Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Tujuan : untuk mengetahui kejadian VTE pada pasien Indonesia yang menjalani bedah ortopedi mayor dan tidak menerima tromboprofi laksis. Metode Uji klinik terbuka pada pasien Indonesia yang menjalani bedah ortopedi mayor, dilakukan di 3 senter di Jakarta. Venografi bilateral dilakukan antara 5 dan 8 hari pasca bedah untuk menemukan VTE yang asimptomatik dan memastikan VTE yang simptomatik. Pasien dievaluasi hingga 1 bulan pasca bedah. Hasil Telah diteliti 17 pasien dengan median usia 69 tahun dan 76,5% di antaranya perempuan. Enam belas dari 17 pasien (94,1%) menjalani bedah fraktur panggul. Median waktu antara fraktur dengan tindakan adalah 23 hari (antara 2 sampai 197 hari), median lamanya tindakan bedah 90 menit (antara 60 sampai 255 menit), dan median lamanya imobilisasi 3 hari (antara 1 sampai 44 hari). Tiga belas dari 17 pasien menjalani venografi kontras untuk mendeteksi VTE yang asimtomatik. VTE ditemukan pada 9 dari 13 pasien (69,2%) saat akan keluar dari rumah sakit (RS). VTE yang simtomatik ditemukan pada 3 pasien (23,1%), semuanya dengan tanda-tanda klinis DVT dan tidak seorangpun dengan tanda klinis embolisme paru (PE). Pasien tersebut diobati dengan heparin berat molekul rendah, dilanjutkan dengan antikoagulan oral warfarin. Tidak ada kematian mendadak sampai pasien keluar dari RS. Tidak ada kasus VTE simtomatik baru sejak keluar dari RS sampai 1 bulan kemudian. Tidak ditemukan kematian mendadak, komplikasi pendarahan, ataupun perawatan ulang di RS dalam studi ini. Kesimpulan Insidens VTE asimtomatik sebesar 69,2% dan simtomatik 23,1% setelah bedah ortopedi mayor tanpa tromboprofi laksis. Studi yang lebih besar dibutuhkan untuk memastikan insidens yang benar, dan yang lebih penting, untuk menggunakan tromboprofi laksis pada pasien-pasien ini.

---

Aim To estimate the incidence of VTE in Indonesian patients undergoing major orthopedic surgery and not receiving thromboprophylaxis. Methods This was an open clinical study of consecutive Indonesian patients undergoing major orthopedic surgery, conducted in 3 centers in Jakarta. Bilateral venography was performed between days 5 and 8 after surgery to detect the asymptomatic and to confi rm the symptomatic VTE. These patients were followed up to one month after surgery. Results A total of 17 eligible patients were studied, which a median age of 69 years and 76.5% were females. Sixteen out of the 17 patients (94.1%) underwent hip fracture surgery (HFS). The median time from injury to surgery was 23 days (range 2 to 197 days), the median duration of surgery was 90 minutes (range 60 to 255 minutes), and the median duration of immobilization was 3 days (range 1 to 44 days). Thirteen out of the 17 patients were willing to undergo contrast venography. A symptomatic VTE was found in 9 patients (69.2%) at hospital discharge. Symptomatic VTE was found in 3 patients (23.1%), all corresponding to clinical signs of DVT and none with clinical sign of PE. These patients were treated initially with a low molecular weight heparin, followed by warfarin. Sudden death did not occur up to hospital discharge. From hospital discharge until 1-month follow-up, there were no additional cases of symptomatic VTE. No sudden death, bleeding complication, nor re-hospitalization was found in the present study. Conclusion The incidence of asymptomatic (69.2%) and symptomatic (23.1%) VTE after major orthopedic surgery without thromboprophylaxis in Indonesian patients (SMART and AIDA), and still higher than the results of the Western studies. A larger study is required to establish the true incidence, and more importantly, that the use of thromboprophylaxis in these patients is warranted.

Abstrak :
Summary
A retrospective study of 13 Equinus feet of 10 patients of Cerebral Palsy that we were able to collect and review, between December 1985 and November 1988, has been done.

Tendoachilles lengthening by the closed method for 5 feet of 3 patients and open method for 8 feet of 7 cases in those patients has been performed. The result in both methods are comparable.

Although the number of cases of these· two methods were too small for statistical analysis the results find to inaicate that closed ·1 method of Achil les Tendon Lengthening is a good procedure in children with Cerebral Palsy.

Achilles Tendon lengthening for Equi nus has been performed since Ancient times using either an open or closed method.

