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"[ABSTRAKLatar belakang: Kasus baru dan kematian kanker paru semakin meningkat. Rokok tembakau sangat berperan tetapi hanya 15% yang menderita kanker paru. Oleh karena itu faktor genetik diduga berperan pada kanker paru. Penelitian-penelitian kohort selama ini menunjukan hubungan bermakna risiko kanker paru dengan riwayat kanker di keluarga. Tujuan: Tujuan utama dari penelitian ini adalah untuk menentukan proporsi subjek kanker paru dengan riwayat kanker pada keluarga.Metode: Penelitian ini adalah studi observasi deskriptif potong lintang dengan subjek kanker paru yang berobat jalan maupun inap di RSUP Persahabatan Jakarta 1 Januari 2013 sampai 31 Mei 2015.Hasil: Subjek penelitian 380 dengan komposisi laki-laki lebih banyak dibandingkan perempuan (72,9% banding 27,1%) dengan median 56 tahun dan nilai minimum dan maksimum 20-86 (66) tahun. Sebanyak 65.3% subjek adalah perokok. Dari total subjek yang merokok, 33,2% termasuk perokok dengan Indeks Brickman (IB) sedang. Jenis sel kanker terbanyak adalah masuk kelompok Kanker Paru Karsinoma Bukan Sel Kecil (KPKBSK) yaitu adenokarsinoma 73,4%. Sebagian besar subjek terdiagnosis pada stage lanjut baik pada kelompok KPKBSK maupun Kanker Paru Karsinoma Sel Kecil (KPKSK). Proporsi subjek dengan riwayat kanker keluarga sebesar 8,2% dengan subjek laki-laki lebih besar dibandingkan perempuan (5,8% dibandingkan 2,4%). Nilai minimum-maksimum usia 35-72 tahun, median 55 tahun. Subjek yang merokok hanya ditemukan pada laki-laki sebanyak 71% dan jenis kanker terbanyak adenokarsinoma 71%. Hubungan keluarga 1 orang lebih banyak ditemukan dibandingkan lebih 1 orang (64,4% banding 35,6%) dengan dominasi ayah (25,8%). Jenis kanker keluarga paling banyak bukan kanker paru dibandingkan kanker paru (85,4% banding 14,6%). Kesimpulan: Proporsi subjek kanker paru dengan riwayat kanker pada keluarga adalah 8,2%. Subjek dengan 1 anggota keluarga yang memiliki kanker paling banyak 64,4% dengan dominasi ayah 25,8%. Jenis kanker paru dengan riwayat kanker keluarga terbanyak adenokarsinoma 71%. Jenis kanker keluarga lebih banyak adalah bukan kanker paru 85,4%.

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ABSTRACTBackground: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer?s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject?s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%.;Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer.Objective: To determine the proportion of lung cancer?s subjects with a cancer history in the family.Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer?s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject?s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%., Background: The new cases and mortality of lung cancer are increasing. Smoking tobacco have a role play but only 15% smokers are suffering from lung cancer. Therefore, genetic factors thought to play a role in lung cancer. Many studies show a significant association with the risk of lung cancer in the family history of cancer. Objective: To determine the proportion of lung cancer’s subjects with a cancer history in the family. Methods: Using cross-sectional a descriptive observational study with the outpatient and inpatient lung cancer’s subject at Persahabatan Hospital, Jakarta started from January 1st, 2013 until April 30th, 2015.Results: The total subject of the study are 380 with the composition of men higher than women (72.9% vs 27.1 %) with a median is 56 and a minimum-maximum age is 20-86 (66). From those subjects, 65.3% are smokers with the most moderate IB is 33.2%. The most type cancer cells in group of Non Small Cell Lung Cancer Carcinoma (NSCLCC) is adenocarcinoma (73.4%). Most subjects diagnosed at an advanced stage either in groups of NSCLCC or Small Cell Lung Cancer Carcinoma (SCLCC). The subject’s proportion with the family cancer history is 8.2% in which male subjects are larger than females (5.8% vs 2.4%). A minimum-maximum age is 35-72 (37) and median 55. Smoker is only found in male 71% and the most type cancer cells is adenocarcinoma 71%. Family relation of the subjects found that 1 person is much more found than more 1 person (64.4% vs 35.6%) with dominated by father (25,8%). The type of cancer in the family is non lung cancer higher than lung cancer (85,4% vs 14,6%).Conclusions: The proportion of subjects with lung cancer in their family cancer is 8.2%. The most type family relation of the subjects is 1 person 64,4% with dominated by father 25,8%. The most type lung cancer cells which have family history cancer is adenocarcinoma 71%. The most type of cancer in the family is non lung cancer 64.4%.]"

