Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Pendahuluan: Fatigue merupakan gejala yang paling mengganggu bagi pasien sirosis, dan menurunkan kualitas hidup pasien, sehingga perlu dilakukan penelitian tentang faktor yang paling berpengaruh terhadap fatigue pada pasien sirosis.

Metode: Desain penelitian cross sectional, jumlah sampel 70 orang, teknik pengambilan sampel: consecutive sampling. Data dikumpulkan menggunakan lima kuesioner: karakteristik responden, FSS, MOSsss, self efficacy for managing chronic disease 6 item scale, hasil laboratorium Hb dan skor child pugh. Analisis data dengan chi square dan regresi logistik.

Hasil: Terdapat tiga faktor yang paling berpengaruh terhadap fatigue pada pasien sirosis, diantaranya: anemia: OR = 6,556 (95%CI = 1,683 ; 25,535), dukungan sosial: OR = 5,914 (95%CI = 1,582 ; 22,113) dan self efficacy: OR = 4,559 (95%CI = 1,395 ; 14,901). Ketiga faktor tersebut dapat dijadikan acuan, dalam melakukan intervensi keperawatan yang tepat, untuk mengatasi fatigue pada pasien sirosis.

Rekomendasi: Perawat perlu memiliki format pengkajian deteksi dini fatigue yang valid, dan pemberian edukasi terkait faktor risiko fatigue.

---

Introduction: Fatigue is the most disturbing symptom for patients with cirrhosis, and decreases patients quality of life, so it is necessary to do research on the factors that most influence fatigue in patients with cirrhosis.

Method: Cross sectional study design, total sample 70 respondent, sampling technique: consecutive sampling. Data were collected using five questionnaires: respondent characteristics, FSS, MOSsss, self efficacy for managing chronic disease 6 items, laboratory Hb results and child pugh score. Data analysis with chi square and logistic regression.

Results: There were three factors that most influenced fatigue in cirrhotic patients, including: anemia: OR = 6.556 (95% CI = 1.683; 25,535), social support: OR = 5,914 (95% CI = 1,582; 22,113) and self efficacy: OR = 4,559 (95% CI = 1,395; 14,901). These three factors can be used as references, in carrying out appropriate nursing interventions, to overcome fatigue in patients with cirrhosis.

Recommendation: Nurses need to have a valid fatigue early detection assessment format, and education regarding risk factors for fatigue.

Abstrak :
The recent advances of endoscopic examination had proven that source of upper gastrointestinal bleeding in liver cirrhosis is not always caused by esophageal varices rupture but also gastric mucosal lesion. The prevalence of gastric ulcer in patients with liver cirrhosis is higher than healthy individuals. Imbalance of defensive and aggressive factors of gastric mucosa may involve in development of portal hypertensive gastropathy (PHG). Several studies reported hemodynamic changes associated wuth portal hypertension causing decreased mucus layer thickness as one of mechanism of PHG. Other dialogic factors of PHG were hypoacidity, hypergastrinemia, reduced hexosamin concentration, mucus metabolic function associated with decreased prostaglandin E2, and increased nitric oxyde which had caused mucus wall thickness changes. Gastric mucus damage induced by portal hypertension has important role in the pathogenesis of gastric ulcer in liver cirrhosis.

