Papers by Kuntjoro Harimurti
Acta Medica Indonesiana, 2017
house dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular ... more house dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular diagnostic study of specific IgE to HDM allergens has not been done in Indonesia. In addition, the association of quantitative specific IgE measurement with asthma severity has not been investigatedd. This study aimed to investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides (D.) pteronyssinus, D. farinae and Blomia tropicalis sensitization in intermittent and persistent allergic asthma. this was a cross-sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger study within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma (GINA) 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test (Polyc...
Asian Pacific Journal of Cancer Prevention, 2013
Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thy... more Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis. This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis. Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with ...
Jurnal Penyakit Dalam Indonesia
Pendahuluan. Pasien sindrom koroner akut (SKA) seringkali mengalami gangguan fungsi ginjal yang b... more Pendahuluan. Pasien sindrom koroner akut (SKA) seringkali mengalami gangguan fungsi ginjal yang berhubungan dengan peningkatan risiko kematian SKA. Tatalaksana optimal dapat memperbaiki angka mortalitas, namun pasien dengan gangguan fungsi ginjal seringkali tidak mendapatkan tatalaksana optimal. Sampai saat ini belum ada studi yang meneliti hubungan antara gangguan fungsi ginjal dengan mortalitas selama perawatan di ICCU pada populasi di Indonesia yang berbeda dalam karakteristik klinis dengan populasi di luar negeri. Diperlukan penelitian mengenai hubungan antara gangguan fungsi ginjal dengan mortalitas selama perawatan di ICCU pada populasi Indonesia. Dengan demikian, diharapkan dapat dilakukan identifikasi dan stratifikasi pasien dengan risiko mortalitas tinggi sehingga dapat diberikan tatalaksana yang lebih optimal.Metode. Studi kasus kontrol dengan teknik sampling konsekutif dilakukan di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada bulan Januari-Mei 2008 dengan sampel...
Acta medica Indonesiana, 2020
BACKGROUND late-life surgery poses a greater risk for complications and a higher mortality rate. ... more BACKGROUND late-life surgery poses a greater risk for complications and a higher mortality rate. Frailty has been noted to predict adverse outcomes after surgery in elderly patients. We aimed to investigate the impact of frailty on 30-day post-elective surgery complications in elderly patients. METHODS this prospective cohort study was conducted based on data collected from patients undergoing elective surgery in Cipto Mangunkusumo Hospital, Indonesia. Frailty was assessed using the Frailty Index 40 items, and 30-day post-surgery complications were assessed using Clavien-Dindo classification. Multivariate logistic regression analysis was performed to determined adjusted relative risk (RR) of the development of 30-day post-surgery complications. RESULTS a total of 180 subjects were enrolled in the study, with average age of 67.1 (SD 6.06) years old. More than half of the subjects fell into pre-frail category (55.6%), followed by frail (26.7%) and fit (17.7%) respectively. About 21.1%...
Acta medica Indonesiana, 2012
Acta medica Indonesiana, 2008
Increased life expectancy have an effect on the rising percentage of elderly population in Indone... more Increased life expectancy have an effect on the rising percentage of elderly population in Indonesia and health problem associated with the elderly, particularly immobilization. Immobilization may cause various complications, especially when it has been overlooked without any appropriate and proper medical care in keeping with the procedures. High incidence of immobilization in elderly and the life-threatening complication call for an agreement on management of immobilization and its complication. Management of immobilization needs interdisciplinary team-work cooperation, the patients and their family. The management may be commenced through a complete geriatric review, formulating functional goals and constructing therapeutic plan. Various medical conditions and external factors that may act as risk factors of immobilization as well as drugs intake that may exaggerate the immobilization should be evaluated and optimally managed. Any complication due to immobilization and other conc...
Acta medica Indonesiana, 2021
BACKGROUND chronic kidney disease (CKD) increases the severity and risk of mortality in acute cor... more BACKGROUND chronic kidney disease (CKD) increases the severity and risk of mortality in acute coronary syndrome (ACS) patients. The role of β2-M as a filtration and inflammation marker and FGF23 as a CKD-MBD process marker might be significant in the pathophysiology in ACS with CKD patients. This study aims to determine the association of β2-M and FGF23 with major adverse cardiac event (MACE) in ACS patients with CKD. METHODS we used cross sectional and retrospective cohort analysis for MACE. We collected ACS patients with CKD consecutively from January until October 2018 at Dr. Cipto Mangunkusumo General Hospital. Data were analyzed using logistic regression and Cox's Proportional Hazard Regression. RESULTS a total of 117 patients were selected according to the study criteria. In bivariate analysis, β2-M, FGF23, and stage of CKD had significant association with MACE (p = 0.014, p = 0.026, p = 0.014, respectively). In multivariate analysis, β2-M - but not FGF 23- was significant...
