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Abstrak :
Latar belakang: Lupus eritrematosus sistemik (LES) adalah penyakit yang kompleks dengan manifestasi yang bervariasi. Interleukin-6 (IL-6) merupakan sitokin pleitropik yang mempunyai aktivitas biologis dengan rentang luas yang berperan penting pada regulasi imun dan inflamasi. Saat ini belum ada biomarker yang dapat membedakan kondisi remisi total dengan aktivitas penyakit ringan. Interleukin-6 diharapkan dapat digunakan sebagai parameter aktivitas penyakit terutama pada kasus-kasus dimana antara manifestasi klinis dan skor SLEDAI tidak sesuai yaitu pada pasien LES dengan aktivits ringan dan remisi total. Tujuan: Mengetahui karakteristik IL-6 pada LES anak dengan berbagai aktivitas ringan dan remisi total. Metode: Penelitian kasus kontrol dilakukan di poli rawat jalan Alergi-Imunologi Departemen Ilmu Kesehatan Anak RSUPN dr. Cipto Mangunkusumo, Jakarta dan RSUP Dr. Sardjito, Yogyakarta mulai Mei hingga Juni 2019. Pasien anak usia 1-18 tahun dengan diagnosis LES dinilai kadar IL-6 dan aktivitas penyakit yang dinilai dengan skor SLEDAI. Uji korelasi chi square dilakukan untuk mengetahui hubungan variabel bebas dan luaran. Analisis data dilakukan dengan program SPSS for Window ver 20,0 Hasil: Dari 60 subjek penelitian yang terdiri dari 30 pasien LES aktivitas ringan dan 30 remisi total. tidak ada perbedaan kadar IL-6 tinggi pada kelompok kasus dibanding kelompok kontrol dengan p=0,500, OR= 0,483 (95% IK: 0,041-5,628). Terdapat 2 subyek dengan kadar IL-6 tinggi menderita infeksi saluran kencing. Simpulan: Tidak ada perbedaan aktivitas penyakit pada pasien LES anak dengan aktivitas ringan dibanding remisi total. ......Background: Systemic Lupus Erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities that plays an important role in immune regulation and inflammation. Recently, there is no other biomarker that could differentiate total remission condition and mild disease activity in juvenile SLE. Interleukin-6 may be used as a parameter of disease activity, especially in the cases with different clinical manifestations and SLEDAI scores among SLE patients with mild activities and total remissions. Aim: To indentify the characterictics of serum IL-6 concentration in juvenile systemic lupus erythematosus with mild activities and total remissions. Methods: Case control study was performed at outpatient clinic of allergy-immunology, department of child health dr. Cipto Mangunkusumo hospital, Jakarta and dr. Sardjito hospital, Yogyakarta during May-June 2019. Serum IL-6 consentration and disease activity were assessed in all juvenile SLE patients aged 1-18 year. SLE disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme linked immunosorbent assay. Chi square correlation analysis was used to determine the correlation of serum IL-6 concentration with disease activity in juvenile SLE patients. Analyses of data were performed using the SPSS statistical software for windows version 20,0. Results: Among 60 subjects included in this study, 30 subjects with mild activities in the case group and 30 subjects with total remissions in the control group. There was no differences of serum IL-6 concentration between case and control group (p=0,500, OR= 0,483 (95% IK: 0,041-5,628)). In this study, we found 2 subjects with urinary tract infection have high serum IL-6 concentration. Conclusion: There was no differences of serum IL-6 concentration between juvenile SLE patients with mild activities compared with total remissions.

Abstrak :
ABSTRAK
Latar Belakang: Lupus Eritematosus Sistemik (LES) atau Systemic Lupus Erythematosus (SLE) adalah sebuah penyakit autoimun yang memicu inflamasi kronik sistemik yang umumnya terjadi pada perempuan usia reproduktif. SLE berpotensi mempengaruhi luaran reproduksi perempuan melalui berbagai mekanisme sejak di masa pra-konsepsi hingga pasca konsepsi. Pasien SLE memiliki karakter yang berbeda-beda baik dari aspek demografik, maupun dari karakter kliniknya. Karakter pasien SLE yang bervariasi kemungkinan berperan dalam luaran maternal dan janin pada penderita SLE yang hamil. Tatalaksana SLE yang diterima oleh pasien tentunya bervariasi sesuai dengan berat ringannya SLE. Seorang pasien SLE seharusnya mencapai tahapan remisi minimal 3 bulan dengan menggunakan terapi yang minimal sebelum diizinkan untuk hamil. Meski demikian kemungkinan terjadinya komplikasi kehamilan yang mempengaruhi luaran ibu maupun janin tentunya masih sangat mungkin terjadi.

