Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Penegakkan diagnosis sedini dan setepat mungkin menjadi hal utama dalam penatalaksanaan kanker paru. Beberapa penelitian sebelumnya tentang biopsi transtorakal dengan panduan USG menunjukkan akurasi diagnosis yang cukup baik. USG dinilai sebagai modalitas radiologi yang mudah digunakan secara aman, bedside, real-time, mobile dan bebas pajanan radiasi. Saat ini di RSUP Persahabatan Jakarta belum terdapat penelitian tentang biopsi jarum halus transtorakal dengan panduan USG.Metode Penelitian:  Studi observasional dengan pendekatan potong lintang terhadap subjek dengan tumor paru atau tumor mediastinum yang dilakukan biopsi jarum halus transtorakal dengan panduan ultrasononografi toraks pada bulan April-September 2021. Pengambilan sampel dilakukan secara consecutive sampling. Peneliti melakukan observasi terhadap karakteristik lesi, karakteristik prosedur dan komplikasi. Diagnosis akhir berdasarkan hasil sitologi biopsi jarum halus transtorakal dengan panduan USG.Hasil Penelitian: Dari 46 subjek, rerata usia subjek adalah 52 tahun dan didominasi jenis kelamin laki-laki (69,6%) dan jenis tumor terbanyak adalah tumor paru (80,4%). Proporsi kepositifan sitologi biopsi jarum halus transtorakal dengan panduan USG toraks adalah 78,3%. Karakteristik lesi pada subjek dengan hasil sitologi TTNA positif antara lain memiliki rerata diameter lesi 9,61 ± 2,27 cm, lesi di anterosuperior paru (63,9%), memiliki gambaran ekogenitas hipoekoik heterogen (58,3%) dan memiliki kontak dengan pleura (77,8%). Karakteristik prosedur pada subjek dengan hasil sitologi TTNA positif antara lain dilakukan teknik aspirasi (77,8%), pengambilan TTNA sebanyak < 3 set (58,3%), rerata jumlah gelas objek yang terpakai adalah 15 ± 4 dan median kedalaman insersi adalah 4 (2 – 6) cm. Komplikasi pasca tindakan terjadi pada dua subjek yaitu hemoptisis (4%).Kesimpulan: Biopsi jarum halus transtorakal merupakan metode diagnostik yang invasif minimal dengan proporsi kepositifan yang tinggi (78,3%) dan angka komplikasi yang rendah (4%).

---

Background: Treatment of multidrug-resistant tuberculosis (MDR-TB) using second-line drugs is known to have more side effects. Recent studies have shown concern about bedaquiline and delamanid that can cause a prolonged QT interval. This condition is a known risk factor for Torsades de Pointes, a lethal cardiac arrhythmia. This study sought to observe the condition among such patients treated in the study location.

Methods: This study was a prospective cohort study  of MDR-TB patients receiving bedaquilin in the outpatient clinic and inpatient ward of National Respiratory Referral Hospital Persahabatan, Jakarta, Indonesia between February 2020 to February 2021. Patients received 400 mg on week 0-2 (intensive phase) and followed by 200 mg 3 times per week (continuation phase) of bedaquiline. Sampling was carried out by consecutive sampling and data on subjects who met the inclusion criteria were taken from medical records.

Result: From a total of 71 subjects, all of them met the inclusion criteria. Prolonged QT interval was experienced in 18.3% patients. From eleven patients who experienced prolonged QT interval, two patients required hospitalization: one presented with nausea and gastric upset and one patient presented with dyspnea and palpitation. Prolonged QT interval occurred in initial phase and correlated with drug dosing. A mycobacterial culture conversion at month-6 was observed in those receiving multidrug regimens which include bedaquiline, quinolone, and clofazimine. There was a correlation between prolonged QT interval and hypocalemia. Treatment success rate was 46.5% without prolonged QT. Other outcomes included 4.2% died, 26.8% loss-to-follow up, and 4.1% treatment failed.

Conclusion: The use of bedaquiline MDR-TB appeared to be effective and safe across different settings, although the certainty of evidence was assessed as very low. Hypokalemia was correlated with the outcomes of patients receiving bedaquiline, particularly in those experienced prolonged QT interval."

