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Abstrak :
Pendahuluan: Infeksi HIV menyerang pusat kontrol dari sistem imun yang mengakibatkan terjadinya infeksi oportunistik, keganasan dan kematian. Disregulasi dari sistem imun memegang peranan penting dalam progresifitas penyakit HIV. Beberapa penelitian melaporkan bahwa pada pasien-pasien HIV mempunyai kecendrungan untuk menderita penyakit alergi seperti sinusitis, asma dan dermatitis atopik. Juga dilaporkan terjadinya peningkatan kadar serum imunoglobulin E dan peningkatan prevalensi atopi. Tujuan Penelitian: 1. Diketahuinya angka kejadian atopi pada pasien HIV dan non HIV. 2.Diketahuinya hubungan antara jenis kelamin, penggunaan obat intravena, riwayat alergi di keluarga dan jurnlah limfosit CD4 dengan kejadian atopi. 3. Diketahuinya korelasi antara jumlah limfosit CD4 dengan kadar IgE total Metode Penelitian: Dilakukan penelitian potong lintang terhadap 92 orang dengan infeksi HIV / AIDS dan 90 orang non HIV. Adanya atopi dinyatakan berdasarkan pemeriksaan uji tusuk kulit dengan menggunakan enam macam aeroalergen yang umurn di lingkungan. Terhadap pasien-pasien dengan HIV/AIDS yang sebelumnya telah dilakukan pemeriksaan konfirmasi dengan ELISA 3 kali ataupun pemeriksaan Western Blot dilakukan pemeriksaan kadar imnuoglobulin E total, jumlah limfosit CD4 serta dilakukan pengambilan anamnesis. Hasil Penelitian: Dari sembilan puluh dua pasien dengan infeksi mv dan sembilan puluh orang non HIV yang diteliti, didapatkan terdiri atas 65 laki-laki (70.7%) dan 27 perempuan (29.3%) pada kelompok HIV, sedangkan pada kelompok non HIV terdiri atas 40 laki-laki (44.4%) dan 50 wanita ( 55.6%). Umur subjek penelitian berkisar antara 20 sampai dengan 55 tahun dengan rerata 29.325.7 tahun pada kelompok HIV, sedangkan rerata umur kelompok kontrol adalah 27.9 ± 4.5 tahun. Berdasarkan rute transmisi HIV didapatkan sebanyak 52 orang adalah pengguna obat-obatan intravena (56.5%), 35 orang melalui transmisi seksual (38%) sedang sisanya 5 orang (5.5%) mempunyai risiko keduanya. Jumlah limfosit CD4 berkisar 2 sampai 674 selluL dengan median 160 selluL. Kadar imunoglobulin E total berkisar dari 3 sampai dengan 20.000 IU/mL dengan median 283.5 ID/mL. Lima puluh orang dengan HIV dinyatakan atopi lebih tinggi bila dibandingkan dengan kelompok non HIV (54.3% vs 30%, p= 0.001) Aeroalergen tersering yang menimbulkan sensitasi adalah D farinae sebanyak 50% dan D pteronyssinus (30%). Kami juga mendapatkan adanya korelasi negatif yang bermakna antara jumlah limfosit CD4 dengan kadar imunoglobulin E total. Kami tidak mendapatkan hubungan yang bermakna antara jenis kelamin, rute transmisi, riwayat alergi di keluarga serta jumlahlimfosit CD4 dengan kejadian atopi. Kesimpulan: Terjadi peningkatan prevalensi atopi pada pasien-pasien dengan HIV/AIDS serta terdapat korelasi negatif yang bermakna antara jumlah limfosit CD4 dengan kadar imunogobulin E total. Oleh karena itu merupakan hal yang penting untuk melakukan evaluasi status atopi pasienHIV I AIDS untuk mencegah timbulnya penyakit alergi pada pasien terse but yang dapat mempercepat progresifitas penyakitnya melalui disregulasi dari sistem imun. ......Background: HIV infection attacks the centre of immune control system resulting opportunistic infection, malignancy and death. Dysregulation immune system plays the central role in the progression of the disease. Some studies have reported HIV -infected patient prone to have allergic disease such as sinusitis, asthma and atopic dermatitis. Elevated serum immunoglobulin E (Ig E) and increased prevalence of atopy also had been reported in HIV infected patient Objective: I.To determine and compare the prevalence of atopy among HIV infected/AIDS patient with non HIV patients and investigate its predictors. 