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Kartika Hajarani
Prevalensi Disfagia Dan Gambaran Fungsi Menelan Bayi Laringomalasia Primer: Kajian Kesesuaian antara Pemeriksaan Static Endoscopic Evaluation of Swallowing (SEES) dan Flexible Endoscopic Evaluation of Swallowing (FEES) = Prevalence of Dysphagia and Overview of Swallowing Function in Primary Laryngomalacia Infants: The Conformity Study between Static Endoscopic Evaluation of Swallowing (SEES) and Flexible Endoscopic Evaluation of Swallowing (FEES)
"ABSTRAK
Latar belakang:Bayi laringomalasia primer memiliki komorbiditas yang tinggi akibat silent aspiration. Hingga saat ini, belum diketahui prevalensi disfagia dan data mengenai gambaran fungsi menelan bayi laringomalasia primer. Tujuan penelitian: Mengetahuiprevalensi disfagia dan gambaran fungsi menelanpada bayi laringomalasia primersertamengetahui kesesuaian antara SEES dan FEES.Metode: Penelitiancross-sectional yang bersifat deskriptifdan analitik komparatif terhadap 34subjek bayi laringomalasia primersecara konsekutif di RS Dr. Cipto Mangunkusumoperiode Januari-Maret 2020. Hasil:Prevalensi disfagiapada bayi laringomalasiaprimersebanyak 9 dari 34 subjek (26,5%). Gejala disfagia pada bayi< 6 bulan tersering adalah regurgitasi dan apneasaat menyusu (5/6), sedangkan pada bayi>6 bulan adalah terdengar banyak lendir di tenggorok (3/3). Komorbid terbanyak adalah kelainan genetikdan PRGE(3/9). Komplikasi terseringadalah pneumonia aspirasi (6/9). Pada pemeriksaan awal FEES, kontrol postural terganggu(7/9) merupakantanda yang paling sering ditemukan. Pada pemeriksaan FEES, preswallowing leakagedidapatkan pada konsistensi puree, tim saring, dan tim kasar. Pada pemeriksaan SEES dan FEES, residu, penetrasi,dan aspirasipalingbanyak didapatkan pada konsistensi susu. Silent aspirationdidapatkan pada4 dari 9subjek dengan disfagia. Pemeriksaan SEES memiliki kesesuaian dengan FEES berdasarkanuji McNemarpadaparameter ada tidaknya penetrasi, residu, dan aspirasi.Kesimpulan:Prevalensi disfagia pada bayi laringomalasia primersebanyak 9 dari 34 subjek(26,5%), penetrasi dan aspirasi didapatkan pada konsistensi air dan susuterutama pada bayi< 6 bulan, dan SEES memiliki kesesuaian dengan FEESdalam menilai fungsi menelanberdasarkan parameter ada tidaknya residu, penetrasi, dan aspirasi.
Background:Silent aspiration is oftenunrecognized comorbidity in infants with congenital laryngomalacia with serious medical consequence. However, prevalence of dysphagia and characteristic of dysphagia ininfants with congenital laryngomalacia is still unknown. Aim: To find the prevalence and the overview of swallow function in infants with congenital laryngomalacia and also to know the conformity between SEES and FEES in assessing swallow function. Methods:This is a descriptive cross-sectional and comparative analytic study involving 34 infants with congenital laryngomalacia who came consecutivelytoDr. Cipto Mangunkusumo Hospitalon January-March 2019. Results: The prevalence of dysphagia was 9 out of 34 subjects (26,5%).Dysphagia symptom in infants<6 months was regurgitation and apneawhile bottle/breast feeding (5/6). Meanwhile, in infants>6 monthswaswet sounding voice (3/3). The comorbidities found mostly were geneticanomaly and GERD(3/9). The complication mostly was aspiration pneumonia (6/9). In pre-FESS examination, poor postural controlwas dominant(7/9). In FEES examination, preswallowingleakagewas found in puree, soft steam porridge, and rough steam porridge. In FEES and SEES examination, residue, penetration, and aspirationwas mostly found inthick liquid. Silent aspiration was found in 4 out of 9subjects with dysphagia. SEES has a conformity to FEES based on McNemar test in the presence of residue, penetration, and aspiration. Conclusion: The prevalence of dysphagia in infants with congenital laryngomalaciawas9 out of 34 subjects(26,5%). In FEES examination, penetration,and aspiration were found mostly in thin liquid, <6months of age predominantly.SEES has a conformity to FEES based on presence of residue, penetration, and aspiration in assessing swallow function."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tugas Akhir  Universitas Indonesia Library
