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Abstrak :
ABSTRAK
Pendahuluan: Biopsi jarum inti dianggap memiliki hasil akurasi yang sama dengan biopsi terbuka dan telah menjadi prosedur rutin untuk menegakkan diagnosis lesi muskuloskeletal. Namun demikian uji diagnostik biopsi jarum inti di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN CM) belum dilaporkan. Tujuan dari analisis retrospektif ini adalah untuk mendapatkan nilai ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal. Metode: Dari Januari 2011 hingga Agustus 2015, semua pasien dengan lesi muskuloskeletal di RSUPN CM yang menjalani biopsi jarum inti dan eksisi tumor diidentifikasi dan diambil datanya. Ketepatan diagnosis dianalisis baik untuk kesimpulan histopatologi maupun kesimpulan clinical pathology conference (CPC). Hasil: Sebanyak 86 sampel dikumpulkan dalam penelitian ini. Ketepatan diagnosis biopsi jarum inti dibandingkan dengan spesimen pasca eksisi adalah 74,4%. Setelah dilakukan CPC, nilai ketepatan menjadi 83,7% dengan sensitivitas 98%, spesifisitas 59%, NDP 87%, NDN 93% (p = 0.00). Ketepatan biopsi jarum inti setelah pulasan imunohistokimia naik menjadi 84,9% (p = 0,438). Ketepatan untuk membedakan lesi jinak dan ganas adalah 97,1% (jinak) dan 82,7% (ganas) (p = 0.00). Ketepatan untuk membedakan lesi primer dan metastasis adalah 97,2% (primer) dan 85,7% (metastasis) (p = 0.00). Diskusi: Kami mendapatkan nilai ketepatan biopsi jarum inti yang sedikit lebih rendah karena dalam penelitian ini dituntut untuk membuat diagnosis sampai tingkat morfologi (ICD O dan ICD X). Namun demikian, dengan modalitas lain seperti imunohistokimia dan kesimpulan CPC, ketepatan menjadi meningkat. Ketepatan diagnosis untuk membedakan lesi jinak-ganas dan primer-metastasis tinggi. Biopsi jarum inti direkomendasikan untuk penegakkan diagnosis lesi muskuloskeletal.ABSTRACT
Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions. ;Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions. ;Introduction: Core needle biopsy is considered to have similar results with open biopsy in accuracy and already become a routine procedure to establish the diagnosis of musculoskeletal lesion. However, diagnostic test of core needle biopsy application in Cipto Mangunkusumo Hospital has not been reported. Therefore, the aim of this retrospective analysis was to attain the accuracy of musculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy and subsequent tumour excision were indentified and enrolled. Diagnostic accuracy were calculated for both histopathology and clinical pathology conference (CPC) conclusion. Results: A total of 86 samples were indentified and enrolled in this study. The accuracy of core needle biopsy compared to subsequent excision is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%, PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is 84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguish primary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p= 0.00). Discussion: We found slightly inferior results for core needle biopsy accuracy compared to literature due to high specificity diagnosis obligatory (ICD O and ICD X morphology) in our study. However, with other modalities such as immunohistochemistry and CPC, the accuracy is increased. The accuracy to distinguish between benign vs malignant and primary vs metastatic lesion is high. Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.

Abstrak :
ABSTRAK
Soluble CD14-ST presepsin merupakan penanda sepsis baru untuk diagnosis dan prognosis sepsis neonatorum. Kadar presepsin meningkat pada keadaan sepsis disebabkan oleh aktivitas protease di fagolisosom. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin sebagai penanda pemantauan respons terapi dan prognosis pada pasien SNAL secara bedside dengan menggunakan sampel darah kapiler. Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 20 neonatus sehat dan 42 pasien SNAL. Pemeriksaan kadar presepsin dengan alat Pathfast pada hari ke-1, ke-3, dan ke-6 setelah diterapi. Kadar presepsin pada pasien SNAL 1104 pg/mL (608 ? 6225 pg/mL) lebih tinggi dibandingkan pada neonatus sehat 448 pg/mL (191 ? 513 pg/mL), nilai p 0,000. Pada pasien SNAL kelompok respons terapi kadar presepsin lebih rendah dibandingkan dengan kelompok non respons pada hari ke-3 dan ke-6 (p<0,05). Pada pasien SNAL kelompok non survivor kadar presepsin lebih tinggi dibandingkan dengan kelompok survivor hari ke-6 (p<0,05). Kadar presepsin berkorelasi positif dengan kadar CRP (r=0,488) dan jumlah leukosit (r=0,321). Nilai cut-off kadar presepsin hari ke-6 untuk penentuan prognosis 1365 pg/mL mempunyai AUC 0,789 (IK 95% 0,652 ? 0.926), sensitivitas 90.9%, dan spesifisitas 67,7%. Pemeriksaan presepsin hari ke-3 atau ke-6 secara bedside dengan darah kapiler bermanfaat untuk pemantauan terapi dan prognostik pasien SNAL.ABSTRACT
Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.

