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"Infeksi Human Papillomavirus (HPV) pada kasus karsinoma sel skuamosa (KSS) rongga mulut dan orofaring semakin meningkat, keterlibatan HPV sudah banyak dibuktikan meningkatkan risiko terjadinya keganasan selain konsumsi rokok dan alkohol. Keterlibatan HPV terbukti memberikan respon radiasi yang lebih baik yang berujung kepada prognosis. Polymerase Chain Reaction (PCR) merupakan baku emas diagnostik infeksi HPV yang memiliki kekurangan hanya bisa dilakukan di laboratorium tertentu dengan biaya relatif mahal, sementara metode lain menggunakan p16 surrogate biomarker dengan imunohistokimia (IHK) sangat tergantung dari cutoff point yang ditetapkan. Penelitian ini merupakan uji diagnostik p16 surrogate biomarker dengan IHK terhadap baku emas pada kasus KSS rongga mulut dan orofaring. Hasil penelitian ini menunjukkkan cutoff point p16 IHK yang mendekati hasil PCR adalah 50%, dengan sensitivitas 66% dan spesifisitas 84%, dapat digunakan untuk mendiagnosis infeksi HPV pada kasus KSS rongga mulut dan orofaring.

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Prevalence of Human Papillomavirus (HPV) infection in cases of oral and oropharyngeal squamous cell carcinoma (SSC) is increasing, HPV involvement has been shown to increase the risk of malignancy in addition to cigarette and alcohol consumption. HPV involvement proves to provide a better radiation response that leads to better prognosis. Polymerase Chain Reaction (PCR) is the gold standard examination for diagnostics of HPV infection yet can only be performed in certain laboratories at relatively expensive cost, while other methods using surrogate biomarkers p16 with immunohistochemistry (IHC) are highly dependent on the specified cutoff point. This study was a diagnostic test of surrogate biomarker p16 with IHC on HPV examination using PCR in cases of oral cavity and oropharynx SSC. The results of this study obtained a minimum 50% cutoff point of IHC approaching PCR result with sensitivity of 66% and specificity of 84%, and applicable to diagnose HPV infection in cases of oral cavity and oropharynx SCC replacing PCR examination."

"Latar BelakangKanker serviks adalah penyakit kronis yang mudah dicegah dan dapat ditangani jika ditemukan dini. Meskipun demikian, sampai saat ini, kanker serviks masih menjadi penyakit dengan angka kejadian dan kematian yang tinggi di Indonesia dan dunia serta menimbulkan beban yang signifikan bagi penderita maupun masyarakat. Infeksi HPV merupakan penyebab utama terjadinya kanker serviks dan tindakan pencegahan lainnya tidak cukup untuk mencegah terjadinya infeksi HPV tanpa didampingi dengan vaksinasi. Oleh karena itu, penelitian untuk menelusuri pengetahuan, sikap, dan perilaku serta faktor sosial ekonomi yang dapat menjadi penghambat terjadinya vaksinasi HPV diperlukan. MetodeDilakukan pengambilan data menggunakan kuesioner pada tanggal 20-23 November 2023 di Poli Kebidanan dan Penyakit Kandungan RSCM Kiara. Sampel yang di ambil berupa data dari sosiodemografi dan pengetahuan, sikap, dan perilaku (PSP) terkait HPV serta kanker serviks pada populasi cakupan untuk melihat hubungan diantaranya.HasilSubjek penelitian ini sebagian besar sudah memiliki sikap yang positif terhadap infeksi HPV, vaksinasi HPV, dan kanker serviks (69,3%). Akan tetapi, sebagian besar masih memiliki pengetahuan dan perilaku yang buruk (72,4% dan 84,3%). Pada penelitian ini terdapat hubungan antara pengetahuan dengan sikap (p 0,001, OR 6,857, 95% CI=1,954- 24,062) dan pengetahuan dengan perilaku (p 0,003, OR 4,227, 95% CI=1,569-11,389). Akan tetapi, tidak ditemukan hubungan yang signifikan secara statistik antara sikap dengan perilaku. Pada penelitian ini tidak terdapat hubungan yang signifikan antara status pengetahuan dengan status vaksinasi HPV (p 1,000), tidak terdapat hubungan yang signifikan antara status sikap dengan status vaksinasi HPV (p 0,455), dan tidak terdapat hubungan yang signifikan antara status perilaku dengan status vaksinasi HPV (p 1,000). KesimpulanDitemukan tingkat pengetahuan dan perilaku subjek yang buruk dengan sikap yang positif. Penelitian ini juga menemukan bahwa terdapat hubungan yang signifikan antara pengetahuan dengan sikap dan pengetahuan dengan perilaku, tetapi tidak antara sikap dengan perilaku. Selain itu, tidak ada hubungan antara status pengetahuan, sikap, dan perilaku denga status vaksinasi.

