Hasil Pencarian  ::  Simpan CSV :: Kembali

"Rhinos® SR adalah kapsul kombinasi tetap loratadin 5 mg dengan pseudoefedrin 60 mg lepas cepat dan pseudoefedrin 60 mg lepas lambat. Studi ini bertujuan untuk menilai efikasi Rhinos® SR pada nasal airway resistance (NAR) secara obyektif dengan rhinomanometer dan gejala-gejala nasal serta nonnasal pada pasien dengan rinitis alergik sepanjang tahun (RAST) di negara tropis. Ini adalah studi paralel berpembanding plasebo, acak, tersamar ganda, dilakukan pada 59 pasien RAST berobat jalan di klinik THT RS Umum Dr. Soetomo, Surabaya. Pasien laki-laki dan perempuan, menderita RAST sedang sampai berat minimal 2 tahun, berumur 12 tahun ke atas, dengan total skor gejala nasal (TSGN) > 6 dan skor kongesti nasal (SKN) > 2, mendapat Rhinos® SR atau plasebo 2 kali sehari selama 7 hari. Parameter efikasi yang utama adalah berkurangnya nilai-nilai NAR (yang diukur dengan rhinomanometer pada hari pertama) dari Rhinos® SR dibandingkan dengan plasebo. Nilai-nilai NAR dihitung sebagai luas area di bawah kurva (area under the curve = AUC) dari NAR terhadap waktu. Parameter efikasi sekunder adalah berkurangnya gejala-gejala klinik (nasal dan nonnasal) yang dinilai oleh pasien maupun oleh dokter peneliti setelah 1 minggu penggunaan Rhinos® SR atau plasebo. Dari 59 pasien yang memenuhi syarat, semuanya menyelesaikan studi 1 minggu ini. Untuk nilai-nilai NAR, setelah baseline disamakan menjadi 100%, AUC0-10 jam tidak berbeda bermakna antara Rhinos® SR dan plasebo. Akan tetapi waktu pseudoefedrin mencapai kadar puncak, yakni 2 jam untuk yang lepas cepat dan 6 jam untuk yang lepas lambat, maka AUC0-2 jam dan AUC0-6 jam Rhinos® SR lebih rendah secara bermakna dibandingkan dengan plasebo. TSGN berdasarkan penilaian penderita (jumlah skor 3 pagi terakhir) untuk Rhinos® SR menurun 33.0% dari skor awal (p < 0.001), untuk plasebo juga menurun 21.9% dari skor awal (p = 0.002), tetapi penurunan oleh Rhinos tidak berbeda bermakna dengan penurunan oleh plasebo. Penurunan TSGN berdasarkan penilaian dokter peneliti, serta penurunan skor kongesti nasal (SKN) dan total skor gejala (nasal dan nonnasal), dan bahkan skor masing-masing gejala, berdasarkan penilaian pasien maupun dokter peneliti, menunjukkan pola yang sama, yakni Rhinos® SR dan plasebo menurunkan gejala secara bermakna dari nilai awal, dan penurunan oleh Rhinos® SR lebih besar dibandingkan penurunan oleh plasebo tetapi tidak berbeda bermakna. Dalam studi ini tidak ditemukan efek samping. Dari penelitian ini disimpulkan bahwa pada pasien RAST sedang sampai berat di negara tropis, Rhinos® SR efektif dalam mengurangi kongesti nasal dengan pengukuran obyektf NAR. Rhinos® SR 2 x sehari selama 7 hari juga efektif dalam mengurangi gejala-gejala klinik RAST meskipun tidak mencapai kemaknaan statistik dibandingkan dengan plasebo, serta dapat ditoleransi dengan baik.

