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Hasil Pencarian

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Atit Puspitasari Dewi
"Latar belakang: Pneumonia menjadi penyebab infeksi tersering yang meningkatkan mortalitas dan morbiditas pasien kanker paru. Serum procalcitonin (PCT) merupakan penanda hayati yang sering digunakan untuk mendiagnosis infeksi terutama pneumonia. Nilai titik potong kadar PCT untuk mendiagnosis pneumonia pada kanker paru sampai saat ini belum diketahui. Tujuan penelitian ini untuk mengetahui peran PCT dalam diagnosis pneumonia pada pasien kanker paru.
Metode: Penelitian uji diagnostik dengan desain potong lintang terhadap pasien kanker paru dan terduga pneumonia di Instalasi Gawat Darurat dan ruang perawatan paru RSUP Persahabatan Jakarta bulan Agustus-Oktober 2018. Pneumonia ditegakkan berdasarkan panduan pneumonia yang dikeluarkan oleh Persatuan Dokter Paru Indonesia. Pemeriksaan PCT dilakukan untuk mengetahui perbedaan kadar PCT pada kanker paru dengan dan tanpa pneumonia serta dilakukan analisis untuk menentukan titik potong optimal kadar PCT untuk diagnosis pneumonia pada pasien kanker paru dengan menggunakan ROC.
Hasil: Sebanyak 60 pasien kanker paru diikutsertakan. Pasien kanker paru dengan pneumonia sebanyak 31 orang (51,7%) dengan karakteristik laki-laki sebanyak 77,4% dan rerata usia 54,68±10,59 tahun, jenis kanker terbanyak adenokarsinoma (51,6%), stage IV (83,9%), skala tampilan 3 (45,2%), status gizi kurang (45,2%), dan bekas perokok (54,8%). Terdapat perbedaan bermakna median kadar PCT pasien kanker paru dengan pneumonia dibandingkan tanpa pneumonia [1,81 (0,08-200)μg/L berbanding 0,30 (0,05-3,67) μg/L;p<0,001]. Terdapat peningkatan kadar PCT pasien kanker paru dengan metastasis, komponen neuroendokrin, jumlah metastasis ≥ 2, metastasis hepar meskipun hasil ini tidak bermakna secara statistik. Serum PCT berperan lebih baik dibandingkan kadar leukosit dan hitung jenis neutrofil untuk membedakan antara pneumonia dan bukan pneumonia pada pasien kanker paru (p <0,001, p=0,297; p=0,290). Serum PCT memiliki akurasi yang baik dengan AUC 0,829 (IK 95% 0,722-0,935]. Titik potong optimal kadar PCT untuk mendiagnosis pneumonia pada pasien kanker paru adalah 0,65 μg/L dengan sensitivitas 77,4% dan spesifisitas 79,3%.
Kesimpulan: Kadar PCT pada pasien kanker paru dengan pneumonia lebih tinggi dibandingkan tanpa pneumonia. Titik potong optimal kadar PCT untuk diagnosis pneumonia pada kanker paru adalah 0,65 μg/L.

Background: Pneumonia accounts for higher morbidity and mortality than any other infections in lung cancer patients. Procalcitonin (PCT) is a clinical biomarker to diagnose infection including pneumonia. Cut off point to diagnose pneumonia in lung cancer patient still unclear. The study aims to determine the roleof PCT in diagnosing pneumonia in lung cancer patients.
Methods: Diagnostic test with cross sectional design was conducted in lung cancer patients with suspected pneumonia admitted to emergency and pulmonary ward of Persahabatan Hospital Jakarta, Indonesia between August – October 2018. A diagnosis of pneumonia was complying to the guideline provided by the Indonesian Society of Respirology. Serum PCT level (sPCT) between lung cancer patients with and without pneumonia was measured followed by statistical analysis. The optimal sPCT cut off point to diagnose pneumonia in lung cancer was determined using ROC curve.
Result: From sixty patients, lung cancer patients presented with pneumonia was found in 31 patients (51.7%) with mean age 54.68±10.59 yo, which 77.4% were males, 51.6% were adenocarcinomas, 83.9% were stage IV cases, 45.2% were patients with ECOG performance status of 3, 45.2% were underweight and 54.8% were ex-smokers. The sPCT were significantly higher in lung cancer with pneumonia compared to those without pneumonia [1.81 (0.08-200)μg/L vs 0.30 (0.05-3.67) μg/L; p<0.001]. The sPCT were higher in lung cancer accompanied with metastasis, neuroendocrine component, ≥2 metastatic sites and liver metastatic, although these results were not statistically significant. The sPCT showed a better performance in differentiating pneumonia in lung cancer compared to leucocyte count and absolute neutrophil count (p <0.001, p=0.297; p=0.290, respectively). The sPCT showed a good accuracy to diagnose pneumonia in lung cancer with AUC 0.829 (CI 95% 0.722-0.935). The optimal cut off point of sPCT to diagnose pneumonia in lung cancer was 0.65 μg/L with 77.4% sensitivity and 79,3% specificity.
