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"ABSTRAKBackground: Systemic lupus erythematosus (SLE) is an autoimmune disease that more commonly affects women of childbearing age. It is a multi-organ disease and can involve virtually any organ in the body. Pleural effusion can occurred in 30% of patients with SLE, which may be a result of SLE itself, pulmonary emboli, or end-organ damage such as heart or renal failure. The management of pleural effusions in SLE patient can be challenging because the numerous of potential underlying cause and sometimes effusion recur despite appropriate treatment of primary process. Case Report: We reported 33 years old woman patient admitted to our ED with chief complaint of shortness of breath for last 1 week. Chest X-ray result showed bilateral pleural effusion. Serial pleural fluid analysis consistent with conclusion of transudate fluid. Echochardiograpy showed dilatation of left atrium and ventricle and reduced LVEF 34%. These data suggest congestive heart failure as the cause of pleura effusion. A few days after initial thoracocentesis, the patient become dyspnea again because of reccurent pleural effusion. To relieve the symptom, we did insertion of pigtail catheter connected with mini WSD (Water seal drainage). Conclusion: Pleural effusion is a relatively common clinical presentation of a patient with SLE. Pleural effusions may be a result of SLE itself, pulmonary emboli, or end-organ damage such as heart or renal failure. The management of pleural effusions are mainly to relieve the symptoms and treatment of underlying cause."

"Seorang wanita usia 22 tahun datang dengan keluhan utama timbul bercak kemerahan dan rasa gatal pada wajah sejak 5 hari sebelum masuk rumah sakit. Keluhan lainnya adalah timbul bengkak pada kedua tungkai, nyeri tenggorokan, dan batuk. Pasien sedang dalam pengobatan untuk lupus eritematosus sistemik dan tuberkulosis paru (sejak 12 hari yang lalu). Pada pemeriksaan fisik, pasien kompos mentis, hemodinamik stabil, dengan edema anasarka, lesi multipel makulo purpura yang tersebar pada tubuhnya, konjungtivis pada kedua mata, lesi multipel ulserasi di rongga mulut, dan tampak eritema pada mukosa genitalia. Hasil laboratorium menunjukkan anemia, lekopenia, hipoalbuminemia, proteinuria. Kami mencurigai pasien ini menderita sindrom Stevens Johnson akibat obat antituberkulosis. Selama perawatan, kami menghentikan pemberian obat antituberkulosis, dan memberikan metilprednisolon parenteral, serta terapi suportif lainnya. Pasien diizinkan untuk rawat jalan setelah terjadi perbaikan klinis dan dapat mobilisasi sendiri.

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AbstractA 22-year-old woman was admitted to the hospital because of 5-days history of redness and itch on her face. Additional complains were swelling on her feet, sore throat, and cough. Patient was on treatment for systemic lupus erythematosus and pulmonary tuberculosis (since 12 days). On physical examination, patient was alert, stable hemodynamic, anasarca edema, multiple purpuric macules lesion spread on her body, conjunctivitis of both eyes, multiple oral ulcers, erythema on genital mucosa. Laboratory results were anemia, leucopenia, hypoalbuminemia, proteinuria. We suspected this patient as Stevens Johnson syndrome due to tuberculostatic drugs. During treatment, we stopped the tuberculostatic drugs, and gave her parenteral methylprednisolone, with other supportive treatments. The patient was discharge after improvement of clinical condition and capable of self mobilization."

"Salah satu penyakit tidak menular yang mengancam masyarakat perkotaan adalah systemic lupus erythematosus. Systemic lupus erythematosus adalah penyakit autoimun dimana sistem imun memproduksi autoantibodi yang menyerang jaringan tubuh sendiri dan menyebabkan kerusakan pada organ yang diserang. Penyakit ini dapat menimbulkan masalah psikososial ketidakberdayaan karena systemic lupus erythematosus tidak dapat disembuhkan dan bersifat periodik. Karya Ilmiah Akhir Ners ini bertujuan untuk memberikan gambaran asuhan keperawatan ketidakberdayaan pada klien yang mengalami systemic lupus erythematosus. Evaluasi hasil implementasi menunjukkan berkurangnya tanda dan gejala ketidakberdayaan yang dialami klien.

