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Diffuse Large B Cell Lymphoma, Bilateral Lower Extremity Lymphedema, and Ulcerated Inguinal Lymph Node LUGITO, NATA PRATAMA HARDJO; KURNIAWAN, ANDREE; YANTO, THEO AUDI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : "Dharmais" Cancer Center Hospital

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Lymphedema (LE) is a chronic medical condition characterized by lymphatic fluid retention, resulting in tissue swelling. There are two general classifications of LE; primary and secondary which are based on two mechanisms; lymphatic obstruction and lymphatic interruption. The most common cause of LE in the developing world is secondary to an infection known as filariasis. Cancer including Hodgkin and non-Hodgkin lymphomas; and its treatment are some causes of secondary LE. LE also could maintain the persistence of an occult localization of lymphoma. This case illustration describes a female, 57 year-old with stage II lymphedema of both legs, bilateral inguinal lymphadenopathies that were biopsied. The filarial blood examination was negative. Biopsies showed diffuse large B-cell lymphoma.

Koagulasi Intravaskuler Diseminata pada Kanker KURNIAWAN, ANDREE; HARDJO LUGITO, NATA PRATAMA
Indonesian Journal of Cancer Vol 9, No 3 (2015): Jul - Sept 2015
Publisher : "Dharmais" Cancer Center Hospital

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Disseminated Intravascular Coagulation is one of thrombosis manifestation other than venous thromboembolism, which onset is acute and has slight different clinical manifestation that tends to be chronic. Pathogenesis of the DIC in hematology malignancy is caused by the activation of fibrinolytic pathway by tumor cells. In solid tumor the pathogenesis is mainly because of the activation of cogulation factor by tissue factor expressed by tumor cells. Thediagnosis of DIC in cancer still needs further validation from the international society of thrombosis and hemostasisand Japanese society hematology criteria in cancer subjects. The principle of therapy for DIC in cancer patients is management of the cancer itself as the underlying etiology with the target is remission. The uses of anticoagulant therapy needs further clinical trial in the future. Coagulation factor and platelet transfusion can be given if there is significant bleeding.Â Koagulasi intravaskuler diseminata (KID) adalah manifestasi trombosis lain selain tromboemboli vena yang bersifat akut. Pada pasien kanker gambarannya sedikit berbeda, yaitu cenderung bersifat kronik, tergantung pada jenis kankernya. Patogenesis KID pada keganasan hematologi adalah akibat fibrinolisis yang meningkat. Sedangkan pada tumor solid terjadi akibat aktivasi faktor koagulasi oleh faktor jaringan yang diekspresikan oleh sel kanker. Diagnosis KID pada kanker masih memerlukan validasi kriteria dari perhimpunan trombosis hemostasis internasional dan Jepang pada kelompok pasien kanker. Prinsip terapi KID pada kanker adalah tata laksana kanker yang menjadi penyebab, dengan target remisi penyakit. Pemberian antikoagulan memerlukan uji klinis menggunakan populasi pasien kanker. Transfusi faktor koagulasi dan atau trombosit hanya diberikan apabila terdapat perdarahan yang bermakna.

A 21 Year-Old Male Colorectal Cancer Patient with Clostridium Difficile and Intestinal Amebiasis Infection LUGITO, NATA PRATAMA HARDJO; -, SUSANTI; KURNIAWAN, ANDREE
Indonesian Journal of Cancer Vol 8, No 2 (2014): April-Juni 2014
Publisher : "Dharmais" Cancer Center Hospital

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Colorectal cancer is a rare yet aggressive neoplasm in young adult. This cancer was associated with several bacterial and viral infections like Streptococcus bovis, Helicobacter pylori, human papilloma virus, and Clostridium septicum. Here we report a case of Clostridium difficile and Entamoeba histolytica infection in young adult male patient with colorectal cancer. The patient presented with chronic bloody diarrhea since one year prior to diagnosis with histories of antibiotics but no hospitalization, surgery or chemotherapy.