Jurnal Penyakit Dalam Indonesia
Pendahuluan. Gejala klinis tuberkulosis (TB) pada HIV seringkali tidak khas sehingga diagnosis me... more Pendahuluan. Gejala klinis tuberkulosis (TB) pada HIV seringkali tidak khas sehingga diagnosis menjadi sulit. Hal ini mengakibatkan underdiagnosis atau overdiagnosis dengan konsekuensi meningkatnya morbiditas dan mortalitas. Hingga saat ini, gejala dan tanda yang berhubungan dengan diagnosis TB paru belum banyak diteliti. Penelitian ini dilakukan untuk mengetahui nilai diagnostik dari gabungan gejala (batuk, penurunan berat badan, demam, dan rontgen toraks) dalam diagnosis TB paru pada pasien HIV dan nilai tambah biakan MGIT 960 dalam meningkatkan kemampuan diagnosis TB paru pada pasien HIV. Metode. Penelitian potong lintang terhadap pasien HIV dengan kecurigaan TB yang datang ke Poli HIV atau pasien ruang rawat Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta dari Oktober 2011 hingga April 2012. Hubungan gejala klinis dan radiologis dengan diagnosis TB (biakan Lowenstein Jensen) dianalisis dengan regresi logistik. Kemudian ditentukan kontribusi masing masing determinan diagnosis terhadap diagnosis TB. Kemampuan biakan MGIT 960 dalam menegakkan diagnosis TB dinilai dengan membuat kurva ROC dan menghitung AUC. Analisis data dilakukan dengan menggunakan program SPSS versi 16.0. Hasil. Subjek penelitian umumnya laki-laki (63%) dengan median usia 32 (rentang 18-52) tahun, status gizi baik (43%), CD4 <50 μl sebanyak 48%. Risiko transmisi terbanyak adalah pengguna narkoba suntik (penasun) (51%). Dari analisis multivariat, demam dan penurunan berat badan mancapai kemaknaan secara statistik. Nilai area under curve (AUC) manifestasi klinis adalah 71,9%. Penambahan biakan BTA MGIT 960 akan meningkatkan AUC 24,9% menjadi 95,7%. Simpulan. Gabungan gejala demam dan penurunan berat badan mampu memprediksi diagnosis TB paru pada pasien HIV. Penambahan biakan BTA MGIT 960 bermanfaat meningkatkan kemampuan gabungan gejala klinis dalam diagnosis TB paru pada pasien HIV.
Acta medica Indonesiana, 2011
AIM to determine factors that independently predict health-related quality of life of Indonesian ... more AIM to determine factors that independently predict health-related quality of life of Indonesian community-dwelling elderly and to obtain scoring system to predict their quality of life. METHODS this is a cross-sectional study covering a sample representative of the Indonesian community-dwelling elderly. The study was conducted among 487 elderly in 43 cities in Indonesia between November-December 2010. A structured questionnaire was applied to obtain independent variable such as age, sex, number of diseases, present activities, functional status (ADL score), cognitive status (AMT score), nutritional status (NRI score), and depression status. Quality of life as dependent variable was assessed by Euroqol-5D (Eq-5D). We defined good quality of life as 3 or more dimensions of Eq5D having score of 1. Predictors of quality of life were identified using multiple logistic regression analysis. We constructed a scoring system based on coefficients in multivariable analysis. Calibration perfor...