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Introduction

Cervical cancer is a chronic disease that is easy to prevent and can be treated if found early. However, to date, cervical cancer is still a disease with a high incidence and mortality rate both in Indonesia and globally, while also causing a significant burden for sufferers and society. HPV infection is the main cause of cervical cancer and, without vaccination, other preventive measures alone are not enough to prevent HPV infection. Therefore, research to explore knowledge, attitudes, and behavior as well as socio- economic factors that can hinder HPV vaccination is needed.

Method

Data were collected using a questionnaire on 20-23 November 2023 at the Obstetrics and Gynecology Clinic, RSCM Kiara. The sample that was taken was data from sociodemographics and knowledge, attitudes, and practice (KAP) related to HPV and cervical cancer in the coverage population to see the relationship between them.

Results

Most of the subjects in this study had a positive attitude towards HPV infection, HPV vaccination, and cervical cancer (69.3%). However, the majority still have poor knowledge and behavior (72.4% and 84.3%). This research found a relationship between knowledge with attitudes (p 0.001, OR 6.857, 95% CI=1,954-24,062) and knowledge with behavior (p 0.003, OR 4.227, 95% CI=1,569-11,389). However, no statistically significant relationship was found between attitudes with behavior. This study found that there was no significant relationship between knowledge status with HPV vaccination status (p 1.000), there was no significant relationship between attitude status with HPV vaccination status (p 0.455), and there was no significant relationship between behavior status with HPV vaccination status (p 0.455).

Conclusion

It was found that the subject's level of knowledge and behavior was poor with a positive attitude. This study also found that there was a statistically significant relationship between knowledge with attitudes and knowledge with behavior, but not between attitudes with behavior. Apart from that, there is no relationship between knowledge status, attitudes, and practice with vaccination status."

"ABSTRAKLatar Belakang: Infeksi virus dengue di sebabkan oleh salah satu dari 4 serotype virus dengue yaitu DENV-1,DENV-2,DENV-3, DENV-4. Perjalanan infeksi dengue memiliki tiga fase yaitu fase demam, fase kritis dan penyembuhan, dengan manajemen tatalaksana yang tepat dan kemampuan mengenali tanda bahaya (warning sign) sangat menentukan kesembuhan pasien dengue berat.Tujuan: Untuk mengetahui faktor prognosis yang mempengaruhi probabilitas kesembuhan pasien infeksi dengue PCR positif.Metode: Penelitian ini dilakukan dengan menggunakan desain Kohort Retrospektif. Subyek adalah pasien infeksi dengue yang di rawat di RSUD Kanujoso Djatiwibowo Balikpapan yang di amati sejak di diagnosis infeksi dengue sampai dinyatakan sembuh oleh dokter. Diagnosis infeksi dengue di konfirmasi virus penyebabnya dengan pemeriksaan RT PCR yang dilakukan kerjasama antara subdit Pengendalian Arbovirosis dan Balitbangkes Kemenkes RI mulai Oktober 2014 sampai dengan Desember 2016.Hasil: Dari 125 subyek 112 (89.6%) terjadi event (sembuh) dan 13 (10,4 %) subyek mengalami sensor. Probabilitas kesembuhan secara keseluruhan 92.1% dengan median kesembuhan pada hari ke 7 dari masa pengamatan 10 hari. Faktor prognosis yang mempengaruhi probabilitas kesembuhan pasien infeksi dengue dari hasil analisis bivariat menggunakan Kaplan Meier adalah usia, lama demam sebelum masuk rumah sakit, derajat infeksi dengue (DD,DBD atau SSD), dan parameter laboratorium (trombosit, lekosit dan hematokrit).Kesimpulan: Faktor prognosis yang berpengaruh terhadap probabilitas kesembuhan pasien infeksi dengue adalah usia, lama demam sebelum masuk rumah sakit, derajat infeksi dengue (DD,DBD atau SSD), dan parameter laboratorium (trombosit, lekosit dan hematokrit).