---

AbstractRhinos® SR is a fixed combination of 5 mg loratadine and 60 mg pseudoephedrine immediate release and 60 mg pseudoephedrine sustained release. The present study was aimed to assess the efficacy of Rhinos® SR on nasal airway resistance (NAR) objectively using rhinomanometer and on nasal symptoms in patients with perennial allergic rhinitis (PAR) in a tropical country. This was a randomized, double-blind, parallel group study in 59 PAR patients who visited the ENT clinic at Dr. Soetomo General Hospital, Surabaya. Outpatients of both gender, having moderate to severe PAR for a minimal of 2 years, aged 12 years or older, with a total nasal symptom score (TNSS) > 6 and a nasal congestion score > 2, received Rhinos® SR or placebo twice daily for 7 days. The primary efficacy parameter was the decrease in the NAR values (measured by rhinomanometer on Day 1) of Rhinos® SR from those of placebo. The NAR values were calculated as the area under the curve (AUC) of NAR versus time. The secondary efficacy parameters were the percentage reduction of the clinical symptoms (nasal and nonnasal) evaluated by both the patient and the physician after 1 week use of Rhinos® SR or placebo. From 59 eligible patients, all completed this 1-week trial. For NAR values, after the baseline were considered as 100%, the AUC0-10 h were not significantly different between Rhinos® SR and placebo. However, as the pseudoephedrine reached its peak concentration, i.e. 2 hrs for the immediate release and 6 hrs for the sustained release, then AUC0-2 h and AUC0-6 h of Rhinos® SR were significantly lower compared to those of placebo. Total nasal symptom score (TNSS) evaluated by the patient (sum of the last 3 mornings) for Rhinos® SR decreased 33.0% from baseline (p < 0.001), for placebo decreased 21.9% from baseline (p = 0.002), but the decrease by Rhinos® SR was not significantly different from the decrease by placebo. TNSS evaluated by the physician, nasal congestion score (NCS) and total symptom score (TSS, total nasal and nonnasal), and even the individual symptom scores, evaluated by the patient and the physician, showed similar pattern, i.e. both Rhinos® SR and placebo decreased the symptoms significantly from baseline, and the decreases by Rhinos® SR were larger than the decreases by placebo, but the decreases by Rhinos® SR and placebo were not statistically different. No adverse event was found in this study. From the present study it was concluded that in patients with moderate to severe PAR in a tropical country, Rhinos® SR was effective in relieving nasal congestion by objective measurements of NAR. Rhinos® SR twice a day for 7 days was also effective in reducing the clinical symptoms of PAR although the reductions did not reach statistical significance compared to those by placebo, and was well tolerated. "

"AbstrakPURPOSE:House dust mites (HDM) are major allergens that cause allergic rhinitis (AR). Allergen-specific subcutaneous immunotherapy (SCIT) has been shown to be clinically beneficial in many clinical trials. Such trials, however, are not reflective of all patient populations. The aim of this study was to describe the efficacy and safety of SCIT in routine clinical practice in Korean adults with AR sensitized to HDM.METHODS:We reviewed medical records of 304 patients with AR treated at an allergy clinic of a tertiary hospital using SCIT with aluminum hydroxide-adsorbed allergen extract targeting HDM alone or with pollens for at least 1 year from 2000 to 2012. Patients with asthma were excluded. Rates of remission, defined as no further requirement of maintenance medication, over time were determined by means of life tables and extension of survival analysis. Specific immunoglobulin E (IgE) levels to HDM were categorized into 6 classes.RESULTS:The mean time until achieving remission was 4.9±0.1 years, and the cumulative incidence of remission from AR was 76.6%. Severe AR (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.23-0.69; P=0.001), specific IgE levels to HDM ≥17.5 kU/L (OR, 1.85; 95% CI, 1.01-3.37; P=0.045), and duration of immunotherapy ≥3 years (OR, 7.37; 95% CI, 3.50-15.51; P<0.001) were identified as significant predictors of clinical remission during SCIT for patients with AR sensitized to HDM. Overall, 73 patients (24.0%) experienced adverse reactions to SCIT, and only 1 case of anaphylaxis (0.3%) developed.CONCLUSIONS:SCIT with HDM was found to be effective and safe for patients with AR. Specific IgE levels to HDM and a duration of SCIT ≥3 years may be predictors of clinical responses to SCIT in AR patients."