Conclusion: The sPCT was significantly higher in lung cancer with pneumonia than those without pneumonia. The optimal cut off point of sPCT to diagnose pneumonia in lung cancer was 0.65 μg/L.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Reza Nugraha Yulisar
"Latar Belakang: Diagnosis sepsis pada pasien tumor padat metastasis sulit karena adanya gejala, seperti demam dan leukositosis, dapat timbul tanpa adanya infeksi. Procalcitonin (PCT) merupakan salah satu parameter untuk mendiagnosis sepsis. Titik potong PCT untuk diagnosis sepsis pada pasien tumor padat metastasis dengan demam dan leukositosis masih belum diketahui. Studi sebelumnya belum ada yang menilai titik potong PCT pada pasien tumor padat metastasis dengan demam dan leukositosis.
Tujuan: Mengetahui titik potong PCT dalam diagnosis sepsis pada pasien tumor padat metastasis dengan demam dan leukositosis.
Metode: Studi potong lintang terhadap pasien tumor padat metastasis dengan demam dan leukositosis yang berobat di RSCM Juni 2016 - April 2018. Pada pasien ditentukan ada tidaknya sepsis menggunakan kriteria sepsis sesuai The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), yaitu menggunakan mSOFA. Dilakukan pemeriksaan darah perifer dan PCT. Dilakukan pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasien tumor padat metastasis dengan demam dan leukositosios menggunakan ROC.
Hasil: Didapatkan 86 pasien tumor padat metastasis dengan demam dan lekositosis, dengan wanita sebanyak 61,6%, rerata usia 49,48 ±11,44 tahun. Sebanyak  43 pasien (50%) mengalami sepsis. Dari kurva ROC kadar PCT pada tumor padat metastasis dengan demam dan leukositosis yang mengalami sepsis, didapatkan AUC [0,873 ,IK 0,799 - 0,946, p <0,001]. Nilai titik potong PCT untuk diagnosis sepsis pada pasien tumor padat metastasis dengan demam dan leukositosis adalah 1,755 ng/mL dengan sensitivitas 76,7% dan spesifisitas 81,4%, NDP 80,5%, NDN 77,8%.
Kesimpulan: Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis dengan demam dan leukositosis adalah 1,755 ng/mL.

Background: Diagnosis of infection in advanced solid tumor patients can be difficult since fever and leucocytosis is a non-specific clinical marker and can occur without infections. Untreated infections can lead to sepsis, increasing mortality in those patients. Procalcitonin has been used to support the diagnosis of sepsis. Procalcitonin cut off in advanced stage solid tumor patients with fever as a sepsis biomarker is still unclear. No study has seen procalcitonin cut-off in advanced solid tumor patients with fever.
Objective: To discover the cut-off point for sepsis in advanced solid tumor patients with fever.
Method: A cross-sectional study was conducted in the advanced solid tumor patients with fever patients who were admitted to Cipto Mangunkusumo Hospitals, Indonesia during June 2016 to April 2018. Demographic characteristics, physical examinations, laboratory examinations were recorded. Sepsis was defined using 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference criteria.
Results: A total of 86 subjects were enrolled in this study, 61,6% were female with mean age 49,5 years old. Among them, 43 patients (50%) were diagnosed with sepsis. The ROC curve showed that the levels of procalcitonin for sepsis in advanced solid tumor patients with fever was in the area under curve (AUC) 0,891 (CI 826 - 956). Cut-off procalcitonin for diagnosing sepsis in advanced solid tumor patients with fever was 1,755 ng/mL, sensitivity 76,7%, specificity 81,4%, PPV 80,5%, NPV 77,8%.
Conclusions: The cut-off point of procalcitonin level to support sepsis diagnosis in advanced solid tumor patients with fever was higher than normal populations.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T58575
UI - Tesis Membership  Universitas Indonesia Library
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Segal Abdul Aziz
"ABSTRAK
Latar Belakang: Pengaruh metastasis sebagai penyebab peningkatan procalcitonin
(PCT) pada pasien tumor padat nonsepsis masih belum jelas. Studi-studi
sebelumnya memberikan hasil yang tidak konklusif. Nilai titik potong PCT untuk
diagnosis sepsis pada tumor padat metastasis juga belum diketahui.
Tujuan: Mengetahui peran PCT dalam diagnosis sepsis pada pasien tumor padat
dengan metastasis.
Metode: Studi potong lintang terhadap pasien tumor padat yang berobat di RSCM
September-Desember 2015. Pada pasien ditentukan ada tidaknya sepsis
menggunakan kriteria sepsis ACCP/SCCM 2001, dilakukan pemeriksaan darah
perifer, serta PCT. Dilakukan analisis untuk mengetahui perbedaan kadar PCT
pasien tumor padat metastasis dan tanpa metastasis yang tidak sepsis. Selain itu,
dilakukan pula pencarian nilai titik potong PCT untuk diagnosis sepsis pada pasien
tumor padat metastasis dengan menggunakan ROC.
