Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: Cisplatin merupakan kemoterapi efektif dengan spektrum luas. Efek terapeutiknya bertambah bermakna pada peningkatan dosis. Namun aplikasi dosis tinggi (>50 mg/m2) dibatasi nefrotoksisitasnya yang berat.Tujuan: Mempelajari efek cisplatin terhadap aktivitas eritropoiesis, kadar eritropoietin dan fungsi ginjal pasien tumor padat ganas.Metode dan Cara : Studi pre & post sejak Nopember 2004 sampai Januari 2005 dilakukan pada 14 pasien kanker tumor solid (KNF, Osteosarkoma, Ca paru) yang mendapat rejimen kemoterapi mengandung cisplatin dosis 70-100 mg/m2. Pengambilan sampel dilakukan pra, pasta kemoterapi 1 dan II, dengan rentang 21 hari. Analisis univariat dilakukan terhadap usia, Janis kelamin, Janis tumor dan stadium klini.k Dilakukan analisis bivariat pads komponen eritropoiesis, kadar EPO dan TKK hitung..Hasil : Didapatkan tumor solid berupa karsinoma nasofaring (88,24%), osteosarkoma (5,88%) dan adenokarsinoma pare (5,88%). Di mana stadium III (70,6%) dan stadium IV (29,4%). Didapatkan penurunan nilai Hb bermakna pasca siklus 110,74% (p = 0, 029)_ Pasca siklus H, Hb turun 1% (p = 0,37). Evaluasi pasca 2 siklus, lib turun 7,7% (p 0, 035). Hasil yang sama didapatkan pada nilai Ht, pasca kemoterapi siklus I (p = 0,03) dan pasca 2 siklus (p = 0, 008). Sedangkan pasca siklus II tidak bermakna (p = 0,594). Jumlah eritrosit pasca siklus I turun 13% (p = 0,00) dan pasca siklus II turun 8,7% (p = 0,00). Jumlah eritrosit turun 20,8% pasca 2 siklus (p = 0,00). Pasca 2 siklus, indeks retikulosit turun 1,59% (p = 0,975). Kadar eritropoietin pasca siklus I turun 12,7% (p = 0,73), pasta siklus II turun 20% (p = 0,03). Pasca 2 siklus didapatkan penurunan eritropoietin 30% (p = 0,925). TKK hitung mengalami penurunan pasta siklus 112,65% (p = 0,052) dan Il 0,4% (p = 0,157). Pasca 2 siklus TKK hitung turun sebesar 13% (p = 0,052). Terdapat korelasi lemah antara eritropoietin dan jumlah eritrosit pasca siklus H. Tidak didapatkan korelasi antara eritropoietin dengan Hb, indeks retikulosit dan TKK hitung.Kesimpulan: Pemberian cisplatin dosis tinggi (70-100 mg/m2) menyebabkan penurunan eritropoiesis, TKK hitung. Penurunan kadar eritrbpoietin tidak berkorelasi gagal ginjal akut Penurunan jumlah eritrosit disebabkan pula oleh rendahnya nilai eritropoeitin.

---

Background: Cisplatin (Cis diaminodichloro Platinum II) is known as an effective broad spectrum anti tumor. Even though, the nephrotoxicity is one of serious side effects. The accumulation of toxic effects against to tubules area, where erythropoietin is produced, causes acute renal failure and anemia.Purpose: To study the effect of 2 cycles cisplatin against erythropoiesis, erythropoietin level and creatinine clearance at patients with solid tumor cancer.Methods: Pre and post study was done to 14 solid tumor cancer patients that receive high dose cisplatin regiment (70-100 mglm2). Hb, Ht, erythrocyte count, erythropoietin level and calculated creatinin clearance test were determined before each cycle. Age, sex, tumor type, clinical stages were evaluated Statistical analysis was done with student T and Wilcoxon Rank and Pearson correlation.Results: Tumors were NPC 88.24%, Adeno Ca 5.88% and Osteosarcoma 5.88%. Clinical stage Ili 70.6% and IV 29.4%. There were decline level among groups after 1" cycle in Hb (10.74%, p=O.029), Ht (7.6%, p=0.03), erythrocyte count (13%, p=0.OO), erythropoietin level (12.7%, p=4.73) and creatinin clearance (12.65%, p4'.1052). After 2°d cycle, there were decline in Hb (1%, pl.37), Ht (1.46%, p 4l.59), erythrocyte count (8.7%, p=0.00), erythropoietin level (20%, p.03) and creatinin clearance (0.4%, p 0.15).Reticulocyte index was not reduce after 1" and 2"d cycle. After 2 cycles assessment, there were decline level in Hb (7.7%, p=0.035), Ht (48.7%, p=0.008), erythrocyte count (20.8%, p=0.00), erythropoietin level (30%, p4.).92) and creatinin clearance (13%, p=0.022).There is a low correlation between erythropoietin level and erythrocyte count after 1 s` (r-0,397, p=0,159) and 2nd cycle (r x.46, p l.09). Variable's correlation between erythropoietin level and Hb, reticulocyte index, erythrocyte count did not reach statistical significance.Conclusion: High dose cisplatin (70-100 mglm2) cause decrease in eritropoiesis process and creatinin clearance. Decreasing erythropoietin level is not affected by acute renal failure. Low erythrocyte count is also caused by low level of erythropoietin."