"Hubungan antara dislipidemia dengan terjadinya aterosklerosis dan penyakit jantung koroner sudah terbukti dalam banyak studi. Penelitian ini bertujuan mengevaluasi perubahan kadar lipid setelah pemberian fenofibrat produksi lokal (trichol) atau lipanthyl supra pada pasien dislipidemia di RSJPD Harapan Kita secara teracak (randomized) dan tersamar (double-blinded). Sebanyak 68 pasien dengan kadar HDL40 mg/dL; trigliserida 200?600 mg/dl; dan/atau LDL130 mg/dL diikutsertakan sebagai subyek penelitian. Subyek dirandomisasi untuk mendapatkan lipanthyl 160 mg satu kali/hari atau trichol 300 mg satu kali/hari. 61 pasien mengikuti uji klinik ini sampai selesai. Kadar lipid sebelum terapi (data dasar) dan 4, 8, 12 minggu setelah terapi diperiksa dan dianalisis. Dibandingkan dengan data dasar, terapi selama 12 minggu mampu meningkatkan kadar HDL sebesar 18.8% dan 14.3% (P<0.001), menurunkan kadar trigliserida sebesar 38.2% dan 37.2% (P<0.001), meningkatkan kolesterol total sebesar 3.1% (P=0.114) dan 8.4% (P<0.005), menurunkan rasio kolesterol total/HDL sebesar 17.6% dan 18.4% (P<0.001), meningkatkan ApoA-1 sebesar 15.0% dan 9.7% dan menurunkan kadar fibrinogen sebesar 13.8% dan 6.4% untuk lipanthyl dan trichol. Tidak ada perbedaan yang bermakna pada kadar LDL untuk kedua grup. Hal yang menarik adalah trichol mampu menurunkan tingkat kolesterol total (P<0.05) lebih baik dibanding lipanthyl. Efek samping yang diakibatkan oleh kedua perlakuan tidak berbeda bermakna. Terapi dengan trichol dan lipanthyl mampu memperbaiki kadar lipid pasien dislipidemia. Kedua obat meningkatkan kadar HDL dan menurunkan kadar trigliserida secara bermakna. Selain itu, penurunan kadar kolesterol total secara bermakna dapat dicapai setelah 12 minggu terapi dengan trichol tetapi tidak dengan lipanthyl. (Med J Indones 2007; 16:159-67)

---

The relation of dyslipidemia with the development and progression of atherosclerosis and coronary artery diseases has been demonstrated. This study compared the lipid modifying effects of locally-manufactured fenofibrate (trichol) versus lipanthyl supra in a randomized double-blind controlled study. A total of sixty-eight patients with levels of HDL cholesterol ≤40 mg/dL; triglyceride of 200?600 mg/dL; or LDL of ≥130 mg/dL were recruited to this study and were randomized to either receive trichol 300 mg once daily or lipanthyl 160 mg once daily. Sixty one patients completed the study. Lipid levels before and 4, 8, and 12 weeks after the treatments were measured and analyzed. Compared to baseline values, 12-weeks treatment with either lipanthyl or trichol significantly increased plasma HDL by 18.8% and 14.3% respectively (P<0.001), decreased triglyceride by 38.2% and 37.2% (P<0.001), but with no significant change in LDL levels. Furthermore, we observed a decreased in total cholesterol levels compare to baseline by 8.4% (P<0.05) and 3.1% (P=0.114), in total cholesterol/ HDL ratio by 17.6% and 18.4% (P<0.001), in fibrinogen level by 13.8% and 6.4% and an increase in ApoA-1 by 15.0% and 9.7% for lipanthyl and trichol, respectively. Interestingly, the decrease in total cholesterol level is significantly higher in trichol than lipanthyl groups (P<0.05).The adverse events of both treatments were comparable. The lipid-modifying effects of 300 mg daily dose of trichol is comparable to that of 160 mg daily dose of lipanthyl. Both drugs efficiently increased the plasma HDL levels and decreased plasma triglycerides concentration. Besides, a significant reduction of total cholesterol was achieved after 12 weeks treatment with trichol, but not lipanthyl. (Med J Indones 2007; 16:159-67)"