Nutritional Status and Quality of Life in Breast Cancer Patients in Karawaci General Hospital KURNIAWAN, ANDREE; LUGITO, NATA PRATAMA HARDJO
Indonesian Journal of Cancer Vol 10, No 1 (2016): Jan - Mar 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTCancer is related to a deterioration of nutritional status and quality of life (Qol), but the extent of these conditions in patients with breast cancer has not been studied well. Malnutrition is prevalent among cancer patients and maybe correlated with altered quality of life. The aim of this study is to evaluate the association of QoL and nutritional status after breast cancer diagnosed. Nutritional status was evaluated with Patient Generated Subjective Global Assessment and QoL using Short form 36 (SF-36) and also with the specific module for breast cancer patients. A consecutive sampleof twenty two patients diagnosed with breast cancer was evaluated. The associations of QoL with stadium and nutrition status were evaluated using T-test analysis. The mean of body mass index was 21.3 kg/m2. Fifty percent patient have menopause. Most patients were stage II (77.3%), the others stage III (18.2%) and stage I (4.5%). Sixty eight point two percent had risk of malnutrition. The stadium of tumor was significantly related to physical functioning (p < 0.000), physical limitation (p < 0.024), emotional limitation (p < 0.013), well-being (p < 0.020), health changes (p < 0.010). Thestatus of nutrition was significantly related to physical functioning (p < 0.001), loss of energy (p < 0.010) and general health (p <0.005). For Conclusion, the status of nutrition breast cancer patients were related to QoL especially physical functioning, loss of energy and general health after they were diagnosed.ABSTRAKKanker sangat terkait dengan perburukan status nutrisi dan kualitas hidup. Namun demikian, belum banyak studi yang yang melaporkan masalah nutrisi dan kulitas hidup pada kanker payudara. Malnutrisi sering ditemukan pada kanker dan mungkin terkait dengan perubahan kulaitas hidup. Tujuan penelitian ini adalah untuk mengevaluasi hubungan antara kualitas hidup dengan status nutrisi setelah kanker payudara terdiagnosis. Evaluasi status nutrisi dilakukan dengan Patient Generated Subjective Global Assessment dan kualitas hidup dengan Short form 36 (SF-36) sertakarakteristik pada kanker payudara. Sampel diambil dengan teknik konsekutif terhadap 22 pasien yang terdiagnosis kanker payudara. Hubungan kualitas hidup dengan stadium kanker dan status nutrisi dinilai menggunakan analisis T-test. Indeks massa tubuh rata-rata adalah 21,3 kg/m2. Lima puluh pasien telah menopause. Terbanyak adalah stadium 2 (77,3%), stadium 3 (18,2%), dan stadium 1 (4,5%). Enam puluh dua koma dua persen berisiko malnutrisi. Stadium tumor secara bermakna berhubungan dengan fungsi fisik (p <0,000), keterbatasan fisik (p<0,024), keterbatasan emosi(p<0,013), rasa nyaman (p<0,020), dan perubahan kesehatan (p<0,000). Status nutrisi berhubungan secara bermakna dengan fungsi fisik (p<0,001), kehilangan energi (p<0,010), dan kesehatan secara umum (p<0,005). Simpulan, status nutrisi pasien kanker payudara berhubungan dengan kualitas hidup, terutama fungsi fisik, kehilangan energi, status kesehatan umum setelah mereka terdiagnosis.

Diffuse Large B Cell Lymphoma, Bilateral Lower Extremity Lymphedema, and Ulcerated Inguinal Lymph Node LUGITO, NATA PRATAMA HARDJO; KURNIAWAN, ANDREE; YANTO, THEO AUDI
Indonesian Journal of Cancer Vol 8, No 1 (2014): Jan - Mar 2014
Publisher : Indonesian Journal of Cancer

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (504.521 KB)

Lymphedema (LE) is a chronic medical condition characterized by lymphatic fluid retention, resulting in tissue swelling. There are two general classifications of LE; primary and secondary which are based on two mechanisms; lymphatic obstruction and lymphatic interruption. The most common cause of LE in the developing world is secondary to an infection known as filariasis. Cancer including Hodgkin and non-Hodgkin lymphomas; and its treatment are some causes of secondary LE. LE also could maintain the persistence of an occult localization of lymphoma. This case illustration describes a female, 57 year-old with stage II lymphedema of both legs, bilateral inguinal lymphadenopathies that were biopsied. The filarial blood examination was negative. Biopsies showed diffuse large B-cell lymphoma.