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ABSTRACTBackground: Dengue virus infection caused by one of 4 serotypes of dengue virus is DENV-1, DENV-2, DENV-3, DENV-4. Dengue infection has three phases: the phase of fever, critical phase and convalescens, with standart management and good treatment the ability to detect early warning sign severe dengue can be saved.Objective: To determine the prognostic factors that affect survival probability of patients with positive PCR dengue infection.Methods: This is Retrospective Cohort design study. Subjects are dengue infection patients who are admitted in Kanujoso Hospital Djatiwibowo Balikpapan since the diagnosis of dengue infection until declared recovery by the doctor. The diagnosis of dengue infection is confirmed of PCR which is done by cooperation between Arbovirosis Control sub-directorate and National Health Research from October 2014 until December 2016.Result: From 125 subjects 112 (89.6%) has event (recovered) and 13 (10,4%) subjected to sensor. The overall survival probability was 92.1% with median recovery on day 7 from 10-day observation period. Bivariate analysis using Kaplan Meier show that prognosis factors influence the probability of dengue infection patients are age, duration of fever before admission, diagnostic dengue infection (Dengue fever, Dengue hemarhagic fever, or Dengue Shock Syndrome), and laboratory parameters (platelets, leukocytes and hematocrit).Conclusion: The most dominant prognostic factors affect the probability of recovery dengue infection patients are age, duration of fever before admission, diagnostic dengue infection (Dengue fever, Dengue hemarhagic fever, or Dengue Shock Syndrome), and laboratory parameters (platelets, leukocytes and hematocrit)."

"Latar belakang: Peningkatan insidensi karsinoma sel skuamosa (KSS) rongga mulut dan orofaring telah memicu berbagai studi mengenai peran Human Papilloma Virus (HPV) pada patogenesis KSS rongga mulut dan orofaring. Dewasa ini, pemeriksaan imunohistokimia p16, suatu protein penanda yang dibentuk oleh sel tubuh akibat terinfeksi HPV, semakin marak digunakan sebagai alternatif dari pemeriksaan polymerase chain reaction (PCR). Pemeriksaan ini membutuhkan biaya tinggi dengan ketersediaannya yang rendah. Status p16 juga menentukan stadium KSS orofaring berdasarkan panduan diagnosis oleh American Joint Commitee on Cancer (AJCC) edisi ke-8. Panduan diagnosis tersebut dibuat berdasarkan penelitian yang menyatakan bahwa respons radiasi dan prognosis KSS orofaring lebih baik pada pasien dengan status p16 positif. Tujuan penelitian: Membandingkan respons radiasi pada pasien dengan KSS rongga mulut dan orofaring berdasarkan status p16. Metode: Penelitian ini menggunakan desain cross-sectional dan melibatkan 27 pasien KSS rongga mulut dan orofaring di RSUPN Cipto Mangunkusumo. Data karakteristik pasien diambil dari rekam medis, anamnesis pasien, serta hasil pemeriksaan CT scan dan/atau MRI. Status p16 ditentukan dengan pemeriksaan imunohistokimia dengan pulasan antibodi p16INK4a. Analisis data dilakukan menggunakan Statistical Program for Social Science (SPSS) versi 20. Hasil: Status p16 positif ditemukan pada 11 dari 27 subjek (40,7%). Berdasarkan analisis bivariat, tidak terdapat asosiasi yang bermakna antara status p16 dengan respons terapi (p>0,05). Kesimpulan: Tidak terdapat pengaruh signifikan dari status p16 terhadap respons radiasi pada KSS orofaring dan rongga mulut