Hasil dan Pembahasan: Didapatkan 112 pasien tumor padat, pria sebanyak 51%,
dengan rerata usia 47,9 ±12,47 tahun. Sebanyak 71 (63,4%) pasien sudah
didapatkan metastasis, 36 (32,1%) diantaranya sepsis, dan 6 (5,3%) mengalami
SIRS. Dari 41 (36,6%) pasien tanpa metastasis, 9 (8%) mengalami sepsis, dan 5
(4,4%) SIRS. Terdapat perbedaan bermakna kadar PCT pada pasien tumor padat
metastasis dibandingkan tanpa metastasis pada kondisi nonsepsis [0,25 ng/mL
(0,07-1,76) vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Pasien tumor padat metastasis
yang mengalami sepsis memiliki kadar PCT lebih tinggi dibandingkan nonsepsis
[3,5 ng/mL (0,66-189,4) vs. 0,25 ng/mL (0,07-1,76); p<0,001]. Dari kurva ROC
kadar PCT pada tumor padat metastasis, didapatkan AUC [0,956, IK 0,916-0,996]
untuk mendiagnosis sepsis. Nilai titik potong PCT untuk diagnosis sepsis pada
pasien tumor padat metastasis adalah 1,14 ng/mL dengan sensitivitas 86% dan
spesifisitas 88%.
Kesimpulan: Pada kondisi nonsepsis, kadar PCT pasien tumor padat metastasis
lebih tinggi dibandingkan pasien tanpa metastasis. Nilai titik potong PCT untuk diagnosis sepsis pada tumor padat metastasis adalah 1,14 ng/mL. ABSTRACT
Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. ;Background: The effect of metastasis as a cause of increased procalcitonin (PCT)
in patients with solid tumors without sepsis remains unclear. Previous studies did
not provide conclusive results. Cut off point of PCT for sepsis diagnosis in
metastatic solid tumors is also unknown.
Objective: To determine the role of PCT in the diagnosis of sepsis toward
metastatic solid tumors patients.
Methods: A cross sectional study was conducted in solid tumor patients who were
admitted to Cipto Mangunkusumo, Jakarta between September 2015 and December
2015. The ACCP/SCCM 2001 criteria was used to identify sepsis or SIRS in
patients. Procalcitonin level, as well as routine blood examination, was performed
to determine the differences of PCT level among solid tumor patients with and
without metastasis. Cut off point of PCT for diagnosing sepsis in patients with
metastatic solid tumors was determined using ROC curve.
Results and Discussion: There were 112 patients with solid tumors, 51% male,
with mean of age 47,9 ± 12,47 years. A total of 71 (63,4%) patients had metastasis,
while 36 (32,1%) of them had sepsis and 6 (5,3%) experienced SIRS. Among 41
(36,6%) patients without metastasis, 9 (8%) had sepsis and 5 (4,4%) had SIRS. In
the absence of sepsis, the PCT level was significantly higher in patients with
metastatic solid tumors compared those without metastasis [0,25 ng/mL (0,07-1,76)
vs. 0,09 ng/mL (0,03-0,54); p<0,001]. Metastatic solid tumor patients with sepsis
had PCT levels higher than those without sepsis [3,5 ng / mL (0,66 to 189,4) vs.
0,25 ng / mL (0,07-1,76); p <0,001]. ROC curve showed that level of PCT for sepsis
in metastatic solid tumors was AUC [0,956, IK 0,916-0,996]. Cut off point of PCT
for sepsis in patients with metastatic solid tumors was 1.14 ng / mL with a
sensitivity of 86% and specificity of 88%.