Tujuan: Mengetahui hubungan antara karakter pasien SLE dengan luaran maternal dan janin.

Metode: Penelitian ini merupakan penelitian observasional analitik dengan menggunakan desain penelitian cross sectional, Penelitian ini telah dilakukan di Departemen Obstetri dan Ginekologi bekerja sama dengan Departemen Ilmu Penyakit Dalam Divisi Imunologi Fakultas Kedokteran, Universitas Indonesia Divisi Immunoendokrinologi RSCM tahun 2019-2020.

Hasil: Dari 120 subjek penelitian yang memenuhi kriteria inklusi didapatkan 104 orang dengan kriteria jenis SLE Neuro 52,9%, Hematologi 1,9%, Muskulo 28,8%, dan Renal 16,3%. Terdapat hubungan antara SLE dengan luaran Neonatal (IUFD, PJT, dan Abortus), dan terdapat hubungan antara SLE dengan Preeklampsia.

Kesimpulan: Penyakit lupus mempengaruhi wanita terutama pada usia reproduksi yang dimulai dengan mempengaruhi siklus menstruasi seorang wanita penderita, yang selanjutnya dipengaruhi oleh penggunaan jenis terapi sebelum pasien mengalami kehamilan. Dan apabila pasien tidak mematuhi pemakaian obat dapat mengakibatkan terjadi luaran ibu dan bayi karena pengaruh penyakit lupus tersebut.

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ABSTRACT
The focus of this study is the freshman student of Faculty of Psychology at University of Indonesia experience of acquiring, evaluating and using information, when they enroll in "Program Dasar Pendidikan Tinggi (PDPT)" 2003. The purpose of this study is to understand how freshman students acquire, evaluate and use information. Knowing this will allow library to identify changes should be made to improve user education program at University of Indonesia. This research is qualitative descriptive interpretive. The data were collected by means of deep interview. The researcher suggests that library should improve the user education program and provide facilities which can help students to be information literate.

Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that triggers chronic systemic inflammation commonly occurs in women of reproductive age. SLE is a potential influence on women's reproductive outcomes through a variety of mechanisms from pre-conception to post-conception. SLE patients have different characters both from the demographic aspects, and the clinical characters. The varied character of SLE patients may have a role in maternal and fetal outcomes in pregnant SLE patients. The management of SLE received by patients varies according to the severity of SLE. The patient should reach at least 3 months' remission using minimal therapy before being allowed to become pregnant. Nevertheless the possibility of pregnancy complications that affect both maternal and fetal outcomes is likely possible to occur.

Aim: To determine the relationship between the character of SLE patients and maternal and fetal outcomes.

Method: This is an observational analytic research using a cross sectional design, conducted in the Obstetric and Gynecology Department in collaboration with the Internal Disease Department Division of Immunology, Faculty of Medicine, Universitas Indonesia Division of Immunoendocrinology, RSCM 2019-2020.

Result: From 120 research subjects who met the inclusion criteria, 104 people were obtained with SLE Neuro 52.9%, Hematologist 1.9%, Muskulo 28.8%, and Renal 16.3% criteria. There is a relationship between SLE and neonatal outcomes (IUFD, PJT, and Abortion), and there is a relationship between SLE and preeclampsia.

Conclusion: Lupus affects women especially in reproductive age starts by affecting the menstrual cycle of a sufferer, which is further influenced by the use of type of therapy before the patient have a pregnancy. The result in maternal and infant outcomes due to lupus, caused if the patient does not obey when using the medicines.

