Eksaserbasi asma dalam kehamilan dapat mempersulit proses persalinan dan berisiko bayi lahir dengan berat badan lahir rendah dan ibu berisiko mengalami persalinan preterm, preeklampsia, dan sectio caessaria. Penyebab eksaserbasi asma dalam kehamilan dapat akibat terapi kurang optimal selama kehamilan akibat kekhawatiran personal pasien dan dokter yang kurang didukung bukti terkait keamanan agen farmakologis asma dalam kehamilan, dan rendahnya kepatuhan pasien untuk kontrol rutin, terutama selama masa pandemi COVID-19. Hingga kini, manajemen asma antenatal menjadi tugas besar dokter umum di layanan primer, dan dokter spesialis obstetrik dan ginekologi, serta dokter spesialis paru di layanan sekunder, sedangkan panduan khusus komprehensif asma dalam kehamilan di Indonesia masih terbatas. Telaah literatur ini bertujuan untuk memberikan pemahaman esensial perubahan klinis dan mekanisme yang berkontribusi terhadap tidak terkontrolnya asma selama kehamilan, pendekatan diagnosis komprehensif asma dalam kehamilan, dan menyediakan informasi obat-obatan yang aman untuk manajemen asma dalam kehamilan. Asthma exacerbations in pregnancy can complicate the delivery process and risk low birth weight in the baby, as well as preterm labor, preeclampsia, and a cesarean section in mothers. Asthma exacerbations during pregnancy can be caused by ineffective treatment due to patient and physician concerns about the safety of asthma medications during pregnancy that are not supported by reliable data, as well as poor patient compliance for routine control, particularly during the COVID-19 pandemic. Asthma management during antenatal care falls primarily on general practitioners in primary care, and obstetricians and gynecologists, and pulmonologists in secondary-level services. While specific guidelines in Indonesia are still limited, this review aims to present a fundamental understanding of clinical changes and mechanisms that contribute to the uncontrolled status of asthma during pregnancy, a comprehensive diagnostic approach to asthma in pregnancy, and provide a safety drug profile during pregnancy
{"title":"Manajemen Asma dalam Kehamilan: Apa yang Harus Dipahami oleh Dokter Umum","authors":"M. Habiburrahman, M. I. D. Rakasiwi","doi":"10.55175/cdk.v50i3.657","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.657","url":null,"abstract":"Eksaserbasi asma dalam kehamilan dapat mempersulit proses persalinan dan berisiko bayi lahir dengan berat badan lahir rendah dan ibu berisiko mengalami persalinan preterm, preeklampsia, dan sectio caessaria. Penyebab eksaserbasi asma dalam kehamilan dapat akibat terapi kurang optimal selama kehamilan akibat kekhawatiran personal pasien dan dokter yang kurang didukung bukti terkait keamanan agen farmakologis asma dalam kehamilan, dan rendahnya kepatuhan pasien untuk kontrol rutin, terutama selama masa pandemi COVID-19. Hingga kini, manajemen asma antenatal menjadi tugas besar dokter umum di layanan primer, dan dokter spesialis obstetrik dan ginekologi, serta dokter spesialis paru di layanan sekunder, sedangkan panduan khusus komprehensif asma dalam kehamilan di Indonesia masih terbatas. Telaah literatur ini bertujuan untuk memberikan pemahaman esensial perubahan klinis dan mekanisme yang berkontribusi terhadap tidak terkontrolnya asma selama kehamilan, pendekatan diagnosis komprehensif asma dalam kehamilan, dan menyediakan informasi obat-obatan yang aman untuk manajemen asma dalam kehamilan. \u0000Asthma exacerbations in pregnancy can complicate the delivery process and risk low birth weight in the baby, as well as preterm labor, preeclampsia, and a cesarean section in mothers. Asthma exacerbations during pregnancy can be caused by ineffective treatment due to patient and physician concerns about the safety of asthma medications during pregnancy that are not supported by reliable data, as well as poor patient compliance for routine control, particularly during the COVID-19 pandemic. Asthma management during antenatal care falls primarily on general practitioners in primary care, and obstetricians and gynecologists, and pulmonologists in secondary-level services. While specific guidelines in Indonesia are still limited, this review aims to present a fundamental understanding of clinical changes and mechanisms that contribute to the uncontrolled status of asthma during pregnancy, a comprehensive diagnostic approach to asthma in pregnancy, and provide a safety drug profile during pregnancy","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129349823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jason Theola, Nurul Mutmainna Yakub, Valentino Ryu Yudianto, Bunga Cecilia Sinaga
Defek septum ventrikel (VSD) adalah kelainan jantung kongenital yang ditandai dengan adanya hubungan abnormal antara ventrikel kiri dan kanan jantung, sehingga menimbulkan gangguan hemodinamik. VSD merupakan kelainan jantung bawaan yang paling sering ditemui pada anak-anak, serta merupakan kelainan kedua paling sering ditemui pada orang dewasa setelah katup aorta bikuspid. Sebagian besar VSD menutup spontan, namun VSD yang gagal menutup dapat menimbulkan komplikasi seperti hipertensi arteri pulmoner, disfungsi ventrikel, dan risiko aritmia. Diagnosis VSD komprehensif melalui anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang untuk menentukan tata laksana dan prognosisnya. Ventricular septal defect is a congenital heart disorder characterized by an abnormal connection between the left and the right ventricle of the heart, causing hemodynamic disturbances. VSD is the most common congenital heart defect in children, and is the second most common abnormality in adults after the bicuspid aortic valve. Most VSDs close spontaneously, but failure to close can lead to complications such as pulmonary arterial hypertension, ventricular dysfunction, and the risk of arrhythmias. Diagnosis needs to be comprehensive through history, physical examination, and other supporting examinations for treatment planning and prognosis.