Conclusion: In the absence of sepsis, PCT levels of patients with metastatic solid
tumors is higher than patients without metastasis. Cut off point of PCT for sepsis
diagnosis in metastatic solid tumors was 1,14 ng / mL. "
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Muhammad Nurman Ariefiansyah
"Latar belakang: Pneumonia terjadi pada sekitar 50-70% pasien kanker paru. Kerentanan pneumonia terjadi akibat gangguan sistem imun dan arsitektur paru yang terjadi karena mekanisme kanker maupun terapi kanker paru. Perubahan imunitas menyeluruh, kaheksia, terapi, perubahan arsitektur paru merupakan faktor-faktor yang dapat menyebabkan inflamasi hingga penurunan imunitas yang dapat menimbulkan kejadian pneumonia pada kanker paru. Pasien kanker paru dengan pneumonia memiliki kesintasan satu tahun yang lebih buruk dan mortalitas satu tahun yang lebih tinggi dibandingkan tanpa pneumonia. Metode: Sampel penelitian merupakan pasien kanker paru tegak jenis yang datag ke IGD RSUP Persahabatan. Jumlah sampel sebanyak 77 pasien diambil secara consecutive sampling periode Januari-Februari 2024. Setiap sampel dilakukan anamnesis serta pemeriksaan fisis untuk mendapatkan data klinis, pemeriksaan laboratorium darah, foto toraks dan pemeriksaan biakan sputum. Pasien dilakukan pengamatan selama perawatan untuk melihat luaran pasien saat keluar rumah sakit. Hasil: Sebanyak 81,1% sampel mengalami pneumonia. Luaran meninggal sebanyak 24,7% dan 30,2% sampel yang mengalami pneumonia memiliki luaran meninggal. Faktor risiko seperti Riwayat merokok, jenis kanker paru, lokasi kanker paru, jumlah leukosit, jumlah neutrofil, RNL dan PCT menunjukkan tidak terdapat hubungan bermakna terhadap kejadian pneumonia (p>0,05). Klebsiella pneumoniae, Acinetobacter baumanii dan Escerichia coli merupakan jenis kuman terbanyak hasil biakan sputum. Kesimpulan: Lebih dari setengah jumlah pasien kanker paru yang masuk ke IGD RSUP Persahabatan mengalami infeksi pneumonia. Tidak terdapat hubungan bermakna faktor risiko terhadap kejadian kanker paru. Klebsiella pneumoniae merupakan jenis mikroorganisme terbanyak penyebab pneumonia berdasarkan hasil biakan sputum pasien kanker paru.

Background: Pneumonia occurs in around 50-70% of lung cancer patients. Pneumonia susceptibility occurs due to disorders of the immune system and lung architecture that occur due to cancer mechanisms and lung cancer therapy. Changes in overall immunity, cachexia, therapy, and changes in lung architecture are factors that can cause inflammation and decreased immunity which can lead to pneumonia in lung cancer. Lung cancer patients with pneumonia had worse one-year survival and higher one-year mortality than those without pneumonia. Method: The research sample was lung cancer patients who were confirmed pathologically and came to the emergency room at Persahabatan Hospital. The total number of samples was 77 patients taken by consecutive sampling for the period January-February 2024. Anamnesis and physical examination were carried out for each sample to obtain clinical data, blood laboratory examination, chest x-ray and sputum culture examination. Patients are monitored during treatment to see the patient's outcome when they leave the hospital. Results: As many as 81.1% of the sample experienced pneumonia. The outcome of death was 24.7% and 30.2% of samples who experienced pneumonia had a death outcome. Risk factors such as smoking history, type of lung cancer, location of lung cancer, leukocyte count, neutrophil count, RNL and PCT showed no significant relationship to the incidence of pneumonia (p>0.05). Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli are the most common types of germs resulting from sputum culture. Conclusion: More than half of lung cancer patients admitted to the emergency room at Persahabatan Hospital have pneumonia infections. There was no significant relationship between risk factors and the incidence of lung cancer. Klebsiella pneumoniae is the most common type of microorganism resulting from sputum culture of pneumonia patients with lung cancer"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Indiane Putri Ningtias
"Latar Belakang : Kanker paru merupakan salah satu penyakit yang memiliki beban terbesar di dunia. Pajanan zat karsinogen merupakan salah satu faktor risiko kanker paru, baik pada rokok maupun di lingkungan, Zat karsinogenik di tempat kerja yang dapat menyebabkan kanker paru adalah silika, asbes dan radon. Silika merupakan salah satu zat karsinogenik dalam IARC kelompok 1. Tujuan penelitian ini untuk mengetahui kadar silika kurasan bronkoalveolar pada pasien kanker paru, serta riwayat pajanannya.
Metode : Penelitian ini merupakan penelitian cross sectional pada pasien tumor paru yang akan dilakukan tindakan diagnostik baik dari instalasi rawat jalan maupun rawat inap di RS Persahabaran. Pengambilan sampel dilakukan secara consecutive sampling dalam kurun waktu April 2019 sampai dengan Juni 2019.
Hasil : Pada penelitian ini yang memenuhi kriteria inklusi sebesar 42 pasien kanker paru yang tegak jenis. Prevalens kanker paru dengan riwayat pajanan silika sebanyak 71.4%, status pajanan terbanyak dari pekerjaan sebanyak 38.1%. Kadar silika kurasan bronkoalveolar terbanyak adalah positif sebanyak 54,8% dengan rata-rata tertinggi dari pajanan pekerjaan dan rokok (2.85±2.9). Hasil ini bermakna secara statistik dengan nilai p<0,05. Jenis keganasan terbanyak dengan kadar silika positif adalah adenokarsinoma sebanyak 44%. Terdapat hubungan bermakna antara status pajanan dengan kadar silika (p 0.001), jenis pekerjaan dengan kadar silika (p 0.000), masa kerja dengan kadar silika (p 0.014), lama kerja dengan kadar silika (p 0.031), penggunaan Alat Pelindung Diri (APD) dengan kadar silika (p 0.005)
Kesimpulan : Didapatkan kadar silika yang positif pada pasien kanker paru dengan riwayat pajanan silika dari pekerjaan dan rokok, terdapat hubungan antara status pajanan, jenis pekerjaan, masa kerja, lama kerja dan riwayat penggunaan APD dengan kadar silika kurasan bronkoalveolar pada pasien kanker paru.