"Latar Belakang: Transbronchial needle aspiration (TBNA) konvensional merupakan salah satu modalitas minimal invasif yang digunakan untuk diagnosis dan staging kanker paru serta tumor mediastinum terutama jika EBUS-TBNA tidak tersedia. Penelitian ini dilakukan untuk mengetahui tingkat kepositifan biopsi TBNA konvensional KGB paratrakeal kanan bawah (KGB 4R) dan subkarina (KGB 7) pada pasien kanker paru dan tumor mediastinum. Metode: Penelitian ini menggunakan desain potong lintang. Pengumpulan data dilakukan dengan cara observasi langsung pada pasien kanker paru atau tumor mediastinum yang menjalani TBNA konvensional pada KGB 4R dan/atau KGB 7 di RSUP Persahabatan Jakarta, Indonesia. Hasil Penelitian: Total 33 pasien menjalani tindakan TBNA konvensional. Hasil TBNA positif sebanyak 20 (60,6%) yang terdiri dari 18 kasus keganasan dan dua kasus infeksi M. Tuberculosis. Pada kasus adenokarsinoma 58,3% pemeriksaan mutasi EGFR menggunakan sediaan sitologi TBNA. Jarum 21 G memberikan hasil TBNA positif lebih banyak dibandingkan jarum 19 G (masing-masing 68,2% dan 45,5%). Kelompok 1-2 set TBNA menunjukkan hasil TBNA positif 55,6% sedangkan kelompok 3-4 set TBNA menunjukkan hasil TBNA positif 66,7%. Kelompok jiggling 10-14 tusukan menunjukkan hasil TBNA positif 70% sedangkan kelompok jiggling 15-20 tusukan menunjukkan hasil TBNA positif 56,5%. Kelenjar getah bening subkarina memberikan hasil TBNA positif lebih banyak dibandingkan KGB paratrakeal kanan bawah (masing-masing 75% dan 47,1%). Ukuran KGB < 30 mm memberikan hasil TBNA positif lebih sedikit dibandingkan ukuran KGB ≥ 30 mm (36,4% berbanding 53,8%). Kesimpulan: Jarum TBNA 21 G, pengambilan spesimen sitologi sebanyak 3-4 set TBNA, jumlah jiggling sebanyak 10-14 tusukan, KGB 7 dan KGB berukuran ≥ 30 mm memberikan hasil TBNA positif lebih banyak.

---

Background: Minimally invasive conventional transbronchial needle aspiration (C-TBNA) is an alternative method for diagnosing and staging a lung cancer and mediastinal tumor when EBUS-TBNA is unavailable. This study was to determine the positivity level of C-TBNA biopsies in different techniques (repeated sets and jiggled) at the right lower paratracheal (station 4R) and subcarinal (station 7) lymph nodes in lung cancer and mediastinal tumor cases.

Methods: This cross-sectional study was carried out by direct observation of lung cancer and mediastinal tumor cases examined by using C-TBNA of the station 4R and/or 7 lymph nodes at Persahabatan Hospital Jakarta, Indonesia.

Results: A total of 33 patients underwent C-TBNA. Positive results were 20 (60.6%), of which 18 cases were malignancy and two cases were M. tuberculosis infection. In the case of adenocarcinoma, 58.3% showed EGFR mutations from cytological exam. The 21 G needle yielded more positive TBNA results than the 19 G needle (68.2% and 45.5%, respectively). Repeated 1-2 sets of TBNA showed 55.6% positive results while repeated 3-4 sets of TBNA showed 66.7% positive results. The 10-14 jiggled TBNA showed 70% positive results while the 15-20 jiggled TBNA showed 56,5% positive results. Station 7 lymph node TBNA received more positive TBNA results than station 4R lymph node (75% and 47.1%, respectively). Lymph nodes of size < 30 mm yielded less positive TBNA result than of size ≥ 30 mm (36.4% vs 53.8%).

Conclusion: Specimen collection using 21 G TBNA needle, by means of repeated 3-4 sets or 10-14 jiggled, done at station 7 lymph nodes, and at lymph nodes of size ≥ 30 mm were observed to yield more positive TBNA results."

