Acquired hemophilia A merupakan kondisi dimana faktor koagulasi VIII menjadi tidak aktif akibat pembentukan autoantibodi. Kondisi ini dikaitkan dengan kehamilan, keganasan, dan penyakit auitoimun dengan kelainan kulit. Pada kasus ini, seorang wanita berusia 66 tahun, datang dengan keluhan perdarahan paska tindakan yang disertai dengan lesi kulit. Pasien didiagnosis dengan acquired hemophilia A dengan ditemukannya inhibitor faktor VIII terkait dengan pemfigoid bulosa.Kata Kunci: Acquired hemophilia A, diagnosis, pemfigoid bulosa, tata laksana Diagnosis and Treatment of Acquired Hemophilia A (AHA) with Bullous PemphigoidAcquired hemophilia A is a condition in which coagulation factor VIII become inactive due to autoantibody formation. This condition is related to pregnancy, malignancy, and autoimmune disease with skin disorder. In this case report, a 66 years woman with a post procedural bleeding with skin disorder. Later on, patient diagnosed with acquired hemophilia A with a factor VIII inhibitors related to bullous pemphigoid. Keywords : Acquired hemophilia A, bullous pemphigoid, diagnosis, treatment
Accurate prediction of survival is important for advanced cancer patients to determine medical interventions plan the patient's lives and prepare for their death. The palliative prognostic index (PPI) is most popular scores used worldwide to predict life expectancy in advanced cancer palliative patients. The purpose of this study was to test validity and the performance of PPI in Cipto Mangunkusumo Hospital as a Tertiary Referral Nasional Hospital.This retrospective cohort study, uses total subject during study with consecutive sampling. Palliative prognostic index was assessed by a palliative care team (PCT). Demographic data were summarized as n (%) and Chi square for categorical variables and median or mean for continuous variables. Overall survival was calculated using the Kaplan-Meier method with hazard ratios. The performance of PPI analyzed using SPSS version 20.0, includes for Receiving Operator Characteristics (ROC) and Hosmer-Lemeshow calibration test.160 patients were included in the PPI study. The subjects have an average age of 50.08 years and are mostly women 68.10%. 28 (17.50%) had symptoms of dyspnoea, 22 (14.60%) pneumonia, and 19 (11.90%) had pain. The number of patients who died during hospitalisation was 83 (51.90%). PPI sum score >6 109 (68,10%). Calibration performance PPI score reached x2 = 8.915 (p = 0.259), and showed correlation r 0.799 (p 0.000). The accuracy of PPI scores in predicting survival in advanced cancer patients in studies for survival <3 weeks 81%, with a sensitivity of 85%, specificity 70%, PPV 86%, and NPV 67%. Predictive accuracy of survival within 3-6 weeks had 76%, sensitivity 66%, specificity 88%, PPV 85% and NPV 70%. PPI score discrimination performance is had a AUC value of 0.822 (95% CI 0.749-0.895).Palliative Prognostic Index (PPI ) is valid and has good performance in predicting the survival of advanced cancer patients and may be used to help clinicians in palliative care consultation.
Objective This study will test the performance of the anal swab PCR test when compared with the nasopharyngeal swab PCR test as a diagnostic tool for COVID-19. Design An observational descriptive study which included hospitalised suspected, or probable cases of hopitalised COVID-19 patients, conducted in Dr. Cipto Mangunkusumo National Hospital, Ciputra Hospital, Mitra Keluarga Depok Hospital and Mitra Keluarga Kelapa Gading Hospital, Indonesia. Epidemiological, clinical, laboratory and radiology data were obtained. Nasopharyngeal and anal swabs specimens were collected for SARS-CoV-2 RNA detection. Results We analysed 136 subjects as part of this study. The clinical spectrum of COVID-19 manifesation in this study was typical of hospitalised patients, with 25% classified as mild cases, 14.7% in severe condition and 12.5% of subjects classified as having acute respiratory distress syndrome. When compared with nasopharyngeal swab as the standard specimen for reverse transcription polymerase chain reaction (RT-PCR) detection of SARS-CoV-2 antigen, the sensitivity and specificity of the anal swab was 36.7% and 93.8%, respectively. The positive and negative predictive value were 97.8% and 16.5 %, respectively. The performance of the anal swab remained similar when only the subgroup of patients with gastrointestinal symptoms (n=92, 67.6%) was analysed (sensitivity 40% and specificity 91.7%). Out of all the subjects included in analysis, 67.6% had gastrointestinal symptoms. Similarly, 73.3% of patients in the anal swab-positive group had gastrointestinal symptoms. The two most common gastrointestinal symptoms in the subjects’ population were nausea and anorexia. Conclusion Anal swab specimen has low sensitivity (36.7%) but high specificity (93.8%) for detecting SARS-CoV-2 antigen by RT-PCR. Only one additional positive result was found by anal swab among the nasopharyngeal swab-negative group. Anal swab may not be needed as an additional test at the beginning of a patient’s diagnostic investigation and nasopharyngeal swab RT-PCR remains as the standard diagnostic test for COVID-19.