Background: Lung cancer is one leading cause of death in the world. Carcinogenic exposure is one of the risk factors for lung cancer, both in cigarettes and environment. Carcinogenic substances at work that can cause lung cancer are silica, asbestos and radon. Silica is one of the carcinogenic substances in IARC group 1. The purpose of this study was to determine the silica levels of bronchoalveolar lavage lung cancer patients and their exposure history of silica.
Method: This is cross sectional study based on prodiagnostic lung tumor patients measures both from outpatient and inpatient installations at Persahabatan Hospital. Sampling was done by consecutive sampling in the period April 2019 until June 2019.
Results: Sample of this study match with inclusion criteria are 42 patients with confirmed lung cancer. The prevalence of lung cancer with history of silica exposure was 71.4%, the most from occupational exposure was 38.1%. The highest amount of bronchoalveolar lavage silica was positive as much as 54.8% with the highest average of occupational and cigarette exposure (2.85 ± 2.9). This result is statistically significant with p value <0.05. The most common type of malignancy with positive silica levels was adenocarcinoma 44%. There is significant relationship between exposure status with silica levels (p 0.001), types of occupation with silica levels (p 0.000), years of service with silica levels (p 0.014), length of work with silica levels (p 0.031), use of Personal Protective Equipment with silica levels (p 0.005)
Conclusion: Positive silica levels from bronchoalveolar lavage in lung cancer patients with exposure silica history was found, the most from occupational and cigarettes exposure, there is relationship between exposure status, occupational type, length of service, length of work and history of using personal protective equipment with bronchoalveolar lavage silica levels in lung cancer patients.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Kuntjoro Harimurti
"Latar Belakang. Hipoalbuminemia sudah diketahui merupakan faktor prediktor morbiditas dan mortalitas pada pasien usia lanjut dengan pneumonia dan CRP merupakan petanda klinis yang penting pada pneumonia. Namun hubungan antara kadar CRP dengan penurunan kadar albumin, sebagai protein fase akut negatif, saat infeksi akut belum pernah diteliti sebelumnya.
Tujuan. Mendapatkan: (1) perbedaan kadar CRP awal perawatan antara pasien dengan daa tanpa penurunan albumin, (2) perbedaan risiko teradinya penurunan albumin antara pasien dengan kadar CRP awal tinggi dan rendah, dan (3) korelasi antara kadar CRP dan albumin saat awal perawatan pada pasien-pasien usia lanjut dengan pneumonia komunitas yang dirawat di rumah sakit.
Metodalogi. Stuart potong-lintang dan kohort-prospektif dilakukan pada pasien-pasien usia lanjut (>60 tahun) dengan diagnosis pneumonia komunitas yang dirawat di RSCM, untuk diamati penurunan kadar albuminnya selama 5 hari perawatan. Pasien-pasien dengan keadaan-keadaan yang dapat mempengaruhi kadar albumin dan CRP, serta infeksi selain pn nimcnia komunitas dieksklusi dari penelitian. Penilaian kadar CRP dilakukan pada hari pertama perawatan (cut-off 20 mg/L), sementara penurunan albumin ditentukan dari perubahan kadar albumin selama 5 hari perawatan (cut-off 10%). Analisis statistik dilakukan dengan uji-t independen, uji chi-square, dan uji korelasi sesuai dengan tujuan penelitian.
Hasil Utama. Selama periode April-Juni 2005 terkumpul 26 pasien usia lanjut dengan pneumonia komunitas yang masuk perawatan di RSCM. Hanya 23 pasien yang menyelesaikan penelitian sampai 5 hari dengan 17 pasien memiliki kadar CRP awal tinggi, dan didapatkan penurunan albumin >10% pada 7 pasien setelah 5 hari perawatan. Terdapat perbedaan rerata kadar CRP hari-1 diantara kedua kelompok (175,36 mgfL vs 75,67 mg/L; P = 0,026; 1K95% 13,25-186,13 mgfL). Namun tidak didapatkan perbedaan risiko bermakna antara pasien dengan kadar CRP tinggi dengan pasien dengan kadar CRP rendah scat awal dengan terjadinya penurunan albumin saat awal perawatan (RR = 2,12; P = 0,621; 11(95% 0,256-29,07). Tidak didapatkan pula korelasi antara kadar CRP dan albumin saat awal perawatan (r = 0,205, P = 0,314)
Kesimpulan. Tingginya kadar CRP awal perawatan berhubungan dengan terjadinya penurunan kadar albumin selama perawatan, namun tidak ada perbedaan risiko terjadinya penurunan albumin selama perawatan antara pasien dengan CRP awal tinggi dan CRP awal rendah, serta tidak ada korelasi antara kadar CRP dan albumin scat awal perawatan pada pasien-pasien usia lanjut dengan pneumonia komunitas yang dirawat di rumah sakit.

