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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
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Articles 8 Documents
 1 
Search results for , issue "Vol. 10, No. 3 September 2009" : 8 Documents clear
SEORANG PENDERITA SINDROM NEFRITIK AKUT PASCA INFEKSI STREPTOKOKUS Renny A Rena, Ni Made; Suwitra, Ketut
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

Acute nephritic syndrome is classically de! ned by symptoms of oliguria, oedem, hypertension and also urinalysisabnormality such as proteinuria less than 2 grams/day, hematuria, or ! nding of erytrocite silinder in the urine. The etiology ofacute nephritic syndrome are disorders of primary glomerulopathy (idiopathic), glomerulopathy after infection, DisseminatedLupus Erythomatosus (DLE), vasculitis and hereditary nephritis (Alport syndrome). Acute nephritic syndrome is one of clinicalmanifestation of acute glomerulonephritis after streptococcal infection, which is in" lamation occur on tubulus and glomerularof the kidney, after streptococcal infection of skin or upper respratory tract. The most frequent cause by particular strain ofhemolyticus streptococcus ß group A type 12. Herewith, we reported a case of acute glomerulonephritis after streptococcalinfection with clinical manifestation acute neph! tic syndrome. A fourteen years old Balinese male patient found with anasarcaoedem, oliguria and hematuria. Previous medical history with infection of throat 2 weeks before admitted to hospital. On physicalexamination, we found with Stage II hypertension, laboratory data shown urinalysis: hematuria and proteinuria, protein esbach3.25 gram/liter/day, ASTO 200 IU/ml, ANA test negative and throat swab isolated Streptococcus viridans, alpha hemoliticus.Imaging data showed right pleural effusion and bilateral nephritis of the kidney. Patient gives a good respon to corticosteroid(metilprednisolone), diuretic and also ACE inhibitor
HUBUNGAN ANTARA KADAR ADIPONEKTIN PLASMA DAN RESISTENSI INSULIN PADA PENDUDUK ASLI DESA TENGANAN PEGRINGSINGAN - KARANGASEM Putrawan, Ida Bagus Putu; Suastika, Ketut
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

The association between plasma adiponectin level and insulin resistance (IR), diabetes mellitus (DM)-2, hypertension,and cardiovascular disease have been reported previously. Adiponectin is expressed and produced by adipocyte cells, and playscritical role in the glucose metabolism. IR in the adipose cells increases lipolysis and release free fatty acid (FFA). Furthermore,inactivation of mitochondrial pyruvat dehydrogenase and Þ nally decreases glucose uptake through disturbance of insulin receptorsignaling.To investigate the association between plasma adiponectin level and IR that was calculated by HOMA-IR, a cross sectionalanalytic study was conducted in Tenganan region, Bali from December 2007 to January 2008. As many as 80 participants whoseage was 18 ! 65 years old were involved.The study involved 38 (47.5%) males and 42 (52.5%) females whose mean of waist circumference (WC) was 78.03± 10.88 cm, mean of plasma glucosa was 91.73 ± 8.84 mg/dl, median of insulin was 2.70 (2.00 ! 17.90)  IU/ml, median ofHOMA-IR was 0.67 (0.38 ! 3.71), mean of HDL cholesterol was 58.93 ± 13.73 mg/dl, and mean of triglycerides was 145.64± 67.97 mg/dl, systolic blood pressure (SBP) was 70 ! 180 mmHg, and diastolic blood pressure (DBP) was 50 ! 100 mmHg. Inthis study, we found signiÞ cant correlation between plasma adiponectin level and IR (r = -0.370; p < 0.001). IR also signiÞ cantlycorrelation with central obesity (r = 0.361; p < 0.001), body mass index (BMI) (r = 0.381; p < 0.001), plasma HDL level (r =-0.327; p= 0.002), TG (r = 0.255; p = 0.011), and SBP (r = 0.198; p = 0.039). On multivariate analysis with multiple logisticregression, only central obesity has independent association with IR (B = 1.641; p = 0.023). Central obesity and sex weresigniÞ cantly inß uential to the plasma adiponektin level (ß = -1.542; p = 0.035) dan (ß = 2.865; p < 0.001) respectively in whichmean of the plasma adiponectin level in female (5.610 ± 2.815) was signiÞ cantly higher than that of male (3.365 ± 2.365; MD= -2.245; p < 0.001). Mean difference to plasma adiponectin level was signiÞ cantly inß uential of the plasma HDL level dan TG(MD = -10.500; p < 0.001) and (MD = 35.075; p = 0.020) respectively
TERAPI TERKINI MULTIPLE MYELOMA Suega, Ketut; Sripurnama Sjah, Yunny
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