"ABSTRAKLatar Belakang: Kanker tiroid merupakan keganasan endokrin yang paling sering ditemukan dan insidennya semakin meningkat. Meskipun metode biopsi aspirasi jarum halus memiliki sensitivitas yang baik dalam mendiagnosis nodul tiroid, sebanyak 10-40 masih memberikan hasil inkonklusif dalam penentuan keganasan. Hal ini sering merugikan pasien karena harus mengalami re-operasi apabila terdapat keganasan pada hasil histopatologi.Tujuan Penelitian: Mengetahui proporsi dan mendapatkan nilai diagnostik dari pemeriksaan mutasi BRAF, NRAS, dan promoter TERT pada spesimen BAJAH untuk meningkatkan akurasi diagnosis kanker tiroid.Metode Penelitian: Studi retrospektif dengan mengikutsertakan 50 pasien nodul tiroid yang memerlukan pembedahan. Spesimen diambil pada saat proses BAJAH atau pasca operasi. Deteksi mutasi BRAF, NRAS, dan promoter TERT menggunakan metode DNA sekuensing Sanger . Hasil mutasi akan dibandingkan dengan pemeriksaan baku emas histopatologi.Hasil: Dari 50 kasus yang ikut dalam analisis, terdapat 39 kasus 78 merupakan keganasan tiroid. Nilai proporsi mutasi BRAF, NRAS, dan pTERT berturut-turut sebesar 31 , 18 , dan 13 . Uji diagnostik mutasi BRAF menghasilkan sensitivitas, spesifisitas, nilai duga positif, dan nilai duga negatif berturut-turut 31 , 100 , 100 , 29 terhadap kanker tiroid. Untuk mutasi NRAS sebesar 18 , 100 . 100 , 26 . Sedangkan untuk mutasi pTERT sebesar 13 , 100 , 100 , 24 . Jika ketiga mutasi tersebut dikombinasikan, maka nilainya akan meningkat menjadi 49 , 100 , 100 , 35 . Kesimpulan: Pemeriksaan mutasi BRAF, NRAS dan promoter TERT pada kanker tiroid masing-masing memiliki spesifisitas yang tinggi. Jika ketiganya dikombinasikan maka akan meningkatkan sensitivitas untuk membantu dalam meningkatkan akurasi diagnosis keganasan tiroid.

---

ABSTRACTBackground Thyroid cancer is the most common endocrine malignancy and it rsquo s incidence is on the rise. Although the fine needle aspiration biopsy FNAB has a good sensitivity in the diagnosis of thyroid nodules, as much as 10 40 still gives inconclusive results in malignant determination. This is often detrimental to patients having to undergo re surgery if there is a malignancy in the histopathologic outcome.Aim To establish the proportion and diagnostic value of BRAF, NRAS, and TERT promoter mutation detection on FNAB specimens to improve the accuracy of thyroid cancer diagnosis.Methods The retrospective study by involving 50 patients with thyroid nodules surgery. Specimens were taken during the FNAB or postoperative process. Detection of BRAF, NRAS, and TERT promoter mutation using DNA sequencing method Sanger . The mutation results will be compared with the histopathologic gold standard examination.Resuts Of the 50 cases involved in the analysis, there were 39 cases 78 of thyroid malignancies. The proportion of BRAF, NRAS, and pTERT mutations was 31 , 18 , and 13 , respectively. BRAF mutation diagnostic test results in sensitivity, specificity, positive predictive value, and negative predictive value were 31 , 100 , 100 , 29 respectively. For NRAS mutation were 18 , 100 . 100 , 26 . As for pTERT mutation were 13 , 100 , 100 , 24 . If the three mutations are combined, then the value will increase to 45 , 100 , 100 , 35 .Conclusion Detection mutations of BRAF, NRAS and TERT promoters in thyroid cancer have a high specificity. If all three are combined it will increase the sensitivity to improve the accuracy of the diagnosis in thyroid malignancy."

"ABSTRAKBACKGROUND: The incidence lung tumors and mediastinum tumors are the main causes of death due to malignancies with 12,9% of all malignancy cases. Lung tumors are more common in developing countries. Biopsy of lung tumors and mediastinal tumors is a frequent and multidisciplinary action. The minimally invasive technique that is mostly done is percutaneus transthoracic needle aspiration biopsy (PTNAB). Research states that PTNAB is a safe, effective, and accurate procedure.OBJECTIVE: This study aimed to assess the effect of needle biopsy size on the success of biopsy and the incidence of pneumothorax in intrathoracal tumor patients in Hasan Sadikin General Hospital for the period 2014-2016.METHODS: This study is a clinical epidemiological study and observational analytic with a cross sectional study design involving 232 data of patients who met the inclusion criteria and did not meet the exclusion criteria. Matching is done because there are differences in the number of research subjects in each group. The total number of research subjects is 158 patient data. The test used is chi square.RESULTS: The results showed that PTNABs actions using large and small needles had a success rate of 73,4% and 49,4%, respectively, and were significantly different (p <0,05). The success rate of PTNABs actions is not significantly different from lung tumors and mediastinum. The success rate of PTNABs actions in mediastinal tumors using large and small needles was 92,3% and 50%, respectively, and was significantly different (p <0,05). The incidence of pneumothorax after PTNABs action is zero in both groups so analysis cannot be performed.CONCLUSION: This study concluded that the success of PTNABs actions using large-sized needles on small-sized needles differed significantly."

