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Abstrak :
ABSTRAK
Obat anti inflamasi non steroid sudah dipergunakan sajak lama dalam pengobatan penyakit rematik. Jenis obat yang pertama kali dikenal adalah prepafat asam asetil salisilat, yang dipergunakan oleh Felix Hofman dalam pengobatan penyakit rematik pada tahun 1893.

Penelitian yang akan kami lakukan berdasarkan bahwa pemakaian obat anti inflamasi non steroid sering disertai dengan antasid, dengan maksud untuk mengurangi atau mencegah efek samping pada gaster dan duodenum. Biasanya penilitian terhadap efek samping berdasarkan keluhan subjektif atau objektif tidak langsung, seperti pemeriksaan darah dalam feses. Keadaan secara objektif dalam hal ini gambaran endoskopi, perlu diteliti untuk dapat dilihat secara jelas. Selain itu dengan dosis antasid yang biasa diberikan akan mempunyai daya lindung terhadap mukosa gaster atau duodenum, juga diperlukan pemeriksaan yang lebih terarah, dalam hal ini endoskopi. Di Indonesia sepanjang yang kami ketahui penelitian ini belum pernah dilakukan.

Tujuan dari penelitian ini adalah : 1. Menentukan kelainan endoskopi pada gaster dan duodenum, Serta membandingkan kelainan yang didapat antara sebelum dan sesudah pengobatan, pada pemakaian obat anti inflamasi non steroid bersama antasid. 2. Membandingkan gejala subjektif dan objektif yang diketahui dengan pemeriksaan endoskopi. 3. Menentukan lokasi pada gaster dan duodenum yang sering didapatkan kelainan. 4. Menentukan jenis kelainan yang sering terjadi. 5. Menentukan secara klinis hasil pengobatan kelainan sendi.

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Abstrak :
Artritis reumatoid merupakan penyakit otoimun yang ditandai dengan inflamasi kronik pada daerah persendian. Rumput mutiara sering digunakan dalam terapi inflamasi dalam praktik pengobatan herbal, tetapi belum banyak data yang mendukung. Penelitian ini bertujuan untuk mengetahui efek antiartritis ekstrak etanol 70% rumput mutiara diamati dari penurunan volume udem telapak kaki tikus yang diinduksi Complete Freund's Adjuvant (CFA) serta pengaruhnya terhadap sistem imun diamati dari jumlah leukosit, limfosit serta granulosit. Penelitian ini menggunakan 36 tikus putih jantan galur Sprague-Dawley, dibagi menjadi 6 kelompok. Kelompok kontrol normal dan kontrol induksi, keduanya diberikan CMC 0,5%, kelompok kontrol diklofenak diberikan suspensi natrium diklofenak 1 mg/200 g bb tikus, kelompok variasi dosis diberikan ekstrak etanol 70% rumput mutiara dengan variasi dosis berturut-turut, 28,06 mg; 63,14 mg; dan 142,07 mg/200 g bb tikus. Semua kelompok diinduksi dengan 0,1 ml CFA pada hari ke-1 kecuali kontrol normal. Bahan uji diberikan satu kali sehari secara oral pada hari ke-2 sampai 28. Pengukuran volume telapak kaki dilakukan pada hari ke-7, 14, 21 dan 28 setelah induksi, dan penghitungan jumlah leukosit, limfosit dan granulosit dilakukan pada hari ke-14 dan 28. Hasil yang diperoleh menunjukkan bahwa pemberian ekstrak etanol 70% rumput mutiara dengan variasi dosis yang diberikan belum mampu menurunkan volume udem, tetapi mampu menurunkan jumlah leukosit, limfosit serta granulosit secara signifikan pada kelompok dosis 142,07 mg/200 g bb. ......Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation in the joints. Pearl grass are often used in inflmamation therapy in the practice of herbal medicine, but not a lot of data that support. This study aimed to determine the anti-arthritic effect of 70% ethanolic extract of pearl grass in terms of reduction in edema volume on rat foot induced by Complete Freund's Adjuvant (CFA) and its influence on the immune system in terms of the number of leukocytes, lymphocytes and granulocytes. This study used 36 male white rats Sprague-Dawley strain, were divided into 6 groups. Normal control and induction control group, both given 0.5% CMC, the diclofenac control group given a suspension of sodium diclofenac 1 mg/200 g bw, the dose variation is given by the variation of pearl grass extract consecutive doses, 28,06 mg; 63,14 mg; dan 142,07 mg/200 g bw. All the groups induced with 0,1 ml of CFA on day-1 except for the normal controls. Test material administered orally once daily on days 2 through 28. Foot-pad volume measurements performed on days 7, 14, 21 and 28 after induction, and the number of leukocytes, lymphocytes and granulocytes counted on day 14 and 28. The results showed that the extract of pearl grass with a given dose variations have not been able to reduce the volume of edema, but can decrease leukocytes, lymphocytes and granulocytes in a significant at 142,07 mg/200 g bw dose groups.