Unusual Metastases of Hepatocellular Carcinoma to the Heart KURNIAWAN, ANDREE; LUGITO, NATA PRATAMA HARDJO
Indonesian Journal of Cancer Vol 10, No 4 (2016): October - December 2016
Publisher : Indonesian Journal of Cancer

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ABSTRACTHepatocellular carcinoma (HCC) is the sixth most prevalent cancer worldwide. Metastasis of HCC to the heart is rare with prevalence on autopsy of less than 6%. There is still limited study evaluated the metastasis of hepatocellular carcinoma to the heart. The aim of this study is to know the prevalence and characteristic of metastasis of HCC to theheart in Indonesia. This retrospective study was conducted in secondary referral hospital in Tangerang county, Indonesia. We evaluated from medical record included baseline characteristic, survival and treatment of HCC and echocardiogram data for diagnosing metastasis to the heart from 2013-2015. There were 5 HCC patients recorded in thelast 3 years. All patients were male with median age 56(53-61) years old. Four patients were diagnosed using transthoracic echocardiograph and the rest using multi sliced CT scan. All patients were having continuous thrombus from inferior cava vein until right atrial. For the conclusion Hepatocellular carcinoma were reported as the cause ofintra-heart metastases in Indonesia. All patients were in late stage.ABSTRAKKarsinoma hepatoselular adalah kanker keenam terbanyak di seluruh dunia. Metastasis karsinoma hepatoselular ke jantung jarang, prevalensi yang ditemukan pada otopsi kurang dari 6 persen. Masih amat jarang studi yang mengevaluasi metastasis karsinoma hepatoselular ke jantung. Tujuan dari studi ini adalah ingin mengetahui prevalensi dankarakteristik metastasis karsinoma hepatoselular ke Jantung di Indonesia. Studi retrospektif ini dilakukan di rumah sakit rujukan tipe B di daerah Tangerang, Indonesia. Kami mengevaluasi dari rekam medis, meliputi karaktersitik dasar, kesintasan, dan terapi karsinoma hepatoselular; serta data ekokardiografi untuk mendiagnosis metastasis ke jantung dari 2013-2015. Terdapat 5 pasien hepatoselular karsinoma pada 3 tahun terakhir. Semua pasien laki-laki dengan usia median 56 (53-61) tahun. Empat pasien terdiagnosis menggunakan ekokardiografi trans torakal dan sisanya menggunakan CT scan. Semua pasien memiliki trombus kontinu dari vena cava inferior hingga atrium kanan. Sebagai simpulan, karsinoma hepatoselular dilaporkan sebagai penyebab metastasis ke jantung di Indonesia. Semua pasien datang pada stadium lanjut.

Clinical Characteristics and Microbiological Profiles of Community-Acquired Intra-Abdominal Infections Lugito, Nata Pratama Hardjo; Cucunawangsih, Cucunawangsih; Kurniawan, Andree; Tjiang, Margaret Merlyn
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 1 (2014): VOLUME 15, NUMBER 1, April 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Background: Intra-abdominal infections (IAIs) have different aspects to consider. One important aspectis the microbiological analyses, especially in the era of broad spread of resistant microorganisms. The studywas designed to describe the clinical characteristics and microbiological profiles of community acquired IAIs. Method: An observational study was performed on medical records of 12 months period (January toDecember 2013) in a General Hospital, Karawaci, Tangerang. Adult patients undergoing surgery for IAIs with positive microbiological culture and identification of microorganisms were included. Data collected were clinical characteristics and microbiological profiles and wereanalyzed statisticallyusing the SPSS version 17. Results: In 12 months period of study, 17 patients of IAIs with a total of 17 intra peritoneal specimens were collected. A total of six microorganisms were cultured. All the IAIs were monomicrobial, with aerobicmicroorganism dominantly Gram-negative bacilli. The dominant microorganism was Escherichia coli (E.coli), found in 58.8% of IAIs. The most common site was appendix (41.2%), and none from small intestine. Thesusceptibility test found that piperacillin tazobactam, tigecycline, meropenem and amikacin were the most activeantimicrobial against E. coli. Multi-drug resistant (MDR) E. coli in this study was 40%. The MDR E. coli had66.6% resistance to levofloxacin and ciprofloxacin, 66.6% susceptibility to ceftriaxone and ceftazidime, and100.0% susceptibility to amikacin. Conclusion: The most common site of community-acquired IAIs was appendix (41.2%). E. coli is still adominant microorganism with the MDR E. coli proportion of 40%.Keywords: intra-abdominal infections, clinical characteristics, microbiological profiles