Acta medica Indonesiana, 2021
BACKGROUND Diabetic kidney disease (DKD), as a common cause of end-stage renal disease (ESRD), is... more BACKGROUND Diabetic kidney disease (DKD), as a common cause of end-stage renal disease (ESRD), is a chronic complication of diabetes mellitus (DM). It has been established that vitamin D deficiency is one of DKD risk factors, which may be related to vitamin D receptor (VDR) polymorphisms. This study aimed to analyze the association between VDR polymorphisms and DKD in Indonesian population, also risk factors that influence it. METHODS a cross-sectional study was conducted in Type 2 DM patients who visited internal medicine outpatient clinic at Dr. Cipto Mangunkusumo Hospital, Jakarta, from November 2014 until March 2015. Data collection includes characteristics of subjects and laboratory examination, including BsmI polymorphisms in the vitamin D receptor gene. Patients with acute and severe disease were excluded from the study. Bivariate and multivariate analyses were done. RESULTS of 93 DM subjects, 42 (45.2%) subjects were without DKD and 51 (54.8%) subjects had DKD. Most of the...
Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical cha... more Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical challenge for various reasons. The clinical manifestation in the elderly is not frank and atypical manifestations, e.g. falls, decrease of functional status and food intake or urinary incontinence, may be present. These reasons may be associated with under or over diagnosis, which consequently contribute to the higher observed mortality rate in the elderly population with CAP. Study about factors related to diagnosis of CAP in the elderly was rarely performed. Methods. From January to October 2010, 158 elderly patients suspected of having pneumonia at RSCM were registered. Relationship between clinical, laboratory and radiologic factors which consist of classic manifestations (cough, productive cough, dyspnea, fever, rales, leucocytosis, infiltrates) and atypical manifestations (decrease of intake and functional status, falls, urinary incontinence) with diagnosis community acquired pneumoni...
Acta medica Indonesiana, 2016
AIM to obtain the proportion of frailty and the incidence of 30-day major adverse cardiovascular ... more AIM to obtain the proportion of frailty and the incidence of 30-day major adverse cardiovascular events (MACE) as well as to review the impact of frailty on the prognosis of elderly patients with coronary heart disease who underwent elective PCI. METHODS this is a prospective cohort study to assess the frailty of elderly patients with coronary artery disease that underwent elective PCI in Cipto Mangunkusumo Hospital using the frailty phenotype criteria. They were subsequently followed-up for 30 days to see whether there was any MACE developed. RESULTS there were 100 elderly patients with coronary artery disease who underwent elective PCI between September 2014 and June 2015. The mean age of patients was 66.95 (SD 4.875) years and 69% of the patients were males. Frailty was present in 61% of the patients. MACE were occurred in 8.19% of frail patients and 5.12% were occurred in non-frail patients. The association between frailty and MACE was demonstrated by the result of crude HR of 1...
Publishing a manuscript of study results in a medical or biomedical journal is not as easy as we ... more Publishing a manuscript of study results in a medical or biomedical journal is not as easy as we imagine. There are some components that should be noticed in publishing a medical scientific journal. Although every journal has different manuscript format, in general, a manuscript contain some components, which consist of: introduction, methods, results, and discussion. Before submitting the manuscript, be sure that it has been consistent with instructions to authors of the desired journal. Submitted manuscript should be enclosed by a cover letter, a statement about any sponsor or other potential relationship that may cause conflict of interest, a statement that the manuscript has been read and agreed by the author(s), and any information about a corresponding author. Writing skills is very important to obtain a good manuscript of study result, in order to achieve greater possibility for publication. Writing skills can be learned through various books or electronic sources such as int...
Introduction Direct-acting antiviral drugs (DAAs) have changed the paradigm of hepatitis C therap... more Introduction Direct-acting antiviral drugs (DAAs) have changed the paradigm of hepatitis C therapy for both HCV/HIV co-infected and HCV mono-infected patients. We aimed to describe the HCV continuum of care of HIV-infected patients treated in an HIV clinic after a free DAA program in Indonesia and identify factors correlated with sofosbuvir-daclatasvir (SOF-DCV) treatment failure. Methods We did a retrospective cohort study of adult HIV/HCV co-infected patients under routine HIV-care from November 2019 to April 2020 in the HIV integrated clinic of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. We evaluated some factors correlated with sofosbuvir-daclatasvir treatment failure: gender, diabetes mellitus, previous IFN failure, cirrhosis, concomitant ribavirin use, high baseline HCV-RNA, and low CD4 cell count. Results and discussion Overall, 640 anti-HCV positive patients were included in the study. Most of them were male (88.3%) and former intravenous drug users (76.6%) with a mean ...