Abstrak :
ABSTRAK
Backgrounds : There was a two-fold increase in cardiovascular-related mortality in rheumatoid arthritis (RA). Postprandial triglyceride (PPTG) related to increased risk of ischemic heart disease, myocardial infarction, ischemic stroke, mortality and elevated level of adhesion molecules. Increased endothelial adhesion molecules was a sign of endothelial activation, an early process in the development of atherosclerotic lesion. There was no study evaluating the role of NTG in cardiovascular risk assessment in RA patients. Aim : This study observed the relationship between PPTG and sICAM-1 and sE-selectin, as markers of endothelial activation. Methods : This was a cross-sectional study of fifty consecutively-recruited RA patients. Lipid profiles, sICAM-1, and sE-selectin were measured postprandially. Further analysis using multiple regression was performed. Results : There was no correlation found between PPTG and sICAM-1, nor NTG and sE-selectin. Level of sICAM-1 was influenced by HDL (R2=0,087) while sE-selectin was influenced by DAS-28 (R2=0,174), body mass index (R2=0,125), and postprandial glucose (R2=0,138). Conclusion : PPTG did not correlated with sICAM-1 and sE-selectin in RA patients.

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ABSTRACT
Backgrounds : There was a two-fold increase in cardiovascular-related mortality in rheumatoid arthritis (RA). Postprandial triglyceride (PPTG) related to increased risk of ischemic heart disease, myocardial infarction, ischemic stroke, mortality and elevated level of adhesion molecules. Increased endothelial adhesion molecules was a sign of endothelial activation, an early process in the development of atherosclerotic lesion. There was no study evaluating the role of NTG in cardiovascular risk assessment in RA patients. Aim : This study observed the relationship between PPTG and sICAM-1 and sE-selectin, as markers of endothelial activation. Methods : This was a cross-sectional study of fifty consecutively-recruited RA patients. Lipid profiles, sICAM-1, and sE-selectin were measured postprandially. Further analysis using multiple regression was performed. Results : There was no correlation found between PPTG and sICAM-1, nor NTG and sE-selectin. Level of sICAM-1 was influenced by HDL (R2=0,087) while sE-selectin was influenced by DAS-28 (R2=0,174), body mass index (R2=0,125), and postprandial glucose (R2=0,138). Conclusion : PPTG did not correlated with sICAM-1 and sE-selectin in RA patients.

Abstrak :
Mortalitas penderita artritis reumatoid(AR) yang cukup tinggi disebabkan oleh penyakit kardiovaskular akibat aterosklerosis.Penelitian ini bertujuan untuk mengetahui sensitivitas dan spesifitas skor kalsifikasi arkus aorta di foto polos toraks berdasarkan klasifikasi Ogawa dalam mendeteksi aterosklerosis pada penderita AR. Penelitian ini menggunakan desain potong lintang pada 76 pasien AR di Poliklinik Reumatologi RSUPN Cipto Mangunkusumo. Hasil penelitian menunjukkan sensitivitas 25% dan spesifitas 91,7% pada titik potong skor Ogawa 3,125%, dengan demikian lebih baik untuk mendeteksi pasien AR tanpa aterosklerosis. Pasien AR dengan kalsifikasi arkus aorta kemungkinan memiliki aterosklerosis sebesar 3,7 kali daripada pasien AR tanpa kalsifikasi arkus aorta. ......Mortality of rheumatoid arthritis (RA) patients which is quite high caused by cardiovascular disease due to atherosclerosis. This study aims to determine the sensitivity and specificity of the aortic arch calcification score on plain chest X-ray based on classification Ogawa in detecting atherosclerosis in RA patients. This study used a cross-sectional design in 76 patients at the Rheumatology Division Cipto Mangunkusumo Hospital. The results showed a sensitivity of 25% and specificity of 91.7% at the cut off point Ogawa scores 3.125%, thus it is better to detect RA patients without atherosclerosis. The possibility of arthritis rheumatoid patients with aortic arch calcification having atherosclerosis by 3.7 times than RA patients without aortic arch calcification.