2. To investigate the relationship between CD4 cell count, Ig E level and atopy Methods: A cross sectional method study was performed to 92 HIV infected/AIDS patient and 90 non HIV patients. They were studied for the presence of atopy based on the immediate hypersensitivity to six common aeroallergens by skin prick test. CD 4 cell count, total serum immunoglobulin level and medical history were taken. The HIV infected patients had been confirmed by the presence of antibody determined by ELISA method done three times or by western blot methods. Result: Ninety-two HIV infected patients and ninety non HIV patients had been studied, they were 65 males (70.7%) and 27 female (29.3%) in HIV arm and 40 males (44.4%), 50 females (55.6%) in non mv group. Subject's age between 20 to 55 years old. (mean: 29.3±5.7years) in HIV ann and 27.9 ± 4.5 years old in control group. Belonging to HIV route transmission: 52 intravenous drug users (56.5%), 35 heterosexual partners of HIV infected patients (38%) and 5 subjects who have both risks (5.5%). CD4 cell count of the subjects range from 2 to 674 cells, median 160 cellslmm3 . The total of immunoglobulin E level range from 3 to 20,000 IU/mL with median 283.5 IU/mL. 50 subjects with HIV + were identified as atopic higher than in non HIV (54.3% vs 30%, p= 0.001). The most common aeroallergen is D farinae (50% subjects of atopy shown positive result) and D pteronyssinus (30%). We also found a significant negative correlation between CD4 count and Total immunoglobulin E level (r= -0.544, p=O.OOO), but there is no relationship between gender, allergic history in family, route of transmission, and CD4 count with atopy. Conclusion: There is an increase prevalence of atopy among HIV I AIDS patients and negative correlationship between CD4 count and total Imunnoglobulin E level. It is important to evaluate the atopic state in HIV patient to prevent the patients from allergic diseases which could accelerate HIV infection by dysregulation of immune system.

Abstrak :
Background The prevalence of allergic disease to be increasing across the world. More than 20 of the population worldwide suffer from diseases which mediated by immunoglobulin E, such as asthma, rhinoconjunctivitis, atopic dermatitis or eczema. There is no data about allergen sensitization of allergic disease in Manado. Objective The purpose of this study is to know the allergen sensitization in children with allergic diseases atopic dermatitis, allergic rhinitis, asthma . Children were divided into group less than and more than or equal to 3 years old, which was evidenced by skin prick test or IgE Atopy test in Prof. Dr. R.D. Kandou Hospital Manado. Methods This study was a descriptive cross sectional study, conducted from June until August 2016. Results A total of 95 children were included in the study, of which 77 children were ge 3 years old and 18 children were 3 years old. Seventy five children underwent skin prick test and 20 children underwent IgEAtopy test. In 3 years old children, there were 14 children diagnosed with atopic dermatitis and 4 children diagnosed with atopic dermatitis and asthma. In ge 3 years old children, the most common diagnosis was allergic rhinitis, as many as 21 children. Allergen sensitization found in 3 years old children with atopic dermatitis and atopic dermatitis asthma was cow rsquo s milk, house dust mites and egg white. Sensitization to house dust mites most commonly found in patients with atopic dermatitis. The most common allergen sensitization in ge 3 years old children was house dust mites, egg white, potatoes, dog fur, cow 39 s milk, wheat flour and soya formula. Conclusion The most common allergen sensitization in 3 years old children with atopic dermatitis is cow 39 s milk, while in children with asthma and atopic dermatitis is house dust mites, whereas in ge 3 years old children with atopic dermatitis, allergic rhinitis, asthma, or combination of the disease is house dust mites.