Abstrak :
ABSTRAK
Nama : Ario Perbowo PutraProgram Studi : Ilmu Penyakit DalamJudul : Faktor-Faktor yang Berhubungan dengan Pelaksanaan Surveilans untuk Deteksi Dini Karsinoma Hepatoselular pada Pasien Sirosis Hati Latar Belakang: Sedikitnya pasien KHS yang didiagnosis melalui surveilans diduga merupakan penyebab terus rendahnya angka kesintasan, sehingga penting untuk diketahui proporsi pelaksanaan surveilans untuk deteksi dini KHS pada pasien sirosis hati dan faktor-faktor yang berhubungan. Tujuan: Mengetahui proporsi pelaksanaan surveilans untuk deteksi dini KHS pada pasien sirosis hati dan faktor-faktor yang berhubungan. Metode: Studi kohort retrospektif pasien sirosis hati di RSCM periode Januari - Desember 2013. Data didapatkan dari rekam medis dan dikonfirmasi ulang dengan telepon. Surveilans disyaratkan USG abdomen dengan atau tanpa AFP minimal satu kali setahun dalam 3 tahun setelah periode tersebut. Faktor-faktor yang diteliti adalah jenis kelamin, suku bangsa, tingkat pendidikan, tingkat penghasilan, ketersediaan jaminan pengobatan, lokasi tempat tinggal, keberhasilan edukasi surveilans, etiologi sirosis, serta derajat beratnya sirosis. Uji regresi logistik digunakan untuk mengetahui faktor-faktor yang berhubungan dengan pelaksanaan surveilans. Hasil: Dari 200 pasien sirosis hati, 50 pasien 25,0 menjalani surveilans, 150 pasien 75,0 tidak menjalani surveilans. Analisis bivariat menghasilkan 4 variabel dengan nilai p < 0,25 yaitu jenis kelamin p = 0,056 , suku bangsa p = 0,231 , keberhasilan edukasi surveilans p = 0,005 , dan derajat beratnya sirosis p = 0,005 . Analisis multivariat menghasilkan faktor risiko terlaksananya surveilans adalah keberhasilan edukasi surveilans OR 2,615, IK 95 1,332 - 5,134 , p = 0,005 dan derajat beratnya sirosis OR 2,766, IK 95 1,413 - 5,415 , p = 0,003 . Simpulan: Keberhasilan edukasi surveilans dan derajat beratnya sirosis merupakan faktor-faktor yang berhubungan dengan pelaksanaan surveilans untuk deteksi dini KHS pada pasien sirosis hati. Kata Kunci: Sirosis hati, surveilans, faktor yang berhubungan.

---

ABSTRACT
Name Ario Perbowo PutraStudy Program Internal MedicineTitle Factors Related to The Implementation of Surveillance for Early Detection of Hepatocellular Carcinoma in Patients with Liver Cirrhosis Background Minimal number of KHS patients diagnosed through surveillance is thought to be the cause of continued low survival. It is important knowing the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors. Objective Determine the proportion of surveillance for early detection of KHS in patients with liver cirrhosis and related factors. Methods Retrospective Cohort study of patients with liver cirrhosis at RSCM from January to December 2013. Data obtained from medical records and reconfirmed by telephone. Surveillance is required for abdominal ultrasound with or without AFP at least once a year within 3 years after that period. Factors studied were gender, ethnicity, education level, income level, availability of medical assurance, location of residence, surveillance education successfulness, cirrhosis etiology, and severity of cirrhosis. Then logistic regression test is used in the multivariate analysis. Results From 200 patients, 50 patients 25,0 underwent surveillance, 150 patients 75,0 did not. Bivariate analysis resulted in 4 variables with p

Abstrak :
Sirosis hati merupakan penyakit hati kronis yang mempunyai komplikasi seperti varises esophagus, asites dan ensefalopati hepatikum. Karena bersifat kronis dan tidak bisa dipulihkan serta adanya komplikasi dari penyakit tersebut, maka secara substansial akan mengurangi kualitas hidup mereka. Oleh karena itu, diperlukan manajemen diri yang baik dalam mengelola penyakit sirosis demi menjaga agar tetap memiliki kualitas hidup yang baik pula. Penelitian deskriptif analitik dengan pendekatan cross-sectional ini bertujuan untuk melihat apakah ada hubungan antara self management dengan kualitas hidup pada pasien dengan sirosis hati di poliklinik RSUPN Dr.Cipto Mangunkusumo. Jumlah sampel pada penelitian ini adalah 102 yang ditentukan berdasarkan non probability sampling. Penelitian ini menggunakan 3 kuesioner yang terdiri dari kuesioner karakteristik demografi, Self Management dan Chronic Liver Desease Quationnare (CLDQ). Hasil penelitian menunjukkan adanya hubungan bermakna antara self management dengan kualitas hidup pada pasien dengan sirosis hati (p=0,002, α=0,05). Peneliti menyarankan perlunya upaya peningkatan self management pada pasien sirosis hati guna meningkatkan kualitas hidup mereka.