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Indah Trisnawaty
Gambaran pemeriksaan flexible endoscopic evaluation of swallowing fees pada anak dengan kecurigaan kesulitan menelan disfagia di RSUPN Dr. Cipto Mangunkusumo = Flexible endoscopic evaluation swallowing examination overview in pediatric patients with dysphagia suspicion in Dr. Cipto Mangunkusumo National General Hospital
"Kemampuan makan dan menelan pada anak bersifat dinamis sejalan dengan proses tumbuh kembang anak. Struktur anatomi mengalami pertumbuhan yang selanjutnya berdampak pada kematangan fungsi menelan. Gangguan pada proses menelan menyebabkan disfagia. Tesis ini membahas mengenai gambaran proses menelan pada anak dengan kecurigaan disfagia, dengan menggunakan pemeriksaan menelan dengan endoskopi serat optik lentur, serta menilai karakteristik percontoh berdasarkan usia, masa kehamilan, pengasuh, gejala, komplikasi serta kelainan medis. Penelitian ini adalah penelitian potong lintang dengan desain deskriptif pada 54 subyek yang diambil secara berurutan. Hasil dari penelitian ini didapatkan prevalensi disfagia pada anak dengan kecurigaan kesulitan makan sebesar 63 . Gejala disfagia pada anak le; 6 bulan yang paling sering adalah apnea saat menyusu 7/34 . Sedangkan pada anak > 6 bulan adalah postur tubuh terganggu 10/34 , mengeces berlebih 6/34 , dan batuk saat makan 8/34 . Kelainan medis yang mendasari adalah kelainan struktural 25/34 , kelainan jantung / paru / laring 24/34 , dan kelainan neurologis 23/34 . Komplikasi yang terjadi adalah PRGE 12/34 , gagal tumbuh 10/34 , dan pneumonia aspirasi 3/34 . Pada pemeriksaan FEES didapatkan standing secretion 22/34 dan pergerakan lidah terganggu 20/34 adalah tanda yang sering ditemukan pada anak disfagia; dan residu sering terjadi pada konsistensi tim kasar 44,7 , penetrasi pada konsistensi air 44,2 , serta aspirasi pada konsistensi susu 34,8 .Kata kunci: aspirasi, disfagia, pemeriksaan menelan dengan endoskopi serat optik lentur, penetrasi, residu, sekret yang terkumpul di hipofaring.
Eating and swallowing ability in Children had dynamic characteristic and closely related with growth process in themselves. The anatomical structure underwent growth process, therefore had impact in the maturity of swallowing ability. Disruption of swallowing process may caused dysphagia. This study use Flexible Endoscopic Evaluation of Swallowing FEES and also assessed the characteristics of the subjects based on age, gestation age, caregivers, symptom, complication, and medical disorder. This study is a descriptive cross sectional design involving 54 subjects with consecutive sampling. The result of this study are prevalence of dysphagia is 63 in children with dysphagia suspicion. Dysphagia symptom in children 6 months, apnea while bottle breast feeding 7 34 . Meanwhile, in children 6 months, postural impairment 10 34 , drooling 6 34 , and cough while eating 8 34 . Underlying disease are structural anomaly 5 34 , cardiopulmonary larynx disorder 24 34 and neurological disorder 23 43 . The complication are GERD 12 34 , failure to thrive 10 34 , and aspiration pneumonia 3 34 . In FESS examination, standing secretion 22 34 and impaired tongue movement 20 34 are sign for dysphagia, and residue is more common in gastric rice consistency 44,7 while penetration in thin liquid 44,2 and aspirations is more common in thick liquid 34,8."
Depok: Universitas Indonesia, 2017
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UI - Tesis Membership  Universitas Indonesia Library
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Iman Pradana Maryadi
Gambaran pemeriksaan flexible endoscopic evaluation of swallowing pada anak sindrom down dengan kecurigaan gangguan menelan = Flexible endoscopic evaluation of swallowing examination overview in down syndrome children with dysphagia suspicion
"Anak sindrom Down memiliki risiko komorbiditas yang tinggi akibat silent aspiration yang persisten. Hingga saat ini, belum ada data secara khusus mengenai gambaran disfagia pada anak sindrom Down dengan menggunakan instrumen FEES.
Tujuan penelitian: Mengetahui gambaran disfagia pada anak sindrom Down dengan melihat prevalensi, karakteristik subjek dan gambaran disfagia berdasarkan parameter FEES.
