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"Background: nowadays, specific IgE measurement has been conducted in Indonesia, however there is still lack of data regarding diagnostic test to detect inhalant allergen in patients with respiratory allergies.This study aimed to determine the accuracy of specific IgE test in diagnosing specific sensitization of inhalant allergen in patients with respiratory allergies.Methods: this was a cross sectional study in patients with respiratory allergies and part of epidemiology study regarding to specific IgE sensitization in Allergy-Immunollogy Division, Cipto Mangunkusumo Hospital, Jakarta within November-December 2016. Measurement of specific IgE sensitization using Immunoblot method (Euroline, Euroimmun AG, Germany). The tested allergen is house dust mites Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t) and cockroach Blatella germanica (Bla g). The result is compared with gold standard, skin prick test. The diagnostic result includes sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-).Results: a total of 101 patients were enrolled; 77 (76.2%) were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t (76.2%), followed by Der p (70.3%), Der f (69.3%), and Bla g (41.6%). Specific IgE-sensitization was highest for Der f (52.9%), followed by Der p (38.2%), Blo t (33.3%) and Bla g (10.8%). Der p allergen had 50.7% sentivity, 90% specificity, 92.3% PPV, 43.5% NPV, 5.1 LR+ and 0.1LR-. Der f showed 71.4% sensitivity, 87.1% specificity, 82.6% PPV, 57.4% NPV, 5.5 LR+ and 0.3 LR-. Blo t allergen had 41.6% sensitivity, 91.7% specificity, 94.1% PPV, 32.8% NPV, 5.0 LR+, and 0.6 LR-. Bla g allergen had 23.8% sensitivity, 98.3% specificity, 90.9% PPV, 64.4% NPV, 14.5 LR+ and 0.8 LR-.Conclusion: serum specific IgE testing to common inhalant allergen in patients with respiratory allergy showed only low-to-moderate sensitivity, but high specificity and PPV. This new assay can be used to diagnose allergen sensitization in the population with high prevalence of TDR and cockroach."

"ABSTRAK Latar Belakang: Pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai akurasinya dalam mendeteksi alergen tungau debu rumah dan kecoa pada pasien asma dan atau rinitis alergi. Tujuan: Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnosis pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t dan Blatella germanica Bla g pada pasien asma dan atau rinitis alergi.Metode: Penelitian ini adalah studi potong lintang pada pasien alergi pernapasan dan merupakan bagian dari studi epidemiologi mengenai sensitisasi IgE spesifik di Divisi Alergi-Immunologi, RS Cipto Mangunkusumo, Jakarta, antara September dan Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot Euroline , Euroimmun AG, Germany . Alergen yang diuji adalah Der p, Der f, Blo t, dan Bla g. Hasilnya dibandingkan dengan baku emas uji tusuk kulit. Uji diagnostik yang dilakukan meliputi sensitivitas, spesifisitas, positive predicitive value PPV , negative predictive value NPV , likelihood ratio positif dan negatif LR and LR- .Hasil: Serbanyak 101 pasien dilibatkan dalam studi, 77 76,2 di antaranya adalah perempuan. Rerata usia pasien adalah 38,8 tahun. Berdasarkan uji tusuk kulit, sensitisasi tertinggi yang didapatkan adalah terhadap Blo t 76,2 , disusul oleh Der p 70,3 , Der f 69,3 , dan Bla g 41,6 . Sensitisasi IgE-spesifik tertinggi ditunjukkan oleh Der f 52,9 , diikuti oleh Der p 38,2 , Blo t 33,3 dan Bla g 10,8 . Alergen Der p memiliki 50,7 sentivitas, 90 spesifisitas, 92,3 PPV, 43,5 NPV, 5,1 LR dan 0,1 LR-. Der f memperlihatkan 71,4 sensitivitas, 87,1 spesifisitas, 82,6 PPV, 57,4 NPV, 5,5 LR dan 0,3 LR-. Alergen Blo t menunjukkan 41,6 sensitivitas, 91,7 spesifisitas, 94,1 PPV, 32,8 NPV, 5,0 LR , dan 0,6 LR-. Alergen Bla g menghasilkan 23,8 sensitivitas, 98,3 spesifisitas, 90,9 PPV, 64,4 NPV, 14,5 LR dan 0,8 LR-.Kesimpulan: Pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, dan Blatella germanica pada pasien asma dan atau rinitis alergi memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi.