Abstrak :
Summary: Arthritis in Black and White, by Anne C. Brower, MD and Donald J. Flemming, MD, provides you with a concise, practical introduction to the radiographic diagnosis of arthritic disorders. Completely revised, this popular, easy-to-read resource contains high-quality digital radiographs with correlating MRIs throughout and a practical organization that aids in your recognition, diagnosis, and treatment of common arthritides. In print and online at www.expertconsult.com, it is perfect for residents in training and experienced radiologists wishing to refresh their knowledge. Easily reference diagnostic guidance by presenting symptom, see what to look for, and understand how to effectively diagnose the patient. Reference key information quickly and easily thanks to a consistent, user-friendly format and a unique two-part organization (radiologic approaches to specific joints and full description of the individual common arthritides) that facilitates finding the exact information you need for any joint in the body.

Abstrak :
Latar Belakang. Flat fool adalah salah satu kelainan kaki yang sering dijumpai pada penderita artritis reumatoid. Selain nyeri yang disebabkan oleh penyakitnya, penderita AR juga dapat mengalami nyeri akibat flat foot. Selama ini kita selalu menganggap nyeri kaki dan gangguan berjalan pada penderita AR selalu disebabkan oleh AR, padahal mungkin juga akibat flat fool. Di Amerika prevalensi flat foot sebesar 50%. Untuk itu ingin diketahui proporsi kelainan ini pada penderita AR yang mengunjungi poliklinik reumatologi RSCM, serta gambaran dan faktor-faktor yang mempengaruhinya. Tujuan. (1) Mengetahui proporsi flat foot pada penderita AR. (2) Mengetahui rasio odds faktor-faktor lama menderita penyakit (LMP), Disease Activity Score (DAS), dan Indeks Massa Tubuh (IMT) terhadap kejadianflat foot pada penderita AR. Metodologi. Dilakukan studi potong lintang pada penderita AR dengan keluhan kaki yang berobat ke poliklinik reumatologi RSCM untuk mengamati gambaran cetak kaki, dan kelainan kaki yang diderita, IMT, DAS, dan LMP. Gambaran kelainan kaki pada penderita AR disajikan dalam bentuk statistik deskriptif. Faktor-faktor yang mempengaruhi flat foot dianalisa dengan uji chi square serta perhitungan rasio odds. Hasil. Selama periode Juli - September 2005 terkumpul sebanyak 52 orang penderita AR di Poliklinik Reumatologi Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta. Dua orang tidak sesuai dengan kriteria inklusi, sehingga hanya 50 orang yang dapat dianalisa. Ditemukan proporsi kelainan ini sebesar 40% (11(95% 26% - 53%). Pengujian bivariat menggunakan uji chi square menemukan faktor-faktor yang mempengaruhi kejadian flat foot ialah IMT (P = 0,03; 012 = 3,7; IK95% 1,1 - 12,2) dan DAS (P = 0,047; OR = 0,2; IK 95% 0,03 - 0,9). Untuk mengetahui faktor-faktor yang paling berperan, dilakukan uji multivariat terhadap faktor-faktor dengan P < 0,25 (LMP, DAS, dan IMT). Ditemukan faktor yang paling berperan ialah IMT (P = 0,05; OR = 3,5;IK95% 0,99 - 12,2). Kesimpulan. Proporsi kelainan flat foot pada penderita AR yang berobat di Poliklinik Reumatologi RSCM tidak berbeda dengan penelitian di Amerika. Faktor risiko yang berhubungan ialah IMT. Penelitian ini tidak menemukan hubungan LMP dan DAS terhadap kejadian. Flat foot pada penderita AR.

