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"ABSTRAK Latar Belakang: Depresi adalah komorbid kejiwaan yang paling sering ditemui pada penyakit kronik. Pada infeksi Human Immunodeficiency Virus (HIV) yang saat ini dianggap sebagai penyakit kronik akibat manfaat terapi kombinasi anti retroviral (ARV), depresi berefek langsung terhadap luaran dan kepatuhan berobat pasien. Selain faktor biologis penyakit kronik dan stressor sosial, depresi juga dapat disebabkan oleh efek samping obat. Perhatian khusus perlu diberikan kepada pasien HIV yang mendapatkan efavirenz (EFV) yang telah diketahui memiliki efek samping depresi dan saat ini merupakan komponen pilihan utama pada terapi kombinasi ARV lini 1.Tujuan: Mengetahui proporsi depresi pada pasien mendapatkan terapi EFV jangka panjang dan mengetahui faktor-faktor yang berhubungan dengan kejadian depresi pada pasien HIV.Metode. Dilakukan studi potong lintang terhadap 251 pasien HIV yang berobat jalan di Unit Pelayanan Terpadu HIV RS Cipto Mangunkusumo dari bulan Juni hingga September 2018. Diagnosis depresi dilakukan melalui penapisan menggunakan Beck Depression Inventory-II (BDI-II) versi Bahasa Indonesia dan diagnosis menurut kriteria diagnosis dari Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5) dengan cara melakukan anamnesis. Analisis bivariat terhadap variabel kategorik-kategorik dilakukan menggunakan uji Chi Square. Variabe numerik dianalisis dengan T-test pada data dengan sebaran normal dan Mann-Whitney pada data sebaran tidak normal. Variabel-variabel bermakna selanjutnya dilakukan analisis multivariat menggunakan uji regresi logistik.Hasil. Dari 251 pasien dengan HIV yang memenuhi kriteria inklusi sebagai subyek penelitian, didapatkan proporsi depresi sebesar 23,5% (IK 95 % 18.25%-28.74). Jenis kelamin, tingkat pendidikan, pendapatan, adanya dukungan sosial, kadar CD4 nadir, riwayat infeksi intrakranial, dan penggunaan zat psikotropika, narkotika atau alkohol tidak berhubungan dengan kejadian depresi pada pasien HIV yang mendapatkan efavirenz jangka panjang. Dari analisis bivariat didapatkan variabel kelompok usia 36-55 tahun, durasi mendapatkan EFV dan homoseksual berhubungan dengan depresi. Berdasarkan analisis multivariat didapatkan bahwa variabel usia 36-55 tahun (OR=0,454; 95% CI 0,244-0,845) dan durasi penggunaan EFV berhubungan dengan depresi pada penggunaan EFV lebih dari satu tahun (OR 0,843; IK 95% 0,755-0,940).Kesimpulan. Proporsi depresi pada pasien HIV yang mendapatkan EFV jangka panjang adalah 23,5% (IK 95% 18,25%-28,74). Kelompok usia 36-55 tahun berhubungan dengan kecenderungan lebih sedikit mengalami depresi dibandingkan kelompok usia <35 tahun, dan pemakaian EFV berhubungan dengan kecenderungan semakin sedikit mengalami depresi(OR 0,843; IK 95% 0,755-0,940).

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ABSTRACT

Background: Depression is considered as the most important psychiatric comorbid in Human Immunodeficiency Virus infection milestones. Special attention should be given to PLWH in long term efavirenz, the first choice for combination therapy in Indonesia since 2012, which also known for neuropsychiatric adverse effect. Aim: To determine the prevalence of depression in PLWH in long-term EFV therapy and contributing factors. Method. A cross-sectional study of 251 HIV-infected adults was conducted at the HIV integrated unit clinic in Cipto Mangunkusumo Hospital from June to September 2018. The eligible subject was screened using Beck Depression Inventory-II and diagnosis of depression was made according to Diagnostic and Statistical Manual of Mental Disorder-5 by doing structured interview. Bivariate analysis was conducted using Chi Square test and Mann-Whitney test. Significant variables were analyzed with multivariate analysis using logistic regression test. Result. From 251 eligible subjects, the prevalence of depression is 23.5% (95% CI 18.25%-28.74). Bivariate analysis shows variable of group of age 36-55 years, EFV duration and homosexuality are associated with depression but multivariate analysis showed only variable of age of 36 to 55 years old (OR=0.454; 95% CI 0.244-0.845) and EFV duration is associated independently with depression (p 0.002, OR 0.843; 95% CI 0.755-0.940). Conclusion. Prevalence of depression in people living with HIV in long-term efavirenz therapy is 23.5% (CI 95% 18.25%-28.74), group of age of 36 to 55 years is tend to have lesser depression than age <35 years and the longer duration of EFV is associated with the lesser tendency of depression."

