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"Latar Belakang: Peningkatan kasus kanker tiroid belakangan ini menimbulkan pertanyaan tentang overdiagnosis. ACR-TIRADS merupakan sistem stratifikasi yang dikembangkan untuk mengurangi overdiagnosis dalam mendeteksi kanker tiroid dengan menggunakan ultrasonografi. AI-TIRADS merupakan modifikasi baru dari ACR-TIRADS yang diklaim memiliki nilai diagnostik yang lebih baik, namun AI-TIRADS belum pernah diuji pada populasi Indonesia. Tujuan: Peneliti ingin mengetahui apakah AI-TIRADS memang benar lebih baik dibandingkan ACR-TIRADS dalam menentukan keganasan suatu nodul tiroid. Metode: Penelitian ini mengevaluasi 124 nodul tiroid yang terdiri atas 62 nodul jinak dan 62 nodul ganas berdasarkan ACR-TIRADS dan AI-TIRADS. Setiap penentuan keganasan didasarkan dari lima kategori yang dipakai oleh TIRADS (komposisi, ekogenisitas, bentuk, tepian dan fokus ekogenik). Hasil temuan kedua sistem stratifikasi risiko ini kemudian dibandingkan nilai diagnostiknya dengan pemeriksaan sitopatologi berdasarkan kriteria Bethesda. Hasil: AI-TIRADS secara umum menunjukkan nilai diagnostik yang lebih baik daripada ACR-TIRADS. Tingkat kesesuaian AI-TIRADS terhadap pemeriksaan sitopatologi lebih baik dibandingkan ACR-TIRADS (0,387 dan 0,242). Spesifisitas AI-TIRADS lebih baik (58,06% vs 41,94%; p< 0,00) dibandingkan ACR-TIRADS, namun sensitivitas AI-TIRADS sedikit lebih rendah dibandingkan ACR-TIRADS (80,65% vs 82,26%; p<0,00). AI-TIRADS juga memiliki nilai duga positif dan nilai duga negatif yang lebih baik dibandingkan ACR-TIRADS (AI-TIRADS: 65,79% dan 75% vs ACR-TIRADS: 58,62% dan 70,27%). Kesimpulan: AI-TIRADS memiliki nilai diagnostik yang lebih baik dan dapat mengurangi jumlah positif palsu, namun AI-TIRADS masih memiliki kesulitan dalam mendeteksi keganasan pada nodul tiroid yang padat kistik. Diperlukan pengembangan lebih lanjut dari AI-TIRADS untuk meningkatkan kemampuan diagnostik dalam menentukan keganasan nodul tiroid, khususnya pada nodul padat kistik.......Background: The recent increase in thyroid cancer cases has raised questions about overdiagnosis. ACR-TIRADS is a risk stratification system developed to reduce overdiagnosis in thyroid cancer detection using ultrasound. AI-TIRADS is a recent modification of ACR-TIRADS claimed to have better diagnostic value, but it has not been tested in the Indonesian population. Objective: The author aimed to determine whether AI-TIRADS is indeed superior to ACR-TIRADS in assessing the malignancy of thyroid nodules. Methods: This study evaluated 124 thyroid nodules, consisting of 62 benign and 62 malignant nodules, based on ACR-TIRADS and AI- TIRADS. Malignancy determinations were based on five categories used by TIRADS (composition, echogenicity, shape, margins, and echogenic foci). The findings of both risk stratification systems were then compared with their diagnostic values in cytopathological examinations based on Bethesda criteria. Results: AI- TIRADS, in general, demonstrated superior diagnostic value compared to ACR- TIRADS. The concordance rate of AI-TIRADS with cytopathological examinations was better than that of ACR-TIRADS (0.387 and 0.242). AI-TIRADS exhibited better specificity (58.06% vs. 41.94%; p < 0.00) compared to ACR-TIRADS, although AI-TIRADS had slightly lower sensitivity (80.65% vs. 82.26%; p < 0.00) compared to ACR-TIRADS. AI-TIRADS also had better positive predictive values and negative predictive values (AI-TIRADS: 65.79% and 75% vs. ACR-TIRADS: 58.62% and 70.27%). Conclusion: AI-TIRADS has better diagnostic value and managed to reduces the number of false positives. However, AI-TIRADS still faces challenges in detecting malignancy in solid cystic thyroid nodules. Further development of AI-TIRADS is needed to enhance its diagnostic capabilities in determining the malignancy of thyroid nodules, especially in solid cystic nodules."

