Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang. Lean NAFLD lebih sering ditemukan di negara Asia dan prevalensinya di Indonesia masih belum diketahui. Tingginya prevalensi, asimptomatik dan baru bergejala setelah timbul komplikasi, dan tingginya mortalitas lean NAFLD menjadikan perlunya deteksi dini pada populasi dewasa dengan IMT <23 kg/m2. Skrining pada populasi umum tidak direkomendasikan karena meningkatkan biaya kesehatan.Tujuan. Membuat sistem skoring untuk penapisan lean NAFLD pada populasi dewasa di Jakarta.Metode. Studi ini menggunakan desain potong lintang dari laporan pemeriksaan kesehatan individu dewasa >18 tahun dengan IMT <23 kg/m2 yang melakukan pemeriksaan kesehatan di klinik. Parameter yang dianalisis antara lain usia, jenis kelamin, lingkar pinggang, kadar GDP, kolesterol total, HDL, LDL, trigliserida, AST, ALT, dan asam urat. Variabel dengan nilai p <0,25 dilanjutkan ke analisis multivariat untuk pembuatan sistem skoring.Hasil. Sebanyak 276 individu diikutsertakan pada penelitian ini dan didapatkan prevalensi lean NAFLD sebesar 9,8%. Lean NAFLD lebih banyak ditemukan pada laki-laki dan memiliki karakteristik usia lebih tua, IMT, lingkar pinggang, kadar GDP, ALT, dan trigliserida lebih tinggi dibanding lean tanpa NAFLD. Analisis bivariat mendapatkan jenis kelamin laki-laki, usia ≥45 tahun, kadar GDP ≥100 mg/dL, ALT ≥35 U/L, dan trigliserida ≥150 mg/dL berhubungan dengan lean NAFLD. Sistem skoring melibatkan 4 parameter yaitu laki-laki, kadar GDP ≥100 mg/dL, ALT ≥35 U/L, dan trigliserida ≥150 mg/dL dengan masing-masing bernilai 1 poin. Model skoring ini memiliki sensitivitas 44,4%, spesifisitas 84,3%, dan AUROC 0,74.Kesimpulan. Parameter jenis kelamin, kadar GDP, ALT, dan trigliserida dapat digunakan sebagai sistem skoring dengan performans menengah untuk penapisan lean NAFLD dewasa......Background. Lean NAFLD is commonly found in Asian countries and its prevalence in Indonesia is still unknown. The high prevalence, asymptomatic until complications occur, and the high mortality of lean NAFLD makes it necessary for early detection in adult with BMI <23 kg/m2. Screening in general population is not recommended due to the high cost burden.Aim. To develop a scoring system for screening lean NAFLD in adults in Jakarta Methods. A cross-sectional study design was conducted from medical examination reports from individual >18 years old and BMI <23 kg/m2 who performed medical check up at the clinic. Several parameters including age, gender, waist circumference (WC), fasting blood glucose (FBG), total cholesterol (TC), HDL, LDL, triglycerides (TG), AST, ALT, and uric acid (UA) were analyzed in this study. Variabels with p-value <0.25 were included in multivariate analysis for the development of scoring systems.Results. A total of 276 people were enrolled in this study. Prevalence of lean NAFLD is 9.8%. Lean NAFLD are more commonly found in men and have older age, higher BMI, WC, GDP, ALT, and TG levels than lean non-NAFLD. In bivariate analysis, male sex, age ≥ 45 years, FBG ≥100 mg/dL, ALT ≥35 U/L, and TG ≥150 mg/dL are associated with lean NAFLD. The scoring system involves four parameters including male, FBG ≥100 mg/dL, ALT ≥35 U/L, and TG ≥150 mg/dL, worth 1 point each. This model has sensitivity 44.4%, specificity 84.3%, and AUROC 0.74.Conclusion. Parameters including gender, FBG, ALT, and TG levels can be used as a scoring system with moderate performance for screening lean NAFLD in adults."

"

Latar Belakang: Non alcoholic fatty liver disease (NAFLD) merupakan kondisi perlemakan hati yang merupakan salah satu faktor risiko karsinoma hepatoselular (KSH). NAFLD melibatkan berbagai faktor dalam patogenesisnya, salah satunya mikrobiota saluran cerna. Disbiosis mikrobiota saluran cerna dianggap sebagai faktor utama dalam peristiwa disregulasi sistem imun dan inflamasi pada patogenesis NAFLD.

Tujuan: Studi ini bertujuan untuk melihat profil dan konfigurasi mikrobiota saluran cerna pasien dengan NAFLD dan pengaruhnya terhadap nilai kondisi fibrosis dan stratosis hati yang tercermin dalam nilai controlled attenuation parameter (CAP) dan transient elastography (TE).