"Latar Belakang: Bronkoskopi adalah prosedur yang umum digunakan sebagai tindakan membantu penegakkan diagnosis kasus tumor paru. Hipoksemia disebut sebagai salah satu komplikasi yang sering terjadi pada bronkoskopi diagnostik oleh karena itu diperlukan data untuk mengetahui faktor yang berpengaruh dan dampak klinis yang ditimbulkan.Metode: Penelitian ini menggunakan desain potong lintang pada pasien tumor paru yang menjalani bronkoskopi diagnostik dan dilakukan selamaJanuari-April 2019 di Rumah Sakit Umum Pusat Rujukan Respirasi Nasional (RSUPRRN) Persahabatan Jakarta. Total 195 pasien diikutsertakan dan dilakukan pengamatan terhadap nilai saturasi oksigen pada tahap premedikasi, durante, pascatindakan. Hipoksemia adalah subjek dengan saturasi oksigen<90% dan diamati berbagai faktor yang dianggap berpengaruh dan dampak klinis yang terjadi.Hasil:Jumlah kejadian hipoksemia pada bronkoskopi diagnostik sebanyak 40 kasus (20,5%). Waktu kejadian hipoksemia paling banyak pada tahap durante tindakan (20%) dengan median lama hipoksemia berlangsung 15 detik. Proporsi waktu muncul hipoksemia terjadi paling banyak pada 10 menit pertama tindakan (11,3%). Faktor demografi yang bermakna terhadap kejadian hipoksemia adalah jenis kelamin (p=0,04) dan riwayat merokok (p=0,005). Faktor yang dianggap berpengaruh dan memiliki hubungan bermakna dengan kejadian hipoksemia antara lain lama waktu tindakan dan timbulnya komplikasi (p<0,05). Total 5 pasien dirawat pascatindakan di ruang intensif dan tidak ada kasus kematian yang dilaporkan. Kesimpulan: Penelitian ini mendapatkan jenis kelamin, riwayat merokok, lama waktu tindakan dan timbulnya komplikasi menjadi faktor yang berpengaruh terhadap kejadian hipoksemia pada tindakan bronkoskopi diagnostik kasus tumor paru. Hipoksemia yang muncul pada bronkoskopi diagnostik kasus tumor paru tidak menimbulkan dampak klinis yang fatal seperti kematian pada penelitian ini.

---

Background: Bronchoscopy is a commonly medical procedure perfomed for diagnose lung tumor cases. Hypoxemia often appear as complication related diagnostic bronchoscopy. Therefore, there is a need of research data to knowing related factors and clinical consequences may occur ahead.

Methods:Design of this study is cross sectional with suspicion lung malignancy population who undergoing diagnostic bronchoscopy from January until april 2019 at National Respiratory Center Persahabatan General Hospital Jakarta. Total 195 consecutive patients participated dan observed for oxygen saturation in premedication, during and post-bronchoscopy. Hypoxemia was defined as an desaturation <90% and reviewed several related factor and clinical consequences may appear

Results:Total hypoxemia events on diagnostic bronchoscopy was 40 cases (20,5%). The most frequent occurrence hypoxemia time is during bronchoscopy (20%) with median duration of hypoxemia is 15 seconds. The proportion of time appears hypoxemia is commonly in first 10 minutes bronchoscopy (11,3%). Demographic factors like gender and smoking history are statistically significant with hypoxemia events (p=0,04 & p=0,005). Other factors may have relation dan statiscally significant are duration of procedure and procedure with complication (p<0,05). Total 5 cases observed in intensive care unit after procedure and no death event have reported in this study

