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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Arjuna Subject : -
Articles 9 Documents
 1 
Search results for , issue "Vol. 10, No. 1 Januari 2009" : 9 Documents clear
EUTHYROID SICK SYNDROME Rai Purnami, Ni Ketu; Ratna Saraswati, Made; Sustika, I Ketut
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Subclinical thyroid dysfunction is a common clinical problem for which there are many controversial issues regardingscreening, evaluation and management. Subclinical hypothyroidism is defined as an elevated serum TSH level associated withnormal total or free T4 and T3 levels. Euthyroid sick syndrome (ESS) identifies abnormalities in thyroid function tests observedin patients with systemic nonthyroidal illnesses (NTIs) and those undergoing surgery or fasting. Abnormalities of thyroid functionin NTIs have been classified as 1). Low T3 syndrome, 2). Low T3-low T4 syndrome, 3). High T4 syndrome, and 4). Otherabnormalities. The condition is not considered to need treatment because there are no symptoms and the tests go back to normalwhen the stressful illness has passed. It has been reported a case of euthyroid sick syndrome of a 49 years old woman, whoÕssuffering from sistemic illness of space occupaying lession in thoracal VII-VIII (with histopathologycal findings: metastaticadeno carcinoma). We found low levels of T3 (0.49 nmol/L) and TSH (<0.05 uI/ml), but normal levels of T4 (96.91nmol/L). Inseverely ill patients, T4 decreases and both T4 and T3 are inversely correlated with mortality rate.
HUBUNGAN JUMLAH SEL LIMFOSIT T CD8+ PADA ULKUS KAKI DIABETIK DERAJAT 3, 4, 5 DAN ULKUS NON DIABETIK Putu Sutirta Yasa, I Wayan; Sudewa Djelantik, Anak Agung Gde; Suastika, Ketut; Mantik Astawa, Nyoma; Yuatmadja, Ignatius Ferdi
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Diabetes mellitus (DM) is a complex metabolism disorder characterized by a severe chronic hyperglycemia with a largenumber of complications, diabetic foot ulcer (DF) is one of its disastrous progressive complication. It can cause a significantmorbidity if not treated adequately. Diabetic foot ulcer is very difficult to heal as it is generally associated with other co-morbidities,such as vassal complications (peripheral vassal disease) that may cause ischemia sufficient to damage many tissues in thebody. The excess of free radical products induces widespread inflammatory reactions. These conditions may also be exacerbatedby neuropathy and foot injury which directly cause the formation of DF. If the process is followed by infection, the inflammatoryreaction will be more severe. All these events will disrupt the normal immune response to participate in wound healing process.This cross sectional study was performed to determine CD8+ T lymphocyte count in diabetic foot ulcer graded 3, 4, and 5based on Wagner Ulcer Classification System (1989) and to test the hypothesis that CD8+ T cells count in DF grade 3, 4, and 5 islower than non-DM ulcer. As many as 11 patients with DF grade 3, 10 patients with grade 4, 7 patients with grade 5 were includedin this study. Sixteen patients with non-DM ulcer as control group. Red pea-shaped fresh ulcer tissues of lower extremity werecollected from each group for CD8+ T cell lymphocyte count and 2 cc blood were collected from vein for blood glucose examination.The result showed that CD8+ T cell count consistently decreased along with the increase of DF grade. The greatest countwas observed in non-DM ulcer {26/10 field view (10 fv)}, followed respectively by grade 3 (12/10 fv), 4 (8/10 fv), and 5 (6/10fv). Statistical analysis showed the difference in CD8+ T cell count among diabetic foot ulcer groups and foot ulcer non diabeticwas highly significant (p<0.05). The relationship between CD8+ T cell lymphocyte count among groups (Non-DM ulcer, DFgrade 3, 4, 5) based on Spearman Correlation test was 0.84 for CD8+ T cell lymphocyte (r = -0,846, p<0.001).
