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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 :
[ABSTRAK
Latar Belakang: Penyakit Demam Berdarah Dengue (DBD) masih endemis dan merupakan masalah yang besar dan serius di Indonesia. Peningkatan kadar laktat dalam darah merupakan petanda hipoksia jaringan pada penyakit DBD, bila hipoksia jaringan tidak terdeteksi lebih awal/dini, dan tidak diberikan cairan lebih agresif dan sesuai, maka akan meningkatkan angka komplikasi dan kematian. Tujuan: Mengetahui perbedaan rerata kadar hematokrit dan albumin serum serta beda proporsi efusi pleura dan atau asites, pasien infeksi dengue dewasa pada berbagai derajat hiperlaktatemia untuk mengetahui secara dini adanya hipoksia jaringan Metode: Penelitian ini adalah Studi uji Potong Lintang. Penelitian dilakukan di RSUPN Cipto Mangunkusumo dan RSUP Persahabatan Jakarta, pada pasien yang dirawat periode waktu April 2014 sampai dengan Mei 2015. Menilai beda rerata kadar hematokrit darah dan albumin serum menggunakan uji statistik Uji T, sedangkan beda proporsi efusi pleura dan atau asites dengan Uji Kai Kuadrat. Hasil: Sebanyak 62 pasien infeksi demam dengue, dibagi kedalam 2 kelompok masing-masing 31 pasien berdasarkan kadar laktat darah. Kelompok I dengan kadar laktat darah > 2 sampai ≤ 2,4 mmol/L dan kelompok II > 2,4 mmol/L. Rerata kadar hematokrit darah pada kelompok I dan II masing-masing 40,06 (SB 4,54) dan 41,03 (SB 4,77). Tidak ada perbedaan rerata kadar hematokrit darah pada kedua kelompok dengan nilai p = 0,42. Rerata kadar albumin serum pada kelompok I dan II masing-masing 3,94 (SB 0,29) dan 3,89 (SB 0,30). Tidak ada perbedaan rerata kadar albumin serum pada kedua kelompok dengan nilai p = 0,49. Proporsi efusi pleura dan atau asites pada kelompok I dan II masing-masing 54,8% dan 58,1%. Tidak ada perbedaan proporsi adanya efusi pleura dan atau asites pada kedua kelompok dengan p = 1. Kesimpulan: Tidak ada perbedaan rerata kadar hematokrit darah dan albumin serum, serta beda proporsi efusi pleura dan atau asites pada kelompok kadar laktat darah > 2 sampai ≤ 2,4 mmol/L dibandingkan > 2,4 mmol/L.

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ABSTRACT
Background: Dengue Haemorrhagic Fever (DHF) is still endemic and is a big and serious problem in Indonesia. Increased levels of lactate in the blood is a marker for tissue hypoxia in DHF , when tissue hypoxia is not detected early and not given the more aggressive fluids and appropriate, it will increase the rate of complications and mortality. Objective: To determine differences in average levels of hematocrit and serum albumin as well as different proportions pleural effusion and/or ascites, adult patients with dengue infection in various degrees hyperlactatemia to know at an early stage for tissue hypoxia. Methods: This study is a test study Cross Sectional. The study was conducted at Cipto Mangunkusumo and at Persahabatan Hospital, Jakarta, in-patients admitted to the time period April 2014 through May 2015. Assessing the mean difference of blood hematocrit levels and serum albumin using statistical test T test, while the different proportion of pleural effusion and/or ascites with test Chi Square. Results: A total of 62 patients of dengue fever infections, distributed into 2 groups of each 31 patients based on blood lactate levels. Group I with a blood lactate levels > 2 to ≤ 2,4 mmol/L and Group II > 2.4 mmol/L. The mean blood hematocrit levels in group I and II, respectively 40.06 (SD 4.54) and 41.03 (SD 4.77). There is no difference in mean blood hematocrit levels in both groups with p = 0.42. The mean levels of serum albumin in group I and II respectively 3.94 (SD 0.29) and 3.89 (SD 0.30). There is no difference in the mean serum albumin levels in both groups with p = 0.49. The proportion of pleural effusion and/or ascites in groups I and II respectively 54.8% and 58.1%. There is no difference in the proportion of the pleural effusion and/or ascites in both groups with p = 1. Conclusion: There is no difference in mean blood hematocrit levels and serum albumin, as well as the different proportions of pleural effusion and/or ascites founds in the group of blood lactate levels > 2 to ≤ 2,4 mmol/L compared to > 2.4 mmol/L.;Background: Dengue Haemorrhagic Fever (DHF) is still endemic and is a big and serious problem in Indonesia. Increased levels of lactate in the blood is a marker for tissue hypoxia in DHF , when tissue hypoxia is not detected early and not given the more aggressive fluids and appropriate, it will increase the rate of complications and mortality. Objective: To determine differences in average levels of hematocrit and serum albumin as well as different proportions pleural effusion and/or ascites, adult patients with dengue infection in various degrees hyperlactatemia to know at an early stage for tissue hypoxia. Methods: This study is a test study Cross Sectional. The study was conducted at Cipto Mangunkusumo and at Persahabatan Hospital, Jakarta, in-patients admitted to the time period April 2014 through May 2015. Assessing the mean difference of blood hematocrit levels and serum albumin using statistical test T test, while the different proportion of