Backgrounds. Hypoalbuminemia widely known as a predictive factor for increasing morbidity and mortality in elderly patients, including with pneumonia; while CRP has known as a clinical marker for pneumonia. But relationship between CRP level with decrease of serum albumin level, as a negative acute-phase protein, during acute infection has never been studied before.
Objectives. To found: (1) CRP level difference between patient with and without decreased of serum albumin level, (2) risk for developing decreased of serum albumin level in patients with high CRP compared to patients with low CRP level, and (3) correlation between CRP and albumin level on admission in hospitalized elderly patients with community-acquired pneumonia.
Methods. Cross-sectional and prospective-cohort studies was conducted in hospitalized elderly patients with community-acquired pneumonia that admitted to RSCM, to observed the decreased of serum albumin level in five days of hospitalization. Conditions that known could influence CRP and albumin consentration have been excluded, and other infections as well. CRP level was determined on admission (cut-off 20 mgfL), while decreased of serum albumin was observed for 5 days of hospitalization (cu[-off 10%). Statistical analysis was done by using independent t-test, chi-square test, and correlation test appropriately accord-ing to the objectives of the study.
Main Results. During study period (April to June, 2005) 26 hospitalized elderly patients with community-acquired pneumonia had been included into study, but only 23 of them that finished the study for 5 days. There were 17 patients that have high level of CRP on admission, and 7 patiens that developing decreased of serum albumin level more than 10% in fifth day compared to their serum albumin level on admission. There was significant mean CRP difference among 2 groups (175,36 mgfL vs 75,67 mg/L; P = 0,026; 95%CI 13,25-186,13 mgfL), but there was no risk difference between patients with high and low CRP level on admission for developing decreased albumin level on fifth day of hospitalization (RR = 2,12; P = 0,621; 95%CI 0,256-29,07). And there was no correlation between CRP and albumin level on admission (r = 0,205, P = 0,314)
Conclusions. Patients with high CRP level on admission tend to have decreased of serum albumin level during hospitalization, but there was no risk difference for developing decreased of serum albumin level between patients with high and low CRP level, and there was no correlation between CRP and albumin level on admission in hospitalized elderly patients with community-acquired pneumonia.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2005
T21310
UI - Tesis Membership  Universitas Indonesia Library
cover
Claresta Diella
"Penelitian ini bertujuan untuk mengetahui aktivitas laktat dehidrogenase LDH serum dan korelasinya dengan asupan karbohidrat pada pasien kanker paru stadium lanjut di Rumah Sakit Kanker Nasional Dharmais Jakarta. Pada sel kanker terjadi efek Warburg yaitu kecenderungan sel kanker untuk melakukan glikolisis anaerob. Enzim LDH berfungsi sebagai katalisator untuk mengubah piruvat menjadi laktat pada keadaan anaerob. Peran laktat pada pada sel kanker meliputi inisiasi pertumbuhan tumor, menjaga kelangsungan sel kanker, proliferasi, angiogenesis, dan metastasis. LDH dapat digunakan sebagai marker diagnostik, penentu prognosis, sensitivitas dan resistensi tumor terhadap terapi, dan target potensial untuk kemoterapi. Subjek didapatkan melalui consecutive sampling yang melibatkan 56 subjek kanker paru stadium lanjut. Rerata usia hasil adalah 56,98 10,36 tahun, sebanyak 55,4 berjenis kelamin laki-laki. Asupan karbohidrat berdasarkan food recall 1 x 24 jam adalah 57,64 10,85 , sedangkan berdasarkan food frequency questionnaire FFQ semikuantitatif adalah 57,98 10,50 . Nilai median aktivitas LDH adalah 541,5 164 ndash;6539 IU/L yang sebanyak 60,7 aktivitasnya meningkat. Pada penelitian ini didapatkan korelasi negatif yang bermakna dengan kekuatan sedang p = 0,017, r = - 0,317 antara asupan total karbohidrat per hari dalam gram berdasarkan metode food recall 1 x 24 jam dengan aktivitas LDH serum. Tidak didapatkan korelasi yang bermakna antara total karbohidrat per hari dalam gram berdasarkan metode FFQ semikuantitatif dan asupan karbohidrat terhadap total energi dengan aktivitas LDH baik berdasarkan metode FFQ semikuantitatif dan food recall 1 x 24 jam.Kesimpulan: Asupan karbohidrat dalam 24 jam berkorelasi negatif bermakna dengan aktivitas LDH serum pada pasien kanker paru stadium lanjut.