DIAGNOSIS DAN PENATALAKSANAAN ARTRITIS SEPTIK Dary, I Wayan; Raka Putra, Tjokorda
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Septic arthritis which caused by bacterial infection is a serious disease and still as challenge to physician because theprognosis has not improved significantly over the past two decades. The route of spread infection to joint through hematogenousor other routes include direct inoculation through joint prosthetic. The most often aetiology is Staphylococcus aureus. The processof native joint infection can be divided into three steps: bacterial colonization, establishing an infection, and induction ofhost inflammatory response. The diagnosis of septic arthritis rests on isolation of the pathogen from joint fluid. If we find classicsign and symptoms associated septic arthritis should not to delay the diagnosis of septic arthritis. Once septic arthritis is suspectedand the proper sample for microbiologic studies are collected, appropriate antibiotic treatment and adequate joint drainage shouldbegin immediately. The aim management of septic arthritis mainly are joint decompression, joint sterilization, and reserve jointfunction. Sterilization joint with empirical antibiotic based on gram stain and co-morbid disease and than adjusted base onbaterial culture result. Antibiotic should be administrated intravenously at least 2 weeks than continued orally. Joint decompressioncan be achieved by a variety methods include closed-needle aspiration, tidal irrigation, arthroscopy, and arthrotomy. Prophylacticuse of antibiotics is controversial for events posing a risk of haematogenous bacterial arthritis through transientbacteraemia. Prognosis of septic arthritis is poor since a permanent reduction in joint function is seen in approximately 30% ofpatients.
INTERLEUKIN-6 YANG TINGGI SEBAGAI FAKTOR RISIKO TERHADAP KEJADIAN OSTEOPOROSIS PADA WANITA PASCAMENOPAUSE DEFISIENSI ESTROGEN Kawiyana, Siki
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

In estrogen deficient post-menopausal women, the decrease of estrogen level in blood is not the sole cause for osteoporosis.Osteoporosis occurs due to the increase of osteoclastic bone resorption activity. OsteoclastÕs number and activity depend onits activating factors such as interleukine-6 (IL-6). The aim of the study was to prove that high IL-6 serum concentration is a riskfactor for osteoporosis. The study was an analytic-observational study in case-control design, which was done at Sanglah GeneralHospital, Denpasar. The sample size was 41 case subjects (osteoporosis) and 41 control subjects (non-osteoporosis) using pairedcase-control sample size formula. The t-paired and McNemartestsresults were: (1). IL-6 concentration was higher significantlyin case compared than control (3.47 ± 1.75 pg/mL vs 2.51 ± 1.13 pg/mL, p=0.001). (2). As risk factor for osteoporosis, using 2.17pg/ml as the cut off point, the IL-6 has significant OR as high as 4 (CI 95%: 1.23 Ð 14.24, p=0.032). From this study we mayderive conclusions as follows: (1). In estrogen deficient post-menopausal women, IL-6 concentration was higher in osteoporosisthan non-osteoporosis. (2). The high IL-6 serum concentration was a risk factor for osteoporosis in estrogen deficient postmenopausalwomen. (3). High IL-6 serum concentration can be used as predictor for osteoporosis in estrogen deficient postmenopausalwomen
HEMOLYTIC UREMIC SYNDROME Ngurah Wisesa, Ida Bagus; Loekman, Jodi S
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Hemolytic uremic syndrome (HUS) is caused primarily by Shiga toxin–producing Escherichia coli O157:H7. Hemolyticuremic syndrome can occur in adults, and the most common cause of acute renal failure in children. Characteristic features of thesyndrome are microangiopathic anemia, thrombotic thrombocytopenia, and renal failure. Although the presentation of this syndromeis diverse, the classic prodromal illness is bloody diarrhea. Children with HUS generally present with gastroenteritiscomplaints (e.g., abdominal pain or tenderness, nausea or vomiting, fever, anemia); affected adults may be asymptomatic. Complicationsfrom HUS can include intussusception, chronic renal failure, and seizures in severe cases. Because an incubation periodof approximately one week occurs between the start of diarrhea and the onset of HUS, physicians should maintain a high index ofsuspicion; early laboratory testing is important to diagnose and manage this syndrome. Obtaining a complete blood count andstool culture and performing Shiga toxin testing are the first of a series of tests that may help diagnose of HUS.