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Systemic lupus erythematosus is one of non-communicable disease that threaten urban communities. Systemic lupus erythematosus is autoimune disease where immune system produces autoantibodies that attack it own body tissues and cause damage to the organ. This disease can evoke psychosocial problem that is powerlessness because systemic lupus erythematosus can not be cured and periodic. The purpose of this Paper is to describe nursing care of powerlessness in patient with systemic lupus erythematosus. Evaluation of the results of implementation shows that there is a slight decrease in the signs and symptoms of powerlessness that occured on the client. "

"Banyak penyakit kronis yang menjadi masalah bagi aktivitas pekerjaan dan status bekerja (Taylor, 2003). Dengan bekerja, laki-laki memenuhi tugasnya dalam tahap dewasa awal dan peran gender sebagai penjaga dan pemberi nafkah (Papalia et al., 2007). Untuk memenuhi hal tersebut, pada penderita SLE diperlukan pengambilan keputusan dengan mempertimbangkan berbagai alternatif berdasarkan pada teori Janis (dalam Janis & Mann, 1977), yang terdiri dari lima tahap proses pengambilan keputusan dan lima faktor yang berperan dalam proses pengambilan keputusan (Kemdal & Montgomery, dalam Reynard, Crozier, & Svenson, 1997).Penelitian ini bertujuan untuk mengetahui gambaran proses pengambilan keputusan untuk bekerja pada penderita SLE laki-laki dan faktor-faktor yang berperan dalam proses pengambilan keputusan. Partisipan penelitian ini adalah tiga penderita SLE laki-laki usia dewasa muda dan bekerja.Hasil penelitian menunjukkan bahwa tidak semua partisipan melewati kelima tahap dalam proses pengambilan keputusan. Kedua partisipan melewati tahap satu sampai empat dan hanya satu partisipan yang melewati tahap satu sampai tahap kelima. Selain itu, faktor preference, belief, circumstances dan action merupakan faktor yang berperan dalam proses pengambilan keputusan pada ketiga partisipan. Diantara keempat faktor tersebut, faktor preference dan circumstances merupakan faktor yang paling berpengaruh dibandingkan faktor lainnya.

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There are so many chronic diseases which become a problem in working activity and working status (Taylor, 2003). By working, men could fulfill his duty on young adulthood and gender role as a care taker and live provider (Papalia et al., 2007). In order to fulfill that situation, the SLE patient needs a decision making by considering various alternatives based on Janis theory (in Janis & Mann, 1977), which consist of five level the decision making process and five factors which have a role in decision making (Kemdal & Montgomery, in Reynard, Crozier, & Svenson, 1997).

This research intend to acknowledge the description of the decision making process to work on the men SLE patient and factors which have a role in decision making process. This research participant are three men SLE patient young adulthood and work.

The research result showed that not all participants pass through all the fifth level in decision making process. Two participants pass through first level up to fourth level and only one participant who pass through first level up to fifth level. Beside that, the preference, belief, circumstances and action factors are factors which have a role in decision making process on three participants. Among the fourth factor, preference and circumstances factors are the most influential factor than others."

"Gastrointestinal manifestations are common is systemic lupus erythematosus (SLE). Although the relationship between SLE with ulcerative colitis (UC) rarely obtained, SLE patients with gastrointestinal manifestations should preferably be evaluated for the possibility of an inflammatory bowel disease (IBD). UC prognosis associated with SLE is usually good, whereas by proper diagnosis and management, the clinical output and a good life expectancy of patients will be obtained. A young female, 17 years old, who had previously been diagnoses with SLE for 5 years, come with complaints of abdominal pain and chronic diarrhea. From the result of colonoscopy and biopsy of the intestinal mucosa was noted that in accordance with UC. After receiving treatment for 6 days, she no longer obtained compalints of abdominal pain and diarrhea."