"ABSTRAKPendahuluanPenyakit infeksi paru dan kanker paru termasuk 5 penyakit respirasi terbanyak ditemukan di dunia. Infeksi pernapasan akut menyebabkan 4 juta kematian per tahun dan kanker paru sebanyak 1,18 juta kematian secara terpisah. Penyakit infeksi juga merupakan bagian dari perjalanan penyakit kanker paru dan menjadi salah saru penyebab kematian tersering pada kanker paru berkisar 50-70% kasus. Tren munculnya patogen baru dan meningkatnya angka resistensi obat menyebabkan penanganan infeksi ini menjadi lebih sulit.Metode Studi deskriptif potong lintang pada pasien kanker paru yang dilakukan bilasan bronkus dan diperiksakan biakan mikroorganisme dari bahan bilasan tersebut. Jumlah sampel adalah total sampling dalam kurun waktu 1 tahun. Penelitian dilakukan di SMF Paru RSUP Persahabatan.HasilBakteri yang banyak ditemukan pada pasien kanker paru merupakan golongan gram negatif dengan species terbanyak adalah K. pneumonia dan B. cephacia. Ditemukan resistensi obat pada hampir semua jenis bakteri dan minimal dari 2 golongan antibiotik. Jenis jamur yang terbanyak dari genus Candida yaitu C. Albicans. Ditemukan resistensi obat anti jamur golongan azol pada species C. tropicalis, C. krusei dan A. Flavus. Hanya ditemukan 2 pasien kanker paru dengan biakan M. tuberculosis positif dari 108 pasien yang diperiksa dan tidak ditemukan resistensi obat anti tuberkulosis (OAT) lini pertama.KesimpulanPemeriksaan jenis mikroorganisme pada saluran napas bawah pasien kanker paru perlu dilakukan sebagai dasar pemberian terapi empiris bila terjadi infeksiIntroduction: Lung infections and lung cancer include in 5 most common respiratory diseases in the world. Acute respiratory infection and lung cancer caused 4 million deaths per year and 1.18 million deaths respectively. Infectious diseases are part natural course of lung cancers and become one of the most common causes of death in lung cancer patients ranging from 50-70%. The emergence of new pathogens and the increasing numbers of drug resistance causing infections treatment become more difficult. Method: A cross-sectional descriptive study obtaining cultured microorganisms results in lung cancer patients who have been performed bronchial washings. These have been a total sampling within a period of 1 year. Research has been conducted in the Department of Pulmonology Persahabatan Hospital. Result: Most common bacteria type found in lung cancer patients belong to gram-negative group with K. pneumoniae and B. cepacia as the most common species. Drug resistance found in most of bacteria from at least two classes of antibiotics. Most common types of fungi come from Candida genus, namely C. albicans. Drugs resistance in antifungal drug, azole, was found in C. tropicalis, and C. krusei. Only 2 lung cancer patients had M. tuberculosis positif culture from 108 patients were examined and first line anti-tuberculosis drugs resistance was not found. Conclusion: Microorganism culture obtained from lower respiratory tract in lung cancer patient is neccesary as basis of empiric therapy when infection occurs"

