Hasil Pencarian  ::  Simpan CSV :: Kembali

Hasil Pencarian

Ditemukan 2 dokumen yang sesuai dengan query
cover
Ika Megatia
Hubungan antara faktor risiko stenosis vena sentral dengan keberhasilan neoplastic di RSCM = Correlation between central vein stenosis risk factors with success rate of venoplasty in Cipto Mangunkusumo Hospital
"ABSTRAK
Latar belakang Dalam lima tahun terakhir, pengunaan kateter pada pasien penyakit ginjal kronis PGK di RSCM kerap diikuti stenosis vena sentral SVS , 60-70 . Sejak 2013 SVS ditangani melalui prosedur venoplasti, namun belum ada evaluasi keberhasilan. Penelitian ini ditujukan melakukan evaluasi keberhasilan venoplasti dan faktor risiko terjadinya stenosis. Metode Dilakukan studi deskriptif analitik dengan desain potong lintang melibatkan pasien PGK stadium 4-5 yang terdiagnosis simtomatik SVS, secara klinis dan radiologis, yang memiliki risiko stenosis, memenuhi kriteria inklusi dan ekslusi serta menjalankan venoplasti. Variabel independen yaitu onset gejala, jenis, lokasi, durasi dan frekuensi pemasangan kateter. Variabel dependen adalah keberhasilan venoplasti dinilai dengan residual stenosis 60 tahun, 61,8 laki-laki dan 70,6 memiliki hipertensi sebagai etiologi PGK. Angka berhasilan venoplasti 85,3 , nilai rerata initial stenosis adalah 79,1 13,8 dan median residual stenosis 24,5 dengan range 10-90 . Letak stenosis terbanyak di vena subklavia 47,1 . Tidak didapatkan hubungan bermakna terhadap keberhasilan venoplasti, namun angka ketidakberhasilan venoplasti yang lebih tinggi ditemukan pada lokasi di vena subklavia OR 2,45; p = 0,627 dan frekuensi pemasangan kateter >2 kali OR 1,85; p = 0,648 . Kesimpulan Keberhasilan venoplasti pada SVS 85,3 dengan keberhasilan ditemukan dua kali lebih tinggi pada implantasi di vena subklavia dan frekuensi > 2 kali. Namun pada studi ini tidak bermakna secara statistik. Ketidakberhasilan venoplasti lebih sering ditemukan pada subjek dengan pemasangan kateter di vena subklavia, durasi pemasangan panjang, onset gejala lambat dan riwayat pemasangan berulang. ABSTRACT Background In the last five years, the use of deep vein catheter in chronic kidney disease CKD often leads to central vein stenosis CVS at Cipto Mangunkusumo Hospital 60 70 . Since 2013, CVS has been managed with venoplasty, and has never been evaluated. The study aimed to evaluate of its success rate and the risk factors might be correlated. Method A descriptive analytic study with cross sectional design conducted enrolling of stage 4 5 CKD patients with symptomatic CVS who underwent venoplasty. Independent variables are onset of symptoms, type, location, duration and frequency of catheter implantation. Dependent variable is venoplasty success, which was determined by residual stenosis 60 years old, 61.8 were male and 70.6 with hypertension. Venoplasty success rate found on this study was 85.3 , mean initial stenosis was 79.1 13.8 and median residual stenosis was 24.5 ranged of 10 90 . The most common stenosis was found in subclavian vein 47.1 . There was no significant correlation with venoplasty success rate. Nevertheless, higher venoplasty success rate found in subjects with catheter located in subclavian vein OR 2.45 p 0.627 and the frequency of implantation 2 times OR 1.85 p 0.648 . Conclusion Venoplasty success rate on CVS patients was 85.3 with success rate found twice higher with implantation at subclavian vein and frequency 2 times. However, there was no statistically significant correlation between stenosis risk factors with this success rate. Venoplasty failure is often found on CVS subjects with catheter implantation on subclavian vein, prolonged duration, delayed onset of symptoms and history of recurrent implantation. Keywords Central vein stenosis, venoplasty, risk factors."