---

Liver cirrhosis is a chronic liver disease that has complications such as esophageal varices, ascites and hepatic encephalopathy. It has been reported that this chronic disease affects quality of life. Self management is deemed to contribute the quality of life in patient with chronic disease. This analytic descriptive study with a cross-sectional approach aimed to investigate relationship between self management and quality of life in patients with outpatient cirrhosis. The number of samples in this study was 102 which were determined based on non probability sampling. This study used 3 questionnaires consisting of demographic characteristic questionnaires, Self Management and Chronic Liver DeseaseQuationnare (CLDQ). The results indicate the majority of respondents have good self management (57 people) and have a good quality of life (53 people). Analysis data also showed there was a significant relationship between self management and quality of life in patients with liver cirrhosis (p = 0.003, α = 0.05). Thus, it is recommended that the need to increase self-management in liver cirrhosis is important in patients with liver cirrhosis.

Abstrak :
Background Hepatic encephalopathy is found in 50-70% cases of liver cirrhosis. Management of hepatic encephalopathy is based on the hypothesis of ammonia and false neurotransmitters. A vegetable diet is the diet of choice, since vegetable proteins have a high biological value, contains non-ammonigenic essential amino acids, and contains fiber. The results of soy fermentation by Rhizopus sp can increase the nutritional value to make it easier for body digestion. Study aim To determine improvements in hepatic encephalopathy by measuring the ammonium level and determining the psychometric test in patients with liver cirrhosis receiving a tempe diet compared to those receiving a liver diet (conventional diet). Method This is a random open clinical trial with a proportional stratification according to the Child Pugh criteria. Study subjects are patients with liver cirrhosis who are hospitalized at the Internal Medicine Ward and ambulatory patients at the out-patient Gastro-hepatology Polyclinic of Dr. Sarjito Public General Hospital, from January 1999 to May 2000. The trial was conducted for 20 days, where the first (trial) group was given a tempe diet, while the second (control) group was given liver diet Will (conventional). Measured outcomes include peripheral blood ammonium level, and psychometric test using the Numeric Connection Test (NCT). Results In the first group, we found a significant reduction of ammonium level in Child-Pugh A patients and a non-significant reduction in Child-Pugh B/C patients, a non-significant psychometric test improvement in Child-Pugh A patients, and significant psychometric test improvement in Child-Pugh B/C patients. In group II: there is no significant difference in the changes in ammonium level or psychometric test in patients from both Child-Pugh categories. Conclusion A 20-day tempe diet can reduce ammonium levels and improve results on the psychometric test. Key words: liver cirrhosis, hepatic encephalopathy, tempe diet, numeric connection test, Child-Pugh criteria

Abstrak :
Background: Thin study aimed to investigate gastric mucosa mucous layer thickness in portal hypertensive gastropathy (PHG) compare to normal mucosa in functional dyspepsia and its correlation with several variables such as child class, severity of esophageal varices and gastropathy. Materials and Methods: Biopsy specimens were taken from the antrum and corpus from both group of patients with PHG and functional dyspepsia. The specimen was given cryometric for frozen section. Tissue were sliced by sagital section II urn, placed in object glass, fixed and stained to evaluate mucous thickness and giemsa stained to observe Helicobacter pylori. Measurement of mucous thickness was done upward muscularis mucosa started from upper epithelial layer from faveale tip until outer mucous layer on 15 points which were marked randomly and calculate the mean value by micrometer (/jm). Results: Mean value of antral mucous thickness in PHG was 13.30 ± 6.5 fim, while in the functional dyspepsia it was 25.59 ± 5.66 /an. Statistical analysis for both kinds of mucous thickness was p<0.001. Mean corpus mucous thickness in PHG was 10.6 ± 6.81 /jm, while mucous thickness in dyspepsia was 32.54 ± 6.51 fjm. Statistical analysis revealed p<0.001. This result showed significant difference of mucous thickness of antrum and corpus statistically between PHG and dyspepsia as control group. Conclusion: The study had proven the presence of decreased gastric mucosa mucous layer thickness in corpus and antrum in PHG. Thus, therapeutic approach to increase mucous thickness must be considered in patients with PHG.