"Latar belakang: Gangguan tidur merupakan keluhan yang sering terjadi pada rinitis kronis, dengan penyebab tersering adalah hidung tersumbat. Hidung tersumbat juga merupakan faktor risiko terjadinya sleep disordered breathing (SDB). SDB memiliki spektrum penyakit yang luas, salah satunya adalah obstructive sleep apnea (OSA). Walaupun berbagai literatur telah membuktikan adanya gangguan tidur pada pasien rinitis alergi, penelitian mengenai gangguan tidur pada pasien rinitis nonalergi masih terbatas. Tujuan penelitian: Membandingkan derajat gangguan tidur antara kelompok rinitis alergi dan rinitis nonalergi di RSUPN Cipto Mangunkusumo. Metode: Penelitian ini menggunakan desain potong lintang pada 11 subjek rinitis alergi dan 11 subjek rinitis nonalergi yang berusia 18-60 tahun di Poliklinik THT RSUPN Ciptomangunkusumo. Derajat obstruksi nasal dinilai menggunakan kuesioner NOSE. Derajat gangguan tidur dinilai secara subjektif dengan kuesioner ESS, PSQI, dan ISI serta secara objektif dengan polisomnografi. Hasil: Tidak didapatkan perbedaan pada hasil skor NOSE, ESS, RSI, PSQI, ISI, maupun parameter polisomnografi antara kelompok rinitis alergi dengan kelompok rinitis nonalergi (p > 0,05). Didapatkan hubungan bermakna antara RDI NREM, RERA, saturasi minimum oksigen dan saturasi baseline oksigen dengan klasifikasi OSA pada kelompok rinitis kronis (p< 0,05). Kesimpulan: Tidak didapatkan perbedaan derajat gangguan tidur antara rinitis alergi dan rinitis nonalergi.

---

Background: Sleep disturbance is common in chronic rhinitis, primarily caused by nasal congestion. Nasal congestion is also a risk factor for sleep disordered breathing (SDB). SDB refers to a spectrum of breathing abnormalities, one of which includes obstructive sleep apnea (OSA). Although many studies have linked sleep disturbance with allergic rhinitis, data regarding its association with nonallergic rhinitis seem to be limited. Aim : To compare the severity of sleep disturbance between allergic and nonallergic rhinitis. Methods: This cross-sectional study consisted of 11 subjects with allergic rhinitis and 11 subjects with nonallergic rhinitis at ORL-HNS outpatient clinic, Cipto Mangunkusumo Hospital. NOSE questionnaire was used to assess the degree of nasal obstruction. The severity of sleep disturbance was subjectively assessed using ESS, PSQI, and ISI questionnaires and objectively assessed using polysomnography. Results: No significant differences in NOSE, ESS, RSI, PSQI, and ISI scores were found between both groups (p > 0,05). There was a significant relationship between RDI NREM, RERA, minimum oxygen saturation and baseline oxygen saturation with OSA classification in the chronic rhinitis group (p <0.05). Conclusion: The type of rhinitis (allergic or nonallergic) did not influence the severity of sleep disturbance."

"Background: Vitamin D role in immune system have been investigated due to the presence of VDR on immune cells. Based on this information deficient level of vitamin D could affect the progression of allergic rhinitis. Unfortunately the data regarding vitamin D status in the normal population and allergic rhinitis patient were very limited in Indonesia. This research was done to provide illustration regarding the status of vitamin D in healthy and allergic rhinitis patients in Jakarta and also to investigate the factor that might affect the level of vitamin D in allergie rhinitis. Methods: This research was an observational cross sectional research. There were 22 subjects used during this research all diagnosed with moderate-severe allergic rhinitis. The study used the Electrochemiluminescence Immunoassay (ECLIA) technique. The data then were analyzed with IBM® SPSS statistic version 22 Results: The difference between the mean vitamin D of patients suffering from allergic rhinitis with healthy controls (12.7±10.3 ng/mL to 15.1±8.1 ng/mL). There was no significant diference in mean vitamin D between the gender groups (Independent Sample T-test p= 0.62). There were no statistical difference between the vitamin D level in patient with different eosinophil count and IL-5 level (IL-5 group: one-way ANOVA: p= 0.897; eosinophil group: One Way ANOVA: p = 0.752). Conclusion: The mean level of vitamin D in allergic rhinitis patients compared to healthy controls showed no significant difference. Comparison studies about level of vitamin D between groups with different gender, IL-5 and eosinophil count showed no significant difference"

