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"ABSTRAKLatar Belakang: Pasien cedera kepala sedang (CKS) dan cedera kepala berat (CKB) memerlukan perawatan di rumah sakit sehingga beresiko terkena infeksi nosokomial seperti pneumonia yang dapat memperburuk keluaran. Karena banyaknya faktor yang dapat mempengaruhi keluaran pasien cedera kepala dengan pneumonia, diperlukan suatu sistem skoring untuk menilai derajat keparahan pneumonia.Tujuan: Untuk mengetahui apakah sistem skoring CURB-65 dapat dipakai untuk memprediksi keluaran pasien CKS dan CKB yang mengalami pneumonia.Metode: Penelitian ini merupakan studi prospektif. Subjek penelitian adalah seluruh pasien CKS dan CKB yang dirawat di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta selama periode penelitian. Diagnosis pneumonia ditegakkan sesuai kriteria The Center for Disease Control (CDC). Penilaian derajat keparahan pneumonia dilakukan dengan skoring CURB-65. Keluaran yang dinilai adalah hidup atau meninggal.Hasil: Dari 176 pasien CKS dan CKB, terdapat 26 pasien yang menderita pneumonia. Rentang usia subjek penelitian adalah 15 - 71 tahun. Sebagian besar berjenis kelamin laki-laki dan berusia < 65 tahun. Nilai maksimal dari CURB-65 pada penelitian ini adalah 3. Sedangkan nilai yang terbanyak adalah 2. Nilai CURB-65 ditemukan tidak bermakna sebagai prediktor keluaran pasca cedera kepala. Keluaran pasien cenderung dipengaruhi variabel usia, penurunan kesadaran, peningkatan kadar BUN, dan peningkatan frekuensi napas. Diantara 5 pasien yang meninggal, ada 2 pasien yang memiliki nilai CURB-65 = 3, sehingga tampak adanya kecenderungan peningkatan mortalitas pada pasien-pasien dengan nilai CURB-65 = 3.Kesimpulan: Walaupun skoring CURB-65 tidak bermakna sebagai prediktor keluaran pada pasien CKS dan CKB dengan pneumonia, penelitian pendahuluan ini menemukan adanya kecenderungan pengaruh masing-masing komponen CURB-65 (penurunan kesadaran, frekuensi napas, kadar BUN, serta usia) terhadap resiko kematian pasien

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ABSTRACTBackground: Patients with moderate and severe traumatic brain injury (TBI) require hospitalization, therefore they have higher risk in developing nosocomial infections such as pneumonia which can worsen their outcomes. Since there are many factors that can affect outcome of head-injured patients with pneumonia, a scoring system for evaluating the severity of pneumonia is needed.Objective: To know whether the CURB-65 scoring system can be used to predict the outcome of moderate and severe TBI patients who developed pneumonia during hospitalization.Methods: This was a prospective study. The study subjects were all moderate and severe TBI patients who had been hospitalized in Cipto Mangunkusumo Hospital during the research period. Diagnosis of pneumonia was confirmed if the patient fulfiled the criteria from The Center for Disease Control (CDC). The severity of pneumonia was determined by using CURB-65 scoring system. The outcome would either be dead or alive.Results: Of 176 patients with moderate and severe TBI, there were 26 patients who developed pneumonia. The age of the subjects ranged between 15 to 71 years. Most of them were male and over the age of 65. The maximum score of CURB-65 was 3. The mode of CURB-65 score was 2. CURB-65 was shown to be not useful in predicting outcome of head-injured patients with pneumonia. The outcome was seemingly associated with age, loss of consciousness, BUN, and respiratory rate. Among 5 patients who were dead, there were 2 patients who had a CURB-65 score of 3, thus there was a trend of increasing mortality in patients with a CURB-65 score of 3.Conclusions: Although the CURB-65 scoring system was not found to be useful in predicting outcome of moderate and severe TBI patients, this preliminary study have found that there were a tendency that each component of CURB-65 (loss of consciousness, respiratory rate, BUN, age) have some effects on mortality. "

"ABSTRAKLatar Belakang. Perkembangan teknologi dan meningkatnya peran penggunaantangan di bidang industri, rumah tangga dan perkantoran akan meningkatkanangka kejadian STK. Hal ini akan memiliki dampak negatif di bidang medis,sosial dan ekonomi. Pemeriksaan Ultrasonografi (USG) berguna sebagaipenunjang dalam mendiagnosis STK. Kemajuan dalam kualitas dan portabilitasUSG telah menempatkan USG sebagai alat pilihan dalam penelitian danpenerapan klinis di bidang neurologi. USG mudah dijumpai di pelayanankesehatan, memiliki biaya yang murah, waktu pemeriksaan yang singkat dan tidakinvasif, serta memiliki sensitivitas dan spesifisitas yang cukup baik dalammendiagnosis STKMetode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalahpasien Poliklinik Neurologi RSCM yang memenuhi kriteria inklusi dan eksklusi.Subyek diperoleh secara konsekutif. Pada subyek dilakukan wawancara, pengisiankuesioner, pemeriksan fisik, elektroneurografi dan ultrasonografi di PoliklinikNeurologi RSCM. Dilakukan analisis data menggunakan perangkat SPSS 17.0Hasil. Diperoleh 58 subyek tangan yang masuk kriteria inklusi. Sensitivitas danspesifisitas kombinasi gambaran klinis dan USG adalah 86,04% dan 73,33%.Sedangkan akurasi kombinasi gambaran klinis dan USG sebesar 82,75%.Terdapat kesesuaian antara pemeriksaan kombinasi klinis dan USG dengankombinasi klinis dan elektroneurografi dalam mendeteksi STK (kappa = 0,70).Kesimpulan. Nilai sensitivitas kombinasi gambaran klinis dan USG sama denganelektroneurografi. Sedangkan spesifisitas kombinasi gambaran klinis dan USGlebih rendah daripada elektroneurografi. Kombinasi gambaran klinis dan USGdapat digunakan sebagai alternatif pemeriksan dalam mendiagnosis STK

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ABSTRACTBackground. Technological development and the increased use of hands in thefields of industrial, household and office space will increase the prevalence ofCarpal Tunnel Syndrome (CTS). This will have a negative impact on medicalscience, social and economic. Ultrasonography (USG) is useful to supportdiagnosis of CTS. Progress in the quality and portability of ultrasound has placedultrasound as a chosen instrument in research and clinical application in the fieldof neurology. USG is easily found at the health centers, has a lower cost, a shortexamination time and not invasive, as well as having superior specificity andsensitivity is good enough in diagnosing CTS.Method. A cross-sectional sectional study was conducted. The research subjectwere patients of the Neurology Clinic of RSCM Hospital who meet all of theinclusion and exclusion criteria.Result. Fifthy eight hands were included in this study. The sensitivity andspecificity of the combination of clinical features and ultrasonography were86.04% and 73.33%. While, the accuracy of the combination of clinical featuresand ultrasonography was 82.75%. There is a conformity between the combinationof clinical features and ultrasound with a combination of clinical picture andelectroneurography in diagnosing CTS (kappa = 0.70)Conclusion. The combination of clinical features and ultrasonography has similarsensitivity with electroneurography. Meanwhile, the specificity of thecombination of clinical features and ultrasonography is inferior toelectroneurography. Thus, the combination of clinical features andultrasonography can be used as an alternative to electroneurography in diagnosingCTS."