{"title":"Defek Septum Ventrikel: Diagnosis dan Tata Laksana","authors":"Jason Theola, Nurul Mutmainna Yakub, Valentino Ryu Yudianto, Bunga Cecilia Sinaga","doi":"10.55175/cdk.v50i3.656","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.656","url":null,"abstract":"Defek septum ventrikel (VSD) adalah kelainan jantung kongenital yang ditandai dengan adanya hubungan abnormal antara ventrikel kiri dan kanan jantung, sehingga menimbulkan gangguan hemodinamik. VSD merupakan kelainan jantung bawaan yang paling sering ditemui pada anak-anak, serta merupakan kelainan kedua paling sering ditemui pada orang dewasa setelah katup aorta bikuspid. Sebagian besar VSD menutup spontan, namun VSD yang gagal menutup dapat menimbulkan komplikasi seperti hipertensi arteri pulmoner, disfungsi ventrikel, dan risiko aritmia. Diagnosis VSD komprehensif melalui anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang untuk menentukan tata laksana dan prognosisnya. \u0000Ventricular septal defect is a congenital heart disorder characterized by an abnormal connection between the left and the right ventricle of the heart, causing hemodynamic disturbances. VSD is the most common congenital heart defect in children, and is the second most common abnormality in adults after the bicuspid aortic valve. Most VSDs close spontaneously, but failure to close can lead to complications such as pulmonary arterial hypertension, ventricular dysfunction, and the risk of arrhythmias. Diagnosis needs to be comprehensive through history, physical examination, and other supporting examinations for treatment planning and prognosis.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126289124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karina Puspaseruni, Edmond Da Rizka, Wisnu Sakulat
Hypertensive emergencies are characterized by severe increases in blood pressure with evidence of hypertension-mediated organ damage (HMOD) and are associated with an increased risk of cardiovascular events, i.e. coronary heart disease (CHD) and mortality. Case: A 75-year-old man with typical chest pain with nausea and vomiting 1 hour before admission. Blood pressure was 200/100 mmHg, ECG showed T inversion in leads II, III, AVF, V1-V6 and prolonged QT interval, cardiomegaly on chest x-ray, and leukocytosis, hyperglycemia, and hypokalemia. The diagnoses were non-ST elevation acute coronary syndrome (NSTE-ACS), hypertensive emergency, and T2DM. Treatment in the ICCU consists of intravenous antihypertensive, antiplatelet, anticoagulant, statin, nitrate, insulin, and potassium chloride for electrolyte correction. The patient was admitted to the ICCU for further observation and management. Hipertensi emergensi ditandai dengan kenaikan tekanan darah yang sangat disertai bukti kerusakan organ yang progresif (hypertension-mediated organ damage - HMOD). Keadaan ini berkaitan dengan peningkatan risiko kejadian penyakit kardiovaskular, seperti penyakit jantung koroner bahkan kematian. Kasus: Seorang laki-laki usia 75 tahun dengan nyeri dada tipikal sejak 1 jam sebelum datang ke rumah sakit disertai mual dan muntah. Tekanan darah 200/100 mmHg, pada EKG didapatkan inversi T pada lead II, III, AVF, V1-V6, dan pemanjangan interval QT. Pada pemeriksaan X-ray dada didapatkan kardiomegali, hasil laboratorium menunjukkan leukositosis, hiperglikemi, dan hipokalemi. Pasien didiagnosis non-ST elevation acute coronary syndrome (NSTE-ACS), hipertensi emergensi, dan diabetes melitus tipe 2. Tata laksana di ICCU menggunakan anti-hipertensi intravena, anti-platelet, anti-koagulan, statin, nitrat, insulin, dan kalium klorida untuk koreksi elektrolit. Pasien dirawat di ICCU untuk observasi dan tata laksana lebih lanjut.