Abstrak :
ABSTRAK
Diagnosis infark miokard akut ditegakkan apabila memenuhi 2 dari 3 kriteria, yaitu klinis, perubahan EKG, dan peningkatan kadar penanda biokimia jantung. Troponin merupakan penanda biokimia jantung yang spesifik untuk infark miokard, akan tetapi memiliki keterbatasan yaitu kurang sensitif apabila dilakukan pada fase awal karena troponin akan meningkat dalam darah setelah 4 -10 jam setelah infark miokard. Copeptin merupakan penanda stres endogen, yang dapat meningkat pada awal onset infark miokard akut, namun kurang spesifik. Penelitian tentang copeptin-us sebagai penanda biokimia jantung masih sedikit dan di Indonesia penelitian tentang copeptin-us sebagai penanda biokimia jantung belum pernah dilakukan. Penelitian ini mengikutsertakan 91 pasien tersangka sindrom koroner akut yang terbagi atas 15 (16,5%) NSTEMI, 43 (47,3%) UA, dan 33 (36,3%) non SKA. Diagnosis ditegakkan oleh dokter di IGD RS Jantung dan Pembuluh Darah Harapan Kita. Karakteristik pasien yang memenuhi kriteria inklusi dan eksklusi dicatat dan kemudian dilakukan pemeriksaan copeptin-us. Nilai rerata copeptin-us pada NSTEMI adalah 151,80 ± 130,03 pmol/L, median copeptin-us pada UA adalah 7,12(1,145 ? 62,23) pmol/L, dan rerata copeptin-us pada non SKA adalah 7,36 ± 4,17 pmol/L. Nilai cut off copeptin-us untuk membedakan NSTEMI dengan UA/non SKA adalah 13,97 pmol/L. Area under curve (AUC) kombinasi hs-cTnT saat masuk rumah sakit dengan copeptin-us adalah 0,941 (0,882 ? 1,00), hs-cTnT saat masuk rumah sakit 0,885 (0,790 ? 0,98), dan AUC hs-cTnT 3 jam kemudian adalah 0,925 (0,824 ? 1,00). Nilai median hs-cTnT saat masuk RS pada NSTEMI adalah 114(29-1102) pg/mL, pada UA adalah 16 (3-3352) pg/mL, dan pada non SKA adalah 6(3-366) pg/mL. Nilai median hs-cTnT 3 jam pada NSTEMI adalah 488 (81-18437) pg/mL, pada UA 14(3-2224) pg/mL, dan pada non SKA adalah 3(3-679) pg/mL. Kombinasi copeptin-us ≥ 13,97 pmol/L dan hs-cTnT ≥ 14 pg/mL dan untuk membedakan NSTEMI dengan UA/non SKA memberikan sensitivitas 100%, spesifisitas 90,78%, NPP 68,18%, dan NPN 100%. Uji diagnostik kombinasi copeptin-us dan hs-cTnT saat masuk RS lebih baik dibandingkan hs-cTnT saat masuk RS saja dan dapat digunakan untuk rule out NSTEMI.ABSTRACT
Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done. In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured. The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%. The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done. In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured. The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%. The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done. In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured. The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%. The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.