"Latar belakang: Kanker serviks menyumbang angka kematian kanker keempat terbanyak di dunia khususnya di negara berkembang seperti Indonesia dimana didapatkan sebanyak 0,8 kasus kanker serviks per 1000 penduduk. Inspeksi Visual dengan Asam Asetat (IVA) merupakan cara yang efektif untuk deteksi dini kanker serviks dengan nilai sensitivitas yang cukup baik. Pasien dengan hasil IVA positif perlu segera dilakukan tatalaksana untuk mencegah perkembangan lesi prakanker. Namun, krioterapi sebagai pilihan utama terapi belum tersedia luas di Indonesia. Alternatif tatalaksana yang menjanjikan adalah dengan menggunakan larutan Trichloroacetic Acid (TCA). TCA 85% merupakan bahan yang dapat menginduksi keratocoagulation yang mudah ditangani, murah, dan sebelumnya telah terbukti efektif digunakan untuk menangani keganasan lainnya di area vagina dan anus. Tujuan: Mengetahui efikasi TCA 85% pada tatalaksana IVA positif dibandingkan dengan krioterapi.Metode: Penelitian ini merupakan penelitian randomized control trial menggunakan metode non-inferiority study. Subyek penelitian ini merupakan pasien dengan hasil IVA positif yang dirujuk ke Puskesmas Kecamatan Jatinegara, Jakarta Timur. Dilakukan random block sampling untuk menentukan subjek yang mendapatkan terapi TCA (n=36) atau krioterapi (n=36). Selanjutnya dilakukan follow-up pada bulan ke-3 pasca tatalaksana. Dari data yang didapatkan dilakukan analisis bivariat dengan fisher exact test untuk mengetahui hubungan antara variabel.Hasil:Dari 72 subjek yang diteliti, 36 subjek diterapi dengan TCA 85% sedangkan 36 lainnya diterapi dengan krioterapi. Sebanyak 35 (97,2%) pasien yang ditatalaksana dengan TCA 85% mengalami konversi menjadi IVA negatif pada follow-up bulan ke-3, sedangkan seluruh pasien yang ditatalaksana dengan krioterapi menjadi konversi menjadi IVA negatif. Dilakukan analisis bivariat fishers exact test dan didapatkan nilai p sebesar 1,00 (p>0,05). Kesimpulan:Tidak ada perbedaan bermakna dari efikasi penggunaan TCA 85 % dibandingkan dengan krioterapi pada terapi IVA positif.

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Background: Cervical cancer mortality rate accounts for fourth among all cancer. In a Developing country such as Indonesia, the prevalence of cervical cancer is 0,8 case per 1000 population. Visual Inspection with Acetic Acid (VIA) is an effective cervical cancer screening method. Patients with positive VIA result have to be immediately treated in order to avoid cancer progression. However, cryotherapy as the first line treatment of positive VIA result is not currently widely available in Indonesia. Alterative treatment using Trichloroacetic Acid (TCA) solution is a promising treatment alternative to cryotherapy as it is cheap and easy to be handled. Furthermore, TCA has been proven to be effective to treat vaginal and anal neoplasia.Objective: To investigate the effectiveness TCA 85% compared to cryotherapy to treat patients with positive IVA result.Method: This is a non-inferiority randomized controlled trial study. Patients with positive VIA result referred to Jatinegara Primary Health Center were included in this study. Eligible samples were then treated with either TCA 85% or cryotherapy. The treatment was determined using simple random sampling method. Samples were then followed up 3 months after treatment in order to determine VIA result conversion.Result: Thirty-six patients were treated with TCA 85% and 36 others were treated with cryotherapy. 35 (97,2%) patients treated with TCA 85% converted to negative VIA, whereas all of the patients that were treated with cryotherapy convert to negative VIA. Bivariate analysis fisher exact test was then conducted with a result P value of 1,00 (p > 0,05).Conclusion: There were no statistically significant difference of result between TCA and Cryotherapy for treating patients with positive VIA result."

"Cytologic diagnosis by examination of exfoliated cells in serous cavity fluids is one of the most challenging areas in clinical cytopathology. Almost 20% of the effusions examined are directly or indirectly related to the presence of malignant disease, with carcinoma of the lung as the most common underlying culprit. This volume published in the essentials in cytopathology book series will fulfill the need for an easy-to-use and authoritative synopsis of site specific topics in cytopathology. These guide books fit into the lab coat pocket, ideal for portability and quick reference. Each volume is heavily illustrated with a full color art program, while the text follows a user-friendly outline format."

"Cytopathology of infectious diseases is the first book of its kind to focus entirely on the cytopathology of infectious diseases. It contains all of the pertinent information about the cytology of infectious diseases and microorganisms and will serve as an ideal handy reference. This unique volume covers the cytomorphology of various microorganisms and the host reactions they elicit, and also incorporates an update on advances in the field. Newly recognized infections such as the recent discovery of the Merkel Cell Polyomavirus (MCV) are included, as well as the utility of new immunostains (e.g. CM2B4 for MCV) and the role of molecular techniques that assist in the identification, classification and even quantification of microorganisms. Each chapter is succinctly written and concisely referenced with key published articles and resources. The volume includes practical pointers, useful diagnostic criteria, differential diagnoses and potential pitfalls. Many color images of high resolution that illustrate microorganisms (e.g. branching hyphae) and host reactions (e.g. viral cytopathic effect) are included throughout. Relevant tables with diagrams that provide quick reference guides are incorporated. "

"Serous (peritoneal, pleural and pericardial) effusions are a frequently encountered clinical finding in everyday medical practice and one of the most common specimen types submitted for cytological evaluation. The correct diagnosis of effusions is critical for patient management, as well as for prognostication and yet many clinicians find diagnosis and treatment of cancer cells in effusions very challenging.Featuring multiple microscopic illustrations of all diagnostic entities and ancillary techniques (immunhistochemistry and molecular methods), this book provides a comprehensive, authoritative guide to all aspects of serous effusions, including etiology, morphology and ancillary diagnostic methods, as well as data related to therapeutic approaches and prognostication. Section one covers diagnosis for benign and malignant effusions including the etiological reasons for the accumulation of effusions that provides the reader with the full spectrum of differential diagnoses at this anatomic site. Section Two discusses biology, therapy and prognosis highlighting clinical approaches that may be of value to patients and the movement towards personalized medicine and targeted therapy."