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Acta Interna : The Journal of Internal Medicine
Published by Universitas Gadjah Mada
ISSN : 2303131X     EISSN : 25415441     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
The Journal considers any original research that advocates change in, or illuminates, clinical practice. The journal also publishes interesting and informative reviews and opinions pieces on any topics connected with clinical practice. Manuscripts must be solely the work of the author(s) stated, not have been published previously elsewhere, and not be under consideration by another journal. all papers should be written to be clearly understandable to the journal`s readers in a wide range of specialities and countries. Diagrams, figures, and photographs should be used to supplement and enhance the text.
Arjuna Subject : -
Articles 129 Documents
 1   2   3   4   5 
THE COGNITIVE FUNCTION OF ANTHRACYCLINE-BASED ADJUVANT CHEMOTHERAPY IN WOMEN WITH BREAST CARCINOMA Sendjaja, Sukendro; Purwanto, Ibnu; Kurnianda, Johan
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

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ABSTRACT Objective. The objective of this study was to determine the changes cognitive function of anthracycline-based adjuvant chemotherapy in women with breast carcinoma.Method. The study design was prospective longitudinal study. The breast cancer patients who received anthracycline-based adjuvant chemotherapy were recruited from internal medicine wards and TULIP outpatient department Dr. Sardjito General Hospital Yogyakarta. Subjects eligible with inclusion and exclusion criteria were examined for cognitive function by mini-mental state examination (MMSE) before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3). The mean difference of MMSE scores were analyzed with Wilcoxon-signed rank test and P<0.05 was considered statistically significant.Result. There were 47 subjects eligible to study criteria in October 1st 2008 – October 31st 2009. Forty subjects finished this study and were analyzed. The mean age was 47.08±6.65 with age ranged from 27 to 61 years old. The mean MMSE scores before chemotherapy (T0), 3 weeks after 2nd adjuvant chemotherapy (T1), 3 weeks after 4th adjuvant chemotherapy (T2), and 3 months after 4th adjuvant chemotherapy (T3) were 29.28±1.20, 28.60±1.69, 28.18±1.89, and 27.85±2.03, respectively. The mean MMSE score changes (ΔT0-T1), (ΔT0-T2), and (ΔT0-T3) were 0.68±0.80, 1.10±1.06, and 1.43±1.36, respectively and P<0,001. The incidence of cognitive impairment with MMSE scores < 24 was 2.5% and P=1.0.Conclusion. There was a significant decline of MMSE score in women with breast carcinoma who received anthracycline-based adjuvant chemotherapy at 3 weeks after 2nd adjuvant chemotherapy, 3 weeks after 4th adjuvant chemotherapy, and 3 months after 4th adjuvant chemotherapy compared with before chemotherapy. Key Words: Cognitive Function, Breast Cancer, Adjuvant Chemotherapy, Anthracycline 
ANEMIA AS RISK FACTOR OF HANDGRIP STRENGTH DECREASED ON ELDERLY IN YOGYAKARTA PROVINCE’S PANTI WERDHA Hidayat, Ganda; Kurnianda, Johan; Pramantara, I Dewa Putu
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground: According to the WHO, by the end of 20 th century, the more the world population grow, the more the elderly population will be. Yogyakarta province has a 13.72% of Indonesian elderly. The anemia prevalence increased as the age added. Aging process resulted in strength muscle reduced. Handgrip strength test is a valid and consistent as well as simple alternative to value the muscle strength decreased advanced age. Purpose of this study is to know whether anemia is a risk factor against muscle strength decreased measured by handgrip strength test on elderly population in nursing house.Method: This study used cross sectional study design to the advanced ages in DIY province’s nursing house. The study time was in August 2010. The advance ages fullfilling the inclusion and exclusion criteria were conducted physical examination, routine blood test and handgrip strength measurement.Result: This study involved 118 elderly participants. There was difference of mean handgrip strenght in: age (14.52 kg vs 19.64 kg; p=0.001), gender (13.39 kg vs 22.47 kg; p=0.001), activity level (7.94 kg vs 16.75 kg; p=0.001) and anemia status (13.60 kg vs 17.84 kg; p=0.001); for women even in mild anemia group, there was difference with non anemia group (12.36 kg vs 14.68 kg ; p=0.027). Conclusion: According to multivariable analysis,. There are 3 factors involving of handgrip strength in elderly, namely; Age, activity levels, and anemia which are statistically significant. In this study, it was conclude anemia is a risk factor of handgrip strength decreased in elderly, for women even in mild anemia, there was statistically significant different with non anemia group. Keywords : Elderly, anemia, handgrip strength