"ABSTRAKTesis ini membahas gambaran hasil terapi rinitis alergi persisten sedang-berat pada 2 kelompok terapi di RSCM, dimana kelompok pertama diberikan terapi reduksi konka radiofrekuensi disertai steroid topikal hidung, sedangkan kelompok kedua diberikan terapi steroid topikal hidung saja. Penelitian ini adalah penelitian pendahuluan dengan metode penelitian uji klinis. Penilaian skala analog visual (SAV) untuk 4 gejala utama rinitis alergi (bersin-bersin, gatal hidung, ingus encer, dan sumbatan hidung), pemeriksaan nasoendoskopi untuk menilai ukuran konka inferior, dan pemeriksaan aliran udara hidung dengan Peak Nasal Inspiratory Flow (PNIF) dilakukan pada sebelum terapi dan minggu ke-6 pasca terapi. Pada penelitian ini rerata usia kelompok steroid topikal hidung adalah 28,3 tahun (SD 10,3 tahun), sedangkan pada kelompok reduksi konka adalah 27,6 tahun (SD 8,1 tahun). Sebanyak 67% subyek adalah perempuan. Keluhan rinitis alergi paling berat adalah sumbatan hidung. Sebanyak 80% subyek penelitian mengalami hipertrofi konka inferior, yaitu 50% hipertrofi derajat 3 dan 30% hipertrofi derajat 4. Ditemukan perbedaan bermakna ukuran konka inferior sebelum terapi dengan minggu ke-6 pasca terapi, baik pada kelompok reduksi konka maupun kelompok steroid dan ditemukan pula perbedaan bermakna ukuran konka inferior pada minggu ke-6 pasca terapi antara kedua kelompok terapi. Untuk nilai SAV gatal hidung, ditemukan perbedaan bermakna sebelum terapi dengan minggu ke-6 pasca terapi, baik pada kelompok reduksi konka maupun kelompok steroid topikal saja, dan ditemukan pula perbedaan bermakna nilai SAV gatal hidung pada minggu ke-6 pasca terapi antara kedua kelompok terapi. Perbedaan bermakna sebelum terapi dengan minggu ke-6 pasca terapi ditemukan pada nilai SAV gejala rinitis alergi yang lain (bersin-bersin, ingus encer, dan sumbatan hidung) dan nilai PNIF, baik pada kelompok reduksi konka maupun kelompok steroid topikal saja. Tidak ditemukan perbedaan bermakna nilai SAV gejala rinitis alergi yang lain dan nilai PNIF, jika dibandingkan antara kedua kelompok terapi pada minggu ke-6 pasca terapi.

---

ABSTRACTThis paper reported result of treatment in moderate-severe allergic rhinitis at Cipto Mangunkusumo Hospital. In this research, there were 2 groups of treatment. First group was treated with radiofrequency turbinoplasty and nasal steroid after turbinoplasty performed, second group was treated only with nasal steroid. This research is a pilot clinical study. Analogue Visual Scale for 4 major symptoms of allergic rhinitis (sneezing, nose itching, rhinorrhea, nose obstruction), nasoendoscopy to evaluate size of inferior turbinate, peak nasal inspiratory flow to evaluate nasal air flow were performed before treatment and 6 weeks after treatment. In this research, mean age of patients in steroid alone group was 28,3 years old with standard deviation 10,3 years, and in radiofrequency group mean age was 27,6 years old with standard deviation 8,1 years. Sixty seven percent patients was woman. The most bothering symptom found was nasal obstruction. Eighty percent patients had inferior turbinate hypertrophy, 50% patient with grade 3 and 30% patient with grade 4. Statistical significance in inferior turbinate degree was found if comparison performed before treatment with 6 weeks after treatment, in both treatment group,and also found statistical difference if compared between 2 treatment group at 6 weeks after treatment. Statistical difference was found only in VAS for nasal itching symptom if compared between 2 treatment group at 6 weeks after treatment. There were no statistical difference for another major symptom with VAS if compared between 2 group at 6 weeks after treatment. If comparison was performed before treatment with 6 weeks after treatment for VAS in all allergic rhinitis major symptoms and peak nasal inspiratory flow, there were statistical significance found, in radiofrequency group and nasal steroid group, but if comparison was performed between 2 treatment groups at 6 weeks after treatment, there were no statistical difference found."

