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ABSTRAK
Frequent upper respiratory tract infections and allergic reactions may cause upper respiratory tract obstruction (OURT). Mouth breathing (MB) occurs in individuals with nasal breathing problems. A person with MB will raise his head higher; thus, MB is a risk factor for head posture (HP) deviation. Children with MB during growth and development may exhibit dentocraniofacial (DCF) deviation. Objective: To evaluate the prevalence of MB, HP, and DCF deviation in OURT patients to know risk factors of HP deviation, morphological aberrations of DCF and DCF deviation growth and development. Methods: This cross sectional study included 285 OURT subjects aged 9 until 15 years. Data obtained from cephalometric analysis, physical examination, and questionnaires were analyzed. Results: Of 285 OURT subjects, 80.4% showed MB, 44.2% HP deviation, and 66.7% DCF deviation. As risk factors for DCF deviation, MB and HP showed odds ratios of 20.45 and 8.11 and population attributable risks of 87.5% and 59.7%, respectively. Conclusion: The prevalence of MB and DCF deviation in OURT patients is high, but that of HP deviation is generally comparable. MB and deviated HP are risk factors for DCF deviation growth and development.

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Penelitian survival secara historical cohort pada enam puluh dua penderita tumor ovarium borderline. Terdapat 9 penderita stadium FIGO IA, 9 stadium IC, 3 stadium IIIA, 2 stadium IIIB, 4 stadium IIIC, 1 stadium IV dan 34 stadium inadekuat. Dua puluh satu penderita dilakukan pembedahan radikal, 10 penderita hanya dilakukan histerektomi total dan salfingo-ooforektomi bilateral, 6 penderita dilakukan pembedahan konservatif, 24 penderita hanya dilakukan unilateral salfingo-ooforektomi atau kistektomi dan 1 penderita hanya biopsi saja. Enam belas penderita mendapat kemoterapi adjuvan kombinasi dengan platinum base, yaitu 8 penderita stadium inadekuat, 7 stadium III dan 1 stadium IV. Lama pengamatan lanjut antara 0,002 sampai 10,48 tahun dengan median 3,5 tahun. Lima puluh sembilan penderita tetap hidup. Tiga penderita meninggal karena penyakitnya. Residif terjadi pada 4 penderita. Ketahanan hidup penderita 2 tahun 96% dan 10 tahun 94%. Pada test ?log rank? didapatkan residu dan tipe histologi merupakan faktor prognostik yang bermakna mempengaruhi survival. (Med J Indones 2002; 11: 222-9)

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Sixty-two patients with borderline tumors of ovary were historical cohort analyzed for survival characteristics. There were 9 patients with FIGO stage IA, 9 with stage IC, 3 with stage IIIA, 2 with stage IIIB, 4 with stage IIIC, 1 with stage IV and 34 with inadequate stage tumors. Twenty one patients had surgical staging with radical surgery, 10 patient had at least a total abdominal hysterectomy and bilateral salpingo-oophorectomy, 6 patient had surgical staging with conservative surgery, 24 patient had at least a unilateral salphingo-oophorectomy or ovarian cystectomy and 1 patient had biopsy. Sixteen patients received cisplatin-based combination chemotherapy, that were 8 with inadequate stage tumors, 7 with stage III tumors and 1 with stage IV tumor. Follow-up range from 0.02 to 10.48 years, with a median of 3.5 years. Fifty nine patient were alive. Three patients died, all of disease. Recurrence were found in 4 patients. The overall 2-years survival rate was 96% and 10-years survival rate was 94%. In log rank test, residual disease and histology type were significant predictor of survival. (Med J Indones 2002; 11:222-9)