THE DIFFERENCE OF SERUM CARBOXY-TERMINAL PROPEPTIDE OF PROCOLLAGEN TYPE I (PIP) IN STAGE A, B AND C HEART FAILURE PATIENTS CAUSED BY HYPERTENSION Aini, Nurul
Acta Interna The Journal of Internal Medicine Vol 3, No 1 (2013): Acta Interna The Journal of Internal Medicine
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ABSTRACTIntroduction. Arterial hypertension affects the heart tissue composition which leads to structural remodeling of the myocardium. The imbalance between synthesis and degradation of type I collagen leading to myocardial fibrosis in a form of type I collagen fiber accumulation in the interstitial and perivascular myocardium. Collagen fiber accumulation reduces relaxation stage, diastolic suction, myocardial stiffness and diastolic dysfunction which affect systolic dysfunction leading to heart failure. Concentration of carboxy-terminal pro peptide of pro collagen type I (PIP) in peripheral blood am a synthesis index of type I collagen in HHD. Thus, the measurement of PIP is useful to monitor myocardial fibrosis stage in heart failure and to determine the therapeutic strategy that aims not only to reduce arterial pressure and left ventricular mass but also to prevent myocardial remodeling.Aim of the study. The aim of the study was to ascertain the difference PIP level in patients with the heart failure stage A, B, and C which are caused by hypertension. The serum concentration of PIP was measured by enzyme immunoassay. This research was a cross sectional research designed for cardiology policlinic’s outpatients at Dr. Sardjito General Hospital Yogyakarta from August 2009 until the calculated sample number is fulfilled. Method. One-way ANOVA was used to analyze the differences between the three groups of heart failure stages after being tested for the normality using Kolmogorov-Smirnov normality test. If the result did not show a normal value, a non-parametric test would be undergone using Kruskal-Wallis test followed by Mann-Whitney U test. The differences considered as significant if p < 0.05 with a confidence interval of 95%.Result. The research was performed in 64 patients heart failure caused by hypertension consisted of 22 stages A, 19 stage B and 23 stage C. PIP mean levels of the group stage B 819.78 ± 91,03 ng/ml was higher compared stage A 808.47± 80.8 ng/ml and PIP mean level stage C 852 ± 55.51 ng/ml was higher compared stage B. The PIP mean levels did not differ statistically significantly (p=0. 317).Conclusion. There were no significant differences in serum level of PIP on the stage heart failure A, B and C. Keywords: Collagen, fibrosis, hypertension, heart failure, carboxy-terminal pro peptide
Effect of Curcuminoid versus Diclofenac Sodium on Monocytes Secretion of Tumor Necrosis Factor–α in Knee Osteoarthritis Hudiyanti, Vivin
Acta Interna The Journal of Internal Medicine Vol 2, No 1 (2012): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground. Tumor Necrosis Factor-α (TNF-α), a pro-inflammatory cytokine produced by monocyte is increased in osteoarthritis synovial fluid. Curcuminoid from Curcuma domestica Val. suppresses the secretion of TNF-α.Objective. The purpose of this study was to investigate the suppression effect of curcuminoid from Curcuma domestica Val on synovial fluid monocyte’s TNF-α secretion compared to diclofenac sodium in knee osteoarthritisMethods. A prospective randomized open end blinded evaluation (PROBE) method was applied. Subjects were patients with knee osteoarthritis visiting Rheumatology Clinic Dr. Sardjito Hospital and Wirosaban Hospital Yogyakarta. Curcuminoid 30 mg three times daily or diclofenac sodium 25 mg three times daily were administered for 4 weeks. The level of TNF-α secreted by synovial fluid’s monocytes were measured by ELISA before and after treatment.Results. A total of 80 subjects were enrolled, 39 subjects on curcuminoid treatment groups and 41 subjects on diclofenac sodium group. Seven subjects were dropped out, 5 from the curcuminoid group and 2 from the diclofenac sodium group. There was a significant decrement of TNF-α level during 4 weeks treatment in both groups (p< 0.001 respectively). There was no significant difference on TNF-α levels between groups (p= 0,237), neither in 50% decrement of TNF-α levels (p= 518).Conclusion. The effect of curcuminoid in decreasing TNF- α level on patients with osteoarthritis is similar with sodium diclofenac. Keywords: osteoarthritis-monocyte-TNF-α-curcuminoid-diclofenac sodium