Abstrak :
Latar Belakang Prevalensi asma meningkat dalam 30 tahun terakhir dan bervariasi di berbagai negara, komunitas, etnis yang berbeda. Penelitian di Indonesia melaporkan prevalensi asma pada anak dan orang dewasa 6-7 %. identifikasi faktor-faktor risiko seperti faktor keturunan, atopi, urutan kelahiran dalam keluarga, rokok, hewan piaraan, gizi, pola makanan, obesitas dengan kejadian asma perlu untuk menjelaskan variasi tersebut. Sampai saat ini studi prevalensi asma dan identifikasi faktor risiko di daerah pantai dengan jumlah sampel yang besar belum pernah dilakukan di Indonesia. Tujuan Mencari faktor-faktor risiko asma pada anak sekolah usia 13 hingga 18 tahun di Kepulauan Seribu. Metodologi Uji potong lintang dilanjutkan dengan disain kasus kontrol bersarang. Pada responden dibagikan kuesioner yang dikelompokkan berdasar diagnosis asma, pernah asma dan bukan asma. Untuk kelompok asma dalam 12 bulan terakhir, pernah asma dan tidak asma (keiompok kontrol) dipilih secara acak untuk dilakukan uji tusuk kulitlskin prick test. Hasil Telah dilakukan di 15 sekolah (SD, SLTP, SLTA) yang tersebar di Kepulauan Seribu sebanyak 1505 responden terdiri atas 713 laki-laki dan 792 perempuan. Distribusi responden menurut jenis kelamin pada kasus asma dan kontrol tidak terdapat hubungan yang bermakna (IK 95%; 0,54-1,47, p=0,66). Hubungan orang tua menyandang asma dengan kejadian asma pada responden menunjukkan hubungan bermakna. Pada ayah (IK 95%; 6,09-59,9, p=0,001). Pada ibu (IK 95%; 1,23-7,95, p=4,001), Berdasarkan hasil uji tusuk kulit pada kelompok mengi dan kontrol menunjukkan hubungan yang bermakna (D. Pteronyssinus) dengan kejadian asma (p 0,0001). Sedangkan faktor risiko asma lainnya (urutan kelahiran dalam keluarga, rokok, hewan piaraan, dan obesitas) tidak menunjukkan hubungan bermakna dengan kejadian asma. Simpulan PrevaIensi gejala asma pads anak usia 13 hingga 18 tahun di Kepulauan Seribu berdasarkan riwayat mengi = 11,8%, mengi 12 bulan terakhir = 5,4 %. Didapat hubungan bermakna pada orang tua menyandang asma terhadap kejadian asma pada anak. Hasil uji tusuk kulit (D. pteronyssinus) menunjukkan hubungan bermakna dengan kejadian asma.

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Background The prevalence of asthma has been increasing in the last 30 years and varied among different countries, communities and ethnic groups. Study in Indonesia had reported that the prevalence of asthma in children and adults was 6-7%. Identification of risk factors, atopy, smoking, pet, nutrition, dietary pattern, obesity and incidence of asthma are necessary to explain the variation. Up to now, study on the prevalence of asthma and risk factors identification with big sample size in maritime region has never been conducted in Indonesia. Objectives The aim of the study is to determine risk factors of asthma in school children aged 13-18 years old in Kepulauan Seribu. Methods A cross sectional study continued by nested case control was conducted in Kepulauan Seribu in June 2005. All respondents have to fill out questionnaire forms and were grouped based on diagnosis of asthma, history of asthma and no asthma. For the asthma group in last 12 months, history of asthma and no asthma (control group) were selected randomly for skin prick test. Results Data was obtained from 1505 subjects in 15 schools (elementary school, junior high school, senior high school) consisted of 713 boys and 792 girls. The prevalence of asthma in adolescents aged 13 - 18 years old in Kepulauan Seribu based on symptom of wheezing (11.8%), wheezing in the last 12 months (5.4%). Distribution of respondents based on gender found no significant relation between asthma and control group (CI 95%; 0.54-1.47, p=4.66). Subjects with asthma associated significantly with their parents who also had asthma (fathers CI 95%; 6.09-59.9, p=0.04I and mothers CI 95%; 1.23-7.95, p=0.001). Based on skin prick test, we found there was significant relation between alergen (D. Pteronyssinus) with incidence of asthma (p=4.0001), while other risk factors (family size, smoking, obesity, pet) had not showed significant relation with asthma. Conclusions The prevalence of asthma in adolescent aged 13-18 years old in Kepulauan Seribu based on history of wheezing was 11.8%, while symptom of wheezing in 12 month was 5.4%. Subjects with asthma associated significantly with their parents who also had asthma. Skin prick test (D. pteronyssinus) had significant relation with incidence of asthma.

Abstrak :
Uap logam merupakan agen penyebab atopi golongan berat molekul rendah yang menyebabkan terjadinya Metal Fume Fever(MFF). Adanya mekanisme alergi pada MFF belum diketahui dengan jelas. Penelitian ini bertujuan untuk mengetahui peran atopi dan faktor lain yang mempengaruhi terjadinya MFF. Desain potong lintang dengan analisis komparatif digunakan untuk mengetahui hubungan atopi serta faktor lain terhadap terjadinya MFF pada pekerja las.Subjek penelitian adalah 234 pekerja las di industri suku cadang otomotif PT X di Bekasi, Indonesia.Pengumpulan data dilakukan melalui kuesioner, pemeriksaan klinis, uji tusuk kulit, serta pengukuran arus puncak ekspirasi. 108 dari 234 sampel (46%) mengalami MFF.Tidak ditemukan adanya perbedaan proporsi yang bermakna antara subjek dengan atopi dan subjek tanpa atopi terhadap terjadinya MFF. Berdasarkan RRsuaian dengan melakukan penyesuaian antar variabel yaitu atopi, masa kerja dan APD tidak diperoleh adanya variabel yang merupakan faktor determinan, walaupun pada perhitungan RRkasar ditemukan masa kerja > 5 tahun dan tidak menggunakan APD meningkatkan risiko MFF dengan masing-masing RRkasar (1.46, 95%IK=1.03-2.09) dan (1.5, 95%IK=1.05-2.15). Sebagai simpulan yaitu prevalensi MFF pada pekerja las sebesar 46%. Tidak terdapat perbedaan secara statistik antara proporsi subjek dengan faktor atopi untuk mengalami MFF dengan subjek tanpa faktor atopi.