Management strategies for Multiple Myeloma (MM) have continued to evolve as the result of innovative treatmentmodalities and efÞ cacy data used in establishing new standard of care. In 2004, multiple myeloma was diagnosed in more than15.000 people in the United States and will account for approximately 20% of deaths due to hematologic malignancies. Mostcommonly diagnosed in the growing elderly population.Until recently, few effective treatment existed. The use of alkylating agents and corticosteroid had remained the treatmentof choice for almost four decades. On a cellular level, the disease is characterized by complex interactions between tumor cellsand the surrounding bone marrow microenvironment. Understanding of the relationship between malignant plasma cells andthe microenvironment has sparked ongoing efforts to develop targeted therapeutic agents for treatment of this disease. Recentadvances in its treatment including using of the immunomodulatory drugs such as thalidomide and lenalidomide as well as theproteasome inhibitor bortezomib. Each of these agents is undergoing extensive clinical evaluation in combination with othertherapies to produce unprecedented response rates in newly diagnosed and relapsed MM. They have each improved the responseto therapy, but they are expensive. In recent years, evidence supporting a survival beneÞ t for three new drugs have resulted intheir inclusion, in combination with older drugs, in the management of younger and older patients. Each of these new drugs hasmultiple mechanisms of action, targeting both intracellular signaling pathways and tumor microenvironment. This review focuson the newer agents such as thalidomide, bortezomib, and lenalidomide in treatment of patient with newly diagnosed MM andrelapsed MM, treatment-related side effect, and future using of these agent including new combination therapy
PREVALENSI ASMA EKSASERBASI PADA IBU HAMIL DAN PENGARUHNYA TERHADAP JANIN DAN IBU DI RSUP SANGLAH DENPASAR Ngurah Rai, I B
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

The prevalence of asthma among pregnant females is increasing. Asthma is one of the most common chronic medicalconditions that cause complications in pregnancy. There is evidence that asthma can adversely impact on pregnancy outcomes,and conversely that pregnancy may result in a change in the clinical status of a female with asthma. The aim this study was toknow prevalence of asthma exacerbation in pregnancy and the effects to infant and maternal in Sanglah General Hospital. Thisstudy is retrospective study to medical record of pregnancy patients delivery at Sanglah General Hospital. In this study we found1959 pregnancy patients and prevalence of asthma exacerbation was 0.71% (14 asthmatic patients) Proportion of pathologicdelivery, pre-eclampsia and congenital malformations of the fetus was lower in asthmatic group than in group without asthmabut not signi! cant. The mean of birth weight was lower in asthma group than in group without asthma (3107.14 ± 521.78 grams: 3306.70 ± 366.21 grams) p = 0.05 95%CI (-399.14 ? 0.012). The conclusion this study is prevalence of asthma exacerbationson pregnant females in Sanglah General Hospital was 0.71%. Birth weight both in pregnant females with asthma and pregnantfemales without asthma was in normal limit but trend was lower in pregnant females with asthma than pregnant females withoutasthma.
KELAINAN HEMATOLOGI PADA DEMAM BERDARAH DENGUE 1Ni Made Renny A Rena, 2Susila Utama, 2Tuty Parwati M 1 Divisi Hematologi Onkologi Medik, 2 Divisi Penyakit Tropik dan Infeksi Bagian / SMF Ilmu Penyakit Dalam, FK Unud RSUP Sanglah Denpasar Email: renny_ang@ Renny A Rena, Ni Made; Utama, Susila; Parwati M, Tuty
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

Dengue infection can cause a unique and complex alteration to the homeostasis mechanism of the body. The underlying of bleeding, as a more frequent clinical manifestation of dengue was based on multiple factors such as thrombocytopenia, thrombopathy, Disseminated Intravascular Coagulation (DIC), prolonged of bleeding time and prothrombin time, decrease of some coagulation factors, hypoÞ brinogenemia and also increasing of Þ brin degradation products. Beside, kinin and bradikinin sytem was also activated. Endothelial dysfunction as one of coagulopathy disorder in dengue infection patients can shown as some clinical manifestation. Antigen antibody complex of dengue, activated the coagulation system, start from Haegeman factor (factor XII become factor XIIa). Therefore, factor XIIa activated the others coagulation factors respectively until Þ brin are produced, Þ brinolysis system are also activated, plasminogen change become plasmin through enzymatic process. Disseminated intravascular coagulation, is an emergency complication of dengue infection, which occur because activation of coagulation system and decreasing of thrombocyte level. Others condition such as shock, hypoxia, and acidosis also thought to be the factors that cause the DIC. Deterioration of all of the hemopoesis system, which are hypoplasia occur on the beginning of the infection and increasing of erythropoesis after Þ fth day of infection. This is caused by direct suppression of the viral and activation of the proinß ammatory cytokines
ANEMIA PADA PENDERITA HIV-AIDS DI POLIKLINIK TERATAI RS HASAN SADIKIN- BANDUNG Sumantri, Rachmat; Wicaksana, Rudi; Ariantan, Agnes R; Supandiman, Iman; Idjradinata, Ponpon; Creven, Reinout van-; der Ven, Andre van
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