"[Latar Belakang : Sesak napas merupakan keluhan utama pada kanker paru. Obatgolongan opioid seperti morfin dapat digunakan untuk mengurangi keluhan sesaknapas. Penelitian ini bertujuan untuk menetapkan efek pengurangan sesak napasdengan pemberian morfin oral lepas lambat 2x10 mg dan 2x30 mg, serta efeksamping yang ditimbulkan. Metode : Penelitian uji klinis dengan subjek pasien kanker paru denganmembandingkan keluhan sesak napas sebelum dan sesudah pemberian morfin oral2x10 mg selama 2 hari dan dilanjutkan dengan 2x30 mg selama 2 hari. Derajatsesak dinilai dengan menggunakan skor sesak modified Borg?s dyspnea scale danVisual Analog Scale (VAS) untuk sesak. Efek samping dipantau selamapemberian obat. Hasil : Tiga puluh tiga peserta penelitian dengan 27 laki-laki (81,8%), jeniskanker paru adenokarsinoma 25 orang (75,8%). Terdapat perbaikan keluhan sesaknapas setelah morfin 2x10 mg pada 18 dari 33 peserta (54,5%) dengan penurunanrata-rata skor sesak Borg dan VAS sebanyak 0,70 dan 6,72 dengan p <0,001dibanding skor awal. Setelah pemberian morfin 2x30 mg perbaikan sesak napasdidapat pada 26 dari 33 peserta (78,8%) dengan penurunan rata-rata skor sesakBorg dan VAS sebanyak 1,64 dan 16,06 dengan p <0,001 dibanding skor awal.Terdapat perbedaan bermakna antara pemberian morfin 2x10 mg dan 2x30 mg (p<0,001). Efek samping yang didapat setelah morfin 2x30 mg yaitu 33,3%mengeluh konstipasi, 42,4% mengantuk, dan 12,1% mual. Tidak ada pasien yangmengalami depresi pernapasan berat. Kesimpulan : Terdapat perbaikan keluhan sesak napas setelah pemberian morfinoral lepas lambat 2x10 mg dan dan perbaikan yang lebih baik dengan 2x30 mg. Tidak ada efek samping yang berat setelah pemberian morfin oral.;Background: Dyspnea is a major complaint in lung cancer. Opioids drugs such as morphine is known to be used to reduce dyspnea. This study aims to determinewhether there is an improvement of dyspnea by titrating morphine sustainedrelease tablet 2x10 mg and 2x30 mg in lung cancer patient, and the side effectsthat appear. Methods: The study is a clinical trial with the subject of lung cancer patients bycomparing dyspnea before and after administration of 2x10 mg morphine tabletsfor 2 days, followed by 2x30 mg for 2 days. The degree of dyspnea assessed usingthe modified Borg's dyspnea scale and the Visual Analog Scale (VAS) fordyspnea. Side effects are observed during administration of the drug. Results: Thirty-three study participants with predominantly 27 men (81.8%) and25 participants with adenocarcinoma (75.8%). There were improvements indyspnea after morphine 2x10 mg in 18 of the 33 participants (54.5%) with anaverage improvements of Borg and VAS scores for 0.70 and 6.72 with p <0.001compared to the initial score. After administration of morphine 2x30 mgimprovements in dyspnea were obtained in 26 of the 33 participants (78.8%) withan average improvements of Borg and VAS scores for 1.64 and 16.06 with p<0.001 compared to the initial score. There were significant differences betweenthe administration of morphine 2x10 mg and 2x30 mg (p <0.001). Side effectswere obtained after 2x30 mg morphine such as 33.3% complained of constipation,drowsiness in 42.4%, and nausea in 12.1%. No patients experienced severerespiratory depression. Conclusion: There is dyspnea improvement after administration of sustainedreleasemorphine tablet 2x10 mg and better improvement with 2x30 mg. No severe side effects after administration of oral morphine., Background: Dyspnea is a major complaint in lung cancer. Opioids drugs such as morphine is known to be used to reduce dyspnea. This study aims to determinewhether there is an improvement of dyspnea by titrating morphine sustainedrelease tablet 2x10 mg and 2x30 mg in lung cancer patient, and the side effectsthat appear. Methods: The study is a clinical trial with the subject of lung cancer patients bycomparing dyspnea before and after administration of 2x10 mg morphine tabletsfor 2 days, followed by 2x30 mg for 2 days. The degree of dyspnea assessed usingthe modified Borg's dyspnea scale and the Visual Analog Scale (VAS) fordyspnea. Side effects are observed during administration of the drug. Results: Thirty-three study participants with predominantly 27 men (81.8%) and25 participants with adenocarcinoma (75.8%). There were improvements indyspnea after morphine 2x10 mg in 18 of the 33 participants (54.5%) with anaverage improvements of Borg and VAS scores for 0.70 and 6.72 with p <0.001compared to the initial score. After administration of morphine 2x30 mgimprovements in dyspnea were obtained in 26 of the 33 participants (78.8%) withan average improvements of Borg and VAS scores for 1.64 and 16.06 with p<0.001 compared to the initial score. There were significant differences betweenthe administration of morphine 2x10 mg and 2x30 mg (p <0.001). Side effectswere obtained after 2x30 mg morphine such as 33.3% complained of constipation,drowsiness in 42.4%, and nausea in 12.1%. No patients experienced severerespiratory depression. Conclusion: There is dyspnea improvement after administration of sustainedreleasemorphine tablet 2x10 mg and better improvement with 2x30 mg. No severe side effects after administration of oral morphine.]"