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Background. Flat foot, as one of the deformities found on Rheumatoid Arthritis (RA) patients, also causes pain. In the case of RA patients, we often thought foot pain or gait disturbances were caused by pain from RA, on the other hand they might be caused by flat foot. Study in United States of America (USA) revealed the prevalence of flat foot were 50%. For this reason we would like to know the proportion of these deformities among RA patients visiting the rheumatology outpatient unit in dr. Cipto Mangunkusumo hospital, and factors which influenced it. Objectives. To find : (1) the proportion of flat foot on RA patient, (2) the odds ratios of Body Mass Index, disease duration, and Disease Activity Score on the prevalence of flat foot in RA patients. Methods. A cross sectional study was done on RA patients with lower extremity complaints who came to Rheumatology outpatient unit at Cipto Mangunkusumo General Hospital, Jakarta. The study was done by observing foot print, foot deformities, Body Mass Index (BMI), Disease Activity Score (DAS), and disease duration. The description of flat foot was presented in the form of descriptive statistics. Factors which influenced flat foot were analyzed using chi square method and odds ratios measurements. Results. We observed 52 patients with RA during July - September 2005 in rheumatology outpatient unit Dr. Cipto Mangunkusumo Hospital, Jakarta. Two patients did not conform inclusion criteria, thus excluded from this study. We found the proportion of flat foot in those patients was 40% (95% CI = 26% to 53%). Bivariate analysis using chi square method revealed BMI (P = 0.03, OR = 3.7 95% CI = 1.1 to 12.2) and DAS (P = 0.047, OR = 0.2, 95% CI = 0.03 to 0.9) as factors related to flat foot in RA patients. Further analysis on variables which had P value <0.25 (BMI, DAS, and disease duration) using multivariate method revealed BMI as the factor related to flat foot in RA patients. Conclusion. The flat foot proportion on RA patients visiting Rheumatology outpatient Unit RSCM did not differ from that in USA. Factor related to this deformity was BMI. This study did not find relations of disease duration and DAS to flat foot in RA patients.

Abstrak :
ABSTRAK
Artritis rematoid merupakan penyakit otoimun sistemik yang paling sering ditemukan di dunia pada berbagai populasi dan ras, ditandai oleh inflamasi menetap pada jaringan sendi yang meliputi sendi perifer, distribusi simetris, dengan atau tanpa kerusakan rawan sendi dan erosi tulang. Pemantauan aktivitas penyakit diperlukan untuk menentukan keberhasilan terapi. Selama ini, pemantauan aktivitas penyakit menggunakan Disease Activity Score 28 (DAS28), meskipun terdapat kekurangan berupa parameter klinis yang bersifat subjektif, menggunakan perhitungan yang rumit, dan terdapat ketidakseragaman nilai titik potong derajat aktivitas penyakit pada berbagai penelitian.

Penelitian ini merupakan penelitian potong lintang untuk menilai korelasi antara kadar anti-CCP serum dan cairan sendi dengan aktivitas penyakit (DAS28) pada 30 subjek dengan artritis rematoid. Subjek yang memenuhi kriteria masukan dan tidak ada kriteria tolakan dilakukan penentuan skor DAS28 serta pemeriksaan anti-CCP serum dan cairan sendi.

Median (rentang) kadar anti-CCP serum secara keseluruhan, pada tingkat aktivitas penyakit sedang, dan berat adalah 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), dan 157.59 (1.07-1853.07) RU/mL. Median (rentang) kadar anti-CCP cairan sendi secara keseluruhan, pada tingkat aktivitas penyakit sedang dan berat adalah 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), dan 110.23 (0.90-4150.58) RU/mL. Median (rentang) skor DAS28 pada keseluruhan subjek ditemukan 5.04 (4.04-7.10). Uji korelasi Spearman didapatkan korelasi positif lemah namun tidak bermakna secara statistik antara kadar anti-CCP serum dan DAS28 dengan rs = 0.296, p = 0.056, korelasi positif lemah yang bermakna secara statistik antara anti- CCP cairan sendi dan DAS28 dengan rs = 0.331, p = 0.037, sedangkan korelasi antara anti-CCP serum dengan cairan sendi ditemukan kuat yang bermakna secara statistik dengan rs = 0.907, p <0.01.

Kami menyimpulkan kadar anti-CCP cairan sendi berkorelasi lemah dengan aktivitas penyakit (DAS28). Tidak ditemukan korelasi yang bermakna secara statistik antara kadar anti-CCP serum dengan aktivitas penyakit (DAS28). Terdapat korelasi kuat antara kadar anti-CCP serum dengan kadar anti-CCP dalam cairan sendi.

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ABSTRACT
Rheumatoid arhtritis is the most common chronic systemic autoimmune disease worldwide among many populations and races, characterized by persistent joint inflammation affecting peripheral joints, symmetrical distribution, with or without joint damage or bone erosion. Disease activity monitoring is needed to determine treatment response. Nowadays, Disease Activity Score 28 (DAS28) is used to monitor disease activity, although it uses subjective clinical parameter, complicated calculation, and ununiformity cut-off value for disease activity stages on various researches.