"Pendahuluan: Status batas sayatan merupakan faktor prognostik penting pada operasi tumor ganas solid. Frozen section (FS) sebagai baku emas batas sayatan intraoperatif butuh waktu tunggu dan alat FS mahal. Pewarnaan vital (PV) adalah metode pewarnaan pada sel hidup tanpa menyebabkan kematian sel. Tujuan penelitian ini adalah didapatkannya cara cepat untuk membedakan tumor ganas solid dengan jaringan normal. Metode: Studi dilakukan pada pasien tumor solid yang dioperasi oleh Bedah Onkologi RSCM periode Desember 2017 – April 2018. Penelitian ini disetujui oleh Komite Etik FKUI/RSCM. Kriteria eksklusi adalah sampel berukuran <5 mm, jaringan nekrosis, dan tidak setuju ikut penelitian. Total 150 pasien tumor solid (payudara, tiroid, mulut, dan lain-lain). Spesimen dibelah dua (mirroring technique) sebagai sampel perlakuan dan kontrol. Sampel perlakuan disemprot dengan asam asetat 10%, dibilas, lalu disemprot iodin, lalu bilas dengan akuades. Perubahan menjadi putih (acetowhitening) merupakan hasil positif. Bila berubah kuning kecoklatan merupakan hasil negatif. Ahli PA di-blinding. Hasil PA fokus ganas atau ganas tergolong hasil positif. Hasil PA selain hasil tersebut dicatat sebagai negatif. Analisis Data: Metode riset berdasarkan VIA (Visual Inspection Acetic Acid) dari WHO. Data dianalisis dengan IBM SPSS versi 25, menggunakan chi square. Hasil: Dari 150 pasien didapatkan 520 sampel. Sensitivitas staining 82%, spesifisitas 63,5%, PPV 65,8%, NPV 80,5%. Pada subgrup tumor payudara epitelial sensitivitasnya 100%, spesifisitas 79,3%, PPV 66,8%, NPV 100 %. Pada kasus tiroid sensitivitas 65,7%, spesifisitas 83,3%, PPV 92%, NPV 45%. Kasus tumor rongga mulut sensitivitasnya 94,1%, spesifisitas 33,3%, PPV 88,9%, NPV 50%. Diskusi: Staining ini bereaksi positif terhadap tumor ganas solid secara umum dan bereaksi negatif terhadap jaringan normal. Sensitivitas tertinggi pada kasus tumor payudara dan rongga mulut, dan spesifisitas tinggi pada kasus tiroid. Iodin bereaksi terhadap glikogen, namun struktur sel yang bereaksi dengan asam asetat adalah protein inti sel dan sitoplasma. ......Introduction: The surgical margin is an important prognostic factor in solid cancer surgery. Frozen section (FS) as the gold standard for intraoperative surgical margin evaluation but requires waiting time and expensive FS devices. Vital staining (VS) is a method of coloring on living cells without causing cell death. The purpose of this study was to obtain a quick way to distinguish solid cancer from normal tissue or nonmalignant tumor. Methods: The study was conducted on solid tumor patients who were operated on by RSCM Surgical Oncologic Division in the period December 2017 - April 2018. This study was approved by the Ethics Committee of FMUI / RSCM. Exclusion criteria were samples measuring less than 5 mm, tissue necrosis, and the patient did not agree to join the study. A total of 150 of solid tumors (breast, thyroid, mouth, etc.) patients. The specimen is divided (mirroring technique) as a treatment and control sample. The treatment sample was sprayed with 10% acetic acid, rinsed, then sprayed with iodine, then rinse with distilled water. Acetowhitening reaction of the sample is a positive result. But if the sample turns brownish yellow, it is a negative result. The pathologist is blinded in this study. Focused or malignant lesion of PA results are classified as positive results. The results of PA other than these results are recorded as negative. Data Analysis: Research method based on WHO (Visual Inspection Acetic Acid). Data were analyzed with IBM SPSS version 25, using chi square. Results: From 150 patients 520 samples were obtained. Staining sensitivity was 82%, specificity was 63.5%, PPV was 65.8%, NPV was 80.5%. In the subgroup epithelial breast tumor, the sensitivity was 100%, specificity was 79.3%, PPV was 66.8%, NPV was 100%. In the case of thyroid sensitivity 65.7%, specificity 83.3%, PPV 92%, NPV 45%. For oral cancer cases sensitivity 94.1%, specificity 33.3%, PPV 88.9%, NPV 50%. Discussion: This staining reacts positively to solid malignant tumors in general and reacts negatively to normal tissue. The highest sensitivity in breast and oral cavity tumors cases, and high specificity in the of thyroid cases. Iodine reacts to glycogen, but the cell structure that reacts with acetic acid is nuclear and cytoplasmic protein."