"Efusi pleura ganas (EPG) sebagai bentuk perluasan dari keganasan sering muncul pada penderita kanker paru, mempersulit penatalaksanaan kanker paru, dan membuat prognosis pasien memburuk dengan rerata angka ketahanan hidup 6 bulan. Penelitian ini bertujuan untuk melihat karakteristik dan ketahanan hidup pasien kanker paru dengan EPG di RS Kanker Dharmais Jakarta tahun 2009-2013. Desain penelitian ini adalah kohort longitudinal dengan analisis univariat dan ketahanan hidup. Sampel penelitian ini adalah pasien kanker paru dengan EPG (stadium IIIB atau IV) dari metastasis kanker paru berdasarkan pemeriksaan sitologi atau biopsi dan memiliki rekam medik lengkap. Hasil penelitian menunjukkan bahwa rata-rata umur pasien adalah 58,73 tahun, berjenis kelamin laki-laki, tidak merokok, dan status pekerjaan terbanyak adalah pensiunan. Mayoritas pasien mengeluhkan gangguan respirasi saat pertama berobat, memiliki jenis sel kanker adenokarsinoma, sudah mencapai stadium IV, dan lokasi efusi berada di paru-paru kanan. Sekitar 68.5% pasien bertahan hidup 6 bulan setelah diagnosis dan median survival adalah 12,5 bulan. Diharapkan ada KIE bagi masyarakat, terutama terkait kebiasaan merokok dan ditujukan untuk populasi berisiko, mengenai kanker paru untuk mengurangi jumlah pasien yang baru berobat setelah kanker mencapai stadium lanjut.

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Malignant pleural effusion (MPE) often appears in patients with lung cancer and deteroriates prognosis of patients with mean survival rate of 6 months. This study aims to look at the characteristics and survival of lung cancer patients with MPE (stage IIIB or IV) at Dharmais Cancer Hospital Jakarta in 2009-2013. Study design was longitudinal cohort with univariate and survival analysis. Sample was lung cancer patients with metastatic MPE based on cytology test or biopsy with complete medical record.

Results showed average age of patients was 58.73; most were male, nonsmoker, and pensioner. Majority of patients had respiratory disorder, adenocarcinoma cancer type, reached stage IV, and effusion in the right lung. Approximately 68.5% of patients surviving 6 months after diagnosis and median survival were 12.5 months. IEC is needed for community; especially population with lung cancer risk, to help reducing number of new patients seeking treatment after cancer reaches advanced stage."

"[ABSTRAKPraktik Spesialis Keperawatan Medikal Bedah Kekhususan Respirasi di RSUP Persahabatan Jakarta bertujuan untuk mengaplikasikan peranners spesialis da1am mengelola pasien dengan gangguan sistem respirasi melalui pendekatan Model Adaptasi Roy (MAR). Seorang ners spesialis memiliki target memberikan asuhan keperawatan sebanyak 30 pasien sebagai resume dan 1 pasien sebagai laporan kelolaan utama pada pasien kanker paro. Peran ners spesialis juga menerapkan tindakan keperawatan berbasis bukti ilmiah (evidence based musing practice) dengan memberikan latihan progressive muscle relaclation (PMR) dalam mengontrol breathlessness pada pasien kanker peru, Selain itu ners spesialis sebagai pembaharu melakukan inovasi Water Seal Drainoge (WSD) Pionir 1 botol, etas dasar aspek estetika, quality and safety guna meningkatkan kualitas pelayanan keperawatan dan rumah sakit. Hasil praktik menunjukkan bahwa MAR. Efektif digunakan pada pasien dengan gangguan sistem respirasi dan PMR memiliki kecenderungan mengon1ro1 breathlessness pada pasien kanker pam dan kegiatan inovasi mendapat respon positif dari pibak rumah sakit untuk menjadi agenda penelitian bersama.

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ABSTRACTSurgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda., Surgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda.]"