Conclusion:This study suggested gender, smoking history, duration of procedure and procedure with complication were related factors with hypoxemic events in lung tumor cases undergoing diagnostic bronchoscopy. Hypoxemia related diagnostic bronchoscopy in this study was not rise into fatal event. "

"Tumor merupakan sebuah benjolan abnormal dalam tubuh yang dapat bersifat jinak atau ganas dan biasanya disebabkan oleh penyebaran sel abnormal yang tumbuh tidak terkontrol dan tidak terkendali (keganasan) maupun infeksi. Pasien dengan penyakit kanker mengalami gejala fatigue, gangguan pola tidur, ansietas, depresi dan nyeri. Karya ilmiah ini bertujuan menganalisis pengaruh teknik relaksasi Benson sebagai salah satu intervensi keperawatan dalam mengatasi masalah nyeri. Metode yang digunakan berupa laporan kasus yang telah dikelola selama 4 hari terhadap pasien individu yang terdiagnosis tumor paru dan sedang menjalani perawatan di ruang Anggrek lantai 1 di salah satu rumah sakit umum pusat di Jakarta. Hasil menunjukkan bahwa pasien dapat menerima intervensi yang diberikan, melakukannya dengan baik dan rutin, sehingga dapat merasakan efek yang positif yaitu perasaan yang lebih nyaman dan tenang serta berkurangnya sensasi rasa nyeri. Kata kunci : relaksasi benson, nyeri, paliatif, ruang rawat.

---

Tumor is an abnormal lump in the body that can be benign or malignant and is usually caused by the spread of abnormal cells that grow uncontrollably and uncontrollably (malignancy) or infection. Patients with cancer experience symptoms of fatigue, disturbed sleep patterns, anxiety, depression and pain. This scientific work aims to analyze the effect of Benson's relaxation technique as a nursing intervention in overcoming pain problems. The method used is a case report that has been managed for 4 days on individual patients diagnosed with lung tumors and currently undergoing treatment at the Orchid Room on the 1st floor of one of the central public hospitals in Jakarta. The results show that patients can accept the intervention given, did it well and routinely, therefore the patient could feels positive effects which are more comfortable and relaxed, as well as  reduced pain sensation. Keywords : benson relaxation, pain, palliative care"

"ABSTRACTLatar belakang: Diagnosis pasti kanker paru ditegakkan dengan menemukan sel ganas pada pemeriksaan sitologi/ histopatologi pada spesimen yang didapat dari berbagai prosedur diagnostik.Tujuan: Untuk mengetahui jumlah sel ganas dari pemeriksaan sitologi yang didapat dari berbagai prosedur diagnostik TTNA terpandu CT scan, TTNA tidak terpandu, TTNA terpandu USG, BJH, sikatan bronkus, bilasan bronkus, TBNA, BAL, sitologi cairan pleura dan sitologi sputum .Metode: Penelitian potong lintang pada slide pasien kanker paru dari pemeriksaan sitologi yang ditegakkan dari berbagai prosedur diagnostik di Rumah Sakit Umum Pusat Persahabatan. Data diambil dari laborarorium Patologi Anatomi, Rekam Medis Rumah Sakit Umum Pusat Persahabatan dan data khusus Adenokarsinoma paru diambil dari laboratorium KalGen Jakarta Pusat pada periode 1 Juni 2015 sampai 31 Juli 2016. Slide pasien yang mengandung sel ganas akan dikoding oleh SpPA dan dihitung jumlahnya dibawah mikroskop dibawah supervisi Sp.PA.Hasil: Sampel penelitian 425 slide sitologi dengan karateristik pasien laki-laki 72,5 median usia 57 tahun, range usia 26-92 tahun dan pasien kanker paru perempuan 27,3 median usia 54 tahun, range usia 18-84 tahun . TTNA terpandu CT Scan merupakan prosedur diagnostik yang paling sering dapat menemukan sel ganas > 200 16,9 , diikuti BJH dengan jumlah sel > 200 11,8 , TTNA tidak terpandu dengan jumlah sel ganas > 200 7,3 . Jumlah sel ganas minimal yang memungkinkan untuk pemeriksaan molekuler lanjutan EGFR khususnya pada jenis adenokarsinoma paru adalah didapatkan 0,8 pemeriksaan EGFR pada jumlah sel ganas < 50 sel dan semakin tinggi jumlah sel ganas maka semakin memungkinkan untuk pemeriksaan molekuler lanjutan. Jumlah slide mempengaruhi jumlah sel ganas yang didapatkan nilai p=0,000 dan semakin banyak jumlah slide maka semakin banyak juga jumlah sel ganas yang didapatkan.Kesimpulan: Jumlah sel ganas pada slide sitologi kanker paru paling banyak ditemukan dengan pemeriksaan TTNA terpandu CT scan, dikuti BJH dan TTNA tidak terpandu. Jumah slide mempengaruhi jumlah sel ganas nilai bermakna, p= 0,000 .Kata kunci: Kanker paru, sel ganas, slide sitologi, prosedur diagnostik