"Terapi Paliatif bertujuan untuk meningkatkan kualitas hidup dan mengurangi gejala, namun menambah kompleksitas terapi pasien. Penelitian ini bertujuan untuk menganalisis profil pengobatan dan prevalensi DRPs yang terjadi pada pasien yang menjalani terapi paliatif di RSK 'Dharmais'. Penelitian ini adalah penelitian cross sectional. Data pada penelitian diambil secara prospektif dari data medis pasien bulan maret sampai juni 2011. Karakteristik pasien, 33 orang (68,8%) perempuan, 15 orang (31,3%) laki-laki, dan kasus kanker padat terbesar adalah kasus kanker payudara sebanyak 15 orang (33,3%). Berdasarkan profil pengobatan, 64,6% hanya menjalani satu kali terapi paliatif. Reaksi obat yang tidak diinginkan (ROTD) manifestasi dialami olah 70,1% subyek uji dan 66,2% mengalami ROTD potensial. Lima koma tujuh persen (5,7%) mengalami interaksi dengan signifikansi moderate dan 15,0% terjadi karena pemakaian morphine, dan amitriptyline. Peningkatan risiko kejadian ROTD dipengaruhi oleh (1) usia, bertambahnya usia tidak selalu menyebabkan peningkatan ROTD manifestasi; (2) jenis kelamin, laki-laki akan lebih berisiko mengalami peningkatan ROTD manifestasi; (3) riwayat rejimen kemoterapi kuratif, meningkatkan risiko ROTD manifestasi; (4) penyakit penyerta, meningkatkan risiko ROTD manifestasi dan potensial; (5) jumlah obat; penggunaan > 5 jenis obat dapat meningkatkan risiko ROTD manifestasi dan ROTD potensial. Risiko kejadian interaksi obat dipengaruhi oleh faktor adanya penyakit penyerta dan penggunaan > 5 jenis obat. ......The goal of palliative care is to increase the quality of life and to reduce the symptomps, but its often increace the complexity of patient's therapy. The aim of these research is to analyst the patient's therapy profile and the prevalence of DRPs of patient undergoing the palliative care at 'Dharmais' Hospital National Cancer Center. This reasearch is a cross sectional study. The data of the research is prospectively taken from the patients' medical records start from march to june 2011. The patient characteristic who followed the reasearch are 33 patients (68.8%) women, 15 patient (31.3%) men, and the most solid cancer case are breast cancer, 15 patients (31.3%). Based on therapy profile, 64.6% only had once palliative care. Manifest adverse reaction happen in 70.1% patient of subject and 66.2% subjects get potential adverse reaction. Five point seven percent (5.7%) of drug interaction had moderate signification, 15.0% caused by the morphine, and amitriptyline use. The risk of incident adverse reactions influenced by (1) age, increasing the age not always increase the risk of having the manifest adverse reaction, (2) sex, men will have higher risk of manifest adverse reaction, (3) history of curative chemotherapy regimen, increase the risk of manifest adverse reaction, (4) comorbidities will increase the risk of manifest and potential adverse reaction, (5) the number of drug use, using more than 5 drugs ( > 5 drugs) will increase the risk of manifest and potential adverse reaction. The risk of drug interaction will increase because of the comorbidities and the number of drugs using ( > 5 drugs)."