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ABSTRACTBackground Serum specific IgE testing has recently been introduced in Indonesia, but diagnostic test has not been performed to know its performance to detect house dust mite and cockroach allergens in patients with allergic asthma and or rhinitis.Objective The objective of this study was to obtain diagnostic accuracy of serum specific IgE testing in diagnosing allergen sensitization to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis.Method This was a cross sectional study among patients with respiratory allergy and was part of a larger epidemiology study on specific IgE sensitization in the Division of Allergy Immunology, Cipto Mangunkusumo Hospital, Jakarta between September and December 2016. Specific IgE sensitization was measured using immunoblot method Euroline , EuroImmun AG, Germany . Allergens tested were Dermatophagoides pteronyssinus Der p , Dermatophagoides farinae Der f , Blomia tropicalis Blo t , and Blatella germanica Bla g . The results was compared to the standard skin prick test . Diagnostic test were performed and include sensitivity, specificity, positive predicitive value PPV , negative predictive value NPV , positive and negative likelihood ratio LR and LR .Results A total of 101 patients were enrolled 77 76.2 were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t 76.2 , followed by Der p 70.3 , Der f 69.3 , and Bla g 41.6 . Specific IgE sensitization was highest for Der f 52.9 , followed by Der p 38.2 , Blo t 33.3 and Bla g 10.8 . Der p allergen had 50.7 sentivity, 90 specificity, 92.3 PPV, 43.5 NPV, 5.1 LR and 0.1LR . Der f showed 71.4 sensitivity, 87.1 specificity, 82.6 PPV, 57.4 NPV, 5.5 LR and 0.3 LR . Blo t allergen had 41.6 sensitivity, 91.7 specificity, 94.1 PPV, 32.8 NPV, 5.0 LR , and 0.6 LR . Bla g allergen had 23.8 sensitivity, 98.3 specificity, 90.9 PPV, 64.4 NPV, 14.5 LR and 0.8 LR .Conclusion Serum specific IgE testing to Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, and Blatella germanica allergens in patients with allergic asthma and or rhinitis showed only low to moderate sensitivity, but high specificity and PPV."

"Latar Belakang. Disfungsi otonom merupakan salah satu gejala penyakit parkinson yang sering ditemukan clan berpengaruh terhadap morbiditas dan mortalitas penderita penyakit parkinson. Disfungsi otonom memberikan gejala klinis yang seringkali tidak disadari penderita. Tujuan penelitian adalah mengetahui gambaran disfungsi otonom penyakit Parkinson menggunakan pemeriksaan Sympathetic Skin Response.Metode. Penelitian ini merupakan studi potong lintang deskriptif dengan populasi semua penderita penyakit parkinson yang memenuhi kriteria inklusi. Dilakukan pencatatan berupa identifikasi karakteristik penderita dan riwayat perjalanan penyakit, anamnesis dan pemeriksaan fisik untuk mencari gejala klinis-penyakit parkinsnn, gejala disfungsi otonom, jenis obat anti parkinson yang dipakai dan respon pengobatan . Diagnosis disfungsi otonom ditegakkan melalui pmeriksaan Sympathetic Skin Response (SSR). Data dianalisis menggunakan tes chi-square, fisher's exact dan t test dengan memakai program STATA.Hasil. Pada penelitian ini didapatkan 34 pasien penyakit parkinson. Sebagian besar subyek berjenis kelamin pria (67,8%), dengan usia rata-rata 61.11+_10.01 tahun dan terbanyak pada kelompok usia 60-69 tahun ( 41.2%). Sebanyak 22 subyek (64.7%) mengalami gejala disfungsi otonom, dengan gejala yang tersering adalah disfagia (44%) ,diikuti gejala konstipasi (38.2%), dan hipersalivasi (35.3%). SSR abnormal dijumpai pada 23 subyek (67.6%). Rata-rata subyek dengan nilai SSR abnormal lebih tua dibandingkan dengan subyek dengan SSR normal. Rata-rata lama menderita parkinson untuk SSR abnormal adalah 6.52+_3.64 . Abnormalitas SSR dijumpai pada seluruh subyek yang menderita penyakit parkinson lima tahun atau lebih (p=0.0x4) dan pada semua subyek dalam periode non honeymoon (p=0.000). SSR cenderung abnormal dengan meningkatnya derajat keparahan penyakit berdasarkan skala Hoehn & Yahr. SSR abnormal lebih sexing ditemukan path subyek yang mengalami instabilitas postural clan subyek dengan skor bradikinesia, tremor dart rigiditas dari UPDRS yang lebih tinggi. Subyek yang mengalami gejala hipotensi postural simptomatik (p=0.023), konstipasi (p=0.402), hipersalivasi (p=0.043) dan disfagia (p=0.000) menunjukkan nilai SSR abnormal. Semua subyek yang mengalami dua (p-0.04) atau lebih gejala otonom (p=0,0001). Tiga subyek (13%) yang tidak mengalami gejala disfungsi otonon ternyata menunjukkan nilai SSR abnormal.Kesimpulan. Disfungsi otonom penyakit parkinson ditemukan pada 67.6% penderita. SSR cenderung abnormal dengan meningkatnya derajat keparahan penyakit berdasarkan skala Hoehn & Yahr maupun berdasarkan skor UPDRS untuk tremor, rigiditas, bradikinesia dan stabilitas postural. Subyek yang mengalami gejala hipotensi postural simptomatik, konstipasi, hipersalivasi dan disfagia menunjukkan nilai SSR abnormal. Nilai SSR abnormal juga ditemukan pada semua subyek yang mengalami dua atau lebih gejala otonom.