"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.

---

Latar belakang: pemeriksaan IgE spesifik serum baru diperkenalkan di Indonesia, tetapi belum ada data uji diagnostik mengenai kinerjanya dalam mendeteksi alergen hirupan yang sering pada pasien alergi pernapasan. Tujuan penelitian ini adalah untuk mendapatkan akurasi diagnostik pemeriksaan IgE spesifik serum dalam mendiagnosis sensitisasi alergen hirupan tertentu pada pasien alergi pernapasan.

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, pada bulan November sampai Desember 2016. Pengukuran sensitisasi IgE spesifik dilakukan dengan metode imunoblot (Euroline®, Euroimmun AG, Germany). Alergen yang diuji adalah tungau debu rumah [Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t)], dan kecoa [Blatella germanica (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: sebanyak 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 terhadap alergen inhalan pada pasien alergi pernapasan memperlihatkan sensitivitas rendah sampai sedang, tetapi spesifisitas dan PPV yang tinggi. Pemeriksaan dapat digunakan mendiagnosis sensitisasi alergen pada populasi dengan prevalensi TDR dan kecoa yang tinggi."

"Background and objective: Antimicrobial resistance is a global problem and the prevalence is high in many Asian countries.Methods: A prospective observational study of the prevalence of bacterial pathogens and their antimicro-bial susceptibilities in patients with acute exacerba-tions of chronic bronchitis (AECB) was conducted in Indonesia, Philippines, Korea, Thailand, Malaysia, Taiwan and Hong Kong from August 2006 to April 2008. The diagnosis of AECB was based on increased cough and worsening of two of following: dyspnoea, increased sputum volume or purulence. Patients who had taken antibiotics within 72 h of presentation were excluded. All bacterial strains were submitted to a central labo-ratory for re-identification and antimicrobial suscepti-bility testing to 16 antimicrobial agents according to Clinical and Laboratory Standards Institute.Results: Four hundred and seven isolates were iden-tified among 447 patients of AECB. The most frequent organisms isolated were Klebsiella pneumoniae and associated species (n = 91 + 17), Haemophilus influen-zae (n = 71), Pseudomonas aeruginosa (n = 63), Streptococcus pneumoniae (n = 32), Acinetobacter baumannii (n = 22) and Moraxella catarrhalis (n = 21). According to Clinical and Laboratory Standards Insti-tute susceptibility breakpoints, 85.7% and >90% of these pathogens were susceptible to levofloxacin and cefepime respectively. Other options with overall lower susceptibilities include imipenem, ceftazidime, ceftri-axone and amoxicillin/clavulanate.Conclusions: Gram-negative bacteria including Kleb-siella spp., P. aeruginosa and Acinetobacter spp. consti-tute a large proportion of pathogens identified in patients with AECB in some Asian countries. Surveil-lance on the local prevalence and antibiotic resistance of these organisms is important in guiding appropriate choice of antimicrobials in the management of AECB."