Metode: Penelitian cross-sectional yang bersifat deskriptif terhadap 43 anak sindrom Down dengan kecurigaan disfagia di RSUPN Cipto Mangunkusumo dengan pemeriksaan FEES periode November 2019–Januari 2020.
Hasil: Prevalensi disfagia didapatkan 13 dari 43 subjek (30,2%). Gejala disfagia pada anak ≤6 bulan adalah apnea saat menyusu (2/2), pada anak >6 bulan adalah hanya makan makanan tertentu atau lebih menyukai cairan kental (8/11). Komorbid yang paling banyak menyertai adalah kelainan jantung dan tiroid (6/13). Komplikasi yang sering terjadi adalah pneumonia aspirasi (4/13). Pada pemeriksaan awal FEES didapatkan lip seal lemah (12/13). Pada pemeriksaan FEES, Preswallowing leakage, residu, penetrasi dan aspirasi paling sering terjadi pada konsistensi air dan susu. Standing secretion (6/13) dan silent aspiration (1/13).
Kesimpulan: Prevalensi disfagia sebesar 30,2% dan pada pemeriksaan FEES penetrasi dan aspirasi pada konsistensi cair terutama terjadi pada usia ≤24 bulan.
Background: Persistent silentaspiration is an often unrecognized comorbidity in children with Down syndrome. However, there is still limited study on the characteristic of dysphagia in children with Down syndrome using FEES.
Aim : To find the prevalence and the characteristics of the subjects and dysphagia in children with Down syndrome using FEES’ parameters.
Methods: This is a descriptive cross-sectional study involving 43 Down syndrome children with dysphagia suspicion in Dr. Cipto Mangunkusumo National General Hospital from November 2019–January 2020.
Results: The prevalence of dysphagia was 13 out of 43 subjects (30,2%). Dysphagia symptom in children ≤ 6 months was apnoea while bottle/breast feeding (2/2). Meanwhile, in children > 6 months was food texture selectivity or liquid consistency food preferred (8/11). The comorbidities found mostly were heart anomaly and congenital hypothyroid (6/13). The complication mostly was aspiration pneumonia (4/13). In pre-FESS examination, poor lip sealed was dominant (12/13). In FEES examination, pre-swallowing leakage, residue, penetration, and aspiration were more common in thin and thick liquid. Standing secretion (6/13) and silent aspiration (1/13).
Conclusion: The prevalence of dysphagia was 30,2% and in FEES examination, penetration and aspiration were found mostly in thin liquid, ≤24 months of age predominantly."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tesis Membership  Universitas Indonesia Library
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Evaluasi proses menelan disfagia orofaring dengan Fiberoptic Endoscopic Examination of Swallowing (FEES)
"Latar Belakang: Disfagia adalah kesulitan dalam memulai atau menyelesaikan proses menelan. Disfagia dapat dibedakan menjadi disfagia orofaring dan disfagia esofagus. Sebagian besar pasien dengan keluhan disfagia mengeluhkan atau mengalami kesulitan menelan terutama pada fase orofaring. Disfagia orofaring dapat disebabkan oleh kelainan neurologis dan kelainan struktur yang terlibat dalam proses menelan. Tujuan: Penelitian ini dilakukan untuk mengetahui perbedaan kejadian temuan FEES pada disfagia neurogenik dan mekanik. Metode: Penelitian observasional pada 10 kasus disfagia neurogenik dan 40 kasus disfagia mekanik kemudian dilakukan pemeriksaan FEES untuk melihat regurgitasi,
leakage, residu, penetrasi, dan aspirasi setelah diberikan 6 jenis bolus makanan yang berbeda mulai dari air, susu, bubur saring, bubur tepung, bubur biasa 5 ml, dan seperempat biskuit. Hasil: Terdapat perbedaan bermakna antara disfagia neurogenik dengan disfagia mekanik dalam hal kejadian residu air (p=0,001; RP=16,000; IK 95%: 2,830-90,465), penetrasi (p=0,006; RP=9,333; IK 95%: 1,721-50,614). Penetrasi air (p=0,020; RP=6,000; IK 95%: 1,365–26,451), aspirasi (p=0,018; RP=7,000; IK 95%:
1,480-33,109), aspirasi air (p=0,018; RP=7,000; IK 95%: 1,480-33,109). Tidak didapat perbedaan yang bermakna dalam hal regurgitasi; leakage; residu susu, bubur saring, bubur tepung, dan biskuit; penetrasi susu, bubur biasa, bubur tepung, dan biskuit; serta aspirasi susu, bubur biasa, bubur tepung, dan biskuit. Kesimpulan: Terdapat perbedaan bermakna antara disfagia neurogenik dengan mekanik dalam hal kejadian residu air, penetrasi air, aspirasi, dan aspirasi air. Tidak didapat perbedaan yang bermakna dalam hal regurgitasi, leakage, residu, penetrasi, dan aspirasi pada konsistensi yang lain."