高血压急症的特点是血压严重升高，伴有高血压介导的器官损伤(HMOD)，并与心血管事件(即冠心病)和死亡风险增加相关。病例:75岁男性，入院前1小时胸痛伴恶心呕吐。血压200/100 mmHg，心电图示II导联、III导联、AVF导联、V1-V6导联T反转，QT间期延长，胸片示心脏增大，白细胞增多，高血糖，低钾血症。诊断为非st段抬高急性冠状动脉综合征(NSTE-ACS)、高血压急诊和T2DM。重症监护病房的治疗包括静脉注射抗高血压药、抗血小板药、抗凝血药、他汀类药物、硝酸盐、胰岛素和用于纠正电解质的氯化钾。患者被送入重症监护室进一步观察和处理。高血压介导的器官损伤(HMOD)。Keadaan ini berkaitan dengan peningkatan visiko kejadian penyakit cardiovaskular, perti penyakit jantung koroner bakan kematian。Kasus: Seorang laki-laki usia 75 tahun dengan nyeri dada tipikal sejak 1 jam sebelum datang ke rumah sakit disertai互丹蒙塔。T导联II, III, AVF, V1-V6, dan pemanjangan间期QT, pada pemeriksaan x线数据didapatkan心脏肥大，hasil laboratorium menunjukkan白细胞增多症，hiperglikami, dan hipokalemi。帕森诊断为非st段抬高急性冠状动脉综合征(NSTE-ACS)，高血压，糖尿病2型。抗高血压，抗血小板，抗凝血酶，他汀类药物，硝酸盐，胰岛素，丹克罗里达钾。帕西尼迪拉特是国际货币基金组织(ICCU)的成员之一。
{"title":"Non-ST Elevation Acute Coronary Syndrome (NSTEACS) as Hypertension-Mediated Organ Damage (HMOD) in Hypertensive Emergencies","authors":"Karina Puspaseruni, Edmond Da Rizka, Wisnu Sakulat","doi":"10.55175/cdk.v50i3.659","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.659","url":null,"abstract":"Hypertensive emergencies are characterized by severe increases in blood pressure with evidence of hypertension-mediated organ damage (HMOD) and are associated with an increased risk of cardiovascular events, i.e. coronary heart disease (CHD) and mortality. Case: A 75-year-old man with typical chest pain with nausea and vomiting 1 hour before admission. Blood pressure was 200/100 mmHg, ECG showed T inversion in leads II, III, AVF, V1-V6 and prolonged QT interval, cardiomegaly on chest x-ray, and leukocytosis, hyperglycemia, and hypokalemia. The diagnoses were non-ST elevation acute coronary syndrome (NSTE-ACS), hypertensive emergency, and T2DM. Treatment in the ICCU consists of intravenous antihypertensive, antiplatelet, anticoagulant, statin, nitrate, insulin, and potassium chloride for electrolyte correction. The patient was admitted to the ICCU for further observation and management. \u0000Hipertensi emergensi ditandai dengan kenaikan tekanan darah yang sangat disertai bukti kerusakan organ yang progresif (hypertension-mediated organ damage - HMOD). Keadaan ini berkaitan dengan peningkatan risiko kejadian penyakit kardiovaskular, seperti penyakit jantung koroner bahkan kematian. Kasus: Seorang laki-laki usia 75 tahun dengan nyeri dada tipikal sejak 1 jam sebelum datang ke rumah sakit disertai mual dan muntah. Tekanan darah 200/100 mmHg, pada EKG didapatkan inversi T pada lead II, III, AVF, V1-V6, dan pemanjangan interval QT. Pada pemeriksaan X-ray dada didapatkan kardiomegali, hasil laboratorium menunjukkan leukositosis, hiperglikemi, dan hipokalemi. Pasien didiagnosis non-ST elevation acute coronary syndrome (NSTE-ACS), hipertensi emergensi, dan diabetes melitus tipe 2. Tata laksana di ICCU menggunakan anti-hipertensi intravena, anti-platelet, anti-koagulan, statin, nitrat, insulin, dan kalium klorida untuk koreksi elektrolit. Pasien dirawat di ICCU untuk observasi dan tata laksana lebih lanjut.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"187 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114539198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Psoriasis merupakan penyakit radang kulit kronis dengan dasar genetik yang kuat. Berdasarkan tipenya, psoriasis dibagi menjadi psoriasis plak (psoriasis vulgaris), psoriasis gutata, psoriasis pustulosa generalisata/lokalisata, psoriasis inversa, dan eritroderma psoriatika. Manajemen psoriasis pustulosa mempertimbangkan tingkat keparahan penyakit. Acitretin, cyclosporine, methotrexate, dan infliximab merupakan terapi lini pertama untuk psoriasis pustular generalisata. Adalimumab, etanercept, dan psoralen plus ultraviolet A (PUVA) adalah modalitas lini kedua. Berbagai modalitas terapi lain yang sedang dikembangkan adalah agen biologis dan terapi berdasar sel punca. Manajemen psoriasis pustulosa dapat menggunakan