"Latar Belakang : Efusi pleura masif merupakan salah satu masalah pada tatalaksana kanker paru dan menyebabkan kematian. Pemasangan kateter intrapleura merupakan tatalaksana utama keganasan dengan efusi pleura masif. Kateter yang digunakan yaitu water sealed drainage, indwelling pleural catheter atau pigtail catheter. Water sealed drainage saat ini merupakan kateter yang terbanyak digunakan.Tujuan : Penelitian ini adalah penelitian pendahuluan untuk mengetahui penggunaan (toleransi dan efikasi) water sealed drainage, indwelling pleural catheter dan pigtail catheter pada penatalaksanaan kanker paru dengan efusi pleura masif.Metode : Penelitian observasional kohort retrospektif pada pasien kanker paru tegak jenis dengan efusi pleura masif yang terpasang kateter intrapleura (WSD, IPC atau pigtail catheter). Data diambil dari rekam medis Rumah Sakit Umum Pusat Persahabatan Jakarta pada periode 1 Januari 2012 sampai 31 Desember 2015 dan dilakukan penilaian tolerasi (komplikasi akut dan lanjut) dan efikasi (lama penggunaan, lama rawat dan alasan pencabutan) pemasangan kateter intrapleura.Hasil : Subjek penelitian 77 pasien dengan karakteristik laki-laki (55,8%), median usia 57 tahun, range 26-84 tahun, adenokarsinoma (84,4%) dan terapi kemoterapi (32,5%). Komplikasi akut sebesar 70,1%, komplikasi terbanyak nyeri lokasi pemasangan kateter (58,4%). Komplikasi lanjut sebesar 54,5%, komplikasi terbanyak nyeri lokasi kateter bertambah atau menetap (29,9%). Rerata lama rawat pasca pemasangan kateter 14,14 hari, median 10 hari dan range 1-72 hari. Rerata lama pemakaian kateter 55,98 hari, median 30 hari dan range 2-310 hari. Alasan pencabutan kateter terbanyak adalah produksi cairan minimal (46,75%).Kesimpulan : Toleransi dan efikasi penggunaan kateter intrapleura pada pasien kanker paru dengan efusi pleura masif cukup baik dan aman. Diperlukan penelitian kohort prospektif dengan jumlah sampel yang sama pada tiap kelompok kateter, sehingga penggunaan kateter dapat dianalisis perbandingannya dan penelitian dengan kelompok pembanding, contohnya tindakan pleurodesis, yang merupakan baku emas tatalaksana efusi pleura ganas.Background : Massive pleural effusion is one of the problems in lung cancer treatment that cause death. The main treatment of cancer patient with massive pleural effusion is the placement of intrapleural catheter. Catheters that can be used are water sealed drainage, indwelling pleural catheter or pigtail catheter. Currently, water sealed drainage is the most catheter used.Objective : This is a preliminary study which is aimed to assess tolerancies and efficacies of water sealed drainage, indwelling pleural catheter or pigtail catheter for treatment of lung cancer with massive pleural effusion.Methods : This study is a retroscpective observational cohort study. Subjects are lung cancer patients with massive pleural effusion and catheterized with intrapleural catheter (WSD, IPC or pigtail catheter). The datas were taken from medical record at RSUP Persahabatan between 1 January 2012-31 December 2015 and assessed for tolerancies (acute or late complication) and efficacies ((length of hospital admission after catheter placement, duration and the reason of retraction) of intrapleural catheterResults: Subjects of study are 77 patients, with characteristic, male (55,8%), median age 57 years old, range from 26 to 84 years old, adenocarcinoma (84,4%) and the most main therapy is chemotherapy (32,5%). Acute complication obtained in 70,1% patients, with the most common complication is pain in catheter location (58,4%). Late complication obtained in 54,5% patients with the most common complication is pain in the catheter location (29,9%). The mean of length of staying in hospital after the placement of catheter are 14,14 days, median 10 days, range from 1 to 72 days. The mean of duration of catheter placement is 55.98 days, median 30 days, range from 2 to 310 days. Minimal fluid production (46,75%) are the most reason of intrapleural catheter retraction.Conclusion: Tolerancies and efficacies of intrapleural catheter (WSD, IPC or pigtail catheter) in lung cancer patients with massive pleural effusion are quite good and safe. Prospective cohort studies are needed in the future to determine which type of intrapleural catheter is better for the treatment of massive pleural effusion in lung cancer patients and studies with comparison group for example pleurodesis, which is the gold standard for treatment of malignant pleural effusion."

"Latar belakang: Pneumonia terjadi pada sekitar 50-70% pasien kanker paru. Kerentanan pneumonia terjadi akibat gangguan sistem imun dan arsitektur paru yang terjadi karena mekanisme kanker maupun terapi kanker paru. Perubahan imunitas menyeluruh, kaheksia, terapi, perubahan arsitektur paru merupakan faktor-faktor yang dapat menyebabkan inflamasi hingga penurunan imunitas yang dapat menimbulkan kejadian pneumonia pada kanker paru. Pasien kanker paru dengan pneumonia memiliki kesintasan satu tahun yang lebih buruk dan mortalitas satu tahun yang lebih tinggi dibandingkan tanpa pneumonia. Metode: Sampel penelitian merupakan pasien kanker paru tegak jenis yang datag ke IGD RSUP Persahabatan. Jumlah sampel sebanyak 77 pasien diambil secara consecutive sampling periode Januari-Februari 2024. Setiap sampel dilakukan anamnesis serta pemeriksaan fisis untuk mendapatkan data klinis, pemeriksaan laboratorium darah, foto toraks dan pemeriksaan biakan sputum. Pasien dilakukan pengamatan selama perawatan untuk melihat luaran pasien saat keluar rumah sakit. Hasil: Sebanyak 81,1% sampel mengalami pneumonia. Luaran meninggal sebanyak 24,7% dan 30,2% sampel yang mengalami pneumonia memiliki luaran meninggal. Faktor risiko seperti Riwayat merokok, jenis kanker paru, lokasi kanker paru, jumlah leukosit, jumlah neutrofil, RNL dan PCT menunjukkan tidak terdapat hubungan bermakna terhadap kejadian pneumonia (p>0,05). Klebsiella pneumoniae, Acinetobacter baumanii dan Escerichia coli merupakan jenis kuman terbanyak hasil biakan sputum. Kesimpulan: Lebih dari setengah jumlah pasien kanker paru yang masuk ke IGD RSUP Persahabatan mengalami infeksi pneumonia. Tidak terdapat hubungan bermakna faktor risiko terhadap kejadian kanker paru. Klebsiella pneumoniae merupakan jenis mikroorganisme terbanyak penyebab pneumonia berdasarkan hasil biakan sputum pasien kanker paru.