Pendahuluan. Kanker payudara merupakan jenis kanker tersering dan penyebab kematian kanker utama pada perempuan. Pengobatan kanker payudara memerlukan pemeriksaan imunohistokimia (IHK) untuk menentukan prognostik dan prediktif. Namun, saat ini di Indonesia hanya terdapat 17 rumah sakit yang dapat melakukan pemeriksaan IHK. RSUD Kota Bogor seperti RS Tipe B lainnya belum memiliki fasilitas pemeriksaan IHK sehingga untuk melengkapai pemeriksaan tersebut perlu dilakukan pemeriksaan lanjutan di rumah sakit rujukan. Karena keterbatasan, ada sebagian pasien yang tidak melanjutkan pemeriksaan IHK dan tetap mendapatkan kemoterapi berbasis antrasiklin. Tujuan penelitian ini adalah untuk mengetahui profil IHK pasien kanker payudara yang mendapat regimen kemoterapi berbasis antrasiklin di RSUD Kota Bogor. Metode. Penelitian deskriptif retrospektif melalui penelusuran data rekam medik pasien pasien kanker payudara periode Januari 2014 – Desember 2017 di RSUD Kota Bogor. Hasil. Terdapat 174 Subjek penelitian yang terdiri dari 84 subjek (48%) dengan pemeriksaan IHK sedangkan 90 subjek (52%) tanpa pemeriksaan IHK. Adapun profil pemeriksaan IHK dari pasien kanker payudara yang mendapatkan kemoterapi berbasis antrasiklin pada periode Januari 2014 – Desember 2017 di RSUD Kota Bogor adalah tipe luminal 6(4%), HER2-enriched (18%), dan TNBC (18%). Simpulan: Tipe Luminal merupakan subtipemolekuler terbanyak pada pasien kanker payudara yang mendapat kemoterapi berbasis antrasiklin di RSUD Kota Bogor. Namun karena keterbatasan, pada periode Januari 2014 - Desember 2017 pemeriksaan IHK baru dilakukan pada 48% pasien kanker payudara yang mendapat kemoterapi berbasis antrasiklin di RSUD Kota Bogor. Kata Kunci: Antrasiklin, Imunohistokimia (IHK), Kanker payudara, RSUD Kota Bogor Immunohistochemistry Profile of Breast Cancer Patients that Get Anthracyclin–Based Chemotherapy in RSUD Kota Bogor Introduction . Breast cancer is the most prominent cancer and causing death in women. Treatment of breast cancer requires immunohistochemistry (IHC) to determine prognostic and predictive and imaging tests to determine staging. However, currently in Indonesia only 17 hospital can conduct IHC test. RSUD Kota Bogor like other Type B Hospital have no IHC test facilities . To fullfil that test, it’s important to refer patient to referal hospital. Because of limitation there are patients who did not do IH C test and continued get anthracycline chemotherapy. The objective of this research is t o find out immunohistochemistry profile of breast cancer patients who received anthracycline-based chemotherapy in RSUD Kota Bogor. Method s . A descriptive retrospective study by collecting the breast cancer patients medical records was done since January 2014 to December 2017 in RSUD Kota Bogor. Results . T otal of 174 subjects were include in this study which consist of 84 subjects (48%) with IHC test and 90 subjects (52%) without IHC test . The immunohistochemistry profile of breast cancer patients who received anthracycline-based chemotherapy since January 2014 to December 2017 in RSUD Kota Bogor were luminal type (64 % ) , HER 2 -e nriched ( 1 8 % ) , and TNBC ( 1 8 % ) . Conclusion . Luminal type is the most molecular subtypes in breast cancer patients who received anthracycline-based chemotherapy in RSUD Kota Bogor . However, because of limitation, since January 2014 to December 2017 only 48% of breast cancer patient that get anthracyclin chemotherapy who got IHC test in RSUD Kota Bogor.
