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"Tuberculosis is a common infectious disease in our community. The management of this disease become more difficult and also the prognosis when there were an advanced complication and a high prevalence of multidrugs resistance. We report a -10-year-old female patient with pyopneaenatorax with history of discontinuing tuberculosis drugs before"

"Penyakit Graves merupakan penyakit autoimun pada kelenjar tiroid dengan manifestasi berbagai sistem organ, termasuk sistem kardiovaskular akibat hipertiroid. Pada pasien hipertiroid terjadi peningkatan fungsi sistolik ventrikel kiri dibandingkan populasi normal. Beberapa penelitian tentang kadar hormon tiroid mendapatkan hasil yang berbeda-beda. Hipotesis pada penelitian ini adalah peningkatan kadar hormon tiroid akan diikuti peningkatan fungsi ventrikel kiri.TujuanDiketahui korelasi kadar tiroksin bebas dan fraksi ejeksi ventrikel kiri pada pasien Graves yang belum diobati.MetodePada penelitian potong lintang ini digunakan kadar tiroksin bebas sebagai parameter hormon tiroid dan fraksi ejeksi ventrikel kiri (LVEF) menurut cara Simpson yang dimodifikasi dengan ekokardiografi sebagai parameter fungsi sistolik ventrikel kiri. Kadar tiroksin bebas diperiksa di laboratorium sedangkan fraksi ejeksi ventrikel kiri cara Simpson dinilai dengan alat ekokardiografi.HasilDidapatkan 10 pasien, 7 laki-laki dan 3 perempuan, dengan usia 18-52 tahun. Lama gejala dirasakan pasien 2-12 bulan. Pada pasien didapatkan rerata kadar fT4 5,75 (SB 0,96) ngldL dan rerata fraksi ejeksi ventrikel kiri 70,57 (SB 4,50) %. Didapatkan koefisien korelasi positif antara kadar tiroksin bebas dan fraksi ejeksi ventrikel kiri (r=0,711, p=0,021) pada pasien Graves yang belum diobatiKesimpulanPada penelitian ini didapatkan korelasi positif kuat antara kadar tiroksin bebas (fT4) dan fraksi ejeksi ventrikel kiri (LVEF) pada pasien Grave yang belum mendapat pengobatan.

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Graves' disease is an autoimmune disease of thyroid gland which can be manifested in many organ system, especially cardiovascular system due to hyperthyroid. Hyperthyroid patients have a higher left ventricular systolic function than normal. Several studies of correlation between thyroid hormone level and cardiac function have showed different results. The hypotesis tested in this study is the increasing thyroid level will followed by the increase of left ventricular systolic function in Graves' disease.

Objective

To determine the correlation between thyroid hormone level and left ventricular ejection fraction in newly diagnosed Graves' patients.

Methods

In this cross-sectional study, we use the free thyrosine level as a parameter of thyroid hormon and use left ventricular ejection fraction as a parameter of left ventricular systolic function. Free thyroxine level was measured in the laboratory and the LVEF were assessed by Simpson's methods of echocardiography study.

Results

Ten patients (7 men and 3 women; age 18-52 years old) were studied. Their average of ff4 was 5.75 (SD 0.96) ngldL and their average of LVEF was 70.57 (SD 4.50) %. There was positive correlation coefficient between free thyroxine level and left ventricular ejection fraction (r=0.711, p=0.021) in newly diagnosed Graves' patients.

Conclusion

In this study there was strong positive correlation between free thyroxine (fT4) and left ventricular ejection fraction (LVEF) in newly diagnosed Graves' patients."

"Latar Belakang. Lama rawat intensif pasien pascabedah jantung yang memanjang mempengaruhi alur pasien bedah jantung berikutnya. Pengaturan pasien berdasarkan lama rawat diperlukan agar alur pasien lancar. Tujuan. Membuat prediksi lama rawat intensif 48 jam berdasarkan nilai skor dari model EuroSCORE dan model yang dimodifikasi dari faktor-faktor EuroSCORE. Metode. Penelitian restrospektif dilakukan pada Januari 2012 - Desember 2013 pada 249 pasien yang menjalani bedah jantung di Unit Pelayanan Jantung RSUPN Dr Cipto Mangunkusumo Jakarta. Analisis survival dan regresi Cox dilakukan untuk membuat prediksi lama rawat intensif 48 jam. Hasil. Median kesintasan lama rawat intensif 43 jam. Nilai skor EuroSCORE tidak memenuhi asumsi hazard proporsional. Model baru telah dibuat dari 7 variabel EuroSCORE yang secara substansi berhubungan dengan lama rawat intensif (AUC 0,67). Kesimpulan. Model baru dari tujuh faktor EuroSCORE cukup dapat memprediksi lama rawat intensif 48 jam.

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Background. Prolonged intensive care unit length of stay (ICU-LOS) in a postcardiac surgery may shortage of ICU beds due to clog of patient flow. Improving ICU-LOS may lead to better patient flow.

Objectives. To predict 48-hour ICU-LOS based on EuroSCORE model and to create a modified EuroSCORE factors model.

Methods. A retrospective study was conducted from January 2012 to December 2013 among 249 patients who underwent cardiac surgery at Integrated Cardiac Services, Cipto Mangunkusumo Hospital, Jakarta. Survival analysis and Cox?s regression were performed to make a prediction model for 48-hour ICU-LOS.

Results. Median survival of ICU-LOS was 43-hour. The EuroSCORE model did not meet the proporsional hazard assumption. A new substantial model from 7- EuroSCORE factors was created to predict 48 hours ICU-LOS (AUC 0.67).

Conclusions. Seven EuroSCORE factors was sufficient as a new model to predict the 48-hour ICU-LOS."