Complications of Biliary Atresia in a 27-Year-Old Male Patient Lugito, Nata Pratama Hardjo; Tyasto, I Gede Resmino; Laksmi, Purwita Wijaya
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Biliary atresia (BA) is a disease of the extrahepatic biliary tree that presents with biliary obstruction in the neonatal period, which is caused by fibro-obliterative process. Kasai procedure, a hepatoportoenterostomy(HPE) as an attempt to restore bile flow from the liver to the proximal small bowel, has been shown to improve survival in BA patients. Many BA survivals who had undergone Kasai HPE will have slowly progressive liverdisease and the majority of patients will ultimately require liver transplantation. In spite of many experimental treatments, cirrhosis still occurs in BA patients survival.This case report presents a male patient with biliary atresia that has survived for 27 years after Kasai procedure. He had been repeatedly admitted to hospital with complications caused by cirrhosis, such as repeated variceal and hemorrhoid bleeding and also refractory ascites. These complications are indications for liver transplantation. Although Kasai HPE procedure improves survival in BA patients in Indonesia, long-termcomplications of cirrhosis makes the patient awaits for liver transplantation. Keywords: biliary atresia, Kasai procedure, hepatoportoenterostomy, cirrhosis, liver transplantation

Tuberkulosis Payudara Primer sebagai Diagnosis Banding Massa Payudara Pratama Hardjo Lugito, Nata; Gunawan, Edy; Chandra, Margaret; Kurniawan, Andree; Isbandiarti, Darti
Cermin Dunia Kedokteran Vol 43, No 1 (2016): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Dilaporkan kasus seorang pasien perempuan berusia 40 tahun dengan TB payudara primer, suatu bentuk TB ekstra-paru yang jarang dijumpai. Keluhan berupa benjolan payudara kanan sejak 2 minggu dan pembesaran kelenjar getah bening aksila kanan. Ultrasonografi menemukan abses dan pembesaran kelenjar getah bening. Biopsi abses menemukan gambaran infeksi Mycobacterium tuberculosis. Setelah pengobatan anti-TB selama 6 bulan, abses membaik. Gambaran klinis TB payudara bervariasi dan memiliki kemiripan dengan beberapa penyakit lainnya. TB payudara merupakan salah satu diagnosis alternatif massa payudara di daerah dengan insidens TB tinggi.

Psychometric Properties of the Indonesian Version of Impact of Event Scale-Revised Questionnaire During COVID-19 Pandemic Felix Wijovi; Andree Kurniawan; Nata Pratama Hardjo Lugito; Fransisca Handy Agung; Darien Alfa Cipta; Stella Angelina; Devina Adella Halim; Claudia Jodhinata; Sisilia Orlin; Audrey Hamdoyo; Nadya Nathalia Evangelista
Medicinus Vol 9, No 2 (2021): June 2021-September 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i2.4703

Background: COVID-19 is a respiratory infection caused by SARS CoV-2. A health-related disaster may result in a wide range of mental consequences, including PTSD. IES-R is a self-reported instrument, and it corresponds to DSM-IV symptoms of PTSD. However, there were scarce data about the validation of the Indonesian version of IESR.Aim: The purpose of this study was to validate the IES-R in the Indonesian adult population by comprehensively and systematically assessing the epidemiological evidence about PTSS during the COVID-19 pandemic.Methods: This was a cross-sectional study. The IES-R questionnaire was translated from English to Indonesian, back-translated. All health workers were excluded to avoid the biased result. Pearson correlation and Cronbach's alpha coefficients to determine the validity and reliability of the questionnaire.Results: A total of 234 Indonesian-speaking adults completed the survey. The Indonesian IES-R had proven to be a valid (r= 0.756 -0.938, p= 0.000) and reliable (alpha coefficient: 0.858-0.868) measure for PTSS in a sample of Indonesian adults during the COVID-19 pandemic. In addition, the final model which consisted of 3 subscales with 20 items demonstrated acceptable factor loadings.Conclusion: The results of this study suggested IESR is valid and reliable to be used in the Indonesian population especially during pandemics.

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