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All Journal Medical Journal of Indonesia Jurnal Penyakit Dalam Indonesia
Shufrie Effendy
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Medicine & Pharmacology

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Clinical Manifestation of Acute Myocardial Infarction in the Elderly Suryadipradja, Miftah; Dewabrata, Wahyu; Harun, S.; Alwi, Idrus; Hakim, Lukman; Effendy, Shufrie
Medical Journal of Indonesia Vol 12, No 4 (2003): October-December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (187.954 KB) | DOI: 10.13181/mji.v12i4.112

Abstract

A retrospective study were performed in patients with acute myocardial infarction (AMI) that hospitalized in ICCU Cipto Mangunkusumo hospital, Jakarta during the period of January 1994 until Decmber 1999. There were 513 patients hospitalized with MCI, 227 patients (44.2%) were classified as elderly, and 35.2% of them were female. Most of the elderly AMI patients reported typical chest pain just like their younger counterparts. Elderly AMI patients tend to come later to the hospital, and more Q-wave myocardial infarction were identified compared to non- Q-wave myocardial infarction. Risk factors of diabetes mellitus and hypertension were more common among the elderly. The prevalence of atrial fibrillation and the mortality rate were higher among elderly AMI patients. (Med J Indones 2003; 12: 229-35) Keywords: clinical manifestation, acute myocardial infarction, elderly
Anti-thrombin III, Protein C, and Protein S deficiency in acute coronary syndrome Ismail, Dasnan; Harun, S.; Alwi, Idrus; Tambunan, Karmel L.; Effendy, Shufrie
Medical Journal of Indonesia Vol 11, No 2 (2002): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (756.386 KB) | DOI: 10.13181/mji.v11i2.54

Abstract

The final most common pathway for the majority of coronary artery disease is occlusion of a coronary vessel. Under normal conditions, antithrombin III (AT III), protein C, and protein S as an active protein C cofactor, are natural anticoagulants (hemostatic control) that balances procoagulant activity (thrombin antithrombin complex balance) to prevent thrombosis. If the condition becomes unbalanced, natural anticoagulants and the procoagulants can lead to thrombosis. Thirty subjects with acute coronary syndrome (ACS) were studied for the incidence of antithrombin III (AT III), protein C, and protein S deficiencies, and the result were compare to the control group. Among patients with ACS, the frequency of distribution of AT-III with activity < 75% were 23,3% (7 of 30), and only 6,7% ( 2 of 30 ) in control subject. No one of the 30 control subject have protein C activity deficient, in ACS with activity < 70% were 13,3% (4 of 30). Fifteen out of the 30 (50%) control subjects had protein S activity deficiency, while protein S deficiency activity < 70% was found 73.3.% (22 out of 30). On linear regression, the deterministic coefficient of AT-III activity deficiency to the development ACS was 13,25 %, and the deterministic coefficient of protein C activity deficient to the development of ACS was 9,06 %. The cut-off point for AT-III without protein S deficiency expected to contribute to the development of vessel disease was 45%. On discriminant analysis, protein C activity deficiency posed a risk for ACS of 4,5 greater than non deficient subjects, and AT-III activity deficiency posed a risk for ACS of 3,5 times greater than non deficient subjects. On binary logistic regression, protein S activity acted only as a reinforcing factor of AT-III activity deficiency in the development of ACS. Protein C and AT III deficiency can trigger ACS, with determinant coefficients of 9,06% and 13,25% respectively. Low levels of protein C posed a greater risk of ACS than low levels of AT III. Protein S deficiency was a reinforcing factor on AT-III deficient to development of ACS. The cut-off point of AT-III without protein S deficiency expected to give single vessel disease was 45%, and 9,5% for the development of triple vessel disease. (Med J Indones 2002; 11: 87-92)Keywords: acute coronary syndrome, Anti-thrombin III, Protein C, Protein S
Antiphospholipid Antibody Profile in HIV/AIDS Patients Pandjaitan, Inolyn; Sukmana, Nanang; Effendy, Shufrie
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
Publisher : UI Scholars Hub