berbagai modalitas dengan memperhatikan kondisi pasien dan keterjangkauan terapi Psoriasis is a chronic skin inflammation with a strong genetic basis. Based on its type, psoriasis is divided into plaque psoriasis (psoriasis vulgaris), guttate psoriasis, generalized/localized pustular psoriasis, inverse psoriasis, and psoriatic erythroderma. The management of pustular psoriasis depends on the disease severity. Acitretin, cyclosporine, methotrexate, and infliximab are first-line therapies for generalized pustular psoriasis. Adalimumab, etanercept, and psoralen plus ultraviolet A (PUVA) are second-line modalities. Other therapeutic modalities being developed are biologic agents and stem cell-based therapies. Management of pustular psoriasis can use various modalities, depending on the patient’s condition and its affordability
{"title":"Manajemen Psoriasis Pustulosa","authors":"Yefta, D. Winarni, Y. Wirohadidjojo","doi":"10.55175/cdk.v50i3.658","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.658","url":null,"abstract":"Psoriasis merupakan penyakit radang kulit kronis dengan dasar genetik yang kuat. Berdasarkan tipenya, psoriasis dibagi menjadi psoriasis plak (psoriasis vulgaris), psoriasis gutata, psoriasis pustulosa generalisata/lokalisata, psoriasis inversa, dan eritroderma psoriatika. Manajemen psoriasis pustulosa mempertimbangkan tingkat keparahan penyakit. Acitretin, cyclosporine, methotrexate, dan infliximab merupakan terapi lini pertama untuk psoriasis pustular generalisata. Adalimumab, etanercept, dan psoralen plus ultraviolet A (PUVA) adalah modalitas lini kedua. Berbagai modalitas terapi lain yang sedang dikembangkan adalah agen biologis dan terapi berdasar sel punca. Manajemen psoriasis pustulosa dapat menggunakan berbagai modalitas dengan memperhatikan kondisi pasien dan keterjangkauan terapi \u0000 \u0000Psoriasis is a chronic skin inflammation with a strong genetic basis. Based on its type, psoriasis is divided into plaque psoriasis (psoriasis vulgaris), guttate psoriasis, generalized/localized pustular psoriasis, inverse psoriasis, and psoriatic erythroderma. The management of pustular psoriasis depends on the disease severity. Acitretin, cyclosporine, methotrexate, and infliximab are first-line therapies for generalized pustular psoriasis. Adalimumab, etanercept, and psoralen plus ultraviolet A (PUVA) are second-line modalities. Other therapeutic modalities being developed are biologic agents and stem cell-based therapies. Management of pustular psoriasis can use various modalities, depending on the patient’s condition and its affordability","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116262422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prevalensi stroke terus meningkat setiap tahun. Penanganan kasus stroke harus dilakukan sesegera mungkin untuk memaksimalkan pemulihan serta mencegah berulang. Pada kasus stroke iskemik akut, pengobatan fibrinolitik tPA terbukti efektif. Beberapa kriteria pemberian harus dipenuhi. Pasien yang mendapat tPA harus mendapat observasi tekanan darah ketat dan memastikan tidak terjadi efek samping perdarahan. Hingga saat ini, hanya alteplase yang disetujui untuk pengobatan fibrinolitik pada pasien stroke iskemik akut. Telaah ilmiah berbasis bukti menunjukkan manfaat tPA lain. yaitu tenecteplase. The prevalence of stroke continues to increase. To minimize brain injury, prompt management is necessary to maximize patient recovery and prevent recurrent strokes. Fibrinolytic tPA has been proven to be effective for acute ischemic stroke. Several criteria must be met before tPA administration. Patients should receive close monitoring of blood pressure and for bleeding risk. Until recently, only tPA alteplase has been approved for fibrinolytic treatment in acute ischemic stroke. Several evidence-based studies have shown the benefits of tenecteplase - another tPA - in acute ischemic stroke management.