Correlation between cystasin C to disease severity of cirrhosis on model of end stage liver disease score Gunadi, Heribertus; Bayupurnama, Putut; Nurdjanah, Siti
Acta Interna The Journal of Internal Medicine Vol 1, No 2 (2011): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground:    Cirrhosis patients  with renal failure  are  at   high   risk  for   death   and  reduced survival   as   compared   with   those   without   renal failure,  and have poor prognosis.  Some studies  have suggested   that  cystatin  C did  more  accurate   than creatinine /0  detect glomerulusfiltration    rate (GFR) in patients  with cirrhosis.  Model  of End Stage  Liver Disease  (MELD)  score  can be used in patients  with cirrhosis  with variously  Widely severity  disease  and etiologies.  Until nmv, there is no study about correlation  between  levels  of cystatin  C to disease severity  in cirrhosis based on MELD score.Objective:  This present  study  was to investigate  the correlation  between levels of cyst at ill C with disease severity  in cirrhosis  based on MELD score.Method:   Study  design  was cross sectional s t u d y,     This      study       was     conducted          at Gastoenterohepatology         outpatient     clinic    and Internal Medicine  ward of Dr Sardjito  General Hospital,     Yogyakarta.    Inclusion     criteria     were patients    with    cirrhosis    diagnosed     by   clinical criteria,  laboratory   and  USG.findillg,   age   >  18 years,   had  complete  medical  record  and  obtained informed consent. Exclusion criteria were chronic kidney  disease,  sepsis,  hepatocellutare   carcinoma, used high doses  of steroid,  had thyroid dysfunction. hypertension  and diabetes mellitus.Result:   The  mean  of cystatin   C based  on categorical    MELD    score   were   MELD    <10   = 0.93±0.19   mgll;   MELD    IO-19=1.08±0.26    mg/l; MELD  20-29   =  1.25±O.27 mgll;  MELD  30-39   = 2.49 mg/l and  MELD  >40  = 2.43 mgll;  0)=0.013; 95%   CI  0.000-0.061).     There   was   a  significant correlation   between  cystatin  C to MELD  score  as demonstrated   byp=O.OOOand r=0.485.Conclusion:     Our  data  suggested    a significant     correlation     with   medium    strength between cystatin  C to severity  disease  of cirrhosis based 011 MELD score. Keywords:  cirrhosis,  cystatin  C, MELD score  
A CROSS SECTIONAL STUDY QUALITY OF LIFE PEOPLE LIVING WITH HIV&AIDS: EMPHASIZE IN ANTHROPOMETRIC VALUE Walewangko, Olivia Cicilia
Acta Interna The Journal of Internal Medicine Vol 2, No 2 (2012): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground. The nutritional problem is a significant role factor in determine of health, mortality and quality of life of people with HIV&AIDS. Therefore, it is very important to provide the nutritional assessment, nutritional management, counseling and education which are very useful to upgrade the quality of life of people with HIV&AIDS.Objective. This study was designed to analyze the correlation between anthropometric measurement with quality of life of people with HIV&AIDS.Method. The study design was a cross sectional study. The subjects were HIV&AIDS patients who came to outpatient clinic in Dr. Sardjito General Hospital Yogyakarta, from November 2009 – January 2010. Subjects eligible with inclusion criteria were examined for anthropometric measurement and fill the WHOQOL-bref questioner.Result. There were 53 subjects eligible to the study criteria from November 2009 to January 2010. Majority of the subjects were man (73.6%), single (62.3%) and live alone (58.5%), last education was high school (41.5%) and employed (73.6%). Mean of ages was 33 years old, weight 53.67±10.3kg, height 161.28±7.68cm, BMI 20.57± 3.48 Kg/m2, MUAC 24.40 ± 3.23 cm, waist circumference 76.17 ± 8.10 cm, hip circumference 87.04 ± 8.03 cm , ST 11.17 ± 8.10 mm. Mean score of total WHOQOL-bref was 75.68 ± 10.3, Domain 1 (physics) 21.32 ± 3.07, Domain 2 (psychology) 19.75 ± 3.62 , Domain 3 (social) 10.04 ± 1.87, Domain 4 (environment) 24.75 ± 4.58. There was a very weak correlation between anthropometric measurements with quality of life; with the p value was statistically insignificant.Conclusion. There was no significant correlation between nutritional statuses which is measured by the anthropometric value with the quality of life in people with HIV&AIDS. Keywords: HIV, nutrition, anthropometric, QOL 
Relationship between plasma fi brinogen levels with model of end stage liver disease score in patients with liver cirrhosis Nasir, Moch. Abdul; Ratnasari, Neneng; Bayupurnama, Putut