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Tujuan Untuk mengidentifikasi faktor-faktor prediksi dan biomarker dalam perkembangan lesi prakanker leher rahim atau neoplasia serviks intraepitel (CIN). Metode Penelitian dilakukan dari bulan Agustus 2007 hingga September 2008. Desain penelitian adalah kasus-kontrol dengan stratifikasi uji respons dosis. Kasus adalah penderita dengan CIN. Kontrol adalah pasien non CIN. Dilakukan analisis bivariat diikuti dengan analisis multivariat. Hasil Ada 130 pasien, yang terdiri dari 124 pasien yaitu CIN 1, CIN 2 dan CIN 3, dengan jumlah masing-masing 30, 41,33, dan 26 pasien non CIN. Analisis bivariat menunjukkan bahwa umur <41 tahun, pendidikan ≥ 13 tahun, mitra seksual ≥ 2, hubungan HPV DNA positif, ekspresi p16INK4a, Ki-67, MCM5 dan Survivin tinggi merupakan variabel independen untuk terjadinya CIN dengan nilai P <0,05. Namun demikian, hasil analisis multivariat, menunjukkan bahwa variabel independen yang ditemukan adalah umur, pendidikan ≥ 13 tahun, ≥ 2 orang mitra seksual, HPV DNA positif, dan ekspresi berlebih p16INK4a, Ki-67 dan Survivin yang menunjukkan nilai P <0,005. Kesimpulan Usia muda, pendidikan usia ≥ 13 tahun, mitra seksual ≥ 2 orang, HPV DNA positif, ekspresi p16INK4a,Ki-67 dan Survivin tinggi merupakan faktor risiko untuk terjadinya peningkatan CIN, dan digunakan dalam persamaan untuk memprediksi peningkatan lesi prakanker serviks.

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Aim To identify the predictive factors and biomarkers in the progression of cervical precancer lesion or Cervical Intraepithelial Neoplasia (CIN). Methods The study was conducted from August 2007 to September 2008. Design of the study was case-control with stratifications of test dose response. The cases were patients with CIN. Control patients were non CIN patients. Bivariate analysis followed by multivariate analysis was conducted. Results There were 130 patients, consisting of 124 CIN patients divided into CIN 1, CIN 2 and CIN 3, with the following numbers of patients: 30, 41, and 33, respectively and 26 patients without CIN (non CIN). Bivariate analysis showed that age < 41 years, education ≥ 13 years, sexual partner ≥ 2, fi rst sexual relationship at age < 22 years, smoking, the presence of sexuallly transmitted infections, positive HPV DNA, high p16INK4a, Ki-67, MCM5 and Survivin expression constituted independent variables for the occurrence of CIN with P value of < 0.05. However, on multivariate analysis, independent variables that emerged were age, education ≥ 13 years, sexual partner ≥ 2 persons, positive HPV DNA, and over expression of p16INK4a, Ki-67 and Survivin that showed a P value of < 0.005. Conclusion Younger ages, education age ≥ 13 years, sexual partner ≥ 2 persons, positive HPV DNA, high p16INK4a,Ki-67 and Survivin expression constituted the risk factors for the occurrence of the progress of CIN, and was used in the equation to predict the progress of cervical precancer lesion.

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Penelitian dengan desain potong lintang ini bertujuan untuk menguji hubungan antara kadar kolesterol total dengan tekanan darah. Data dikumpulkan pada 14 _ 21 Juni 2011, terhadap 51 subjek penelitian berusia > 30 tahun yang tidak mengonsumsi obat antihipertensi ataupun antikolesterol, dipilih secara consecutive antara pengunjung Puskesmas Kelurahan Joglo-II, Jakarta. Tekanan darah diukur dengan sfigmomanometer sesuai pedoman baku. Kadar kolesterol total darah sewaktu diukur dari sampel darah tepi dengan alat tes kolesterol. Analisis data menggunakan regresi linier, korelasi Pearson dan General Linear Model dengan koreksi Bonferroni. Pada 51 responden (nilai tengah usia 50 tahun, 70,6% perempuan), rerata kadar kolesterol total adalah 200 mg/dL dan rerata tekanan darah adalah 135/84 mmHg. Pada faktor perancu yang disetarakan, kadar kolesterol total yang tinggi berhubungan dengan tingginya tekanan darah sistolik (r = 0,39; nilai p = 0,005) ataupun diastolik (r = 0,43; nilai p = 0,002). Responden pada kelompok kuartil ketiga total kolesterol memiliki tekanan darah 26/11 mmHg lebih tinggi secara bermakna dibandingkan mereka pada kelompok kuartil kedua (nilai p = 0,001 dan nilai p = 0,002 berturut-turut untuk tekanan darah sistolik dan diastolik). Menjaga kadar kolesterol total dalam batas normal merupakan salah satu upaya untuk mencegah hipertensi.