ORLI 44:2 (2014)
Artikel Jurnal  Universitas Indonesia Library
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Michael Keenan Efendi
Karakteristik Gangguan Menelan pada Pasien Stroke Berdasarkan Hasil Kuesioner EAT-10 dan FEES = The Characteristics of Swallowing Disorder in Stroke Patients Based on The Results of EAT-10 Questionnaire and FEES
"Latar Belakang Salah satu komplikasi yang paling sering terjadi dari stroke adalah PSD (post-stroke dysphagia). Hingga saat ini, belum banyak penelitian yang dilakukan untuk membandingkan karakteristik klinis disfagia pada pasien stroke iskemik dan hemoragik dengan kuesioner EAT-10 (eating assessment test-10) dan FEES (flexible endoscopic examination of swallowing). Oleh karena itu, penelitian ini bertujuan untuk meneliti berbagai karakteristik klinis dari disfagia pada pasien stroke dengan kuesioner EAT-10 dan FEES. Metode Data rekam medis 50 pasien stroke dengan disfagia di Poli Endoskopi RSCM diambil secara konsekutif. Jenis stroke dan lesi otak dikonfirmasi dengan melihat hasil pemeriksaan radiologi (CT scan kepala). Hasil anamnesis dan pemeriksaan FEES dicatat untuk kemudian dianalisis secara statistik. Hasil Kondisi PSD lebih banyak ditemukan pada pasien lanjut usia (62%). Pasien stroke dalam studi ini paling banyak mengalami lesi pada area supratentorial, yaitu sejumlah 60%. Hasil uji statistik menunjukkan bahwa tidak terdapat perbedaan yang signifikan secara statistik dalam karakteristik disfagia pada pasien stroke iskemik dan hemoragik berdasarkan pemeriksaan fisik dan FEES (p > 0,05). Namun, terdapat perbedaan bermakna dalam skor residu pada pasien stroke dengan lesi infratentorial dan supratentorial (p = 0,034). Kesimpulan Masalah penurunan berat badan dan nyeri saat menelan paling jarang dialami pasien stroke menurut kuesioner EAT-10. Terdapat 80% pasien stroke yang mengalami kebocoran pra-menelan dan 32% pasien yang mengalami aspirasi. Tidak terdapat perbedaan bermakna pada karakteristik disfagia antara pasien stroke iskemik dan hemoragik berdasarkan kuesioner EAT-10 dan FEES. Variabel standing secretion dialami oleh 88,9% pasien stroke lesi infratentorial. Sejumlah 50% pasien stroke lesi supratentorial tidak memiliki masalah penetrasi dan aspirasi.
Introduction One of the most frequent complications of stroke is post-stroke dysphagia. There have not been many studies conducted to compare the characteristics of dysphagia in ischemic and hemorrhagic stroke patients based on EAT-10 (eating assessment test-10) and FEES (flexible endoscopic examination of swallowing). Hence, this study aims to examine various clinical characteristics of dysphagia in stroke patients based on EAT-10 and FEES. Method Medical record data of 50 stroke patients from Poli Endoskopi RSCM were collected consecutively. Stroke types and lesions were confirmed by looking at radiological examinations. The results of history taking and FEES were written down to be analyzed statistically. Results Post-stroke dysphagia occurs more often in older patients (62%). In this study, the most prevalent location of lesions in stroke patients was lesions in supratentorial area (60%). There was no significant difference in dysphagia characteristics between ischemic and hemorrhagic stroke patients based on EAT-10 and FEES (p > 0,05). However, there was a significant difference in residual scores between stroke patients with supratentorial lesions and infratentorial lesions (p = 0,034). Conclusion Weight loss and pain during swallowing were the least problems experienced by stroke patients according to the EAT-10 questionnaire. There were 80% of stroke patients who experienced pre-swallowing leakage and 32% of them experienced aspiration. There was no significant difference in dysphagia characteristics between ischemic and hemorrhagic stroke patients based on the EAT-10 questionnaire and FEES. Standing secretion was experienced by 88.9% of infratentorial lesion stroke patients. Half of supratentorial lesion stroke patients did not have penetration and aspiration."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Skripsi Membership  Universitas Indonesia Library
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Reni Rozanti Basyar
Uji Kesahihan dan Keandalan Gugging Swallowing Screen (GUSS) Versi Bahasa Indonesia sebagai Alat Uji Penapisan Tingkat Keparahan Disfagia = Validity and Reliability Test of Indonesian Version of Gugging Swallowing Screen (GUSS) as a Screening Test Tool to Predict the Severity of Dysphagia