---

ABSTRACTBackground A definitive diagnosis of lung cancer by finding malignant cells on cytology histopathology examination of the specimen obtained from a variety of diagnostic procedures.Objective To determine the number of malignant cells of cytologic examination that are obtained from a variety of diagnostic procedures CT guided TTNA, unguided TTNA, ultrasound guided TTNA, FNAB, bronchial brushing, bronchial washing, TBNA, BAL, cytology examination of pleural fluid and sputum cytology .Methods A cross sectional study in lung cancer patients slides from cytological examination from a variety of diagnostic procedures in the Central General Hospital Persahabatan. Data are taken from Anatomical Pathology laborarorium, Medical Record of Central General Hospital Persahabatan and the specific data of lung adenocarcinoma taken from the laboratory KalGen in Central Jakarta from1 June, 2015 until July 31, 2016. Slides containing malignant cells of patients are to be coded by SpPA and numbered under a microscope under the supervision of Sp.PA.Results The research sample with characteristic cytologic slide of 425 male patients were 72.5 median age 57 years, range 26 92 years of age and female lung cancer patients were 27.3 median age 54 years, age range 18 84 year . CT guided TTNA was a diagnostic procedure that was most often able to find malignant cells 200 16.9 , followed by the BJH of cell counts 200 11.8 , unguided TTNA with the number of malignant cells 200 7.3 . Minimal number of malignant cells that were possible for advanced molecular examination EGFR , particularly on the type of lung adenocarcinoma was obtained 0.8 EGFR examination in the number of malignant cell "

"Latar Belakang : Tingkat akurasi EUS FNA dalam diagnosis lesi pankreas diduga dipengaruhi oleh berbagai macam faktor. Penelitian mengenai faktor yang mempengaruhi keberhasilan EUS FNA belum pernah dilakukan di Indonesia. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang mempengaruhi keberhasilan EUS FNA untuk diagnosis lesi pankreas pada populasi Indonesia.Metode : Penelitian ini merupakan studi potong lintang dari data rekam medis pada januari 2012-Juli 2022 atau total seluruh subjek yang dilakukan EUS FNA karena lesi pankreas di PESC RSCM. Pasien dengan data tidak lengkap dan lesi peripankreas tidak diikutkan. Karakteristik dasar subjek penelitian ditampilkan dalam bentuk tabel. Analisis bivariat menggunakan uji chi square dilakukan dengan masing-masing variabel bebas terhadap keberhasilan diagnostik EUS FNA untuk menghitung nilai odds ratio (OR). Variabel dengan nilai p< 0,25 pada analisa bivariat dimasukkan ke analisa multivariat dengan regresi logistik.Hasil : Sebanyak 201 pasien dengan lesi pankreas yang menjalani pemeriksaan EUS FNA diikutkan dalam penelitian. Angka keberhasilan diagnostik EUS FNA pada lesi pankreas adalah sebesar 77,11%. Ukuran lesi ³3 cm diasoasikan dengan peningkatan keberhasilan diagnosis EUS FNA berdasarkan analisis bivariat (OR 2,46; IK95 1,25-4,86; p= 0,008). Analisis multivariat menunjukan bahwa ukuran lesi ³3 cm (OR 18,95; IK95 4,77-75,29; p = 0,000),  lokasi lesi di korpus (OR 2.82; IK95 1.03-7.77; p= 0,04) dan ukuran jarum 22G (OR 7.49; IK95 1.87-29.97; p= 0.004) diasoasikan dengan peningkatan keberhasilan diagnosis. Kesimpulan : Ukuran lesi, lokasi lesi dan ukuran jarum, merupakan faktor yang mempengaruhi keberhasilan diagnostik EUS FNA pada lesi pankreas.