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Background. Autonomic dysfunction is one of the signs that is frequently found in PD, which influences the patient's morbidity and mortality. It also comprises some frequently neglected clinical manifestations.

Aim. The aim of this study is to review autonomic dysfunction in PD, using Sympathetic Skin Response test.

Methods. This is a descriptive cross-sectional study. Population of this study is PD patients that meet the inclusion criteria. Patient's characteristic was identified. History of illness was recorded and physical examination was done to indentify patient's signs and symptoms, autonomic dysfunctions, medications used, and the responses. Diagnosis of autonomic dysfunction was confirmed by using Sympathetic Skin Response (SSR) test. Chi-Square test, fisher's exact test, and t were used to analyze the data, using the STATA program.

Results. There were 34 PD patients identified. Most of the subjects are men (67,8%) with the mean age of 61,1+10,01 year-old and mostly within 60-90 year-old group age (41,2%). Twenty two subjects (64,7%) had autonomic dysfunction with the most presenting symptoms are dysphagia .04,8%), constipation (38,2%), and hypersalivation (35,3%). Abnormal SSR was found in 23 subjects (67,6%). Most subjects with abnormal SSR are older than subjects with normal SSR. The duration of PD in subjects with abnormal SSR is 6,52+3,64 years. Abnormal SSR was found in all subjects that have had PD for five years or more (p=0,004) and all subjects were in non-honeymoon period (p=0,000), SSR tends to be abnormal when the severity of the disease is higher, based on the Hoehn & Yahr scale. Abnormal SSR is more often found in subjects who suffer postural instability and whose IJPRDS score of bradikinesia, tremor, and rigidity is high. Subjects with symptomatic postural hypotension (p=0,023), constipation (p=0,002), hypersalivation (p=0,003) and dysphagia (p=0,000) show abnormal SSR. Every subject shows two or more autonomic symptoms (p=0,0001). Three subjects (13%) that didn't show autonomic dysfunction symptoms, however, had abnormal SSR

Conclusions. Autonomic dysfunction in PD was found in 67,6% subjects. SSR tends to be abnormal when the severity of the PD is high, based on the Hoehn & Yahr scale, UPRDS score of bradikinesia, tremor, and rigidity, and the presence of postural hypotension. Subjects with symptomatic postural hypotension, constipation, hypersalivation, and dysphagia show abnormal SSR. Abnormal SSR was also found in all subjects who had two or more autonomic symptoms."

"Buku ini merupakan kamus saku terjemahan bahasa Perancis ke Belanda. "