"Disfagia merupakan ketidakmampuan menelan dengan cara yang aman dan efisien, yang dihasilkan dari berbagai kondisi medis. Identifikasi awal gangguan menelan sangat penting untuk dilakukan karena dapat menyebabkan berbagai komplikasi seperti dehidrasi, malnutrisi, dan pneumonia aspirasi. Gugging Swallowing Screen (GUSS) merupakan suatu alat uji penapisan disfagia yang menggunakan 3 konsistensi berbeda untuk ditelan (semisolid, cair dan padat). Instrumen ini memungkinkan penilaian bertahap dari kemampuan menelan, memprediksi tingkat keparahan disfagia, dan memungkinkan rekomendasi tekstur diet. Penelitian ini bertujuan untuk menguji kesahihan dan keandalan instrumen GUSS yang diadaptasi dan diterjemahkan kedalam budaya dan bahasa Indonesia. Penelitian ini dilaksanakan di poliklinik Departemen Rehabilitasi Medik RSCM dari 1 Oktober 2021 hingga 31 Desember 2021. Metode yang digunakan adalah desain potong lintang dengan sampel berjumlah 47 orang. Uji kesahihan konstruk dinilai dengan menghitung nilai r hitung pada corrected item total correlation yang berkisar antara 0,502-0,913 dengan rerata 0.783. Nilai keandalan GUSS didapatkan dari uji konsistensi internal, uji test-retest, serta inter-rater. Nilai konsistensi internal koefisien Cronbach’s α keseluruhan 0,939, sedangkan nilai masing-masing subtes 0,939 pada tes menelan tidak langsung, 0,793 tes menelan langsung. Uji test-retest dengan waktu minimum dari 1 uji ke uji berikutnya adalah 2 jam, didapatkan nilai intraclass correlation coefficient (ICC) 0,939 (95% confidence interval 0,910 – 0,962). Perhitungan uji statistik Kappa antar dua pemeriksa berdasarkan total item didapatkan nilai koefisien к=0,789 (p<0,001). Berdasarkan proses translasi, adaptasi bahasa, uji kesahihan dan keandalan maka dapat disimpulkan GUSS versi bahasa Indonesia merupakan instrumen yang sahih dan memiliki keandalan yang baik antara rater untuk digunakan sebagai alat uji penapisan tingkat keparahan disfagia di Indonesia.
Dysphagia is the inability to swallow safely and efficiently, resulting from various medical pathologies. Early identification of swallowing disorders is very important because it can cause complications such as dehydration, malnutrition, and aspiration pneumonia. Gugging Swallowing Screen (GUSS) is a dysphagia screening tool that uses 3 different consistencies to be swallowed (semisolid, liquid and solid). This instrument allows a stepwise assessment of swallowing ability, predicts the severity of dysphagia, and allows recommendations for dietary texture. This study aims to examine the validity and reliability of the GUSS instrument which was adapted and translated into Indonesian culture and language using the WHO guideline. This research was conducted at the RSCM Medical Rehabilitation Department Polyclinic from 1 October 2021 to 31 December 2021. The method used was a cross-sectional design with a sample of 47 people. The validity test was assessed by calculating the value of corrected item total correlation 0.783(95% confidence interval 0.502-0.913). The reliability test of GUSS is obtained from internal consistency, test-retest, and inter-rater tests. The overall internal consistency value of Cronbach's α coefficient is 0.939, while the value of each subtest is 0.939 on the indirect swallowing test, 0.793 on the direct swallowing test. Test-retest test with a minimum time from 1 test to the next test is 2 hours, obtained an intraclass correlation coefficient (ICC) value of 0.939 (95% confidence interval 0.910 – 0.962). Calculation of the Kappa statistical test between two examiners based on total items obtained a coefficient value of к=0.789 (p<0.001). Based on the translation process, language adaptation, validity, and reliability tests, it can be concluded that the Indonesian version of the GUSS is a valid instrument and has good reliability among raters to be used as a screening test tool for the severity of dysphagia in Indonesia."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Gerie Amarendra
Efektifitas hidrasi agresif sebagai pencegahan pankreatitis pasca endoscopic retrograde cholangiopancreatography: uji klinis acak tersamar ganda = Comparison between aggressive hydration and standar hydration in preventing pancreatitis post endoscopic retrograde cholangio pancreatography: double blind randomized clinical trial
"Latar Belakang : Pankreatitis pasca ERCP adalah komplikasi tersering dan menyebabkan peningkatan morbiditas dan mortalitas. Hidrasi agresif sebagai terapi pencegahan pankreatitis belum diteliti lebih lanjut.