SEKRESI INTERLEUKIN-8 (IL-8) DAN HUBUNGANNYA DENGAN TINGKAT KEPARAHAN PENYAKIT INFEKSI DENGUE Wihandani, DM; Ayu Dewi, NN; Somia, Agus
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Elevation of IL-8 was found in many viral infection include dengue infection and related to the increases of illnessgradation. The aim of study is to know the secretion of IL-8 and the relation with the severity of the disease that caused by dengueviral infection that hospitalized at Sanglah hospital. There were 58 patients that diagnosed with dengue haemorrhagic fever basedon WHO criterion. Those samples consist of 38 patients of DHF grade I (mild) and 20 patients of DHF grade II, III and IV(severe). Serum was taken and then the level of IL-8 was examined by ELISA method with microplate reader in 450 nm wavelength (bioMerieux Reader 250). The data was analize statistically with non parametric measurement. The result showed thatthere were significant differences of IL-8 level between healthy people (control) and samples, and between mild and severepatients. We conclude that increase of IL-8 level related to severity of dengue viral infection
OSTEOSARKOMA DIAGNOSIS DAN PENANGANANNYA Kawiyana, Siki
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Osteosarcoma is the second most common bone malignant neoplasm. Occurs between 5 Ð 30 years old, most oftenbetween 10 Ð 20 years old. It is located at long bone metaphyses which has rapid growth rate, therefore it is most often found inthe knee. Its diagnosis is established based on clinical findings, laboratory examination, radiographic examination such as plain xrayphoto, CT-scan, MRI, bone scan, angiography and biopsy histopathologic examination. The osteosarcoma prognosis dependson its stage and treatment effectivity. The osteosarcoma currently is managed by giving chemotherapy at pre-operative(induction=neoadjuvant chemotherapy) and post-operative (adjuvant chemotherapy). ÓLimb salvageÓ is the expected objective insurgical treatment for osteosarcoma. Post-operative follow up is very crucial in managing patient with osteosarcoma.
HUBUNGAN ANTARA STADIUM KEGANASAN NON-HEMATOLOGI DENGAN D-DIMER SEBAGAI INDIKATOR KEJADIAN TROMBOSIS Wantera, I Putu; Bakta, I Made
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Thrombotic complications are among the most common causes of death in patients with malignancy. D-dimer level is apersistent hemostatic activity sign and a predictor of a repeated thrombosis. This study was cross sectional study to knowcorrelationthe level of D-dimer with the clinical stages of non-hematologic malignancy.Forty three consecutive patients with non-hematologic malignancy. All patients underwent D-dimer testing. The relationshipsbetween D-dimer and stages of non-hematologic malignancy were analised by spearman correlation.43 patients with non-hematologic malignancy, 8 (18.6%) were in stage II with median D-dimer 445.0 mg/dL (226.25 Ð 959.25), 28(65%) were in stage III with median D-dimer 1012.0 mg/dL (454.00 Ð 1632.75), 7 (16.3%) were in stage IV with median Ddimer666.0 mg/dL (590.00 Ð 1721.00). Of 43 patients, 5 (11.6%) were with nasopharynx malignancy and median D-dimer level628.0 mg/dL (380.00 Ð 3214.50); 19 (44.2%) were with cervix malignancy and median D-dimer 849.0 mg/dL (344.00 Ð 1458.00);7 (16.3%) were with mammae malignancy and median D-dimer 617.0 mg/dL (380.75 Ð 1370.75); 4 (9.3%) were with lungmalignancy and median D-dimer 1758.0 mg/dL (897.00 Ð 4361.00); 8 (18.6%) were with other malignancies and median D-dimer675.3 mg/dL (412.0 Ð 1208.50). Median D-dimer levels had a tendency to increase as the stages of non hematologic malignancywere higher. However, D-dimer had no correlation to stages of non hematologic malignancy (correlation spearman 0.157; p=0.313 ).There is no correlation between D-dimer level and stages of non hematologic malignancies as an indicator of thrombosis.But there was a tendency of increasing level of D-dimer as the stages were increasing
PENGARUH PROPOLIS TERHADAP SEKRESI INTERLEUKIN-12 PADA SUPERNATAN KULTUR MAKROFAG DARI PENDERITA TUBERKULOSIS PARU YANG DIINFEKSI Mycobacterium tuberculosis Linawati, Made; Bagiada, Made
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

The uses of adjuvan imunotherapy has attract the attention tuberculosis treatment, because of the increasing patientpersentage in antituberculosis agent. Propolis is bee glue, contain of caffeic acid phenethyl ester (CAPE) that assumeimmunomodulator activities. The aim of this study were to assess the role of propolis to interleukin 12 secretion in macrophagesculture from pulmonary tuberculosis patient that infected with Mycobacterium tuberculosis (M tb). This study was true experimentalusing post test only control group design, with sampel from peripheral blood mononuclear cells (PBMC) of lung tuberculosispatient that divided into 3 groups within 6 replication. Group I as control group without M tb infection and propolis intervention;group II treatment group with M tb infection only; and group III treatment with M tb infection and propolis intervention.Interleukin 12 secretion were measured 48 hours post M.tb infection. Result showed that means of interleukin 12 secretion atthese groups are 11 pg/ml; 23.33 pg/ml; 37 pg/ml in which intervention of propolis 10 mg/ml before M tb infection could increaseinterleukin 12 consentration significanly (p< 0.05) compared with control group and group with infection of M tb only. Weconclude that propolis could increases macrophages activities with in increase secretion of interleukin 12.

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