Abstrak :
Kasus penyakit LES mempunyai prevalensi yang cukup tinggi di Indonesia dan dunia. Prevalensi di berbagai negara sangat bervariasi antara 2.9/100.000 – 400/100.000. Namun, belum terdapat data epidemiologi LES yang mencakup semua wilayah Indonesia. Diagnosis Lupus Eritematosus Sistemik tidak mudah dan sering terlambat akibat dari gejala yang timbul menyerupai gejala berbagai penyakit sehingga Lupus dikenal dengan sebutan penyakit 1000 wajah. Gejala penyakit Lupus sangat beragam, mulai dari gejala ringan hingga yang dapat mengakibatkan kematian. Penelitian berupa kajian kepustakaan (literature review) terhadap 3 jurnal penelitian internasional pada tahun 2000-2020. Penelitian ini bertujuan untuk mengetahui peran faktor risiko paparan silika pada kejadian Lupus Eritematosus Sistemik. Hasil penelitian menunjukan bahwa terdapat hubungan yang signifikan antara paparan silika dengan kejadian Lupus Eritematosus Sistemik dengan rata-rata OR 3,6. Paparan silika yang terhirup tidak mungkin menjadi penyebab utama LES pada populasi umum, namun paparan silika menjadi salah satu faktor risiko yang berperan dalam pengembangan penyakit LES. Memahami mekanisme yang digunakan oleh silika dalam LES dapat membantu kita lebih memahami peran paparan lingkungan terutama paparan silika pada LES. ......Literature Review: The Role of Risk Factors for Silica Exposure in Systemic Lupus Erythematosus. Systematic Lupus Erythematosus have a high prevalence in Indonesia and the world. Prevalence in various countries varies greatly between 2.9 / 100.000 - 400/100,000. However, there are no epidemiological data covering all regions of Indonesia for SLE. Diagnoses of Systemic Lupus Erythematosus is not easy and often late due to symptoms that resemble the symptoms of various diseases, so that Lupus is known as 1000 facial diseases. Symptoms of lupus are very diverse, ranging from mild symptoms to those that can result in death. The research was in the form of a literature review of 8 international research journals in 2000-2020. This study aims to determine the role of risk factors for silica exposure in the incidence of Systemic Lupus Erythematosus. The results showed that there was a significant relationship between exposure to silica with the incidence of Systemic Lupus Erythematosus with an average OR of 3.6. Exposure to inhaled silica may not be a major cause of SLE in the general population, but silica exposure is one of the risk factors that play a role in the development of LES disease. Understanding the mechanism used by silica in SLE can help us better understand the role of environmental exposure especially silica exposure in SLE.

Abstrak :
Latar Belakang. Gangguan tidur sering dijumpai pada penyakit autoimun seperti lupus eritematosus sistemik (LES). Tidur yang buruk berdampak pada kualitas hidup yang rendah serta eksaserbasi akut dari inflamasi akibat LES. Penelitian mengenai kualitas tidur yang buruk pada pasien LES serta faktor - faktor yang berhubungan di Indonesia masih terbatas. Tujuan. Mengetahui proporsi kualitas tidur yang buruk pada pasien LES di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo (RSCM) dan mengetahui faktor-faktor yang berhubungan. Metode. Metode yang digunakan adalah studi potong lintang, melibatkan 166 subjek LES berusia minimal 18 tahun yang berobat ke poliklinik Alergi Imunologi RSCM sejak Januari 2019. Subjek mengisi secara mandiri kuesioner kualitas tidur menggunakan Pittsburgh Sleep Quality Index(PSQI) dan kuesioner gejala depresi dan ansietas menggunakan Hospital Anxiety Depression Scale(HADS). Skala nyeri dinilai mengggunakan Visual Analogue Scale(VAS), aktivitas penyakit LES dinilai menggunakan Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI-2K). Subjek menjalani pemeriksaan imbalans otonom yang dinilai menggunakan rasio Low Frequency/High Frequency (LF/HF) dari Heart Rate Variability(HRV), dan pemeriksaan kadar high sensitivity C-Reactive Protein(hs-CRP).Analisis bivariat menggunakan uji Chi Squaredan analisis multivariat menggunakan regresi logistik. Hasil. Rerata untuk skor PSQI global pada 166 subjek sebesar 9,36 (3,61) dengan proporsi kualitas tidur buruk sebanyak 82,5%. Pada analisis bivariat didapatkan dua variabel dengan hubungan bermakna dengan kualitas tidur yang buruk yaitu gejala depresi (OR: 5,95; p: 0,03) dan gejala ansietas (OR: 2,44; p: 0,05). Regresi logistik tidak menunjukkan variabel dengan hubungan bermakna dengan kualitas tidur yang buruk. Simpulan.Proporsi kualitas tidur buruk pada pasien LES sebesar 82,5%. Tidak terdapat faktor yang berhubungan dengan kualitas tidur buruk pada LES. ......Background. Sleep disturbances are often seen in systemic lupus erythematosus (SLE). Poor sleep will lead to poor quality of life and frequent exacerbations of SLE. However, studies about poor sleep quality in SLE patients as well as the contributing factors are limited. Objectives. The aim of this study is to determine the proportion of poor sleep quality in SLE patients in Cipto Mangunkusumo National General Hospital (RSCM) and to assess its contributing factors. Methods. This study used a cross sectional design involving 166 subjects of SLE patients from Immunology clinic since January 2019. The Pittsburgh Sleep Quality Index was used to assess sleep quality of subjects. Depression and anxiety symptoms was assesed using the Hospital Anxiety Depression Scale (HADS). Pain scale was assesed using Visual Analogue Scale (VAS) and SLE activity was assessed using Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). Autonomic imbalance was assesed using Low Frequency/High Frequency(LF/HF) ratio from Heart Rate Variability(HRV), and subjects went through high sensitivity C-Reactive Protein(hs-CRP) test. Bivariate analysis using Chi Square test and multivariate analysis using logistic regression. Result.The mean global score for the PSQI among 166 subjects was 9,36 (3,61). The proportion of poor sleep quality was 82.5%. There were two variables with significant association including depressive symptoms (OR 5.95; p 0.03) and anxiety symptoms (OR 2.44; p 0.05). There were no variable with significant association through logistic regression. Conclusion. The proportion of poor sleep quality from SLE patients in RSCM was 82.5%. This study did not find any factors associated with poor sleep quality in SLE patients.