The aim of this study is to determine serum lactate dehydrogenase LDH activity and its correlation with carbohydrate intake in advanced lung cancer patients at Dharmais National Cancer Hospital Jakarta. Cancer cells are characterized by increase anaerobic glycolysis termed the Warburg effect. LDH enzyme catalyzes the convertion of lactate to pyruvate in anaerobic condition. Activity of lactate in cancer influences on tumor growth initiation, tumor survival, proliferation, angiogenesis and metastasis. Serum LDH activity can be used as a diagnostic marker, prognostic marker, predictive marker for tumor sensitivity and resistancy to therapy, and potensial target for chemotherapy. 56 subjects of advanced lung cancer are recruited by consecutive sampling. The mean of age subjects is 56,98 10,36 years old and 55,4 were male. Carbohydrate intake based on food recall 1 x 24 hours is 57,64 10,85 , while based on food frequency questionnaire FFQ semiquantitative is 57,98 10,50 . The median of LDH activity is 541,5 164 ndash 6539 IU L and 60,7 is increse. This study show medium negative significant correlation p 0,017, r 0,317 between total carbohydrate intake per day in grams based on food recall 1 x 24 hours with LDH serum activity. There is no significant correlation between total carbohydrate intake per day in grams based FFQ semiquantitative and carbohydrate intake of total energy with LDH serum activity based on food recall 1 x 24 hours and FFQ semiquantitative. In conclusion, there is medium negative significant correlation between carbohydrate intake in 24 hours with LDH serum activity in advanced lung cancer patients."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Budhi Arifin Noor
"[ABSTRAK
Luka bakar menyebabkan terbentuknya eskar. Endotoksin bakteri pada eskar dan mediator inflamasi yang terbentuk saat lisis eskar menyebabkan sepsis. Eksisi tangensial dini merupakan upaya menurunkan risiko sepsis melalui pembuangan eskar. Prokalsitonin (PCT) adalah penanda inflamasi yang baik pada sepsis yang akan menurun kadarnya dengan tatalaksana yang adekuat.
Sampai saat ini belum ada penelitian yang menghubungkan eksisi dini dengan PCT. Penelitian ini bertujuan untuk mengetahui pengaruh tindakan eksisi tangensial dini terhadap kadar PCT serum pasien luka bakar berat. Desain penelitian ini adalah analitik observasional pre and post intervention study. Besar sampel yang digunakan adalah empat puluh. Data PCT diambil dari data sekunder yaitu dari rekam medis kemudian dianalisis menggunakan uji Wilcoxon. Didapati perbedaan bermakna antara PCT sebelum operasi dengan PCT sesudah operasi (2,78 (0,09-50,62) vs 1,31 (0,02-83,14), p < 0,005).
ABSTRACT Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).;Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn?t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005)., Burn trauma caused cell death with the formation of eschar. Bacteria endotoxins and inflammation mediators that are formed when eskar was lysis cause sepsis. Early tangential excision is the efforts to decrease the risk of sepsis by disposing the eschar. Procalcitonin (PCT) is a good biomarker of sepsis that will decreased with the proper treatment. Until now, there hasn’t been any research linked early excision with PCT. The aim of this research is to know the influence of early tangential excision to the level of PCT serum on severe burn patients. The study design was observational analytic pre and post interventional study. The sample size was forty. PCT data were taken from medical records then analyzed using the Wilcoxon test. There were significant differences between preoperative PCT to postoperative PCT (2.78 (0.09 to 50.62) vs 1.31 (0.02 to 83.14), respectively, p<0.005).]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Shahyawidya Ramadhanti
"Ventilator-associated pneumonia VAP adalah infeksi paru yang muncul setelah lebih dari 48 jam pemakaian ventilator mekanik atau pemasangan intubasi endotrakeal. Insidensi VAP bervariasi antara 8 hingga 28 dan memiliki angka mortalitas sampai 50 . Hal ini tentu saja berhubungan dengan peningkatan resiko infeksi lain, peningkatan biaya rawat inap biaya kesehatan dan peningkatan lama rawat di ICU. Tujuan penelitian ini adalah mengevaluasi kualitas penggunaan antibiotik untuk pengobatan VAP di ruang ICU RS Kanker Dharmais dengan metode Gyssens dan mengevaluasi perbedaan outcome pasien dengan antibiotik rasional dan antibiotik tidak rasional. Penelitian deskriptif analitik dengan pendekatan prospektif ini dilaksanakan dari Februari sampai Mei 2017. Peneliti mengambil sampel dengan metode total sampling, sehingga mengikutsertakan seluruh pasien yang berada di ruang ICU dengan memberikan beberapa kriteria inklusi dan eksklusi kemudian dianalisis dengan metode Gyssens. Dari 159 pasien yang menggunakan ventilator ada 29 pasien 18,24 yang memenuhi kriteria VAP dan menjadi subyek penelitian ini. Antibiotik yang paling sering digunakan adalah meropenem dan kemudian diikuti dengan levofloxacin. Faktor yang mempengaruhi kualitas penggunaan antibiotik antara lain adalah jenis terapi, jumlah antibiotik yang digunakan oleh pasien dan lama perawatan pasien P