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Background: The increasing incidence of oral cavity and oropharyngeal squamous cell carcinoma (SCC) has led to the initiation of various studies on human papillomavirus (HPV), which plays a role in the pathogenesis of oral cavity and oropharyngeal SCC. Nowadays, immunohistochemistry examination of p16, a marker protein formed by HPV-infected cells, is increasingly used as an alternative to polymerase chain reaction (PCR) which requires high cost yet has low availability. According to 8th American Joint Committee of Cancer (AJCC) guideline on oropharyngeal cancer, p16 status also determines the staging of oropharyngeal SCC, indicating that the radiation response and prognosis of oropharyngeal SCC are better in p16-positive patients. Aim: To compare the radiation response in patients with oral and oropharyngeal SCC based on p16 status. Methods: This is a cross-sectional study involving 27 patients with oral and oropharyngeal SCC at Dr. Cipto Mangunkusumo National General Hospital. Patients characteristics were obtained from medical records, history taking, and CT scan and/or MRI results. p16 status was determined by p16INK4a immunohistochemistry and nasal polyp paraffin block examination (eosinophil infiltration and biofilm). Data analysis was performed using Statistical Program for Social Science (SPSS) version 20. Results: Positive p16 status was found in 11 of 27 subjects (40,7%). Based on bivariate analysis, no significant association was found between p16 status and radiation response (p>0.05)."

"[ABSTRAKHuman Papilloma Virus (HPV) merupakan penyebab infeksi menular seksual yang paling sering di dunia. HPV genital berdasarkan potensi onkogeniknya terdiri dari low risk HPV (lr-HPV) dan high risk HPV (hr-HPV). Kondiloma akuminata merupakan penyakit menular seksual yang disebabkan oleh HPV dan memiliki angka morbiditas paling tinggi di seluruh dunia termasuk di RS Cipto Mangunkusumo. Sebagian besar kondiloma akuminata disebabkan oleh lr- HPV, tetapi dewasa ini diketahui terdapat proporsi infeksi hr-HPV yang cukup besar pada kondiloma akuminata. Infeksi hr-HPV pada kondiloma akuminata merupakan salah satu faktor risiko terjadinya keganasan anogenital. Penelitian ini bertujuan untuk mendapatkan proporsi hr- HPV serta HPV 16 dan 18 pada lesi kondiloma akuminata atipikal regio anogenital di RS dr. Cipto Mangunkusumo dengan metoda Real Time Polymerase Chain Reaction (PCR). Dilakukan pemeriksaan PCR terhadap 21 lesi kondiloma akuminata atipikal dari 20 subyek penelitian. Hasil pemeriksaan mendapatkan proporsi hr-HPV sebesar 42,9% (9 dari 21 lesi) serta proporsi HPV 16 dan 18 sebesar 23,8% (5 dari 21 lesi).

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ABSTRACTHuman papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. ;Human papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. , Human papillomavirus (HPV) is the most common cause of sexually transmitted disease in the world. In accordance to its oncogenic property, genital HPV is known to be low risk HPV (lr-HPV) and high risk HPV (hr-HPV). Condyloma acuminata is a sexually transmitted disease caused by HPV and has a high morbidity worldwide including in Cipto Mangunkusumo National Hospital. Most of condyloma acuminata caused by lr-HPV, although recently findings revealed a high proportion of hr-HPV in condyloma acuminata. Infection of hr-HPV in condyloma acuminata is one of risk factor for anogenital malignancy. This study aimed to obtain the proportion of hr-HPV in atypical lesion of condyloma acuminata in anogenital region at Cipto Mangunkusumo National Hospital with Real Time Polymerase Chain Reaction (PCR). Real Time PCR was conducted on 21 atypical lesion from 20 subject. The proportion of hr-HPV from those lesions was 42,9% and HPV 16/18 was 23,8%. ]"

