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"Non-arteritic anterior ischemic optic neuropathy (NAION) adalah penyakit multifaktorial yang mekanismenya belum diketahui secara pasti, namun hiperkoagulasi diduga merupakan faktor yang berperan pada NAION. Karena merupakan penyakit mikrovaskular, maka aktivasi koagulasi pada fase awal dapat menyebabkan koagulasi pada NAION. Penelitian ini bertujuan untuk mengetahui peran hiperkoagulasi pada kejadian NAION dalam upaya memberikan tata laksana yang lebih baik pada pasien NAION. Penelitian dilakukan pada bulan Oktober 2020 hingga April 2022 di Poliklinik Mata Divisi Neuro-oftalmologi FKUI-RSCM Kirana. Subjek adalah pasien NAION yang dibagi menjadi kelompok hiperkoagulasi dan non-hiperkoagulasi. Penelitian potong lintang dilakukan untuk menilai penanda koagulasi dini yaitu E-selectin, P-selectin, microparticle tissue factor (MPTF), prothrombin fragment 1+2 (PF1+2), dan hasil pemeriksaan penunjang berupa optical coherence tomography (OCT), OCT angiography (OCTA), dan Humphrey visual field (HVF). Uji klinis eksperimental dilakukan untuk menilai efektivitas terapi hiperkoagulasi dalam waktu 1 bulan. Terdapat 64,3% subjek NAION dengan hiperkoagulasi dan terjadi aktivasi penanda koagulasi dini pada kedua kelompok. Kesesuaian lokasi OCTA dengan ganglion cell inner plexiform layer (GCIPL) ditemukan pada 33% subjek, retinal nerve fiber layer (RNFL) pada 6,7% subjek, dan HVF pada 40% subjek, namun tidak terdapat korelasi jumlah sektor atau kuadran yang terkena. Nilai GCIPL dan HVF tidak berkorelasi dengan OCTA, di kuadran yang terkena, RNFL berkorelasi dengan OCTA. Kelompok terapi hiperkoagulasi menunjukkan penurunan perfusi lebih sedikit. Tajam penglihatan membaik pada 57,2% subjek di kelompok NAION dengan hiperkoagulasi dan 42,9% di kelompok NAION nonhiperkoagulasi. Berdasarkan fungsi lapang pandang, kedua kelompok menunjukkan perbaikan pada sebagian besar subjek (71,4% pada kelompok NAION dengan hiperkoagulasi dan 85,8% pada kelompok NAION nonhiperkoagulasi). Disimpulkan hiperkoagulasi berperan pada mekanisme NAION, sehingga tata laksana terkait hiperkoagulasi penting pada pasien NAION dalam mencapai luaran klinis yang lebih baik.

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Non-arteritic anterior ischemic optic neuropathy (NAION) is a multifactorial disease with an uncertain mechanism. Hypercoagulability is believed to be one of the factors involved in NAION. Considering that NAION is a microvascular disease, this study assumes that coagulation activation in the early phase is sufficient to cause a coagulation state in NAION. The aim of this research is to evaluate the role of hypercoagulability in the occurrence of NAION in order to provide better management for NAION patients. The subjects were NAION patients divided into hypercoagulability and non-hypercoagulability groups. A cross-sectional study was conducted to assess early coagulation markers, namely E-selectin, P-selectin, microparticle tissue factor (MPTF), and prothrombin fragment 1+2 (PF1+2), as well as ancillary tests such as optical coherence tomography (OCT), OCT angiography (OCTA), and Humphrey visual field (HVF). An experimental clinical trial was conducted to evaluate the effectiveness of hypercoagulation therapy within one month. It was found that 64.3% of NAION subjects had hypercoagulability. Early coagulation marker activation occurred in both groups. There was a concordance between OCTA and ganglion cell inner plexiform layer (GCIPL) location in 33% of subjects, retinal nerve fiber layer (RNFL) in 6.7% of subjects, and HVF in 40% of subjects. However, no correlation was found regarding the number of affected sectors or quadrants. GCIPL and HVF values did not correlate with OCTA, whereas in the affected quadrant, RNFL correlated with OCTA. The hypercoagulation therapy group showed less perfusion reduction. Visual acuity improved in 57.2% of subjects in the hypercoagulability NAION group and 42.9% in the non-hypercoagulability NAION group. Based on visual field function, both groups showed improvement in the majority of subjects (71.4% in the hypercoagulability NAION group and 85.8% in the non- hypercoagulability NAION group). It can be concluded that hypercoagulability plays a role in the mechanism of NAION, thus emphasizing the importance of managing hypercoagulability in NAION patients to achieve better clinical outcomes."