{"title":"Terapi Tissue Plasminogen Activator untuk Stroke Iskemik Akut","authors":"Allen","doi":"10.55175/cdk.v50i3.661","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.661","url":null,"abstract":"Prevalensi stroke terus meningkat setiap tahun. Penanganan kasus stroke harus dilakukan sesegera mungkin untuk memaksimalkan pemulihan serta mencegah berulang. Pada kasus stroke iskemik akut, pengobatan fibrinolitik tPA terbukti efektif. Beberapa kriteria pemberian harus dipenuhi. Pasien yang mendapat tPA harus mendapat observasi tekanan darah ketat dan memastikan tidak terjadi efek samping perdarahan. Hingga saat ini, hanya alteplase yang disetujui untuk pengobatan fibrinolitik pada pasien stroke iskemik akut. Telaah ilmiah berbasis bukti menunjukkan manfaat tPA lain. yaitu tenecteplase. \u0000The prevalence of stroke continues to increase. To minimize brain injury, prompt management is necessary to maximize patient recovery and prevent recurrent strokes. Fibrinolytic tPA has been proven to be effective for acute ischemic stroke. Several criteria must be met before tPA administration. Patients should receive close monitoring of blood pressure and for bleeding risk. Until recently, only tPA alteplase has been approved for fibrinolytic treatment in acute ischemic stroke. Several evidence-based studies have shown the benefits of tenecteplase - another tPA - in acute ischemic stroke management.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124687674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hipertensi portal merupakan konsekuensi klinis dari sirosis hati. Angka kematian karena hipertensi portal masih tinggi di Indonesia. Pada kondisi sirosis kompensata munculnya hipertensi portal yang signifikan secara klinis (clinically significant portal hypertension/CSPH) dapat memprediksi kejadian dekompensasi dan merupakan penanda prognosis penyakit yang lebih buruk. Diagnosis CSPH dapat dengan cara invasif ataupun non-invasif. Tata laksana CSPH pada kondisi sirosis kompensata diutamakan untuk mencegah timbulnya dekompensasi sirosis. Pemberian penghambat beta non-selektif (non-selective beta blocker/NSBB) pada kondisi sirosis kompensata efektif menurunkan hipertensi portal dan mampu mencegah dekompensasi. Portal hypertension is a major consequences of liver cirrhosis. Mortality rate from portal hypertension is quite high in Indonesia. In patients with liver cirrhosis, the development of clinically significant portal hypertension (CSPH) is predictive for decompensation and worse prognosis. Diagnosis of CSPH can be carried out by either invasive or non-invasive methods. The aim of CSPH management in compensated cirrhosis is to prevent the incidence of decompensation. Management of compensated cirrhosis with non-selective beta blocker (NSBB) has been shown to reduce portal hypertension and the incidence of first decompensation.
{"title":"Carvedilol untuk Tata Laksana Clinically Significant Portal Hypertension pada Sirosis Kompensata","authors":"Ach. Sulaiman","doi":"10.55175/cdk.v50i3.660","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.660","url":null,"abstract":"Hipertensi portal merupakan konsekuensi klinis dari sirosis hati. Angka kematian karena hipertensi portal masih tinggi di Indonesia. Pada kondisi sirosis kompensata munculnya hipertensi portal yang signifikan secara klinis (clinically significant portal hypertension/CSPH) dapat memprediksi kejadian dekompensasi dan merupakan penanda prognosis penyakit yang lebih buruk. Diagnosis CSPH dapat dengan cara invasif ataupun non-invasif. Tata laksana CSPH pada kondisi sirosis kompensata diutamakan untuk mencegah timbulnya dekompensasi sirosis. Pemberian penghambat beta non-selektif (non-selective beta blocker/NSBB) pada kondisi sirosis kompensata efektif menurunkan hipertensi portal dan mampu mencegah dekompensasi. \u0000Portal hypertension is a major consequences of liver cirrhosis. Mortality rate from portal hypertension is quite high in Indonesia. In patients with liver cirrhosis, the development of clinically significant portal hypertension (CSPH) is predictive for decompensation and worse prognosis. Diagnosis of CSPH can be carried out by either invasive or non-invasive methods. The aim of CSPH management in compensated cirrhosis is to prevent the incidence of decompensation. Management of compensated cirrhosis with non-selective beta blocker (NSBB) has been shown to reduce portal hypertension and the incidence of first decompensation.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127545310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabrielle Alexander Kartawan, Achmad Yusri Rachmani Diartoputro
Tamponade jantung merupakan kondisi emergensi yang disebabkan oleh peningkatan tekanan intraperikardium karena akumulasi cairan pericardium, sehingga terjadi kompresi ruang-ruang jantung, mengakibatkan curah jantung menurun. Terapi definitif tamponade jantung adalah perikardiosentesis, dapat dilakukan dengan bantuan ekokardiografi. Keberhasilan perikardiosentesis ekokardiografi mencapai >95%, namun juga memiliki risiko tinggi hingga beberapa komplikasi. Kasus seorang perempuan 17 tahun dengan SLE dan tamponade jantung datang dengan instabilitas hemodinamik. Perikardiosentesis ekokardiografi berhasil dilakukan. Laporan ini disertai langkah-langkah prosedur perikardiosentesis ekokardiografi dan pembahasan komorbiditas hipertensi pulmonal dan komplikasinya. Cardiac tamponade is an emergency condition caused by intrapericardial pressure increase due to pericardial fluid accumulationresulting in compressed cardiac chambers and reduced cardiac output. Definitive therapy is pericardiocentesis, which could be done with the guidance of echocardiography. Echocardiography-guided pericardiocentesis procedure has a>95% success rate, but it carries some potential high risks and several complications. The case is a 17-year-old SLE female patient presenting with cardiac tamponade and hemodynamic instability. Echocardiography-guided pericardiocentesis was successfully done. This case report is supplemented by a step-by-step procedure and discussion on possible pulmonary hypertension comorbidities and their complications.