"ABSTRAKTujuan: Untuk menilai pemanjangan Iatensi Event-Related Potential P300 auditorik padapenderita lupus eritematosus sistemik (LES) berdasarkan beberapa variabel seperti umur, durasi penggunaan steroid, aktifitas penyakit dan depresi.Metode: Penelitian potong lintang pada populasi penderita LES yang terdaftar di Yayasan Lupus Indonesia dan berdomisili di Jakarta, Bogor, Depok, Tangerang and Bekasi (Jabodetabek) serta memenuhi kriteria inlusi.Hasil: Didapatkan 55 penderita LES dan terutama perempuan kelompok usia 30-40 tahun (rerata 33,54 SD 8.41). Abnormalitas latensi P300 didapatkan pada 32 orang (58.2%) dan terdapat kemaknaan berdasarkan umur (p=0.000), aktifitas penyakit (p=0.015) dan fungsi kognitif (p=0.020). Kelompok usia muda dan derajat aktifitas penyakit pada analisa multivariat merupakan penentu abnormlitas latensi P300. Komponen gelombang lain seperti P200, N200 and P200 daiam batas normal baik latensi dan amplitudo.Kesimpulan: P300 dapat digunakan untuk evaluasi aspek kognitif sebagai manifestasi sistim saraf pusat pada penderita LES."

"Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with various clinical disorders and frequent exacerbations. Psoriasis vulgaris is a common skin disorder which affect 1-3% of general populations. The pathophysiology regarding the coexistence of these diseases is not fully understood. Therapeutic challenges arise since the treatment one of these diseases may aggravate the other. We reported two cases of SLE with psoriasis vulgaris with clinical manifestations as recurrent erythroderma with photosensitivity. Improvement in clinical condition was observed after treating the patients with methylprednisolone combined with methotrexate. The coexistence SLE and psoriasis are considered very rare. The presence of this overlap syndrome may precede one another or occur simultaneously and is closely related with the presence of anti-Ro/SSA. Thus, it raises new challenge regarding its relationships, diagnosis, therapeutic, and management."

"ABSTRAKSystemic Lupus Erythematosus SLE adalah penyakit autoimun, dimana sistem kekebalan tubuh menyerang organ tubuh sendiri. Orang dengan Lupus Odapus mengalami berbagai perubahan secara fisik, ekonomi, sosial, dan psikologis yang menyebabkan mereka memiliki penghayatan akan penyakit yang dimiliki, atau disebut juga illness cognition. Penghayatan ini mempengaruhi kognisi Odapus dalam memandang penyakit dan mempengaruhi perilaku kesehatan serta coping akan permasalahan yang disebabkan oleh SLE. Penelitian bertujuan untuk mengubah illness cognition Odapus terkait penyakit SLE yang dimiliki. Penelitian merupakan penelitian kuasi-eksperimental dengan one group pretest-posttest design. Kelompok terdiri dari lima orang yang diperoleh lewat accidental sampling. Partisipan mengikuti lima kali sesi individual serta satu kali pra-sesi dan satu kali sesi follow-up. Analisis dilakukan dengan cara membandingkan data kuantitatif menggunakan adaptasi alat ukur Illness Cognition Questionnaire ICQ serta data kualitatif tentang perubahan kognitif, perilaku, dan strategi pemecahan masalah sebelum dan sesudah mengikuti intervensi. Hasil penelitian menunjukkan bahwa intervensi kognitif-perilaku dapat meningkatkan illness cognition pada Odapus. Partisipan dapat menerima penyakit SLE sebagai bagian dari hidupnya, menghayati adanya berbagai hal positif dari penyakit SLE, dan memiliki harapan serta dapat melakukan kontrol terhadap berbagai keterbatasan yang diakibatkan oleh penyakit SLE. Pada akhirnya, partisipan dapat meningkatkan kemampuan untuk menyelesaikan masalah yang diakibatkan oleh penyakit SLE secara lebih efektif.