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Background: Pneumonia occurs in around 50-70% of lung cancer patients. Pneumonia susceptibility occurs due to disorders of the immune system and lung architecture that occur due to cancer mechanisms and lung cancer therapy. Changes in overall immunity, cachexia, therapy, and changes in lung architecture are factors that can cause inflammation and decreased immunity which can lead to pneumonia in lung cancer. Lung cancer patients with pneumonia had worse one-year survival and higher one-year mortality than those without pneumonia. Method: The research sample was lung cancer patients who were confirmed pathologically and came to the emergency room at Persahabatan Hospital. The total number of samples was 77 patients taken by consecutive sampling for the period January-February 2024. Anamnesis and physical examination were carried out for each sample to obtain clinical data, blood laboratory examination, chest x-ray and sputum culture examination. Patients are monitored during treatment to see the patient's outcome when they leave the hospital. Results: As many as 81.1% of the sample experienced pneumonia. The outcome of death was 24.7% and 30.2% of samples who experienced pneumonia had a death outcome. Risk factors such as smoking history, type of lung cancer, location of lung cancer, leukocyte count, neutrophil count, RNL and PCT showed no significant relationship to the incidence of pneumonia (p>0.05). Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli are the most common types of germs resulting from sputum culture. Conclusion: More than half of lung cancer patients admitted to the emergency room at Persahabatan Hospital have pneumonia infections. There was no significant relationship between risk factors and the incidence of lung cancer. Klebsiella pneumoniae is the most common type of microorganism resulting from sputum culture of pneumonia patients with lung cancer"

"Latar Belakang: Kanker paru dan tuberkulosis TB adalah dua masalah kesehatan di seluruh dunia dengan angka kesakitan dan kematian yang tinggi. Meningkatnya kasus TB aktif dan reaktivasi TB laten pada pasien kanker paru serta dampak buruknya terhadap prognosis pasien memerlukan upaya untuk melakukan deteksi TB laten pada pasien kanker paru. Penelitian ini bertujuan untuk mengetahui berapa besar proporsi TB laten pada pasien kanker paru, karakteristiknya dan hubungan antar keduanya. Metode: Penelitian ini menggunakan desain potong lintang dan sampel dikumpulkan secara consecutivesampling terhadap 86 pasien kanker paru baru terdiagnosis di Rumah Sakit Umum Pusat Persahabatan Jakarta tahun 2015 hingga 2016. Pemeriksaan sputum Xpert MTB/RIF dilakukan untuk menyingkirkan kemungkinan TB aktif. Penentuan TB laten dilakukan dengan pemeriksaan Interferon Gamma Release Assay IGRA menggunakan alat QuantiFERON-TB Gold-in-Tube QFT-GIT. Hasil: Pemeriksaan TB laten mendapatkan hasil IGRA 11 pasien 12,8 , IGRA - 59 pasien 68,6 dan IGRA indeterminate I 16 pasien 18,6 . Karakteristik sosiodemografi pasien kanker paru dengan TB laten adalah 63,6 laki-laki, rerata usia 56 tahun, 36,4 diimunisasi BCG, 9 dengan kontak erat TB, 72,7 dengan riwayat merokok. Karakteristik klinis pasien tersebut 90 memiliki status gizi normal lebih dengan nilai tengah indeks massa tubuh IMT 19,12 18,24-29,26 kg/m2, nilai tengah hitung limfosit total 1856 1197-4210 sel/ul, 9 dengan komorbid diabetes mellitus, 81,8 tumor paru mengenai lokasi khas predileksi TB paru. Jenis kanker terbanyak adalah adenokarsinoma 81,8 dengan stage lanjut 81,8 dan status tampilan umum 2-3 63,6 . Karakteristik yang menunjukkan hubungan bermakna dengan hasil IGRA adalah lokasi tumor yang mengenai daerah lesi khas TB secara radiologis. Hitung limfosit total yang rendah berhubungan dengan hasil IGRA I dengan nilai tengah 999,88 277-1492,60 sel/ul. Kesimpulan: Proporsi TB laten pada pasien kanker paru di RSUP Persahabatan adalah 12,8. Karekteristik pasien kanker paru yang berhubungan dengan TB laten adalah lokasi tumor yang mengenai daerah lesi khas TB walaupun belum dapat disimpulkan hubungannya secara biologis. Hasil IGRA I pada pasien kanker paru dengan hitung limfosit total yang rendah menunjukkan keterbatasan sensitivitas IGRA dalam mendeteksi infeksi TB laten pada pasien imunokompromais.