This is usually performed by an open Z or fractional lengthening of the tendon proper. In 1943, Whi te (5.7 ) was one of the first proponents of · closed method. Nowadays, most of the surgeons have found and consider the · sliding method of lengthening either by the White method or the Hoke method ( 1954} ··more controlled and very satisfactory. However closed method is not a widely used method for treatment of Equinus Contracture in Cerebral Pa1sy.

This study reviews patients with C.P. who had closed or open method of Achi11es Tendon Lengthening in National University Hospital between Cecember 1965 and November 1988.

Abstrak :
Tesis ini membahas analisis dan perancangan Computer Assisted Surgery (CAS) untuk robot ortopedi yang menggunakan metode Rod and Screw Correcive Manipulation (RSCM) dengan tujuan hasil analisis dan perancangan dapat dipergunakan untuk pembuatan prototipe. Penelitian ini dilakukan dengan tahapan: analisis kebutuhan, analisis sistem dan perancangan sistem. Hasil penelitian menerangkan bahwa masukan sistem ini didefinisikan sebagai nilai pengukuran yang dilakukan oleh robot ortopedi, dan keluarannya merupakan tampilan pada layar monitor yang memberikan nilai tekanan, besar sudut koreksi tulang belakang dan amplitudo keadaan syaraf. Proses untuk mendapatkan keluaran dibuat sesederhana mungkin sehingga proses berjalan cepat dan tepat.

---

This thesis discusses the analysis and design of Computer Assisted Surgery (CAS) for orthopedic robot using Rod and Screw Corrective Manipulation (RSCM) methods with the purpose, that the analysis and design can be used for prototyping. This research was carried out in phases: requirements analysis, system analysis and system design. The results explained that the input defined as the value of measurements made by the orthopedic robot, and its output is the display on the monitor which gives the value of pressure, the angle of correction and the amplitude of spinal nerves. The process to get the output was made as simple as possible so the process goes quickly and accurately.

Abstrak :
With the time available to surgeons-in-training ever dwindling, there is great emphasis placed on practical learning tools. Mirroring his earlier book on practical procedures in trauma surgery, Prof Giannoudis has produced a reference in more elective techniques. In most medical schools, most emphasis is placed on orthopaedic trauma surgery, with elective techniques often delayed until much later in a surgeon?s training.

Abstrak :
Tindakan operasi orthopaedi membutuhkan tarif yang tinggi karena dilakukandengan alat berteknologi tinggi, proses perawatan komplek dan seringkali menggunakanimplan berharga mahal. Terdapat variasi tarif rumah sakit pada operasi orthopaedi yangperlu diidentifikasi penyebabnya. Penelitian bertujuan mengetahui komponen tarif danmenganalisa faktor-faktor yang berhubungan dengan tarif operasi orthopaedi pasien JKNpada prosedur anggota tubuh atas, sendi tungkai bawah dan fusi tulang belakang padalengkungan tulang belakang di RSUP Fatmawati tahun 2017. Desain penelitian adalahcross sectional dengan pendekatan kuantitatif melalui menghitung tagihan danpendekatan kualitatif melalui wawancara mendalam. Hasil penelitian menunjukkangambaran rata-rata tarif prosedur anggota tubuh atas Rp22.264.612 terdiri atas komponenbahan alat 51, jasa rumah sakit 14 dan jasa pelayanan 35, gambaran rata-rata tarifprosedur sendi tungkai bawah Rp61.700.637 yaitu bahan alat 75, jasa rumah sakit 10 dan jasa pelayanan 15, dan gambaran rata-rata tarif prosedur fusi tulang belakangRp79.501.208 yaitu bahan alat 63, jasa rumah sakit 11 dan jasa pelayanan 26 .Faktor penggunaan dan harga implan, tingkat keparahan, lama hari rawat, danpenggunaan ICU mempengaruhi tarif pada tiga prosedur, sedangkan faktor metode costplus pricing dan kelas perawatan tidak mempengaruhi tarif pada tiga prosedur. RSUP Fatmawati telah melakukan upaya untuk mengatasi variasi tarif pada komponen bahanalat, jasa rumah sakit dan jasa pelayanan. Rumah Sakit perlu melakukan perhitungan unitcost berkala, pembuatan unit cost pada tagihan yang belum memiliki unit cost,pemenuhan dan kepatuhan Clinical Pathway dan Panduan Praktik Klinis untuk tindakanoperasi khususnya yang memiliki lama hari rawat dan jumlah terbanyakKata kunci: variasi tarif operasi orthopaedi, prosedur anggota tubuh atas, prosedur senditungkai bawah, prosedur fusi tulang belakang pada lengkungan tulang belakang, implan.