{"title":"Perikardiosentesis Ekokardiografi pada Tamponade Jantung dan Suspek Hipertensi Pulmonal: Langkah-Langkah Prosedur dan Komplikasinya","authors":"Gabrielle Alexander Kartawan, Achmad Yusri Rachmani Diartoputro","doi":"10.55175/cdk.v50i3.663","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.663","url":null,"abstract":"Tamponade jantung merupakan kondisi emergensi yang disebabkan oleh peningkatan tekanan intraperikardium karena akumulasi cairan pericardium, sehingga terjadi kompresi ruang-ruang jantung, mengakibatkan curah jantung menurun. Terapi definitif tamponade jantung adalah perikardiosentesis, dapat dilakukan dengan bantuan ekokardiografi. Keberhasilan perikardiosentesis ekokardiografi mencapai >95%, namun juga memiliki risiko tinggi hingga beberapa komplikasi. Kasus seorang perempuan 17 tahun dengan SLE dan tamponade jantung datang dengan instabilitas hemodinamik. Perikardiosentesis ekokardiografi berhasil dilakukan. Laporan ini disertai langkah-langkah prosedur perikardiosentesis ekokardiografi dan pembahasan komorbiditas hipertensi pulmonal dan komplikasinya. \u0000Cardiac tamponade is an emergency condition caused by intrapericardial pressure increase due to pericardial fluid accumulationresulting in compressed cardiac chambers and reduced cardiac output. Definitive therapy is pericardiocentesis, which could be done with the guidance of echocardiography. Echocardiography-guided pericardiocentesis procedure has a>95% success rate, but it carries some potential high risks and several complications. The case is a 17-year-old SLE female patient presenting with cardiac tamponade and hemodynamic instability. Echocardiography-guided pericardiocentesis was successfully done. This case report is supplemented by a step-by-step procedure and discussion on possible pulmonary hypertension comorbidities and their complications.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"185 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121280618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gagal jantung pediatrik merupakan penyebab mortalitas dan morbiditas anak-anak. Terdapat hubungan antara gagal jantung pediatrik, penyakit jantung bawaan, dan kardiomiopati. Tujuan pengobatan gagal jantung pediatrik untuk mencegah perburukan dan agar perkembangan anak optimal. Tata laksana gagal jantung pada anak-anak diekstrapolasi dari pendekatan tata laksana dewasa. Pediatric heart failure is a leading cause of mortality and morbidity in children. There is an association between pediatric heart failure, congenital heart disease, and cardiomyopathy. The treatment goal for heart failure in children is to prevent worsening and to provide optimal development. Management of heart failure in children is extrapolated from management in adults.