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Background: Lung cancer and pulmonary tuberculosis TB are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and the negative effect of pulmonary TB in lung cancer prognosis underline the need for a through screening of lung cancer patients for latent TB infection LTBI. The aims of this study are to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them.

Methods" This study used a cross sectional design and sample was collected using consecutive sampling of the 86 newly diagnosed treatment naive lung cancer patients from a referral respiratory hospital, Rumah Sakit Umum Pusat Persahabatan Jakarta in 2015 to 2016. The presence of LTBI was determined by Quantiferon TB Gold In Tube QFT GIT after having Mycobacterium TB not detected result from Xpert MTB RIF sputum test. Demographic characteristics and cancer related factors associated with LTBI were investigated.

Results: There are 11 patients 12,8 with IGRA result and 16 patients 18,6 with IGRA indeterminate I result. Sociodemographic characteristics of lung cancer patients with latent TB are 63,6 male, mean of age 56 years, 36,4 with BCG immunization, 9 had TB close contacts history, 72,7 with a history of smoking. The clinical characteristics of these patients are 90 had a normal nutritional status with the median body mass index BMI 19,12 18,24 29,26 kg m2, the median of total lymphocyte count is 1856 1197 4210 cells ul, 9 with diabetes mellitus as comorbid, 81,8 of lung tumour located in the typical predilection for pulmonary tuberculosis. Most types of lung cancer are adenocarcinomas 81.8 with advanced stage 81,8 and the WHO performance status of 2 3 63,6. Characteristics having significant relationship with IGRA results is the tumour located in the typical TB area radiologically. Low total lymphocyte count is associated with indeterminate IGRA results with median 999,88 277 1492,6 cells ul.

Conclusion" The proportion of latent TB in lung cancer patients is 12,8 . Characteristics of patients with lung cancer associated with latent TB is the location of the tumor lesions typical of the area although it can not be concluded biologically. Having indeterminate IGRA results in lung cancer patients with a low total lymphocyte count showed the limitations of QFT GIT in detecting latent TB infection in immunocompromised patients."

"Latar Belakang: Penelitian ini merupakan studi awal untuk menetapkan proporsi pneumonitis radiasi pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan. Metode: Penelitian ini menggunakan desain retrospektif pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan antara Juni 2013-Juli 2015. Pengambilan data melalui rekam medik dan dilakukan evaluasi ulang foto toraks 1 bulan pasca radiasi. Hasil: Terdapat 33 pasien kanker paru yang memenuhi kriteria inklusi. Karakteristik subyek meliputi usia ≥51 tahun (63,6%), laki-laki (66,7%), riwayat merokok (75,8%), IB sedang (60%), dosis radiasi 300-4000 (60,6%), fraksi radiasi 10-19 (60,6%), tidak mempunyai riwayat kemoterapi (54,5%), kanker paru jenis adenokarsinoma (66,7%) dan stage IV (84,84%). Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4% yang terdiri dari gambaran hazy ground glass opacities, hazy ground glass opacities dan fibrosis serta fibrosis. Ditemukan perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi (p<0,05). Kesimpulan: Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4%. Terdapat perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi.

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Introduction: This is a preliminary study to determine proportion radiation pneumonitis in lung cancer patients who got radiaton in Persahabatan Hospital.

Method: This was a retrospective study in lung cancer patients who got radiation in Persahabatan Hospital between June 2013 ? July 2015. Interpretation data were from medical record and did reevaluation chest x ray 1 month after radiation.