Sindrom kelelahan kronis yang juga dikenal sebagai Myalgic Encephalomyelitis (ME), adalah kondisi kronis kompleks yang ditandai oleh kelelahan parah, disertai nyeri muskuloskeletal, gangguan kognitif, dan sistem autonom. Patofisiologi CFS melibatkan inflamasi kronis, disfungsi mitokondria, dan ketidakseimbangan sistem kekebalan, yang ditunjukkan dengan tingginya kadar sitokin pro-inflamasi. Aktivitas sitokin ini berperan dalam munculnya gejala utama seperti kelelahan, nyeri, dan penurunan kognitif. Diagnosis CFS merupakan proses yang kompleks karena didasarkan pada metode eksklusi dan belum adanya biomarker definitif sehingga menyebabkan banyak pasien tidak terdiagnosis. Heart Rate Variability (HRV) telah diajukan sebagai metode non-invasif untuk menilai disfungsi autonom pada CFS, di mana HRV rendah menunjukkan peningkatan risiko kelelahan dan disfungsi parasimpatis. Penggunaan HRV dan sitokin sebagai biomarker potensial menawarkan pendekatan yang lebih terukur dalam mendiagnosis CFS serta memprediksi prognosis. Namun, heterogenitas dalam hasil penelitian terkait peran sitokin menekankan pentingnya konsistensi metodologis di masa mendatang. Studi lanjutan tentang HRV dan inflamasi pada CFS diharapkan dapat berkontribusi pada strategi terapi yang lebih spesifik.
Background: Major Depressive Disorder (MDD) is a pervasive global health concern characterized by complex interactions between genetic and environmental factors, resulting in structural and functional alterations within the brain. This abstract explores the involvement of neurotrophin-3 (NT-3) in MDD, shedding light on its potential as a therapeutic target. Neuroanatomical evidence implicates brain regions like the amygdala, hippocampus, prefrontal cortex, and ventral striatum in MDD pathology, with aberrant synaptic plasticity and neurogenesis playing a crucial role. Methods: We conducted a review using a systematic search of MEDLINE. The results of the studies that match the search criteria are then analyzed using a narrative synthesis to include in the literature review. Results: There are four known brain regions and neurocircuits that are involved in depression, which are amygdala, hippocampus, prefrontal cortex, and ventral striatum. NT-3, a member of the neurotrophin family, has emerged as a critical modulator of depressive processes, whereas NT-3 influences monoamine neurotransmitters, serotonin, and noradrenaline while also regulating synaptic plasticity, neurogenesis, brain-derived neurotrophic factor signaling, and the hypothalamic-pituitary-adrenal (HPA) axis. Conclusion: NT-3 emerges as a promising therapeutic target for MDD, with multifaceted effects on neurotransmitters, synaptic plasticity, neurogenesis, and the HPA axis. However, further preclinical and clinical studies are needed to comprehensively evaluate its potential in managing mood disorders.
People living with HIV (PLHIV) are considered a high-risk population for developing a severe form of COVID-19. Vaccination is still one of the most important modalities in combating the disease due to the lack of an effective treatment. This multicenter study was performed from September to December 2021 with the aim to analyze the intention of PLHIV to receive the COVID-19 vaccination based on an integrated behavior model (IBM) in Indonesia. Of a total of 470 participants, 75.6% of patients were intent to be vaccinated. The model that was designed in this study explains 43.4% of the variance in intention to be vaccinated against COVID-19 in PLHIV (adjusted R2 = 0.434). Furthermore, the determinants used included instrumental attitude (β = 0.127, p < 0.05), subjective norm (β = 0.497, p < 0.01), and perceived behavioral control (β = 0.116, p < 0.01). This study concluded that an IBM could predict the intention of PLHIV to receive COVID-19 vaccination.
The data contain many variable that we analyzed and present in our paper entitled " Helicobacter pylori Prevalence in Indonesia: Higher Infection Risk in Eastern Region Population" All variable are result of the investigation and observation.
Coronavirus disease (COVID-19) pandemic occurred abruptly. It is an unexpected disaster. Uncertain treatment for this viral infection increases excessive anxiety, which does not occur only in one person but also in majority of people; therefore, it can create mass panic. Mass panic is a serious problem that must be immediately identified and managed. Mass panic management will reduce COVID-19 incidence.