Fakultas Kedokteran Universitas Indonesia, 2017
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Ika Megatia
Kesesuaian tripel diagnostik dengan histopatologis pada kanker payudara stadium awal di RSCM dan RSUPP = Accuracy of triple diagnostic in early stage breast cancer at Ciptomangunkusumo Hospital and Persahabatan Hospital
"Latar belakang: Kanker payudara merupakan kanker terbanyak dengan insiden 40,3 per 100.000 perempuan dan angka mortalitas sebesar 16,6 per 100.000 perempuan di Indonesia. Pada stadium awal I-II, penentuan terapi operatif mastektomi seringkali membutuhkan pemeriksaan potong beku intraoperatif untuk menilai keganasan, namun sering tidak tersedia di banyak rumah sakit. Tripel diagnostik pemeriksaan fisik, ultrasonografi dan fine needle aspiration biopsy merupakan metode diagnostik preoperatif yang juga dinilai akurat dan mudah dilakukan. Studi ini menilai kesesuaian tripel diagnostik dengan histopatologis khususnya pada benjolan yang curiga ganas di RSCM dan RSUPP selama Februari 2016-Agustus 2017.
Metode: Subjek dengan benjolan payudara curiga ganas pada stadium awal yang memenuhi kriteria inklusi di RSCM dan RSUPP dilakukan tripel diagnostik preoperatif, kemudian dilakukan pemeriksaan potong beku intraoperatif dan histopatologi pasca operasi. Menggunakan desain studi diagnostik statistik, dilakukan analisis kesesuaian tripel diagnostik maupun potong beku dibandingkan dengan histopatologi yaitu sensitivitas, spesifisitas, nilai prediksi positif NPP, nilai prediksi negatif NPN dan akurasi.
Hasil Didapatkan 33 subjek kanker payudara stadium awal prevalensi 4,3 dengan rerata umur 49,6 tahun dengan kelompok umur terbanyak di atas 40 tahun 78,8. Sekitar 63,6 subjek memiliki ukuran tumor 2-5 cm dan jenis histopatologi terbanyak berupa karsinoma invasif 84,8. Dibandingkan hasil histopatologi: a Potong beku memiliki sensitivitas 96,8, spesifisitas 100, NPP 100, NPN 66,7, dan akurasi 97,0 ; dan b Tripel diagnostik mempunyai sensitivitas 77,4, spesifisitas 100, nilai prediksi positif tinggi 100, nilai prediksi negatif 22,2 dan akurasi 78,8 p = 0,016.
Kesimpulan: Tripel diagnostik merupakan metode diagnostik yang cukup akurat pada kanker payudara stadium awal sehingga dapat digunakan sebagai metode diagnostik alternatif di fasilitas pelayanan tipe C dan D di Indonesia di saat potong beku tidak tersedia.
Background: Breast cancer is the most common cancer with incidence rate 40.3 per 100.000 women and mortality rate 16.6 per 100.000 women in Indonesia. In early stage, decision for operative therapy mastectomy requires intraoperative frozen section to assess its malignancy, which is often unavailable in many hospitals. Triple diagnostic physical examination, breast ultrasonography and fine needle aspiration biopsy is an accurate and easily performed preoperative diagnostic method. This study assesses the suitability of triple diagnostic with histopathology results in suspicious malignant breast lumps at Ciptomangunkusumo and Persahabatan hospital during February 2016 August 2017.
Method: Subjects with supicious malignant breast lump that met the inclusion criteria underwent preoperative triple diagnostic, intraoperative frozen section and postoperative histopathology examination. With statistic diagnostic study design, the suitability of triple diagnostic and frozen section were assesed in comparation to histologic examination sensitivity, specificity, positive predictive value PPV, negative predictive value NPV and accuracy.
Result: 33 subjects with early stage breast cancer were obtained prevalence 4.3 with average mean of age of 49.6 years, were above 40 years 78.8. Around 63.6 had tumor size between 2 5 cm, and most histopathologic types were those with invasive carcinoma 84.8. When compared to histopathologic result a Frozen section has 96.8 sensitivity, 100 specificity, 100 PPV, 66.7 NPV and 97.0 accuracy and b Triple diagnostic has 77.4 sensitivity, 100 specificity, high PPV 100, 22.2 NPV and 78.8 accuracy. p 0.016.
Conclusion: Triple diagnostic is a relatively accurate diagnostic method in early stage breast cancer, hence, can be used as an alternative diagnostic method at type C and D heatlhcare facilities in Indonesia whenever frozen section is unavailable. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library