{"title":"Tata Laksana Gagal Jantung Pediatrik","authors":"Erick Ferdinand, Ni Made Candra Widyantari","doi":"10.55175/cdk.v50i3.655","DOIUrl":"https://doi.org/10.55175/cdk.v50i3.655","url":null,"abstract":"Gagal jantung pediatrik merupakan penyebab mortalitas dan morbiditas anak-anak. Terdapat hubungan antara gagal jantung pediatrik, penyakit jantung bawaan, dan kardiomiopati. Tujuan pengobatan gagal jantung pediatrik untuk mencegah perburukan dan agar perkembangan anak optimal. Tata laksana gagal jantung pada anak-anak diekstrapolasi dari pendekatan tata laksana dewasa. \u0000Pediatric heart failure is a leading cause of mortality and morbidity in children. There is an association between pediatric heart failure, congenital heart disease, and cardiomyopathy. The treatment goal for heart failure in children is to prevent worsening and to provide optimal development. Management of heart failure in children is extrapolated from management in adults.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122115657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ethylene glycol (EG) dan diethylene glycol (DEG) adalah senyawa alkohol toksik berbentuk cairan dengan rasa manis; senyawa ini dapat ditemukan di beberapa alat rumah tangga, zat antibeku, dan pelarut automotif dan industri. Keracunan akibat konsumsi bisa fatal. Keracunan EG dan DEG merupakan keadaan darurat medis yang membutuhkan diagnosis segera dan pengobatan agresif meliputi terapi suportif, antidot fomepizole atau ethanol, dan hemodialisis. Ethylene glycol (EG) and diethylene glycol (DEG) are toxic alcohol compounds in the form of liquids with a sweet taste found in some household appliances, antifreeze agents, and solvents for automotive and industrial purposes. Poisoning from ingestion can be fatal. EG and DEG poisoning are medical emergencies requiring prompt diagnosis and aggressive treatment, including supportive therapy, antidotes fomepizole or ethanol, and hemodialysis.
{"title":"Tata Laksana Keracunan Ethylene Glycol dan Diethylene Glycol","authors":"Johan Indra Lukito","doi":"10.55175/cdk.v50i2.526","DOIUrl":"https://doi.org/10.55175/cdk.v50i2.526","url":null,"abstract":"Ethylene glycol (EG) dan diethylene glycol (DEG) adalah senyawa alkohol toksik berbentuk cairan dengan rasa manis; senyawa ini dapat ditemukan di beberapa alat rumah tangga, zat antibeku, dan pelarut automotif dan industri. Keracunan akibat konsumsi bisa fatal. Keracunan EG dan DEG merupakan keadaan darurat medis yang membutuhkan diagnosis segera dan pengobatan agresif meliputi terapi suportif, antidot fomepizole atau ethanol, dan hemodialisis. \u0000Ethylene glycol (EG) and diethylene glycol (DEG) are toxic alcohol compounds in the form of liquids with a sweet taste found in some household appliances, antifreeze agents, and solvents for automotive and industrial purposes. Poisoning from ingestion can be fatal. EG and DEG poisoning are medical emergencies requiring prompt diagnosis and aggressive treatment, including supportive therapy, antidotes fomepizole or ethanol, and hemodialysis.","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123292644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: A subsequent headache within seven days of a head injury (or after regaining consciousness after the head trauma)is referred to as a post-traumatic headache (PTHA); it is referred to as chronic or chronic post-traumatic headache (CPTHA) if it lasts longer than three months after the injury. Case : A 17-year-old male with headache since 3 months ago, 3 days after suffered a blow to his left head from falling from a chair. At that time, the patient fainted for about 15 minutes but had no complaints after regained consciousness. Pain is felt on the left side of the head, throbbing, mild-moderate intensity, and feels heavier with a loud sound or a too-bright light. Discussion: Post-traumatic headache is clinically diagnosed. Laboratory and routine diagnostic imaging studies are unnecessary and have minimal clinical utility. Conclusion: Chronic post-traumatic headaches often occur, especially after minimally traumatic brain injury. The clinical picture is variable and may be similar to tension-type headaches and/or migraines. Pendahuluan: Nyeri kepala dalam tujuh hari setelah cedera kepala atau setelah sadar kembali dari trauma kepala disebut nyeri kepala pasca-trauma (post-traumatic headache/PTHA); disebut sakit