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Metal fume is low molecular weight atopy agent which cause Metal Fume Fever (MFF). The allergic mechanisms of MFF is still unclear. This study aims to determine role of atopy and other factors influence MFF.This was a cross-sectional study with a comparative analysis to determine assosiation between atopy and other influencing factors with occurrence of MFF on welder. Subjects were 234 workers in PT X an automotive sparepart industry in Bekasi, Indonesia. Data collected through questionnaires, clinical examination, skin prick test and peak expiratory flow measurements. 108 of 234 samples (46%) experienced MFF. There were no significant differences proportion between subjects with atopy and non atopy to the occurrence of MFF. Based on adjusted Relative Risk (adjusted RR) by making adjustments between variables atopy, working period and usage of PPE, this study wasn?t obtained the existance of a variable which act as determinant factor. Although crude relative risk analysis was found work period over 5 years and not using PPE increases the risk of MFF, which for working periode (RRcrude=1.46; 95%CI=1:03-2:09) and a habit of not using Personal Protective Equipment (PPE) (RRcrude =1.5; 95%CI=1:05-2:15).The prevalence of MFF on welder was46%. No statistic significant differance between proportion of subjects with atopy and subjects without atopy for experiencing MFF.

Abstrak :
Osteitis dapat berperan sebagai sumber inflamasi kronis pada struktur tulang sinonasal pada kasus rinosinusitis kronik RSK dengan atau tanpa polip yang menyebabkan rekurensi pasca terapi medikamentosa maupun pembedahan. Tesis ini membahas mengenai korelasi antara derajat osteitis serta inflamasi mukosa pada RSK dengan polip hidung bilateral refrakter. Penelitian menggunakan desain korelatif potong lintang pada 29 subjek yang diambil secara retrospektif. Hasil dari penelitian ini didapatkan korelasi signifikan antara skor LMSS dan GOSS r = 0,36, p = 0,05 , tidak terdapat korelasi signifikan pada subjek dengan polip bilateral derajat 2 -3 r = 0,39, p = 0,439 , maupun pada subjek dengan polip grade 4 ndash; 6 r = 0,27, p = 0,204 , dan tidak terdapat korelasi signifikan pada subjek dengan riwayat pembedahan satu kali r = 0,44, p = 0,145 , maupun pada subjek dengan riwayat pembedahan lebih dari satu kali r = 0,27, p = 0,29 , Median skor LMSS dan GOSS lebih tinggi pada kelompok pembedahan berulang dan polip derajat 4 ndash; 6. Hasil penelitian ini membuktikan bahwa identifikasi osteitis dapat digunakan untuk mengetahui derajat keparahan RSK serta memprediksi kekambuhan yang selanjutnya dapat membantu untuk menentukan terapi medikamentosa dan pembedahan yang tepat. ......Osteitis may served as a nidus for chronic inflammation in Chronic Rhinosinusitis CRS with or without polyps, that may explain for any recurrence post medical treatment and surgery. The purpose of this thesis paper was to determine correlation between osteitis and mucosal inflammation in CRS with refractory bilateral nasal polyps. This is a cross ndash sectional corelative research in 29 subjects which were taken by retrospective sampling. The results are significant correlation between LMSS and GOSS score r 0,36, p 0,05 , , no significant correlation in subject with bilateral nasal polyps grade 2 ndash 3 r 0,39, p 0,439 and subject with polyps grade 4 ndash 6 r 0,27, p 0,204 , and no significant correlation also in subject with history of primary surgery r 0,44, p 0,145 , and also no significant correlation in subjects with history of revision surgery r 0,27, p 0,29 Median LMSS and GOSS score were higher in revision surgery and polyps grade 4 ndash 6 group. The conclusion was identifying osteitis can be used to determine the degree of severity and predicting recurrency and further help to determine proper medical treatment and surgery.