---

Background: Diagnostic accuracy of EUS FNA in diagnosing pancreatic lesion are affected by several factors. Clinical study regarding these factors had not been done in Indonesia. This study aims to study factors affecting the diagnostic yield of EUS FNA in diagnosing pancreatic lesion in Indonesian population. 

Method: This study is a cross-sectional study of medical record data in January 2012-July 2022 or a total of all subjects who underwent EUS FNA due to pancreatic lesions at PESC RSCM. Patient with incomplete data and peripacreatic lesion was excluded. Clinical characteristics of sample is presented in a table. Bivariat analysis was conducted with chi square test between independent factors and diagnostic success of EUS FNA to obtained the odds ratio (OR). Factors with p-value above 0,25 are included for multivariat analysis using logistic regression.  

Result: A total of 201 patients underwent EUS FNA was included in this study. Success rate of diagnosing pancreatic lesion using EUS FNA was 77,11%. Lesion size ³3 cm increased the odds for diagnostic success based on bivariat analysis (OR 2,46; 95% CI 1,25-4,86; p = 0,008). Multivariate analysis showed that the lesion size ³ 3 cm (OR 18.95; CI95 4.77-75.29; p = 0.000), the location of the lesion in the corpus (OR 2.82; CI95 1.03-7.77; p = 0.04) and needle size 22G (OR 7.49; CI95 1.87-29.97; p= 0.004) was associated with an increase in diagnostic yield.

Conclusion: The size of the lesion, the location of the lesion and the size of the needle, are factors that influence the diagnostic yield of EUS FNA in pancreatic lesions"

"ABSTRAKLatar Belakang : Pasien kanker paru umumnya datang pada stage yang sudah lanjut. Keterlambatan bisa diakibatkan oleh pasien itu sendiri, dokter dan sistem kesehatan. Sejak diberlakukan Jaminan Kesehatan Nasional, RSUP Persahabatan sebagai rujukan penyakit paru mengalami peningkatan jumlah pasien kanker paru. Diagnosis kanker paru ditargetkan tegak dalam dua minggu. Namun, selama ini ini belum ada data berapa lama diagnosis kanker paru dapat ditegakan dan berapa biaya yang dikeluarkan serta faktor-faktor apa saja yang mempengaruhinya.Metode : Penelitian ini merupakan studi observasional. Sebanyak 110 subjek terdapat pada penelitian ini. Kami mengevaluasi berapa waktu dan biaya yang dibutuhkan sejak subjek datang ke RSUP Persahabatan sampai diagnosis histopatologi kanker paru didapat. Kami juga mengevaluasi beberapa faktor yang menentukan lama dan besarnya biaya penegakan diagnosis kanker paru.Hasil : Sebanyak 110 subjek terdapat dalam penelitian ini. Delapan puluh empat 76,36 subjek laki-laki dan 26 23,64 perempuan. Nilai tengah umur subjek adalah 57 tahun dengan kisaran 26 sampai 86 tahun. Sebanyak 53 48,2 mendapatkan diagnosis dalam waktu le; dan 57 51,8 subjek mendapatkan diagnosis lebih dari 2 minggu. Nilai tengah penegakan diagnosis adalah 15 hari dengan kisaran 1 ndash;68 hari. Pasien dengan stage lanjut, tampilan status yang jelek dan dirawat dengan pembiayaan umum memiliki waktu tunggu yang lebih singkat. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Subjek dengan stage lanjut, tampilan status yang buruk, memiliki penyulit dan dirawat di kelas non JKN memiliki biaya yang lebih besar.Kesimpulan : Nilai tengah waktu penegakan diagnosis kanker paru pada penelitian ini adalah 15 hari dengan kisaran 1-86 hari. Waktu tunggu berhubungan dengan stage pada saat datang, tampilan status, kelas perawatan. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Biaya penegakan diagnosis berhubungan dengan stage pada saat datang, tampilan status, penyulit dan kelas perawatan.Kata Kunci : Kanker paru, diagnosis, keterlambatan diagnosis