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This cross-sectional study was aimed to examine the association between total cholesterol levels and blood pressures. Data was collected on June 14 _ 21, 2011, among 51 subjects, aged > 30 years, who were taking neither antihypertensive nor anticholesterol drug, consecutively selected among peoples attending Joglo-II Sub-district Primary Health Center, Jakarta. Blood pressures were measured using a manual sphygmomanometer according to the standard protocols. Peripheral blood samples were collected and non-fasting total cholesterol were assessed using a cholesterol-test kit. Analyses were perfomed using linear regression, Pearson correlation, and General Linear Model (with Bonferroni correction). In 51 respondents (median age 50 years, 70.6% female), mean total cholesterol level was 200 mg/dL and blood pressure were 135/84 mmHg. After adjustment for confounding factors, higher total cholesterol levels were associated with higher systolic (r = 0.39; p value = 0.005) or diastolic (r = 0.43; p value = 0.002) blood pressures. Participant in the third quartile category had blood pressures 26/11 mmHg significantly higher than that of those in the second quartile category (p value = 0,001 and p value = 0,002 for sistolic and diastolic blood pressures, respectively). Maintaining total cholesterol levels within the normal limits may be one way to prevent hypertension.

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Aim: to evaluate the role of clinical characteristics, functional markers of vasodilation, inflammatory response, and atherosclerosis in predicting wound healing in diabetic foot ulcer. Methods: a cohort study (February-October 2010) was conducted from 40 subjects with acute diabetic foot ulcer at clinical ward of Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia. Each subject underwent at least two variable measurements, i.e. during inflammatory phase and proliferation phase. The studied variables were clinical characteristics, complete peripheral blood count (CBC) and differential count, levels of HbA1c, ureum, creatinine, lipid profile, fasting blood glucose (FBG), marker of endothelial dysfunction (asymmetric dimethylarginine/ADMA, endothelin-1/ET-1, and flow-mediated dilation/FMD of brachial artery), and marker of vascular calcification (osteoprotegerin/OPG). Results: median of time achieving 50% granulation tissue in our study was 21 days. There were nine factors that contribute in the development of 50% granulation tissue, i.e. family history of diabetes mellitus (DM), previous history of wound, wound area, duration of existing wound, captopril and simvastatin medications, levels of ADMA, ET-1, and OPG. There were three out of the nine factors that significantly correlated with wound healing, i.e. wound area, OPG levels, and simvastatin medications. Conclusion: in acute diabetic foot ulcers, wound area and OPG levels had positive correlation with wound healing, whereas simvastatin medications had negative correlation with wound healing.

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Tujuan penelitian ini adalah untuk mengidentifikasi faktor prediktor metastasis kelenjar getah bening (KGB) pada pasien dengan kanker serviks stadium IB dan IIA. Penelitian dilakukan dari bulan Mei 1996 sampai bulan Desember 2001. Ada 183 pasien kanker serviks dengan stadium menurut FIGO IB dan IIA menjalani operasi histerektomi radikal dan limfadenektomi. Dari pasien tersebut 158 pasien yang dapat dinilai, terdiri dari 43 pasien dengan metastasis KGB dan 115 tanpa metastasis KGB. Rancangan penelitian adalah kasus-kontrol. Kasus adalah pasien dengan metastasis KGB dan kontrol pasien tanpa metastasis KGB. Analisis multivariat dilakukan setelah analisis bivariat. Pada analisis bivariat umur < 39 tahun, diameter lesi >4 cm, stadium IIA > 4 cm, histopatologi dengan diferensiasi sedang dan buruk, invasi ke pembuluh darah dan limfa merupakan variabel yang independen terjadinya metastasis KGB dengan nilai p ≤ 0,05. Tetapi pada analisis multivariat yang muncul sebagai variabel independen adalah umur muda, paritas > 4, diameter lesi, histopatologi adenoskuamosa, dan invasi limfo-vaskular dengan nilai p ≤ 0,05. Kesimpulan: Usia muda, paritas > 4, stadium IIA > 4 cm, diameter lesi, histopatologi adenoskuamosa, invasi limfa-vaskular merupakan faktor risiko terjadinya metastasis dan dapat dipergunakan sebagai faktor prediktor metastasis KGB. (Med J Indones 2004; 13: 113-8)