Tujuan : Mengetahui perbandingan efektivitas pencegahan pankreatitis pasca ERCP antara hidrasi agresif dengan hidrasi standar.
Metode : Uji Klinis Acak tersamar ganda, satu sentral penelitian di Pusat Endoskopi Saluran Cerna (PESC) RS Cipto Mangunkusumo pada pasien usia antara 18-60 tahun yang menjalani tindakan ERCP periode Agustus-Oktober 2018. Randomisasi manual, Teknik sampling konsekutif dilakukan untuk mengalokasikan kelompok hidrasi agresif dan hidrasi standar. Pankreatitis ditegakkan dengan kriteria Atlanta.
Hasil :  Didapatkan 92 pasien yang dirandomisasi kedalam dua kelompok. Didapatkan nilai Control Event Rate (CER) sebesar 15,2%, Experiment Event Rate (EER) sebesar 4,3% Absolute Risk Reduction (ARR) 10,9% Relative Risk (RR) 0,28 Relative Risk Reduction (RRR) 71,7% Number Needed to Treat (NNT) 9.  Tidak didapatkan efek samping pada kedua kelompok. Hidrasi agresif lebih efektif dalam mencegah pankreatitis pasca ERCP walaupun secara statistik tidak bermakna.  
Pancreatitis post ERCP is a common complication and increased morbidity and mortality. Aggressive hydration as prevention of post ERCP pancreatitis has not been fully research.
Aims : To compare effectivity between aggressive hydration and standard hydration in preventing pancreatitis post ERCP.
Design and Methods : A double blind randomized clinical trial in one center at gastrointestinal endoscopy center RSCM was conducted on patients aged between 18-60 years old that had endoscopic retrograde cholangiopancreatography in the period from August to October 2018. Consecutive manual randomization was performed to allocate aggressive hydration and standard hydration. Pancreatitis diagnosed using Atlanta criteria.
Results : Two groups with total 92 subject was randomized equally. Analyzed resulted  Control Event Rate (CER) 15,2%, Experiment Event Rate (EER) 4,3%, Absolute Risk Reduction (ARR) 10,9%, Relative Risk (RR) 0,28, Relative Risk Reduction (RRR) 71,7%, Number Needed to Treat (NNT) 9.  No side effect reported in this trial. Aggressive hydration more effective in perventing post ERCP pancreatitis although statistically not significant.  "
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
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UI - Tesis Membership  Universitas Indonesia Library
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Melya Arianti
Uji Diagnostik Alat Skrining Gugging Swallowing Screen Versi Bahasa Indonesia (Guss-Ina) Dengan Modifikasi Bahan Uji Pada Kasus Disfagia Neurogenik = Diagnostic Test of Gugging Swallowing Screen Indonesian Language Version (GUSS-INA) with Test Material Modification in Neurogenic Dysphagia Cases
"Pasien dengan disfagia rentan mengalami komplikasi seperti pneumonia aspirasi hingga kematian. Oleh karena itu diperlukan alat skrining untuk mendiagnosis disfagia secara cepat. GUSS merupakan alat skrining dengan validitas dan reliabilitas yang baik dalam menilai disfagia, namun belum dilakukan uji diagnostik di Indonesia. Subjek penelitian terdiri dari pasien disfagia neurogenik yang kemudian menjalani pemeriksaan GUSS-INA dengan modifikasi bahan uji, dilanjutkan dengan pemeriksaan baku emas FEES. Selanjutnya, dilakukan uji diagnostik untuk melihat sensitivitas dan spesifisitas GUSS-INA sebagai metode skrining disfagia. Rerata pasien disfagia neurogenik di RSCM berusia 56 tahun dengan jumlah proporsi laki – laki lebih besar dengan penyebab tersering adalah stroke, dengan komorbid hipertensi (56.5%), dengan komplikasi pneumonia 21.7%. Sebagian besar mengalami disfagia kronik, seluruh pasien mengalami keluhan subjektif disfagia dengan 3 gejala tersering adalah batuk, tersedak, dan sulit menelan terutama konsistensi padat. Lebih dari separuh pasien membutuhkan selang makan. Rerata status gizi pasien menunjukan indeks masa tubuh 24.92, dengan rerata penurunan BB 2 kg. Berdasarkan pemeriksaan pencitraan pasien stroke, lokasi tersering berada supratentorial, dengan derajat stroke sedang. Rerata nilai GUSS 14 (disfagia sedang) pada seluruh subjek, 28.3% mengalami aspirasi. Hasil Uji diagnostik GUSS-INA sebagai alat skrining deteksi disfagia memiliki nilai Sensitivitas 84%, Spesifisitas 78%, NDP 94%, NDN 54% dan AUC 0.86. Modalitas GUSS-INA dapat dijadikan alat skrining disfagia yang cukup baik.
