Hasil Pencarian  ::  Simpan CSV :: Kembali

"We report a case of carcinoma of the esophagus in a 58 years old woman with achalasia, who has been diagnosed since 30 years ago, which initiated by surgical treatment (myotomy) and the symptoms recurred since 3 years ago. According to the progress of the disease, malignancy was strongly suspected due to prolonged stasis and mucosal irritation caused by achalasia (achalasia carcinoma sequence). Because of these contributing factors for the development of serious complications such as malignancy the diagnosis of achalasia must be systematically diagnosed and treated agressively. Surveillance endoscopy in patients with achalasia should be performed every 1-2 years."

"Achalasia merupakan salah satu penyakit saluran pencernaan yang dapat terjadi pada masyarakat perkotaan. Pola diet tidak sehat diperkirakan menjadi faktor risiko terjadinya masalah pencernaan yang dapat berkembang menjadi Achalasia. Dampak dari Achalasia adalah asupan makanan yang sulit baik secara oral ataupun enteral. Salah satu usaha untuk menangani Achalasia adalah dengan tindakan operasi. Tatalaksana pra operasi untuk persiapan fisik klien adalah dengan meningkatkan asupan nutrisi ke dalam tubuh melalui pemberian terapi nutrisi parenteral. Tujuan karya ilmiah ini adalah untuk menganalisis intervensi keperawatan yaitu pemberian nutrisi parenteral pada klien dengan Achalasia. Penulisan ini menggunakan pendekatan studi kasus klinik. Intervensi yang dilakukan selama 17 hari perawatan pra operasi menunjukan bahwa terapi nutrisi parenteral melalui vena perifer mampu memberikan asupan nutrisi yang adekuat dan membuat klien menjadi lebih berenergi dari sebelumnya. Namun disamping itu, klien juga mengalami phlebitis sebanyak 3 kali selama masa perawatan. Rekomendasi studi kasus ini dalam mengoptimalkan asupan nutrisi parenteral pada klien dengan Achalasia adalah dengan melakukan perawatan akses vena perifer secara rutin dan memperhatikan faktor-faktor yang dapat memunculkan phlebitis.

---

Achalasia is one of the gastrointestinal diseases that can occur in urban communities. Unhealthy diet patterns are estimated to be a risk factor for digestive problems that can develop into Achalasia. The impact of Achalasia is a difficult dietary intake both orally and enterally. One attempt to deal with Achalasia is by surgery. Preoperative management for the client 39;s physical preparation is by increasing the intake of nutrients into the body through the provision of parenteral nutrition therapy. The purpose of this scientific paper is to analyze the nursing intervention that is giving parenteral nutrition to the client with Achalasia. This writing uses a clinical case study approach. Interventions performed during the 17 days of preoperative treatment show that parenteral nutrition therapy through peripheral vein can provide adequate nutritional intake and make the client more energetic than before. In addition, clients also experience phlebitis 3 times during the treatment period. The recommendation of this case study in optimizing the intake of parenteral nutrition on clients with Achalasia is by routinely perform peripheral venous access treatments and notice the factors that causes phlebitis. "

"Achalasia is defined as a motor disorder of I he esophageal smooth muscle in which the lower esophageal sphincter does not relax properly with swallowing and the normal peristalsis of the esophageal body is replaced by abnormal contractions. The definite etiology is unknown. The incident is infrequent. The diagnosis of achalasia was established by clinical, radiological investigation, and manometric data. The management of achalasia consists of conservative treatment, dilation and surgical treatment. Esophageal dilation is the technique used to stretch open the blocked portion of the esophagus. Balloon dilation is a form of definite treatment beside myotomy or Heller's operation. We hereby report a case managed by balloon dilation catheter after failure by means of conservative treatment."