This study was a cross sectional study to assess wheter there was any correlation between anti-CCP serum and synovial fluid concentration with disease activity (DAS28) in 30 rheumatoid arhtritis subject. Blood and synovial fluid specimen collection and DAS28 determination was performed on subjects who fulfill inclusion and exclusion criteria, followed by anti-CCP assay on each specimen.

Median (range) anti-CCP serum concentration in overall, moderate, and severe disease activity were 112.23 (1.02-1853.07), 70.98 (1.02-1224.07), and 157.59 (1.07-1853.07) RU/mL, respectively. Median (range) anti-CCP synovial fluid concentration in overall, moderate, and severe disease activity were 85.54 (0.90-4150.58), 58.90 (1.03-2477.81), and 110.23 (0.90-4150.58) RU/mL, respectively. Median (range) of DAS28 were 5.04 (4.04-7.10). A weak but not statistically significant correlation was found between serum anti-CCP concentration and DAS28 with rs = 0.296 (p = 0.056). A weak and significant correlation was found between synovial fluid anti-CCP concentration and DAS28 with rs = 0.331 (p = 0.037). A strong and significant correlation are found between serum and synovial fluid anti-CCP concentration, with rs = 0.907 (p <0.01) using Spearman correlation test.

We concluded that synovial fluid anti-CCP concentration weakly correlated with disease activity. No significant correlation was found between serum anti-CCP concentration with disease activity. Strong correlation was found between serum and synovial fluid anti-CCP concentration.

Abstrak :
ABSTRAK
Tujuan Mengetahui hubungan antara kerusakan sendi dinilai menggunakan metode Sharp/ van der Heijde dengan lama sakit penderita artritis reumatoid.

Metode Penelitian analitik potong lintang serial menggunakan data sekunder radiografi manus dan pedis bilateral dari 72 penderita artritis reumatoid dewasa yang berobat ke poliklinik Reumatologi RS Ciptomangunkusumo. Dari data radiografi tersebut dilakukan pengukuran kerusakan sendi dengan metode Sharp/ van der Heijde. Data lama sakit dikelompokkan menjadi 3 kategori yaitu < 2 tahun, 2-4 tahun dan > 4 tahun. Dilakukan uji statistik Kruskall Wallis untuk mengetahui hubungan kerusakan sendi dinilai menggunakan metode skoring Sharp/ van der Heijde dengan lama sakit pasien artritis reumatoid.

Hasil Didapatkan korelasi antara skor kerusakan sendi dinilai dengan menggunakan metode Sharp/ van der Heijde dengan lama sakit serta grafik progresivitas kerusakan sendi seiring lama sakit pasien artritis reumatoid. Didapatkan pula data data dasar pasien artritis reumatoid, data sebaran lesi patologis, data sebaran lokasi kerusakan sendi tiap-tiap kategori lama sakit.

Kesimpulan Didapatkan korelasi secara statistik signifikan antara kerusakan sendi pasien artritis reumatoid dinilai dengan menggunakan metode Sharp/ van der Heijde dengan lama sakit. Didapatkan pula data lain berupa lokasi kerusakan tersering yaitu pergelangan tangan dan lesi patologis terbanyak berupa osteoporosis parartikular dan kista subkortikal. Pengaruh terapi terhadap skor kerusakan sendi tidak dapat disimpulkan karena tidak terdapat data mengenai jenis, lama dan kepatuhan pasien dalam terapi.

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ABSTRACT
Objectives To determine correlation between joint damage in RA patients using Sharp/ van der Heijde method and duration of complaints.

Methods Analytic cross sectional research design utilizing secondary data of bilateral hand and feet radiograph of 72 adult rheumatoid arthritis seeking medical treatment at Rheumatology clinic, Ciptomangunkusumo Hospital. Measurement of radiographic data is done to determine joint damage through Sharp/ van der Heijde method. Duration of complain data is categorized into 3 groups, < 2 years, 2-4 years and > 4 years. Kruskall Wallis statistic analysis was carried out to determine correlation between joint damage using Sharp/ van der Heijde scoring method and duration of rheumatoid arthritis duration of complaints.

Results Joint damage score, measured through Sharp/ van der Heijde method is correlated with duration of complain, demonstrated with progressivity graphic. Distribution of pathologic lesion and joint damages was also obtained for each duration of complaint category.

Conclusion Statistical significant correlation was obtained between joint damage and duration of complaint. Data concerning derangement location was also obtained, namely at wrist and the most common pathologic lesion is periarticular osteoporosis and subcortical cyst. The influence of treatment to joint derangement score was inconclusive due to the absence of data concerning method, duration and patient complience of treatment.