Abstrak :
ABSTRAK
Penggunaan transportasi tabung pneumatik di laboratorium berpotensi mengakibatkan kerusakan sel darah dan mempengaruhi hasil pemeriksaan Penelitian ini bertujuan mendapatkan data perbedaan hasil pemeriksaan jumlah eritrosit leukosit trombosit LDH kalium dan indeks hemolisis antara darah yang ditransportasi kurir dan tabung pneumatik Desain penelitian potong lintang dengan 58 subjek menggunakan darah K3EDTA berpasangan dan darah beku berpasangan Pada penelitian ini tidak ada perbedaan statistik pada jumlah eritrosit leukosit trombosit dan kalium antara kedua cara transportasi Terdapat peningkatan LDH dan indeks hemolisis yang bermakna secara statistik pada darah yang ditransportasi tabung pneumatik Peningkatan LDH melebihi batas ketelitian laboratorium tetapi tidak bermakna secara klinis ABSTRACT
The use of pneumatic tube system has a possibility to induce damage on blood cells and affects laboratory result This study aim to obtain the difference between the result of erythrocyte leukocyte thrombocyte LDH kalium and hemolysis index in blood transported by courier and by pneumatic tube system The method used was a cross sectional study with 58 voluntary subjects using paired K3EDTA blood and paired coagulated blood There was no significant statistical difference between erythrocyte leukocyte thrombocyte count and kalium in blood transported by courier and by pneumatic tube system There was an increased in LDH and hemolysis index in blood transported by pneumatic tube The increase of LDH caused by pneumatic tube was higher than laboratory precision limit but not clinically significant

Abstrak :
Pelaporan nilai kritis laboratorium merupakan salah satu indikator mutu yang sangat penting. Kegagalan melaporkan nilai kritis kepada DPJP akan menjadi sebab potensial untuk menimbulkan kejadian yang tidak diharapkan. Di Rumah Sakit Umum Pusat sanglah Denpasar tingkat pelaporan nilai kritis baru mencapai 15,8%. Tujuan dari penelitian ini adalah untuk mendapatkan gambaran pelaporan nilai kritis laboratorium berdasarkan parameter pemeriksaan, jenis pasien (rawat jalan dan rawat inap), area perawatan, sub laboratorium, dan waktu dalam satu hari dan untuk melihat implementasi manajemen dalam pelaporan nilai kritis tersebut. Ada variasi jumlah hasil kritis berdasarkan parameter, jenis pasien, ruang perawatan, sub laboratorium dan waktu dalam sehari. Implementasi manajemen dari pelaporan nilai kritis tidak dilakukan secara utuh. ...... Laboratory critical value reporting is one of important quality indicator. Failure to report critical values to care givers will be a potential cause of adverse events. In Sanglah Central General Hospital critical values reporting rate only reached 15.8%. The purpose of this study was to obtain an overview of laboratory critical values reporting based on parameters, patient type, treatment areas, sub-laboratory, time of the day and to see the management implementation of the critical value reporting. There were variations in the number of critical values based on parameters, patient type, treatment areas, sub-laboratory, and time of the day. Management implementation in the critical values reporting system is not executed comprehensively.

Abstrak :
Laboratorium memiliki potensi bahaya dan risiko yang cukup tinggi karena dalam aktivitas pekerjaannya terkait dengan penggunaan bahan-bahan dan peralatan yang berbahaya. Tidak terkecuali di Laboratorium FKUI yang dalam proses kerjanya sering menggunakan bahan-bahan kimia dan biologi. Terdapat berbagai macam upaya yang dapat dilakukan untuk meminimalisasi risiko K3 di tempat kerja, salah satunya adalah dengan cara memberikan pelatihan K3 guna meningkatkan skill dan pengetahuan para pekerja tentang K3. Sebelum melaksanakan suatu pelatihan maka terlebih dahulu perlu dilakukan analisis kebutuhan pelatihan. Analisis kebutuhan pelatihan terdiri dari tiga tahap analisis, yaitu analisis organisasi, analisis personal dan analisis tugas. Tujuan dari penelitian ini adalah untuk menganalisis kebutuhan pelatihan K3 yang diperlukan oleh para Laboran sehingga pelatihan K3 yang akan diberikan dapat berjalan efektif dan efisien serta dapat menjawab permasalahan terkait K3 di Laboratorium. Desain yang digunakan dalam penelitian ini adalah desain penelitian deskriptif kualitatif. Terdapat 8 informan yang diambil dari 6 Departemen-departemen preklinik FKUI. Metode pengambilan data dilakukan dengan mewawancarai 8 informan, observasi di Laboratorium dan telaah dokumen dari Laboratorium atau Departemen. Hasil dari penelitian ini menunjukkan bahwa organisasi telah mendukung pelaksanaan K3 di Laboratorium meskipun belum secara maksimal dan merata di semua Laboratorium. Terdapat 4 jenis tugas utama Laboran yaitu membantu praktikum mahasiswa, maintenance rutin alat, administrasi dan membantu penelitian Dosen atau Departemen serta sudah dapat menggambarkan jenis pelatihan yang dibutuhkan. Terkait aspek personal didapatkan bahwa pengetahuan dan keterampilan Laboran akan bahaya dan risiko yang ada di Laboratorium sudah cukup baik. Berdasarkan ketiga hal tersebut, pelatihan yang harus segera dilaksanakan adalah Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS), dan Safe Storage.