Result: There were 33 lung cancer patients were filled inclusion criteria. Subjects characteristic were age ≥51 years (63,6%), male (66,7%), history of smoking (75,8%), moderate IB (60%), radiation doses 3000-4000 (60,6%), radiation fractions 10-19 (60,6%), had no history of chemotheraphy (54,5%), adenocarcinoma (66,7%) and stage IV (84,84%). Proportion radiation pneumonitis based on chest x ray were 39,4% that include hazy ground glass opacities, hazy ground glass opacitiesand fibrosis and only fibrosis. There were significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05).

Conclusion: Proportion radiation pneumonitis based on chest x ray are 39,4%. There are significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05)."

"ABSTRAKLatar belakang: Penyebab kematian pada kanker paru seringkali tidak tergambarkan dengan jelas. Penelitian ini untuk mengetahui gambaran penyebab kematian pada kanker paru dan faktor-faktor yang mempengaruhinya di RS Persahabatan dan untuk mengetahui kesesuaian antara penyebab kematian yang terdapat dalam lembar kematian dengan penyebab kematian sesuai dengan audit kematian. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang mengalami kematian pada Januari 2010 – Desember 2011. Penyebab kematian langsung dan tidak langsung pada pasien kanker paru dicatat dari rekam medis kemudian dilakukan audit kematian dan dinilai kesesuaian dengan penyebab kematian langsung dan tidak langsung yang tertulis di rekam medis dengan audit kematian. Hasil: Total data kematian dari 96 rekam medis. Penyebab kematian langsung berdasarkan rekam medis adalah efusi pleura masif 19 kematian (19,8%) sedangkan penyebab kematian tidak langsung menurut rekam medis adalah sepsis s 44 kematian (45,8%) Sementara itu, penyebab kematian langsung berdasarkan audit kematian terbanyak adalah efusi pleura masif 48 kematian (50%), penyebab kematian tidak langsung menurut audit kematian adalah sepsis 16 kematian (16,7%). Lembar kematian yang sesuai dengan rekam medis adalah 43 kasus (44,8%) dan yang tidak sesuai 53 kasus (55,2%) sedangkan SOP yang dijalankan adalah 37 kasus (38,5%) dan SOP yang tidak dijalankan 59 kasus (61,5%). Alasan mengapa SOP tidak dijalankan adalah karena keadaan umum pasien yaitu 12 kasus (20,3%) sedangkan karena biaya dan administrasi 47 kasus (79,6%). Dari hasil uji statistik yang menilai hubungan antara SOP yang dijalankan dengan faktor pembiayaan ternyata tidak didapatkan hubungan yang bermakna (p=0,48). Diskusi : Audit kematian memang bukan standar baku emas penentuan penyebab kematian melainkan dengan autopsi klinis. Dalam konteks sosial dan budaya di Indonesia, autopsi klinis tidak mudah dilakukan sebagai penentu penyebab kematian. Dalam penelitian ini audit kematian mempunyai peran jaminan dan kendali mutu layanan kesehatan. Ketidaksesuaian penyebab kematian antara rekam medis dan kematian, serta seberapa banyak SOP yang dijalankan dan mengapa SOP tidak dijalankan dapat diungkapkan. Walaupun dari penelitian ini menunjukkan tidak terdapat hubungan bermakna antara faktor pembiayaan dengan SOP yang dijalankan atau tidak..

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ABSTRACTIntroduction: The causes of death for patients with lung cancer were inadequately described. This study objectives were to describe the causes of death in lung cancer and contributing factors in Persahabatan Hospital and to describe discrepancies between the causes of death from medical records and death audit. Method: A cross sectional study was held in PersahabatanHospital involving lung cancer patients who were died between January 2010 to December 2011. The immediate and indirect causes of death from medical records were assessed and compared with death audit. The discrepancies between were analysed. Result: A total of 96 cases were found from medical record, massive pleural effusion was found as the immediate causes in 19 cases (19.8%), while sepsis was found as the indirect causes 44 cases (45.8%). From the death audit, massive pleural effusion was found as immediate causes in 48 cases (50%), while sepsis was found asthe indirect causes 16 cases (16.7%). The discrepancies between both were found in 53 cases (55.2%). SOP was executed in 37 cases (38.5%) and unexecuted in 59 cases (61.5%). The reason of unexecuted SOP due to cost was found in 47 cases (79.6%). There is no significant correlation between the executed SOP with cost was found in factors (p=0.48). Discussion : The death audit is not the gold standard method in determining the causes of death but the clinical autopsy. This study reveals that death audit have roles inhealth care quality control and assurance. The causes of death discrepancies, the unexecueted SOP, and why SOP could not be executed could be revealed from this study."