---

ABSTRAKBackground and aim Most lung cancer patients had been diagnosed in advanced stage. Most reasons for the delay of the diagnosis, might be from patients and or health system. Currently, in Indonesia has National Health Insurance System Jaminan Kesehatan Nasional . That situation made an increasing numbers of patients who come to referral hospital. In Persahabatan Hospital the National Referral for Respiratory Diseases, the maximum time interval for lung cancer diagnosis was set not more than two weeks, however several cases were delayed. We had been conducting a study to evaluate time diagnostic time and cost for diagnose lung cancer.Method We performed bservational study in Persahabatan Hospital Jakarta. One hundred an ten new patients was recruited in this study. We evaluated how long the time was and how much was needed from the first visit until the initial diagnosis by histopatology obtained. We also evaluated the factors that have correlated with time and cost of diagnosis.Results One hundred and ten patients were enrolled in this study. Eighty four 76,36 were male and 26 23,64 were female. The median age was 57 years old with range 26 to 86 years old. Data had shown that 53 48,2 patient were diagnosed under target time 2 weeks but 57 51,8 had diagnostic time more than 2 weeks. The median time of diagnostic was 15 days with range 1 ndash 68 days. Diagnostic delay was correlated with early stage of the diseases, good performance status, financial resource. The median cost of diagnosis was Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Subject who came with late stage, poor performance status, had complication of lung cancer and hospitalized in private area had higher cost of diagnostic. Conclusion Median diagnostic time of lung cancer in RSUP Persahabatan is 15 days range from 1 to 86 days. Diagnostic time correlates with stage at admission, performance status at admission and source of financial. The median cost of diagnosis is Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Cost of diagnosis correlates with stage at admission, performance status at admission, source of financial and complication related with lung cancer."

"Latar belakang: Core biopsy transtorakal merupakan metode biopsi tumor intratorakal yang digunakan untuk mendapatkan sampel histopatologi demi menentukan penatalaksanaan. Core biopsy dipandu gambar pindaian CT toraks di ruang operasi dilakukan terutama bagi pasien yang tidak mampu berbaring, namun belum ada studi akurasi diagnostik baik di Indonesia. Tujuan: Mengetahui akurasi diagnostik core biopsy transtorakal dipandu gambar pindaian CT toraks di ruang operasi untuk tumor intratorakal. Metode: Uji diagnostik dengan studi potong lintang pada semua pasien yang menjalani core biopsy transtorakal di ruang operasi di Rumah Sakit Umum Pusat Persahabatan sejak Januari 2016-Desember 2019. Tindakan dipandu gambar pindaian CT toraks, menggunakan jarum core 18G, hasil dikelompokan menjadi ganas, jinak, dan non-diagnostik. Nilai sensitivitas, spesifisitas, akurasi, nilai duga positif, dan nilai duga negatif sebagai luaran untuk menilai akurasi diagnostik. Hasil: Penelitian melibatkan 105 subjek dengan hasil akurasi diagnostik 86,7%, sensitivitas 83,1%, spesifisitas 100%, nilai duga positif 100%, nilai duga negatif 71% dalam mendiagnosis keganasan tumor intratorakal. Komplikasi pneumotoraks 4,8%, hemotoraks 1%, tidak ada hemoptisis maupun mortalitas. Kesimpulan: Core biopsy transtorakal dipandu gambar pindaian CT toraks di ruang operasi memperlihatkan akurasi diagnostik 86,7% pada tumor intratorakal dan relatif aman.

---

Background: Transthoracic needle core biopsy is one of biopsy method of intrathoracic tumors to gain histopathology sample for treatment decision. We performed CT image-guided transthoracic core biopsy in operation theatre for patient who are not able to/tolerate lie down position. Unfortunately, there are still no diagnostic accuracy study in Indonesia.

Objective: to aim diagnostic accuracy of CT image-guided transthoracic needle core biopsy in operating theatre for intrathoracic tumors.

Methods: All patients underwent CT image-guided transthoracic needle core biopsy since January 201-December 2019 are review retrospectively. Eighteen gauge automated core devices were used, and guided by CT image, core biopsy results were divide in to malignant, non-malignant, and non-diagnostic. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy are main outcome to describe diagnostic accuracies.

Results: This study enrolled 105 subjects which had sensitivity of 83,1%, specificity of 100%, positive predictive value of 100%, negative predictive value of 71%, and diagnostic accuracy of 86,7% for intrathoracic malignancies. Complications of pneumothorax are 4,8% and hemothorax are 1%. No mortality was reported.

Conclusion: CT image-guided transthoracic needle core biopsy in operating theatre for intrathoracic tumors had 86,7% of diagnostic accuracy, and a relatively safe procedure."