"Analisis Praktik Residensi Keperawatan Medikal Bedah dan Studi Kasus Pemberian Asuhan Keperawatan Pada Pasien Akalasia Esofagus Dengan Pendekatan Model Adaptasi Roy Di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta Abstrak Pendahuluan: Pelaksanaan praktek klinik selama masa residensi keperawatan peminatan digestif bertujuan untuk mampu menampilkan peran perawat spesialis sebagai pemberi asuhan keperawatan lanjut, pendidik, advokat, konselor, kolaborator, pembaharu dan peneliti. Peran pemberi asuhan keperawatan lanjut dilakukan dengan menggunakan Model Adaptasi Roy pada pasien Akalasia Esofagus dan 30 pasien lainnya. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologis dengan diagnosa keperawatan ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Intervensi keperawatan berupa manajemen nutrisi ditujukan untuk meningkatkan adaptasi pasien dalam mencapai status nutrisi. Evidence Based Nursing dilakukan dengan menerapkan pemberian minuman maltodekstrin pada pasien pra operasi elektif pada dua pasien untuk mengatasi mual, muntah dan nyeri pasca operasi, diperoleh hasil keluhan mual dan muntah tidak ada sama sekali pada 0-24 jam pasca operasi, sedangkan keluhan nyeri ringan masih dirasakan pada satu pasien. Program inovasi kelompok berupa penerapan protokol ERAS yaitu pemberian maltodekstrin pra operasi, mengunyah permen karet pasca operasi dan mobilisasi dini 2 jam pasca operasi terbukti efektif mengatasi keluhan mual dan muntah pasca operasi, meningkatkan motilitas usus dan mencegah nyeri bahu pasca operasi.

---

Analysis of Medical Surgical Nursing Residency Practice and Case Study of Nursing Care Delivery on Achalasia Oesophagoes Using Roy Adaptation Model ApproachAbstractImplementation of clinical practice during the residency of digestive nursing aims to be able to showcase the role of specialist nurse as advanced nursing care provider, educator, advocator, counselor, collaborator, innovator and researcher. Role of specialist as advance nursing care provider was done by using Roy Adaptation Model on Achalasia Oesophagus and 30 other patients. Maladaptive behavior at most is a physiological adaptation mode with imbalanced nutrition: less than body requirement nursing diagnosis. Nursing outcome of nutrition management is aimed at improving patient adaptation in gaining nutrition status. Evidence Based Nursing was performed by applying preoperative oral carbohydrate loading to two patients undergoing laparoscopy cholesystectomy for relieving post operative nausea and vomiting. The innovation program was implementing ERAS protocol e.g preoperative oral carbohydrate loading, chewing gum and early mobilization proved effective as nursing intervention in pre and post operative management. "

"Penilaian karakteristik asimetris dinding nasofaring pada karsinoma nasofaring KNF pasca terapi memiliki implikasi penting pada penatalaksanaan pasien, tetapi seringkali sulit untuk mendiferensiasikan antara lesi tumoral dan non tumoral menggunakan CT scan/ MRI konvensional. Penelitian ini bertujuan untuk mengetahui titik potong nilai ADC antara lesi tumoral dan non tumoral pada follow up MRI pasca terapi. Penelitian merupakan studi kesesuaian dengan pendekatan potong lintang antara nilai ADC dan histopatologi. Penelitian menggunakan data primer 21 pasien KNF pasca kemoradioterapi yang melakukan pemeriksaan MRI nasofaring di Departemen Radiologi RSUPN-CM pada Juni 2016-Oktober 2017. Range of interest dan pemetaan ADC nilai b 1000 s/mm2 diletakkan pada komponen solid. Rerata jarak terapi dan evaluasi MRI pasca terapi adalah 9,3 bulan. Rerata nilai ADC lesi tumoral 0,7 x 10-3 mm2/s SD 0,05 dan non tumoral 1,2 x 10-3 mm2/s SD 0,3. Pada uji independent T-test menunjukkan perbedaan bermakna secara statistik antara rerata nilai ADC tumoral dan non tumoral. Pada analisis ROC nilai ADC didapatkan titik potong 0,86 x 10-3 mm2/s AUC= 0,97; SE= 0,04 dengan nilai sensitivitas 100 dan spesifisitas 93,8. Berdasarkan uji McNemar nilai p> 0,005 menunjukkan bahwa tidak ada perbedaan bermakna antara temuan ADC dan histopatologi. Terdapat kesesuaian yang sangat kuat antara nilai ADC dan histopatologi untuk membedakan lesi tumoral dan non tumoral KNF pasca terapi. Pemeriksaan MRI sekuens DWI-ADC dapat digunakan untuk memberikan informasi tambahan pada kasus follow up KNF pasca terapi.