The prevalence of anemia in HIV-infection ranging between 1.3 ? 95% depend on the stadium of infection. Anemiamakes bad impact on morbidity and mortality, and anemia is an independent risk factor for death in HIV-infected patients. Across-sectional study has been done in Teratai Clinic Hasan Sadikin Hospital to evaluate the prevalence and the etiology ofanemia between 1 January to 30 June 2008. Inclusion criteria were all patients who signed the informed consent. There were534 patients, 222 were anemic, prevalence of anemia was 41.6% (95% CI: 37.4 ? 45.8%), men 167 (72.2%). 188 were mildanemia (Hb 10 ?12/14 g/dl), 26 moderate anemia (Hb 8 ? 10 g/dl), and severe anemia in 6 patients (Hb < 8 g/dl). Anemia ofchronic disease or anemia of in! ammation were found in 142 (64.5%) cases, zidovudine related anemia 32 (14.5%) cases, ironde" ciency 14 (6.4%), hemolytic anemia 15 (6.8%) cases, thallassemia 8 (3.6%) cases, and megaloblasic 9 (4.1%) cases. All ofanemic patients showed low (< 2) reticulocyt index, high ferritin, low sTfR, and high hs-CRP.
EFUSI PLEURA MALIGNA: DIAGNOSIS DAN PENATALAKSANAAN TERKINI Ngurah Rai, I B
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

Malignant pleural effusions (MPE) are an important complication for patients with intra and extrathoracic malignancies.MPE are also a complication of far advanced malignancies or as the initial manifestations of an underlying malignancy, withmore than 150.000 cases/year in America. Median survival after diagnosis of an MPE is about 4 months. Although almost everytumor can cause it, more than 75% of MPE caused by malignancies at lung, breast, ovaries, mesotheliomas and lymphomas. Thestandard management approach begins with a diagnostic and or therapeutic thoracentesis. New imaging modalities help us todiagnose MPE, however positive cytologic conÞ rmation is necessary to establish a diagnosis. But, there are difÞ culties to Þ nd theetiology and deal with rapid recurrences of MPE. It is where several biomarkers took place in diagnosing MPE. Managementsof an MPE remain palliative. Several options include thoracenteses, pleurodesis, continuous outpatient drainage with indwellingcatheter, and pleuroperitoneal shunting. Recent studies focused on molecular marker and inß ammatory cytokine as a diagnostictool and target therapy for MPE. Many studies look for the role of EGFR (Epidermal Growth Factor Receptor), MCP-1 (monocytechemoattractant protein-1), VEGF (vascular endothelial growth factor), and TNF-  in diagnosing and possibly treat MPE.
RELATIONSHIP OF INFECTION AND GAMMA INTERFERON ( IFN ) OF PLASMA AND LYMPHOCYTE CULTURE SUPERNATANT IN IRON DEFICIENCY ANEMIA PATIENTS WITH INFECTION Suega, Ketut; Bakta, I Made
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

Iron is an essential nutrient for every living cells because of it role as molecule for transport of oxygen, as well as DNAsynthesis through synthesis of ribonucleotide reductase. Although the underlying mechanism of immune defect in iron deÞ ciencyanemia (IDA) is not clearly understood, multifactor events considered play their contributing roles such as impairment of T-cellproliferation and activities, altered cytokine production of Interleukin-2 (IL-2) and Interferon gamma (IFN ).Cross sectional study was done to asses the relationship of gamma IFN with infection in IDA patients on plasma andlymphocyte culture supernatant of IDA patients. Sixty-four IDA patients treated in Sanglah General Teaching Hospital wererecruited, and 31 (48.4%) out of 64 IDA patients were man and 33 (51.6%) women, have been selected for the study. This studyfound 17 (26.7%) IDA patients with infection, aged 38 ± 14.48 years and 47 (73.3%) IDA patients without infection, with ageaverage of 40.5 ± 14.4 years. The study revealed that there were no differences of cytokine level observed between older andyounger age (upper and below 44.5 years) in IDA patients. Furthermore, no differences of cytokine level were found based ongender between IDA male 10.9 pg/l (8.60 ! 12.65) patients and IDA female patients 10.6 pg/l (7.50 ! 13.43) with Z -0.490,p = 0.624. Nevertheless, signiÞ cant differences were noted between plasma and supernatant of IFN  in IDA patients withinfection when compared to IDA patients without infection (Z = - 2.638, p = 0.008 for plasma IFN ; and Z = -2.569, p = 0.010for supernatant IFN ).The study conclusion is that level of IFN  from plasma and lymphocyte culture supernatant of patient suffered from IDAwith infection is signiÞ cantly lower when compared to IDA patient without infection

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