"Latar belakang: Infeksi Human Papilloma Virus (HPV) merupakan salah satu faktor etiologi KSS (Karsinoma Sel Skuamosa) kepala dan leher serta mempengaruhi hasil terapi. Hipoksia tumor menunjukkan respon terapi yang buruk pada sebagian besar keganasan, termasuk KSS. Studi ini bertujuan mengevaluasi karakteristik HPV dan hipoksia dalam KSS rongga mulut dan orofaringeal serta kaitannya terhadap respons radiasi.Metode: Penelitian eksperimental pada KSS rongga mulut dan orofaring yang telah menjalani terapi radiasi di Departemen Radioterapi antara Januari 2013 hingga Desember 2017.Hasil: Dari total 18 subjek, 44,4% memiliki infeksi HPV positif, 66,7% menunjukkan marker hipoksia positif. Hubungan infeksi HPV dan hipoksia dalam penelitian ini menunjukkan tidak ada hubungan yang signifikan (OR HPV = 2,0 (0,2-15,3), OR hipoksia positif = 0,6 (0,15-2,5), atau hipoksia negatif = 1,2 (0,6-2,3), p = 0,638). Dalam penelitian ini, enam pasien (33,3%) memiliki respon lengkap, tujuh pasien (38,8%) memiliki respon parsial, satu pasien memiliki respon stabil, dan empat pasien (22,2%) memiliki respon progresif terhadap radiasi. Tidak ada hubungan yang signifikan antara HPV + / hipoksia +, HPV + / hipoksia-, HPV- / hipoksia +, dan kelompok HPV- / hipoksia- terhadap tanggapan terapi (p = 0,514).Kesimpulan: Peningkatan insiden HPV dan hipoksia tumor yang tinggi pada pasien dengan rongga mulut dan kanker orofaringeal. Namun, tidak ada efek signifikan dari HPV dan tumor hipoksia terhadap respons radiasi. Hipoksia berhubungan dengan respon progresif.

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Background: Human Papilloma Virus (HPV) infection can lead to head and neck cancer and affect therapy outcomes. Hypoxic tumors are known to show poor therapy response in majority of malignancies, including Squamous Cell Carcinoma (SCC). This study aimed to show characteristics of HPV and hypoxia in oral cavity and oropharyngeal cancer and their association in radiation response.

Method: We conducted an experimental study on patients diagnosed with oral cavity cancer and oropharyngeal cancer who had undergone radiation therapy in Radiotherapy Department between January 2013 until December 2017.

Result: From a total of eighteen subjects, 44.4% had positive HPV infection, 66.7% had positive for hypoxia.. The association of HPV infection and hypoxia in this study showed no significant relationship (OR HPV = 2.0(0.2-15.3), OR positive hypoxia = 0.6(0.15-2.5), OR negative hypoxia = 1.2(0.6-2.3), p=0.638). In this study, six patients (33.3%) had complete response, seven patients (38.8%) had partial response, one patient (5.6%) had stable response and four patients (22.2%) were progressive respon to the radiation. There was also no statistically significant association between HPV+/hypoxia+, HPV+/hypoxia-, HPV-/hypoxia+, and HPV-/hypoxia- group against therapy responses (p=0.514). In this study all progressive response related with hypoxia status.