---

Assessment of nasopharyngeal wall asymmetric characteristics of post treatment nasopharyngeal carcinoma NPC has important implication for management of the patients, but it is often difficult to distinguish between non tumoral and tumoral lession by using CT scan conventional MRI. The objective is to assess ADC cut off values between tumoral and non tumoral lession on MRI follow up after treatment. This research is a conformity study with cross sectional approach between ADC values compared with histopathology. This study used primary data of 21 post chemoradiotherapy NPC patients, who were examined nasopharnygeal MRI at Radiology Departement of Cipto Mangunkusumo Hospital in June 2016 October 2017. Range of interest ROI and ADC mapping b value 1000 s mm2 were placed on solid components. Mean interval between therapy and post treatment MRI was 9.3 months. Mean ADC values of tumoral lesions were 0.7 x 10 3 mm2 s SD 0.05 and non tumoral lession 1.2 x 10 3 mm2 s SD 0.3 . Independent T test showed statistically significant difference between the mean ADC values in tumoral and non tumoral lesions. In ROC analysis, ADC cut off value was obtained 0,86 x 10 3 mm2 s AUC 0,97 SE 0,04 with 100 sensitivity and 93,8 specificity. Based on the McNemar test p 0,05 , there was no significant difference between ADC findings and histopathology. There is very strong suitability between ADC and histopathologic values to differentiate tumoral and non tumoral lession in post treatment NPC. DWI ADC can be used to provide additional information on follow up post treatment NPC. "

"Adenoid cystic carcinoma is an extremely rare case of the esophagus. We present a female patient, aged 76 years who present with dysphagia and weight loss for tire last three month. On endoscopy there was a luminal narrowing in the middle third of the esophagus. Diagnosis was challenging due to the stenosis and the tumor size. Histopathological confirmation was obtained by subcarinal fine-needle aspiration biopsy. This type of cancer is very aggressive with short survival time. Further studies are needed to define optimal treatment."

"Skripsi ini membahas suatu metode yang biasa dikenal dengan nama DIALIGN untuk mencari penyejajaran terbaik dari dua barisan DNA. Algoritma ini berdasarkan pada perbandingan segmen dengan segmen bukan seperti yang biasa dilakukan yaitu perbandingan residu dengan residu. Selain itu, algoritma ini juga menghindari kesulitan dalam menentukan pemilihan untuk memberikan penalti yang tepat bagi gap. Pada DIALIGN, seluruh diagonaldiagonal yang mungkin dari input barisan yang diberikan akan diberi bobot dan dibandingkan dengan diagonal yang lain untuk mendapatkan diagonaldiagonal yang akan membentuk penyejajaran optimal. Penghitungan bobot dari diagonal berdasarkan pada probabilitas kesamaan residu pada diagonal. Setelah diperoleh skor maksimum, penyejajaran akan dibangun dengan cara menelusuri kembali komponen-komponen yang telah memproduksi skor maksimum. Penyejajaran yang telah dihasilkan merupakan sehimpunan diagonal-diagonal yang konsisten. Di akhir, algoritma DIALIGN diimplementasikan pada suatu program. Berdasarkan simulasi program, algoritma DIALIGN mampu memproduksi penyejajaran optimal dari sepasang barisan. Dan kinerja program sangat baik untuk barisan-barisan pendek.

---

This skripsi discusses a method known DIALIGN to find the best alignment of two DNA sequences. This algorithm is based on segment-tosegment comparison instead of the commonly used residue-to-residue comparison. Also, this algorithm avoids the wellknown difficulties concerning the choice of appropriate gap penalties. In DIALIGN, all possible diagonals of the input sequences will be weighted and compared to find the diagonals which compose optimal alignment. Diagonal weight is based on match probability of residues in the diagonal. Having the maximum score, the alignment will be constructed by tracing back the components which produce the maximum score. The resulted alignment can be considered as consistent collections of diagonals. In the final, the algorithm is implemented in a program. According to the simulation of the program, DIALIGN algorithm is able to produce optimal sequence alignment from a pair of sequence. And the program performs well on short sequences."