Hasil Pencarian  ::  Simpan CSV :: Kembali

"PURPOSES: Pancreatic fistula (PF) is a challenging complication of pancreaticoduodenectomy (PD). Soft pancreas is reported as a risk factor for PF; however, palpation by the surgeon is not an objective method of evaluating pancreatic texture. We conducted this study to investigate whether a texture analyzer called a Tensipresser can be used to quantify pancreatic tissue hardness and predict the development of postoperative PF.METHODS: We assessed pancreatic texture in 85 patients who underwent PD. After surgeons assessed the texture of the pancreas subjectively, the physical properties were measured on the pancreatic margin intraoperatively, by the two-bite method using the Tensipresser. The incidence and severity of PF were based on the definitions of the International Study Group on Pancreatic Fistula.RESULTS: Symptomatic PF (grade B and C) developed in 16% of the patients. Patients were divided into two groups based on the Tensipresser measurement: those with a soft and fragile pancreas with hardness < 2070 gw/cm2 and cohesiveness < 0.65 (SF group); and all other patients (non-SF group). In the univariate and multivariate analysis, a small pancreatic duct diameter (<4 mm), no conduction of preoperative chemoradiation therapy, and inclusion in the SF group were significant predictors of PF.CONCLUSION: The Tensipresser can evaluate pancreatic texture objectively, helping to define intraoperatively, those at risk of the development of PF."

"Dengan semakin majunya ilmu dan teknologi di dunia di segala aspek kehidupan turut memberikan konsekuensi semakin majunya ilmu kedokteran yang ada di dunia. limu Kedokteran Forensik adalah salah satu dari ilmu kedokteran tersebut. Adapun Ilmu Kedokteran Forensik terdefinisikan sebagai salah satu cabang spesialistik dari ilmu kedokteran yang memanfaatkan ilmu kedokteran dan bermanfaat untuk membantu penegakkan hukum dan masalah-masalah hukum. Pada mulanya ilmu kedokteran forensik hanya diperuntukkan bagi kepentingan peradilan, namun perkembangan jaman mengakibatkan pemanfaatannya juga di bidang-bidang yang bukan peradilan.Pada masyarakat kita, pemanfaatan ilmu kedokteran forensik Iebih banyak dikenal dalam pelayanan pembuatan visum et repertum yakni melalui pemeriksaan mayat atau bedah mayat. Meskipun sebenarnya masih banyak pelayanan yang bisa diberikan dari ilmu kedokteran forensik, seperti pemeriksaan korban perkosaan, pencabulan, paternitas dan lain sebagainya, namun sepertinya hal tersebut masih belum "familiar" atau karena memang belum dikenal. Jika boleh dikatakan saat ini masyarakat Iebih cenderung memberikan istilah dari ilmu kedokteran forensik adalah lama halnya dengan "ilmu bedah mayat" dan dokter forensik adalah "dokter mayat" atau "dokter bedah mayat", atau istilah-istilah semakna lainnya.Di Indonesia, sejak abad 19 pemanfaatan kedokteran forensik sudah dilakukan oleh dokter Belanda untuk kepentingan peradilan dan Iebih banyak dikenal berkaitan dengan bedah mayat atau pelayanan otopsinya saja. Sedangkan pemanfaatan pembuatan visum untuk orang hidup nampaknya belum lama dikenal oleh masyarakat atau konsumen pemintanya (penyidik).Dengan semakin majunya negara, akan menimbulkan konsekuensi meningkatnya kompleksitas pada setiap bidang kehidupan. Di negara berkembang kompleksitas ini mengakibatkan persaingan yang masingmasing berusaha untuk dapat mempertahankan kehidupannya, sehingga akhirnya mengakibatkan meningkatnya angka kriminaiitas. Sebagai gambaran maka jumlah kasus kejahatan di Indonesia terhadap tubuh dan jiwa manusia berfluktuasi sekitar 10.000 per tahunnya."

"Vol. 2 published by Medical Dept., Harper & Row.Includes bibliographies."

"Keganasan kolorektal membuat pasien mengalami perubahan status kesehatan yang signifikan dan sangat mempengaruhi kehidupannya. Status kesehatan pasien mengarah kepada kondisi kronis dan membutuhkan adaptasi dari pasien terhadap keadaannya untuk bisa memperoleh kondisi kesehatan yang maksimal. Pasien Tn. S dengan kanker kolorektal post laparatomi hemikolektomi, stoma ileokolotransversal dengan komplikasi efusi pleura mengalami perdarahan pada haluaran stoma, dan alkalosis respiratorik. Diagnosa keperawatan utama yang diangkat adalah gangguan pertukaran gas dan kekurangan volume cairan, dengan intervensi manajemen asam basa dan manajemen cairan dan elektrolit.