Abstrak :
Tujuan : Untuk meningkatkan peran radiodiagnostik dalam mendeteksi adanya varises esofagus yang belum berdarah serta menilai ketepatan diagnostik pemeriksaan barium esofagogram dalam mendiagnosis varises esofagus pada pasien dengan sirosis hati. Bahan dan Cara : Pemeriksaan esofagogram dilakukan pada 25 pasien, dengan usia antara 23 tahun-80 tahun. Jenis kelamin terbanyak laki-laki 17 orang (68 %) sedangkan perempuan 8 orang (32%), semua pasien dengan kelainan sirosis hati yang belum berdarah (hematemesisl melena) dan hipertensi portal. Varises esofagus yang belum berdarah telah diperlihatkan dengan baik dengan pemeriksaan esofagogram yang hasilnya dikorelasikan dengan temuan endoskopi sebagai bake emas. Hasil dan Kesimpulan Pada uji statistik didapat hasil sensitifitas pemeriksaan esofagogram 84% dengan spesifisitas 0%, nilai PPV 100%. dan NPP 0%. Nilai Kappa dari pemeriksaan ini 0,79 didapat kesesuaian baik. Hasil penelitian ini memperlihatkan esofagogram dapat dipergunakan untuk menilai adanya varises esofagus pada pasien sirosis hati yang belum berdarah. Dari penelitian ini juga didapat kesesuaian yang baik antara pemeriksaan endoskopi dan esofagogram.

---

Purpose : To improve the role of radiodiagnosis in detecting unruptured esophageal varices and to evaluate the accuracy of barium esophagogram in establishing the diagnosis of esophageal varices in patients with liver cirrhosis. Material and method : Esophagogram is performed in 25 patients (23-80 years old). 17 patients (68%) are male and 8 patients (32%'- are female. All patients are suffering from uncomplicated liver cirrhosis (no hematemesis or nrelena) and portal hypertension. Unruptured esophageal varices is visualized well using esophagogram, and the result is compared to endoscopic finding as gold standard. Result and conclusion : Statistical analysis concluded that esophagogram has 84% sensitivity, 0% spesfficity, 100% PPV value and 0% NPP value. Kappa score from this examination is 0,79 with good correlation. This study shows that esophagogram can be used to evaluate esophageal varices in patients with uncomplicated liver cirrhosis. There is good correlation between esophagogram and endoscopic examination.

Abstrak :
Spontaneous bacterial peritonitis (SBP) is one of serious complication of liver cirrhosis. Most of the patient with SBP have severe reduced liver function that clasified as Child Plugh class C. There are other risk factors for SBP such as poor nutritional status, GI bleeding, intravascular catheter insertion, ascites fluid protein concentration of less than I g/L, large volume paracentesis, urinary tract infection and respiratory tract infection. The management of SBP is mainly the administration of proper antibiotics. The antibiotic of choice for the emperial treatment is cefotaxim.

Abstrak :
Peptic ulcer is a clearly marginated ulceration in mucosal membran that can penetrate until muscularis layer and resulted from imbalance between aggressive factor (gastric acid and pepsin) and defensive factor (gastric mucous, bicarbonate and prostaglandin, mucosal blood flow, and cell replacement). Factors that can act as aggressive factor include H. pylori, NSAID, and smoking. Duodenal ulcer is frequently associated with H. pylori, in which Helicobacter pylori is found in 95 - 100% of duodenal ulcer patients.. It was reported, a 39 years old female patient with cirrhosis hepatis who suffered from melena in which endoscopic examination revealed duodenal ulcer as a source of bleeding.The re was no H. pylori, based on serologic examination (IgG antiHP) and culture. The ulcer is suspected caused by NSAID based on history of using traditional medicine that may contain NSAID. Treatment with proton pump inhibitor and sucralfate can heal the ulcer after two week treatment.