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Difficult systemic lupus erythematosus; how to manage
Artikel Jurnal  Universitas Indonesia Library
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Hendra Gunawan
The coexistence of systemic lupus erythematosus and psoriasis: is it possible?
"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."
Jakarta: Interna Publishing, 2018
610 IJIM 50:2 (2018)
Artikel Jurnal  Universitas Indonesia Library
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I Putu Eka Krisnha Wijaya
Recurrent pleural effusion in a patient with systemic lupus erythematosus
"ABSTRAK
Background: 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."
Bandung : Interna Publishing (Pusat Penerbitan Ilmu Penyakit Dalam), 2019
CHEST 6:1 (2019)
Artikel Jurnal  Universitas Indonesia Library
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Risk factors for poor pregnancy outcome in systemic lupus erythematosus patients
"Background: systemic lupus erythematosus (SLE) is still a challenging autoimmune disease, especially in pregnancy setting. An early risk factors awareness of poor pregnancy outcome is important to optimize the outcome of pregnancy in SLE patients. This study was conducted to describe pregnancy outcome and determine the risk factors associated with poor pregnancy outcome in SLE patients.
Methods: a retrospective case-control study of SLE patients with poor and normal pregnancy outcome was performed. Pregnancy histories were reviewed from Dr. Hasan Sadikin General Hospital lupus registry study. The case group was pregnancy with poor outcome, defined as abortion, premature birth, stillbirth, intrauterine growth restriction (IUGR) and neonatal death. The control group was pregnancy with good outcome, defined as live birth and full term.
Results: a total of 84 SLE patients were enrolled in this study with 109 pregnancies after SLE diagnosis. The median age of subjects at the time of pregnancy was 28 (25-32) years old. Poor pregnancy outcome comprising 22.9% abortion, 14.7% premature birth, 5.5% stillbirth, 1.8% IUGR and 4.6% neonatal death. There was a significant difference in the number of planned pregnancy (P=0.011) between groups with poor and good outcome. Clinical variables significantly associated with poor pregnancy outcome were lupus nephritis (OR = 4.813, 95% CI 1.709 - 13.557, P = 0.003) and neuropsychiatric SLE (OR = 5.045, 95% CI 1.278 - 19.920, P = 0.021).
Conclusion: the pregnancy in SLE patient should be planned to have better outcome. Lupus nephritis and neuropsychiatric (NP) SLE were risk factors for poor pregnancy outcome in SLE patient."
Jakarta: University of Indonesia. Faculty of Medicine, 2019
610 UI-IJIM 51:2 (2019)
Artikel Jurnal  Universitas Indonesia Library
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Stevens Johnson Syndrome in a patient with systemic lupus erythematosus on tuberculostatic treatment
"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.
Abstract
A 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."
[Fakultas Kedokteran Universitas Indonesia, Universitas Atma Jaya. Fakultas Kedokteran], 2012
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Artikel Jurnal  Universitas Indonesia Library
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Jennifer Josephine
Survei Kebutuhan Edukasi Pasien Lupus Eritematosus Sistemik = Systemic Lupus Erythematosus Educational Needs Survey
"Pasien Lupus Eritematosus Sistemik (LES) yang mengalami penyakit kronik membutuhkan edukasi yang tepat untuk meningkatkan kesiapan pasien menghadapi penyakitnya. Di era modern ini, edukasi melalui internet dan media sosial berperan penting. Oleh karena itu, penelitian ini bertujuan mengetahui penggunaan internet terkait lupus, kebutuhan materi edukasi, serta platform edukasi yang paling diminati pasien. Penelitian ini merupakan studi potong lintang pada pasien LES dewasa di RS Cipto Mangunkusumo, Jakarta pada Juli-Agustus 2023. Responden mengisi kuesioner penggunaan internet terkait lupus dan preferensi platform edukasi, serta kuesioner Educational Needs Assessment Tool (ENAT) mengenai materi edukasi. Jumlah subjek yang terlibat adalah 65 orang perempuan dengan median (min-maks) usia 32 (19-56) tahun. Sebanyak 92,3% responden menggunakan internet dan media sosial untuk hal yang berkaitan dengan lupus. Domain ENAT yang menjadi prioritas materi edukasi pasien adalah pengetahuan tentang penyakit (skor 89%) dan manajemen perasaan (skor 85%). Sementara sumber edukasi utama yang diinginkan pasien adalah edukasi dari dokter/perawat secara langsung (87,7%), Instagram (55,4%), dan YouTube (55,4%). Pengetahuan tentang penyakit dan manajemen perasaan adalah materi edukasi yang paling dibutuhkan pasien LES dengan sumber edukasi utama adalah dokter/perawat secara langsung. Penggunaan internet untuk lupus yang tinggi menunjukkan tingginya peluang pemberian edukasi melalui internet, yang dapat dilakukan melalui Instagram dan YouTube.