Conclusion: There were high incidences of HPV and tumor hypoxia in patients with oral cavity and oropharyngeal cancer. However, there was no significant effects of HPV and tumor hypoxia to final radiation response. Hypoxia related to progressive disease. "

"Infeksi Clostridium difficile toksigenik meningkat tajam pada satu dekade terakhir, menyebabkan pseudo membran colitis (PMC) dan Clostridium difficile associated diarrhea (CDAD). Salah satu faktor risikonya adalah penggunaan antibiotik. Tujuan penelitian adalah mengetahui prevalensi dan gambaran karakteristik subyek dengan Clostridium difficile toksigenik serta menilai kemampuan rapid test toksin terhadap real time PCR. Subyek penelitian prospektif ini adalah 90 subyek dewasa dengan terapi antibiotik lebih dari 2 minggu. Hasil pemeriksaan menggunakan rapid test dan real time PCR disajikan dalam tabel 2x2, dilakukan uji statistik dengan chi square. Hasil penelitian menunjukkan 2 spesimen dieksklusi karena hasil invalid, 24 spesimen positif dan 64 negatif dengan rapid test toksin; 33 spesimen positif dan 55 negatif dengan real time PCR. Prevalensi Clostridium difficile toksigenik berdasar rapid test toksin adalah 27,3% dan real time PCR 37,5%. Terdapat perbedaan bermakna antara konsistensi feses dan jumlah antibiotik dengan terdeteksinya Clostridium difficile toksigenik (p<0,05). Terdapat hubungan antara lama terapi antibiotik dengan terdeteksinya Clostridium difficile toksigenik menggunakan real time PCR (p=0,010, RR=2,116). Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kemungkinan positif dan rasio kemungkinan negatif rapid test toksin terhadap real time PCR berturut-turut adalah 69,7%; 98,2%; 95,8%; 84,4%; 39,2 dan 0,31. Dari hasil penelitian disimpulkan bahwa prevalensi Clostridium difficile di RSCM lebih tinggi dibanding Malaysia, Thailand dan India; subyek dengan terapi antibiotik lebih dari 4 minggu berisiko terdeteksi Clostridium difficile toksigenik 2 kali lebih besar dibanding subyek dengan terapi antibiotik kurang dari 4 minggu; rapid test toksin dapat digunakan sebagai alat deteksi Clostridium difficile toksigenik.

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Toxigenic Clostridium difficile infection have increased sharply in the last decade, causing a pseudo membrane colitis (PMC) and Clostridium difficile associated diarrhea (CDAD). One of the biggest risk factor is the use of antibiotics. The purpose of the study was to determine the prevalence and characteristics of subjects with toxigenic Clostridium difficile and assess the ability of the toxin rapid test compared to real-time PCR. Ninety adult subjects with antibiotic therapy more than 2 weeks were enrolled to this prospective study. The results of toxin rapid test and real-time PCR were presented in 2x2 table, statistical tests was calculated with chi square. Two specimens were excluded due to invalid results. The results showed 24 positive and 64 negative specimens by toxin rapid test; 33 positive and 55 negative specimens by real-time PCR. The prevalence of toxigenic Clostridium difficile based on toxin rapid test were 27.3% and 37.5% by real-time PCR. There were significant differences between stool consistency and number of antibiotics that were used with the detection of toxigenic Clostridium difficile. There was a relationship between duration of antibiotic therapy with detection of toxigenic Clostridium difficile using real-time PCR (p = 0.010, RR = 2.116). Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio of toxin rapid test against real-time PCR were 69.7%; 98.2%; 95.8%; 84.4%; 39.2 and 0.31, respectively. The study concluded that the prevalence of Clostridium difficile in RSCM was higher than Malaysia, Thailand and India; subjects with antibiotic therapy for more than 4 weeks had double risk to have toxigenic Clostridium difficile than subjects with antibiotic therapy for less than 4 weeks and toxin rapid test could be used as a tool to detect toxigenic Clostridium difficile."