"Kejadian kardiovaskular adalah penyebab kematian utama pada artritis reumatoid AR . Periodontitis diketahui berperan dalam patogenesis disfungsi endotel pada AR. E-selectin merupakan penanda disfungsi endotel yang spesifik dihasilkan oleh endotel. Tujuan penelitian ini adalah mengetahui efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Penelitian ini merupakan uji klinis randomisasi pada penderita AR yang berobat di Poliklinik Reumatologi RSCM periode Maret-Mei 2017. Pengambilan sampel dilakukan secara konsekutif. Randomisasi dilakukan dengan randomisasi blok. Subyek dibagi menjadi kelompok terapi periodontal dan kontrol. Dilakukan Uji t untuk melihat perbedaan selisih E-selectin awal dan akhir studi antara kelompok intervensi dengan kontrol. Periodontitis ditemukan pada 31 subyek 64,5 . Tidak didapatkan perbedaan selisih E-selectin awal dan akhir studi yang signifikan secara statistik antara kelompok intervensi dengan kontrol p=0,303 . Sebagai kesimpulan tidak didapatkan pengaruh terapi periodontal terhadap kadar E-selectin pada pasien AR.

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Cardiovascular event is the main cause of mortality in rheumatoid arthritis RA . Periodontitis is known to be involved in the pathogenesis of endothelial dysfunction in RA. E selectin is a marker of endothelial dysfunction and was expressed specifically in endothelial cells. The objective of this study was to determine the effect of periodontal treatment on E selectin level in RA patients. This was a randomized clinical trial in RA patients visiting Rheumatology Clinic RSCM between March May 2017. Samples were collected using consecutive sampling method. Randomization was done using block randomization. Subjects was divided into nonsugical periodontal treatment group and control group. T test was used to measure the difference of delta E selectin before after study between periodontal treatment group and control. Periodontitis was found in 31 subjects 64,5 . There was no statistically significant difference of delta E selectin before after treatment between periodontal treatment group and control. As a conclusion, periodontal treatment has no effect on E selectin level in RA patients."

"ABSTRACTRheumatoid arthritis (RA) is an autoimmune disease which has recently been recognized to manifest as not only intraarticular events, presented either subclinically or clinically, were discovered more in AR patients. Atherogenic inflammatory mediator in AR including interleukin-6 (IL 6) was thought tobe one of nontraditional cardiovascular risk factor contributing to increase the endothelial dysfunction biomarker such as e selectin."

"Artritis reumatoid AR adalah penyakit autoimun yang saat ini telah diketahui menunjukkan manifestasi klinis bukan hanya intraartikular, tetapi juga ekstraartikular. Kejadian kardiovaskular baik subklinis maupun klinis ditemukan lebih tinggi pada penderita AR. Mediator inflamasi aterogenik pada AR seperti interleukin-6 IL-6 diduga menjadi salah satu faktor risiko nontradisional kardiovaskular yang berkontribusi meningkatkan penanda disfungsi endotel seperti E-Selectin. Penelitian ini bertujuan mengetahui peran mediator inflamasi dalam kejadian disfungsi endotel, khususnya korelasi IL-6 dan E-selectin, pada pasien artritis reumatoid tanpa faktor risiko kardiovaskular. Studi potong-lintang dilakukan pada 40 pasien AR di Poliklinik Reumatologi RSUPN Dr. Cipto Mangunkusumo, Indonesia, pada bulan September-November 2017. Pemeriksaan IL-6 dan E-Selectin dilakukan dengan teknik enzyme-linked immunosorbent assay ELISA. Analisis korelasi bivariat dilakukan untuk menemukan korelasi kedua penanda tersebut. Rerata usia subjek penelitian ini adalah 44,9 13,1 tahun dan median durasi sakit adalah 36 bulan. Korelasi kadar IL-6 dengan kadar E-Selectin memiliki kekuatan korelasi lemah tetapi tidak bermakna secara statistik r = 0.232, p=0,149. Tidak terdapat korelasi antara IL-6 dengan E-Selectin pada pasien AR tanpa faktor risiko tradisional kardiovaskular.

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Rheumatoid arthritis RA is an autoimmune disease which has recently been recognized to manifest as not only intraarticular but also extraarticular symptoms. Cardiovascular events, presented either subclinically or clinically, were discovered more in AR patients. Atherogenic inflammatory mediator in AR including interleukin-6 IL-6 was thought to be one of nontraditional cardiovascular risk factor contributing to increase the endothelial dysfunction biomarker such as E-Selectin. This study was purposed to determine the correlation between inflammatory mediator and endothelial dysfunction event, especially between IL-6 and E-Selectin, in RA patient without traditional cardiovascular risk factor. A cross-sectional study was performed to 40 RA patients of Rheumatology Clinic of Cipto Mangunkusumo National General Hospital, Indonesia from September to November 2017. Measurement of the level of IL-6 and E-Selectin were performed using enzyme-linked immunosorbent assay ELISA. Bivariate correlation analysis was performed to determine the correlation between those two biomarkers. The mean age of this study subjects was 44.9 13.1 years and median of disease duration was 36 months. This study showed weak correlation between IL-6 and E-Selectin level, but not statistically significant.232, p=0.149 . There is no correlation between IL-6 and sE-Selectin in rheumatoid arthritis patient without traditional risk factor cardiovascular."