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"Background systemic sclerosis (SSc) is a chronic autoimmune disease which presents immunological, endothelilal dysfunction, skin and organs fibrosis. The inflammatory process is an important pathopshsiology of systemic sclerosis. Disease activity assessment using clinical parameters of c creative protein (CRP), erytrocyte sedimentation rate (ESR) and soluble CD40 lingand."

"Background: Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods: This study was conducted using descriptive quantitative design in September until October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015 until 30 June 2016 using total sampling method. The collected data were expected to comprise patients clinical manifestation and laboratory finding. Results: Most of patients had cutaneous 57 100.0 pecent and musculoskeletal 40 70.2 pecent involvement. Some of the disease manifestations were Raynauds phenomenon 38 66.7 pecent , fingertip lesion 33 57.9 pecent, stiffness in skin 34 59.6 pecent, and arthalgia 29 50.9 pecent. Gastrointestinal involvements were present in 29 50.9 pecent patients. Renal involvement were determined from urinalysis result showed proteinuria 10 17.5 pecent and hematuria 8 14.0 pecent, found in 24 42.1 pecent patients, while pulmonary and cardiac involvements were found in 30 52.6 pecent patients, acknowledged from clinical symptoms such as dyspnea 12 21.1 pecent. Identification of autoantibodies was found in 12 21.1 pecent patients, with 10 17.5 pecent patients had reactive ANA and 3 3.5 pecent had positive anti Scl70. Conclusion: Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings."

"Background: Interstitial Lung Disease is one of the major cause of morbidity and mortality in Systemic Sclerosis. The gold standard to diagnose ILD is using High Resolution Computed Tomography scan. HRCT scan need a lot of cost and not always available, so another diagnosing test is needed as an alternative modality to diagnose ILD. ILD is a restrictive lung disease caused by lung fibrosis which is proved by the decrease of Forced Vital Capacity in spirometry, and followed by the increase of soluble CD40L level in plasma. This sCD40L may become a potential biomarker to evaluate lung fibrosis in SSc patients. The aim of this study is to analyze the correlation of sCD40L levels with FVC score in SSc patients with restrictive lung disease. Method: This cross sectional study was enrolled by the SSc patient who has restrictive lung disease based on spirometry test, at Rheumatology outpatient clinic dr. Hasan Sadikin Hospital from May 2015 to May 2016. All subject took underwent history, physical examination, spirometry and blood test for sCD40L. Data were analyzed using Pearson correlation.Result There were 38 subjects involved in this study, dominated bywoman 92.1 pecent with mean age 41years. Subjects consist of 22 57,9 pecent with limited SSc, 16 42,1 pecent with diffuse SSc patients and 33 subjects treated with DMARD. Mean sCD40L serum in this study was 6.690,3 pg/mL, with no statistical difference between limited and diffuse type p 0.154. Mean FVC score in this study was 58.2. There was no significant correlation between sCD40L serum with FVC r 0.058, p 0.366. There was weak correlation on DMARD naïve subject between sCD40L serum and FVC r 0.058, p 0.366 but statistically insignificant. There was no significant correlation between sCD40L serum with mRSS r 0,066 p 0,346. Conclusion: This study founds no correlation between sCD40L with FVC in SSc at dr. Hasan Sadikin Hospital."

"scleroderma is an autoimmune disease characterized by organ fibrosis, resistant to standard treatment. It is suspected the addition of Physalis angulata Linn. (Ciplukan) extract as adjuvant therapy can improve the scleroderma skin fibrosis. The aim at this study is to evaluate the effect of ciplukan extract as adjuvant on scleroderma skin fibrosis in standard therapy, based on modified Rodnan skin scale (MRSS), inflammatory biomarkers, immunology and serum fibrosis. Methods: double-blind, randomized clinical trial was performed in scleroderma patients with stable disease at Cipto Mangunkusumo hospital and Hasan Sadikin hospital during November 2015−March 2017 who met the selection criteria and continued to receive standard therapy. The subjects were randomly allocated into two groups: the study group received the ciplukan extract 3 x 250 mg / day for 12 weeks and the placebo group. Examination of MRSS, ESR, P1NP, BAFF and sCD40L was performed every 4 weeks until the end of the study. Results: fifty-nine subjects completed the study. They consisted of 29 subjects of the treatment group and 30 of the placebo group, with an average age of 41 (SD 9) years, the proportion of women: male = 9 : 1. There was a significant improvement of skin fibrosis in the study group with a highly significant decrease in MRSS (35.9% VS 6.3%, p <0.001) and a relative decrease in P1NP levels (17.8% VS 0.7%, p = 0.002). No decrease in ESR, BAFF and sCD40L levels in both groups. There was a weak but significant positive correlation between MRSS with P1NP levels (r = 0.236, p = 0.036). Conclusion: Ciplukan extract with dose 3 x 250 mg for 12 weeks as adjuvant on scleroderma standard therapy alleviates skin fibrosis significantly based on MRSS and P1NP levels."