ABSTRACT. The increase in dementia incidence among the elderly is directly related to aging, whic... more ABSTRACT. The increase in dementia incidence among the elderly is directly related to aging, which is associated with changes in bodily functions and other health-related risk factors. Alzheimer's dementia is the most prevalent form of dementia, and individuals in the late stages are predominantly dependent on other family members. Therefore, it is important for families, as the closest support group, to recognize common symptoms early. Objective: To provide a family-friendly guide to the ten common symptoms of Alzheimer's dementia. Methods: This is a descriptive survey-based research that included 354 families comprising elderly people (≥60 years) residing in Jakarta. The instrument aimed at identifying ten common Alzheimer’s dementia symptoms in Indonesia. Descriptive statistical analysis based on frequency tables was used. Results: The participant’s major characteristics were age ≥66 years (52.3%), female sex (70.3%) and primary school education (87.3%). The predominant s...
Indian Journal of Public Health Research and Development, 2020
Background: Cognitive impairment may lead to dementia, which can affect the elderly quality of li... more Background: Cognitive impairment may lead to dementia, which can affect the elderly quality of life.Improving awareness and prevention of dementia risk factors become very essential to prevent cognitiveimpairment, and one of the effort is through.Objective: This study aimed at observing the relationship between elderly characteristics as dementia riskfactors with cognitive impairment incidence.Method: Descriptive study with a cross-sectional approach was used. The population was elderly whoresided in Special Capital Region of Jakarta, Indonesia. A sample of 341 elderlies, aged 60 years old orabove was selected and screened through multistage random sampling. Chi-Square and Fisher’s Exact testsused to analyze the data.Results: The results of dementia screening using CDT found as much as 91.8 %elderly were suffered fromcognitive impairments. There was a significant correlation between sex and educational background withcognitive impairment(p=0.003 and p=0.005).Conclusions: Educational...
BACKGROUND acute myocardial infarction (AMI) is often followed by hyperglycemia. To date, there i... more BACKGROUND acute myocardial infarction (AMI) is often followed by hyperglycemia. To date, there is no study that examine the role of myocardial damage, ion channel changes and increased inflammatory response as a pathomechanism of malignant arrhythmias due to hyperglycemia in AMI patients. The aim of this study is to determine the effect of acute hyperglycemia on the occurence of malignant arrhythmias, troponin I, VLP, echocardiographic strain, ion channel changes (CaMKII) and hsCRP. This study also aims to assess the effect of troponin I, VLP, GLS, CaMKII and hsCRP on the occurence of malignant arrhythmias in AMI patients with acute hyperglycemia. METHODS a cross-sectional study followed by a cohort study was conducted on AMI patients treated at ICCU Cipto Mangunkusumo Hospital Jakarta during November 2018 to May 2019 period. Patients with severe infections and who had experienced malignant arrhythmias at admission were excluded from the study. The occurence of malignant arrhythmia...
AIM to determine the incidence and predictors for delirium and to develop a prediction model for ... more AIM to determine the incidence and predictors for delirium and to develop a prediction model for delirium in hospitalized elderly patient in Indonesia. METHODS a retrospective cohort study was conducted in elderly patients (aged 60 years and older) who were hospitalized in Internal Medicine Ward and Acute Geriatric Ward Cipto Mangunkusumo Hospital from January 2008 until December 2010. Patients were not delirious on admission. Twelve predefined predictors for development of delirium during hospitalization were identified on admission. Independent predictors for delirium were identified by Cox's proportional hazard regression analysis and each independent predictor was quantified to develop delirium prediction model. The calibration performance of the model was tested by Hosmer-Lameshow test and its discrimination ability was determined by calculating area under the receiver operating characteristic curve (AUC). RESULTS subjects consist of 457 patients, predominantly male (52.5%)...
AIDS Research and Therapy
Objectives Accelerated atherosclerosis in older HIV-infected patients has been attributed to pers... more Objectives Accelerated atherosclerosis in older HIV-infected patients has been attributed to persistent immune activation and high burden cytomegalovirus (CMV), as demonstrated in transplant recipients and the general population. Here we assess CMV and inflammatory markers linked with vascular health in young adult patients treated in Indonesia. Study design HIV-infected adults (n = 32) were examined when they began antiretroviral therapy (ART) with
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Papers by Kuntjoro Harimurti