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The aim of this study was to identify possible predictor factors of lymph node metastases in patients with cervical cancer stage IB and IIA. Study was conducted between May 1996 and December 2001. There were 183 patients of cervical cancer with FIGO Stage IB and IIA who were underwent radical hysterectomy and lymphadenectomy. From those 158 patients could be evaluated, consisting 43 patients with node metastases 115 patients without metastases. Research design was case control study. Case was patients with node metastases and control was those without node metastases. Multivariate analysis was made after bivariate analysis. On bivariate analysis age < 39 years, diameter of lesion > 4 cm, stage IIA > 4 cm, histopathology moderate and poor differentiation, blood and lymphatic vessel invasion were independent variables for node metastases with p value ≤ 0.05. However, on multivariate analysis younger age, parity ≥ 4, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) as independent factors for node metastases with p value ≤ 0.05. Conclusion: Younger age, parity ≥ 4, stage IIA > 4 cm, diameter of lesion, histopathology adenosquamous, and lymph vascular invasion (+) were risk factors for node metastases and can be used as predictors. (Med J Indones 2004; 13: 113-8)

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Tujuan penelitian ini adalah untuk memperoleh informasi tentang survival kanker servik stadium lanjut dengan gangguan fungsi ginjal (KSSLGFG) serta faktor-faktor yang mempengaruhinya. disamping itu diharapkan dapat ditemukan sistem scoring untuk prediksi kematian pasien KSSLGFG. Rancangan studi yang digunakan adalah retrospektif kohort. Data yang dikumpulkan berasal dari rekam medik penderita KSSLGFG dari 1 januari 1998 sampai 31 Desember 2003 di Rumah Sakit Umum Pusat Nasional Dr Cipto Mangunkusumo, Jakarta, dengan jumlah sampel 70 kasus. Hasil penelitian menunjukkan rerata Survival secara keseluruhan pasien KSSLGFG 8,2 bulan, survival bulan ke-6 sebesar 39%, survival 1 tahun sebesar 3,2%. Median survival 5,3 bulan. Faktor-faktor yang berpengaruh terhadap survival pasien KSSLGFG adalah gambaran histopatologik (sel adenoskuamosa dan diferensiasi sel), ketebalan korteks ginjal < 1 cm dan nefrostomi. (Med J Indones 2005; 14: 173-8)

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The objective of this study was to obtain information on the survival rate of advanced cervical cancer patients with renal impairment (ACCRI) and its prognostic factors. In addition, it is hoped that by this method the scoring system for predicting the death of ACCRI patients hopetully could be obtained. Design of the study used was retrospective cohort study. Data collected were retrieved from medical records of ACCRI patients from 1 January 1998 to 31 December 2003 at Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, with a total sample of 70 cases. The results of the study showed that mean survival of all ACCRI patients was 8.2 months, mean survival at sixth month was 39%, and mean survival at one year was 3.2%. Median survival was 5.3 months. Prognostic factors affecting the survival of ACCRI patients included histopathological type (adenosquamous cell and cell differentiation), cortical thickness of the kidney less than 1 cm, and nephrostomy. (Med J Indones 2005; 14: 173-8)