Patient with dysphagia has the tendency to undergo serious complications such as aspiration pneumonia that can cause increased mortality. Screening tool to effectively diagnose dysphagia in patient with difficulty swallowing is needed. GUSS is a screening tool with good validity and reliability; however, no diagnostic test has been done in Indonesia. This study samples consisted of neurogenic dysphagia patients which underwent GUSS-INA with test material modification assessment followed by FEES as gold standard examination. Diagnostic test was then done to analyze sensitivity and specificity of GUSS-INA as dysphagia screening tool. The average age of neurologenic dysphagia patients in Cipto Mangunkusumo Hospital was 56 years with higher male proportion, most common etiology was stroke, with most common morbidity being hypertension (56,5%). History of pneumonia was found in 21.7% patients.Majority of patients have chronic dysphagia, all patients had subjective dysphagia complaint with three most common symptoms being cough, choking, and difficulty swallowing especially of solid texture. More than half of the patients needed feeding tube. The average of BMI was 24.93, with average weight loss of 2 kg. Based on radiology results on post-stroke cases, the most common lesion was supratentorial, with moderate stroke score. Average GUSS score is 14 (moderate dysphagia) from all subjects and in 18.3% patients aspiration in found. Diagnostic test result of GUSS-INA as screening tool for neurogenic dysphagia had 84% sensitivity, 78% specificity, 94% PPV, 54% NPV, and AUC of 0.86. GUSS-INA could be used as a screening tool for dysphagia."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library
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Akahoshi, Kazuya
Practical handbook of endoscopic ultrasonography
"Endoscopic ultrasonography (EUS) has evolved from an obscure method of investigation in the 1980s to a distinct endoscopy subspecialty with interventional and therapeutic capabilities. The art of interpreting EUS images is a skill every endoscopist needs to master. This book helps to meet that need as it is concise, simple to read, and amply illustrated, and describes the technique in a step-by-step manner. Many high-resolution EUS images of diseases are included, and literature reviews are kept short and concise while separate discussions and illustrations are devoted to radial and linear techniques. The book can be used as a reference handbook in the endoscopy room, yet contains all of the relevant information required to perform EUS, interpret images, and reach a diagnosis. Important pathological conditions are thoroughly discussed using representative EUS images, pointing out salient differentiating features, and relevant literature reviews are included. The section on interventional EUS deals with advanced interventional or therapeutic procedures, and potential complications and methods to avoid them are discussed. "
Tokyo: Springer, 2012
e20426043
eBooks  Universitas Indonesia Library
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Marion Cinta Kuntjoro
Pengaruh manuver mendelsohn sebagai terapi latihan terhadap disfagia fase faring pada penderita karsinoma nasofaring pasca-kemoradiasi = The Influence of swallowing exercise with mendelsohn manuever on pharyngeal phase dysphagia in post chemoradiation nasopharyngeal carsinoma patients
"ABSTRAK
Latar Belakang: Disfagia fase faring ditemukan pada sebagian besar pasien karsinoma nasofaring (KNF) pasca-kemoradiasi. Manuver Mendelsohn bertujuan untuk meningkatkan durasi elevasi kompleks hyolaringeal, telah digunakan dalam penatalaksanaan disfagia dengan berbagai penyebab. Penelitian ini menilai pengaruh latihan manuver Mendelsohn pada penderita KNF pasca-kemoradiasi dengan disfagia fase faring.