Abstrak :
Often considered the prototypic autoimmune disease, Lupus is characterized by protean manifestations and affects a wide range of organ systems. Despite widespread availability of anti nuclear antibody testing and other technological diagnostic advances, the diagnosis of lupus can be elusive, difficult, and inexact. Treatment of the disease can also be challenging. Advances in immunology and biotechnology have led to a burgeoning world of new therapies in development that offer patients the real possibility of new therapies and physicians and scientists novel insights into the pathogenesis of this complicated immunological disease. Lupus erythematosus : clinical evaluation and treatment summarizes the clinical aspects of lupus facing the general clinician in the 21st century. In this invaluable, practical book, the reader will find introductory chapters regarding general diagnostic and treatment principles, followed by chapters addressing the lupus-specific organ manifestations. Special topics regarding pregnancy and comorbidities are also presented. Written by highly experienced physicians with special expertise in lupus.

Abstrak :
Penelitian ini membahas tentang bagaimana bentuk stres yang dirasakan oleh Orang dengan Penyakit Lupus akibat keberadaan diagnosa dan kondisi fisik mereka yang mengidap penyakit lupus. Orang dengan Penyakit Lupus menggunakan dukungan sosial yang diperoleh dari anggota keluarga terdekat mereka dalam mengelola dan mengurangi stres yang mereka rasakan. Penelitian ini dilakukan melalui pendekatan kualitatif dengan metode studi kasus. Hasil penelitian ini menggambarkan bahwa bentuk dukungan emosional, instrumental, informasi, dan jaringan sosial yang diperoleh dari anggota keluarga terdekat dapat membantu Orang dengan Penyakit Lupus mengelola dan mengurangi bentuk stres fisiologis, psikologis, dan tingkah laku yang mereka rasakan. ......This research describes the forms of stress experienced by people diagnosed lupus as well as the impact of their illness to their physical condition. People with lupus used social support from close family in coping and reducing stress. The approach used qualitative with case study method. Study concludes that emotional, instrumental, information, and social network supports from close family member can be positive in coping and reducing physiological, psychological, and behavioral stress in people with lupus.