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
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ABSTRACTIntroduction. One of the complications which often occur in the liver cirrhosis is bleeding. Closely associated with weighing of bleeding were disturbance haemostatic homeostasis disorders that commonly associated with impaired liver function. Therefore certain biomarkers are needed to objectively measure the severity of liver cirrhosis. Fibrinogen is one of the clotting factors that can be used to determine the severity of liver cirrhosis.The model of end-stage liver disease (MELD) score is most excellent alternative of the Child-Pugh score. It can be used in patients with liver cirrhosis spacious ranges severity of disease and etiology even in patients whose cirrhosis etiology are not clear. Currently, there was not any data showing the correlation between the level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis. Aims. This study aimed to determine the correlation between level of plasmatic fi brinogen and MELD score in patients with liver cirrhosis.Method. This study was cross-sectionally conducted used consecutive sampling. Study population were eligible patients with liver cirrhosis who visited outpatient and inpatient clinic in the Division of Gastroentero-hepatology, Dr. Sardjito general hospital, between November 2011 to October 2012. Correlation between the level of plasmatic fibrinogen and MELD score was statistically assessed using correlation test with fi nal result stated as correlation coefficient (r).Result. There were 40 subjects that met criteria, 28 male and 12 female, with average age of 53 ± 12,51 years. Etiology of cirrhosis was viral hepatitis B in 16 (40,0%) subjects, hepatitis C in 11 (27,5%) subjects and non viral in 13 (32,5%) subjects. Subjects with ascites were 19 (47, 5%) and without ascites were 20 (52.5%). Bleeding was experienced by 30 (80.0%) subjects while 10 (20,0%) subjects did not present with bleeding. Mean of plasma fibrinogen was 198 ± 102, 89 mg/dl, and mean of the MELD score was 17,05 ± 8.79. Spearman correlation coefficients between fi brinogen and MELD score was r = -0,404 (p = 0,010).Conclusion. There was a negative correlation between plasma fi brinogen and the MELD score in liver cirrhosis patients visiting our local setting.Keywords: liver cirrhosis, fi brinogen, MELD score
Differences of lung function in elderly patients with and without hypertension in RSUP Dr. Sardjito Yogyakarta Sutriningsih, Bungsu Wahyu; Sumardi, Sumardi; Pramantara, I Dewa Putu
Acta Interna The JOurnal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground: In the elderly, there is a decrease in lung vital capacity to 68%. The prevalence of hypertension is at the age above 65 years with 13% of the population. The Incidence of lung function decline in chronic heart failure and hypertension was found mainly in the elderly.Aims: The aim of the study was to know the differences ilung function in elderly patients with and without hypertension.Methods: The Study was cross-sectional, a study in November 2012 until January 2013 of the elderly population over 60 years of research with a sample of 58 people (29 people and 29 groups of hypertensive people without hypertension). Inclusion criteria for the study subjects were elderly patients over 60 years of signing the informed consent, can perform spirometry maneuvers correctly. Data were analyzed by T-test to examine some differences in the mean or median, between the two groups.Results: In this research, there were no signifi cant difference in lung function as measured by FVC and FEV1 in the elderly with hypertension and without hypertension (p = 0.984, 95% CI-0, 13-0,139 for FVC and p = 0.83, 95 IK-0, 14-0,116% for FEV1).Conclusion: There is no signifi cant difference in lung function in the elderly with and without hypertension.Keywords: elderly, hypertension, pulmonary function1Speciality
Effects of latihan pasrah diri in quality of life in chronic kidney disease-dialysis patients with depression symptoms Widyaningrum, Widyaningrum; Siswanto, Agus; Djarwoto, Bambang