Metode: Desain kuasi eksperimen dengan penilaian sebelum dan sesudah latihan menelan dengan manuver Mendelsoh selama 6 minggu. Penelitian dilakukan pada 20 pasien KNF yang memenuhi kriteria penelitian. Sampel didapat secara konsekutif. Penilaian dilakukan dengan flexible endoscopic swallowing study (FEES) terhadap standing secretion, residu, penetrasi, dan aspirasi menggunakan konsistensi pure, thick liquid dan thin liquid.
Hasil: Terdapat perbedaan bermakan pada penilaian standing secretion (p=0,034). Penilaian terhadap residu mendapatkan perbedaan bermakna pada pemberian pure dan thick liquid (p=0,021 dan p=0,008), sedangkan pada pemberian thin liquid tidak didapatkan perbedaan bermakna (p=0,129). Penilaian terhadap penetrasi mendapatkan perbedaan bermakna pada pemberian pure dan thick liquid (p=0,034 dan p=0,008), pada pemberian thin liquid tidak didapatkan perbedaan bermakna (p=0,059). Penilaian terhadap aspirasi tidak mendapatkan perbedaan bermakna pada pemberian ketiga konsistensi (p=>0,05).
Kesimpulan: Latihan menelan dengan manuver Mendelsohn selama 6 minggu memeperbaiki standing secretion, residu pada pemberian pure dan thick liquid, penetrasi pada pemberian pure dan thick liquid. Latihan ini tidak memperbaiki aspirasi secara bermakna pada pemberian ketiga konsistensi.
ABSTRACT
Background: Dysphagia is commonly seen in patients with nasopharingeal carcinoma (NPC) post chemoradiation. The Mendelsohn maneuver which promotes a prolonged voluntary of hyolaryngeal elevation at the peak of swallowing process has been used to treat various causes of pharyngeal dysphagia. The aim of the study was to see of the influence of swallowing exercise with Mendelsohn manuever in post-chemoradiation NPC patients with pharyngeal phase dysphagia.
Methods: A quasi experimental with pre and post-test assessment at before and after six weeks exercise of Mendelsohn manuever. The study was conducted on 20 NPC patients who met the study criteria. Flexible endoscopic of swallowing study (FEES) was used to asess standing secretion, residue, penetration, and aspiration by giving 3 consistency of food/fluid (pure, thick liquid and thin liquid).
Results: There was a significant difference in standing secretion assesment (p=0,034). Significant differences were found in residue assesment of pure and thick liquid, although no significant difference was found in thin liquid (p=0,129). There were also significant differences in penetration assesment of pure and thick liquid (p=0.034 and p = 0.008), but no significant difference in thin liquid ( p = 0.059 ). The study did not find significant differences in assesment of aspiration in all kind of consistencies (p > 0.05).
Conclusion: Six weeks swallowing exercise with Mendelsohn manuever can reduce severity of standing secretion, residue and penetration of pure and thick liquid. However the exercise improve aspiration status but did not reach significant difference at all consistencies. ;Background: Dysphagia is commonly seen in patients with nasopharingeal carcinoma (NPC) post chemoradiation. The Mendelsohn maneuver which promotes a prolonged voluntary of hyolaryngeal elevation at the peak of swallowing process has been used to treat various causes of pharyngeal dysphagia. The aim of the study was to see of the influence of swallowing exercise with Mendelsohn manuever in post-chemoradiation NPC patients with pharyngeal phase dysphagia.
Methods: A quasi experimental with pre and post-test assessment at before and after six weeks exercise of Mendelsohn manuever. The study was conducted on 20 NPC patients who met the study criteria. Flexible endoscopic of swallowing study (FEES) was used to asess standing secretion, residue, penetration, and aspiration by giving 3 consistency of food/fluid (pure, thick liquid and thin liquid).
Results: There was a significant difference in standing secretion assesment (p=0,034). Significant differences were found in residue assesment of pure and thick liquid, although no significant difference was found in thin liquid (p=0,129). There were also significant differences in penetration assesment of pure and thick liquid (p=0.034 and p = 0.008), but no significant difference in thin liquid ( p = 0.059 ). The study did not find significant differences in assesment of aspiration in all kind of consistencies (p > 0.05).
Conclusion: Six weeks swallowing exercise with Mendelsohn manuever can reduce severity of standing secretion, residue and penetration of pure and thick liquid. However the exercise improve aspiration status but did not reach significant difference at all consistencies. "
2015
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UI - Tugas Akhir  Universitas Indonesia Library
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