Objectives This study aims to evaluate the quality of antibiotic use for VAP treatment in ICU Dharmais Cancer Hospital using Gyssens method, evaluate the different outcomes of antibiotic therapy that are rational and irrational according to the Gyssens method, and evaluating the distribution of rational category 0 and irrational category 1 5 antibiotic use. Methods This prospective study was carried out from February to May 2017 with descriptive analyses. Antibiotic uses were documented prospectively by a pharmacist and analyse by using Gyssens method. Pharmacist was used total sampling method, which is included all adult VAP patients in ICU. Results A total of 29 patients 18,24 were reviewed from 159 patients. The most dominant antibiotic use for VAP empiric treatment was meropenem and the most dominant antibiotic use for VAP definitive treatment was levofloxacin. Factors affecting the quality of antibiotic use include type of therapy, number of antibiotic used by patient and length of stay P"
Depok: Universitas Indonesia, 2018
T49567
UI - Tesis Membership  Universitas Indonesia Library
cover
Agus Rahmadi
"ABSTRAK
Kanker paru merupakan kanker yang paling banyak dijumpai sebagai salah satu penyebab kematian didunia. Kaheksia sering terjadi pada pasien kanker paru dengan tingkat survival yang rendah. Kaheksia ditandai dengan penurunan berat badan yang berdampak pada berkurangnya jaringan lemak dan otot rangka, kelelahan dan inflamasi sistemik. Sitokin berhubungan dengan terjadinya inflamasi sistemik. Salah satu sitokin yang berperan adalah IL ndash;6. IL ndash;6 dapat menstimulasi pembentukan protein fase akut yang berperan menyebabkan penurunan berat badan pada kaheksia. Seperti diketahui bahwa miRNA berperan dalam proses myogenesis. Salah satu myomiR yang berperan adalah miRNA ndash;206. MyomiR ndash;206 merupakan kelompok myomiR yang terekspresikan pada otot rangka. MiRNA berperan penting sebagai modulator ekspresi gen, namun mekanisme terjadinya atropi otot pada kaheksia belum banyak diketahui. Desain penelitian ini adalah penelitian cross sectional. Tujuan penelitian ini adalah untuk mengetahui ekspresi myomiR ndash; 206 pada pasien kanker paru yang mengalami kaheksia dan kaitannya dengan IL ndash;6. Ekspresi miRNA diukur dalam serum darah pasien dengan menggunakan RT-qPCR. Hasil penelitian menunjukkan terdapat perbedaan ekspresi myomiR ndash;206 antara kelompok pre kaheksia dengan kelompok kaheksia namun tidak bermakna secara statistik. Sedangkan perbedaan IL ndash;6 antara kelompok prekaheksia dengan kaheksia menunjukkan hubungan bermakna secara statistik. Dapat disimpulkan bahwa terdapat perbedaan ekspresi myomiR ndash;206 pada pasien kanker paru yang mengalami kaheksia namun tidak bermakna secara statistik dan berkaitan dengan IL ndash;6.

ABSTRACT
Lung cancer is the leading cause of cancer related deaths worldwide. Cachexia are frequently observed in lung cancer patients and associated with poor survival. Cachexia is characterized by a significant reduction in body weight resulting predominantly from loss of adipose tissue and skeletal muscle, fatique and systemic Inflamation. Cytokines are related to systemic inflammation . One of these cytokines is IL ndash 6. IL ndash 6 stimulates the synthesis of acute phase proteins are important in promoting weight loss in cachexia. In Additional, miRNAs have been identified and shown to have an important role in myogenesis. One of these myomiRs is miRNA ndash 206. MyomiR ndash 206 is expressed in skeletal muscle. MiRNAs are important modulators of gene expression but their role the atrophy muscle in cachexia is unknown.This research was a cross sectional study. The aim of this study was to see expression of myomiR ndash 206 in lung cancer patient with cachexia in correlation with IL ndash 6. MicroRNA expression was measured from serum of blood using RT qPCR.. These results, There was difference expression of myomiR ndash 206 in lung cancer patient between precachexia and cachexia but there was no significant in statistic. There was significant in IL ndash 6 between precachexia and cachexia. Our results suggest that there was difference expression of myomiR ndash 206 in lung cancer patient with cachexia but there was no significant statistic and associated with IL ndash 6."
2017
T55638
UI - Tesis Membership  Universitas Indonesia Library
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