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ABSTRACTSystemic Lupus Erythematosus SLE is autoimmune disease which the immune system damage their own body. Patient with SLE experience change in physical, economic, social, and psychology that caused a perception to their own disease, called illness cognition. This perception influence patient rsquo s cognition about their disease and predispose their health behavior and coping problem related to their disease. This study aimed to identify effectiveness of cognitive behavior therapy to change illness cognition patient about SLE. This was quasi experimental study conducted with one group pre test post test design. Group consisted of five participant recruited through accidental sampling. Participants participated in five individual sessions, preceded by a pre session and followed by a follow up session. Analysis was conducted by comparing quantitative data obtained by Indonesian adaptation of Illness Cognition Questionnaire ICQ and qualitative data showing changes in participants rsquo cognition, behavior, and problem solving before and after the intervention took place. This study showed that cognitive behavior therapy can successfully enhance illness cognition in patient with SLE. Participants may receive SLE disease as a part of their life, appreciate many positive things of SLE, have hope also can control various limitations caused by SLE. Participants can improve their ability to coping with problem related to SLE more effectively."

"ABSTRAKLatar Belakang. Lupus eritematosus sistemik (LES) merupakan penyakit inflamsi autoimun kronik. LES dapat bermanifestasi ke berbagai macam organ, antara lain kulit, sendi, ginjal, paru-paru, sistem saraf, dan organ lainnya. Secara potensial fatal atau mengancam jiwa. Neuropsikiatrik LES (NPLES) merupakan istilah untuk menggambarkan klinis gejala neurologis dan gejala psikiatrik yang terjadi pada 18-60% pasien yang terdiagnosis LES dan merupakan keadaan yang paling berat dari menifestasi Lupus. Kejadian penyakit pembuluh darah otak pada NPLES didapatkan sekitar 5-18% kasus LES.Metode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalah pasien LES yang memenuhi kriteria inklusi penelitian. Subyek diperoleh secara consecutive sampling. Pada subyek dilakukan wawancara, pengisian kuisioner, pemeriksaan fisik dan carotid duplex dan TCD. Dilakukan analisis data menggunakan perangkat SPSS 17.0.Hasil. Diperoleh 100 subyek pasien LES di RSCM. Prevalensi aterosklerosis pada pembuluh darah karotis komunis adalah 31% yang terdiri dari, hard plaque kanan 4%, soft plaque kanan 4%, penebalan intima media 20%, plaque dan penebalan intima media 3%, sedangkan pembuluh darah serebri media 25% yang terdiri dari stenosis pembuluh darah serebri media kanan 13%, serebri media kiri 8%, bilateral 4%.Kesimpulan. Pada semua pasien LES dengan usia < 21-36+ tahun, penggunaan kortikosterosi, dan penyakit penyerta ditemukan adanya aterosklerosis pada pembuluh darah karotis komunis maupun pembuluh darah serebri media. Tidak ditemukan perbedaan yang bermakna.

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ABSTRACTBackground. Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease. Systemic lupus erythematosus (SLE) manifests into a variety organs, such as skin, joint, kidney, lung, nervous system and other organs. Potentially fatal or life-threatening. Neuropsychiatric SLE (NPSLE) is a term that is used to describe the clinical symptoms of neurological and psychiatric symptoms occur in 18-60% of patients diagnosed with SLE and under the most severe manifestation of lupus. The prevalence of cerebrovascular disease in NPSLE obtained approximately 5-18% of SLE cases..Method. The design study is cross-sectional study. The subjects were patients who met the inclusion criteria of the study. Subjects obtained by consecutive sampling. All subjects was interviewed, filled questionnaires, underwent physical examination and Carotid Duplex and TCD examination. Data analysis were performed by using SPSS 17.0 softwareResult. From 100 SLE patients on RSCM, the result showed that the prevalence of atherosclerosis on carotid communis artery was 31%, consists of 4% right hard plaque, 4% right soft plaque, 20% thickening of intima media, 3% plaque and thickening of intima media. Whereas the prevalence of atherosclerosis on cerebri media artery was 25%, consists of 13% stenosis of right cerebri media artery, 8% stenosis of left cerebri media artery, and 4% of bilateral stenosis.Conclusion. In all SLE patient between the age below 21 years old to the age above 36 years old, with corticosteroid therapy and several manifestation of SLE, the result showed that there was no significal difference between the prevalence of atherosclerosis on carotid communis artery and cerebri media artery."