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground: Patients with chronic kidney disease (CKD) suffering from various physical and emotional symptoms show depression and disturbance in quality of life. Patients with chronic kidney disease have a decreased quality of life, and mortality rate about 22% in every year. Depression in patients with CKD must be managed properly because a large effect on HRQOL (Health Related Quality of Life) and the potential side effects on the management of patients with CKD. Latihan pasrah diri (LPD) is a method combining relaxation and remembrance with a focus on breathing exercises and words contained in the dhikr (relaxation and repetitive prayer). The rise of the relaxation response is expected to improve the symptoms of stress or depressive symptoms, which is expected to improve HRQOL.Objective: This study aimed to determine the effect of LPD on quality of life in hemodialysis patients with depressive symptoms that was compared with controls.Methods: The research constituted the study of Randomized Control Trial. The research was measured the KDQOL-SF scores (Kidney Disease Quality of Life-SF) in subjects with LPD treatment during 21 days, compared with controls. The research was conducted at the Hemodialysis Unit of Dr. Sardjito Hospital, Yogyakarta, from May to June 2012. A total of 36 patients who met the inclusion criteria were randomized and divided into LPD group (n = 18) and control group (n = 18).Results: Found a statistically signifi cant decrease in BDI scores in both groups, 23.00 ± 5.34 to 15.00 ± 8.55 (p = 0.001) in the LPD group and 23.00 ± 5.34 to18.33 ± 6, 66 (p = 0.022) in the control group. KDQOL-SF scores after treatment when compared between the LPD and control groups experienced different changes were statistically signifi cant in domains effects of kidney disease 59.65 ±23.52 compared to 39.41 ± 20.03 (p = 0.022), sleep 69 ± 13.17 compared to 46.53. (p = 0.000), overall health 73.89 ± 16.85 compared to 57.22 ± 19.04 (p = 0.009), pain 64.86 ± 20.80 compared to 42.36 ± 24.90 (p = 0.005), general health 53.88 ±16.05 compared to 47.78 ± 20.74 (p = 0.014), and the physical component scale 35.98 ± 6, 83 compared to 29.12 ± 6.46 (p = 0.004). Despite increased KDQOL-SF domain scores, but there were 2 domains that Δ KDQOL-SF score changes were statistically signifi cantly different compared with the control group, which was the domain of sleep and overall health.Conclusion: Latihan pasrah diri twice a day during 21 days (3 weeks) can improved the quality of life of patients with symptoms depression in CKD patients undergoing hemodialysis in domains of sleep and overall health.Keywords: CKD, depression, latihan pasrah diri, KDQOL-SF.
The effects of albumin concentration to outcome of acute respiratory distress syndrome (ARDS) patients in intensive care unit RSUP Dr. Sardjito Yogyakarta Parmawati, Novia Etty
Acta Interna The Journal of Internal Medicine Vol 3, No 2 (2013): Acta Interna The Journal of Internal Medicine
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ABSTRACTBackground: Hipoproteinemia mostly happened in critically ill patients, including ARDS, and usually comes toworst clinical appearance. Early ARDS is characterized by a rising of the permeability in the alveolar-capillarybarrier, leading to an infl ux of fl uid into the alveoli, and albumin also has a major role to control the osmolatoryof plasma.Aim: The aim of the study was to know about the effect of the albumin concentration to outcome (survivor/nonsurvivor) of the ARDS patient in the Intensive Care Unit (ICU) RSUP Dr. Sardjito.Methods: This study used cross-sectional method. The samples of this study were the patients at the ICU RSUPDr. Sardjito Yogyakarta, from January 2009 until December 2011. The diagnosed of ARDS based on EACCcriteria. The inclusion criteria were people with age ≥ 18 years old, fulfi ll diagnostic criteria of ARDS, and treatedin ICU. The demography, laboratory result, and curing process, have been tested statistically in SPSS 17. Thevariable was analyzed by chi-square and Mann-Whitney test, signifi cantly considered if p < 0,05.Results: The samples who fulfi ll these criteria were 61 patients. Mostly women (54,1%) with 49 years-old rangeand the result were 34 patients (55,7%) died. The biggest cause of ARDS was pneumonia (60,7 %) and thebiggest Comorbid was malignant (21,6%). The mortality rate of ARDS was 5,75%. The result of univariat analysiswas the increased of transaminase enzyme (p 0,007), COPD Co morbid (p 0, 02) and length of stay in the ICU (p= 0,021) which was signifi cantly given effect to the outcome of the patients. The survivors have higher albuminconcentration (2, 6) than in non survivors (2, 4), although not statistically signifi cant (p = 0,621).Conclusion:The albumin concentration did not have a statistically signifi cant effect to the outcome of the ARDSpatient in ICU RSUP Dr. Sardjito Yogyakarta. The main factor was the increase of transaminase enzyme, Comorbid COPD, and length of stay in the ICU.Keywords: ARDS, albumin concentration, ICU

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