Abstrak :
Lupus eritematosus sistemik merupakan penyakit autoimun sistemik yang menghasilkan berbagai autoantibodi yang ditujukan terhadap komponen sel, seperti inti sel, sitoplasma dan membran sel. Salah satu autoantibodi tersebut yaitu antibodi anti ?2GP-1 dihubungkan dengan kejadian aterosklerosis dan penyakit kardiovaskular yang timbul lebih dini pada pasien SLE. Penelitian ini bertujuan untuk mengetahui hubungan antibodi anti ?2GP-1 dengan disfungsi endotel dan aterosklerosis pada pasien SLE dan disfungsi endotel pada HUVEC. Penelitian potong lintang pada pasien SLE yang memenuhi kriteria inklusi menurut ACR 1997 di poliklinik khusus Reumatologi, Alergi Imunologi RSCM dan poliklinik khusus Reumatologi RSUP Dr. M. Djamil dari Maret 2016 sampai dengan Juli 2017. Subjek secara acak dibagi atas 2 kelompok berdasarkan nilai CIMT. Dilakukan pemeriksaan antibodi anti ?2GP-1, ox-LDL, ADMA, ICAM-1, VCAM-1, ET-1. Dilakukan pemajanan antibodi anti ?2GP-1 yang berasal dari kelompok aterosklerosis positif dan kontrol pada HUVEC. Enam puluh enam orang subjek direkrut pada penelitian ini, terdiri atas 33 orang aterosklerosis positif dan 33 orang aterosklerosis negatif dan 6 orang kontrol dengan rentang umur 20-45 tahun. Ditemukan korelasi positif antara antibodi anti ?2GP-1 dengan CIMT,ADMA, ICAM-1, VCAM-1 dan ET-1 dengan nilai r = 0,409, 0,89, 0,36, 0,43, 0,37 dan dengan p < 0,05. Tidak ditemukan korelasi antibodi anti ?2GP-1 dengan ox-LDL dengan r = 0,025 dan p > 0,05. Ditemukan perbedaan bermakna kadar antibodi anti ?2GP-1, ADMA, ICAM-1, VCAM-1 dan ET-1 pada kelompok aterosklerosis positif dengan kelompok aterosklerosis negatif dengan nilai p < 0,05, sedangkan kadar ox-LDL tidak ada perbedaan bermakna pada kedua kelompok tersebut dengan nilai p > 0,05. Hasil pemajanan antibodi anti ?2GP-1 pada HUVEC mendapatkan perbedaan bermakna peningkatan kadar ICAM-1, VCAM-1 dan ET-1 pada kelompok SLE aterosklerosis positif dari kontrol dengan nilai p < 0,05. Antibodi anti ?2GP-1 menimbulkan disfungsi endotel pada pasien SLE. ...... Systemic lupus erythematosus SLE is a multi systemic disease characterized by a wide variety of autoantibodies directed to several self molecules found in the nucleus, cytoplasm and cell membrane. One of variety autoantibodies is Antibody anti 2GP 1 which associated with atherosclerosis and premature cardiovascular disease in SLE patients. The purpose of the study is to know the association of antibody anti 2GP 1 with endothelial dysfunction and atherosclerosis in SLE and endothelial dysfunction in HUVEC. Cross sectional study was performed in SLE patients fulfill inclussion criteria according ACR 1997 out patients in Rheumatology and Alergy Immunology polyclinic of Cipto Mangunkusomo Hospital and Dr. M. Djamil Hospital from March 2016 to July 2017. Patients were divided in 2 groups based on CIMT. Examination of antibody anti 2GP 1, ox LDL, ADMA, ICAM 1, VCAM 1 and ET 1 were performed. Purified antibody anti 2GP 1 from positive atherosclerosis and controls groups were exposed to HUVEC. Sixty six patients were enrolled, consists of 33 patients with positive atherosclerosis, 33 patients with negative atherosclerosis and 6 as healthy control with range of age 20 40 year. In this study we found positive correlation between antibody anti 2GP 1 with CIMT, ADMA, ICAM 1, VCAM 1 and ET 1 with r 0.409, 0.89, 0.36, 0.43, 0.43 respectively and p value 0.05. There was no correlation between antibody anti 2GP 1 with ox LDL, r 0.025 and p 0.05. There were significantly different levels of antibody anti 2GP 1, ADMA, ICAM 1, VCAM 1 and ET 1 in positive atherosclerosis compared to negative atherosclerosis group with p 0.05. Level of ox LDL was not different between the two groups with p 0.05. There were significantly different increase of ICAM 1, VCAM 1 and ET 1 levels in HUVEC which was exposed with purified antibody anti 2GP 1 from positive atherosclerosis compared to control with p 0.05. Antibody anti 2GP 1 cause endothelial dysfunction in SLE patients.

Abstrak :
The book is an up-to-date introduction to the disease and includes high quality colour photographs and evidence-based guidelines for diagnosing, treating and managing Lupus in primary care.