Patients with Systemic Lupus Erythematosus (SLE) who suffer from chronic illness, need tailored education to better manage their condition. As nowadays education through internet and social media contributes significantly. This study aims to assess internet usage related to lupus, educational needs, and education sources preferences among patients. This study is a cross-sectional study conducted on adult SLE patients at Cipto Mangunkusumo Hospital, Jakarta, between July-August 2023. Respondents completed a set of questionnaires regarding their internet usage related to lupus, education platform preferences, and Educational Needs Assessment Tool (ENAT). Sixty-five female subjects participated, with a median (min-max) age of 32 (19-56) years. Respondents who used the internet and social media for lupus-related matters were 92.3%. The ENAT domains prioritized by patients were knowledge about the disease (score 89%) and emotional management (score 85%). The primary sources of education desired by patients were direct education from doctors/nurses (87.7%), Instagram (55.4%), and YouTube (55.4%). SLE patients expressed a strong need for knowledge about the disease and emotional management, with doctors/nurses as the preferred sources of education. The widespread use of the internet for lupus-related information indicates a great opportunity for providing education through online platforms, particularly through Instagram and YouTube."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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Mei Puspita Sari
Gambaran pengambilan keputusan untuk bekerja pada penderita systemic lupus erythematosus (SLE) laki-laki = The Description in decision making to work on man?s systemic lupus erythematosus (SLE) patient
"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.
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."
Depok: Fakultas Psikologi Universitas Indonesia, 2008
153.83 SAR g
UI - Skripsi Open  Universitas Indonesia Library
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Yublina Septiani
Asuhan keperawatan ketidakberdayaan pada nn.a yang mengalami systemic lupus erythematosus di ruang antasena RS. Dr. H. Marzoeki Mahdi Bogor = Nursing care of powerlessness in patient with systemic lupus erythematosus
"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.
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. "
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Salwa Muniroh
Afirmasi positif sebagai intervensi ketidakberdayaan pada masalah kesehatan perkotaan systemic lupus erythematosus = Positive affirmation as an intervention for powerlessness in urban health problem systemic lupus erythematosus
"Kerusakan lingkungan yang terjadi di area perkotaan dapat memicu munculnya berbagai masalah kesehatan. Salah satu masalah kesehatan yang berisiko lebih tinggi terjadi di perkotaan adalah Systemic Lupus Erythematosus SLE . SLE dapat menimbulkan masalah psikososial, salah satunya ketidakberdayaan. SLE juga dapat memengaruhi hubungan pasien dengan keluarga atau pun orang terdekatnya. Karya Ilmiah Akhir Ners ini berutjuan untuk menggambarkan asuhan keperawatan dengan masalah ketidakberdayaan pada pasien dan keluarga pasien dengan SLE. Penulis melakukan asuhan keperawatan yang berfokus pada ketidakberdayaan dan penurunan koping keluarga selama delapan hari. Hasil evaluasi menunjukkan bahwa tanda dan gejala ketidakberdayaan pada pasien sudah berkurang. Namun, kondisi penyakit Bapak S yang memburuk menyebabkan masalah tersebut muncul kembali. Di sisi lain, keluarga pasien sudah lebih mampu dalam merawat pasien.
Environmental damage in urban areas may cause many health problems. One of health problems which have higher risk to develop in urban areas is Systemic Lupus Erythematosus SLE . SLE may induce psychosocial problems, such as powerlessness. The aim of this paper was to describe nursing care of powerlessness in family and patient with SLE. Author conducted a nursing care which focused on powerlessness and compromised family coping problems for eight days. The evaluation result showed that sign and symptom of powerlessness in patient has decreased. However, the deterioration of patient rsquo;s health conditions causes the powerlessness signs to reappear. On the other hand, patient rsquo;s family already capable of taking cares of the patient."