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Laboratory has a potential of occupational health and safety (OHS) hazards and risks because of the usage of hazardous materials and dangerous equipments. Laboratories of Faculty of Medicine University of Indonesia (FKUI) for instance use number of chemicals and biological materials and thus reduction of OHS risks is necessary. Training is one method of risk control by improving the OHS skills and the OHS knowledge of the workers. Prior to the training implementation, assessing the need of training is necessary. Training needs analysis consists of three stages which are organizational, personal and task analysis. The purpose of this study was to analyze the need of OHS training for the Laboratory Assistants in order to have an effective and efficient training programs that can address the OHS related issues in the Laboratory. The research design was descriptive qualitative. There were 8 informants sampled from 6 FKUI preclinical Departments were interviewed . Observation and document analysis were also done to collect data. The results of this study was shown that the organization has supported the OHS implementation in the Laboratories although not optimally and evenly distributed in all Laboratories. There were 4 Laboratory Assistant main types of tasks that consists of help students practice, routine maintenance tools, administration and assist Departments and Lecturer’s research and was able to describe the type of training required. Related to personal aspects obtained that Laboratory Assistant’s knowledge and skills about hazards and risks in the Laboratories were good enough. Based on those three, the training must be implemented was Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS) and Safe Storage.

Abstrak :
Pendahuluan. Penglepasan interferon-gamma oleh limfosit T yang antigenspecific akan meningkat setelah sel tersebut dipaparkan kembali dengan antigen tuberkulosis (TB) secara in vitro, khususnya apabila sel tersebut berasal dari lokasi infeksi TB aktif. Penelitian ini merupakan uji diagnostik pemeriksaan interferon-gamma release assay (IGRA) metode enzyme-linked immunospot (ELISPOT), yaitu T-SPOT.TB®, untuk deteksi TB pleura menggunakan spesimen sel mononuklear (MN) cairan pleura. Metode. Sebanyak 48 pasien efusi pleura terduga TB dengan karakteristik cairan pleura eksudatif berdasarkan kriteria Light dan dominasi sel MN lebih dari 50% dilakukan pemeriksaan T-SPOT.TB, biakan TB media cair Mycobacterial Growth Indicator Tube (MGIT), dan aktivitas adenosine deaminase (ADA) cairan pleura. Hasil. Dengan baku emas biakan TB MGIT didapatkan nilai sensitivitas 100%, spesifisitas 20%, nilai prediksi positif (NPP) 20%, dan nilai prediksi negatif (NPN) 100%. Dengan baku emas kombinasi biakan TB MGIT dan aktivitas ADA didapatkan nilai sensitivitas 100%, spesifisitas 88,89%, NPP 97,5%, dan NPN 100%. Kesimpulan. IGRA metode ELISPOT menggunakan spesimen cairan pleura merupakan pemeriksaan yang cepat dan bermanfaat sehingga dapat dipertimbangkan sebagai pemeriksaan tambahan pada pasien efusi pleura terduga TB. ......Introduction. The release of interferon-gamma by antigen-specific T lymphocytes increases after rechallenge with tuberculosis (TB) antigen in vitro, especially at a localized site of TB infection. This study aimed to evaluate the diagnostic value of a commercial enzyme-linked immunospot (ELISPOT) assay for interferon-gamma, T-SPOT.TB®, in the diagnosis of TB pleurisy using pleural fluid mononuclear cells. Methods. 48 subjects, presumed to have pleural TB with exudative pleural effusion by Light's criteria, dominated by mononuclear cells, had their pleural fluid specimen tested with T-SPOT.TB, TB Mycobacterial Growth Indicator Tube (MGIT) culture, and pleural fluid adenosine deaminase (ADA) activity. Results. The sensitivity, specificity, positive and negative predictive values of the assay were 100%, 20%, 20%, 100%, respectively, if TB MGIT culture was used as the gold standard, and 100%, 88,89%, 97,5%, 100%, respectively, if TB MGIT culture and ADA activity of pleural fluid were used as the gold standard. Conclusion. The ELISPOT assay for interferon-gamma is useful and rapid so it can be considered as a supplementary test to explore TB pleurisy.