Metode: Dilakukan studi potong lintang analitik terhadap 37 pasien dengan NAFLD yang memenuhi kriteria inklusi di Rumah Sakit Cipto Mangunkusumo pada Desember 2018 hingga Maret 2019. Dilakukan anamnesis, wawancara food recall, pemeriksaan fisik, pemeriksaan laboratorium, pemeriksaan CAP-TE, dan pengambilan sampel feses pada pasien subjek penelitian. Mikrobiota saluran cerna disekuensing dengan Next-Generation Sequencing (NGS) platform Miseq (Illumina).

Hasil: NAFLD lebih dominan pada wanita dan penderita penyakit sindrom metabolik. Firmicutes, Bacteroidetes, dan Proteobacteria berturut-turut merupakan filum dengan proporsi terbesar. Disbiosis mikrobiaota saluran cerna didapatkan pada separuh dari sampel subjek penelitian. Rasio Firmicutes/Bacteroidetes (RFB) pada setiap pasien berbeda-beda dan tidak berkorelasi secara signifikan terhadap variabel sindrom metabolik. Diversitas mikrobiota saluran cerna didapatkan menurun pada pasien NAFLD dengan trigliserida tinggi dan obesitas sentral.

Simpulan: Sejumlah mikrobiota saluran cerna pada tingkat taksonomi yang berbeda memiliki korelasi positif maupun negatif terhadap fibrosis dan steatosis.

---

Background: Non alcoholic fatty liver disease (NAFLD) is fatty liver condition that can lead to hepatocellular carcinoma (HCC). NAFLD is multifactorial component in its pathogenesis, one of which is gut microbiota. Dysbiosis of gut microbiota is considered as main factor in the dysregulation of immune system  and inflammatory condition in the pathogenesis of NAFLD.

Aim: This study aim to investigate the profile and configuration of gut microbiota in patient with NAFLD dan its correelation withfibrosis and steatosis condition as reflected in controlled attenuation parameter (CAP) dan transient elastography (TE) value.

Method: cross sectional study was done upon 37 NAFLD patients in Cipto Mangunkusumo National General Hospital from December 2018 to March 2019. All subjects undergone food recall examination, physical and laboratory examination, CAP-TE value measurement, and fecal sample examination. The gut microbiota was investigated through 16s RNA sequensing by Next-Generation Sequencing (NGS) platform Miseq (Illumina).

Result: NAFLD was predominant in female subjects and those with metabolic syndrome. Firmicutes, Bacteroidetes, dan Proteobacteria was the predominant phylum consecutively. Dysbiosis was appeared in half of the study subjects. The Ratio of Firmicutes/Bacteroidetes was different in each patients and has no significnat correlation with metabolic syndrome variables. The diversity of gut microbiota was decresed in NAFLD patients with high tryglicerides and central obesity.

Conclusion: Certain gut microbiota at different taxonomy level have positive and negative correlation with fibrosis and steeatosis.

"

"Multiple Liver AbscessLiver abscess is a public health problem in few countries in Asia, Africa, and South America. As time goes, there were only few cases of amebic liver abscess found in developed countries, on the contrary more pyogenic liver abscess are found in those countries. Liver abscess could be caused by bacteria, parasite, or fungus J. The common symptoms among the liver' abscess are fever; chill, fatigue, loss of appetite, weight loss, right upper' abdominal pain,? in a few cases have symptoms like coughing, hiccup, pain in low right chest, or' pain on the shoulder: We reported a male patient 38 years batak ethnic was admitted with major symptoms such as high lever follow by chill, right upper abdominal pain, nausea, vomiting, appetite loss, fatigue and sometimes coughing. Based on clinical, laboratory data, and abdominal USG found this patient suspected suffered from pyogenic liver abscess. Treatment of this pattern consist of antibiotic (cefotaxime 29x1 IV metronidazol 3x500mg orally and aspiration of the liver' abscess). Aspiration was done 2 times with the interval l week, extracted 260cc totally yellow greenish watery fluid with no smell. On the follow up abdominal USG was repeated on January 8, 2003 found enlarge of the liver; 3 small abscesses on the right lobe liver and so recovery process and then patient left the hospital in good condition after 3 weeks hospitalized."

"he fourth edition of this authoritative text covers every aspect of liver disease affecting infants, children, and adolescents. As in the previous editions, it offers an integrative approach to the science and clinical practice of pediatric hepatology and charts the substantial progress in understanding and treating these diseases. All of the chapters are written by international experts and address the unique pathophysiology, manifestations, and management of these disorders. This edition of the landmark text features extended coverage of viral hepatitis, metabolic liver disease, fatty liver disease, and liver transplantation, including a new chapter on post-transplant care and outcomes. All of the chapters have been updated to reflect changing epidemiology and recent advances in molecular medicine and genomics. With the continued evolution of pediatric hepatology as a discipline, this text remains an essential reference for all physicians involved in the care of children with liver disease."