"Purpose: Differences in definitions of condition, relevant triggers, and the geographical locations of study centers, cause estimates of the prevalence of anaphylaxis to vary. Recent epidemiological data indicate that the incidence of anaphylaxis is rising. Methoda: to investigate the causes and clinical features of anaphylaxis in Korean adults, factors associated the severity of the condition, and serious outcomes, a retrospective medical record review performed on adult patients diagnosed with anaphylaxis between 2007 and 2011 in 15 university Hospital of South Korea. Results: A total of 1.806 cases (52% age 16-86 years) were reported. Cutaneous symptoms (84.0%), combined with respiratory (53, 9%) and/or cardiovascular (55.4%) symptoms, were the most frequent presentations. Using a recognized grading system, 1.776 cases could be classified as either mild, 340; moderate, 690; or severe, 746. Although eliciting factors varied significantly by age, gender, and regional and seasonal factors, drugs (46.5%; including nonsterodial ) anti-inflammatory drugs, antibiotics, and radiocontrast media) were the most common cause of anaphylaxis, followed by foods(24.2%), insect stings (16,4%), exercise (5,9%), and unknown etiology (7.0%). All age, multi-organ involvement, a history of allergic disease, and drug-induced anaphylaxis, were significant predictors of serious outcomes requiring hospital admission or prolongation of hospital stay. Epinephrine auto-injectors were prescribed for 74% of reported cases. Conclusions: The principal causes of Anaphilaxis in Korean adults were drugs, food, and insect stings. Drug-associated anaphylaxis, a history of allergic disease, multi organ involvement, older aged, were identified as predictors of serious outcomes. "

"ABSTRAKPengobatan dengan kemoterapi sering kali menyebabkan efek samping pada pasien kanker yaitu kelelahan. Pengobatan dan diagnosa kanker dapat menyebabkan masalah psikologis seperti depresi. Depresi dapat menyebabkan perubahan inflamasi pada tubuh yang terlibat dan ada bukti yang mengatakan inflamasi terlibat dalam patofisiologi kelelahan. Tujuan penelitian ini adalah untuk mencari tahu hubungan antara depresi dengan kelelahan. Desain penelitian ini menggunakan cross sectional dan metode consequtive sampling dengan besar sampel 30 anak kanker usia 8-12 tahun. Hasil penelitian menunjukkan lebih dari setengah anak kanker mengalami depresi. Hasil penelitian menunjukkan skor kelelahan yang dirasakan oleh anak kanker rata-rata 9,4 (SD= 5,642). Hasil uji statistik menemukan ada hubungan yang bermakna antara depresi dengan kelelahan (p=0,003) dan antara jenis kanker dengan kelelahan (p=0,018). Hasil tersebut menunjukkan bahwa anak kanker yang depresi merasakan skor kelelahan yang lebih tinggi. Perawat perlu melakukan pengkajian terhadap kelelahan dan depresi yang dirasakan anak sehingga dapat melakukan intervensi keperawatan yang tepat dalam mengurangi kelelahan pada anak.

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ABSTRACT

Treatment with chemotherapy often causes side effects in cancer patients, such as fatigue. Treatment and diagnosis of cancer cause psychological problems such as depression. Depression have also been found to create inflammatory changes in the body and there was emerging evidence that inflammation was involved in cancer related fatigue. The aims of this study were to find the relationship between depression and fatigue in children with cancer during chemotherapy. This research used cross-sectional study and a total of 30 children with cancer age 8-12 years old was selected by consequtive sampling. More than half of the children with cancer showed depression and the mean score of FOA-A at 9,4 (SD=5,642). A statistically significant relationship was found between depression and fatigue (p=0,003). There was also a relationship between type of cancer and fatigue (p=0,018). These findings indicate that the children with depression and different type of cancer cause more fatigue. Nurse should incorporate fatigue and depression into the routine nursing assessments of children who suffers cancer and determine the right intervention to reduce fatigue in children."