"ABSTRAKLatar Belakang: Obstructive Sleep Apnea (OSA) merupakan kelainan tidur yang terjadi secara periodik dan disertai henti napas. OSA pada anak dapat menyebabkan gangguan perilaku, prestasi sekolah yang buruk, komplikasi kardiovaskular atau disfungsi metabolik endokrin. Tatalaksana kasus OSA anak dapat berupa pembedahan ataupun medikamentosa. Perbaikan kualitas hidup OSA pada anak secara subjektif dapat diukur dengan kuesioner OSA 18 dan secara objektif dengan pemeriksaan polisomnografi.Tujuan: Mengetahui efektivitas terapi tonsiloadenoidektomi pada OSA anak dibandingkan dengan terapi Mometasone Furoate. Metode: Penelitian ini merupakan uji klinis dengan alokasi acak dua kelompok melibatkan 20 subjek, dengan 10 subjek terapi tonsiloadenoidektomi dan 10 subjek menggunakan Mometasone furoate. Analisis dilakukan berdasarkan perubahan skor OSA 18 dan polisomnografi sebelum dan sesudah terapi 6 minggu.Hasil: karateristik jenis kelamin lebih banyak perempuan, dengan rentang usia terbanyak pada kelompok usia 5 hingga 7 tahun, mayoritas tingkat pendidikan sekolah dasar, dengan status gizi subjek berat badan normal (P5%-P85%), rerata lingkar leher adalah 25,28 cm (SB 2,28). Karakteristik pemeriksaan fisik terbanyak adalah hipertrofi tonsil (T3), posisi palatum derajat 2 dan hipertrofi adenoid derajat III berdasarkan pemeriksaan nasoendoskopi serat lentur. Faktor predisposisi alergi pada subjek penelitian didapatkan hasil uji tusuk kulit positif. Pada penelitian ini didapatkan perbedaan perubahan skor OSA 18, Skala Analog Visual (SAV) dan Apnea Hypopnea Index (AHI) sebelum terapi dan 6 minggu setelah terapi, baik pada kelompok intervensi bedah maupun kelompok Mometasone furoate. Tidak ditemukan perbedaan bermakna nilai saturasi oksigen terendah (Sat O2) sebelum terapi dan 6 minggu setelah terapi pada kedua kelompok.Kesimpulan: Pada OSA anak, kuesioner OSA 18, SAV dan parameter AHI dari polisomnografi dapat digunakan sebagai penilaian efektifitas terapi OSA. Tonsiloadenodektomi dapat menjadi pilihan tatalaksana pembedahan, disamping pemberian Mometasone furoate pada pasien OSA anak yang disertai alergi.

---

ABSTRACT

Background: Obstructive Sleep Apnea is a sleep disorder that occurs periodically and accompanied by respiratory rest. OSA in children can cause behavioral disorders, poor academic perfomance, cardiovascullar, endocrine metabolic complications. Management of OSA in children were operatif and non operatif. Subjectively improvement quality of life can be measured with a questionnaire OSA 18 and objectively by polysomnography examination.

Objectives: To determine the effectiveness of the adenotonsilectomy in children with OSA compared with Mometasone furoate therapy. Methods: This study was a clinical trial with random allocation involves two groups of 20 subjects, i.e. 10 subject in adenotonsilectomy group and 10 subjects with Mometasone furoate. The analysis was perfomed based on the changes of OSA 18 scoring and polysomnography before and after 6 weeks therapy.

Result: The subject characteristic in this research was more girls, with average age of 5 to 7 years old, education level at primary school, normal body weight, mean neck circumference was 25.28 (2.28). Physical examination characteristic were tonsilar hypertrophy (T3), 2nd stage palatum position, 3rd stage adenoid hypertrophy based on the flexible nasoendoscopy. Allergy predisposing factor in this research showed positive result from skin prick test. There was statistical significant in OSA 18, Visual Analog Scale (VAS), and AHI at before and 6 weeks after treatment, either in surgical group or intranasal corticosteroid group. But there was no significant difference of the lowest oxygen saturation at before treatment and 6 week after treatment in both groups.

Conclusions: In children, OSA 18 Questionare, VAS, and AHI from polysomnography parameters can be used as evaluation effectiveness of treatment of OSA. Adenotonsilectomy can be treatment of choice as a surgical option along with intranasal corticosteroid as a treatment consideration for patient OSA with allergic. Keywords: Children OSA, OSA 18 Questionare, AHI, adenotonsilectomy, intranasal corticosteroid."