lactamases, extended-spectrum ß lactamases (ESBLs), have the ability to hydrolyse and cause resistance to various types of the newer ß-lactam antibiotics. The management of skin and soft tissue infection with polymicrobial infection and multi drug resistance can be challenging problem. We present a case of an obese patient with polymicrobial SSTI. bPatient showed clinical sign of sepsis with acute kidney injury. With fluid rescucitation, early antibiotic administration and surgical treatment, she gained clinical improvement. The key to successful management of patients with severe skin and soft tissue infection are early recognition and complete surgical debridement. Clinicians need to consider appropriate early empirical antibiotic combination therapy coverage or the use of combination therapy to treat SSTI
Diagnostic Approach and Treatment of Dieulafoy's lesion Saifuddin, Anshari; Renaldi, Kaka; Situmorang, Indah
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Dieulafoy’s lesion is a rare cause of upper gastrointestinal bleeding but become an important etiology. Pathogenesis of the disease evolved from earlier of its invention till now. It has been stated in recent study that the etiology of this disease is vary, from age to genetic. Size and arteriol configuration abnormality has been known as the main pathogenesis of the disease. Endoscopic procedure become the primary diagnostic tool, which effectiveness reached more than 90%. However, in some situation, it’s difficult to find the abnormality by endoscopic procedure. Hemostatic procedure via endoscopy is the main therapy of Dieulafoy’s lesion, which has been progressed from thermal coagulation, mechanical procedure, and epinephrine injection. The development of medical technology has made the better prognosis of the disease.
Keberhasilan Pengobatan Antiretroviral (ARV) Karyadi, Teguh H.
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Effect of Structured Education and Antihypertensive MedicationsAdherence to Decrease Blood Pressure for Hypertension inElderly: a Randomized Controlled Trial Khomaini, Ayatullah; Setiati, Siti; Lydia, Aida; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Hypertension is one of the important problems in elderly due to high impact of cardiovascular complications. Education and antihypertensive medication adherence are considered as influence factors in a holistic and comprehensive hypertension treatment. This study was conducted to determine the effect of structured education and antihypertensive medication adherence in decreasing blood pressure as part of the hypertension treatment in elderly patients. Methods. A randomized clinical trial was conducted in October 2012 to February 2013 on hypertensive elderly patients at Cipto Mangunkusumo hospital, Jakarta. Subjects were divided into 3 groups: group I was received structured education and checklist, group II was received structured education, and group III was received checklist without structured education. Structured education was given 3 times per month for 90 days. Systolic and diastolic blood pressure (SBP and DBP) were measured on day-1 and day-90, then analyzed with anova test. Results. A total of 182 subjects that consisted of 60 subjects in group I, 61 subjects in group II and 61 subjects in group III was included in this study. Analysis results showed a decrease of SBP in group I, II and III to 130 (range 90-179) mmHg, 135 (range 80-174) mmHg and 133 (range 102-209) mmHg, respectively (p=0.04). Diastolic blood pressure (DBP) in group I, II, and III decreased to 70 (range 48-100) mmHg, 74 (range 45-103) mmHg and 78 (range 60-102) mmHg, respectively (p <0.001). Conclusions. Structured education significantly decreased systolic and diastolic blood pressure in elderly hypertensive patients, while adherence to antihypertensive medication did not affect signicifantly.
Predictors of Virological Failure in HIV Patients Receiving FirstLine Antiretroviral Therapy with Good Adherence Kurniawan, Farid; Djauzi, Samsuridjal; Yunihastuti, Evy; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate success or failure of ART. However, in country with limited resources, viral load measurement is not easily accessible by HIV patients receiving ART. Therefore, it is necessary to know which factors that can predict virological failure. In previous studies, adherence was an important factor for suppression of HIV viral load. This study is aimed to know predictors of virological failure in HIV patients receiving recent first line ART regimen with good adherence in Indonesia. Methods. A retrospective cohort study was conducted among adult HIV patients in Out-patient Clinic of Cipto Mangunkusumo Hospital that started ART during periode of January 2011-June 2014. HIV patients with good adherence that had viral load data 6-9 months after initiation of ART were included in this study. Virological failure was defined as viral load ≥ 400 copies/ mL after minimum of 6 months therapy with good adherence. Age at starting ART, risk factor for HIV infection, HIV clinical stage, HIV-TB co-infection, baseline CD4 value, CD4 count increase, baseline hemoglobin level and body mass index, weight changes during therapy, and ART based regimen were analyzed in this study. Results. A total of 197 patients were included in this study. Virological failure was found in 21 patients (10,7%). CD4 increase /mm3 after minimum 6 months of ART was predictor of virological failure (p = 0,003; OR 5,802, 95%CI 1,842-18,270). Conclusion. CD4 increase /mm3 after minimum 6 months therapy can predict virological failure in HIV patients receiving first line ART with good adherence
Fungsi Ginjal dan Kematian Akibat Sindrom Koroner Akut Ginanjar, Eka
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
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Penyakit kardiovaskuler merupakan salah satu penyebab kematian utama di dunia. World Health Organization (WHO) melaporkan 17,5 juta orang meninggal akibat penyakit kardiovaskuler pada tahun 2012, atau diperkirakan 3 dari 10 kematian terjadi akibat penyakit jantung.
Factors Related to Diagnosis of Community-Acquired Pneumonia in the Elderly Sari, Elza Febria; Rumende, C. Martin; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
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Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical challenge for various reasons. The clinical manifestation in the elderly is not frank and atypical manifestations, e.g. falls, decrease of functional status and food intake or urinary incontinence, may be present. These reasons may be associated with under or over diagnosis, which consequently contribute to the higher observed mortality rate in the elderly population with CAP. Study about factors related to diagnosis of CAP in the elderly was ra rely performed. Methods. From January to October 2010, 158 elderly patients suspected of having pneumonia at RSCM were registered. Relationship between clinical, laboratory and radiologic factors which consist of classic manifestations (cough, productive cough, dyspnea, fever, rales, leucocytosis, infiltrates) and atypical manifestations (decrease of intake and functional status, falls, urinary incontinence) with diagnosis community acquired pneumonia were analyzed. Receiver operating characteristics analysis of C-reactive protein was performed to find its association with diagnosis of pneumonia. Results. Of 158 subject, 106 were confirmed of having pneumonia. Final model of multiple logistics regression analysis revealed three factors: cough (p Conclusions. Factors related with diagnosis of community-acquired penumoni in the elderly are cough, rhales and infiltrates. All four atypical manifestations are proven unrelated with diagnosis of pneumonia. C-reactive protein does not predict diagnosis of CAP in the eldery.

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