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Cardiac Dysfunction due to Sepsis Priyantoro, Kabul; Lardo, Soroy; Yuniadi, Yoga
Jurnal Kardiologi Indonesia Vol 31, No 3 (2010): Sept-Des 2010
Publisher : Indonesian Heart Association

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Abstract

Sepsis is a condition where bacteremia persist and precede by SIRS sign, in a severe condition sepsis can manifest as septic shock and refractory septic shock with very high mortality rate, up to 50% during hospitalization, almost equalize death due to myocardial infarction. In a severe sepsis at least one of organ dysfunction is present, cardiovascular is one of the most frequent affected organ system in severe sepsis and almost always affected during septic shock. During sepsis depression of cardiac systolic and diastolic function characterized by bi-ventricular impairment of contractility, decrease in ventriclular compliance which manifest as subsequent reduction in left ventricular ejection fraction and LV stroke work index. The pathophysiology of cardiac depression during sepsis remain unclear up to now, but many evidence showed that circulating cardio toxic agent (IL – 1, IL – 8, C3a), endotoxin (LPS), cytokine (IL – 1, IL – 6, TNF – α), endothelin – 1 (ET – 1), nitric oxide (NO), prostanoid (Tromboxan & Prostasiklin), and adhesion molecule (intercellular adhesion molecule-1 & vascular cell adhesion molecule-1) play important role in depressing cardiac function during sepsis. Definitive therapy regarding cardiac dysfunction during sepsis is still unknown, but adequate supportive management in maintaining adequate preload continued by inotropic and or vasopressor with low dose corticosteroid, low dose nitroglycerine (in selected patients) and statin are prove in clinical trial effective in providing better outcome. Poor cardiac function in sepsis is related to poor outcome during hospitalization. This article discus about cardiac dysfunction, pathophysiology and supportive management in adult with sepsis.(J Karadiol Indones. 2010;31:177-86)Keyword: Sepsis, septic shock, cardiac dysfunction, cardio toxic agent
INDONESIA’S DEFENSE HEALTH PERSPECTIVE Lardo, Soroy
Jurnal Pertahanan Vol 5, No 1 (2019)
Publisher : Indonesia Defence University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (238.161 KB) | DOI: 10.33172/jp.v5i1.425

Abstract

The National Defense System is a systematic and planned concept, structure and organization, fostering the spirit of the universe of the people and nation, to strengthen and defend themselves from various threats, challenges, obstacles and disturbances that break the Indonesian building and network. The concept embodies software that contains the philosophy, purpose, theoretical framework and framework of the concept of national defense, as a soul and heart that moves continuously in the spirit of conscience defending the country. The purpose of this study is to develop a study about the strategic role of defense health as a diversified potential for multifunctional health to guide the national level of resilience. The potential of health in the field of defense with its strategic thinking decomposes the breadth of Indonesia's geographic region, which has distinctive characteristics of health problems based on geomedicine maps. The dynamic stratification of health problems makes geomedicine maps as a measure of defense health policy. The concept proposed in this study is expected to be one of the basic references in forming a defense health study program at Indonesia Defense University. The method, that needs to be developed, is the transformation of the health of Indonesian National Armed Forces (TNI). At this time, it has achieved dynamic values in realizing a broader role, not only in the field of health services and support, but it has begun to expand into the field of research and development (R & D). This development also related to global challenges, where the spread/pandemic of illness becomes an extraordinary homework, especially related to defense health. Defense health is a multiparadigmatic concept with multidisciplinary scientific dimensions and parameters, and various multi-approaches (analysis, synthesis, and solution), based on philosophy and history, build a defense health characteristic that has a scientific perspective that has reliability and validity, so th purpose of this study can be obtained.
Diagnostic and Treatment of Candidiasis Lardo, Soroy
JOURNAL OF THE INDONESIAN MEDICAL ASSOCIATION Majalah Kedokteran Indonesia Vol 63, No 6 (2013): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA

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Abstract

Introdcution:?Fungal infections can occur due to the increasing use of broad-spectrum antibiotics and patients with immunodeficiency. Some pathogens, such as Cryptococcus, Candida, And Fusarium, rarely cause serious disease in the normal host, while other endemic fungi, such as Histoplasmosis, Coccidiodes, and Paracoccidies can cause disease in a normal host, but has a tendency to be aggressive on immunocompromise.