"Latar belakang: Psoriasis adalah suatu penyakit inflamasi kulit yang kronik, ditandai oleh plak eritematosa dan skuama kasar berlapis. Psoriasis dihubungkan dengan berbagai penyakit penyerta. Penyakit perlemakan hati nonalkoholik (PPHNA) merupakan salah satu penyakit penyerta yang sering ditemukan dan dapat memengaruhi derajat keparahan psoriasis, begitu pula sebaliknya. Penelitian untuk mengetahui korelasi derajat keparahan psoriasis dan perlemakan hati nonalkoholik (PHNA) belum pernah dilakukan. Tujuan: Mengetahui korelasi derajat keparahan psoriasis dan derajat PHNA. Metode: Studi potong lintang ini dilakukan terhadap pasien psoriasis dewasa di Poliklinik Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit dr. Cipto Mangunkusumo pada bulan Desember 2017-Februari 2018. Dilakukan anamnesis dan pemeriksaan fisis untuk mendapatkan nilai derajat keparahan psoriasis (psoriasis area and severity index; PASI) dan dicatat pula nilai body surface area (BSA). Penelitian dilanjutkan dengan pemeriksaan derajat PHNA pada semua pasien dengan menggunakan controlled attenuation parameter (CAP). Hasil: Didapatkan total 36 subjek dengan rerata umur 49,08 tahun (+15,52 tahun). Proporsi psoriasis derajat ringan, sedang, dan berat berturut-turut adalah 50%, 27,8%, dan 22,2%. Median PASI 6,1 (2-38,4) dan median BSA 7,5 (2-93). Proporsi PPHNA berdasarkan CAP adalah 77,8%. Rerata skor CAP 250,03+45,64. Tidak terdapat korelasi yang bermakna secara statistik antara derajat keparahan psoriasis berdasarkan PASI dengan derajat PHNA berdasarkan CAP (r=0,258; p=0,128). Namun bila digunakan BSA pada penilaian derajat keparahan psoriasis, didapatkan hasil korelasi yang bermakna (r=0,382; p=0,021). Ditemukan bahwa indeks massa tubuh (IMT) dan lingkar perut berkorelasi positif secara bermakna dengan skor CAP (berturut-turut r=0,448, p=0,006 dan r=0,485, p=0,003). Kesimpulan: Tidak ditemukan korelasi yang bermakna secara statistik antara derajat keparahan psoriasis berdasarkan PASI dengan derajat PHNA. Namun ditemukan korelasi yang bermakna antara derajat keparahan psoriasis berdasarkan BSA dengan derajat PHNA. Luas lesi kulit psoriasis berpengaruh terhadap derajat PHNA. Selain itu terdapat beberapa faktor, misalnya IMT dan lingkar perut, yang dapat memengaruhi derajat keparahan PHNA pada pasien psoriasis.

---

Background: Psoriasis is a chronic inflammatory skin disease, characterized by erythematous plaques and thick scales. Psoriasis is associated with various comorbidities. Nonalcoholic fatty liver disease (NAFLD) is one of the most common comorbidities that can affect the severity of psoriasis, vice versa. Research regarding the correlation of the severity of psoriasis and nonalcoholic fatty liver (NAFL) has never been done. Objective: To measure the correlation of the severity of psoriasis and the degree of NAFL. Methods: A cross-sectional study of adult patients with psoriasis was conducted in Dermatovenereology outpatient clinic of Cipto Mangunkusumo Hospital from December 2017 through February 2018. Psoriasis severity (psoriasis area and severity index; PASI) and body surface area (BSA) were recorded and compared with NAFL severity by controlled attenuation parameter (CAP). Results: A total of 36 subjects were enrolled with an average age of 49.08 years (+15.52 years). The proportions of mild, moderate, and severe psoriasis were 50%, 27.8%, and 22.2%, respectively. Median PASI was 6.1 (2-38.4) and BSA was 7.5 (2-93). The proportion of NAFLD was 77.8%. The mean of CAP score was 250.03+45.64. There was no statistically significant correlation between the severity of psoriasis based on PASI and CAP score (r = 0.258; p = 0.128). However, based on BSA, we found significant correlation (r = 0.382; p = 0,021). The body mass index (BMI) and abdominal circumference were significantly correlated with CAP score (r = 0.448, p = 0.006 and r = 0.485, p = 0.003, respectively). Conclusion: There was no statistically significant correlation between the severity of psoriasis based on PASI and nonalcoholic fatty liver degree, but a statistically significant correlation was found when using BSA in measuring the severity of psoriasis. In psoriasis, the extent of skin lesions may be influential to the degree of nonalcoholic fatty liver. In addition there are several factors, such as BMI and abdominal circumference, which may affect the severity of nonalcoholic fatty liver in psoriasis patients."

"Indonesia is one of the most populous developing countries in the world. Similar with other developing countries, Indonesia has been suffered from the high incidence of gastroenterology diseases that mainly due to infection. In the recent years, Indonesia had also increased number of non-infectious gastroenterology diseases cases such as inflammatory bowel disease, gastroesophageal reflux disease, and colorectal cancer. Nevertheless, the developments of diagnostic and therapeutic modality along with the cooperation between sectors have undergone rapid progress as an effort in improving digestive health in Indonesia."