pleural effusion and/or ascites with test Chi Square. Results: A total of 62 patients of dengue fever infections, distributed into 2 groups of each 31 patients based on blood lactate levels. Group I with a blood lactate levels > 2 to ≤ 2,4 mmol/L and Group II > 2.4 mmol/L. The mean blood hematocrit levels in group I and II, respectively 40.06 (SD 4.54) and 41.03 (SD 4.77). There is no difference in mean blood hematocrit levels in both groups with p = 0.42. The mean levels of serum albumin in group I and II respectively 3.94 (SD 0.29) and 3.89 (SD 0.30). There is no difference in the mean serum albumin levels in both groups with p = 0.49. The proportion of pleural effusion and/or ascites in groups I and II respectively 54.8% and 58.1%. There is no difference in the proportion of the pleural effusion and/or ascites in both groups with p = 1. Conclusion: There is no difference in mean blood hematocrit levels and serum albumin, as well as the different proportions of pleural effusion and/or ascites founds in the group of blood lactate levels > 2 to ≤ 2,4 mmol/L compared to > 2.4 mmol/L.;Background: Dengue Haemorrhagic Fever (DHF) is still endemic and is a big and serious problem in Indonesia. Increased levels of lactate in the blood is a marker for tissue hypoxia in DHF , when tissue hypoxia is not detected early and not given the more aggressive fluids and appropriate, it will increase the rate of complications and mortality. Objective: To determine differences in average levels of hematocrit and serum albumin as well as different proportions pleural effusion and/or ascites, adult patients with dengue infection in various degrees hyperlactatemia to know at an early stage for tissue hypoxia. Methods: This study is a test study Cross Sectional. The study was conducted at Cipto Mangunkusumo and at Persahabatan Hospital, Jakarta, in-patients admitted to the time period April 2014 through May 2015. Assessing the mean difference of blood hematocrit levels and serum albumin using statistical test T test, while the different proportion of pleural effusion and/or ascites with test Chi Square. Results: A total of 62 patients of dengue fever infections, distributed into 2 groups of each 31 patients based on blood lactate levels. Group I with a blood lactate levels > 2 to ≤ 2,4 mmol/L and Group II > 2.4 mmol/L. The mean blood hematocrit levels in group I and II, respectively 40.06 (SD 4.54) and 41.03 (SD 4.77). There is no difference in mean blood hematocrit levels in both groups with p = 0.42. The mean levels of serum albumin in group I and II respectively 3.94 (SD 0.29) and 3.89 (SD 0.30). There is no difference in the mean serum albumin levels in both groups with p = 0.49. The proportion of pleural effusion and/or ascites in groups I and II respectively 54.8% and 58.1%. There is no difference in the proportion of the pleural effusion and/or ascites in both groups with p = 1. Conclusion: There is no difference in mean blood hematocrit levels and serum albumin, as well as the different proportions of pleural effusion and/or ascites founds in the group of blood lactate levels > 2 to ≤ 2,4 mmol/L compared to > 2.4 mmol/L., Background: Dengue Haemorrhagic Fever (DHF) is still endemic and is a big and serious problem in Indonesia. Increased levels of lactate in the blood is a marker for tissue hypoxia in DHF , when tissue hypoxia is not detected early and not given the more aggressive fluids and appropriate, it will increase the rate of complications and mortality. Objective: To determine differences in average levels of hematocrit and serum albumin as well as different proportions pleural effusion and/or ascites, adult patients with dengue infection in various degrees hyperlactatemia to know at an early stage for tissue hypoxia. Methods: This study is a test study Cross Sectional. The study was conducted at Cipto Mangunkusumo and at Persahabatan Hospital, Jakarta, in-patients admitted to the time period April 2014 through May 2015. Assessing the mean difference of blood hematocrit levels and serum albumin using statistical test T test, while the different proportion of pleural effusion and/or ascites with test Chi Square. Results: A total of 62 patients of dengue fever infections, distributed into 2 groups of each 31 patients based on blood lactate levels. Group I with a blood lactate levels > 2 to ≤ 2,4 mmol/L and Group II > 2.4 mmol/L. The mean blood hematocrit levels in group I and II, respectively 40.06 (SD 4.54) and 41.03 (SD 4.77). There is no difference in mean blood hematocrit levels in both groups with p = 0.42. The mean levels of serum albumin in group I and II respectively 3.94 (SD 0.29) and 3.89 (SD 0.30). There is no difference in the mean serum albumin levels in both groups with p = 0.49. The proportion of pleural effusion and/or ascites in groups I and II respectively 54.8% and 58.1%. There is no difference in the proportion of the pleural effusion and/or ascites in both groups with p = 1. Conclusion: There is no difference in mean blood hematocrit levels and serum albumin, as well as the different proportions of pleural effusion and/or ascites founds in the group of blood lactate levels > 2 to ≤ 2,4 mmol/L compared to > 2.4 mmol/L.]