Disamping efek dari infeksi hepatitis C, pengobatan hepatitis C dengan menggunakan pegylated interferon alfa dikatakan memiliki efek samping berupa depresi. Untuk mengevaluasi gejala depresi pada pasien hepatitis C yang mendapatkan terapi pegylated interferon alfa di divisi Gastroentero-hepatologi RSUD Dr. Saiful Anwar Malang. Penilaian depresi dilakukan 1 kali, dengan menggunakan kuisioner Patient Health Questionnaire 9 (PHQ-9). Penelitian ini dilakukan antara tahun 2014-2015. Seluruh pasien hepatitis C yang mendapatkan terapi dengan pegylated interferon alfa, diberikan formulir kuisioner dari Patient Health Questionnaire (PHQ-9) untuk dievaluasi kondisi depresi yang terjadi. Dari keseluruhan pasien berjumlah 24 pasien, didapatkan hasil berupa depresi minimal sebanyak 9 pasien (37,5%), depresi ringan sebanyak 12 pasien (50%), depresi sedang sebanyak 2 pasien (8,3%) dan depresi sedang-berat sebanyak 1 pasien (4,2%). Rerata usia pasien adalah 53,55±12,13 (dalam tahun), dengan rentang usia 30-73 tahun. Jumlah pasien pria sama dengan jumlah pasien wanita (masing-masing 12 orang). Rerata lama terapi adalah 17,78±11,88 (dalam minggu). Genotipe terbanyak adalah genotipe 1 (16 pasien, 66,67%). Manifestasi depresi yang terbanyak adalah kelelahan yang terus menerus dan penurunan nafsu makan. Penelitian membuktikan adanya gangguan depresi pada pasien-pasien hepatitis C yang mendapat terapi pegylated interferon alfa (pegIFNα). Penilaian kondisi mental sebelum memulai terapi dan setelah selesai terapi, perlu dilakukan secara rutin untuk menilai adanya efek samping yang perlu ditangani secara lebih lanjut.Kata Kunci: Derajat depresi, hepatitis C kronis, pegIFNα
A 32-year-old male came with right upper abdominal pain with a mass increasing in size since the last 6 months, with no other typical symptoms. The physical findings revealed right upper abdominal mass, rubbery consistence, irregular surface, rounded edge, unclear border, immobile, without any tenderness. Other physical examination revealed normal findings, without any lymphadenopathy at another site. The laboratory findings revealed non-reactive hepatitis B and C markers, normal AFP, slightly increased LDH. Plain chest X-ray showed elevated right hemidiaphragm, and a large mass sized ± 14.18 x 8.56 x 12.56 cm compressing the liver. We’ve done biopsy with ultrasound guiding on the mass, and the histological examination revealed that it was lymphoma with negative CD20. The diagnosis was established as primary hepatic lymphoma and the patient was then given chemotherapy.
Background: Frailty has become a major health problem among Indonesian elders. Immunosenescence specifically inflammaging are essential components in the development of frailty. Early screening and timely tailored intervention may effectively prevent or delay the adverse outcomes in elders. This study measured the CD4/CD8 ratio from the immunosenescence pathway and plasma IL-6 levels as inflammatory markers from the inflammaging pathway and observed the correlations between robust and frail elders groups Methods: We conducted a cross-sectional survey. Using multistage random sampling, we enrolled 64 participants across Malang city, divided into frail and robust groups. We analyzed the plasma IL-6 levels and CD4/CD8 ratio using an independent t-test and the Mann–Whitney U test. Results: Significant differences between frail and robust elders were found in age and education level, with the frail participants being older than the robust (p=0.001) and lower educational level (p<0.001). However, plasma IL-6 levels (p=0.936) and the CD4/CD8 ratio (p=0.468) were not statistically different between the groups. Conclusion: Plasma level of IL-6 was found to increase similarly in both groups, while CD4/CD8 ratio was normal and not statistically different between the robust and frail group in elders.
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