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UI - Tugas Akhir  Universitas Indonesia Library
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Bagus Anindito
Keandalan dan kesahihan kuesioner lupus quality of life pada pasien lupus eritematosus sistemik di Indonesia = Validity and reliability of lupus quality of life questionnaire in patients with systemic lupus erythematosus in Indonesia
"ABSTRAK
Latar Belakang:
Perkembangan dalam tatalaksana Lupus eritematosus sistemik (LES) telah meningkatkan
kesintasan pasien dengan LES. Kualitas hidup merupakan komponen evaluasi terapi LES dan
value based medicine. Salah satu kuesioner khusus untuk menilai kualitas hidup adalah
Lupus QoL. Saat ini di Indonesia belum ada kuesioner khusus penilaian kualitas hidup pada
pasien dengan LES. Penelitian ini bertujuan membuktikan Lupus QoL sahih dan andal dalam
menilai kualitas hidup pasien dengan LES di Indonesia.
Metode:
Penelitian ini merupakan studi potong lintang. Penelitian diawali dengan menerjemahkan
Lupus QoL ke dalam bahasa Indonesia kemudian diujicobakan pada 10 responden. Penelitian
kemudian dilanjutkan pada jumlah sampel yang lebih besar. Keandalan dievaluasi dengan
Intraclass Correlation Coefficient (ICC) pada tes dan tes ulang dan cronbach α pada
konsistensi internal. Kesahihan konstruksi dinilai dengan multi trait scaling analysis.
Kesahihan eksternal dinilai dengan menilai korelasi antara Short form 36 (SF36) dengan
Lupus QoL dan aktivitas penyakit.
Hasil:
Pengambilan data terhadap 65 pasien LES yang berobat di unit rawat jalan Ilmu Penyakit
Dalam RSCM selama bulan Oktober ? November 2015. Kesahihan eksternal Lupus QoL baik
dengan korelasi terhadap SF36 dengan r :0.38 ? 0.66 (p<0.05). Multi trait analysis scaling
menunjukkan korelasi yang baik antara nilai tiap domain dengan nilai total (r:0.46 ? 0.85)
dan antara skor tiap butir pertanyaan dan skor total domain (r:0.44 ? 0.93). Nilai ICC
(interval 7 hari) baik (ICC>0.7). Nilai cronbach α> 0.7 pada setiap domain. Korelasi Lupus
QoL terhadap aktivitas penyakit memiliki korelasi yang lemah dan tidak bermakna yang
sesuai dengan penelitian ? penelitian sebelumnya.
Simpulan:
Kuesioner Lupus QoL Indonesia sahih dan andal dalam menilai kualitas hidup pada pasien
dengan LES di Indonesia
ABSTRACT
Background:
The development in Systemic Lupus Erythematosus treatment has led into the increasment of survival.
Quality of life has become a component to evaluate therapy ini SLE and value based medicine. One
spesific questionnaire to asses quality of life is Lupus Quality of Life (Lupus QoL). Currently in
Indonesia there has not been spesific questionnaire to asses quality of life in SLE patients. This study
aims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLE patients in
Indonesia.
Methods:
This study is cross sectional study. This study began with the translation the Lupus QoL into
indonesian language then tested in 10 respondents. After that,this study continued with a larger
sample size. The intraclass coefficient correlation was used to evaluate test and re test reliability, the
cronbach alpha was used to evaluate internal consistency. Construct validity evaluated using multi
trait scaling analysis and the extrenal validity evaluated using the correlation between domains in
short form 36 (SF 36) with Lupus QoL and with disease activity. Results:Data collection were done
on 65 SLE patients in Oktober ? November 2015 in RSCM. The external validity with SF 36 was good
with r:0.38-0.66(p<0.05). The construct validity is good with r > 0.4 (0.44 ? 0.93). The ICC value in
one week >0.7 and Cronbach α was >0.7 in each domain. The correlation with disease activity was
weak and consistent with another studies.
Conclusion:
Lupus QoL questionnaire is valid and reliable to asses quality of life in SLE patients in Indonesia."
2016
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UI - Tugas Akhir  Universitas Indonesia Library
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