---

Orthopedic surgery requires high rates because it is done with high tech tools,complex maintenance process and often use expensive implans. There are variations inhospital rates on orthopedic surgery that need to be identified. The objectives of the studywere to determine the tariff components and to analyze factors related to the operatingtariffs of JKN patients on upper limb procedures, lower limb joints and spinal fusion inthe spinal arch at Fatmawati Hospital 2017. This study is cross sectional study designwith quantitative approach through counting the bill and qualitative approaches throughin depth interviews. The results of this study showed that the average tariff procedure ofthe limbs of Rp22,264,612 consisted of 51 of appliance component, 14 hospitalsservice and 35 service, the average cost of lower limb joint procedure Rp61,700,637, ,hospital services 10 and service 15 , and average picture tariff of spinal fusionprocedure Rp79.501.208 yaitu appliance 63 , hospital services 11 and service 26 .Factors of use and implanation rates, severity, length of stay, and use of ICUs affect tariffson three procedures, while cost plus pricing and treatment class methods do not affecttariffs on three procedures. RSUP Fatmawati has made efforts to overcome the variationof tariff on components of equipment, hospital services and services. Hospital need to calculate unit cost periodically, unit cost creation on bills that do not have unit cost,compliance and compliance Clinical Pathway and Clinical Practice Guidelines forsurgery, especially those with long days of service and the highest numberKey words tariif variations of orthopeadi surgery, upper limb procedures, lower limbjoint procedures, spine fusion procedures in the spinal cord, implans.

Abstrak :
Skripsi ini membahas mengenai tanggung jawab hukum dokter dan rumah sakit dalam tindakan emergency orthopaedi. Selain itu juga membahas peranan informed consent dalam tindakan emergency orthopaedi. Penulis mempertajam penelitian ini dengan menganalisis Putusan No.11/PDT.G/2015/PN.KWG dan No.96/PDT.G/2017/PT.BDG. Permasalahan dalam skripsi ini, yaitu bagaimana tanggung jawab dokter dan rumah sakit serta peranan informed consent dalam tindakan emergency orthopaedi. Sri Lestari mengajukan gugatan perbuatan melawan hukum atas dasar malpraktek sebagaimana yang diatur di dalam Pasal 1365, 1366, dan 1367 KUHPerdata. Dalam skripsi ini, metode penelitian yang digunakan adalah yuridis normatif dengan tipe penelitian, yaitu deskriptif. Untuk dapat dikategorikan perbuatan melawan hukum, maka harus memenuhi unsurunsur sebagaimana yang diatur di dalam Pasal 1365 KUHPerdata. Selain itu, untuk menentukan seorang dokter dan rumah sakit dapat bertanggung jawab dan memberikan ganti rugi, erat hubungannya antara kesalahan dan kerugian yang ditimbulkan. Sehingga dalam kasus ini, dokter dan rumah sakit tidak dapat bertanggung jawab atas kerugian yang diderita oleh Sri Lestari. Dari hasil penelitian ini, disarankan perlu adanya pengawasan dari pihak rumah sakit terhadap segala tindakan medis yang dilakukan oleh tenaga kesehatan untuk menghindari terjadinya kesalahan dalam melakukan penanganan terhadap pasien.
This thesis discusses the legal responsibilities of doctors and hospitals in orthopedic emergency actions. It also discusses the role of informed consent in orthopedic emergency action. The author sharpens this research by analyzing Decision No.11/PDT.G/2015/PN.KWG and No.96/PDT.G/2017/PT.BDG. The problem in this thesis, namely how the responsibility of doctors and hospitals and the role of informed consent in orthopedic emergency action. Sri Lestari filed a lawsuit against the law on the basis of malpractice as regulated in Articles 1365, 1366, and 1367 of the Civil Code. In this thesis, the research method used is normative juridical with the type of research, namely descriptive. To be categorized as an unlawful act, it must meet the elements as regulated in Article 1365 of the Civil Code. In addition, to determine that a doctor and hospital can be responsible and provide compensation, there is a close relationship between errors and losses caused. So in this case, doctors and hospitals cannot be held responsible for the losses suffered by Sri Lestari. From the results of this study, it is suggested that there is a need for supervision from the hospital on all medical actions taken by health workers to avoid errors in handling patients.