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Penelitian ini bertujuan untuk menentukan titik potong lingkar lengan atas pada posisi berbaring. Penelitian ini menggunakan desain cross-sectional. Data diambil dari rekam medis pasien poliklinik radioterapi RSUPN Dr. Cipto Mangunkusumo (n=207) dan dilakukan pengukuran antropometri pada pasien. Titik potong lingkar lengan atas diperoleh dari kurva ROC dan indeks Youden tertinggi. Dari penelitian ini didapatkan perbedaan rata-rata antara lingkar lengan atas pada posisi berdiri dan terlentang adalah 0,13 ± 0,33 cm (p<0,001). Lingkar lengan atas dari keseluruhan subjek memiliki korelasi yang kuat dan signifikan dengan indeks massa tubuh (r=0,932; p<0,001). Nilai AUC lingkar lengan atas untuk mendeteksi malnutrisi adalah 0,97 (95% CI 0,947-0,992; p<0,001). Lingkar lengan atas <23,4 cm menunjukkan sensitivitas 94,7% dan spesifisitas 95,6% untuk pria, dan sensitivitas 95% dan spesifisitas 89% untuk wanita. Sebagai kesimpulan, lingkar lengan atas <23,4 cm dapat digunakan sebagai salah satu alternatif pengukuran untuk mendeteksi malnutrisi, terutama bila indeks massa tubuh tidak dapat diukur.

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This study aims to establish a cut-off point for mid-upper arm circumference in the supine position. This is a cross-sectional study. Data were taken from patients at the radiotherapy clinic of Dr. Cipto Mangunkusumo General Hospital (n=207) by medical records, and anthropometric measurements were performed. The cut-off point of the mid-upper arm circumference was obtained from the ROC curve and the highest Youden’s index. This study found that the mean difference between mid-upper arm circumference in the standing and supine positions is 0.13±0.33 cm (p<0.001). The mid-upper arm circumference from all subjects strongly and significantly correlates to body mass index (r=0.932; p<0.001). The area under the curve of the mid-upper arm circumference for detecting malnutrition was 0.97 (95% CI 0.947–0.992; p<0.001). The mid-upper arm circumference of <23.4 cm presents a sensitivity of 94.7% and a specificity of 95.6% for men, and a sensitivity of 95% and a specificity of 89% for women. In conclusion, the mid-upper arm circumference of <23.4 cm can be used as an alternative measurement to detect malnutrition, particularly when body mass index cannot be measured.
 

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"Kanker serviks merupakan penyebab kematian terbesar kedua dan merupakan salah satu beban biaya kesehatan terbesar di Indonesia. Kanker serviks merupakan kondisi yang disebabkan oleh infeksi HPV. Oleh karena itu, pencegahan infeksi virus dapat dilakukan dengan vaksinasi HPV serta pemeriksaan skrining secara rutin. Desain penelitian ini potong lintang. Penelitian mengambil subjek wanita yang berobat ke Poliklinik Ginekologi dan Onkologi Departemen Obstetri dan Ginekologi RSCM tahun 2021—2022 dan didapatkan total 193 subjek untuk dianalisis. Data yang termasuk dalam analisis adalah usia, pendidikan, jumlah pernikahan, paritas, riwayat keguguran, riwayat KB, riwayat vaksinasi HPV, riwayat skrining dengan tes DNA HPV, dan temuan kelainan serviks. Didapatkan proporsi temuan non-neoplastik dan neoplastik serviks beruturut-turut adalah 3,1% dan 96,9%. Ditemukan hubungan vaksinasi HPV terhadap kejadian kelainan serviks berupa OR 0,022 (IK95% 0,002-0,194; nilai P 0,005), dan hubungan riwayat skrining tes DNA HPV dengan temuan kelainan serviks berupa OR 0,033 (IK95% 0,004-0,252; nilai P 0,008). Riwayat vaksinasi HPV, riwayat skrining kanker serviks, dan tingkat pendidikan berhubungan dengan temuan kelainan serviks (prakanker dan kanker).