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Introduction. Through the process of molecular mimicry, human immunodeficiency virus (HIV) infection can increase the concentration of antiphospholipid antibody (APA) which has possible association with thrombosis. The molecular mimicry in this HIV/AIDS patients is influenced by several factors, such as immunocompromised condition, the use of antitretroviral (ARV) therapy, hepatitis B and C coinfection, use of other drugs, and history of intravenous drug user (IDU). We conducted this study to determine the profile and prevalence of antiphospholipid antibody in patients with HIV/ AIDS in Dr. Cipto Mangunkusumo General Hospital. Further, we explored the relationship between APA in HIV/AIDS patients with the factors mentioned before. Methods. This cross sectional study was done on HIV/AIDS outpatient at AIDS Working Group Clinic at Dr. Cipto Mangunkusumo General Hospital. We assessed the patients by history taking and measured their level of antibody anticardiolipin (ACA) dan Anti β2 glycoprotein I (anti-β2 GP1). Subjects were selected using simple random sampling. Descriptive data regarding the characteristics of the subjects and the proportions of APA were presented in numbers and percentages. The bivariate analysis between APA with the history of injecting drug use, the absolute CD4 lymphocyte count, antiretroviral therapy, and chronic hepatitis coinfection was performed using Chi-Square test and Fisher test. Results. APA examination results showed 27 (29,3%) patients were positive for ACA IgM, 77 (83,7%) patients were positive for ACA IgG, 61 (66,3%) patients were positive for anti β2 GP1 IgM, and 7 (7,6%) pateints were positive for anti β2 GP1 IgG. There is significant association between APA and the history of intravenous drug user (IDU) and ARV therapy. No association was observed between CD4 lymphocyte count and hepatitis coinfection with prevalence of APA in patients with HIV/AIDS patient. Conclusion. Proportion of anticardiolipin antibody IgG is higher than IgM (83,7% vs 29,3%), while the proportion of anti-β2 GP1 IgM is higher than IgG (66,3% vs 7,6%).
Hubungan Antibodi Anti Trombosit terhadap Respon Transfusi Trombosit pada Pasien Hemato-Onkologi yang Mendapatkan Multitransfusi Trombosit di RS Dr. Cipto Mangunkusomo Lubis, Anna Mira; Sudoyo, Aru W; Effendy, Shufrie; Djumhana, TB; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
Publisher : UI Scholars Hub

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Pendahuluan: Multitransfusi donor random dan paparan terhadap konsentrat trombosit yang termasuk non-leukocyte depleted diketahui sebagai faktor risiko terjadinya alloimunisasi (HLA dan HPA) yang dapat menjadi salah satu penyebab kegagalan transfusi. Oleh karena itu, perlu dilakukan penelitian mengenai hubungan antibodi anti trombosit tersebut dengan kegagalan respon transfusi trombosit pada pasien hemato-onkologi sehingga dapat dilakukan metode seleksi donor dan crossmatching trombosit donor dan resipien. Metode: Studi observasional dilakukan pada pasien hemato-onkologi dewasa yang mendapatkan multitransfusi trombosit di Rumah Sakit dr Cipto Mangunkusumo (RSCM) Jakarta. Pengamatan dilakukan pada respon transfusi dengan mengukur corrected count increment (CCI) 1 jam post transfusi dengan batas 7.500 m2/mL. Keadaan lain yang dapat mempengaruhi CCI dieksklusi dari penelitian. Antibodi (Ig G) dideteksi dari serum pre transfusi terhadap antigen HLA kelas 1, epitop GP IIb/ IIIa, Ib/IX dan Ia/IIa dengan teknik ELISA secara kualitatif. Pengukuran ini menggunakan kit ELISA komersial Pak-2 LE. Analisis statistik dilakukan dengan uji chi-square dan regresi logistik untuk ditentukan PR dengan IK 95%. Hasil: Selama periode Maret–Juni 2008 terkumpul 36 transfusi yang diberikan pada 21 pasien dengan berbagai diagnosis hemato-onkologi. Sebanyak 33,3% memberikan respon transfusi yang tidak memuaskan (CCI Simpulan: Pasien yang memiliki antibodi HLA kelas 1, memiliki kecenderungan kegagalan transfusi trombosit 11,4 kali lebih besar. Namun, hubungan antibodi GP IIb/IIIa dengan respon transfusi belum dapat ditentukan, sehingga dibutuhkan studi lanjutan dengan sampel yang lebih besar.
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) akibat Kemoterapi pada Pasien Lansia dengan Keganasan Herwanto, Velma; Siregar, Parlindungan; Effendy, Shufrie; Rachman, Andhika
Jurnal Penyakit Dalam Indonesia Vol. 1, No. 1
Publisher : UI Scholars Hub

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Hiponatremia merupakan suatu kondisi yang sering ditemukan pada pasien-pasien dengan keganasan. Keadaan hiponatremia dapat terjadi bersamaan atau mendahului diagnosis suatu keganasan. Hiponatremia terkait kanker bisa mempengaruhi respon terhadap terapi kanker maupun kesintasan pasien. Kami laporkan sebuah kasus hiponatremia pada pasien lansia dengan keganasan yang disebabkan oleh syndrome of inappropriate anti diuretic hormone secretion (SIADH).
Co-Authors Andhika Rachman Anna Mira Lubis Aru W Sudoyo Dasnan Ismail Idrus Alwi Inolyn Pandjaitan, Inolyn Karmel L. Tambunan Kuntjoro Harimurti Lukman Hakim Miftah Suryadipradja Nanang Sukmana Parlindungan Siregar S. Harun TB Djumhana, TB Velma Herwanto Wahyu Dewabrata