---

Colorectal malignancies make patients experience significant changes in health status and greatly affect their lives. The patient's health status leads to chronic conditions and requires adaptation from the patient to his condition to be able to obtain maximum health conditions. Patient Mr. S with post laparatomy hemicolectomy colorectal cancer, ileokolotransversal stoma with complications of pleural effusion experiencing bleeding at the stoma output, and respiratory alkalosis. The main nursing diagnoses raised were interruption of gas exchange and lack of fluid volume, with acid base management interventions and fluid and electrolyte management."

""The Sobotta Atlas covers the complete macroscopic anatomy in full detail and exceptional quality with almost 2000 figures. This Atlas is organised by body regions - this corresponds to the topics for course attendance certificates. Simple new introductions and general overviews help you to understand the more complex figures and connections - step by step. The new Sobotta comes with even more clinical figures, including new imaging techniques, endoscopic images, intraoperative colour photographs of inner organs, pictures from patients with common paralysis and more - designed to be suitable for any type of curriculum."--"

""A cornerstone of gross anatomy since 1943, this book reaches students worldwide with its realistic dissection illustrations, detailed surface anatomy photos, clinical images and comments, and quick-reference muscle tables. Renowned for its accuracy, pedagogy, and clinical relevance, this classic atlas boasts significant enhancements, including updated artwork, new conceptual diagrams, and vibrantly re-colored illustrations. Clinical material is clearly highlighted in blue text for easy identification." -- Publisher."

"ABSTRACTPurpose: To establish if the number of pancreatic acinar cells at the pancreatic cut end is a predictor of postoperative pancreatic fistula (POPF).Methods: The number of acinar cells was assessed histologically in 121 consecutive patients who underwent pancreaticoduodenectomy (PD) between April, 2012 and July, 2016.Results: POPF developed in 23 of the 121 patients. Univariate analysis revealed that male sex, long operating time, high volume of blood loss, soft remnant pancreas, large pancreatic duct, and the number of pancreatic acinar cells were significantly associated with POPF. Multivariate analysis revealed that male sex (p = 0.022) and the number of pancreatic acinar cells (p < 0.0001) were independently associated with POPF. In the receiver operating characteristic (ROC) curve analysis, the area under curve was 0.83895 when the cut off value of the number of pancreatic acinar cells to predict POPF was 890. Sensitivity and specificity of the number of pancreatic acinar cells were 82.6 and 77.6%, respectively.Conclusions: A large number of pancreatic acinar cells at the cut end of the stump is predictive of POPF after PD. Although POPF is associated with multiple factors and the number of acinar cells is only one of these, our study is the first to confirm this common intuition of surgeons, which has not been assessed definitively before."

"Latar belakang. Penderita hemodialisis memerlukan kanulasi arteriovena.Selama ini diperlukan waktu tunggu hingga empat minggu agar fistula arteriovenasiap digunakan. Hal ini meningkatkan morbiditas dan biaya. Diperlukan suatupenelitian untuk mengetahui efektifitas fistula arteriovena pada waktu tungguyang lebih singkat.Metode. Studi potong lintang komparatif membandingkan kelompok kanulasi duaminggu dan empat minggu, menggunakan data sekunder dari RS.P pada kurunwaktu 2010 – 2012. Penilaian efektifitas menggunakan pemeriksaan thrill.Hasil. Terdapat 174 data subyek yang memenuhi kriteria, dimana tidak ditemukanperbedaan thrill pada kelompok kanulasi dua minggu dan empat minggu. Dimanaefekifitas keduanya diatas 90 %. Pada analisis statistik hanya riwayat CVD yangberhubungan dengan hasil kanulasi empat minggu.Pembahasan. Tidak terdapat perbedaan efektifitas pemasangan kanulasi padakelompok dua minggu dan empat minggu, sehingga waktu tunggu untukhemodialisis dapat diusulkan menjadi dua minggu.

---

Background. Hemodyalisis patients requires arteriovenous cannulation. It’s

needed a waiting period for up to four weeks for arteriovenous fistula ready for

use. It will increases morbidity and cost. It’s required a study to determine the

effectiveness of the arteriovenous fistula on a shorter waiting period.

Methods. Comparative cross-sectional study comparing the cannulation two

weeks and four weeks, using secondary data from RS.P in the period from 2010 to

2012. Assessing the effectiveness of using thrill.

Results. There were 174 subjects who met the criteria of data, which is not found

on thrill difference between cannulation two weeks and four weeks. Where both

effectiveness were above 90%. In the statistical analysis only the history of CVD

associated with cannulation results four weeks.

Discussion. There was no difference in the effectiveness of the installation of

cannulation in group two weeks and four weeks, so the waiting period for

hemodialysis may be proposed in two weeks"