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Cervical cancer is the second leading cause of death and one of the biggest health cost burdens in Indonesia. Cervical cancer is a condition caused by HPV infection. Therefore, prevention of viral infection can be done with HPV vaccination as well as regular screening examinations. The design of this study was cross-sectional. The study took female subjects who sought treatment at the Gynecology and Oncology Polyclinic of the Department of Obstetrics and Gynecology of RSCM in 2021-2022 and obtained a total of 193 subjects for analysis. Data included in the analysis were age, education, number of marriages, parity, history of abortion, history of contraception, history of HPV vaccination, history of screening with HPV DNA test, and findings of cervical abnormalities. The proportions of cervical non-neoplastic and neoplastic findings were 3.1% and 96.9%, respectively. The association of HPV vaccination with the incidence of cervical abnormalities was OR 0.022 (95% CI 0.002-0.194; P value 0.005), and the association of HPV DNA test screening history with cervical abnormalities was OR 0.033 (95% CI 0.004-0.252; P value 0.008). HPV vaccination history, cervical cancer screening history, and education level are associated with findings of cervical abnormalities (precancerous and cancerous)."

"ABSTRAK Latar belakang: Berdasarkan Jakarta Cancer Registry tahun 2012, kanker kolorektal merupakan kanker terbanyak keempat pada wanita dan kedua pada pria di Indonesia. Penelitian menggunakan mRNA fekal sebagai penanda kanker kolorektal bersifat non invasif namun cukup representatif menggambarkan kelainan pada usus. Tujuan: Mengevaluasi peran pemeriksaan mRNA CEA feses pada pasien terduga keganasan kolorektal menggunakan nested RT-PCR. Metode: Uji diagnostik ini melibatkan 93 pasien terduga keganasan kolorektal yang ditentukan melalui anamnesis dan pemeriksaan fisik oleh klinisi. Ekstraksi mRNA CEA fekal menggunakan metode Kanaoka dan sintesis DNA menggunakan metode cyclic temperature reverse transcription 2 CTRT-2 . Pemeriksaan mRNA CEA menggunakan metode nested RT-PCR. Hasil: mRNA CEA fekal positif ditemukan pada 22 pasien 23,7 . Penelitian ini mendapatkan sensitivitas 51,61 , spesifisitas 90,32 , nilai prediksi positif 72,73 dan nilai prediksi negatif 78,87 . Meskipun sensitivitas yang diperoleh rendah tetapi spesifisitas mRNA CEA fekal yang tinggi dapat mengkonfirmasi diagnosis lesi neoplastik pada pasien terduga keganasan kolorektal. Kesimpulan: Pemeriksaan mRNA CEA fekal tidak dapat digunakan sebagai penanda tunggal dalam skrining keganasan kolorektal. Pemeriksaan mRNA CEA fekal perlu dikombinasikan bersama penanda diagnostik lainnya agar dapat meningkatkan sensitivitas dan spesifisitas pemeriksaan. Kata kunci: carcinoembryonic antigen; penanda fekal; nested

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Background Based on the 2012 Jakarta Cancer Registry, colorectal cancer is the fourth of most common cancer in women and the second in men. Fecal carcinoembryonic antigen mRNA assay is a non invasive method, yet representatively describes abnormalities of the intestine. Objective To evaluate the role of fecal mRNA CEA assay in suspected colorectal cancer patients using nested RT PCR. Methods The diagnostic study included 93 suspected colorectal cancer patients which were determined by anamnesis and physical examination from the clinician. The fecal mRNA were extracted by Kanaoka method and cDNA were synthesized with cyclic temperature reverse transcription 2 CTRT 2 method. The fecal mRNA CEA assay used nested RT PCR method. Results Positive fecal mRNA CEA was detected in 22 patients 23.7 . Sensitivity, specificity, positive predictive value, and negative predictive value were 51.61 , 90.32 , 72.73 , and 78.87 respectively. This study had low sensitivity but with high specificity. Therefore, fecal mRNA CEA could be used as a confirmatory assay. Conclusions It was not recommended to use fecal mRNA CEA as a single marker in colorectal cancer screening. A fecal mRNA CEA assay should be combined with other diagnostic markers in order to improve the sensitivity and specificity of the assay. Keywords carcinoembryonic antigen fecal marker nested "