kepala pasca-trauma kronis atau kronis (CPTHA) jika berlangsung lebih dari tiga bulan setelah cedera. Kasus: Seorang laki-laki berusia 17 tahun dengan keluhan nyeri kepala sejak 3 bulan, 3 hari setelah kepala kiri terbentur karena jatuh dari kursi. Saat itu, pasien pingsan sekitar 15 menit, tidak ada keluhan setelah sadar. Nyeri dirasakan di sisi kiri kepala, berdenyut, intensitas ringan-sedang, terasa lebih berat jika ada suara keras atau cahaya terlalu terang. Diskusi: Nyeri kepala pasca-trauma didiagnosis secara klinis. Laboratorium dan studi pencitraan diagnostik rutin tidak diperlukan dan memiliki utilitas klinis minimal. Simpulan: Nyeri kepala pasca-trauma kronis sering terjadi, terutama setelah cedera otak traumatis minimal. Gambaran klinisnya bervariasi dan dapat mirip nyeri kepala tipe tegang dan/atau migrain
在头部受伤后7天内(或在头部创伤后恢复意识后)出现的头痛被称为创伤后头痛(PTHA);如果它在受伤后持续超过三个月，则被称为慢性或慢性创伤后头痛(CPTHA)。病例:一名17岁男性，自3个月前左头部因从椅子上摔下而受到打击后3天开始头痛。当时，患者昏倒了约15分钟，但苏醒后没有任何症状。头部左侧感到疼痛，悸动，轻度-中度强度，当声音很大或光线太亮时感觉更重。讨论:创伤后头痛的临床诊断。实验室和常规诊断性影像学检查是不必要的，临床应用也很少。结论:慢性创伤后头痛是常见病，尤其是小创伤性脑损伤后。临床表现是可变的，可能类似于紧张性头痛和/或偏头痛。Pendahuluan: Nyeri kepala dalam tujuh hari setelah cedera kepala atau setelah sadar kembali dari trauma(创伤后头痛/PTHA);disebut sakit kepala pasca-trauma kronis atau kronis (CPTHA) jika berlangsung lebih dari tiga bulan setelah cedera。Kasus: Seorang laki-laki berusia 17 tahun dengan keluhan nyeri kepala sejak 3 bulan, 3 hari setelah kepala kiri terbentur karena jatuh dari kursi15分钟后，你会发现，你会发现，你会发现，你会发现，你会发现。Nyeri dirasakan di sisi kiri kepala, berdenyut, intensitas ringan-sedang, terasa lebih berka ada suara keras atau cahaya terlalu terang。讨论:Nyeri kepala pasca-创伤诊断secara klinis。实验室对小儿麻痹症诊断的研究很少。Simpulan: Nyeri kepala pasca-trauma kronis sering terjadi, terutama setelah cedera takis trauma minimal。Gambaran klinisnya bervariasi dan dapat mirip nyeri kepala tipe tegang dan/atau migration
{"title":"Tension-type Headache and Migraine as Manifestations of Chronic Post-Traumatic Headache","authors":"E. Tedyanto, -I Made Oka Adnyana, I. Widyadharma","doi":"10.55175/cdk.v50i2.528","DOIUrl":"https://doi.org/10.55175/cdk.v50i2.528","url":null,"abstract":"Introduction: A subsequent headache within seven days of a head injury (or after regaining consciousness after the head trauma)is referred to as a post-traumatic headache (PTHA); it is referred to as chronic or chronic post-traumatic headache (CPTHA) if it lasts longer than three months after the injury. Case : A 17-year-old male with headache since 3 months ago, 3 days after suffered a blow to his left head from falling from a chair. At that time, the patient fainted for about 15 minutes but had no complaints after regained consciousness. Pain is felt on the left side of the head, throbbing, mild-moderate intensity, and feels heavier with a loud sound or a too-bright light. Discussion: Post-traumatic headache is clinically diagnosed. Laboratory and routine diagnostic imaging studies are unnecessary and have minimal clinical utility. Conclusion: Chronic post-traumatic headaches often occur, especially after minimally traumatic brain injury. The clinical picture is variable and may be similar to tension-type headaches and/or migraines. Pendahuluan: Nyeri kepala dalam tujuh hari setelah cedera kepala atau setelah sadar kembali dari trauma kepala disebut nyeri kepala pasca-trauma (post-traumatic headache/PTHA); disebut sakit kepala pasca-trauma kronis atau kronis (CPTHA) jika berlangsung lebih dari tiga bulan setelah cedera. Kasus: Seorang laki-laki berusia 17 tahun dengan keluhan nyeri kepala sejak 3 bulan, 3 hari setelah kepala kiri terbentur karena jatuh dari kursi. Saat itu, pasien pingsan sekitar 15 menit, tidak ada keluhan setelah sadar. Nyeri dirasakan di sisi kiri kepala, berdenyut, intensitas ringan-sedang, terasa lebih berat jika ada suara keras atau cahaya terlalu terang. Diskusi: Nyeri kepala pasca-trauma didiagnosis secara klinis. Laboratorium dan studi pencitraan diagnostik rutin tidak diperlukan dan memiliki utilitas klinis minimal. Simpulan: Nyeri kepala pasca-trauma kronis sering terjadi, terutama setelah cedera otak traumatis minimal. Gambaran klinisnya bervariasi dan dapat mirip nyeri kepala tipe tegang dan/atau migrain","PeriodicalId":295318,"journal":{"name":"Cermin Dunia Kedokteran","volume":"221 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124388926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：